RESUMO
Various lepidopteran insects are responsible for major crop losses worldwide. Although crop plant varieties developed to express Bacillus thuringiensis (Bt) proteins are effective at controlling damage from key lepidopteran pests, some insect populations have evolved to be insensitive to certain Bt proteins. Here, we report the discovery of a family of homologous proteins, two of which we have designated IPD083Aa and IPD083Cb, which are from Adiantum spp. Both proteins share no known peptide domains, sequence motifs, or signatures with other proteins. Transgenic soybean or corn plants expressing either IPD083Aa or IPD083Cb, respectively, show protection from feeding damage by several key pests under field conditions. The results from comparative studies with major Bt proteins currently deployed in transgenic crops indicate that the IPD083 proteins function by binding to different target sites. These results indicate that IPD083Aa and IPD083Cb can serve as alternatives to traditional Bt-based insect control traits with potential to counter insect resistance to Bt proteins.
Assuntos
Adiantum/genética , Glycine max/genética , Inseticidas , Mariposas , Controle Biológico de Vetores , Proteínas de Plantas/genética , Zea mays/genética , Animais , Proteção de Cultivos , Plantas Geneticamente Modificadas , Proteínas Recombinantes/toxicidadeRESUMO
BACKGROUND: The prevalence of obesity in children is high, and many do not meet physical activity recommendations. The Safe Routes to School (SRTS) program encourages school-aged children to walk and bike to school. We assessed the condition of the walking/biking environment around schools in Louisiana prior to the state's first SRTS program. METHODS: Assessments were made at the neighborhood level with the Pedestrian Environmental Data Scan (PEDS) instrument, and at the school and individual levels using the National SRTS Center's teacher tallies and parent surveys. PEDS scores were developed to rate conduciveness to walking/bicycling of proposed SRTS routes. Sites' scores were compared with the percentage of students who walk/bike to school. Five schools in Louisiana were evaluated. RESULTS: Overall, more students walked (range: 2.4-17.4%) than biked (range: 0.3-4.5%) to school with more students walking home than to school. Predictors of walking/biking to school include distance from school, speed of traffic, school encouragement, and if a student asked permission. Sites with the highest PEDS score had the highest percentage of students who walked/biked to school. CONCLUSIONS: There is a role and a need for the SRTS program. The environment and other factors influence biking and walking to school.
Assuntos
Ciclismo/estatística & dados numéricos , Planejamento Ambiental/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adolescente , Criança , Docentes , Governo Federal , Feminino , Inquéritos Epidemiológicos , Humanos , Louisiana , Masculino , Obesidade/prevenção & controle , Pais , Projetos Piloto , Instituições Acadêmicas , Estudantes , Estados Unidos , Caminhada/estatística & dados numéricosRESUMO
OBJECTIVE: To examine sex differences in nutritional status in relation to feeding practices over time in a cohort of HIV-exposed children participating in a complementary feeding programme in Rwanda. METHODS: We applied a longitudinal design with three measurements 2-3 months apart among infants participating in a complementary feeding programme who were 6-12 months old at baseline. Using early feeding practices and a composite infant and child feeding index (ICFI) as indicators of dietary patterns, we conducted a multivariate analysis using a cross-sectional time series to assess sex differences in nutritional status and to determine whether there was a link to discrepancies in dietary patterns. RESULTS: Among 222 boys and 258 girls, the mean (±SD) Z-score of stunting, wasting and underweight was -2.01 (±1.59), -0.15 (±1.46), -1.19 (±1.29) for boys; for girls they were -1.46 (±1.56), 0.22 (±1.29), -0.63 (±1.19); all sex differences in all three indicators were statistically significant (P < 0.001). However, there were only minor differences in early feeding practices and none in the ICFI by sex. CONCLUSIONS: HIV-exposed male children may be at higher risk of malnutrition in low-resource setting countries than their female counterparts. However, at least in a setting where complementary foods are being provided, explanations may lie outside the sphere of dietary patterns.
Assuntos
Dieta , Infecções por HIV/epidemiologia , Transtornos da Nutrição do Lactente/epidemiologia , Fenômenos Fisiológicos da Nutrição do Lactente , Estado Nutricional , Magreza/epidemiologia , Aleitamento Materno , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores de Risco , Ruanda/epidemiologia , Caracteres SexuaisRESUMO
Quadratic inference functions (QIFs) and estimating equations using the conjugate gradient method (CGM) for fitting marginal models to longitudinal data show appealing features in improving the efficiency without making assumptions on the correlation structure. However, our simulation study shows that both methods produce biased and inefficient estimates of regression parameters when time-dependent covariates are present. In this paper, we extend both the QIF and CGM methods for fitting marginal models to longitudinal data with time-dependent covariates. The idea is to restrict the moment conditions to the ones that are only valid to certain types of time-dependent covariates. Our simulations show that efficiency on estimating regression parameters is achieved using modified approaches. Furthermore, we apply the modified approach to anthropometric screening data to evaluate the association between body mass index and morbidity in children in the Philippines.
Assuntos
Interpretação Estatística de Dados , Análise de Regressão , Bioestatística , Índice de Massa Corporal , Criança , Simulação por Computador , Feminino , Humanos , Estudos Longitudinais , Masculino , Modelos Estatísticos , Morbidade , Análise Multivariada , Filipinas/epidemiologia , Fatores de TempoRESUMO
BACKGROUND: Trichomonas vaginalis (TV) and bacterial vaginosis (BV) are independently associated with increased risk of vaginal shedding in HIV-positive women. Because these 2 conditions commonly co-occur, this study was undertaken to examine the association between TV/BV co-occurrence and vaginal shedding of HIV-1 RNA. METHODS: HIV-positive women attending outpatient HIV clinics in 3 urban US cities underwent a clinical examination; were screened for TV, BV, Neisseria gonorrhoeae, Chlamydia trachomatis, and vulvovaginal candidiasis; and completed a behavioral survey. Women shedding HIV-1 RNA vaginally (≥50 copies/mL) were compared with women who had an undetectable (<50 copies/mL) vaginal viral load to determine if women who were TV positive and BV positive or had co-occurrence of TV/BV had higher odds of shedding vaginally when compared with women who did not have these conditions. RESULTS: In this sample of 373 HIV-positive women, 43.1% (n = 161) had co-occurrence of TV/BV and 33.2% (n = 124) were shedding HIV-1 RNA vaginally. The odds of shedding HIV vaginally in the presence of TV alone or BV alone and when TV/BV co-occurred were 4.07 (95% confidence interval [CI], 1.78-9.37), 5.65 (95% CI, 2.64-12.01), and 18.63 (95% CI, 6.71-51.72), respectively, when compared with women with no diagnosis of TV or BV, and after adjusting for age, antiretroviral therapy status, and plasma viral load. CONCLUSIONS: T. vaginalis and BV were independently and synergistically related to vaginal shedding of HIV-1 RNA. Screening and prompt treatment of these 2 conditions among HIV-positive women are important not only clinically but for HIV prevention, as well.
Assuntos
Candidíase Vulvovaginal/microbiologia , Infecções por HIV/microbiologia , HIV-1/isolamento & purificação , RNA Viral/metabolismo , Vaginite por Trichomonas/microbiologia , Trichomonas vaginalis/isolamento & purificação , Vaginose Bacteriana/microbiologia , Adulto , Contagem de Linfócito CD4 , Candidíase Vulvovaginal/complicações , Candidíase Vulvovaginal/epidemiologia , Coinfecção , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Prevalência , Comportamento Sexual , Vaginite por Trichomonas/complicações , Vaginite por Trichomonas/epidemiologia , Estados Unidos , População Urbana , Vagina/microbiologia , Descarga Vaginal/microbiologia , Vaginose Bacteriana/complicações , Vaginose Bacteriana/epidemiologia , Carga Viral , Eliminação de Partículas ViraisRESUMO
This article explores cross-sectional associations between depressive symptoms and body mass index (BMI) in women working in schools in the Greater New Orleans area. Self-efficacy for eating and exercise, eating styles, and exercise are examined as potential pathways. This is a secondary data analysis of 743 women who were participating in a workplace wellness randomized controlled trial to address environmental factors influencing eating and exercise behaviors using baseline data prior to the intervention. BMI was the primary outcome examined. Path analysis suggested that increased depressive symptoms were associated with increased BMI in women. Indirect effects of depressive symptoms on BMI were found for increased healthy eating self-efficacy, increased emotional eating, and decreased exercise self-efficacy. The association between greater healthy eating self efficacy and BMI was unexpected, and may indicate a suppressor effect of eating self-efficacy in the relationship between depressive symptoms and BMI in women. The findings suggest the importance of depressive symptoms to BMI in women. Targets for interventions to reduce BMI include targeting depressive symptoms and related sequelae including self-efficacy for exercise, and emotional eating. Further investigation of eating self-efficacy and BMI are recommended with particular attention to both efficacy for health eating and avoidance of unhealthy foods.
Assuntos
Índice de Massa Corporal , Depressão/psicologia , Exercício Físico/psicologia , Comportamento Alimentar/psicologia , Autoeficácia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Modelos Psicológicos , Saúde da Mulher , Adulto JovemRESUMO
This study examined separate and combined maternal and paternal use of spanking with children at age 3 and children's subsequent aggressive behavior at age 5. The sample was derived from a birth cohort study and included families (n = 923) in which both parents lived with the child at age 3. In this sample, 44% of 3-year-olds were spanked 2 times or more in the past month by either parent or both parents. In separate analyses, being spanked more than twice in the prior month at age 3, by either mother or father, was associated with increased child aggression at 5 years. In combined analyses, there was a dose-response association; the greatest risk for child aggression was reported when both parents spanked more than twice in the prior month (adjusted odds ratio: 2.01; [confidence interval: 1.03-3.94]). Violence prevention initiatives should target and engage mothers and fathers in anticipatory guidance efforts aimed at increasing the use of effective and non-aggressive child discipline techniques and reducing the use of spanking.
RESUMO
BACKGROUND: Recent developments in diagnostic techniques for malaria, particularly DNA probes and sero-immunology, have raised questions as to how these techniques might be used to facilitate malaria diagnosis at the most peripheral levels of the primary health care system. At present, malaria diagnosis is based on the standard microscopic examination of blood films in most field epidemiologic studies and is likely to remain so in the immediate future in Africa. The objective of this study was to assess inter-observer agreement for the examination of Giemsa-stained slides for Plasmodium falciparum parasites. METHODS: Children aged 0 to 10 years were enrolled yearly in Bancoumana village (West Africa), mainly during the transmission season (June to October). The blood smears obtained from the persistently negative children in June 1996, August 1996, October 1996 and March 1997 were systematically re-examined. A stratified random sample (10%) proportional to the following parasite density classes 1-100, 101-5000, and 5001 and over was taken from the slides collected. The kappa statistics and the intra-class correlation were used as measures of agreement the first and the second slide examinations. RESULTS: The weighted kappa statistic, widely used as a chance-corrected measure for nominal agreement, showed excellent inter-observer agreement (κ(w)=0.7926; 95% CI [0.7588, 0.8263]; p=0.01). The intra-class correlation co-efficient had the same value of 0.7926 confirming the appropriateness of the weighted kappa statistic. Inter-observer agreement for slides read as negative by one observer, or as containing more than 100 parasites per µl, was excellent: 97% (493/506) and 92% (145/158), respectively. In contrast, the inter-observer agreement for slides read by one observer as containing 1-100 parasites/µl was poor, 36% (96/268). CONCLUSIONS: In field conditions in Mali, there was a high reproducibility for slides reported as negative or as having more than 100 parasites per µl. However, smears with readings of 1-100 parasites per µl were less reproducible and should be re-examined carefully.
Assuntos
Malária Falciparum/diagnóstico , Malária Falciparum/parasitologia , Microscopia/normas , Variações Dependentes do Observador , Carga Parasitária/normas , Parasitemia/diagnóstico , Parasitemia/parasitologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Mali , Microscopia/métodos , Carga Parasitária/métodos , Reprodutibilidade dos TestesAssuntos
Asma/induzido quimicamente , Exposição Ambiental/efeitos adversos , Poluentes Ambientais/toxicidade , Chumbo/toxicidade , Asma/sangue , Criança , Pré-Escolar , Estudos de Coortes , Exposição Ambiental/análise , Poluentes Ambientais/sangue , Feminino , Humanos , Lactente , Chumbo/sangue , Modelos Logísticos , Masculino , Estudos Retrospectivos , Fatores de RiscoRESUMO
The feasibility of working with neighborhood corner stores to increase the availability of fresh fruit and vegetables in low-income neighborhoods in New Orleans was assessed. Household interviews and 24-hour dietary recalls (n = 97), corner store customer intercept interviews (n = 60) and interviews with corner store operators (owners/managers) (n = 12) were conducted in three neighborhoods without supermarkets. Regional produce wholesalers were contacted by phone. Results indicated that the majority of neighborhood residents use supermarkets or super stores as their primary food source. Those who did shop at corner stores typically purchased prepared foods and/or beverages making up nearly one third of their daily energy intake. Most individuals would be likely to purchase fresh fruit and vegetables from the corner stores if these foods were offered. Store operators identified cost, infrastructure and lack of customer demand as major barriers to stocking more fresh produce. Produce wholesalers did not see much business opportunity in supplying fresh produce to neighborhood corner stores on a small scale. Increasing availability of fresh fruit and vegetables in corner stores may be more feasible with the addition of systems changes that provide incentives and make it easier for neighborhood corner stores to stock and sell fresh produce.
Assuntos
Abastecimento de Alimentos/métodos , Frutas/provisão & distribuição , Verduras/provisão & distribuição , Adolescente , Adulto , Idoso , Dieta/estatística & dados numéricos , Inquéritos sobre Dietas , Características da Família , Feminino , Abastecimento de Alimentos/normas , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nova Orleans , Características de Residência , Adulto JovemRESUMO
OBJECTIVES: To establish the prevalence of female genital mutilation (FGM) and force feeding (gavage) practices among children in Mauritania; to investigate factors related to FGM and gavage practices and attitude in Mauritania; and to explore implications related to the protection of children's rights and welfare. METHODS: Data from the Mauritania 2000-2001 DHS were used in this analysis. Data were collected from men and women about their attitude toward the continuation of FGM and gavage; women only were asked if they ever experienced one of these practices. Chi-square statistics were used to investigate differences in attitude and practice of FGM and gavage by demographic characteristics. Binary logistic regression was used to identify socio-demographic factors related to FGM and gavage outcomes. FINDINGS: The overall prevalence of FGM was 77% but varied depending on ethnicity. The majority of both female and male respondents favored the continuation of the practice (64% and 70%, respectively). Almost a quarter (23%) of women reported being force fed as a child and 32% of women and 29% of men approved the continuation of the practice. Gavage is almost exclusively practiced among Arabs. CONCLUSION: The practice of both FGM and gavage is ongoing, although the prevalence and attitude towards both appears to vary as a function of ethnicity, wealth, education, marital status, and age. Contextually relevant intervention and enforcement strategies are needed to challenge these cultural norms and protect the rights and welfare of children in Mauritania.
Assuntos
Circuncisão Feminina/estatística & dados numéricos , Violação de Direitos Humanos/estatística & dados numéricos , Adolescente , Adulto , Criança , Demografia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Mauritânia/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Saúde da Mulher/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: Incorporating cycling into daily life is one way to increase physical activity. PURPOSE: This study examined the impact of building new bike lanes in New Orleans to determine whether more people were cycling on the street and with the flow of traffic after bike lanes were built. METHODS: Through direct observation of one intervention and two adjacent streets, observers counted cyclists riding on the street and sidewalk, with and against traffic, before and after installation of the lanes. Data were tallied separately for adults, children, males, females, and by race for each location. RESULTS: There was an increase in cyclists on all three streets after the installation of the bike lanes, with the largest increase on the street with the new lane. Additionally, the proportion of riders cycling with traffic increased after the lanes were striped. CONCLUSIONS: Bike lanes can have a positive impact in creating a healthy neighborhood.
Assuntos
Ciclismo/estatística & dados numéricos , Promoção da Saúde/métodos , Atividade Motora , Características de Residência , Adulto , População Negra/psicologia , Criança , Planejamento Ambiental , Feminino , Humanos , Masculino , Nova Orleans , População Branca/psicologiaRESUMO
Parents (n = 500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of the parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents who sought advice from religious leaders (vs pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported that they were more likely to follow the advice of pediatricians than any other professional; however, black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents.
Assuntos
Negro ou Afro-Americano/psicologia , Aconselhamento/estatística & dados numéricos , Poder Familiar , Pais/psicologia , Punição , Negro ou Afro-Americano/estatística & dados numéricos , Análise de Variância , Atitude , Criança , Pré-Escolar , Coleta de Dados , Humanos , Louisiana , Poder Familiar/etnologia , Pediatria/estatística & dados numéricos , Análise de Regressão , ReligiãoRESUMO
BACKGROUND: Beliefs about smoking are important predictors of smoking behavior among adolescents, and adolescents who hold positive beliefs about the benefits of smoking are at an increased risk of smoking initiation. An alarming fact is the rising smoking prevalence in Asian countries, particularly the increasing trend in smoking during adolescence. PURPOSE: This cross-sectional study examined smoking beliefs and behavior among a nationally representative sample of youth in South Korea, Taiwan, and Thailand. METHODS: Descriptive statistics, linear regression, and logistic regression methods were used to analyze data from 13-15-year-old adolescents who participated in the 2005 Global Youth Tobacco Survey (GYTS) in South Korea (N = 4,765) and Thailand (N = 15,420) and the 2007 GYTS in Taiwan (N = 3,955). RESULTS: The rate of ever smoking among youth was similar in all three countries and ranged from 26.7 to 28.0 %. The prevalence of current smoking among youth in Thailand (11.4 %) was nearly double the prevalence in South Korea (6.6 %) and Taiwan (6.5 %). Pro-tobacco advertising exposure, as well as older ages, was a positive and significant predictor of positive beliefs about smoking among youth in all three countries. Additionally, youth who reported increased positive smoking-related beliefs, greater pro-tobacco advertising exposure, and were male were more likely to be current smokers in all three countries. CONCLUSION: Results suggest that greater attention be directed to understanding beliefs and attitudes about smoking among youth. Exploring the relationship between these factors and smoking behavior can provide a strong starting point in the development of effective smoking prevention interventions and tobacco control policies in this region.
Assuntos
Povo Asiático/psicologia , Psicologia do Adolescente , Caracteres Sexuais , Fumar/etnologia , Tabagismo/etnologia , Adolescente , Publicidade , Povo Asiático/estatística & dados numéricos , Atitude Frente a Saúde , Estudos Transversais , Cultura , Feminino , Humanos , Masculino , Prevalência , Análise de Regressão , República da Coreia/epidemiologia , Fatores de Risco , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Taiwan/epidemiologia , Tailândia/epidemiologia , Tabagismo/prevenção & controleRESUMO
Although sickle cell trait protects against severe disease due to Plasmodium falciparum, it has not been clear whether sickle trait also protects against asymptomatic infection (parasitemia). To address this question, the authors identified 171 persistently smear-negative children and 450 asymptomatic persistently smear-positive children in Bancoumana, Mali (June 1996 to June 1998). They then followed both groups for 2 years using a cohort-based strategy. Among the 171 children with persistently negative smears, the median time for conversion to smear-positive was longer for children with sickle trait than for children without (274 vs. 108 days, P < 0.001; Cox hazard ratio = 0.56, 95% confidence interval: 0.33, 0.96; P = 0.036). Similar differences were found in the median times to reinfection after spontaneous clearance without treatment (365 days vs. 184 days; P = 0.01). Alternatively, among the 450 asymptomatic children with persistently positive smears, the median time for conversion to smear-negative (spontaneous clearance) was shorter for children with sickle trait than for children without (190 vs. 365 days; P = 0.02). These protective effects of sickle trait against asymptomatic P. falciparum infection under conditions of natural transmission were demonstrable using a cohort-based approach but not when the same data were examined using a cross-sectional approach.
Assuntos
Predisposição Genética para Doença/genética , Malária Falciparum/genética , Traço Falciforme/genética , Fatores Etários , Antimaláricos/uso terapêutico , Doenças Assintomáticas , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Modelos Logísticos , Malária Falciparum/tratamento farmacológico , Malária Falciparum/epidemiologia , Mali/epidemiologia , Razão de Chances , Parasitemia/epidemiologia , Parasitemia/genética , Plasmodium falciparum , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Traço Falciforme/parasitologiaRESUMO
BACKGROUND: Although the prevalence of obesity is increasing during adulthood, there have been few assessments of obesity, cardiovascular risk factors, and levels of physical activity among adult elementary school staff. METHODS: Data were collected from 745 African-American and White female school personnel in a suburban school district in southeastern Louisiana as part of the baseline assessment before implementation of a program to improve eating and physical activity behaviors. Anthropometry, blood pressure, serum lipids and lipoproteins, and glucose were measured using established protocols. Physical activity was assessed by accelerometry. RESULTS: For both White and Black females, 30% were overweight (body mass index [BMI]) ≥25 kg/m(2) but <30 kg/m(2) ). Whereas 37% of White females were obese (BMI ≥ 30 kg/m(2) ), 61% of the Black females were obese. There was a positive association between BMI and other cardiovascular risk factors except for high-density lipoprotein cholesterol, where the association was negative. The mean number of minutes of daily moderate-to-vigorous physical activity was <1 minute per day and was lower for overweight and obese women than for normal weight women. CONCLUSIONS: School personnel in the study have adverse cardiovascular risk factors, including high rates of obesity and very low levels of physical activity. Because these individuals are often called upon to promote health for children, they are an important target population for wellness interventions.
Assuntos
Doenças Cardiovasculares , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Atividade Motora , Instituições Acadêmicas , Estudantes/psicologia , Aceleração , Criança , Intervalos de Confiança , Feminino , Nível de Saúde , Indicadores Básicos de Saúde , Inquéritos Epidemiológicos , Humanos , Louisiana , Masculino , Saúde Ocupacional , Aptidão Física , Fatores de Risco , Local de TrabalhoRESUMO
BACKGROUND: Few data are available evaluating the associations of formal public health education with long-term career choice and professional outcomes among medical school graduates. The objective of this study was to determine if formal public health education via completion of a masters of public health (MPH) degree among US medical school graduates was associated with early and long-term career choice, professional satisfaction, or research productivity. METHODS: We conducted a retrospective cohort study in 1108 physicians (17.1% completed a MPH degree) who had 10-20 years of follow-up post medical school graduation. Multivariable logistic regression analyses were conducted. RESULTS: Compared to their counterparts with no MPH, medical school graduates with a MPH were more likely to have completed a generalist primary care residency only [relative risk (RR) 1.79, 95% confidence interval (CI) 1.35-2.29], obtain employment in an academic institution (RR 1.81; 95% CI 1.33-2.37) or government agency (RR 3.26; 95% CI 1.89-5.38), and practice public health (RR 39.84; 95% CI 12.13-107.38) or primary care (RR 1.59; 95% CI 1.18-2.05). Furthermore, medical school graduates with a MPH were more likely to conduct public health research (RR 8.79; 95% CI: 5.20-13.82), receive NIH or other federal funding (RR 3.11, 95% CI 1.74-5.33), have four or more peer-reviewed publications (RR 2.07; 95% CI 1.56-2.60), and have five or more scientific presentations (RR 2.31, 95% CI 1.70-2.98). CONCLUSION: Formal public health education via a MPH was associated with career choice and professional outcomes among physicians.
Assuntos
Escolha da Profissão , Saúde Pública/educação , Faculdades de Medicina , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Supermarkets might influence food choices, and more distal outcomes like obesity, by increasing the availability of healthy foods. However, recent evidence about their effects is ambiguous, perhaps because supermarkets also increase the availability of unhealthy options. We develop an alternative measure of food environment quality that characterizes urban neighborhoods by the relative amounts of healthy (e.g. fruits and vegetables) to unhealthy foods (e.g. energy-dense snacks). Using data from 307 food stores and 1243 telephone interviews with residents in urban southeastern Louisiana, we estimate a multilevel multinomial logistic model for overweight status. We find that higher quality food environments - but not food store types - decrease the risk of obesity (RR 0.474, 95% CI 0.269-0.835) and overweight (RR 0.532, 95% CI 0.312-0.907). The findings suggest a need to move beyond a sole consideration of food store types to a more nuanced view of the food environment when planning for change.
Assuntos
Comércio , Abastecimento de Alimentos , Alimentos/economia , Obesidade/epidemiologia , Adolescente , Adulto , Coleta de Dados , Planejamento Ambiental , Feminino , Alimentos/classificação , Frutas , Humanos , Louisiana/epidemiologia , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Características de Residência , Risco , População Urbana , Verduras , Adulto JovemRESUMO
INTRODUCTION: Obesity is a public health problem that is due in part to low levels of physical activity. Physical activity levels are influenced by the built environment. We examined how changes in the built environment affected residents' physical activity levels in a low-income, primarily African American neighborhood in New Orleans. METHODS: We built a 6-block walking path and installed a school playground in an intervention neighborhood. We measured physical activity levels in this neighborhood and in 2 matched comparison neighborhoods by self-report, using door-to-door surveys, and by direct observations of neighborhood residents outside before (2006) and after (2008) the interventions. We used Pearson χ² tests of independence to assess bivariate associations and logistic regression models to assess the effect of the interventions. RESULTS: Neighborhoods were comparable at baseline in demographic composition, choice of physical activity locations, and percentage of residents who participated in physical activity. Self-reported physical activity increased over time in most neighborhoods. The proportion of residents observed who were active increased significantly in the section of the intervention neighborhood with the path compared with comparison neighborhoods. Among residents who were observed engaging in physical activity, 41% were moderately to vigorously active in the section of the intervention neighborhood with the path compared with 24% and 38% in the comparison neighborhoods at the postintervention measurement (P < .001). CONCLUSION: Changes to the built environment may increase neighborhood physical activity in low-income, African American neighborhoods.
Assuntos
Negro ou Afro-Americano , Planejamento Ambiental , Atividade Motora , Pobreza , Inquéritos Epidemiológicos , Humanos , Nova Orleans , Obesidade/prevenção & controle , Jogos e Brinquedos , Recreação , População UrbanaRESUMO
HIV and AIDS have altered the context in which millions of children in sub-Saharan Africa are raised. Many are under the care of a widowed or ill parent, and others are residing with their extended family. Caregivers of orphans and other vulnerable children (OVC) face a variety of stressors that may adversely affect children. This study explores potential benefits of caregivers' membership in support groups on their own psychosocial wellbeing, and on the treatment and psychosocial well-being of OVC aged 8-14 under their care. A post-test study design comparing members and non-members was applied, drawing upon random samples of current and prospective beneficiaries from a rural community in Kenya. With up to two children per caregiver eligible for study inclusion, the sample comprised 766 caregivers and 1028 children. Three-quarters of children had lost at least one parent. Nearly 90% were cared for by a female, often their natural mother or grandmother. Half of the caregivers were widowed and one-fifth had a chronic illness. Over one-third of caregivers were members of support groups, more commonly female caregivers. Regression analyses assessed the effect of support group membership after controlling for household, caregiver and child characteristics. Members reported less social marginalization, better family functioning and more positive feelings towards the children in their care than nonmembers. Children with caregivers in support groups exhibited fewer behavioral problems, higher rates of prosocial behavior and reported lower incidence of abuse from adults in their household. The psychological state of caregivers, however, was not associated with support group membership. Results underscore that quality care of vulnerable children hinges on interventions that address the psychosocial challenges facing their caregivers.