COVID-19 Information, Trust, and Risk Perception Across Diverse Communities in the United States: Initial Findings from a Multistate Community Engagement Alliance (CEAL).

Objectives. To provide initial findings from Community Engagement Alliance (CEAL), a multistate effort funded by the National Institutes of Health, to conduct urgent community-engaged research and outreach focused on COVID-19 awareness, education, and evidence-based response. Methods. We collected survey data (November 2020-November 2022) from 21 CEAL teams from 29 state and regional CEAL sites spanning 19 US states, the District of Columbia, and Puerto Rico, which covered priority populations served and trusted sources of information about COVID-19, including prevention behaviors, vaccination, and clinical trials. Results. A disproportionate number of respondents were Latino (45%) or Black (40%). There was considerable variability between CEAL sites regarding trusted sources of information, COVID-19 prevention, and COVID-19 vaccination. For example, more respondents (70%) reported health care providers as a trusted source of COVID-19 information than any other source (ranging from 6% to 87% by site). Conclusions. CEAL rapidly developed novel infrastructure to engage academic, public health, and community organizations to address COVID-19's impacts on underserved communities. CEAL provides an example of how to respond in future public health emergencies to quickly promote trustworthy, evidence-based information in ways that advance health equity. (Am J Public Health. 2024;114(S1):S112-S123. https://doi.org/10.2105/AJPH.2023.307504).

Age-dependent energy metabolism and transcriptome changes in urine-derived stem cells.

The global population over 60 years old is projected to reach 1.5 billion by 2050. Understanding age-related disorders and gender-specificities is crucial for a healthy aging. Reliable age-related biomarkers are needed, preferentially obtained through non-invasive methods. Urine-derived stem cells (UDSCs) can be easily obtained, although a detailed bioenergetic characterization, according to the donor aging, remain unexplored. UDSCs were isolated from young and elderly adult women (22-35 and 70-94 years old, respectively). Surprisingly, UDSCs from elderly subjects exhibited significantly higher maximal oxygen consumption and bioenergetic health index than those from younger individuals, evaluated through oxygen consumption rate. Exploratory data analysis methods were applied to engineer a minimal subset of features for the classification and stratification of UDSCs. Additionally, RNAseq of UDSCs was performed to identify age-related transcriptional changes. Transcriptional analysis revealed downregulation of genes related to glucuronidation and estrogen metabolism, and upregulation of inflammation-related genes in UDSCs from elderly individuals. This study demonstrates unexpected differences in the UDSCs' OCR between young and elderly individuals, revealing improved bioenergetics in concurrent with an aged-like transcriptome signature. UDSCs offer a non-invasive model for studying age-related changes, holding promise for aging research and therapeutic studies.

A cross-sectional examination of post-myocardial infarction physical activity levels among US rural and urban residents: Findings from the 2017-2019 Behavioral Risk Factor Surveillance System.

BACKGROUND: This study sought to examine the relationship between rural residence and physical activity levels among US myocardial infarction (MI) survivors. METHODS: We conducted a cross-sectional study using nationally representative Behavioral Risk Factor Surveillance System surveys from 2017 and 2019. We determined the survey-weighted percentage of rural and urban MI survivors meeting US physical activity guidelines. Logistic regression models were used to examine the relationship between rural/urban residence and meeting physical activity guidelines, accounting for sociodemographic factors. RESULTS: Our study included 22,732 MI survivors (37.3% rural residents). The percentage of rural MI survivors meeting physical activity guidelines (37.4%, 95% CI: 35.1%-39.7%) was significantly less than their urban counterparts (45.6%, 95% CI: 44.0%-47.2%). Rural residence was associated with a 28.8% (95% CI: 20.0%-36.7%) lower odds of meeting physical activity guidelines, with this changing to a 19.3% (95% CI: 9.3%-28.3%) lower odds after adjustment for sociodemographic factors. CONCLUSIONS: A significant rural/urban disparity in physical activity levels exists among US MI survivors. Our findings support the need for further efforts to improve physical activity levels among rural MI survivors as part of successful secondary prevention in US high-MI burden rural areas.

Perceptions of access to care after a rural hospital closure in an economically distressed county of Appalachian Tennessee.

PURPOSE: The rise in rural hospital closures has sparked concern about the potential loss of essential health care services for rural communities. It is crucial to incorporate the perspectives of community residents, which have been largely missing from the literature, when devising strategies to improve health care for this population. The purpose of this study was to describe community residents' perceptions of access to care following a rural hospital closure in an economically distressed Appalachian county of Tennessee. METHODS: This study used a qualitative descriptive approach to illustrate how community residents perceive accessing care post hospital closure. We conducted semi-structured interviews with 24 community residents via telephone in May through August of 2020. Interviews were analyzed using conventional content analysis. FINDINGS: Five themes were identified based on Penchansky and Thomas' framework of health care: accessibility, availability, affordability, accommodation, and acceptability. Accessibility was identified as the most common concern among participants. Specifically, participants perceived longer travel times to receive care, reduced availability of emergency and specialty care, increased costs associated with ambulance services, and extended wait times to see providers. CONCLUSIONS: Our findings provide a critical perspective to inform local leaders and policymakers on the impacts of a hospital closure in a rural community. As rural hospitals continue to close, it is crucial to develop multi-level, community-driven solutions to ensure access to care for rural communities.

The Gut Microbiome Responds Progressively to Fat and/or Sugar-Rich Diets and Is Differentially Modified by Dietary Fat and Sugar.

Describing diet-related effects on the gut microbiome is essential for understanding its interactions with fat and/or sugar-rich diets to promote obesity-related metabolic diseases. Here, we sequenced the V3-V4 hypervariable region of the bacterial 16S rRNA gene to study the composition and dynamics of the gut microbiome of adult mice fed diets rich in fat and/or sugar, at 9 and 18 weeks of diet. Under high-fat, high-sugar diet, the abundances of Tuzzerella and Anaerovorax were transiently increased at 9 weeks, while Lactobacillus remained elevated at 9 and 18 weeks. The same diet decreased the abundances of Akkermansia, Paludicola, Eisenbergiella, and Butyricicoccus at 9 and 18 weeks, while Intestinimonas and UCG-009 of the Butyricicoccaceae family responded only at 18 weeks. The high-fat diet decreased the abundances of UBA1819 at 9 weeks, and Gastranaerophilales, Clostridia UCG-014, and ASF356 at 9 and 18 weeks. Those of Marvinbryantia, Harryflintia, Alistipes, Blautia, Lachnospiraceae A2, Eubacterium coprostanoligenes group, and Eubacterium brachy group were lowered only at 18 weeks. Interestingly, these genera were not sensitive to the high-sugar diet. The mouse gut microbiome was differentially affected by diets rich in fat or fat and sugar. The differences observed at 9 and 18 weeks indicate a progressive microbiome response.

Development of a Data Visualization Tool to Evaluate the Impact of a Maternal and Child Health (MCH) Nutrition Training Program on MCH Populations.

INTRODUCTION: Maternal and Child Health (MCH) Nutrition Training Programs aim to train graduate-level registered dietitian/nutritionists (RDNs) to improve the health of MCH populations. Metrics exist to evaluate the production and success of skilled graduates; however, metrics are needed regarding the reach of MCH professionals. This study aimed to develop, validate, and administer a survey to estimate the reach of a MCH Nutrition Training Program's alumni within the MCH population. METHODS: First, content validity of the survey was established with input from an expert panel (n = 4); face validity was established using cognitive interviews (n = 5) with RDNs; a test-retest (n = 37) was conducted to establish instrument reliability. The final survey, emailed to a convenience sample of alumni, received a response rate of 57% s(n = 56 of 98). Descriptive analyses were completed to identify MCH populations that alumni served. Survey responses were used to develop a storyboard. RESULTS: Most respondents were employed (93%; n = 52) and serving MCH populations (89%; n = 50). Of those serving MCH populations, 72% indicated working with families, 70% with mothers/women, 60% with young adults, 50% with children, 44% with adolescents, 40% with infants, and 26% with children and youth with special health care needs. The storyboard was created and visually represents connections between public health nutrition employment classification, direct reach, and indirect reach of sampled alumni to MCH populations served. CONCLUSION: The survey and storyboard are important tools that allow MCH Nutrition training programs to demonstrate their reach and to justify the impact of workforce development investments on MCH populations.

Drugged driving among U.S. adolescents, 2016-2019, USA.

INTRODUCTION: Drugged driving, the operation of a vehicle under the influence of any illegal drugs and alcohol, is a growing problem, but remains understudied among adolescents. The purpose of this article is to estimate past-year driving under the influence of alcohol, marijuana, and other drugs among a large sample of U.S. adolescents and potential associations (e.g., age, race, metropolitan status, sex). DESIGN: A cross-sectional secondary data analysis of the 2016-2019 National Survey on Drug Use and Health among 17,520 adolescents ages 16-17-years old was conducted. Weighted logistic regression models were built to determine potential associations to drugged driving. RESULTS: An estimated 2.00% of adolescents drove under the influence of alcohol in the past year, 5.65% drove under the influence of marijuana in the past year, and an estimated 0.48% drove under the influence of other drugs other than marijuana in the past year. Differences were based on race, past-year drug use, and county status. CONCLUSIONS: Drugged driving is a growing problem among adolescents and interventions are greatly needed to mitigate these behaviors among youth.

Baricitinib or imatinib in hospitalized COVID-19 patients: Results from COVINIB, an exploratory randomized clinical trial.

Baricitinib and imatinib are considered therapies for coronavirus disease 2019 (COVID-19), but their ultimate clinical impact remains to be elucidated, so our objective is to determine whether these kinase inhibitors provide benefit when added to standard care in hospitalized COVID-19 patients. Phase-2, open-label, randomized trial with a pick-the-winner design conducted from September 2020 to June 2021 in a single Spanish center. Hospitalized adults with COVID-19 pneumonia and a symptom duration ≤10 days were assigned to 3 arms: imatinib (400 mg qd, 7 days) plus standard-care, baricitinib (4 mg qd, 7 days) plus standard-care, or standard-care alone. Primary outcome was time to clinical improvement (discharge alive or a reduction of 2 points in an ordinal scale of clinical status) compared on a day-by-day basis to identify differences ≥15% between the most and least favorable groups. Secondary outcomes included oxygenation and ventilatory support requirements, additional therapies administered, all-cause mortality, and safety. One hundred and sixty-five patients analyzed. Predefined criteria for selection of the most advantageous arm were met for baricitinib, but not for imatinib. However, no statistically significant differences were observed in formal analysis, but a trend toward better results in patients receiving baricitinib was found compared to standard care alone (hazard ratio [HR] for clinical improvement: 1.41, 95% confidence intervals [CI]: 0.96-2.06; HR for discontinuing oxygen: 1.46, 95% CI: 0.94-2.28). No differences were found regarding additional therapies administered or safety. Baricitinib plus standard care showed better results for hospitalized COVID-19 patients, being the most advantageous therapeutic strategy among those proposed in this exploratory clinical trial.

Nutrition-Related Information Shared by Latine Influencers: A YouTube Content Analysis.

Latines are the fastest growing populace in the United States. Latine is a new, inclusive term for Hispanic and Latino populations regardless of gender identity. When compared with non-Latine counterparts, Latines have higher prevalence rates of obesity, diabetes, chronic liver disease, and kidney disease, which are associated with poor dietary behaviors. More research is warranted into the factors behind Latines' understanding of nutrition and potential sources of health information that influence dietary behaviors. This study describes the nutrition-related health information shared through YouTube by English-speaking Latine individuals between the ages of 18 and 49. For this content analysis, a cross-sectional study design was used. A four-step search strategy identified eligible YouTube channels and their corresponding video blogs (vlogs): discovery, screening, eligibility, and included. NVivo 1.0 was used to qualitatively code the nutrition-related information. A total of 68 vlogs were identified and reviewed. Five main themes emerged from the data (what vloggers discussed): Nutrition Philosophies, Inaccurate Information, Product Promotion, Recommendations based on the 2020-2025 Dietary Guidelines for Americans (DGA), and Recommendations not based on the 2020-2025 DGA. Although some of the nutrition-related information shared followed the 2020-2025 DGA, not all information were in line with these guidelines. Misinformation can undermine the scientific work done by health professionals and can threaten the health and lives of the citizenry by creating barriers for accessing, understanding, and utilizing evidenced-informed guidance in making health decisions. This study revealed that more research is warranted into specific aspects of social media and how they influence health behavior.

Fracturas basicervicales tratadas con clavo intramedular con tornillo cefálico único. Serie de casos y revisión bibliográfica / Basicervical fractures treated with single-screw cephalomedullary nail. Case series and review of the literature

Introducción: Debido a la inestabilidad rotatoria de las fracturas basicervicales, en estudios recientes, se sugiere el uso de una hoja espiral, doble tornillo o tornillos de compresión en lugar del tornillo cefálico único. Objetivo: Analizar los resultados de las fracturas basicervicales tratadas con tornillo cefálico único en nuestro centro. Materiales y Métodos: Estudio retrospectivo de una serie de casos formada a partir de la revisión de todas las fracturas extracapsulares de fémur proximal tratadas con clavo intramedular con tornillo cefálico único entre 2016 y 2020. Se revisaron las historias clínicas y las radiografías de 269 pacientes, y solo 12 (6,4%) de ellos cumplieron los criterios de inclusión (fracturas en dos fragmentos no patológicas y con seguimiento mínimo de 9 meses). Se evaluaron diferentes factores, como distancia punta-ápex, posición del tornillo cefálico, calidad de la reducción, tiempo quirúrgico, complicaciones y reintervención, y se analizaron las posibles diferencias entre los pacientes que sufrieron complicaciones y los que no. Resultados: Cuatro de los 12 pacientes tuvieron una falla de la fijación que evolucionó a cut-out (única complicación identificada en la muestra). No hubo diferencias estadísticamente significativas entre pacientes con cut-outo sin cut-out respecto al resto de las variables analizadas. Conclusiones: La elevada proporción de pacientes que desarrollaroncut-out sugiere considerar la hipótesis de que debería evitarse fijar las fracturas basicervicales con tornillo cefálico único. Dada su alta tasa de inestabilidad rotatoria, podría ser más apropiado el uso de implantes que la contrarresten. Nivel de Evidencia: IV

Background: Given the rotational instability of basicervical fractures, recent studies suggest using a spiral blade, a second screw or compression screws instead of single-screw cephalomedullary nail fixation. Objective: The aim of our study is to analyze the outcomes of basicervical fractures treated with single-screw cephalomedullary nails. Materials and Methods: This is a retrospective study based on a case series identified from all extracapsular femoral fractures treated with single-screw cephalomedullary nails in our hospital from 2016 to 2020. Clinical records and radiographs from 269 patients were reviewed; only 12 (6.4%) subjects met inclusion criteria (two-part non-pathologic fractures with at least a 9-month follow-up). Different factors were evaluated, including: tip-apex distance, cephalic screw position, reduction quality, surgical time, complications and re-operations; differences between patients who experienced complications and those who did not were also assessed. Results: Four subjects out of the 12 included patients experienced fixation failure and implant cut-out. There were no statistically significant differences between subjects with and without cut-out regarding the analyzed variables. Conclusions: The high cut-out rate observed in our sample suggests considering the hypothesis that single-screw cephalomedullary nail fixation should not be used in basicervical fractures. Alternative fixation devices capable of controlling the high rotational instability of these fractures may be preferable. Level of Evidence: IV

Competências Emocionais nos Enfermeiros de Saúde Mental: Contributos da implementação de um modelo de supervisão clínica / Emotional Competences in Mental Health Nurses: Contributions of a clinical supervision model implementation / Competencias Emocionales en Enfermeros de Salud Mental: Aportaciones a la implementación de un modelo de supervisión clínica

Resumo Contexto: A Competência Emocional (CE) é definida como um conjunto de conhecimentos, capacidades, habilidades e atitudes necessárias para compreender, expressar e regular de forma apropriada os fenómenos emocionais, bem como realizar diversas atividades com elevado nível de qualidade e eficácia. No contexto de Saúde Mental, esta competência assume relevância pela sua natureza inerente ao exercício profissional, com ação privilegiada a nível das competências interpessoais e relação terapêutica. O desenvolvimento e implementação destas competências no contexto da prática, permite aumentar os ganhos para a organização, cliente de cuidados e saúde mental dos enfermeiros. Existem poucos estudos que avaliam a utilização da supervisão clínica como estratégia de suporte formal para o desenvolvimento destas competências nos enfermeiros quer a nível do contexto da formação inicial ou contínua. Objetivo: Avaliar a implementação do Modelo SafeCare no desenvolvimento de competências emocionais nos enfermeiros de um serviço de Saúde Mental. Métodos: Estudo misto caracterizado pela triangulação concomitante, contemplando um estudo quantitativo descritivo, seguido de realização de entrevistas semiestruturadas. Resultados: Não existem diferenças estatisticamente significativas entre os dois momentos. Na análise de conteúdo efetuada, os enfermeiros identificam mudanças positivas ao nível do seu desenvolvimento pessoal e profissional, comunicação em equipa, gestão de conflitos e dos relacionamentos em grupo. Reportam ainda alterações na qualidade de cuidados e na organização. Conclusões: A implementação do Modelo SafeCare mostrou ter contribuído para o desenvolvimento das competências emocionais nos enfermeiros num contexto de Saúde Mental, contudo, futuros estudos serão necessários para aprofundar a eficácia da implementação do modelo.

Abstract Background: Emotional Competence (EC) is defined as a set of knowledge, skills, abilities and attitudes necessary to understand, express and adequately regulate emotional phenomena, as well as perform various activities with a high level of quality and effectiveness. This competence is highly relevant in mental health environments, strongly influencing interpersonal competencies and the therapeutic relationship. The development and implementation of these competencies in clinical practice produces gains to the organization, patient and nurses' mental health. There are few studies assessing clinical supervision as a formal support strategy to the development of these competencies in nurses either at an initial or continuing training. Aim: To evaluate the implementation of the SafeCare Model in the development of the emotional competence of nurses of a Mental Health service. Methods: Mixed study characterized by concomitant triangulation, including a descriptive quantitative study, followed by semi-structured interviews. Results: No statistically significant differences were found between the two moments. In the content analysis nurses identified positive changes in their personal and professional development, team communication, conflict management and relationships between groups. They also reported changes in the quality of care and in the organizations. Conclusions: The implementation of the SafeCare Model has very likely contributed to the development of nurses' emotional competence in a Mental Health context. However, further research is needed to improve efficacy of the model implementation.

Resumen Contexto: De la Competencia Emocional (CE) forman parte un conjunto de conocimientos, capacidades, habilidades y actitudes necesarias para comprender, expresar y controlar de forma adecuada aspectos emocionales, así como realizar distintas actividades con un gran nivel de eficacia. De acuerdo con la Salud Mental, esta competencia adquiere importancia por su naturaleza inherente al ejercicio profesional, con acción privilegiada a nivel de las relaciones interpersonales y relaciones terapéuticas. El desarrollo y la implementación de esas competencias en perspectiva práctica, permite mejorar la organización, los cuidados con el enfermo y la salud mental de los enfermeros. Hay pocos estudios que evalúan la supervisión clínica como proceso regulable para el desarrollo de las destrezas en los enfermeros en un nivel inicial y en un nivel avanzado. Objetivo(s): Evaluar la eficacia del Modelo SafeCare en el desarrollo de las competencias emocionales de los enfermeros en la Salud Mental. Metodología: Estudio mixto que privilegia un estudio cuantitativo descriptivo y entrevistas semiestructuradas. Resultados: No existen diferencias estadísticas significativas entre los dos momentos. Teniendo en cuenta el análisis del contenido, los enfermeros identifican cambios positivos a nivel de su desarrollo personal y profesional, comunicación en equipo, gestión de conflictos y relaciones grupales. Refieren también alteraciones en la calidad de los cuidados ofrecidos y en la organización. Conclusiones: La implementación del Modelo SafeCare contribuyó para el desarrollo de las competencias emocionales en los enfermeros en el contexto de Salud Mental, sin embargo, serán necesarios más estudios que nos permitan además demostrar la eficacia de la implementación del modelo.

African American Couples' Experiences during an Exercise Intervention Interrupted by the COVID-19 Pandemic: A Qualitative Case Study.

Exercise intervention researchers often struggle to transition participants from supervised/laboratory-based exercise to independent exercise. Research to inform this critical juncture remains underdeveloped. This qualitative case study investigated the transition from laboratory-based to home-based training in a subset of middle-aged and older African American couples whose exercise intervention experience was interrupted by the COVID-19 pandemic. All four couples (N = 8) whose study participation was interrupted participated in dyadic interviews by videoconference. Two investigators independently reviewed verbatim transcripts, and then used an iterative open coding approach to identify themes from the qualitative data. Three main themes were identified: (1) resistance training program modifications, (2) partner interactions, and (3) external pandemic-related factors. Each theme included both positive and negative feedback related to participants' experiences. Overall, virtual, home-based training appeared acceptable and feasible in this group. Further research is needed to investigate the utility of virtual training to effectively transition participants from laboratory-based to independent exercise.

Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children and Dietary Intake in Children: Associations With Race and Ethnicity.

INTRODUCTION: Establishing healthy dietary intake in pediatric populations is important for prevention of chronic disease across the lifespan. Federal nutrition assistance programs can support the dietary intake of U.S. children. The objective of this study was to assess the relationship between Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation status and dietary intake within racial and ethnic groups. METHODS: Dietary intake of children aged 2-4 years in the cross-sectional National Health and Nutrition Examination Survey 2011-2016 was analyzed in 2021. Multivariable linear regression was used to compare stratum-specific mean estimates for nutrient and food group intake of children participating in Special Supplemental Nutrition Program for Women, Infants, and Children (reference group) with those of nonparticipants who were income eligible and income ineligible (i.e., above income limits) for the WIC program. Significance was set to Bonferroni-corrected p-values. RESULTS: Hispanic WIC participants consumed less added sugar (8.9 [SE=0.5] teaspoons) than their higher-income counterparts (14.6 [SE=1.5] teaspoons, p<0.001). Hispanic WIC participants also consumed more fiber (13.0 [SE=0.6] grams) than income-eligible (11.4 [SE=0.7] grams, p=0.032) and income-ineligible (i.e., higher-income, 9.4 [SE=1.3] grams, p=0.019) nonparticipants, but this was not significant at the Bonferroni-adjusted p-value of 0.01. No differences in dietary intake were observed by WIC participation status for non-Hispanic White and non-Hispanic Black children. CONCLUSIONS: Participation in WIC was associated with healthier dietary outcomes among Hispanic children; however, dietary intake of White and Black children was comparable by WIC participation status. Federal nutrition assistance programs should support sound nutrition, an important factor in reducing the risk of chronic disease, in all groups.

Implementing Prevention Plus with Underserved Families in an Integrated Primary Care Setting.

Background: This proof-of-concept trial examined a 6-month Prevention Plus (PP) intervention implemented in a federally qualified health center on child standardized BMI (ZBMI), using a planned clinical effect threshold of -0.16 ZBMI. The relationship between food security status and PP delivered with caregiver goals (PP+) and without caregiver goals (PP-) on energy balance behaviors (i.e., fruits and vegetables, physical activity) and child ZBMI was explored. Methods: Seventy-three, underserved children, 4-10 years of age with a BMI ≥85th percentile, were randomized to one of two interventions, PP+ and PP-, both providing 2.5 hours of contact time, implemented in five clinics by behavioral health consultants (BHCs). Outcomes were child anthropometrics (included 9-month follow-up), implementation data collected from electronic health records, and caregiver and BHC evaluations. Results: Children were 57.5% female and 78.1% Hispanic, with 32.9% from food-insecure households and 58.9% from households with an annual income of less than $20,000. Child ZBMI significantly (p < 0.05) decreased at 6 and 9 months (-0.08 ± 0.24 and -0.12 ± 0.43), with only PP+ reaching the clinical threshold at 9 months (PP+: -0.20 ± 0.42 vs. PP-: -0.05 ± 0.42). Sixty-four percent of families attended ≥50% of the sessions, and BHCs delivered 78.5% ± 23.5% of components at attended sessions. Caregivers were satisfied with the intervention and BHCs found the intervention helpful/useful. No relationship with food insecurity status and outcomes was found. Conclusions: PP+ when delivered by a primary care provider to underserved families showed promise for producing a clinically meaningful effect. Families and providers felt the intervention was a viable treatment option.

Efficacious lifestyle interventions for appropriate gestational weight gain in women with overweight or obesity set in the health care system: a scoping review.

Purpose: Health care systems offer opportunities to scale up interventions for appropriate gestational weight gain (GWG); however, GWG interventions in the health care setting remain largely unavailable to women with overweight or obesity. To inform the translation of efficacious lifestyle interventions to health care delivery systems, this scoping review aimed to systematically identify randomized controlled trials for appropriate GWG in women with overweight or obesity that were set in a health care system.Methods: A scoping review allows for the systematic synthesis of knowledge on an exploratory research question aimed at mapping key concepts (e.g. time, location, source, and evidence) and gaps in a specific area of study. The Colquhoun et al. (2014) framework to conducting scoping reviews was used to develop the research question, identify relevant studies, select studies, extract data, and synthesize data. Specifically, two reviewers searched publication databases for English-language articles published from January 2009 to May 2020 using specific keywords/MeSH terms.Results: Eight peer-reviewed journal articles were identified; six trials were based in Europe and two in the U.S. Only four included lifestyle interventions that were efficacious in reducing GWG. Three trials with efficacious interventions were among women with obesity only and encouraged them to gain at or below the lower limit for total GWG (i.e. ≤5 kg) of the Institute of Medicine (IOM) guidelines. The fourth was among women with overweight or obesity and encouraged women to gain within the IOM guidelines with a telehealth behavioral intervention. Efficacious interventions were initiated in the first half of pregnancy and included frequent contact delivered through multiple modalities (i.e. in-person visits, telephone calls, text messages, email) by trained intervention staff (i.e. dietitian, lifestyle coach, and/or physiotherapist). Only one efficacious intervention trial briefly mentioned theoretical components for health promotion (e.g. self-monitoring); likewise, only one included cost-effectiveness analyses.Conclusions: This review systematically identified randomized controlled trials of efficacious lifestyle interventions (i.e. consisting of diet and physical activity components) for appropriate GWG in women with overweight or obesity that were set in the health care system and delivered by non-clinicians. Translation efforts could draw upon aspects of the efficacious lifestyle interventions described in this review. Future studies should examine theory-based telehealth interventions and cost-effectiveness.

Pet Ownership and Quality of Life: A Systematic Review of the Literature.

Pet ownership is the most common form of human-animal interaction, and anecdotally, pet ownership can lead to improved physical and mental health for owners. However, scant research is available validating these claims. This study aimed to review the recent peer reviewed literature to better describe the body of knowledge surrounding the relationship between pet ownership and mental health. A literature search was conducted in May 2020 using two databases to identify articles that met inclusion/exclusion criteria. After title review, abstract review, and then full article review, 54 articles were included in the final analysis. Of the 54 studies, 18 were conducted in the general population, 15 were conducted in an older adult population, eight were conducted in children and adolescents, nine focused on people with chronic disease, and four examined a specific unique population. Forty-one of the studies were cross-sectional, 11 were prospective longitudinal cohorts, and two were other study designs. For each of the articles, the impact of pet ownership on the mental health of owners was divided into four categories: positive impact (n = 17), mixed impact (n = 19), no impact (n = 13), and negative impact (n = 5). Among the reviewed articles, there was much variation in population studied and study design, and these differences make direct comparison challenging. However, when focusing on the impact of pet ownership on mental health, the results were variable and not wholly supportive of the benefit of pets on mental health. Future research should use more consistent methods across broader populations and the development of a pet-ownership survey module for use in broad, population surveys would afford a better description of the true relationship of pet ownership and mental health.

Cat and/or Dog Ownership, Cardiovascular Disease, and Obesity: A Systematic Review.

Pet ownership, the most common human-animal interaction, is believed to bestow positive health benefits onto pet owners. However, there is limited research on substantiating these assertions. The aim of this review was to systematically identify, evaluate, and summarize primary research on the relationship between cat and/or dog ownership and cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity to inform future research on pet ownership and chronic disease. How pet ownership was defined/measured, and identification of the chronic disease variables and health behaviors most often measured were emphasized. Two researchers independently searched PubMed and Web of Science, where One Health literature are mostly likely to be indexed, for peer-reviewed literature on pet ownership and CVD, T2D, and obesity. A review of 4541 titles and abstracts for relevance resulted in 34 manuscripts eligible for full-text review. Two researchers assessed each eligible manuscript and extracted data only from those that met the inclusion criteria (n = 14). Ten studies on CVD, four studies on obesity, and zero studies on T2D met the study criteria. The CVD and obesity variables varied and were not well described. The relationship between pet ownership and CVD and obesity varied (positive, negative, mixed effects, and no effect). Generalizability lacked across all studies: most studies were with Non-Hispanic White populations. Other areas of weakness were quality of study outcomes and instrument validity. Operationalization of pet ownership varied (from no verification to confirmed pet registration). Integration of the evidence-based influence of the human-animal connection through pet ownership on CVD and obesity may make prevention, mitigation, and treatment strategies more robust.

Minding the Gaps: Health Care Access for Foreign-born People in the U.S.: An Integrative Review.

BACKGROUND: Foreign-born people encounter disproportionate health care access barriers compared with U.S.-born adults. Few studies in the past decade have examined how characteristics of foreign-born people influence access to health care. METHODS: An integrative review regarding health care access for foreign-born people was conducted using Whittemore and Knafl's framework. Andersen's behavioral model of health care utilization was used to explain the findings. We searched electronic databases and identified 33 peerreviewed papers for inclusion. RESULTS: The reviewed articles represented a broad spectrum of research evaluating health care access. Barriers to health care access for foreign-born people are multifactorial and driven by insurance status, citizenship, immigration status, and English language proficiency. CONCLUSION: Future research must comprehensively examine the unmet health needs and predictors of access among foreign-born people.

Using a consumer-based wearable activity tracker for physical activity goal setting and measuring steps in pregnant women with gestational diabetes mellitus: exploring acceptance and validity.

BACKGROUND: Activity monitoring devices may be used to facilitate goal-setting, self-monitoring, and feedback towards a step-based physical activity (PA) goal. This study examined the performance of the wrist-worn Fitbit Charge 3™ (FC3) and sought opinions on walking and stepping-in-place from women with gestational diabetes (GDM). METHODS: Participants completed six 2-min metronome-assisted over ground bouts that varied by cadence (67, 84, or 100 steps per minute) and mode (walking or stepping-in-place; N = 15), with the sequence randomized. Steps were estimated by FC3 and measured, in duplicate, by direct observation (hand-tally device, criterion). Equivalence testing by the two one-sided tests (TOST) method assessed agreement within ± 15%. Mean absolute percent error (MAPE) of steps were compared to 10%, the accuracy standard of the Consumer Technology Association (CTA)™. A subset (n = 10) completed a timed, 200-m self-paced walk to assess natural walking pace and cadence. All participants completed semi-structured interviews, which were transcribed and analyzed using descriptive and interpretive coding. RESULTS: Mean age was 27.0 years (SD 4.2), prepregnancy BMI 29.4 kg/m2 (8.3), and gestational age 32.8 weeks (SD 2.6). The FC3 was equivalent to hand-tally for bouts of metronome-assisted walking and stepping-in-place at 84 and 100 steps per minute (i.e., P < .05), although walking at 100 steps per minute (P = .01) was no longer equivalent upon adjustment for multiple comparisons (i.e., at P < .007). The FC3 was equivalent to hand-tally during the 200-m walk (i.e., P < .001), in which mean pace was 68.2 m per minute (SD 10.7), or 2.5 miles per hour, and mean cadence 108.5 steps per minute (SD 6.5). For walking at 84 and 100 steps per minute, stepping-in-place at 100 steps per minute, and the 200-m walk, MAPE was within 10%, the accuracy standard of the CTA™. Interviews revealed motivation for PA, that stepping-in-place was an acceptable alternative to walking, and competing responsibilities made it difficult to find time for PA. CONCLUSIONS: The FC3 appears to be a valid step counter during the third trimester, particularly when walking or stepping-in-place at or close to women's preferred cadence.