Mollusc and crustacean consumption in the first 1000 days: a scoping review.

Mollusc and crustacean consumption in the first 1000 d may improve maternal and child health by providing essential nutrients. However, in some contexts, molluscs and crustaceans have been associated with allergies and environmental contamination, potentially leading to adverse health and development outcomes. It is unclear whether the health benefits of consuming molluscs and crustaceans, collectively classified as shellfish in nutrition, are outweighed by the potential risks to pregnant women and children. We conducted a scoping review (PROSPERO: CRD42022320454) in PubMed, Scopus and EBSCO Global Health of articles published between January 2000 and March 2022 that assessed shellfish consumption during pregnancy, lactation or childhood (0-2 years) in relation to maternal health, child health or child development. A total of forty-six articles were included in this review. Overall, shellfish consumption was associated with higher biomarkers of environmental contaminants, with mercury being the most studied and having the strongest evidence base. The limited research on nutritional biomarker status shows an association between shellfish consumption and iodine status. Preterm birth was not associated with shellfish consumption, but newborn anthropometry showed mixed results, with several studies reporting lower birth weight with higher shellfish consumption. The few studies that examined child development and maternal health outcomes reported no significant associations. This review revealed trade-off health risks and benefits with inclusion of molluscs and crustaceans in the dietary patterns of mothers and young children. More research is needed to understand how these aquatic animal-source foods may be safely consumed and leveraged for improving human nutrition.

Sensory panel results of a dried fish powder supplement among caregivers and young children in Zambia.

OBJECTIVE: To evaluate the acceptability of traditional Zambian dishes fortified with Complementary Food for Africa+Dried Fish Powder (ComFA+Fish), a locally sourced protein/micronutrient blend designed to impact nutrient deficiencies among infants and young children (IYC) and improve pregnancy and birth outcomes among women of reproductive age (WRA). DESIGN: During two sensory panels, caregivers evaluated: (1) the acceptability of four ComFA+Fish dishes for household consumption, including fortified chibwabwa fisashi, savory Kapenta chutney, fortified complementary maize porridge and fortified bean-vegetable soup and (2) whether their IYC found the fortified complementary maize porridge acceptable. SETTING: Lake Kariba, Southern Province, Zambia. PARTICIPANTS: Women of reproductive age (n 42) and their IYC aged 6-11 months (n 16) and 12-23 months (n 26) were recruited from fishing villages in Gwembe, Siavonga and Sinazongwe District. RESULTS: A majority of caregivers extremely liked/liked the: (1) fortified chibwabwa fisashi's sensory attributes (94·7 %), convenience (92·8 %) and overall acceptability (100 %); (2) savory Kapenta chutney's sensory attributes (81·8 %), convenience (92·8 %) and overall acceptability (100 %); (3) fortified complementary porridge's sensory attributes (83·5 %), convenience (90·5 %) and overall acceptability (88·1 %) and (4) fortified bean-vegetable soup's sensory attributes (66·8 %), convenience (87·5 %) and overall acceptability (87·5 %). Further, a majority of caregivers evaluated the fortified complementary porridge as highly acceptable to their IYC. CONCLUSIONS: Results suggest that ComFA+Fish is strategically well placed to fill nutritional gaps among IYC and WRA in Zambia and has the potential to be scaled across sub-Saharan Africa.

Impact of Mississippi healthy students act of 2007 on district- and school-level health policies: school officials' perspectives.

BACKGROUND: Annual evaluations of the Mississippi Healthy Students Act of 2007 (MHSA) were conducted during 2009-2011 (years 1-3) among 4 stakeholder groups: (1) parents of public school students, (2) adolescents, (3) state-level policymakers (ie, legislators and other state officials), and (4) public school officials (ie, superintendents and school board members). METHODS: We examine results from the first state-wide surveys conducted among purposive samples of superintendents (N = 314) and school board members (N = 689) on childhood obesity as it related to MHSA. These school officials were surveyed in years 1-3 to determine their knowledge or attitudes toward MHSA and support of potential policies, such as reporting results of student body mass index (BMI) assessments to parents. RESULTS: Through the 3 years of the study, school officials were supportive of MHSA across a number of variables, although superintendents were consistently more supportive of current policies as compared with school board members. CONCLUSIONS: Results underscore the current and potential role of school officials relative to the process of fully implementing MHSA within all public school districts in Mississippi. Implications and 3 cases that illustrate diverse ways that school districts have chosen to implement effective school-based health initiatives are discussed.

Development of sexual expectancies among adolescents: contributions by parents, peers and the media.

To expand the scant research on sexual expectancies development among non-sexually active adolescents, we examined the relationship between adolescents' exposure to four socializing agents--mother/female guardian, father/male guardian, peers, and television programs with high sexual content--and their endorsement of four sexual expectancies: social benefit, pleasure, social risk, and health risk. Data are from Waves 2 and 3 of a three-wave annual longitudinal study conducted among California adolescents, the majority of whom were not sexually active (N = 914, 84%). Structural equation models were conducted to examine cross-sectional and longitudinal associations between the socializing agents and the sexual expectancies. Cross-sectional results indicate associations between peer sexual communication and social benefit, pleasure, and social risk expectancies. A positive association was found between exposure to music videos and social benefit expectancies, and a negative association was found between exposure to music videos and health risk expectancies. Longitudinal results suggest that communication with peers positively predicted pleasure expectancies and negatively predicted social risk expectancies. No other socializing agents were associated with any sexual expectancies. An invariance test found that significant correlations were similar across the different age groups. Results suggest that efforts to support positive sexual decision making among non-sexually active adolescents should target peer sexual communication.

Public school parents' perspectives of the Mississippi Healthy Students Act of 2007: findings from 2009-2011.

Annual evaluations of the Mississippi Healthy Students Act of 2007 (MHSA) were conducted from 2009-2011 among four stakeholder groups: (1) parents of public school students; (2) adolescents; (3) school officials (e.g., superintendents); (4) state-level policymakers (e.g., legislators). We examine results from the first state-wide study among a randomized sample of parents (N>3,600 per year) on childhood obesity as it related to MHSA. Parents were surveyed to determine: (1) knowledge/attitudes towards MHSA; (2) knowledge/attitudes/behaviors (KAB) that influence children's health; and (3) perceived overweight/obesity of self and child versus BMI-determined overweight/obesity. Across all three years, parents were very supportive of MHSA across a number of variables, while parents greatly underestimated obesity among self and child when compared to their BMI data. Results highlight complexities of parents' KAB that potentially influence children's health, including the MHSA. Policy implications are discussed.

Relationship Power, Acculturation, and Sexual Risk Behavior Among Low-Income Latinas of Mexican or Puerto Rican Ethnicity.

Young adult Latinas are disproportionately overrepresented among HIV/AIDS incidence cases in the United States, and heterosexual contact has been identified as the primary mode of HIV transmission. This study examined sexual risk behavior among 40 low-income native-born and foreign-born Latinas of Mexican or Puerto Rican ethnicity seeking services at a community-based family planning clinic in a large Midwestern city. Participants were unmarried, noncohabiting Latinas ages 18-29 who were involved in primary heterosexual relationships. Survey data that were collected from participants included sociodemographics, relationship power, acculturation, and unprotected sex with primary and extradyadic partners. After statistically controlling for age and ethnic identity, the authors found that Latinas with less relationship power were significantly more likely to report having unprotected sex with primary partners. These findings suggest that HIV-prevention intervention efforts that focus on relationship power among young heterosexual Latinas in the United States may be effective in reducing sexual risk behavior.

Water insecurity and emotional distress: coping with supply, access, and seasonal variability of water in a Bolivian squatter settlement.

Recent research suggests that insecure access to key resources is associated with negative mental health outcomes. Many of these studies focus on drought and famine in agricultural, pastoral, and foraging communities, and indicate that food insecurity mediates the link between water insecurity and emotional distress. The present study is the first to systematically examine intra-community patterns of water insecurity in an urban setting. In 2004-2005, we collected interview data from a random sample of 72 household heads in Villa Israel, a squatter settlement of Cochabamba, Bolivia. We examined the extent to which water-related emotional distress is linked with three dimensions of water insecurity: inadequate water supply; insufficient access to water distribution systems; and dependence on seasonal water sources, and with gender. We found that access to water distribution systems and female gender were significantly associated with emotional distress, while water supply and dependence on seasonal water sources were not. Economic assets, social assets, entitlements to water markets, and entitlements to reciprocal exchanges of water were significantly associated with emotional distress, while entitlements to a common-pool water resource institution were not. These results suggest that water-related emotional distress develops as a byproduct of the social and economic negotiations people employ to gain access to water distribution systems in the absence of clear procedures or established water rights rather than as a result of water scarcity per se.

Sex and the 'recently single': perceptions of sexuality and HIV risk among mature women and primary care physicians.

Primary care physicians may mistakenly conclude that sexual issues are unimportant to divorced or widowed mature women, based on age and gender biases. Although research suggests that many single mature women are sexually active, physicians are often reluctant to discuss sexual matters with them. Structured and open-ended interviews explored perceptions regarding mature women's sexuality and HIV-related risk for patient-physician communication among 44 'recently single' mature women aged 45-68 and 31 primary care physicians. Age and ethnic group comparisons with the mature women suggest that younger and African-American women reported higher HIV and STI risk perception than older and White women. Many mature women (64%) believed that they were at-risk for HIV and STIs, whereas physicians considered younger patients most at-risk and that risk declined with patients' advancing age and with female status. Mature women and physicians had different expectations regarding initiation of clinical sexual health discussions, with 44% of the mature women placing the onus of responsibility on the patient, whereas 74% of physicians believed it was the role of both doctors and patients to bring up these topics. The findings are instructive to primary care physicians and healthcare policy makers, indicating that sexual health issues are relevant to mature women's continued health and well-being.

Sexual risk behavior in men attending Mardi Gras celebrations in New Orleans, Louisiana.

Previous research with travelers points to higher risk behaviors during vacations. Relative to their day-to-day lives, leisure travelers have more free time to pursue sexual activities and are likely to engage in higher rates of substance use than when at home. Risk behaviors during vacation have not been thoroughly examined in men who have sex with men (MSM), a key group at risk for HIV. The present investigation examined substance use, sexual risk behaviors, and components of the Information-Motivation-Behavioral Skills (IMB) Model in MSM attending Mardi Gras celebrations in New Orleans. Almost half of the sexually active men reported having sex with a partner of unknown HIV status while in New Orleans and a similar number did not disclose their own HIV status to all of their sexual partners. Drug use and excessive alcohol use were associated with unprotected sex (ps < .05). Components of the IMB model also predicted sexual risk behavior: individuals with more accurate HIV transmission information reported fewer unprotected sex acts, and motivation to engage in sexual activity on vacation was associated with more unprotected sex (ps < .05). Findings suggest that some MSM on vacation are placing themselves at risk for HIV. Traditional HIV prevention interventions do not readily lend themselves for use with transient populations. New intervention approaches are needed to reduce sexual risk behaviors in persons traveling for leisure.

Migrant Latinas and brothel sex work in Belize: sexual agency and sexual risk.

Sexual risk variability among brothel-based sex workers has been shown to be influenced by fear of HIV transmission, and by culture-bound gender norms as well as economic need, yet the effect of sexual agency on impoverished Latina sex workers' risk behavior with their clients remains poorly characterized. We investigated perceived health beliefs regarding susceptibility to/severity of HIV/AIDS, and sexual agency regarding barriers to condom use, benefits of unprotected sex, and risk-reduction behavior with clients among a sample of 33 brothel workers in Belize. Although 77% of participants felt at risk for HIV, only 30% always use condoms and 43% did not refuse unprotected sex with clients. Participants' narrative explanations for unprotected sex emphasized that clients'preferences often overrode brothel workers fear of HIV, and that the health benefits of using condoms with clients were often weighed against the social benefits of unprotected sex. Implications for brothel-based condom promotion programs and further research are discussed.

Sexual risk and HIV acquisition among men who have sex with men travelers to Key West, Florida: a mathematical modeling analysis.

The present study investigated the sexual risk behaviors of men who have sex with men (MSM) traveling to a popular gay tourist destination in the United States. In 2004, a brief survey was administered to 247 MSM tourists recruited from gay-oriented venues in Key West, Florida. Data collected included demographics, HIV status, length of stay, substance use, and sexual risk behaviors. A probabilistic model of HIV transmission was used to translate participants' reports of their sexual behaviors while in Key West into estimates of their risk of acquiring HIV. Twenty-two percent of participants reported anal sex with multiple partners over a relatively brief period (M = 4.1 days), and approximately one third reported having sex with a partner met during the vacation period. Modeling analyses suggested that sexual activity among vacationing MSM would account for approximately 201 new HIV infections among MSM visitors to Key West each year. Although previous studies have documented sexual risk behavior in travelers, quantitative estimates of the impact of these behaviors on the spread of HIV are lacking. Findings suggest that the risk-taking behavior of MSM on vacation may play an important role in the dissemination of HIV and other sexually transmitted diseases (STDs). Future research should assess additional factors (e.g., use of highly active antiretroviral therapy) that may affect HIV transmission in MSM travelers. In addition, efforts are needed to develop effective risk-reduction interventions for this population.

Substance use, medications for sexual facilitation, and sexual risk behavior among traveling men who have sex with men.

OBJECTIVES: The objective of the study was to examine correlates of sexual risk behavior among men who have sex with men (MSM) traveling for leisure. STUDY DESIGN: MSM (N = 304) visiting popular tourist areas completed a brief survey assessing sexual behavior and substances used while on vacation, including the use of erectile dysfunction medications (e.g., Viagra). RESULTS: Forty-seven percent of the respondents were sexually active during their vacation, with a mean of 1.33 unprotected anal sex acts during their brief stay (mean = 3.6 days). More than half of the sexually active men reported sex with a partner of unknown HIV status. Individuals reporting substance use or taking erectile dysfunction medications reported higher rates of sexual risk behaviors. CONCLUSION: Many MSM travelers report behaviors that may put their health at risk, including substance use and unprotected sexual activity. Interventions designed to reduce risk behaviors among MSM tourists are needed.

Where the boys are: sexual expectations and behaviour among young women on holiday.

The main objectives of this study were to examine relationships between vacation sex expectations and travelling companionship type (solo, paired, or group), and behavioural outcomes such as engaging in a relationship while on vacation, procuring condoms, and initiating condom use with vacation sex partners among tourist women in Costa Rica. A brief interview was used to assess sociodemographic characteristics, vacation sex expectations and relationships, casual sex variables, and alcohol use among a convenience sample of 128 single female tourists 18 years of age or older. Univariate and multivariate analysis were used to examine relationships among variables of interest. Women who travelled solo or with a single female companion and women who anticipated having sex on holiday were more likely than other tourist women to report one or more vacation relationships, to have procured condoms, and to have initiated condom use with a vacation sex partner. Women who engage in unanticipated vacation relationships may be at increased risk of participating in unsafe sex with a partner met on holiday due to lack of condom procurement and/or initiation of condom use. The findings point to the importance of public health efforts to educate women regarding safer sex precautions when travelling on holiday.