Spatial Clustering of Tobacco Retailers Near US Public Schools.

INTRODUCTION: Previous studies have found that tobacco retailers cluster near schools. However, all retail outlets may be located near each other and near schools due to existing infrastructure and zoning policies. We assessed whether tobacco retailers cluster near schools in the United States more than expected when accounting for existing retail locations. AIMS AND METHODS: We identified 322 056 probable tobacco retailers, 95 110 public schools, and more than 3.8 million businesses comparable to tobacco retailers in land use and business type. We created 500 simulated tobacco retailer datasets by randomly selecting from the larger list of businesses. For each simulated dataset, we calculated the distance from schools to the nearest tobacco retailer (proximity) and the count of tobacco retailers within 800 m of schools (density). Observed proximity and density values were compared to 95% coverage intervals from the 500 simulations. We stratified analyses by urbanicity, percentage of students in the free and reduced-priced lunch program (FRLP), and percentage of Hispanic/Latino, non-Hispanic Black, and non-Hispanic white students. RESULTS: Tobacco retailers were closer to schools in rural areas, cities, and towns and more dense around schools in rural areas, cities, and suburbs compared to random locations in potential retail space. Schools with more students receiving FRLP had higher density than expected while schools with fewer students receiving FRLP had lower density than expected. Within rural areas, clustering did not vary across sociodemographic groups. Within non-rural areas, there were inequities in clustering by racial, ethnic, and socioeconomic school composition. CONCLUSIONS: Tobacco retailers cluster near schools after accounting for existing business patterns. There are inequities in clustering by sociodemographic school composition. IMPLICATIONS: This study provides compelling evidence that tobacco retailers cluster near US public schools and that there are racial, ethnic, and socioeconomic inequities in clustering, even when accounting for overall retail location patterns. Given that public schools tend to reflect neighborhood demographics, policies to limit tobacco retailers near schools may reduce both school-based and neighborhood-based inequities.

Characteristics of and engagement with URL resources shared among online vaping communities on Reddit.

INTRODUCTION: Reddit is a popular social media platform for sharing information about vaping. Little is known about the types of external resources that Reddit users in vaping communities share and engage with. METHODS: We analysed 2315 posts containing uniform resource locators (URLs) published to vaping communities on Reddit between November 2021 and October 2022. We coded URLs into eight mutually exclusive domain types. A mixed-effects Poisson regression model examined whether domain type was associated with user engagement (ie, number of unique commenters). RESULTS: Posts contained links to social media (35%), image hosting (31%), vaping-related commerce (19%), eJuice (12%), general vaping (6%), news (2%) and research (1%) URL domains. There were 237 unique vaping-related commerce domains (eg, ziipstock.com). The average number of commenters per post was 5.43 (SD=8.04). The rate of commenters was higher for posts sharing research (adjusted rate ratio (aRR) 1.74, 95% CI 1.28 to 2.36) and news (aRR 1.56, 95% CI 1.02 to 2.38) domains compared with vape-related commerce domains. CONCLUSION: Reddit users in vaping communities share and interact with a variety of external resources. The >200 different vaping-related commerce domains in our sample speak to the breadth and availability of websites that Reddit users (perhaps even those underage) may be using to browse and purchase vaping devices.

Contributions to Research and Practice Made by the National Cancer Institute's Health Communication and Informatics Research Branch.

The Health Communication and Informatics Research Branch at the U.S. National Cancer Institute was founded in 1999 in response to increasing evidence demonstrating a link between effective health communication and improved cancer-related outcomes and in recognition of the rapid and dramatic technological changes that were transforming health communication at the turn of the 21st century. For the past 25 years, the Health Communication and Informatics Research Branch has been conducting and supporting research at the forefront of emerging cancer communication trends and technologies, making numerous contributions to health communication science, public health, and cancer control practice. In this essay, we provide a brief history of the branch and the context that led to its establishment, discuss contributions made by the branch to health communication research and practice through key projects and initiatives, and conclude by highlighting health communication and informatics research priorities that offer opportunities for significant impact going forward in light of the challenges posed by the current communication environment.

Mitigating Health and Science Misinformation: A Scoping Review of Literature from 2017 to 2022.

Literature on how to address misinformation has rapidly expanded in recent years. The aim of this scoping review was to synthesize the growing published literature on health and science misinformation mitigation interventions. English-language articles published from January 2017 to July 2022 were included. After title/abstract screening, 115 publications (148 empirical studies) met inclusion criteria and were coded for sample characteristics, topics, mitigation strategies, research methods, outcomes, and intervention efficacy. A marked increase in misinformation mitigation research was observed in 2020-2022. COVID-19, vaccines, and climate change were the most frequently addressed topics. Most studies used general population samples recruited online; few focused on populations most vulnerable to misinformation. Most studies assessed cognitive outcomes (e.g., knowledge), with fewer assessing health behavior, communication behavior, or skills. Correction (k = 97) was the most used misinformation mitigation strategy, followed by education and other literacy initiatives (k = 39) and prebunking/inoculation (k = 24). Intervention efficacy varied, with 76 studies reporting positive, 17 reporting null, and 68 reporting mixed results. Most misinformation mitigation interventions were limited to short-term online experiments focused on improving cognitive outcomes. Priority research areas going forward include expanding and diversifying study samples, scaling interventions, conducting longitudinal observations, and focusing on communities susceptible to misinformation.

The Impact of the COVID-19 Pandemic on Tobacco Treatment Program Implementation at National Cancer Institute-Designated Cancer Centers.

INTRODUCTION: The COVID-19 pandemic disrupted cancer screening and treatment delivery, but COVID-19's impact on tobacco cessation treatment for cancer patients who smoke has not been widely explored. AIMS AND METHODS: We conducted a sequential cross-sectional analysis of data collected from 34 National Cancer Institute (NCI)-designated cancer centers participating in NCI's Cancer Center Cessation Initiative (C3I), across three reporting periods: one prior to COVID-19 (January-June 2019) and two during the pandemic (January-June 2020, January-June 2021). Using McNemar's Test of Homogeneity, we assessed changes in services offered and implementation activities over time. RESULTS: The proportion of centers offering remote treatment services increased each year for Quitline referrals (56%, 68%, and 91%; p = .000), telephone counseling (59%, 79%, and 94%; p = .002), and referrals to Smokefree TXT (27%, 47%, and 56%; p = .006). Centers offering video-based counseling increased from 2020 to 2021 (18% to 59%; p = .006), Fewer than 10% of centers reported laying off tobacco treatment staff. Compared to early 2020, in 2021 C3I centers reported improvements in their ability to maintain staff and clinician morale, refer to external treatment services, train providers to deliver tobacco treatment, and modify clinical workflows. CONCLUSIONS: The COVID-19 pandemic necessitated a rapid transition to new telehealth program delivery of tobacco treatment for patients with cancer. C3I cancer centers adjusted rapidly to challenges presented by the pandemic, with improvements reported in staff morale and ability to train providers, refer patients to tobacco treatment, and modify clinical workflows. These factors enabled C3I centers to sustain evidence-based tobacco treatment implementation during and beyond the COVID-19 pandemic. IMPLICATIONS: This work describes how NCI-designated cancer centers participating in the Cancer Center Cessation Initiative (C3I) adapted to challenges to sustain evidence-based tobacco use treatment programs during the COVID-19 pandemic. This work offers a model for resilience and rapid transition to remote tobacco treatment services delivery and proposes a policy and research agenda for telehealth services as an approach to sustaining evidence-based tobacco treatment programs.

Smoking Status, Nicotine Medication, Vaccination, and COVID-19 Hospital Outcomes: Findings from the COVID EHR Cohort at the University of Wisconsin (CEC-UW) Study.

INTRODUCTION: Available evidence is mixed concerning associations between smoking status and COVID-19 clinical outcomes. Effects of nicotine replacement therapy (NRT) and vaccination status on COVID-19 outcomes in smokers are unknown. METHODS: Electronic health record data from 104 590 COVID-19 patients hospitalized February 1, 2020 to September 30, 2021 in 21 U.S. health systems were analyzed to assess associations of smoking status, in-hospital NRT prescription, and vaccination status with in-hospital death and ICU admission. RESULTS: Current (n = 7764) and never smokers (n = 57 454) did not differ on outcomes after adjustment for age, sex, race, ethnicity, insurance, body mass index, and comorbidities. Former (vs never) smokers (n = 33 101) had higher adjusted odds of death (aOR, 1.11; 95% CI, 1.06-1.17) and ICU admission (aOR, 1.07; 95% CI, 1.04-1.11). Among current smokers, NRT prescription was associated with reduced mortality (aOR, 0.64; 95% CI, 0.50-0.82). Vaccination effects were significantly moderated by smoking status; vaccination was more strongly associated with reduced mortality among current (aOR, 0.29; 95% CI, 0.16-0.66) and former smokers (aOR, 0.47; 95% CI, 0.39-0.57) than for never smokers (aOR, 0.67; 95% CI, 0.57, 0.79). Vaccination was associated with reduced ICU admission more strongly among former (aOR, 0.74; 95% CI, 0.66-0.83) than never smokers (aOR, 0.87; 95% CI, 0.79-0.97). CONCLUSIONS: Former but not current smokers hospitalized with COVID-19 are at higher risk for severe outcomes. SARS-CoV-2 vaccination is associated with better hospital outcomes in COVID-19 patients, especially current and former smokers. NRT during COVID-19 hospitalization may reduce mortality for current smokers. IMPLICATIONS: Prior findings regarding associations between smoking and severe COVID-19 disease outcomes have been inconsistent. This large cohort study suggests potential beneficial effects of nicotine replacement therapy on COVID-19 outcomes in current smokers and outsized benefits of SARS-CoV-2 vaccination in current and former smokers. Such findings may influence clinical practice and prevention efforts and motivate additional research that explores mechanisms for these effects.

U.S. public opinion toward policy restrictions to limit tobacco product placement and advertising at point-of-sale and on social media.

The Family Smoking Prevention and Tobacco Control Act granted the U.S. Food and Drug Administration authority to regulate tobacco advertising and promotion, including at the retail level, and preserved state, tribal, and local tobacco advertising and promotion authorities. Public health experts have proposed prohibiting point-of-sale tobacco advertisements and product displays, among other tobacco advertising restrictions. We examined the prevalence and correlates of public support, opposition, and neutrality toward proposed tobacco product placement and advertising restrictions at point-of-sale and on social media utilizing the National Cancer Institute's 2020 Health Information National Trends Survey (HINTS) (N = 3865), a cross-sectional, probability-based postal survey of U.S. addresses conducted from Feb 24, 2020 to June 15, 2020 (Bethesda, MD). Frequencies and unadjusted, weighted proportions were calculated for support, neutrality, and opposition toward the three policies under study, and weighted, adjusted multivariable logistic regression was employed to examine predictors of neutrality and opposition. Tests of significance were conducted at the p < 0.05 level. Sixty-two percent of U.S. adults supported a policy prohibiting tobacco product advertising on social media; 55% supported a policy restricting the location of tobacco product advertising at point-of-sale; and nearly 50% supported a policy to keep tobacco products out of view at the checkout counter. Neutrality and opposition varied by sociodemographic characteristics including age, sex, education, rurality, and presence of children in the household. Understanding public opinion toward tobacco product placement and advertising restrictions may inform policy planning and implementation.

Public Support for Cigarette Pack Pictorial Health Warnings Among US Adults: A Cross-sectional Analysis of the 2020 Health Information National Trends Survey.

INTRODUCTION: The US Food and Drug Administration issued a final rule requiring new warnings for cigarette packages and advertisements. This study examines population-level characteristics of support for-versus neutrality or opposition toward-cigarette pack warnings that use text and images to portray the negative health effects of smoking. METHODS: We used nationally representative cross-sectional data of US adults age 18 and older from the 2020 Health Information National Trends Survey (n = 3865). Frequencies and weighted proportions were calculated for neutrality toward, opposition to, and support for pictorial warnings across sociodemographics and other predictors. Weighted, multivariable logistic regression examined predictors of being neutral or opposed versus supportive of pictorial warnings. RESULTS: In 2020, an estimated 69.9% of US adults supported pictorial warnings, 9.1% opposed, and 20.9% neither supported nor opposed them. In fully adjusted models, current smokers had almost twice the odds of being neutral or opposed to pictorial warnings as never smokers (odds ratio [OR] = 1.99, confidence interval [CI] 1.12, 3.52). Adults 75 years and older (vs. 18-34) (OR = 0.55, CI 0.33, 0.94) and those with children under 18 in their household (vs. no children) (OR = 0.67, CI 0.46, 0.98) were less likely to be neutral or opposed. CONCLUSIONS: In advance of the Food and Drug Administration's implementation of pictorial warnings on cigarette packages, nearly 70% of American adults support this policy. Disseminating information about the effectiveness of pictorial warnings may further strengthen support among current smokers who are less supportive than never smokers. Furthermore, framing messages around the benefits of pictorial warnings for protecting youth may increase public support. IMPLICATIONS: While public support for pictorial warnings on cigarette packages is high in the United States, it may increase further after policy implementation and be strengthened by utilizing information campaigns that convey the evidence that pictorial warnings are an effective public health strategy.

Comparing the effects of two different strains of mycobacteria, Mycobacterium vaccae NCTC 11659 and M. vaccae ATCC 15483, on stress-resilient behaviors and lipid-immune signaling in rats.

Stress-related disorders, such as posttraumatic stress disorder (PTSD), are highly prevalent and often difficult to treat. In rodents, stress-related, anxiety-like defensive behavioral responses may be characterized by social avoidance, exacerbated inflammation, and altered metabolic states. We have previously shown that, in rodents, subcutaneous injections of a heat-killed preparation of the soil-derived bacterium Mycobacterium vaccae NCTC 11659 promotes stress resilience effects that are associated with immunoregulatory signaling in the periphery and the brain. In the current study, we sought to determine whether treatment with a heat-killed preparation of the closely related M. vaccae type strain, M. vaccae ATCC 15483, would also promote stress-resilience in adult male rats, likely due to biologically similar characteristics of the two strains. Here we show that immunization with either M. vaccae NCTC 11659 or M. vaccae ATCC 15483 prevents stress-induced increases in hippocampal interleukin 6 mRNA expression, consistent with previous studies showing that M. vaccae NCTC 11659 prevents stress-induced increases in peripheral IL-6 secretion, and prevents exaggeration of anxiety-like defensive behavioral responses assessed 24 h after exposure to inescapable tail shock stress (IS) in adult male rats. Analysis of mRNA expression, protein abundance, and flow cytometry data demonstrate overlapping but also unique effects of treatment with the two M. vaccae strains on immunological and metabolic signaling in the host. These data support the hypothesis that treatment with different M. vaccae strains may immunize the host against stress-induced dysregulation of physiology and behavior.

Prevalence and correlates of US adult public opinion on restricting junk food advertising to children on social media: 2020 Health Information National Trends Survey.

OBJECTIVE: To describe US adults' levels of support, neutrality and opposition to restricting junk food advertising to children on social media and explore associations with socio-demographic and health-related characteristics. DESIGN: In 2020-2021, we used cross-sectional data from the National Cancer Institute's 2020 Health Information National Trends Survey to estimate the prevalence of opinions towards advertising restrictions and correlates of neutrality and opposition using weighted multivariable logistic regression. SETTING: United States. PARTICIPANTS: Adults aged 18+ years. RESULTS: Among the analytic sample (n 2852), 54 % of adults were neutral or opposed to junk food advertising restrictions on social media. The odds of being neutral or opposed were higher among Non-Hispanic Black adults (v. non-Hispanic White; OR: 2·03 (95 % CI 1·26, 3·26)); those completing some college (OR: 1·68 (95 % CI 1·20, 2·34)) or high school or less (OR: 2·62 (95 % CI 1·74, 3·96)) (v. those with a college degree); those who were overweight (v. normal weight; OR: 1·42 (95 % CI: 1·05, 1·93)) and those reporting a moderate (OR: 1·45 (95 % CI 1·13, 1·88)) or conservative (OR: 1·71 (95 % CI 1·24, 2·35)) political viewpoint (v. liberal). Having strong (v. weaker) weight and diet-related cancer beliefs was associated with 53 % lower odds of being neutral or opposed to advertising restrictions (OR: 0·47 (95 % CI 0·36, 0·61)). CONCLUSIONS: The current study identified subgroups of US adults for whom targeted communication strategies may increase support for policies to improve children's food environment.

Effects of immunization with heat-killed Mycobacterium vaccae on autism spectrum disorder-like behavior and epileptogenesis in a rat model of comorbid autism and epilepsy.

Autism spectrum disorders (ASDs) and epilepsy are often comorbid. The basis for this co-occurrence remains unknown; however, inflammatory stressors during development are a shared risk factor. To explore this association, we tested the effect of repeated immunizations using a heat-killed preparation of the stress-protective immunoregulatory microbe Mycobacterium vaccae NCTC 11,659 (M. vaccae) on the behavioral and epileptogenic consequences of the combined stress-terbutaline (ST) rat model of ASD-like behavior/epilepsy. Repeated immunization of the dam with M. vaccae during pregnancy, followed by immunization of the pups after terbutaline injections, prevented the expression of ASD-like behavior but did not appear to protect against, and may have even enhanced, the spontaneous epileptogenic effects of ST. Maternal M. vaccae injections transferred an anti-inflammatory immunophenotype to offspring, and repeated injections across development prevented ST-induced increases in microglial density at early developmental time points in a region-specific manner. Despite epidemiological comorbidity between ASD/epileptic conditions and shared environmental risk factors, our results suggest that the expression of ASD-like behaviors, but perhaps not epileptogenesis, is sensitive to early anti-inflammatory intervention. These data provide support for the exploration of immunoregulatory strategies to prevent the negative neurodevelopmental behavioral effects of stressors during early critical periods.

Neuroinflammatory priming to stress is differentially regulated in male and female rats.

Exposure to stressors can enhance neuroinflammatory responses, and both stress and neuroinflammation are predisposing factors in the development of psychiatric disorders. Females suffer disproportionately more from several psychiatric disorders, yet stress-induced changes in neuroinflammation have primarily been studied in males. Here we tested whether exposure to inescapable tail shock sensitizes or 'primes' neuroinflammatory responses in male and female rats. At 24 h post-stress, male and female rats exposed to a peripheral immune challenge enhanced neuroinflammatory responses and exacerbated anxiety- and depressive-like behaviors. These changes are likely glucocorticoid dependent, as administering exogenous CORT, caused a similar primed inflammatory response in the hippocampus of male and female rats. Further, stress disinhibited anti-inflammatory signaling mechanisms (such as CD200R) in the hippocampus of male and female rats. In males, microglia are considered the likely cellular source mediating neuroinflammatory priming; stress increased cytokine expression in ex vivo male microglia. Conversely, microglia isolated from stressed or CORT treated females did not exhibit elevated cytokine responses. Microglia isolated from both stressed male and female rats reduced phagocytic activity; however, suggesting that microglia from both sexes experience stress-induced functional impairments. Finally, an immune challenge following either stress or CORT in females, but not males, increased peripheral inflammation (serum IL-1ß). These novel data suggest that although males and females both enhance stress-induced neuroinflammatory and behavioral responses to an immune challenge, this priming may occur through distinct, sex-specific mechanisms.

The Alarmin HMGB1 Mediates Age-Induced Neuroinflammatory Priming.

UNLABELLED: Amplified neuroinflammatory responses following an immune challenge occur with normal aging and can elicit or exacerbate neuropathology. The mechanisms mediating this sensitized or "primed" immune response in the aged brain are not fully understood. The alarmin high mobility group box 1 (HMGB1) can be released under chronic pathological conditions and initiate inflammatory cascades. This led us to investigate whether HMGB1 regulates age-related priming of the neuroinflammatory response. Here, we show that HMGB1 protein and mRNA were elevated in the hippocampus of unmanipulated aged rats (24-month-old F344XBN rats). Furthermore, aged rats had increased HMGB1 in the CSF, suggesting increased HMGB1 release. We demonstrate that blocking HMGB1 signaling with an intracisterna magna (ICM) injection of the competitive antagonist to HMGB1, Box-A, downregulates basal expression of several inflammatory pathway genes in the hippocampus of aged rats. This indicates that blocking the actions of HMGB1 might reduce age-associated inflammatory priming. To test this hypothesis, we evaluated whether HMGB1 antagonism blocks the protracted neuroinflammatory and sickness response to peripheral Escherichia coli (E. coli) infection in aged rats. ICM pretreatment of aged rats with Box-A 24 h before E. coli infection prevented the extended hippocampal cytokine response and associated cognitive and affective behavioral changes. ICM pretreatment with Box-A also inhibited aging-induced potentiation of the microglial proinflammatory response to lipopolysaccharide ex vivo Together, these results suggest that HMGB1 mediates neuroinflammatory priming in the aged brain. Blocking the actions of HMGB1 appears to "desensitize" aged microglia to an immune challenge, thereby preventing exaggerated behavioral and neuroinflammatory responses following infection. SIGNIFICANCE STATEMENT: The world's population is aging, highlighting a need to develop treatments that promote quality of life in aged individuals. Normal aging is associated with precipitous drops in cognition, typically following events that induce peripheral inflammation (e.g., infection, surgery, heart attack). Peripheral immune stimuli cause exaggerated immune responses in the aged brain, which likely underlie these behavioral deficits. Here, we investigated whether the alarmin high mobility group box 1 (HMGB1) mediates age-associated "priming" of the neuroinflammatory response. HMGB1 is elevated in aged rodent brain and CSF. Blocking HMGB1 signaling downregulated expression of inflammatory pathway genes in aged rat brain. Further, HMGB1 antagonism prevented prolonged infection-induced neuroinflammatory and sickness responses in aged rats. Overall, blocking HMGB1 "desensitized" microglia in the aged brain, thereby preventing pathological infection-elicited neuroinflammatory responses.

Disparities in tobacco marketing and product availability at the point of sale: Results of a national study.

OBJECTIVE: Neighborhood socioeconomic and racial/ethnic disparities exist in the amount and type of tobacco marketing at retail, but most studies are limited to a single city or state, and few have examined flavored little cigars. Our purpose is to describe tobacco product availability, marketing, and promotions in a national sample of retail stores and to examine associations with neighborhood characteristics. METHODS: At a national sample of 2230 tobacco retailers in the contiguous US, we collected in-person store audit data on: Availability of products (e.g., flavored cigars), quantity of interior and exterior tobacco marketing, presence of price promotions, and marketing with youth appeal. Observational data were matched to census tract demographics. RESULTS: Over 95% of stores displayed tobacco marketing; the average store featured 29.5 marketing materials. 75.1% of stores displayed at least one tobacco product price promotion, including 87.2% of gas/convenience stores and 85.5% of pharmacies. 16.8% of stores featured marketing below three feet, and 81.3% of stores sold flavored cigars, both of which appeal to youth. Stores in neighborhoods with the highest (vs. lowest) concentration of African-American residents had more than two times greater odds of displaying a price promotion (OR=2.1) and selling flavored cigars (OR=2.6). Price promotions were also more common in stores located in neighborhoods with more residents under age 18. CONCLUSIONS AND RELEVANCE: Tobacco companies use retail marketing extensively to promote their products to current customers and youth, with disproportionate targeting of African Americans. Local, state, and federal policies are needed to counteract this unhealthy retail environment.

Who is behind the stocking of energy-dense foods and beverages in small stores? The importance of food and beverage distributors.

OBJECTIVE: The present study examined food and beverage distributors' sourcing, placement and promotion of obesogenic (energy-dense, nutrient-poor) product categories from the perspective of small food store owners/managers. The obesogenic product categories of interest were savoury snacks, sugary beverages, sweet snacks, confectionery and frozen treats. Specifically, we examined how frequently distributors sourced these products, and the types of agreements and expectations they had for their placement and promotion. Differences were explored by store size and ethnicity. Fresh produce was used as a comparison when examining differences in frequency of sourcing only, with implications for healthy food access. DESIGN: Survey research involving in-person interviews. SETTING: Four urban areas in the USA: Baltimore, MD; Durham, NC; Minneapolis/St. Paul, MN; and San Diego, CA. SUBJECTS: Seventy-two small food store owners/managers, 65 % consent rate. RESULTS: Most distributors sourced obesogenic products weekly. Agreements to place products were predominantly informal (e.g. handshake) with sweet snack, confectionery and frozen treat distributors, and formal (e.g. contract) with savoury snack and sugary beverage distributors. Free-standing displays were the most common incentive provided by distributors and they expected some control over their placement and pricing. Free/discounted products and signage were also common incentives but slotting fees were not. Smaller stores and ethnic stores were less likely to receive various incentives, but among sweet snack distributors, they were more likely to control the price in ethnic v. non-ethnic stores. CONCLUSIONS: Obesogenic products are ubiquitous. Influencing what is made available to consumers in the retail food environment needs to consider the distributor.

Small Food Store Retailers' Willingness to Implement Healthy Store Strategies in Rural North Carolina.

Access to supermarkets is lacking in many rural areas. Small food stores are often available, but typically lack healthy food items such as fresh produce. We assessed small food store retailer willingness to implement 11 healthy store strategies to increase the availability, display, and promotion of healthy foods and decrease the availability, display, and promotion of tobacco products. Interviews were conducted with 55 small food store retailers in three rural North Carolina counties concurrently with store observations assessing current practices related to the strategies. All stores sold low-calorie beverages, sugar-sweetened beverages, candy and cigarettes. Nearly all sold smokeless tobacco and cigars/cigarillos, and 72 % sold e-cigarettes. Fresh fruits were sold at 30.2 % of stores; only 9.4 % sold fresh vegetables. Retailers reported being most willing to stock skim/low-fat milk, display healthy snacks near the register, and stock whole wheat bread. About 50 % were willing to stock at least three fresh fruits and three fresh vegetables, however only 2 % of stores currently stocked these foods. Nearly all retailers expressed unwillingness to reduce the availability of tobacco products or marketing. Our results show promise for working with retailers in rural settings to increase healthy food availability in small food stores. However, restrictions on retail tobacco sales and marketing may be more feasible through local tobacco control ordinances, or could be included with healthy foods ordinances that require stores to stock a minimum amount of healthy foods.

Stable, long-term, spatial memory in young and aged rats achieved with a one day Morris water maze training protocol.

Here, we present data demonstrating that a 1 d Morris water maze training protocol is effective at producing stable, long-term spatial memory in both young (3 mo old) and aged (24 mo old) F344xBN rats. Four trials in each of four sessions separated by a 2.5 h ISI produced robust selective search for the platform 1 and 4 d after training, in both age groups. A 1 h ISI protocol did not produce good retention. Also, compressing the trials into just two sessions separated by a 2.5 h ISI produced limited retention in only young rats.

Sociodemographic Disparities in Proximity of Schools to Tobacco Outlets and Fast-Food Restaurants.

OBJECTIVES: To examine the association of school sociodemographic characteristics with tobacco outlet and fast-food restaurant availability near schools in a national study. METHODS: Business lists and data from the National Center for Education Statistics were used to calculate the numbers of tobacco outlets and fast-food restaurants within 800 meters of public schools in 97 US counties. RESULTS: More than 50% of schools with a majority of Hispanic students had both a fast-food restaurant and tobacco outlet nearby, compared with 21% of schools with a majority of White students. In adjusted models, each 10% increase in the number of low-income and Hispanic students enrolled in a school led to a 3% to 5% increase in the odds of the school having both a fast-food restaurant and a tobacco outlet nearby. CONCLUSIONS: Low-income and Hispanic students are disproportionately exposed to both tobacco outlets and fast-food restaurants near their schools. Easy access to tobacco products and fast food may influence youth smoking initiation and contribute to poor dietary intake.

Integrating Tobacco Control and Obesity Prevention Initiatives at Retail Outlets.

Tobacco products are sold in approximately 375,000 US retail outlets, including convenience stores and pharmacies, which often sell energy-dense, low-nutrient foods and beverages. The Food and Drug Administration's (FDA's) increased authority over tobacco product sales and marketing, combined with declining smoking rates, provides an opportunity to transition tobacco retailers toward healthier retail environments. Unfortunately, research into improving consumer retail environments is often conducted in isolation by researchers working in tobacco control, nutrition, and physical activity. Interdisciplinary efforts are needed to transform tobacco retailers from stores that are dependent on a declining product category, to the sale and promotion of healthful foods and creating environments conducive to active living. The objective of this article is to describe the potential for interdisciplinary efforts to transition retailers away from selling and promoting tobacco products and toward creating retail environments that promote healthful eating and active living.

Calcium dysregulation via L-type voltage-dependent calcium channels and ryanodine receptors underlies memory deficits and synaptic dysfunction during chronic neuroinflammation.

BACKGROUND: Chronic neuroinflammation and calcium (Ca(+2)) dysregulation are both components of Alzheimer's disease. Prolonged neuroinflammation produces elevation of pro-inflammatory cytokines and reactive oxygen species which can alter neuronal Ca(+2) homeostasis via L-type voltage-dependent Ca(+2) channels (L-VDCCs) and ryanodine receptors (RyRs). Chronic neuroinflammation also leads to deficits in spatial memory, which may be related to Ca(+2) dysregulation. METHODS: The studies herein use an in vivo model of chronic neuroinflammation: rats were infused intraventricularly with a continuous small dose of lipopolysaccharide (LPS) or artificial cerebrospinal fluid (aCSF) for 28 days. The rats were treated with the L-VDCC antagonist nimodipine or the RyR antagonist dantrolene. RESULTS: LPS-infused rats had significant memory deficits in the Morris water maze, and this deficit was ameliorated by treatment with nimodipine. Synaptosomes from LPS-infused rats had increased Ca(+2) uptake, which was reduced by a blockade of L-VDCCs either in vivo or ex vivo. CONCLUSIONS: Taken together, these data indicate that Ca(+2) dysregulation during chronic neuroinflammation is partially dependent on increases in L-VDCC function. However, blockade of the RyRs also slightly improved spatial memory of the LPS-infused rats, demonstrating that other Ca(+2) channels are dysregulated during chronic neuroinflammation. Ca(+2)-dependent immediate early gene expression was reduced in LPS-infused rats treated with dantrolene or nimodipine, indicating normalized synaptic function that may underlie improvements in spatial memory. Pro-inflammatory markers are also reduced in LPS-infused rats treated with either drug. Overall, these data suggest that Ca(+2) dysregulation via L-VDCCs and RyRs play a crucial role in memory deficits resulting from chronic neuroinflammation.