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Background Children in the USA are experiencing obesity and overweight at epidemic rates. Schools have started to make policy decisions based on a popularly presumed connection between nutrition and academic achievement. This study aimed to determine whether such a relationship exists, and if so, its nature. Methods Data from the Food Consumption Questionnaire administered to approximately 12 000 fifth graders as part of the nationally representative Early Childhood Longitudinal Study-Kindergarten Cohort was analysed using regression analysis. The analysis used propensity score matching to examine the relationship between students' reported fast-food consumption and their test scores in reading and mathematics. Propensity score matching attempts to control for a host of background characteristics that might be correlated with both fast-food consumption and test scores. Results Standard ordinary least squares regression showed that test scores decreased as reported fast-food consumption increased. In the propensity-score-matched analysis, which controlled for 25 student background characteristics, higher-than-average fast-food consumption ('four to six times in the last 7 days' or more) was associated with significantly lower test scores in both reading (−11.15 points or 0.48 SD) and math (−11.13 points or 0.52 SD), even when teacher experience, school poverty level and school urbanicity were also included in the model. Conclusions Although this study is preliminary, its results indicate that the relationship between poor nutrition and test scores may in fact be quite negative, strengthening the impetus for schools to consider policies that support students' healthy eating. In order to strengthen these findings and investigate possible mechanisms through which poor nutrition might affect test scores, there is a need for further research. [ABSTRACT FROM AUTHOR]

Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006-2009 identified individual and social network characteristics of Black MSM ( n  = 226) that are associated with disclosure that may be leveraged to increase disclosure. Over two-thirds (68.1%) of the sample had ever disclosed to HCPs. Part-time employment (AOR = 0.32, 95% CI = 0.11-0.95), bisexual identity (AOR = 0.29, 95% CI = 0.12-0.70), and meeting criteria for alcohol use disorders (AOR = 0.32, 95% CI = 0.14-0.75) were negatively associated with disclosure. Disclosers were more likely to self-report being HIV-positive (AOR = 4.47, 95% CI = 1.54-12.98), having more frequent network socialization (AOR = 2.15, 95% CI = 1.24-3.73), and having a social network where all members knew the participant had sex with men (AOR = 4.94, 95% CI = 2.06-11.86). These associations were not moderated by self-reported HIV status. Future interventions to help MSM identify social network members to safely disclose their same-sex behavior may also help disclosure of same-sex behavior to HCPs among Black MSM.

Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend's house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals' HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.

Background: The release of the Center for Medicare and Medicaid Service's (CMS) latest quality measure, Severe Sepsis/Septic Shock Early Management Bundle (SEP-1), has intensified the long-standing debate over optimal care for severe sepsis and septic shock. Although the last decade of research has demonstrated the importance of comprehensive bundled care in conjunction with compliance mechanisms to reduce patient mortality, it is not clear that SEP-1 achieves this aim. The heterogeneous and often cryptic presentation of severe sepsis and septic shock, along with the multifaceted criteria for the definition of this clinical syndrome, pose a particular challenge for fitting requirements to this disease, and implementation could have unintended consequences., Objective: Following a simulated reporting exercise, in which 50 charts underwent expert review, we aimed to detail the challenges of, and offer suggestions on how to rethink, measuring performance in severe sepsis and septic shock care., Discussion: There were several challenges associated with the design and implementation of this measure. The ambiguous definition of severe sepsis and septic shock, prescriptive fluid volume requirements, rigid reassessment, and complex abstraction logic all raise significant concern., Conclusions: Although SEP-1 represents an important first step in requiring hospitals to improve outcomes for patients with severe sepsis and septic shock, the current approach must be revisited. The volume and complexity of the currently required SEP-1 reporting elements deserve serious consideration and revision before they are used as measures of accountability and tied to reimbursement., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: The Combined Analysis of Psychiatric Studies (CAPS) project conducted extensive review and regularization across studies of all schizophrenia linkage data available as of 2011 from the National Institute of Mental Health-funded Center for Collaborative Genomic Studies on Mental Disorders, also known as the Human Genetics Initiative (HGI). The authors reanalyzed the data using statistical methods tailored to accumulation of evidence across multiple, potentially highly heterogeneous, sets of data., Method: Data were subdivided based on contributing study, major population group, and presence or absence within families of schizophrenia with a substantial affective component. The posterior probability of linkage (PPL) statistical framework was used to sequentially update linkage evidence across these data subsets (omnibus results)., Results: While some loci previously implicated using the HGI data were also identified in the present omnibus analysis (2q36.1, 15q23), others were not. Several loci were found that had not previously been reported in the HGI samples but are supported by independent linkage or association studies (3q28, 12q23.1, 11p11.2, Xq26.1). Not surprisingly, differences were seen across population groups. Of particular interest are signals on 11p15.3, 11p11.2, and Xq26.1, for which data from families with a substantial affective component support linkage while data from the remaining families provide evidence against linkage. All three of these loci overlap with loci reported in independent studies of bipolar disorder or mixed bipolar-schizophrenia samples., Conclusions: Public data repositories provide the opportunity to leverage large multisite data sets for studying complex disorders. Analysis with a statistical method specifically designed for such data enables us to extract new information from an existing data resource.

Human geneticists are increasingly turning to study designs based on very large sample sizes to overcome difficulties in studying complex disorders. This in turn almost always requires multi-site data collection and processing of data through centralized repositories. While such repositories offer many advantages, including the ability to return to previously collected data to apply new analytic techniques, they also have some limitations. To illustrate, we reviewed data from seven older schizophrenia studies available from the NIMH-funded Center for Collaborative Genomic Studies on Mental Disorders, also known as the Human Genetics Initiative (HGI), and assessed the impact of data cleaning and regularization on linkage analyses. Extensive data regularization protocols were developed and applied to both genotypic and phenotypic data. Genome-wide nonparametric linkage (NPL) statistics were computed for each study, over various stages of data processing. To assess the impact of data processing on aggregate results, Genome-Scan Meta-Analysis (GSMA) was performed. Examples of increased, reduced and shifted linkage peaks were found when comparing linkage results based on original HGI data to results using post-processed data within the same set of pedigrees. Interestingly, reducing the number of affected individuals tended to increase rather than decrease linkage peaks. But most importantly, while the effects of data regularization within individual data sets were small, GSMA applied to the data in aggregate yielded a substantially different picture after data regularization. These results have implications for analyses based on other types of data (e.g., case-control GWAS or sequencing data) as well as data obtained from other repositories.

Using a social network approach to recruitment, we analyzed the factors that predicted recruitment of an HIV seropositive network member by active injection drug users (IDUs). IDUs were asked to bring in drug and sex network members, whom they delineated on a social network inventory. The 297 index participants recruited 425 networks, of whom 17.3% were seropositive. The majority of seropositive members were recruited by IDUs who reported no seropositive risk network members. The strongest predictor of recruiting seropositives was ethnicity, with African American indexes more than 3 times more likely than others to recruit seropositives as compared to other ethnic groups. Those African American indexes who reported that they had no seropositive network members were over 10 times more likely to recruit a seropositive. These results suggest the feasibility to target active drug users to recruit seropositives and emphasize the public health importance of focusing network approaches on the networks of African American IDUs.

Few studies have examined sexual risk behaviors of HIV-positive, heterosexual, injection drug using (IDU) men. We investigated such behaviors and associations with risk among sexually active, HIV-positive IDU men who reported only female sex partners in the 3 months prior to baseline interview. We examined associations separately for four non-exclusive groups of men by crossing partner type (main or casual) and partner serostatus (HIV-positive or HIV-negative/unknown). Of 732 male participants, 469 (64%) were sexually active with only female partners. Of these 469 men, 155 (33%) reported sex with HIV-positive main partners, 127 (27%) with HIV-negative or unknown serostatus main partners, 145 (31%) with HIV-positive casual partners, and 192 (41%) with HIV-negative/unknown serostatus casual partners. Significant multivariate associations for unprotected sex with HIV-negative or unknown serostatus main partners were less self-efficacy to use condoms, weaker partner norms supporting condoms, and more negative condom beliefs. Similar correlates were found for unprotected sex with HIV-positive main and casual partners. In addition, alcohol or drug use during sex was a significant correlate of unprotected sex with HIV-positive main partners, while depression was significant for HIV-positive casual partners. For unprotected sex with HIV-negative/unknown status casual partners, self-efficacy for condom use, sex trade, and education were significant multivariate correlates. A combination of broad and tailored intervention strategies based on the relationship pattern of men's lives may provide the most benefit for reducing unprotected sex with female partners.