Search

The purpose of the current research was to determine if mothers of preschool-aged children enrolled in Head Start perceived their children's weight status accurately. Participants included 281 mothers who were primarily African American (84%), with a mean age of 27.4 years. Mothers were asked to describe their children's weight status as underweight, normal weight, close to being overweight, or overweight. Children's measured height and weight were obtained from Head Start records, and each child's body mass index (BMI, kg/[m.sup.2]) was calculated. Children's weight status was classified as underweight, normal weight, at risk of overweight, or overweight based on current Centers for Disease Control and Prevention (CDC) criteria using BMI-for-age percentiles. A chi-square test of independence comparing maternal perception of children's weight status with children's actual weight classification was significant [/2 (N = 281, df = 9) = 52.16, P < .001]. Standardized residuals were then analyzed. Results indicated that underestimation of children's weight status by mothers was prevalent. Fifty-six children were classified as overweight based on CDC criteria; of these, only 2 (3.6%) were perceived as overweight by their mothers. Of the 236 mothers who perceived their children to be of normal weight, 41 (17.4%) had children who were classified as at risk of overweight and 42 (17.8%) had children who were classified as overweight based on CDC criteria. Interventions to increase maternal awareness of childhood overweight and its potential consequences are warranted in this population. Funded by the USDA Southern Rural Development Center.

Abstract: The effectiveness of community-based participatory research (CBPR) efforts to address the disproportionate burden of hypertension among African Americans remains largely untested. The objective of this 6-month, noncontrolled, pre-/post-experimental intervention was to examine the effectiveness of a CBPR intervention in achieving improvements in blood pressure, anthropometric measures, biological measures, and diet. Conducted in 2010, this multicomponent lifestyle intervention included motivational enhancement, social support provided by peer coaches, pedometer diary self-monitoring, and monthly nutrition and physical activity education sessions. Of 269 enrolled participants, 94% were African American and 85% were female. Statistical analysis included generalized linear mixed models using maximum likelihood estimation. From baseline to 6 months, blood pressure decreased significantly: mean (±standard deviation) systolic blood pressure decreased from 126.0±19.1 to 119.6±15.8 mm Hg, P=0.0002; mean diastolic blood pressure decreased from 83.2±12.3 to 78.6±11.1 mm Hg, P<0.0001). Sugar intake also decreased significantly as compared with baseline (by approximately 3 tsp; P<0.0001). Time differences were not apparent for any other measures. Results from this study suggest that CBPR efforts are a viable and effective strategy for implementing nonpharmacologic, multicomponent, lifestyle interventions that can help address the persistent racial and ethnic disparities in hypertension treatment and control. Outcome findings help fill gaps in the literature for effectively translating lifestyle interventions to reach and engage African-American communities to reduce the burden of hypertension. [Copyright &y& Elsevier]

Objective: Identification of prominent themes to be considered when planning a nutrition intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Design: Qualitative formative research. Setting: Women's social and civic organizations in the Lower Mississippi Delta. Participants: Thirty-seven (5 white and 32 black) women with a college degree or higher. Phenomenon of Interest: Impact of dietary and contextual factors related to the Lower Mississippi Delta culture on intervention planning. Analysis: Case analysis strategy using question-by-question coding. Results: Major themes that emerged were "healthy eating focus" and "promoting a healthy lifestyle" when recruiting organizations (Reach); "positive health changes" as a result of the intervention (Effectiveness); "logistics: time commitment, location, and schedule" to initiate a program (Adoption); "expense of healthy foods" and "cooking and meal planning" as barriers to participation (Implementation); and "resources and training" and "motivation" as necessary for program continuation (Maintenance). The "health of the Delta" theme was found across all dimensions, which reflected participants' compassion for their community. Conclusions and Implications: Results were used to develop an implementation plan promoting optimal reach, effectiveness, adoption, implementation, and maintenance of a nutrition intervention. This research emphasizes the benefits of formative research using a systematic process at organizational and individual levels. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the efficacy and safety of atorvastatin versus placebo in modifying lipids in patients with rheumatoid arthritis (RA) receiving the oral Janus kinase inhibitor, tofacitinib. Methods A randomised, placebo controlled, multicentre phase 2 study, open-label for tofacitinib and blinded for atorvastatin. Patients received tofacitinib 10 mg twice daily for 12 weeks; at week 6, patients were randomly assigned 1:1 to receive oral atorvastatin 10 mg once daily or placebo for 6 weeks. Main outcome measures were lipid moieties, American College of Rheumatology (ACR) response rates, disease activity score in 28 joint counts and safety. Results 111 patients meeting ACR 1987 RA criteria with active disease were enrolled. Tofacitinib-induced elevation of mean total, low-density lipoprotein (LDL) and high-density lipoprotein-cholesterol, triglycerides and apolipoprotein A-1 concentrations were sustained in placebo recipients to week 12; atorvastatin added at week 6 significantly reduced tofacitinib-associated increases in total and LDL-cholesterol, triglycerides and apolipoprotein B to below week 0 levels. Co-administration of atorvastatin resulted in a significant reduction of LDL-cholesterol versus placebo ( primary endpoint; p<0.0001); from week 6 to week 12 the least squares mean reduction was 35.3% with atorvastatin, versus 5.8% increase with placebo. ACR responses were observed with tofacitinib; numerically greater rates were seen with atorvastatin versus placebo. Adverse events were consistent with phase 3 studies. Conclusions Tofacitinib-associated elevated total and LDL-cholesterol and triglycerides were rapidly and significantly reduced by atorvastatin. Further investigation is required to explore the significance of reductions in RA disease activity in patients receiving tofacitinib and atorvastatin. [ABSTRACT FROM AUTHOR]

Objective: To compare differences across food groups for food cost, energy, and nutrient profiles of 100 items from a cross-sectional survey of 225 stores in 18 counties across the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi. Methods: Energy, nutrient, and cost profiles for food items were calculated by using Naturally Nutrient Rich methodology and converting price per 100 g edible portion to price per serving. Foods were grouped into 6 food groups. Mean differences were compared with ANOVA. Results: Significant differences existed by food group for each measure. Energy density was highest for fats/oils/sweets, whereas nutrient density was highest for vegetables. Price per serving was lowest for fats/ oils/sweets and highest for meats. Conclusions and Implications: Educational messages focusing on a complete diet should consider the role of food costs and provide specific recommendations for increasing nutrient-dense foods by replacing a portion of the meat serving at meals with culturally acceptable lower-cost nutrient-dense foods. [ABSTRACT FROM AUTHOR]

The majority of adult diets in the United States, particularly the South, are of poor quality, putting these individuals at increased risk for chronic diseases. In this study, simulation modeling was used to determine the effects of substituting familiar, more healthful foods and beverages for less healthy ones on diet quality and total energy intake in Lower Mississippi Delta (LMD) adults. Dietary data collected in 2000 for 1689 LMD adults who participated in the Foods of Our Delta Study were analyzed. The Healthy Eating Index-2005 (HEI-2005) was used to measure diet quality. The effects of substituting targeted foods and beverages with more healthful items on diet quality were simulated by replacing the targeted items' nutrient profile with their replacements' profile. For the single food and beverage groups, 100% replacement of grain desserts with juice-packed fruit cocktail and sugar-sweetened beverages with water resulted in the largest improvements in diet quality (4.0 and 3.8 points, respectively) and greatest decreases in total energy intake (98 and 215 kcal/d, respectively). The 100% substitution of all food and beverage groups combined resulted in a 12.0-point increase in HEI-2005 score and a decrease of 785 kcal/d in total energy intake. Community interventions designed to improve the diet of LMD adults through the use of familiar, healthy food and beverage substitutions have the potential to improve diet quality and decrease energy intake of this health disparate population. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine Fritz Machlup's method and use of scenario analysis in the policy discussions around exchange rate solutions to balance of payments problems. Design/methodology/approach – The qualitative research on which this paper is based is the sociohistorical biographical approach, based on a close examination of published works and archival materials. Findings – What makes Machlup unique is his focus on the impact to an economic system of discrete human actions, each set of actions associated with a change in exchange rate policy and the operations and institutions necessary to implement it. Impact on the system was evaluated in terms of three values – balance of payments adjustment, liquidity and confidence. In his use of a system's approach, his focus on change and adjustment to change, and most particularly his focus on human action, Machlup is also distinctively Austrian. Research limitations/implications – This is the first paper generated from the author's far larger planned study of Fritz Machlup and the Bellagio Group. Practical implications – The collaborative exploration of alternative futures by senior teams has become increasingly important to strategic planning by governments and corporations. Originality/value – The story of the Fritz Machlup's contribution to exchange rate regimes, international trade and the balance of payments has remained largely untold. [ABSTRACT FROM AUTHOR]

Purpose – The central focus of this paper is the mentorship relationship of economist Fritz Machlup and his graduate student Edith Penrose, and specifically how that relationship contributed both to her development as a scholar and to her seminal work, The Theory of the Growth of the Firm.Design/methodology/approach – The qualitative research on which this paper is based is the sociohistorical biographical approach, based on a close examination of published works and archival materials. Content analysis is used to draw inferences about Fritz Machlup's mentoring content, style, and impact on Penrose's methodology and argumentation as reflected in The Theory of the Growth of the Firm, and the correspondence exchanged while Penrose was writing The Theory of the Growth of the Firm.Findings – The Theory of the Growth of the Firm mirrors Machlup's methodology and methodological framework. The arguments supporting Penrose's theoretic model of the growth of firms were discussed, debated and shaped by the exchange of ideas in the Penrose/Machlup correspondence. Originality/value – While Penrose's work has been acknowledged as "breakthrough" in the areas of entrepreneurship and firm growth, there has been little recognition of the role of her mentor in its creation. This study sets out to correct what would appear to be an historical oversight as well as to understand how Machlup practiced mentorship; how he perceived the roles of mentor and mentee; Machlup's contribution to his graduate students, and the extent to which his students incorporated the learning into their own work. [ABSTRACT FROM AUTHOR]

Purpose – The article looks at how companies pursuing a three-horizon growth strategy weathered the last economic downturn and what became of their growth initiatives. Design/methodology/approach – The paper examines the financial performance and continued investment of three growing companies from 1996-2004: Bombardier (Canada), Hutchison Whampoa (Hong Kong/China) and Disney (US). Findings – The Bombardier, Disney and Hutchison Whampoa cases teach a powerful lesson about the importance of using investment in growth to manage uncertainty and limit downside risk. Research limitations/implications – While the focus of this article is on three companies only, the financial performances of a dozen other growing firms are examined over the same period for purposes of comparison. Practical implications – Following the last downturn, companies sought to preserve the core and outsource non-critical functions to reduce the cost of business. Some chose to sideline growth initiatives during this period. This article analyzes the outcomes for three companies that continued to invest in growth during and after this period. Originality/value – This article addresses a series of questions. Is a three-horizon growth strategy sustainable in a downturn? Have companies that pursued a three-horizon strategy actually grown? Do they continue to finance the growth of horizon two and horizon three businesses? Have any viable options matured? [ABSTRACT FROM AUTHOR]

Context. Studies examining the association between food insecurity and obesity in adults have produced conflicting results, and information is limited on the relationship between food insecurity and adult chronic health conditions, particularly in a high-risk population. Objective. To examine the association between household food insecurity and self-reported weight status and chronic disease in the Lower Mississippi Delta. Design. A two-stage stratified cluster sample representative of the population in 36 counties in the Lower Delta. Data were collected in a cross-sectional telephone survey using list assisted random digit dialing telephone methodology. Setting and Participants. A randomly selected sample of 1,457 adults from a free-living population. Main Outcome Measures. US Food Security Survey Module, self-reported height and weight status (obesity = body mass index > 30 kg/m²), and self-reported hypertension, high cholesterol, diabetes, heart disease, stroke, and a marker for metabolic syndrome. Results. In food-insecure adults, 42.3% were obese, a significantly higher rate than food secure adults (33.2%). After controlling for demographic variables, food insecurity was not independently associated with obesity. Income and the interaction between race and gender were significant predictors of obesity. Food insecure adults were significantly more likely to report hypertension (45.1% vs. 29.5%) diabetes (15.0% vs. 9.3%), heart disease (13.5% vs. 6.8%) and metabolic syndrome (10.1% vs. 4.4%). After controlling for demographic variables, food insecurity was associated with high cholesterol (Odds Ratio [OR] 1.65; 95% Confidence Interval [CI], 1.0 to 2.7), heart disease (OR 2.7: 95% CI, 1.5 to 4.8), and metabolic syndrome (OR 2.8; 95% CI, 1.4 to 5.5). Conclusions. The relationship between food insecurity and obesity in a high-risk population, may be due to income and demographic variables. Individuals in a rural high-risk population with high cholesterol, heart disease, and metabolic syndrome have a high likelihood of being food-insecure. Nutritional interventions targeting high-risk populations should address food insecurity. [ABSTRACT FROM AUTHOR]

Objective: The ORAL Surveillance trial found a dose‐dependent increase in venous thromboembolism (VTE) and pulmonary embolism (PE) events with tofacitinib versus tumor necrosis factor inhibitors (TNFi). We aimed to assess VTE incidence over time and explore risk factors of VTE, including disease activity, in ORAL Surveillance. Methods: Patients with rheumatoid arthritis (RA) aged 50 years or older with at least one additional cardiovascular risk factor received tofacitinib 5 or 10 mg twice daily (BID) or TNFi. Post hoc, cumulative probabilities and incidence rates (patients with first events/100 patient‐years) by 6‐month intervals were estimated for adjudicated VTE, deep vein thrombosis, and PE. Cox regression models identified risk factors. Clinical Disease Activity Index leading up to the event was explored in patients with VTE. Results: Cumulative probabilities for VTE and PE were higher with tofacitinib 10 mg BID, but not 5 mg BID, versus TNFi. Incidence rates were consistent across 6‐month intervals within treatments. Across treatments, risk factors for VTE included prior VTE, body mass index greater than or equal to 35 kg/m2, older age, and history of chronic lung disease. At the time of the event, most patients with VTE had active disease as defined by Clinical Disease Activity Index. Conclusion: Incidences of VTE and PE were higher with tofacitinib (10 > 5 mg BID) versus TNFi and were generally consistent over time. Across treatments, VTE risk factors were aligned with previous studies in the general RA population. These data highlight the importance of assessing VTE risk factors, including age, body mass index, and VTE history, when considering initiation of tofacitinib or TNFi in patients with active RA. [ABSTRACT FROM AUTHOR]