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PurposeSince 2011, US authorities have supported the following 2 approaches to healthier body fat composition: the Centers for Disease Control and Prevention National Diabetes Prevention Program's calorie counting (CC) approach and the US Department of Agriculture's MyPlate (adherence to federal nutrition guidelines). The purpose of this study was to compare the effect of CC vs MyPlate approaches on satiety/satiation and on achieving healthier body fat composition among primary care patients.MethodsWe conducted a randomized controlled trial comparing the CC and MyPlate approaches from 2015 to 2017. The adult participants were overweight, of low income, and were mostly Latine (n = 261). For both approaches, community health workers conducted 2 home education visits, 2 group education sessions, and 7 telephone coaching calls over a period of 6 months. Satiation and satiety were the primary patient-centered outcome measures. Waist circumference and body weight were the primary anthropometric measures. Measures were assessed at baseline, 6 months, and 12 months.ResultsSatiation and satiety scores increased for both groups. Waist circumference was significantly decreased in both groups. MyPlate, but not CC, resulted in lower systolic blood pressure at 6 months but not at 12 months. Participants for both MyPlate and CC reported greater quality of life and emotional well-being and high satisfaction with their assigned weight-loss program. The most acculturated participants showed the greatest decreases in waist circumference.ConclusionsA MyPlate-based intervention might be a practical alternative to the more traditional CC approach to promoting satiety and facilitating decreases in central adiposity among low-income, mostly Latine primary care patients.

IntroductionChildhood obesity disproportionately affects low-income women, children, racial/ethnic minorities, and rural populations. To effectively promote sustainable change, healthy eating and active living initiatives should apply individual plus policy, systems, and environmental (I + PSE) approaches.MethodsFour public health maternal and child nutrition teams selected through an application process participated in 12 months of technical assistance (TA) to develop action plans incorporating I + PSE in nutrition programming. TA included: (1) online modules; (2) community of practice (CoP) meetings; and (3) individual coaching sessions. Teams completed midpoint and endpoint surveys to assess TA knowledge and process outcomes. Semi-structured, in-depth interviews conducted post TA were transcribed and content analysis used to characterize themes and sub-themes.ResultsFacilitators to implementing I + PSE approaches included TA delivery through online modules, participation in the CoP, and individual coaching to address barriers to implementation and leadership support. Barriers were time and funding limitations, working in isolation, and lack of infrastructure and self-efficacy. Co-learning helped TA teams overcome stagnancy and promote development of creative solutions. Teams recognized relationship-building as integral to systems development.DiscussionLessons learned occurred across three main areas: relationships, capacity-building, and barriers encountered. Relationship formation takes time and is often not recognized as an asset impacting public health programing. Relationship direction - upstream, downstream, and lateral - affects ability to build organizational and systems capacity. While this study includes a small number of public health nutrition teams, this practice-based research highlights the value of I + PSE TA to tackle complex problems, with reciprocal, multisectoral support to enhance public health nutrition program impact.

Unrecognized grief (also called disenfranchised grief) is an emotion experienced when a loss is not socially supported, mourned, or acknowledged (Doka, 1989). Elementary students often experience unrecognized grief when relationships with friends, family, teachers, support professionals, and pets change or end. While these developments are often a normal part of life, elementary students experience grief that may lead to academic or behavioral difficulties in school. The purpose of this article is to review the concept of unrecognized grief experienced by elementary students due to relationship loss and provide school counselors with individual, group, and system-wide strategies.

Background: Quality early childhood education (ECE) sets the foundation for children's healthy development. Families make choices regarding the ECE options available to them, and families who desire smaller, more personal, flexible, and less expensive options, often select family child care (FCC) providers over center-based care. In addition, trending research in the United States indicates that there is a decline of FCC providers leading to a gap in the available resources for families. Objective: This study explored the experiences of family child care providers regarding the challenges and benefits of their profession. Methods: Two focus groups (N = 27) comprised of licensed and unlicensed FCC providers were conducted to understand their perspectives on the perceived challenges and benefits of their work. Results: Using Bromer and Korfmacher's conceptual model of high-quality support, we conducted a thematic analysis and found providers identified several challenges including: feeling uncomfortable in their home, payment and scheduling issues, frustration with parents, limited resources, and role conflicts. Providers also described strategies for managing their family childcare program including utilizing critical early childhood education learning strategies with children, separating personal and work spaces, using contracts, and the importance of networking with other professionals. Providers also shared benefits of FCC for the children in their care, themselves, and their own families. Conclusions: The findings align with Bromer and Korfmacher's (2017) conceptual model and suggest a need for networking opportunities to provide information and support amongst FCC providers, improved resource sharing, more accessible funding opportunities, and the need for business training tools.

NASA's Deriving Information on Surface Conditions from Column and Vertically Resolved Observations Relevant to Air Quality (DISCOVER-AQ, conducted in 2011-2014) campaign in the United States and the joint NASA and National Institute of Environmental Research (NIER) Korea-United States Air Quality Study (KORUS-AQ, conducted in 2016) in South Korea were two field study programs that provided comprehensive, integrated datasets of airborne and surface observations of atmospheric constituents, including nitrogen dioxide (NO2), with the goal of improving the interpretation of spaceborne remote sensing data. Various types of NO2 measurements were made, including in situ concentrations and column amounts of NO2 using ground- and aircraft-based instruments, while NO2 column amounts were being derived from the Ozone Monitoring Instrument (OMI) on the Aura satellite. This study takes advantage of these unique datasets by first evaluating in situ data taken from two different instruments on the same aircraft platform, comparing coincidently sampled profile-integrated columns from aircraft spirals with remotely sensed column observations from ground-based Pandora spectrometers, intercomparing column observations from the ground (Pandora), aircraft (in situ vertical spirals), and space (OMI), and evaluating NO2 simulations from coarse Global Modeling Initiative (GMI) and high-resolution regional models. We then use these data to interpret observed discrepancies due to differences in sampling and deficiencies in the data reduction process. Finally, we assess satellite retrieval sensitivity to observed and modeled a priori NO2 profiles. Contemporaneous measurements from two aircraft instruments that likely sample similar air masses generally agree very well but are also found to differ in integrated columns by up to 31.9 %. These show even larger differences with Pandora, reaching up to 53.9 %, potentially due to a combination of strong gradients in NO2 fields that could be missed by aircraft spirals and errors in the Pandora retrievals. OMI NO2 values are about a factor of 2 lower in these highly polluted environments due in part to inaccurate retrieval assumptions (e.g., a priori profiles) but mostly to OMI's large footprint (> 312 km2).

BackgroundPrimary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation.MethodsA comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation.AnalysisBaseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression.ResultsTwo thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m2; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality.ConclusionsThe two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality.Trial registrationNCT02514889 , posted on 8/4/2015.

• The cervical aortic arch is a congenital protrusion of the arch above the clavicle. • Two classifications have been proposed—by Haughton and by Zhong. • Often asymptomatic, it can present symptoms related to vascular compression. • In adults, most patients are female, often have a left-sided cervical aortic arch, and have a case associated with aneurysms. • Zhong's classification is capable of identifying additional anatomical features. The cervical aortic arch (CAA) is an uncommon congenital anomaly in aortic development, characterized by an elongated aortic arch extending at or above the medial ends of the clavicles. Our objective was to examine the clinical and surgical characteristics of this infrequent condition in the adult population. PubMed, ScienceDirect, SciELO, DOAJ, and Cochrane Library databases were searched until December 2023 for case reports describing the presence of a cervical aortic arch in patients aged ≥18 years. Case reports and series were included if the following criteria were met: (1) description of the cervical aortic arch, (2) age ≥18 years, and (3) English language. The literature search identified 2,325 potentially eligible articles, 61 of whom met our inclusion criteria and included a combined number of 71 patients. Mean age was 38.6 ± 15.4 years, with a female prevalence of 67.1% (47/70). Two-thirds of the CAA were left-sided (48/71, 67.6%), and 62.0% (44/71) of patients presented a concomitant arch aneurysm. Asymptomatic patients were 45.7% (32/70), while of those that were symptomatic, 60.5% (23/38) had symptoms related to vascular-induced compression of trachea and esophagus. Surgery was performed in 42 patients (62.7%) among 67 cases that reported the patient's treatment, and 5 patients (11.9%) among those surgically treated underwent the procedure through an endovascular approach. CAA is an uncommon congenital abnormality that presents challenges in diagnosis and treatment due to its high anatomical variability, diverse clinical manifestations, and presence of concomitant diseases. Surgery seems to be a safe and effective option for the resolution of symptoms. [Display omitted] [ABSTRACT FROM AUTHOR]

This article examines how an orientation toward "hope" can guide institutions of higher education in achieving their ultimate purpose of providing education for the common good of society. In today's cultural context, colleges and universities must navigate a multitude of challenges and competing philosophies, many of which question the validity of their inherent value and purpose. As society continues to press questions of market relevance, sustainability, accessibility, quality, and the value of higher education, a basic question remains: How, amid all of these challenges, can today's postsecondary institutions contribute to the cultivation of a better society? In this regard, faith-based colleges and universities can offer guidance. By carrying out their distinctive mandate of infusing their educational mission with the holistic character formation of students, these institutions can promote the common good by coupling the Gospel message of personal hope in Jesus Christ with the call to cultural influence and transformation. To demonstrate this concept, a framework is offered that describes both a starting point--a biblical foundation for understanding humanity and hope--and a pathway through learning. The application of this framework--uncommon learning for the common good--invites implications for curricular design, the facilitation of learning, and institutional leadership that faculty and administrators from across the spectrum of higher education may find timely and relevant to their own learning contexts.

Although race is one of the most salient status characteristics in American society, many observers cannot distinguish the racial ancestries of multiracial youth. This paper examines how people perceive multiracial adolescents: specifically, I investigate whether observers perceive the adolescents as multiracial and whether these racial perceptions are congruent with the multiracial adolescents' self-identifications. Results show that 1) observers perceived close to half of multiracial targets as monoracial, 2) multiracial targets who identified themselves as black were nearly always perceived as black but not always as multiracial, and 3) the demographic and environmental characteristics of observers had no bearing on the congruence of their racial perceptions. That is, regardless of their own demographic characteristics or exposure to people of other races, observers were more congruent when examining targets who self-identified as black or white and less congruent when identifying targets from Asian, Hispanic, American Indian, or Middle Eastern backgrounds. Despite the demographic trend toward multiracialism in the United States, observers' perceptions may maintain the status quo in race relations: a black-white dichotomy where part-blacks remain in the collective black category. (Contains 10 footnotes, 6 tables, and 3 figures.)

The study presented here tested three theories of racial differences in academic performance among monoracial and multiracial high school students. These theories (status attainment, oppositional culture, and educational attitudes) were developed to explain differences in achievement among monoracial groups, but the study tested how the theories apply to a multiracial sample. The results show that ethnic identity and experiences of ethnic discrimination are not strong factors in explaining academic performance among multiracial or monoracial students. Instead, the grades of multiracial students are related to their concrete beliefs about the consequences of school failure, the educational values of their peers, and the racial composition of their neighborhoods and schools. Additional descriptive statistics found that multiracial students who self-identify as black or Hispanic achieve lower grades than do those who self-identify as white or Asian. The author suggests a transracial theory of academic performance that considers the effects of contexts. (Contains 2 figures, 5 tables and 12 notes.)

This study assessed how schools, neighborhoods, nuclear families, and friendship groups jointly contribute to positive change during early adolescence. Analyses showed that the four context indices modestly intercorrelated at the individual student level, but clustered more tightly at the school and neighborhood levels. Joint influence of all four contexts was cumulatively large and generally additive in form, suggesting that both theory and interventions for change should be explicitly pan-contextual. (Author/KB)