Reaching preschool-aged children to establish healthy lifestyle habits, including physical activity, is an important component of obesity prevention efforts. However, few studies have examined family ...child care homes where nearly 1 million children receive care.
A pre- and post-intervention evaluation without a control group was conducted to evaluate what changes occurred in family child care homes that participated in the Healthy Eating and Active Living project, a multicomponent obesity prevention initiative, focused on community-driven policy and environmental change in neighborhoods within Kaiser Permanente service areas.
From 2012 to 2014, a total of 17 family child care homes in Northern California participated in the intervention.
A physical activity workshop for child care staff and technical assistance to develop a policy to promote physical activity and other healthy behaviors.
Pre and post observations, questionnaires, and physical activity logs were completed to assess change in physical activity resources available in the family child care homes, the amount of child screen time offered, type and amount of physical activity offered to children, and implementation of physical activity best practices.
Between baseline and follow-up, providers significantly increased both the number of structured, adult-led activities (2.6 vs 3.2 activities per day) and the number of structured, adult-led minutes of activity in which children participated (49 vs 83 minutes per day). Providers also improved screen time practices and made improvements to the physical activity environment.
In this study, a community-based organization designed and implemented multicomponent strategies tailored for participating family child care homes. The successful implementation of the intervention likely contributed to implementation of practices that increased opportunities for physical activity for the young children attending these family child care homes.
This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.
From 2011 to 2014, small stores in three communities participated in a community-wide obesity prevention initiative. The study aimed to determine how participation in the initiative influenced store ...environments and consumer purchases.
Pre- and post-intervention without control. Structured observations of the store environments and intercept surveys of adult shoppers at all stores, and of children at two stores, conducted at baseline and follow-up. Manager/owner interviews regarding perceived impacts of the intervention conducted at follow-up.
Shoppers at nine small stores in three diverse, low-income communities in Northern California.
The store interventions were determined locally with combinations of strategies such as product displays, healthier options, marketing and promotion, store layout, and facility improvements that were implemented to varying degrees at each site.
Changes in store environments and purchases of select foods and beverages.
Stores experienced consistent, but not always significant, declines in purchases of sweets and chips and increases in purchases of fruits and vegetables at select stores. Decreases in purchases of targeted sugar-sweetened beverages were offset by increases in purchases of other sugar-sweetened beverages. Changes in store environments and promotional activities varied widely from store to store and corresponded to variations in changes in purchasing. The owners/managers perceived benefits to their bottom line and community/customer relations, but challenges were identified that may account for the varied degree of implementation.
Substantive improvements in fruit and vegetable availability and promotion were needed to achieve a measurable impact on purchases but reducing purchases of unhealthy foods, like sweets and chips, required a less consistent intensive effort. These findings suggest it may be challenging to achieve the consistent and targeted implementation of changes and ongoing promotional efforts at a large enough proportion of stores where residents shop that would be required to get measurable impacts at the community level.
This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.
A growing number of health systems are leading health promotion efforts in their wider communities. What impact are these efforts having on health behaviors and ultimately health status? This paper ...presents evaluation results from the place-based Kaiser Permanente Healthy Eating Active Living Zones obesity prevention initiative, implemented in 2011–2015 in 12 low-income communities in Kaiser Permanente’s Northern and Southern California Regions.
The Healthy Eating Active Living Zones design targeted places and people through policy, environmental, and programmatic strategies. Each Healthy Eating Active Living Zone is a small, low-income community of 10,000 to 20,000 residents with high obesity rates and other health disparities. Community coalitions planned and implemented strategies in each community. A population-dose approach and pre and post surveys were used to assess impact of policy, program, and environmental change strategies; the analysis was conducted in 2016. Population dose is the product of reach (number of people affected by a strategy divided by target population size) and strength (the effect size or relative change in behavior for each person exposed to the strategy).
More than 230 community change strategies were implemented over 3 years, encompassing policy, environmental, and programmatic changes as well as efforts to build community capacity to sustain strategies and make changes in the future. Positive population-level results were seen for higher-dose strategies, particularly those targeting youth physical activity. Higher-dose strategies were more likely to be found in communities with the longest duration of investment.
These results demonstrate that strong (high-dose), community-based obesity prevention strategies can lead to improved health behaviors, particularly among youth in school settings.
This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.
Basal HCO
3
−
secretion across the duodenum has been shown in several species to principally involve the activity of apical membrane Cl
−
/HCO
3
−
exchanger(s). To investigate the identity of ...relevant anion exchanger(s), experiments were performed using wild-type (WT) mice and mice with gene-targeted deletion of the following Cl
−
/HCO
3
−
exchangers localized to the apical membrane of murine duodenal villi: Slc26a3 down-regulated in adenoma (DRA), Slc26a6 putative anion transporter 1 (PAT-1), and Slc4a9 anion exchanger 4 (AE4). RT-PCR of the isolated villous epithelium demonstrated PAT-1, DRA, and AE4 mRNA expression. Using the pH-sensitive dye BCECF, anion exchange rates were measured across the apical membrane of epithelial cells in the upper villus of the intact duodenal mucosa. Under basal conditions, Cl
−
/HCO
3
−
exchange activity was reduced by 65–80% in the PAT-1(−) duodenum, 30–40% in the DRA(−) duodenum, and <5% in the AE4(−) duodenum compared with the WT duodenum. SO
4
2−
/HCO
3
−
exchange was eliminated in the PAT-1(−) duodenum but was not affected in the DRA(−) and AE4(−) duodenum relative to the WT duodenum. Intracellular pH (pH
i
) was reduced in the PAT-1(−) villous epithelium but increased to WT levels in the absence of CO
2
/HCO
3
−
or during methazolamide treatment. Further experiments under physiological conditions indicated active pH
i
compensation in the PAT-1(−) villous epithelium by combined activities of Na
+
/H
+
exchanger 1 and Cl
−
-dependent transport processes at the basolateral membrane. We conclude that 1) PAT-1 is the major contributor to basal Cl
−
/HCO
3
−
and SO
4
2−
/HCO
3
−
exchange across the apical membrane and 2) PAT-1 plays a role in pH
i
regulation in the upper villous epithelium of the murine duodenum.
Conclusions 1) Although E wave velocity of 1.2 m/sec is highly specific for severe organic MR, it is not sensitive enough. ...E wave velocity of 0.9 m/sec may be more useful due to optimal ...sensitivity/speficity. 2) a wave dominance pattern alone cannot exclude patients with severe organic MR.
Villi of the proximal duodenum are situated for direct exposure to gastric acid chyme. However, little is known about active bicarbonate secretion across villi that maintains the protective alkaline ...mucus barrier, a process that may be compromised in cystic fibrosis (CF), i.e., in the absence of a functional CF transmembrane conductance regulator (CFTR) anion channel. We investigated Cl
−
/HCO
3
−
exchange activity across the apical membrane of epithelial cells located at the midregion of villi in intact duodenal mucosa from wild-type (WT) and CF mice using the pH-sensitive dye BCECF. Under basal conditions, the Cl
−
/HCO
3
−
exchange rate was reduced by ∼35% in CF compared with WT villous epithelium. Cl
−
/HCO
3
−
exchange in WT and CF villi responded similarly to inhibitors of anion exchange, and membrane depolarization enhanced rates of Cl
−
out
/HCO
3
−
in
exchange in both epithelia. In anion substitution studies, anion
in
/HCO
3
−
out
exchange rates were greater in WT epithelium using Cl
−
or NO
3
−
, but decreased to the level of the CF epithelium using the CFTR-impermeant anion, SO
4
2−
. Similarly, treatment of WT epithelium with the CFTR-selective blocker glybenclamide decreased the Cl
−
/HCO
3
−
exchange rate to the level of CF epithelium. The mRNA expression of Slc26a3 (downregulated in adenoma) and Slc26a6 (putative anion exchanger-1) was similar between WT and CF duodena. From these studies of murine duodenum, we conclude 1) characteristics of Cl
−
/HCO
3
−
exchange in the villous epithelium are most consistent with Slc26a6 activity, and 2) Cl
−
channel activity of CFTR facilitates apical membrane Cl
−
in
/HCO
3
−
out
exchange by providing a Cl
−
“leak” under basal conditions.
The period of early childhood, defined as three to five years of age, is an important and distinct stage in childhood development. Changes in dietary patterns and composition of diets are exposing ...children in developing countries to over-nutrition as well as under-nutrition.
To describe the nutritional status, dietary patterns, and socio-economic conditions of three to five-year-old children living in rural Jamaica.
A convenience sample of 142 children was recruited over a three-year period.
Height and weight measurements were collected. Household dietary patterns and socio-economic indicators were available from a small group (n = 6) of parents.
Children experiencing both under-nutrition and over-nutrition were identified. Nine percent (n = 13) could be classified as moderately to severely under-nourished, and 6.9% (n = 10) classified as overweight. Frying was a common cooking method, and fruits and vegetables were eaten often.
Economic and political changes may place children in developing countries at risk for over-nutrition as well as under-nutrition. The school setting may be an important place to address nutritional issues. This analysis describes the nutritional status of a sample of three to five-year-old children living in rural Jamaica and provides suggestions for future research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Villi of the proximal duodenum are situated for direct exposure to gastric acid chyme. However, little is known about active bicarbonate secretion across villi that maintains the protective alkaline ...mucus barrier, a process that may be compromised in cystic fibrosis (CF), i.e., in the absence of a functional CF transmembrane conductance regulator (CFTR) anion channel. We investigated Cl(-)/HCO(3)(-) exchange activity across the apical membrane of epithelial cells located at the midregion of villi in intact duodenal mucosa from wild-type (WT) and CF mice using the pH-sensitive dye BCECF. Under basal conditions, the Cl(-)/HCO(3)(-) exchange rate was reduced by approximately 35% in CF compared with WT villous epithelium. Cl(-)/HCO(3)(-) exchange in WT and CF villi responded similarly to inhibitors of anion exchange, and membrane depolarization enhanced rates of Cl(-)(out)/HCO(3)(-)(in) exchange in both epithelia. In anion substitution studies, anion(in)/HCO(3)(-)(out) exchange rates were greater in WT epithelium using Cl(-) or NO(3)(-), but decreased to the level of the CF epithelium using the CFTR-impermeant anion, SO(4)(2-). Similarly, treatment of WT epithelium with the CFTR-selective blocker glybenclamide decreased the Cl(-)/HCO(3)(-) exchange rate to the level of CF epithelium. The mRNA expression of Slc26a3 (downregulated in adenoma) and Slc26a6 (putative anion exchanger-1) was similar between WT and CF duodena. From these studies of murine duodenum, we conclude 1) characteristics of Cl(-)/HCO(3)(-) exchange in the villous epithelium are most consistent with Slc26a6 activity, and 2) Cl(-) channel activity of CFTR facilitates apical membrane Cl(-)(in)/HCO(3)(-)(out) exchange by providing a Cl(-) "leak" under basal conditions.
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