Despite improvements in mortality rates over the past several decades, cardiovascular (CV) disease remains the leading cause of death for African-Americans (AAs). Innovative approaches through mobile ...health (mHealth) interventions have the potential to support lifestyle change for CV disease prevention among AAs. We aimed to translate a behavioral theory-informed, evidence-based, face-to-face health education program into an mHealth lifestyle intervention for AAs. We describe the design and development of a culturally relevant, CV health and wellness digital application (app) and pilot testing using a community-based participatory research (CBPR) approach with AA churches.
This mixed methods study used a 4-phase iterative development process for intervention design with the AA community. Phase 1 included focus groups with AA community members and church partners (n = 23) to gain insight regarding potential app end user preferences. In Phase 2, the interdisciplinary research team synthesized Phase 1 input for preliminary app design and content development. Phase 3 consisted of a sequential 3-meeting series with church partners (n = 13) for iterative app prototyping (assessment, cultural tailoring, final review). Phase 4, a single group pilot study among AA church congregants (n = 50), assessed app acceptability, usability, and satisfaction.
Phase 1 focus groups indicated general and health-related apps preferences: multifunctional, high-quality graphics/visuals, evidence-based, yet simple health information and social networking capability. Phase 2 integrated these preferences into the preliminary app prototype. Phase 3 feedback was used to refine the app prototype for pilot testing. Phase 4 pilot testing indicated high app acceptability, usability, and satisfaction.
This study illustrates integration of formative and CBPR approaches to design a culturally relevant, mHealth lifestyle intervention to address CV health disparities among AAs. Given the positive app perceptions, our study supports the use of an iterative development process by others interested in implementing an mHealth lifestyle intervention for racial/ethnic minority communities.
Clinicaltrials.gov NCT03084822.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Malnutrition is associated with adverse clinical outcomes in patients with cirrhosis. Accurate assessment of energy requirements is needed to optimize dietary intake. Resting energy expenditure ...(REE), the major component of total energy expenditure, can be measured using indirect calorimetry (mREE) or estimated using prediction equations (pREE). This study assessed the usefulness of predicted estimates of REE in this patient population.
Individual mREE data were available for 900 patients with cirrhosis (mean ±1 SD age 55.7±11.6 years-old; 70% men; 52% south-east Asian) and 282 healthy controls (mean age 36.0±12.8 years-old; 52% men; 18% south-east Asian). Metabolic status was classified using thresholds based on the mean ± 1 SD of the mREE in the healthy controls. Comparisons were made between mREE and pREE estimates obtained using the Harris-Benedict, Mifflin, Schofield and Henry equations. Stepwise regression was used to build 3 new prediction models which included sex, ethnicity, body composition measures, and model for end-stage liver disease scores.
The mean mREE was significantly higher in patients than controls when referenced to dry body weight (22.4±3.8 cf. 20.8±2.6 kcal/kg/24 hr; p <0.001); there were no significant sex differences. The mean mREE was significantly higher in Caucasian than Asian patients (23.1±4.4 cf. 21.7±2.9 kcal/kg/24 hr; p <0.001). Overall, 37.1% of Caucasian and 25.3% of Asian patients were classified as hypermetabolic. The differences between mREE and pREE were both statistically and clinically relevant; in the total patient population, pREE estimates ranged from 501 kcal/24 hr less to 548 kcal/24 hr more than the mREE. Newly derived prediction equations provided better estimates of mREE but still had limited clinical utility.
Prediction equations do not provide useful estimates of REE in patients with cirrhosis. REE should be directly measured.
People with cirrhosis are often malnourished and this has a detrimental effect on outcome. Provision of an adequate diet is very important and is best achieved by measuring daily energy requirements and adjusting dietary intake accordingly. Prediction equations, which use information on age, sex, weight, and height can be used to estimate energy requirements; however, the results they provide are not accurate enough for clinical use, particularly as they vary according to sex and ethnicity.
Display omitted
•Malnutrition has a significant negative effect on outcome in patients with cirrhosis.•Accurate information on daily energy requirements is essential for effective nutritional management.•Prediction equations provide estimates of daily energy expenditure, but these vary significantly by ethnicity.•Where available, resting energy expenditure should be measured using indirect calorimetry.
A robust forecast of rice yields is of great importance for medium-to-long-term planning and decision-making in cereal production, from regional to national level. Incorporation of spatially ...correlated adjacent effects in forecasting models in general, results in accurate forecast. The Space Time Autoregressive Moving Average (STARMA) is the most popular class of model in linear spatiotemporal time series modelling. However, STARMA cannot process nonlinear spatiotemporal relationships in datasets. Alternately, Time Delay Neural Network (TDNN) is a most popular machine learning algorithm to model the nonlinear pattern in data. To overcome these limitations, two-stage STARMA approach was developed to predict rice yield in some of the most intensive national rice agroecosystems in India. The Mean Absolute Percentage Errors value of proposed STARMA-II approach is lower compared to Autoregressive Moving Average (ARIMA) and STARMA model in all examined districts, while the Diebold-Mariano test confirmed that STARMA-II model is significantly different from classical approaches. The proposed STARMA-II approach is promising alternative to classical linear and nonlinear spatiotemporal time series models for estimating mixed linear and nonlinear patterns and can be advanced tool for mid-to-long-term sustainable planning and management of crop yields and patterns in agroecosystems, i.e., food supply and demand from local to regional levels.
Background and Objectives: Beaten or flattened rice (flakes) is very popular in India for preparing the meal "upma." Commonly marketed rice flakes are fiber depleted, starchy, and may be ...nutritionally poor. Hence, this study aimed at preparing brown rice flakes (BRF) for such "upma" preparation and compared the nutritional and glycemic properties of it with those of white rice flakes (WRF). Materials and Methods: Flakes were prepared from brown rice (BR, ADT-45 variety) by steaming and flattening using a roller flaker. The BRF and commercial WRF were analyzed for nutrient composition, and upma prepared from both the flakes was evaluated for glycemic index (GI) in normal healthy volunteers by using a validated protocol. Results: BRF contained significantly higher (6.2 g%) dietary fiber as compared with WRF (1.8 g%, P < 0.001). Stereo-zoom microscopic examination of BRF revealed retention of bran and germ. BRF was thicker, firmer, and had a lower surface area compared with WRF. BRF upma exhibited medium GI (63.3 ± 6.2), whereas WRF upma showed high GI (70.4 ± 5.6), though the GI values were not statistically significant. Interpretation and Conclusions: BRF upma, a medium GI category meal choice, could be considered a healthier option compared to high GI WRF upma considering the nutritional profile. The BRF described in the study is easy to cook and suitable enough to replace WRF. More trials are required to design and devise innovative protocols for the preparation of BRF with significantly lower glycemic properties.
Problems encountered in the determination of uranium in rubidium uranium sulphate (Rb
2
U(SO
4
)
3
) employing isotope dilution thermal ionisation mass spectrometry (ID-TIMS) are discussed. The ...positive bias of 0.2 to 0.3% in the determination of uranium in Rb
2
U(SO
4
)
3
by ID-TIMS with respect to the stoichiometric composition has been resolved by modifying the chemical exchange procedures. The concentration of uranium in Rb
2
U(SO
4
)
3
could be determined with an accuracy better than 0.1% employing the HClO
4
treatment for proper isotopic exchange between the spike and sample isotopes.
Problems encountered in the determination of uranium in rubidium uranium sulphate (Rbsub 2U(SOsub 4)sub 3) employing isotope dilution thermal ionization mass spectrometry (ID-TIMS) are discussed. The ...positive bias of 0.2 to 0.3% in the determination of uranium in Rbsub 2U(SOsub 4)sub 3 by ID-TIMS with respect to the stoichiometric composition has been resolved by modifying the chemical exchange procedures. The concentration of uranium in Rbsub 2U(SOsub 4)sub 3 could be determined with an accuracy better than 0.1% employing the HClOsub 4 treatment for proper isotopic exchange between the spike and sample isotopes. 12 refs., 1 fig., 5 tabs.
PDF
