The coronavirus disease (COVID-19) pandemic has increased unemployment and food insecurity in the United States (US). Prior to the pandemic, college students exhibited higher rates of food insecurity ...than nonstudent households. The objectives of this study were to assess the prevalence and determinants of food insecurity among college students during the COVID-19 pandemic. We administered an online survey to 651 students on three diverse campuses at a state-funded university in Texas, US, in May 2020. Food security was assessed using a multistep approach that included the 2-item Food Sufficiency Screener and 6-Item USDA Food Security Survey Module (FSSM). Overall, 34.5% of respondents were classified as food insecure within the last 30 days. The strongest predictors of food insecurity were change in current living arrangement (OR = 2.70, 95% CI: 2.47, 2.95), being furloughed (OR = 3.22, 95% CI: 2.86, 3.64), laid off (OR = 4.07, 95% CI: 3.55, 4.66), or losing part-time work (OR = 5.73, 95% CI: 5.09, 6.46) due to the COVID-19 pandemic. These findings highlight the high prevalence of food insecurity among college students during the COVID-19 pandemic, with students who experienced housing insecurity and/or loss of income due to the pandemic being impacted the most.
The COVID-19 pandemic restrictions sent college students online and off campus, potentially reducing access to healthy food. The objective of this cross-sectional, internet-based study was to use ...qualitative and quantitative survey methods to evaluate whether COVID-19 pandemic restrictions in Texas, USA affected college students’ ability to buy food, how/what they shopped for, how they prepared food, what they ate, how they felt about eating, and overall dietary quality (assessed using Healthy Eating Index HEI scores). Survey responses from 502 students (87.5% female; 59.6% nonwhite, mean age 27.5 ± 0.4 years, >50% graduate students) were analyzed. The qualitative analysis of open-ended questions revealed 110 codes, 17 subthemes, and six themes. Almost all students experienced changes in at least one area, the most common being changes in shopping habits. Participants with low or very low food security had lower HEI scores compared to food secure students (p = 0.047). Black students were more likely to report changes in their ability to buy food (p = 0.035). The COVID-19 restrictions varied in their impact on students’ ability to access sufficient healthy food, with some students severely affected. Thus, universities should establish procedures for responding to emergencies, including identifying at-risk students and mobilizing emergency funds and/or food assistance.
Background Most studies of active travel to school (ATS) have been conducted in urban or suburban areas and focused on young children. Little is known about ATS among rural adolescents. Purpose To ...describe adolescent ATS in two predominantly rural states and determine if school neighborhood built environment characteristics (BECs) predict ATS after adjusting for school and individual characteristics. Methods Sixteen BECs were assessed through census data and onsite observations of 45 school neighborhoods in 2007. ATS and individual characteristics were assessed through telephone surveys with 1552 adolescents and their parents between 2007 and 2008. Active travelers were defined as those who walked/cycled to/from school ≥1 day/week. Hierarchic linear modeling was used for analysis, conducted in 2009. Results Slightly less than half ( n =735) of the sample lived within 3 miles of school, of whom 388 (52.8%) were active travelers. ATS frequency varied by season, ranging from a mean of 1.7 (SD=2.0) days/week in the winter to 3.7 (SD=1.6) in the spring. Adolescents who attended schools in highly dense residential neighborhoods with sidewalks were most likely to be active travelers. ATS frequency was greater in school neighborhoods with high residential and intersection densities, on-street parking, food outlets, and taller and continuous buildings with small setbacks. Conclusions The BECs that support safe travel may be necessary to allow for ATS, whereas ATS frequency among adolescents may be influenced by a wider variety of design characteristics. Additional strategies to promote ATS and physical activity are needed in rural areas because of long commuting distances for many students.
Background Little is known about the influence of in-town fast-food availability on family-level fast-food intake in nonmetropolitan areas. Purpose The purpose of the current study was to determine ...whether the presence of chain fast-food outlets was associated with fast-food intake among adolescents and parents, and to assess whether this relationship was moderated by family access to motor vehicles. Methods Telephone surveys were conducted with 1547 adolescent–parent dyads in 32 New Hampshire and Vermont communities between 2007 and 2008. Fast-food intake in the past week was measured through self-report. In-town fast-food outlets were located and enumerated using an onsite audit. Family motor vehicle access was categorized based on the number of vehicles per licensed drivers in the household. Poisson regression was used to determine unadjusted and adjusted risk ratios (RRs). Analyses were conducted in 2011. Results About half (52.1%) of adolescents and 34.7% of parents consumed fast food at least once in the past week. Adolescents and parents who lived in towns with five or more fast-food outlets were about 30% more likely to eat fast food compared to those in towns with no fast-food outlets, even after adjusting for individual, family, and town characteristics (RR=1.29, 95% CI= 1.10, 1.51; RR=1.32, 95% CI=1.07, 1.62, respectively). Interaction models demonstrated that the influence of in-town fast-food outlets on fast-food intake was strongest among families with low motor vehicle access. Conclusions In nonmetropolitan areas, household transportation should be considered as an important moderator of the relationship between in-town fast-food outlets and family intake.
A study conducted at Texas Woman’s University (TWU) 1 year ago, showed high rates of food insecurity (FI) among students, with the strongest predictor of FI being unemployment as a result of the ...COVID-19 pandemic. The purpose of this follow-up study was to assess whether prevalence of FI and diet quality has changed within TWU students since the peak COVID-19 restrictions 12 months ago. In this study, the 502 students who participated in the initial study one year ago were emailed to complete the same food security and diet quality surveys. In the 185 participants who completed the follow-up survey, food insecurity decreased from 26.0% to 18.9% (p = 0.058). The impact of COVID-19 on current employment status decreased from 46.7% to 36.4% (p = 0.009). Diet quality score decreased. In conclusion, since peak COVID-19 restrictions 12 months ago, food security improved and coincided with a significant change in employment status among TWU students.
Abstract Communities are being encouraged to develop locally based interventions to address environmental risk factors for obesity. Online public directories represent an affordable and easily ...accessible mechanism for mapping community food environments, but may have limited utility in rural areas. The primary aim of this study was to evaluate the efficacy of public directories vs rigorous onsite field verification to characterize the community food environment in 32 geographically dispersed towns from two rural states covering 1,237.6 square miles. Eight types of food outlets were assessed in 2007, including food markets and eating establishments, first using two publically available online directories followed by onsite field verification by trained coders. χ2 and univariate binomial regression were used to determine whether the proportion of outlets accurately listed varied by food outlet type or town population. Among 1,340 identified outlets, only 36.9% were accurately listed through public directories; 29.6% were not listed but were located during field observation. Accuracy varied by outlet type, being most accurate for big box stores and least accurate for farm/produce stands. Overall, public directories accurately identified fewer than half of the food outlets. Accuracy was significantly lower for rural and small towns compared to mid-size and urban towns ( P <0.001). In this geographic sample, public directories seriously misrepresented the actual distribution of food outlets, particularly for rural and small towns. To inform local obesity-prevention efforts, communities should strongly consider using field verification to characterize the food environment in low-population areas.
Protein modification by SUMO helps orchestrate the elaborate events of meiosis to faithfully produce haploid gametes. To date, only a handful of meiotic SUMO targets have been identified. Here, we ...delineate a multidimensional SUMO-modified meiotic proteome in budding yeast, identifying 2747 conjugation sites in 775 targets, and defining their relative levels and dynamics. Modified sites cluster in disordered regions and only a minority match consensus motifs. Target identities and modification dynamics imply that SUMOylation regulates all levels of chromosome organization and each step of meiotic prophase I. Execution-point analysis confirms these inferences, revealing functions for SUMO in S-phase, the initiation of recombination, chromosome synapsis and crossing over. K15-linked SUMO chains become prominent as chromosomes synapse and recombine, consistent with roles in these processes. SUMO also modifies ubiquitin, forming hybrid oligomers with potential to modulate ubiquitin signaling. We conclude that SUMO plays diverse and unanticipated roles in regulating meiotic chromosome metabolism.
Background
Untreated depression is associated with negative behavioral, psychosocial, and physical outcomes leading to socioeconomic costs, disability, and premature mortality. Research has not yet ...fully developed intervention models to increase the utilization of mental health treatments. The objective of the current study was to characterize the pathways linking health beliefs to treatment utilization among depressed young adults.
Methods
Data were collected in 2017 from 53,760 college students at 54 universities in the United States. Among the respondents, 5,343 screened positive for moderately severe to severe depression. Becker's Health Belief Model (HBM) was the guiding theoretical paradigm. Confirmatory factor analysis and structural equation modeling (SEM) were conducted to elucidate treatment‐seeking behavior based on health beliefs (perceived severity, perceived benefit, perceived barriers, self‐efficacy, and cues‐to‐action) while controlling for relevant sociodemographic covariates.
Results
Depression treatment utilization was significantly associated with all domains of the HBM. SEM parameter estimates indicated that higher levels of perceived severity, self‐efficacy, and cues‐to‐action were associated with greater depression treatment utilization, whereas perceived benefits and perceived barriers were associated with lower depression treatment utilization.
Conclusions
The HBM may be useful to predict the frequency of seeking treatment by individuals for depression. However, individualized intervention strategies targeting different aspects of the HBM are needed to promote help‐seeking behaviors in young adults with depression.
The objective of this study was to characterize the pathways linking health beliefs to treatment utilization among 5,343 young adults who screened positive for severe depression. Improved depression treatment utilization was significantly associated with higher levels of perceived severity, self‐efficacy, and cues‐to‐action, whereas perceived benefits and perceived barriers were associated with lower depression treatment utilization. Health beliefs are useful to predict the frequency of seeking treatment by individuals for depression.
Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many ...cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury.
First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist's route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries.
This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team's national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.
We hypothesised that combining zanubrutinib with obinutuzumab and venetoclax (BOVen) as an initial therapy for chronic lymphocytic leukaemia and small lymphocytic lymphoma would lead to high rates of ...undetectable minimal residual disease (MRD), and we explored MRD as a biomarker for directing treatment duration.
This multicenter, investigator-initiated, single-arm, phase 2 trial took place at two two academic medical centres in the USA. Patients were eligible for the primary cohort if they had treatment-naive chronic lymphocytic leukaemia or small lymphocytic lymphoma, required therapy, and were at least 18 years of age with an Eastern Cooperative Oncology Group performance status up to 2. BOVen was administered in 28 day cycles (oral zanubrutinib at 160 mg twice per day starting in cycle 1 on day 1; intravenous obinutuzumab at 1000 mg on day 1 split over day 1 with 100 mg and day 2 with 900 mg for an absolute lymphocyte count >25 000 cells per μL or lymph nodes >5 cm in diameter, day 8, and day 15 of cycle 1, and day 1 of cycles 2-8; and oral venetoclax ramp up to 400 mg per day starting in cycle 3 on day 1) and discontinued after 8-24 cycles when prespecified undetectable MRD criteria were met in the peripheral blood and bone marrow. The primary endpoint was the proportion of patients that reached undetectable MRD in both the peripheral blood and bone marrow (flow cytometry cutoff less than one chronic lymphocytic leukaemia cell per 10 000 leukocytes <10
) assessed per protocol. This trial is registered at clinicaltrials.gov (NCT03824483). The primary cohort is closed to recruitment, and recruitment continues in the TP53-mutated mantle cell lymphoma cohort.
Between March 14, 2019, and Oct 10, 2019, 47 patients were screened for eligibility, and 39 patients were enrolled and treated. Median age was 62 years (IQR 52-70) with 30 (77%) of 39 male participants and nine (23%) of 39 female participants. 28 (72%) of 39 patients had unmutated immunoglobulin heavy-chain variable-region and five (13%) of 39 had 17p deletion or TP53 mutation. After a median follow-up of 25·8 months (IQR 24·0-27·3), 33 (89%) of 37 patients (95% CI 75-97) had undetectable MRD in both blood and bone marrow, meeting the prespecified undetectable MRD criteria to stop therapy after a median of ten cycles (IQR 8-12), which includes two cycles of zanubrutinib and obinutuzumab before starting venetoclax. After median surveillance after treatment of 15·8 months (IQR 13·0-18·6), 31 (94%) of 33 patients had undetectable MRD. The most common adverse events were thrombocytopenia (23 59% of 39), fatigue (21 54%), neutropenia (20 51%), and bruising (20 51%), and the most common adverse event at grade 3 or worse was neutropenia (seven 18%) in the intention-to-treat population. One death occurred in a patient with intracranial haemorrhage on day 1 of cycle 1 after initiating intravenous heparin for pulmonary emboli.
BOVen was well tolerated and met its primary endpoint, with 33 (89%) of 37 previously untreated patients with chronic lymphocytic leukaemia or small lymphocytic lymphoma reaching undetectable MRD in both peripheral blood and bone marrow despite a median treatment duration of only 10 months, owing to our undetectable MRD-driven treatment discontinuation design. These data support further evaluation of the BOVen regimen in chronic lymphocytic leukaemia and small lymphocytic lymphoma with treatment duration guided by early MRD response kinetics.
Beigene, Genentech (Roche), Grais-Cutler Fund, Lymphoma Research Fund, Lymphoma Research Foundation, American Cancer Society, Farmer Family Foundation, and the National Instititutes of Health and National Cancer Institute.
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