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BackgroundAmong women, trichomoniasis is the most common non-viral sexually transmitted infection worldwide, and is associated with serious reproductive morbidity, poor birth outcomes, and amplified HIV transmission. Single-dose metronidazole is the first-line treatment for trichomoniasis. However, bacterial vaginosis can alter treatment efficacy in HIV-infected women, and single-dose metronidazole treatment might not always clear infection. We compared single-dose metronidazole with a 7-day dose for the treatment of trichomoniasis among HIV-uninfected, non-pregnant women and tested whether efficacy was modified by bacterial vaginosis.MethodsIn this multicentre, open-label, randomised controlled trial, participants were recruited at three sexual health clinics in the USA. We included women positive for Trichomonas vaginalis infection according to clinical screening. Participants were randomly assigned (1:1) to receive either a single dose of 2 g of metronidazole (single-dose group) or 500 mg of metronidazole twice daily for 7 days (7-day-dose group). The randomisation was done by blocks of four or six for each site. Patients and investigators were aware of treatment assignment. The primary outcome was T vaginalis infection by intention to treat, at test-of-cure 4 weeks after completion of treatment. The analysis of the primary outcome per nucleic acid amplification test or culture was also stratified by bacterial vaginosis status. This trial is registered with ClinicalTrials.gov, number NCT01018095, and with the US Food and Drug Administration, number IND118276, and is closed to accrual.FindingsParticipants were recruited from Oct 6, 2014, to April 26, 2017. Of the 1028 patients assessed for eligibility, 623 women were randomly assigned to treatment groups (311 women in the single-dose group and 312 women in the 7-day-dose group; intention-to-treat population). Although planned enrolment had been 1664 women, the study was stopped early because of funding limitations. Patients in the 7-day-dose group were less likely to be T vaginalis positive at test-of-cure than those in the single-dose group (34 [11%] of 312 vs 58 [19%] of 311, relative risk 0·55, 95% CI 0·34-0·70; p

Background: Consumption levels of fruits and vegetables (F/V) among children/adolescents are low. Programs like school-based salad bars (SB) provide children/adolescents increased F/V access. Aims: The purpose of this study was to examine the relationship between SB use and individual and school-level factors among elementary and secondary school students in New Orleans public schools. Method: Twelve schools receiving SB units from the "Let's Move Salad Bars to Schools Campaign" participated in this study. Self-reported data were collected from students (n = 1,012), administrators (n = 12), and food service staff (n = 37). School environmental data were obtained through direct observation. Generalized estimating equation regression methods were used to develop a multilevel model including both school-level (e.g., length of lunchtime, SB marketing, vending machines) and individual-level (e.g., sex, food preferences, nutrition knowledge) effects. Results: Female students had higher odds of using the SB compared to males. Students with healthier food preferences had higher odds of using the SB than those who reported less healthy food preferences. Within the multilevel model for all students, only sex and healthy food preferences remained significant. In a multilevel model assessing secondary students only, student encouragement toward others for healthy eating and school-based SB marketing were significantly related to SB use. Conclusions: Little research has examined factors related to school-based SB use. These findings suggest recommendations that may help improve student use of SBs. For example, increasing the promotion of SB, particularly in secondary schools, might encourage their use among students.

Purpose/Objectives: Evaluation of school-based activities is a high priority for school personnel. Nutrition activities, such as salad bars (SBs) incorporated into school lunchrooms, may increase children's consumption of low-energy, high fiber diets. The purpose of this paper is to describe a problem-solving/ decision-making model and demonstrate its application in the evaluation of a school-based SB program. Methods: The proposed model includes five steps: 1) problem definition; 2) goal setting; 3) method options; 4) action plans; and 5) ongoing assessment. The Tulane Prevention Research Center (PRC) conducted an SB evaluation with 19 schools in Orleans Parish. The evaluation, developed with the 5-step model, led to multi-level school data collection: administrative, nutrition service, students, and cafeteria environmental scans. Results: Important practical data about lunchroom SBs was obtained. The evaluation, using the model, successfully demonstrated that all methods were achievable, participation reached expected levels, and identified goals were attained. Application to Child Nutrition Professionals: Previously identified problems (safety, extra labor, cost, storage) with SB use make SB evaluation a high priority for school food management. This proposed easy-to-use model can be applied by professionals and non-professionals in evaluating any school-based activities. The demonstration of this SB evaluation showed that the model can provide efficient guidance that yields practical data for school decisions about SBs in school lunchrooms. School personnel will find this model easy to use; the steps of the model are transferable, and the model could potentially be applied to other evaluation issues.

Background: Childhood obesity continues to be a public health problem in the United States. Increasing consumption of fruits and vegetables (F/V) is one strategy for decreasing high consumption of energy-dense, high-fat foods, thereby improving weight status. Many Orleans Parish public schools were provided with salad bars (SBs) to augment school lunch with increased access to F/V. This study identified factors associated with student use of SBs. Methods: Surveys examining SB use, demographics, food preference, nutrition knowledge, and social support were administered to students in the 7th to 12th grades (N?=?702) in Orleans Parish (New Orleans, Louisiana). Generalized estimating equations, which incorporate clustering at the school level, helped to determine associations between independent variables and SB use. Results: Sixty percent of participants were SB users. Non-African-American students were more likely to be SB users than African-American students (odds ratio [OR]?=?2.35, confidence interval [CI]: 1.35-4.07) and students who had high preference for healthy food were more likely to use the SB than those who had low preference (OR?=?2.41, CI: 1.44-4.01). Students who encouraged others to consume F/V were more likely to use the SB than those who did not (p?=?0.015). Conclusions: Individual and interpersonal factors related to SB use can provide guidance in the development of school-based interventions to increase SB use and F/V consumption.

Objective: To examine the predictive validity of an alternative to the DSM-IV for diagnosing posttraumatic stress disorder (PTSD) in preschool children and prospectively explore the course of PTSD symptomatology. Method: Sixty-two traumatized children, ages 20 months through 6 years, were assessed three times in 2 years with caregiver diagnostic interviews. Results: PTSD diagnosis at visit 1 significantly predicted degree of functional impairment 1 and 2 years later and predicted PTSD diagnosis 2 years later but not 1 year later. The lack of 1-year diagnostic continuity may be explained by children with new traumas. Unexpectedly, overall PTSD symptoms did not remit over time, regardless of community treatment; however, reexperiencing symptoms decreased and avoidance/numbing symptoms increased with time, with avoidance/numbing symptoms increasing at a faster rate in children with PTSD at visit 1. The previous finding that arousal may cause emotional numbing was not replicated. Significantly more children were functionally impaired at visits 2 (48.9%) and 3 (74.3%) than were diagnosed with PTSD (23.4% and 22.9%, respectively). Conclusions: This study demonstrates predictive validity for the alternative method of diagnosing PTSD in preschool children. The unremitting course of PTSD symptomatology in preschool children and rates of impairment that are higher than rates of diagnosis indicate the need for efficacious treatment.

Research has suggested that parenting behaviors and other parental factors impact the long-term outcome of children's posttraumatic stress disorder (PTSD) symptoms. In a sample of 62 children between the ages of one and six who experienced life-threatening traumas, PTSD was measured prospectively 2 years apart. Seven maternal factors were measured in a multi-method, multi-informant design. Both moderation and mediation models, with different theoretical and mechanism implications, were tested. Moderation models were not significant. Mediation models were significant when the mediator variable was maternal symptoms of PTSD or depression (measured at Time 1), self-report of maternal escape/avoidance coping (measured at Time 2), or self-report emotional sensitivity (measured at Time 2). Greater maternal emotional sensitivity was associated with greater Time 2 PTSD symptoms among children. Observational measures of emotional sensitivity as the mediator were not supported. Correlation of parents' and children's symptoms is a robust finding, however caution is warranted in attributing children's PTSD symptoms to insensitive parenting., Author(s): Michael S. Scheeringa[sup.1] , Leann Myers[sup.2] , Frank W. Putnam[sup.3] , Charles H. Zeanah[sup.1] Author Affiliations: (1) Tulane University School of Medicine, 1440 Canal St., TB52, 70112, New Orleans, [...]

Describes the effectiveness of the Gimme 5 intervention to increase high school students' fruit and vegetable consumption. Intervention included media campaigns, classroom workshops, school meal modification, and parental support. After two years, daily servings increased more in the intervention group. Control students, who received Gimme 5 measurements without interventions, increased their consumption to similar levels by three years. (SM)

Purposes/Objectives: Fruit and vegetable (F/V) consumption may aid in childhood obesity prevention. F/V consumption in youth is low. School-based salad bars (SBs) may improve F/V access in youth. The purpose of this study was to explore administrative and school nutrition personnel perspectives related to adoption and continued implementation of SBs. Methods: In Orleans Parish schools with SBs (n = 19), self-report questionnaires were administered to school administrators and school nutrition directors (SNDs) and staff. Modified surveys were used in schools not currently operating SBs (n = 7). Results: Administrators of SB schools perceived they had more facilitators for SB operation than administrators from non-SB schools. SNDs from SB schools perceived they had staff capacity, more facilitators, and more barriers for SB operations than SNDs s from non-SB schools. Applications to Child Nutrition Professionals: Findings contribute to understanding factors related to continued use of school-based SBs. Facilitators identified by SNDs and administrators, such as strong support from staff and adequate equipment, may contribute to the successful implementation of SBs.