A193 PERCEIVED BARRIERS TO GLUTEN-FREE FOOD ACCESS ON-CAMPUS EXPERIENCED BY STUDENTS FROM DIFFERENT CANADIAN UNIVERSITIES AND COLLEGES

Background

Students with gluten-related disorders (GRD), a spectrum of conditions including celiac disease (CeD) and non-celiac wheat sensitivity (NCWS), often experience challenges when accessing gluten-free (GF) foods.

Aims

To identify barriers perceived by students with GRD to access GF products on-campus of universities and colleges across Canada.

Methods

We conducted a cross sectional survey using the RedCap platform and distributed it to the Canadian Celiac Association community. We included students who reported adopting a GFD for various reasons including CeD and other GRD. We collected data on adherence to the GFD using a validated questionnaire (CDAT), presence of perceived barriers to follow a GFD while dining on campus, persistent symptoms, and altered quality of life. Continuous data are expressed as median (IQR), and categorical data as proportions of patients. Mann-Whitney U and Chi2 with Fisher correction were used to assess differences between groups.

Results

Seventy nine students responded to the survey (5% male and median age = 25 yrs) and 78 had complete data for analysis. Of the 78 students, 52 (66.6%) reported a diagnosis of CeD, while 26 were adopting a GFD for other reasons (non-CeD). The majority were enrolled in university programs (72/78) and 18% were living on-campus. Almost 90% reported difficulties maintaining a GFD while dining on-campus. Similar proportion of CeD and non-CeD reported eating gluten accidentally (75% vs 80%), while 15% reported eating gluten intentionally on-campus at least a few times per week. This was observed more frequently in non-CeD compared with students with CeD (61% vs 17%; p=0.04). Barriers identified in CeD versus non-CeD groups were related to a reduced GF-food variety (48% vs 69%), lack of availability of GF food (21% vs 46%) and increased cost (46% vs 81%) compared with gluten-containing counterparts. The majority of participants were concerned whether the food available on-campus was truly GF (80% vs 54%) as they reported foods not properly labelled. The majority of participants considered their overall health (79%) and quality of life (65%) was fair to terrible while dining on campus. During the pandemic, 76% of them perceived that it was easier to stick to a GF diet.

Conclusions

Students from various universities and colleges across Canada experience barriers to access GF food on-campus. This has a significant impact on their overall health and quality of life. Proper food labeling, GF certification and improving the variety of GF food on-campus are options for improvement.

Funding Agencies

None

Challenges to the Application of Spatially Explicit Stochastic Simulation Models for Foot-and-Mouth Disease Control in Endemic Settings: A Systematic Review

Simulation modeling has become common for estimating the spread of highly contagious animal diseases. Several models have been developed to mimic the spread of foot-and-mouth disease (FMD) in specific regions or countries, conduct risk assessment, analyze outbreaks using historical data or hypothetical scenarios, assist in policy decisions during epidemics, formulate preparedness plans, and evaluate economic impacts. Majority of the available FMD simulation models were designed for and applied in disease-free countries, while there has been limited use of such models in FMD endemic countries. This paper's objective was to report the findings from a study conducted to review the existing published original research literature on spatially explicit stochastic simulation (SESS) models of FMD spread, focusing on assessing these models for their potential use in endemic settings. The goal was to identify the specific components of endemic FMD needed to adapt these SESS models for their potential application in FMD endemic settings. This systematic review followed the PRISMA guidelines, and three databases were searched, which resulted in 1176 citations. Eighty citations finally met the inclusion criteria and were included in the qualitative synthesis, identifying nine unique SESS models. These SESS models were assessed for their potential application in endemic settings. The assessed SESS models can be adapted for use in FMD endemic countries by modifying the underlying code to include multiple cocirculating serotypes, routine prophylactic vaccination (RPV), and livestock population dynamics to more realistically mimic the endemic characteristics of FMD. The application of SESS models in endemic settings will help evaluate strategies for FMD control, which will improve livestock health, provide economic gains for producers, help alleviate poverty and hunger, and will complement efforts to achieve the Sustainable Development Goals.

The impact of a gluten-free diet on adults with coeliac disease: results of a national survey

OBJECTIVE We sought to evaluate the impact of the gluten-free diet on the 5,240 members of the Canadian Celiac Association (CCA). Data are presented on 2,681 adults (>or=16 years) with biopsy-proven celiac disease (CD).

METHODS

A mail-out survey was used. Quality of life was evaluated using the 'SF12', and celiac-specific questions.

RESULTS

Mean age was 56 years, mean age at diagnosis was 45 years, and 75% were female. The 'SF12' summary scores were similar to normative Canadian data, but were significantly lower for females and newly diagnosed patients. Respondents reported: following a gluten-free (GF) diet (90%), improvement on the diet (83%), and difficulties following the diet (44%), which included: determining if foods were GF (85%), finding GF foods in stores (83%), avoiding restaurants (79%), and avoiding travel (38%). Most common reactions to consumed gluten (among 73%) included pain, diarrhea, bloating, fatigue, nausea, and headache. Excellent information on CD and its treatment was provided by the CCA (64%), gastroenterologists (28%), dietitians (26%) and family doctor (12%).

CONCLUSIONS

Quality of life in those with CD could be increased with early diagnosis, increased availability of gluten-free foods, improved food labelling, and better dietary instruction. Education of physicians and dietitians about CD and its treatment is essential.

Search for a 33.9 MeV/c(2) neutral particle in pion decay

The E815 (NuTeV) neutrino experiment has performed a search for a 33. 9 MeV/c(2) weakly interacting neutral particle produced in pion decay. Such a particle may be responsible for an anomaly in the timing distribution of neutrino interactions in the KARMEN experiment. E815 has searched for this particle's decays in an instrumented decay region; no evidence for this particle was found. The search is sensitive to pion branching ratios as low as 10(-13).

PPD skin reactivity and anergy in HIV-infected patients in Hawaii

This study was a prospective screening study for PPD and anergy skin test reactivity in 304 HIV-positive individuals. A PPD positivity rate of 4.1% and an anergy rate of 50.5% were observed. The Hawaii HIV population has a relatively low prevalence of latent TB compared with the high prevalence of TB in the Hawaii population at large.

Dietary intakes of participants in the IditaSport Human Powered Ultra-marathon

Because very little nutritional research has been conducted on participants in ultra marathons and none has been reported on participants in cold weather ultramarathons, this study was undertaken with the purpose of examining the nutritional intakes and urine characteristics of participants in a cold weather ultramarathon. Fourteen participants (13 males and 1 female) in the IditaSport human powered ultramarathon volunteered to be subjects in this study. Pre and post race weights, skinfolds, and urine samples were taken. In addition, a dietary recall was done for the day(s) of the race. Data analysis revealed that a mean of 30,864 (17,143) kJ of energy were consumed with 71% of the energy coming from carbohydrate sources. Despite no significant change in body fat as measured by skinfolds, there was a significant (P < 0.5) decrease in body weight. Ketonuria and proteinuria were present in 83 percent and 92 percent of the subjects. When compared with participants in endurance events taking place in warmer climates, competitors in the IditaSport races consumed more energy with carbohydrates making up a greater percentage of their diets.

Effects of the Iditarod Sled Dog Race on serum thyroid hormones and body composition

Cold exposure, activity and energy deficit have been associated with changes in body composition and/or changes in serum thyroid hormones. Because these conditions are present during the Iditarod Sled Dog Race, 10 volunteer participants were studied before and after the race. Body composition, total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), and free triiodothyronine (FT) levels were determined. There was a significant decrease in body weight (p < 0.05) and a decrease in body fat (p < 0.01). There were no significant changes in TT4, FT4, TT3 or FT3. On the basis of this study, it can be concluded that the strenuous activity of the Iditarod mitigates against the classic perturbation in thyroid axis brought on by the hypocaloric state.

Body composition testing of athletes in the field using bioelectric impedance analysis

Bioelectric impedance analysis was performed as part of the field testing of seventeen athletes competing in the 1990 Iditarod Sled Dog Race. The purpose was to measure initial body composition and the changes that occurred during this extended performance period under Arctic conditions. Four women and thirteen men aged 26-53 years were tested to measure changes in their lean body weight, total body water, total body fat and percent body water. Study results record average body fat losses of 2.14 kg in the male and 1.02 kg in the female racers. Total body water and lean body mass remained stable, while an increase in body water percentage (men: 4.31%, women: 2.78%) was recorded. Though questions remain, bioelectric impedance analysis demonstrates potential for use in future field research projects.

An assessment of the clinical skills of fourth-year students at four New England medical schools

This paper describes a collaborative effort among five New England medical schools to assess important clinical skills of fourth-year medical students graduating in the class of 1988; results are presented from the four schools that provided sufficient data. Faculty from each school developed 36 patient cases representing a variety of common ambulatory-care problems. Over the course of a day, each student, on average, interacted with 16 different standardized patients, who were nonphysicians trained to accurately and consistently portray a patient in a simulated clinical setting. The students obtained focused histories, performed relevant physical examinations, and provided the patients with education and counseling. At each school, the performance of a small number of the students fell below standards set by the faculty. These deficiencies were not detected with the evaluation strategies currently being used. Although the use of standardized patients should not substitute for the process of faculty observing students as they interact with real patients, it appears that standardized patients can provide faculty with important information, not readily available from other sources, about students' performances of essential clinical activities and the levels of their clinical skills.

Reactogenicity of a malaria merozoite antigen in Aotus monkeys compared with the effects caused by two new adjuvants, CP-20,961 and [B30]-MDP

Six Aotus trivirgatus monkeys were included in a clinical study to compare the adverse reactions caused by a Plasmodium falciparum antigen and 2 adjuvants, a lipoidal amine, CP-20,961, and a muramyl dipeptide derivative, [B30]-MDP. Two monkeys were given 2 intramuscular injections, 3 weeks apart, of 1 of these vaccine components. Both the antigen and the two adjuvants caused local and general reactions as well as hematological and biochemical changes. Except for an up to 60% rise in leukocyte count, the antigen caused reactions least, followed by [B30]-MDP. CP-20,961 evoked more vigorous reactions and changes, but none of them reached such an extent that it would contraindicate its potential use in forthcoming vaccine studies. We conclude that both adjuvants are to be considered as relatively safe when combined with an appropriate P. falciparum antigen.

Cell-mediated immune response to respiratory syncytial virus infection in owl monkeys

The suitability of owl monkeys as experimental models to study the cellular immune response to respiratory syncytial virus (RSV) infection was examined. Seronegative owl monkeys inoculated intranasally with RSV shed large quantities of virus and developed clinically evident upper respiratory disease. RSV infected monkeys had significant lymphoproliferative responses to RSV antigen by 4 weeks post-infection. In contrast, no positive blastogenic responses were elicited during the acute phase of illness. An in vitro 51Cr release assay was developed to study owl monkey antibody-dependent cellular cytoxicity (ADCC) against RSV infected Hep-2 cells. Peripheral blood mononuclear cells from owl monkeys in the presence of RSV specific antibody caused lysis of RSV infected target cells. The effector cell for ADCC was found to be non-adherent to plastic. The owl monkey RSV ADCC system was found to closely parallel RSV specific ADCC observed with human effector cells. In addition, it was found that heterologous matches of human effector cells with monkey sera and monkey effector cells with human sera were equally efficient in mediating RSV specific ADCC. These studies demonstrate the value of the owl monkey as a model to study the pathogenesis or RSV infections.

Comparison of levels of fundamental skill and cardio-respiratory fitness of blind, deaf, and non-handicapped high school age boys

Groups of 14- to 16-yr.-old males who were blind, deaf or normal were administered selected stunts from the Iowa-Brace Motor Educability Test and the Ohio State University Step Test. The non-handicapped students scored significantly higher on the motor educability test than the deaf students. The deaf students scored significantly higher than the non-handicapped students on the Ohio State University Step Test. The deaf student's problem area on the motor educability test was balance due to damage of vestibular mechanism associated with the etiology of deafness. The blind students scored in between the others on both tests and were not significantly different from either. It was concluded that balance-oriented activities should be in the curriculum of the handicapped and that impaired cardio-respiratory fitness is not to be associated with blindness and deafness.