IntroductionBuilt environment attributes have been linked to cardiovascular disease (CVD) risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions.ObjectiveTo conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks.Data SourceMultiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted.Inclusion CriteriaStudies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults.Data ExtractionAuthor(s), country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies.ResultsEighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS) to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes.ConclusionThis study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live.

Objectives: This study aimed to evaluate the effects of HealthKick(HK), a healthy lifestyle intervention, on nutrition knowledge, behavior, and dietary selfefficacy of school children in the Western Cape Province of South Africa. Design:A three-year cluster randomized control trial at primary schools in low socioeconomic settings with a baseline study in 2009 and follow-up in 2010 and 2011.Participants: Participants were Grade four children (n=500) at eight schools in the intervention group and at eight schools in the control group (n=498).Methods: An action planning process was followed with educators whereby they identified their own school health priorities and ways to address them. Schools were provided with nutrition resources, including curriculum guidelines and the South African food-based dietary guidelines. Children completed a questionnaire comprising nutrition knowledge, self-efficacy and behavioral items. Results:The intervention significantly improved the knowledge of the intervention group at the first (mean difference =1.88, 95%CI: .32 to 3.43, P=.021) and second follow-up (mean difference=1.92, 95%CI: .24 to 3.60, P=.031) compared with the control group. The intervention effect for self-efficacy was not significant at the first follow-up (mean difference=.32, 95%CI: -.029 to .94, P=.281) whereas a significant effect was observed at the second followup (mean difference=.71, 95%CI: .04 to 1.38, P=.039). There were no significant differences between the intervention and control groups for nutritional behavior scores at any of the follow-up time points. Conclusion:The HK intervention improved nutrition knowledge and self-efficacy significantly in primary schoolchildren; however, it did not improve their eating behavior.

The successful implementation of ICSI has provided a unique means of allowing couples suffering from severe male infertility to achieve their reproductive goals. However, despite the great therapeutic advantages of the technique, ICSI often provides solutions to clinicians in the absence of an aetiological or pathophysiological diagnosis. The development of a sequential diagnostic schedule for patients consulting for fertility disturbances would be an ideal method of approach. Since sperm morphology recorded by strict criteria has often been correlated with fertilization failure, the present study aimed to evaluate the relationship between normal morphology and chromatin staining among fertile and subfertile men. Both chromomycin A3 (CMA3) and acidic aniline blue (AAB) were employed to record chromatin packaging quality among 58 men visiting the andrology laboratory. Intra- and interassay variations were initially recorded for fertile sperm donors. The coefficients of variation (CV) for all intra- and inter-assay assessments were < 12%. Chromatin packaging was significantly and negatively correlated with normal sperm morphology, namely r = 0.40 (P = 0.001) and r = 0.33 (P = 0.001) for CMA3 and AAB, respectively. Receiver operator characteristics illustrated sensitivity and specificity values of 75% and 82% for CMA3 and 60% and 91% for AAB, respectively. Significantly different CMA3 and AAB staining was recorded among men with severe teratozoospermia (< 4% normal forms) when compared with normozoospermic men (> 14% normal forms), namely 49% vs. 29% for CMA3 and 51% vs. 26% for AAB staining, respectively. Chromatin packaging assessments should be a valuable addition to the sequential diagnostic programme in an assisted reproduction arena.

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