Background Underserved children, particularly girls and those in urban communities, do not meet the recommended physical activity guidelines (>60 min of daily physical activity), and this behavior can lead to obesity. The school years are known to be a critical period in the life course for shaping attitudes and behaviors. Children look to schools for much of their access to physical activity. Thus, through the provision of appropriate physical activity programs, schools have the power to influence apt physical activity choices, especially for underserved children where disparities in obesity-related outcomes exist. Objectives To evaluate the impact of a nurse directed, coordinated, culturally sensitive, school-based, family-centered lifestyle program on activity behaviors and body mass index. Design, settings and participants: This was a parallel group, randomized controlled trial utilizing a community-based participatory research approach, through a partnership with a University and 5 community schools. Participants included 251 children ages 8–12 from elementary schools in urban, low-income neighborhoods in Los Angeles, USA. Methods The intervention included Kids N Fitness©, a 6-week program which met weekly to provide 45 min of structured physical activity and a 45 min nutrition education class for parents and children. Intervention sites also participated in school-wide wellness activities, including health and counseling services, staff professional development in health promotion, parental education newsletters, and wellness policies for the provision of healthy foods at the school. The Child and Adolescent Trial for Cardiovascular Health School Physical Activity and Nutrition Student Questionnaire measured physical activity behavior, including: daily physical activity, participation in team sports, attending physical education class, and TV viewing/computer game playing. Anthropometric measures included height, weight, body mass index, resting blood pressure, and waist circumference. Measures were collected at baseline, completion of the intervention phase (4 months), and 12 months post-intervention. Results Significant results for students in the intervention, included for boys decreases in TV viewing; and girls increases in daily physical activity, physical education class attendance, and decreases in body mass index z-scores from baseline to the 12 month follow-up. Conclusions Our study shows the value of utilizing nurses to implement a culturally sensitive, coordinated, intervention to decrease disparities in activity and TV viewing among underserved girls and boys.

A CSHP using parent and community involvement was effective in reducing the risk of obesity in school-aged Mexican- American children attending low-income schools. The findings need to be examined in a larger, more diverse sample of children.

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Growing interest among academics and health professionals in finding new ways to study and address complex health and social problems has manifested in recent years with increasing community demands for research and program implementation that is community-based, rather than merely community placed. In the United States, community-based participatory research (CBPR), with its emphasis on the creation and use of community-university or community-academic partnerships, is the prevailing paradigm to address these complex problems, especially those concerning racial/ethnic disparities in health and health care. While the need to strengthen the relationship between researchers and the community has been recognised, often from the viewpoint of the university partner, discussions on sustainability of partnerships have been few. The aim of this paper is to share reflections, through the eyes of the community members, on the core elements that tie community and academic members together and the challenges in understanding and nurturing those ties so that the community-academic partnership is sustained over time, and to offer possible recommendations for sustainability. This article speaks from the community’s perspective and reflects on the vital elements/components that tie together community-university partnerships and the challenges that may occur when trying to sustain and grow the partnership. It is based on a research CBPR study that was conducted to (1) evaluate the functioning and future sustainability of the community-university partnership of the Community Child Health Network Study Los Angeles (CCHN-LA) community-university partnership, and (2) evaluate the experience and beliefs of the current CCHN-LA community-university partnership members in their understanding of current functioning. Keywords Community-academic partnerships; sustainability; challenges; solutions

The progressive increase in antibiotic resistance in recent decades calls for urgent development of new antibiotics and antibiotic stewardship programs to help select appropriate treatments with the goal of minimising further emergence of resistance and to optimise clinical outcomes. Three new tetracycline-class antibiotics, eravacycline, omadacycline, and tigecycline, have been approved within the past 15 years, and represent a new era in the use of tetracyclines. These drugs overcome the two main mechanisms of acquired tetracycline-class resistance and exhibit a broad spectrum of in vitro activity against gram-positive, gram-negative, anaerobic, and atypical pathogens, including many drug-resistant strains. We provide an overview of the three generations of tetracycline-class drugs, focussing on the efficacy, safety, and clinical utility of these three new third-generation tetracycline-class drugs. We also consider various scenarios of unmet clinical needs where patients might benefit from re-engagement with tetracycline-class antibiotics including outpatient treatment options, patients with known β-lactam antibiotic allergy, reducing the risk of Clostridioides difficile infection, and their potential as monotherapy in polymicrobial infections while minimising the risk of any potential drug-drug interaction. KEY MESSAGES The long-standing safety profile and broad spectrum of activity of tetracycline-class antibiotics made them a popular choice for treatment of various bacterial infections; unfortunately, antimicrobial resistance has limited the utility of the early-generation tetracycline agents. The latest generation of tetracycline-class antibiotics, including eravacycline, tigecycline, and omadacycline, overcomes the most common acquired tetracycline resistance mechanisms. Based on in vitro characteristics and clinical data, these newer tetracycline agents provide an effective antibiotic option in the treatment of approved indications in patients with unmet clinical needs – including patients with severe penicillin allergy, with renal or hepatic insufficiency, recent Clostridioides difficile infection, or polymicrobial infections, and those at risk of drug–drug interactions.