艾滋病咨询检测辅助软件初步应用评价

目的初步评估自愿咨询检测（VCT）辅助软件的有效与可行性并为软件完善、评估与推广提供线索。方法运用知情人定性访谈、求询者问卷调查和咨询案例比较分析对软件应用的可行性、可接受性及其对咨询服务质量的影响进行综合评价。结果软件使次均咨询时间从5．55min提高到10．73min；使关键咨询内容涉及率平均提高1．5倍以上；使求询相关知识知晓率从40．51％提高到86．34％；绝大多数咨询医生和求询者都认为软件可行、有效、可推广。结论VCT辅助软件值得进一步试用和研究。     

Telephone counseling helps maintain long-term adherence to a high-vegetable dietary pattern

Achieving long-term adherence to a dietary pattern is a challenge in many studies investigating the relationship between diet and disease. The Women's Healthy Eating and Living Study was a multi-institutional randomized trial in 3088 women at risk for breast cancer recurrence. At baseline, the average participant followed a healthy dietary pattern of 7 vegetable and fruit servings, 21 g/d of fiber, and 28.7% energy from fat, although fat intake increased over the enrollment period. Using primarily telephone counseling, the intervention group was encouraged to substantially increase intakes of vegetables, fruits, and fiber while decreasing fat intake. Sets of 24-h dietary recalls were completed on 90% of eligible participants at 1 y and 86% at 4 y. Using a conservative imputation analysis, at 1 y, the intervention group consumed 38% more vegetable servings (100% when including juice) than the comparison group, 20% more fruit, 38% more fiber, 50% more legumes, and 30% more whole grain foods, with a 20% lower intake of energy from fat. At 4 y, the between-group differences were 65% for vegetables (including juice), 25% fruit, 30% fiber, 40% legumes, 30% whole grain foods, and 13% lower intake of energy from fat. The intervention effect on fat intake was similar for early vs. late enrollees. Plasma carotenoid concentrations on a random 28% sample validated self-reported vegetable and fruit intake, with a between-group difference of 66% at 1 y and over 40% at 4 y. This large change will allow testing of hypotheses on the role of dietary change in preventing additional breast cancer events.     

Oligofructose promotes satiety in healthy human: a pilot study

OBJECTIVE: The administration of a fermentable dietary fibre (oligofructose) in rats increases satietogenic gut peptides and lowered spontaneous energy intake. The aim of the study was to assess the relevance of those effects of oligofructose on satiety and energy intake in humans. DESIGN: Single-blinded, crossover, placebo-controlled design, pilot study. SUBJECTS: Volunteers included five men and five women aged 21-39 years, BMI ranging from 18.5 to 27.4 kg/m(2), were randomly assigned as described below. INTERVENTIONS: Subjects were included in two 2-week experimental phases during which they received either fibre (oligofructose (OFS)) or placebo (dextrine maltose (DM)); a 2-week washout period was included between crossover phases. In total, 8 g OFS or 8 g DM were ingested twice daily (16 g/day in total). Energy intake, hunger, satiety, fullness and prospective food consumption were assessed with analogue scales at the end of each experimental phase. RESULTS: During breakfast, OFS significantly increases the satiety (P=0.04) without any difference on other sensations as compared to DM treatment periods. After lunch, no significant differences are observed between treatment period. At dinner, OFS significantly increases satiety (P=0.04), reduces hunger (P=0.04) and prospective food consumption (P=0.05). The energy intake at breakfast and lunch are significantly lower (P=0.01, 0.03, respectively) after OFS treatment than after DM treatment. Total energy intake per day is 5% lower during OFS than in DM period. CONCLUSION: Oligofructose treatment increases satiety following breakfast and dinner, reduces hunger and prospective food consumption following dinner. This pilot study presents a rationale to propose oligofructose supplements in the management of food intake in overweight and obese patients.     

Facilitating dietary change: the patient-centered counseling model

Recent data indicate that the patient-centered counseling model enhances long-term dietary adherence. This model facilitates change by assessing patient needs and subsequently tailoring the intervention to the patient's stage in the process of change, personal goals, and unique challenges. This article describes this model, including its theoretical foundations, a 4-step counseling process, and applications. This behavioral counseling model can help nutrition professionals enhance patient adherence to nutrition care plans and dietary guidelines.     

Telephone interventions for physical activity and dietary behavior change: a systematic review

BACKGROUND: Given the epidemic of lifestyle-related chronic diseases, building the evidence base for physical activity and dietary behavior change interventions with a wide population reach is of critical importance. For this purpose, telephone counseling interventions have considerable potential. PURPOSE: To systematically review the literature on interventions for physical activity and dietary behavior change in which a telephone was the primary method of intervention delivery, with a focus on both internal and external validity. METHODS: A structured search of PubMed, Medline, and PsycInfo was conducted for studies published in English from 1965 to January 2006. Studies targeted primary or secondary prevention in adults, used randomized designs, and included physical activity and/or dietary behavior outcomes. RESULTS: Twenty-six studies were reviewed, including 16 on physical activity, six on dietary behavior, and four on physical activity plus dietary behavior. Twenty of 26 studies reported significant behavioral improvements. Positive outcomes were reported for 69% of physical activity studies, 83% of dietary behavior studies, and 75% of studies addressing both outcomes. Factors associated with positive outcomes appear to be the length of intervention and the number of calls, with interventions lasting 6 to 12 months and those including 12 or more calls producing the most favorable outcomes. Data on the representativeness of participants, implementation of calls, and costs were reported much less frequently. CONCLUSIONS: There is now a solid evidence base supporting the efficacy of physical activity and dietary behavior change interventions in which the telephone is the primary intervention method. Thus, research studies on broader dissemination are necessary, and should address questions relevant to the translation of this body of work into population health practice.     

Measuring dietary change in a diet intervention trial: comparing food frequency questionnaire and dietary recalls

Measurement of dietary change was assessed in a systematic quota subsample (n = 397) of women recruited into the Women's Healthy Eating and Living Study between 1996 and 1998, a multicenter, randomized dietary intervention trial among breast cancer survivors. Women from the intervention and comparison arms completed the Arizona Food Frequency Questionnaire (AFFQ) and 24-hour dietary recalls at baseline (prerandomization) and at year 1 (postrandomization). Both dietary measurement methods demonstrated significant changes in intake of key intervention-associated nutrients at year 1 in the intervention group subjects compared with minimal or no change in the comparison group subjects. The reliability of the AFFQ and recalls was measured in the comparison group and showed correlations of 0.63 and 0.43, respectively. Both instruments captured differences in dietary intake associated with the diet intervention. These results demonstrate the utility of using a multimode, multimethod approach (AFFQ and 24-hour dietary recalls) to measure differences in self-reported dietary intake over time as shown in this dietary intervention trial being conducted among breast cancer survivors.     

Glycemic indices of three commonly consumed foods: a clinical trial in Iranian healthy adults

Type of carbohydrate and glycemic index of traditional foods is still a challenge in nutritional management of diabetics. This study was conducted to determine the GI of pasta (ordinary and infused), made from either nol (common wheat) or semolina (durum wheat) flour, compared to white rice in subjects. Twelve healthy volunteers with body mass index 23.5?±?1.45?kg/m² and age 36?±?2.85?years participated in this study. Twelve hours overnight fasting capillary blood samples were collected from subjects at baseline by finger stick using a sterile lancet pen immediately before ingestion of either 50?g of d-glucose anhydrate dissolved in 300?ml distilled water, 192.3?g cooked pasta or 185.2?g of rice (50?g carbohydrate) alongside 300?ml water. Blood samples were collected again at 0, 15, 30, 45, 60, 90 and 120?min. All subjects consumed the test meals at 1-week interval. The standard glucose solution was administered at the first and fourth week of study. Blood samples were analysed using an Accu-Chek Aviva Blood Glucose Monitor. The area under the curve was calculated as the incremental area under the blood glucose response curve for each test in each individual. The GI values were determined according to FAO/WHO standard methods. This study indicated that the GI of ordinary pasta made from semolina {47} is significantly lower than nol flour pasta {68} or cooked rice {73}. There was a reverse, but non-significant, difference between the GI of semolina-infused pasta {63} versus nol-infused pasta {60}. Glycemic index for pasta (semolina and non-infused) was significantly less than that of nol wheat pasta, cooked rice and white bread. This study underscores the importance of consuming ordinary pasta made from semolina as part of a low GI diet for controlling blood glucose levels.     

Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind, placebo-controlled, randomized clinical trial.

OBJECTIVE: Ginseng is a popular, commercially available dietary supplement that is purported to have a number of psychological benefits. The purpose of this study was to examine these claims, with specific reference to ginseng's effects on affect and mood. DESIGN: Prospective, double-blind, placebo-controlled, randomized clinical trial. PARTICIPANTS/SETTING: Eighty-three adults (40 women, 43 men) participated in this study (mean age = 25.7 year). Participants were recruited from within a university community and at area health clubs. INTERVENTION: Participants were randomly assigned to one of three experimental conditions: placebo (lactose), 200 mg ginseng, or 400 mg ginseng. The ginseng preparation used in this study consisted of the Panax ginseng C A Meyer concentrate G115 in capsular format. Each participant was given a 60-day allotment of their respective supplement along with written instructions about the proper intake and storage of the capsules during the 8-week study period. MAIN OUTCOME MEASURES: Positive affect, negative affect, and total mood disturbance. Measures were obtained pre- and post-intervention. STATISTICAL ANALYSES PERFORMED: Repeated measures multivariate analysis of variance was used. Because there were three dependent variables, and in an effort to minimize the experimentwise-error rate, alpha was adjusted using the Bonferroni technique (i.e., P < .05/3 = P < .016). RESULTS: Ginseng supplementation had no effect on positive affect, negative affect, or total mood disturbance (all P > .016). CONCLUSION: The present findings do not support claims that chronic ginseng supplementation--at either its clinically recommended level or at twice that level--enhances affect or mood in healthy young adults.     

Objectively-assessed physical activity and weight change in young adults: a randomized controlled trial

Background

Reductions in physical activity (PA) are common throughout young adulthood and low PA is associated with weight gain. The SNAP Trial previously reported that two self-regulation approaches to weight gain prevention reduced weight gain over a 2-year period in 18–35 year olds. Presented here are secondary analyses examining changes in PA and the relationship between PA and weight change over 2 years.

Methods

599 young adults (age: 27.4?±?4.4 yrs.; BMI: 25.4?±?2.6 kg/m²) were randomly assigned to 1 of 3 treatment arms: Small Changes (reduce calorie intake by 100 kcals/day & add 2000 steps/day), Large Changes (lose 2.3–4.5 kg initially & increase PA to ≥250 min/wk), or Self-guided (control condition). Small and Large Changes received 10, face-to-face group sessions (months 1–4), and two 4-week refresher courses each subsequent year. Body weight and PA were objectively-measured at baseline, 4 months, 1 and 2 years. Daily steps and bout-related moderate-to-vigorous intensity PA (MVPA: ≥3 METs, ≥10-min bouts) was calculated.

Results

Changes in bout-related MVPA and daily steps did not differ among treatment groups over the 2-year period (p’s?>?0.16). Collapsed across groups, participants gaining >1 lb. (n?=?187; 39.6%) had smaller changes in bout-related MVPA at 4 months, 1 and 2 years relative to those maintaining or losing weight (≤1 lb. weight gain; n?=?282, 60.4%, p’s?<?0.05). Averaged across time points, this difference equated to 47.8 min/week. Those gaining and not gaining >1 lb. did not differ on daily steps (p’s?>?0.10). Among participants engaging in ≥250 min/wk. of MVPA at 2 years (n?=?181), 30% gained >1 lb. from baseline to 2 years, which was not different from those engaging in 150–250 min/wk. (n?=?87; 36%; p?=?0.40), but this percentage was significantly lower when compared to those engaging in <150 min/wk. (n?=?176; 49%; p?<?0.001).

Conclusions

On average, PA differences were not observed between young adults assigned to small or large changes self-regulation interventions to prevent weight gain. Regardless of group assignment, higher levels of MVPA were associated with better weight gain prevention over 2 years. Our data suggest that achieving >150 min/week of MVPA is needed for weight gain prevention and that increasing MVPA, rather than steps, should be targeted.

Trial registration

www.clinicaltrials.gov (NCT01183689). Registered Aug 13, 2010.

     

Short-term effects of whole-grain wheat on appetite and food intake in healthy adults: a pilot study

While it has been proposed, based on epidemiological studies, that whole grains may be beneficial in weight regulation, possibly due to effects on satiety, there is limited direct interventional evidence confirming this. The present cross-over study aimed to investigate the short-term effects on appetite and food intake of 48 g of whole-grain wheat (daily for 3 weeks) compared with refined grain (control). A total of fourteen healthy normal-weight adults consumed, within their habitual diets, either two whole-grain bread rolls (providing 48 g of whole grains over two rolls) or two control rolls daily for 3 weeks. Changes in food intake were assessed using 7 d diet diaries. Changes in subjective appetite ratings and food intake were also assessed at postprandial study visits. There were no significant differences between interventions in energy intake (assessed by the 7 d diet diaries and at the ad libitum test meal), subjective appetite ratings or anthropometric measurements. However, there was a significant difference between interventions for systolic blood pressure, which decreased during the whole-grain intervention and increased during the control intervention (-2 v. 4 mmHg; P = 0·015). The present study found no effect of whole grains on appetite or food intake in healthy individuals; however, 48 g of whole grain consumed daily for 3 weeks did have a beneficial effect on systolic blood pressure. The findings from the present study therefore do not support epidemiological evidence that whole grains are beneficial in weight regulation, although further investigation in other population groups (such as overweight and obese) would be required.     

Phase 1 trial of a 13-valent pneumococcal conjugate vaccine in healthy adults

In a Phase 1 study, 15 healthy subjects were randomized to receive a 13-valent pneumococcal conjugate vaccine (PCV13) and 15 to receive a 23-valent pneumococcal polysaccharide vaccine (23vPS). Antibody responses were measured immediately before and approximately one month after vaccination. Serotype-specific antibodies were measured using an enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) and an opsonophagocytic assay (OPA) for functional antibodies. PCV13 was as immunogenic or more immunogenic than 23vPS and was well tolerated.     

Anthropometric and dietary evaluations in a sample of "healthy" Mexican older adults

The purpose of this study was to describe anthropometric, metabolic, and nutritional characteristics in healthy elderly adults in a primary health care setting. It was conducted through a cross-sectional study of 80 subjects 60 years of age and older. After confirming healthy status, clinical, biochemical, dietetic, and anthropometric evaluations were performed. The findings indicated 22% had anemia, 22% had impaired glucose tolerance, 46% had hypertriglyceridemia, and 51% had hypercholesterolemia. More than 50% had obesity, and almost 80% had a high risk waist circumference measure. Mean energy intake was normal; however, more than 50% of participants did not have adequate intakes of potassium, calcium, magnesium, zinc, folic acid, and vitamins B(12) and A. Inadequate food intakes were common. Specific examples are that 16% of the subjects ate no meat/egg, 31% ate no dairy products, 56% ate no legumes, 22% ate no fruits, and 41% ate no vegetables. Additionally, 31% consumed soft drinks. Therefore, we can conclude that elderly people otherwise considered as "healthy" nonetheless had a high proportion of obesity and cardiovascular risk factors. Inadequate dietary patterns were also observed and corresponded with poor micronutrient intake.