Differential effects of saccharin supplementation on alcohol and water consumption by Wistar rats from different sources

The study was aimed to elucidate whether the dissimilar effects of concurrent presentation of sweet water on alcohol consumption previously reported for Wistar rats from different sources remain unchanged when alcohol is also flavored with 0.1% saccharin. Male Wistar rats from Laboratory of Experimental Biological Models (LEBM) and Krukovo animal farm (K) stocks having had 2 months free access to food, tap water, and 10% alcohol were given four consecutive two-bottle drinking tests: alcohol versus water, alcohol versus sweet water, sweet alcohol versus water, or sweet alcohol versus sweet water. The test order was quasi-random and each test lasted 4 days. In Wistar (K) rats, flavoring of either water or alcohol solution increased consumption of each of the fluids and decreased intake of concurrently available fluids. The elevation in water intake induced by its sweetening was antagonized by flavoring of alcohol solution. In Wistar (LEBM) rats, flavoring of either water or alcohol increased consumption of each of the fluid, but did not change the intake of alternative fluids. The stable alcohol consumption by Wistar (LEBM) rats and its suppression seen in Wistar (K) rats induced by concurrent presentation of flavored water parallel the patterns previously observed among P, sP, and HAD rats suggesting the existence among alcohol-consuming animals of typological diversity of alcohol motivation.     

Longitudinal examination of 24-h urinary iodine excretion in schoolchildren as a sensitive, hydration status-independent research tool for studying iodine status

BACKGROUND: Because worldwide iodine status (IS) depends on continuous fortification, the adequacy of IS needs to be regularly monitored. OBJECTIVE: Our study aimed to evaluate IS in a longitudinal sample of healthy schoolchildren who regularly used table salt iodized with 20 microg I/g. DESIGN: Urine osmolality (Uosm) and 24-h urinary excretion rates of iodine (24-h UI), sodium, creatinine, and total urine volume (24-h Uvol) were measured in 1046 specimens that were collected at repeated intervals from 1996 to 2003 in a sample of 358 German children aged 6-12 y. Energy intake and food consumption were calculated from 3-d weighed dietary records that were collected in parallel to the urine samples. RESULTS: During the 4-y period from 1996 to 1999, the median 24-h UI increased from 87 to 93 microg I/d (P = 0.017), whereas urinary iodine concentration (UIC), Uosm, and 24-h Uvol did not change significantly. Thereafter (from 2000 to 2003), UIC stagnated and Uosm decreased (P = 0.004), whereas 24-h Uvol (P = 0.008) and 24-h UI (P = 0.002) increased. The final median 24-h UI reached 120 microg I/d. Milk, fish, egg, and meat intakes and 24-h sodium excretion were all significant predictors of IS, with an almost doubled contribution from milk intake during the second 4-y period. CONCLUSIONS: Our study shows a continuous improvement of IS in a longitudinal sample of German schoolchildren. This improvement was masked when UIC was used as an IS index, especially from 2000 to 2003 because of changes in hydration status. Thus, in research-oriented studies that focus on UIC measurements, hydration status can be a relevant confounder. Longitudinal analyses of 24-h UI in cohort studies may represent an alternative hydration status-independent tool to examine trends in IS and the contribution of relevant foods to IS.     

Computers and caregiving: reaching out and redesigning interventions for homebound older adults and caregivers

This article discusses computer resources for homebound older adults and informal caregivers as an intervention to promote social support and mental health. Published information related to a computer network designed as an intervention for informal caregivers of persons with Alzheimer's disease is included. This information suggests that homebound older adults and informal caregivers can gain valuable information, confidence, and support by using computer resources. A review of the literature supported those findings and suggested that computer technology can facilitate continuing education and the refinement of skills for nurses. Implications for the use of computer resources in nursing education, practice, and research are presented.     

Satisfaction With Care Coordination for Families of Children With Disabilities

Introduction

Children with disabilities have significant health care needs, and receipt of care coordinator services may reduce caregiver burdens. The present study assessed caregivers’ experience and satisfaction with care coordination.

Medicaid managed care and the unmet need for mental health care among children with special health care needs

OBJECTIVE: To determine the association between Medicaid managed care pediatric behavioral health programs and unmet need for mental health care among children with special health care needs (CSHCN). DATA SOURCE: The National Survey of CSHCN (2000-2002), using subsets of 4,400 CSHCN with Medicaid and 1,856 CSHCN with Medicaid and emotional problems. Additional state-level sources were used. STUDY DESIGN: Multilevel models investigated the association between managed care program type (carve-out, integrated) or fee-for-service (FFS) and reported unmet mental health care need. DATA COLLECTION/EXTRACTION METHODS: The National Survey of CSHCN conducted telephone interviews with a sample representative at both the national and state levels. PRINCIPAL FINDINGS: In multivariable models, among CSHCN with only Medicaid, living in states with Medicaid managed care (odds ratio [OR]=1.81; 95 percent confidence interval: 1.04-3.15) or carve-out programs (OR=1.93; 1.01-3.69) were associated with greater reported unmet mental health care need compared with FFS programs. Among CSHCN on Medicaid with emotional problems, the association between managed care and unmet need was stronger (OR=2.48; 1.38-4.45). CONCLUSIONS: State Medicaid pediatric behavioral health managed care programs were associated with greater reported unmet mental health care need than FFS programs among CSHCN insured by Medicaid, particularly for those with emotional problems.     

State Policy Environment and Delayed or Forgone Care Among Children with Special Health Care Needs

Objective To evaluate if children with special health care needs (CSHCN) residing in states with more generous public insurance programs were less likely to report delayed or forgone care. Methods We used multilevel modeling to evaluate state policy characteristics after controlling for individual characteristics. We used the 2001 National Survey of CSHCN for individual-level data (N = 33,317) merged with state-level data, which included measures of the state’s public insurance programs (Medicaid eligibility and enrollment, spending on Medicaid, SCHIP and Title V, and income eligibility levels), state poverty level and provider supply (including pediatric primary care and specialty providers). We also included a variable for state waivers for CSHCN requiring institutional level care. Results Delayed or forgone care significantly varied among CSHCN between states, net of individual characteristics. Of all the state characteristics studied, only the Medicaid income eligibility levels influenced the risk of experiencing delayed care. CSHCN living in states with higher income eligibility thresholds or more generous eligibility levels were less likely to experience delayed care (OR 0.89(0.80,0.99); P ≤ 0.05). Conclusions By analyzing child health policy in the context of individual characteristics that may place a child at risk for delayed care, we determined that improving Medicaid eligibility levels improved the process of care for CSHCN.     

Factors associated with participation or nonparticipation in a workplace wellness center

The aim of this project was to compare characteristics and factors that distinguished those individuals (n = 101) who participated in a worksite wellness program from those who did not (n = 100). This project was unique in that the majority of subjects were bluecollar workers. Factor analysis of a 35-item questionnaire resulted in six factors: perceived benefits of health promotion behaviors, perceived physical barriers of health promotion, perceived self-efficacy for health promotion behaviors, perceived psychological barriers, situational components relating to convenience of the wellness facility, and the need for social support. Discriminant analysis revealed that self-efficacy was the most useful factor in distinguishing between the two groups. Participants identified more benefits and fewer barriers to health promotion activities. Nonparticipants were older, less educated, and tended to view their age, their perceived lack of fitness, and perceived poorer health status as deterrents to regular physical activity. Nonparticipants also identified shift work, working overtime, responsibilities at home, and distance from work as important barriers to health promotion activities. Self-efficacy factors appear to warrant further investigation in future attempts to explain health promotion behaviors in this high risk group.