Counseling strategies for dietary management: expanded possibilities for effecting behavior change

Successful nutrition counseling culminates when a client develops a sound working knowledge and practice of good health behaviors, compatible with his/her capabilities and environment. Attainment of that goal requires the cooperation and active participation of both the nutrition counselor and the client. Counseling methodologies abound. The incorporation of strategies and techniques from different approaches into the treatment protocol, using a multidisciplinary approach, may enhance the effectiveness of nutrition counseling in facilitating dietary behavior change. A schematic model of nutrition counseling is presented, and varying counseling theories are introduced that could be incorporated into the model.     

Influence of preformed α-helix and α-helix induction on the activity of cationic antimicrobial peptides

One prominent class of cationic antibacterial peptides comprises the α-helical class, which is unstructured in free solution but folds into an amphipathic α-helix upon insertion into the membranes of target cells. To investigate the importance of α-helicity and its induction on interaction with membranes, a series of peptides was constructed based on a hybrid of moth cecropin (amino acids 1-8) and bee melittin (amino acids 1-18) peptides. The new peptides were predicted to have a high tendency to form α-helices or to have preformed α-helices by virtue of construction of a lactam bridge between glutamate and lysine side-chains at positions i and i+ 4 at various locations along the primary sequence. In two examples where the use of lactam bridge constraints induced and stabilized α-helical structure in benign (aqueous buffer) and/or hydrophobic medium, there was a decrease in antibacterial activity relative to the linear counterparts. Thus the preformation of α-helix in solution was not necessarily beneficial to antimicrobial activity. In the one case where the lactam bridge did result in increased antibacterial activity (lower minimal inhibitory concentration values) it did not increase α-helical content in benign or hydrophobic medium. Broadly speaking, good activity of the peptides against Pseudomonas aeruginosa correlated best (r²= 0.88) with a helican parameter which was calculated as the induction of α-helix in α membrane-mimicking environment divided by the α-helix formation under benign conditions. Interestingly, the activity of the lactam bridge peptide constructs correlated in part with alterations in bacterial outer or cytoplasmic membrane permeability.     

The applicability and utility of the MMPI-based offender classification system in a correctional mental health unit

This study investigated the applicability and utility of Megargee and Bohn's MMPI-based offender classification system in correctional mental health units (MHUs). Previous studies found that 11 MHU samples (n = 1723) had substantially more offenders classified in the more pathological MMPI types than did 21 samples (n = 5881) drawn from general male populations in US prisons. In this study of 63 severely disturbed felons, 43% belonged to the most pathological type (‘group How’). Comparing MHU patients with general offenders from the same IvfIvIPI types on staff ratings and case history variables, we found that the MHU patients were significantly poorer in adjustment. Within the MHU sample, there was no difference in case history variables or adjustment ratings between those in the most and least severe MMPI types. These findings differed from those of studies using less severely disturbed, more heterogeneous, MHU populations. It was concluded that, in settings in which the entire population is flagrantly disturbed, the MMPI-based system is more useful in screening potential admissions than it is in making meaningful distinctions among those already admitted.     

ALFENTANIL PLASMA CONCENTRATION v. EFFECT RELATIONSHIPS IN CARDIAC SURGICAL PATIENTS

Effects of alfentanil, preceded by lorazepam, on suppressionof haemodynamic and somatic responses to noxious stimuli wasstudied in patients undergoing CABG. Plasma concentration ofalfentanil, somatic and haemodynamic responses were measuredat loss of consciousness, tracheal intubation, sternotomy andduring multiple applications of electrocoagulation. Additionalalfentanil was administered i.v. to control unwanted responses.Study 1 (six patients): lorazepam 0.08 mg kg^–1 by mouth1–2 h before operation, alfentanil priming infusion (60µg kg^–1 min^–1 for 10 min) followed by maintenanceinfusion (4.5 µg kg^–1 min^–1). With mean plasmaalfentanil 1178 (SEM 54) ng ml^–1, two patients requiredsupplementary alfentanil to suppress somatic motor responses;one patient required nitroglycerin to control an increase inarterial pressure which was unresponsive to additional alfentanilfollowing sternotomy. Study 2 (13 patients): lorazepam 0.04mg kg^–1 by mouth as premedication; one of three maintenanceinfusion rates of alfentanil: 5.4 (n=4), 6.6 (n=5), or 7.8 (n=4)µg kg^–1 min^–1, each preceded by a proportionalpriming infusion. With plasma alfentanil 2181 (62)ng ml^–1,somatic motor responses requiring additional alfentanil occurredin nine patients; haemodynamic responses in four of seven patientstested could not be controlled by alfentanil. The highest plasmaconcentration of alfentanil to prevent response to a stimulusother than tracheal intubation was different between the twostudies (P<0.05). We conclude that alfentanil alone is insufficientto suppress haemodynamic and somatic motor responses to noxiousstimulation during CABG and that the role of premedication issignificant. *Department of Anesthesia, Bowman-Gray School of Medicine Winston-Salem,NC 27103, U.S.A. 2114 de Mayo Road, Del Mar, Ca. 92014, U.S.A.     

An Immunotoxicological Evaluation of 4, 4'-Thiobis-(6-t-butyl-m-cresol) in Female B6C3F1 Mice: 1. Body and Organ Weights, Hematology, Serum Chemistries, Bone Marrow Cellularity, and Hepatic Microsomal Parameters

An Immunotoxicological Evaluation of 4,4'-Thiobis-(6-t-butyl-m77-cresol)in Female B6C3F1 Mice. 1. Body and Organ Weights, Hematology,Serum Chemistries, Bone Marrow Cellularity, and Hepatic MicrosomalParameters. MUNSON, A. E., WHITE, K. L., JR., BARNES, D. W.,MUS-GROVE, D. L., LYSY, H. H., AND HOLSAPPLE, M. P. (1988).Fundam. Appl. Toxicol. 10, 691–700. Adult female B6C3F1mice were gavaged with 4,4'-thiobis-(6-t-butyl-m-cresol) (TBBC)in corn oil at doses of 10, 100, or 200 mg/kg daily for 14 consecutivedays. There was no overt toxicity, as manifested by grosslyobservable behavioral changes, decreased growth rate over theexposure period, or mortality. There were also no marked effectson serum chemistries or hematology, with the exception of asignificant increase (41%) in the number of leukocytes at thehighest dose. Absolute differential counts indicated that significantincreases occurred in the number of lymphocytes (31%) and neutrophils(177%). Studies with bone marrow indicated a significant 30%increase in the number of cells/femur from animals treated withthe highest dose of TBBC. The number of macrophage progenitors(CFU-M)/femur was significantly increased by 28%, while thenumber of granulocyte-monocyte progenitors (CFU-GM)/femur wasnonsig-nificantly increased by 20% in the high dose animals.The weight of both the spleen and liver was increased in a dose-relatedfashion, although the histopathology of the spleen of TBBC-treatedmice was not different from control. The livers of mice receivingthe high dose showed mild focal hydropic degeneration, mildhepatitis, and a slight increase in the number of Kupffer cells.No other organs were affected. Liver microsomal protein andcytochrome P-450 levels were increased in a dose-related fashion.Enzyme activities of aminopyrine demethylase and aniline hydroxylase,but not arylhydrocarbon hydroxylase, were also increased ina dose-related fashion.     

Antimicrobial susceptibility changes in Enterococcus faecalis following various penicillin exposure regimens.

Penicillin-"virgin" strains of Enterococcus faecalis collected from a population of individuals with no previous antibiotic exposure were subjected in vitro to penicillin delivered as repeated pulses, stepwise increasing concentrations, or sustained levels of a single concentration. Changes in resistance to penicillin were assessed by determination of MICs, and time-kill studies were performed to evaluate changes in tolerance to the bactericidal effects of penicillin. Isogenic clones, derived from various exposure regimens, which exhibited changes in either resistance or tolerance were further examined for changes in penicillin-binding proteins. Exposure to repeated pulses of penicillin resulted in the development of tolerance to penicillin without changes in the level of resistance. Clones derived from a regimen of stepwise increases in the penicillin concentration acquired both increased penicillin resistance and tolerance. Clones selected after prolonged continuous exposure to a fixed concentration of penicillin displayed minimally increased resistance to penicillin, but they retained the lytic, nontolerant response to the bactericidal effect of penicillin. Clones which acquired tolerance to the bactericidal effect of penicillin without changes in penicillin resistance exhibited a penicillin-binding protein pattern identical to that of the parental strain. Increased labeling of several penicillin-binding proteins accompanied the development of increased penicillin resistance in both penicillin-tolerant and nontolerant strains. Exposure of E. faecalis to penicillin in repeated pulses of brief duration, for prolonged periods at a constant concentration, or in stepwise graded concentrations can result in the selection of clones with increased resistance to the inhibitory or bactericidal effects of penicillin, or both. These observations may be relevant to the selection of dosing regimes for penicillin in the treatment of enterococcal infections, when bactericidal synergism cannot be achieved with penicillin-aminoglycoside combinations.     

Immunotoxicity of the Semiconductor Gallium Arsenide in Female B6C3F1 Mice

The effects of gallium arsenide (GaAs) exposure on immunocompetenceof B6C3F1 female mice were investigated. GaAs was administeredas a single intratracheal instillation at doses of 50, 100,and 200 mg/kg. Fourteen days after exposure, various cellularand humoral immune parameters were assessed. GaAs exposure increasedspleen cellularity in a dose-dependent manner. However, thepercentages of Thy 1.2 positive and 1g positive cells were decreasedand that of F4/80 positive cells was increased dose dependency.The IgM and IgG antibody-forming cell response of the spleento the T-dependent antigen sheep erythrocytes was reduced by66 and 48%, respectively, at 200 mg/kg. Levels of the serumcomplement protein, C3, were increased by as much as 16% withno significant change in CH50 levels. The mitogenic responseof splenic T cells to Con A and PHA was unaffected by GaAs,but that of B cells to LPS was increased by 52%. The delayedhypersensitivity response to keyhole limpet hemocyanin and mixedlymphocyte response were significantly reduced in a dose-dependentmanner by GaAs exposure. Natural killer cell activity againstthe YAC-1 mouse lymphoma was enhanced in treated mice. Analysisof peritoneal exudate cells (PEC) revealed a dose-dependentdecrease in number and a shift in the composition of PECs. Thepercentage of PEC monocytes increased from 53% of the populationto 81%, while the lymphocytes decreased from 46 to 20%. Theadherent PEC population demonstrated decreased phagocytosisof covaspheres and increased phagocytosis of chicken erythrocytes(CRBC). GaAs exposure had no effect on host resistance to Plasmodiumyoelii or Streptococcus pneumoniae, but dose dependency increasedresistance of the mouse to Listeria monocytogenes Treated micedemonstrated a significantly decreased resistance to the B16F10melanoma with a sevenfold increase in tumor burden at 200 mg/kg.GaAs affects both humoral and cellular immune parameters inmice and impairs the ability of the immune system to protectagainst B16F10 tumor challenge.     

Improved radial maze performance induced by the benzodiazepine antagonist ZK 93 426 in lesioned and alcohol-treated rats

Effects of the benzodiazepine receptor antagonist ZK 93 426 were examined in two groups of rats with long lasting radial maze impairments caused by either ibotenic acid lesions to cholinergic forebrain projections or 28 weeks of alcohol treatment. Animals were trained on the 8-arm radial maze prior to ibotenic acid treatment or following chronic alcohol treatment. Spatial and associative working and reference memory were investigated in parallel. Lesioned rats showed high error rates in all aspects of memory, but particularly in spatial working memory, whilst error rates in alcohol-treated rats were low and uniform. ZK 93 426 improved performance in both experiments. In lesioned rats working memory errors were selectively decreased, in line with evidence that ZK 93 426 enhances attention. However in alcohol-treated rats both reference and working memory errors were reduced to control level, suggesting that these animals primarily showed a mild attentional deficit. Alcohol treatment and lesions were both found to reduce cortical choline acetyltransferase activity, but in view of the non-specificity of alcohol or ibotenic acid to cholinergic neurons and the wide distribution of the GABA-BZ receptor complex, interactions of ZK 93 426 with other systems cannot be ruled out.