Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes

Objective To evaluate parents’ fruit and vegetable intake and their use of pressure to eat in child feeding as predictors of their 5-year-old daughters’ fruit and vegetable, micronutrient, and fat intakes.Subjects Data were obtained from 191 non-Hispanic white families with 5-year-old girls.Design Parent data included reports of pressure in child feeding and their own fruit and vegetable intake. Girls’ intakes of fruits and vegetables, selected micronutrients, and fat were the main outcomes of interest.Statistical analysis Structural equation modeling was used to test a model describing relationships among parents’ fruit and vegetable intake, parents’ use of pressure in child feeding, and daughters’ fruit and vegetable, micronutrient, and fat intakes.Results The model provided a good fit to the data, revealing that girls’ fruit and vegetable intake was positively related to their parents’ reported fruit and vegetable intake. Parents who consumed fewer fruits and vegetables tended to report greater pressure in child feeding and had daughters who consumed fewer fruits and vegetables. Girls’ reported fruit and vegetable intakes were positively related to their micronutrient intakes and negatively associated with fat intake.Applications/conclusions This research demonstrates that parents’ own fruit and vegetable intake may encourage fruit and vegetable intake in their daughters, leading to higher micronutrient intakes and lower dietary fat intakes. Conversely, pressure to eat may discourage fruit and vegetable intake among young girls. J Am Diet Assoc. 2002;102:58–64.     

Change in Nutrient Intakes, Number of Servings, and Contributions of Total Fat from Food Groups in 4- to 10-Year-Old Children Enrolled in a Nutrition Education Study

Objective To determine change in nutrient intakes, number of servings, and contributions of total fat from food groups in children who lowered their dietary fat intake.Design A research and demonstration study designed to lower plasma low-density lipoprotein cholesterol level. There were four study groups: two intervention and two control groups. All children had hypercholesterolemia except for those in one control group. Three 24-hour dietary recalls were collected on randomly assigned days over a 2-week period at baseline and 3 months after the intervention.Subjects Three hundred three 4- to 10-year old children from suburbs north of Philadelphia, Pa.Interventions One intervention involved a home-based, parent-child autotutorial program (PCAT group) with audiotaped stories and print materials for the children and their families; the other intervention involved one face-to-face counseling session with a registered dietitian (counseling group).Outcome measures Change in mean nutrient intakes compared with the Recommended Dietary Allowance (RDA); change in number of servings and mean grams of total fat contributed from 10 different food groups.Statistical analyses performed Analyses of variance and χ² analyses.Results Children in every study group had mean intakes of all nutrients (except vitamin D) greater than 67% of the RDA 3 months after the baseline measurement. Several food groups (ie, meats, dairy products, fats/oils, and desserts) provided less total fat to the diets of children who reduced their dietary lipid intake after 3 months (ie, PCAT and counseling groups). These children also reduced the mean number of servings selected from these food groups. Within these same food groups, some children consumed fewer servings of higher fat foods and more servings of lower fat foods.Applications/conclusions Children who lowered their dietary fat intake after intervention reported both quantitative and qualitative changes in food choices from several food groups. These choices did not significantly reduce their nutrient intakes. J Am Diet Assoc. 1996; 96:865-873.     

Electrophysiologic and histopathologic correlations in a case of permanent form of reciprocating tachycardia

A case of permanent junctional reciprocating tachycardia withpost-mortem documentation of an accessory atrioventricutar pathwayas the substrate of the arrhythmia is reported. Tachycardiahad lasted for 15 years and showed a retrograde P wave (P')and R–P' longer than P'–R interval. The tachycardiacircuit utilized a concealed posterior septal accessory pathwayas the retrograde limb. Because the arrhythmia was disablingand unresponsive to pharmacological treatment, the patient underwentclosed chest ablation of the His bundle. After the procedure,no anterograde or retrograde conduction over the normal conductionsystem was observed; anterograde conduction over the anomalouspathway showed decremental properties. Because of previous myocardialinfarction, the patient developed a ventricular aneurysm anddied suddenly 5 months after His bundle ablation. Histologicalexamination of the heart revealed a group of tiny fibromuscularbundles joining the lower rim of the coronary sinus outlet tothe summit of the interventricular septums; the anomalous atrioventricularconnection pursued a sinuous, tortuous path. The geometricaldisposition of the accessory pathway may have been responsiblefor the decremental properties of conduction observed duringlife.     

The Nominal Group Technique: A Research Tool for General Practice?

Qualitative methods are increasingly recognized as valuable,yet practitioners face difficult decisions in their choice ofmethod and the process of analysis. The nominal group techniquecombines quantitative and qualitative data collection in a groupsetting, and avoids problems of group dynamics associated withother group methods such as brainstorming, Delphi and focusgroups. Idea generation and problem solving are combined ina structured group process, which encourages and enhances theparticipation of group members. The stages involved in conductinga nominal group are described, and practical problems of itsuse in a health care setting are discussed with reference toa study of the priorities of care of diabetic patients, carersand health professionals. Some potential applications of thetechnique in audit and exploratory research are also outlined.     

Acceptability and potential effectiveness of a foot drop stimulator in children and adolescents with cerebral palsy

Aim Ankle–foot orthoses are the standard of care for foot drop in cerebral palsy (CP), but may overly constrain ankle movement and limit function in those with mild CP. Functional electrical stimulation (FES) may be a less restrictive and more effective alternative, but has rarely been used in CP. The primary objective of this study was to conduct the first trial in CP examining the acceptability and clinical effectiveness of a novel, commercially available device that delivers FES to stimulate ankle dorsiflexion. Method Twenty‐one individuals were enrolled (Gross Motor Function Classification System [GMFCS] levels I and II, mean age 13y 2mo). Gait analyses in FES and non‐FES conditions were performed at two walking speeds over a 4 month period of device use. Measures included ankle kinematics and spatiotemporal variables. Differences between conditions were revealed using repeated measures multivariate analyses of variance. Results Nineteen individuals (nine females, 10 males; mean age 12y 11mo, range 7y 5mo to 19y 11mo; 11 at GMFCS level I, eight at level II) completed the FES intervention, with all but one choosing to continue using FES beyond that phase. Average daily use was 5.6 hours (SD 2.3). Improved dorsiflexion was observed during swing (mean and peak) and at foot–floor contact, with partial preservation of ankle plantarflexion at toe‐off when using the FES at self‐selected and fast walking speeds. Gait speed was unchanged. Interpretation This FES device was well accepted and effective for foot drop in those with mild gait impairments from CP.     

Effects of Procainamide and Lidocaine on Defibrillation Energy Requirements in Patients Receiving Implantable Cardioverter Defibrillator Devices

Effects of Procainamide and Lidocaine on Defibrillation. intntduction: In acute canine studies, lidocaine. but not prucainamidc, increases defibrillation energy requirements. We evaluated the effects of lidocaine or procainamide on defihrillation energy requirements in 27 patients undergoing intraoperative testing fur implantable cardioverter dcfibrillator device placement.
Methods and Results: Patients were tested off antiarrhythmic drugs and again following either lidocaine (200 to 250 mg loading and 3 mg/min maintenance infusions) or procainamide (1 gm loading and 3 to 4 mg/min maintenance infusions). The defibrillation testing protocol consisted of initial testing at 15 J, followed by higher or lower energies to determine the lowest energy producing three consecutive successful defibrillations. Overall, the mean defibrillation energy increased from 14 ± 5 J to 18 ± 7 J during lidocaine (plasma concentration 5.1 ± 1.6 μ/mL; P < 0.02) but were similar at baseline (12 ± 5 J) and during procainamide infusion (13 ± 6 J) (plasma concentration: procainamide 10.7 ± 7.2 μ/rnl.; N-acetyl procainamide 1.0 ± 0.4 μ/niL). A positive linear correlation was found between lidocaine plasma concentration and percent change in defibrillation energy (lidocaine: r = 0.61; P = 0.01). Procainamide raised the defibrillation energy in three patients, two with supra therapeutic plasma concentrations. The increase in defibrillation energy equaled or exceeded 25 J in four patients after lidocaine and in one patient after procainamide.
Conclusion: The data suggest that at high plasma concentrations, lidocaine and procainamide adversely affect defibrillation energy requirements consistent with an adverse, concentration-dependent effect of sodium channel blockade on defibrillation energy requirements in patients.     

Antigenicity and immunogenicity of the tegumental outer membrane of adult Schistosoma mansoni

The tegumental membranes of adult Schistosoma mansoni have been isolated and purified and shown to function as potent immunogens; they elicit an essentially identical immune response in rabbits, rats and mice. Anti-membrane antisera harvested from these animals consistently recognized common antigens, of relative molecular weight (mol. wt) 32 000 and 20 000, on the surface of young schistosomula, 5 day old lung worms and adult worm purified membranes. An additional molecule of 25 000 mol. wt was present on the surface of lung worms and adult worm membranes and was specifically recognised by serum from chronically infected mice and by serum from rabbits inoculated with adult worm purified membranes. The concept of antigenic identity between developmental stages that parasitize the mammalian host was further substantiated by the observation that anti-membrane antiserum bound to live schistosomula, lung worms and adult parasites as measured by indirect immunofluorescence. In complement-mediated in vitro cytotoxicity assays, the sera from rabbits inoculated with either adult worm purified membranes, or the 32 000 mol. wt antigen partially purified from adult worm membranes, mediated levels of schistosomula killing as high as those obtained with sera from chronically infected mice. These rabbit antisera also promoted eosinophil adherence and killing of newly transformed schistosomula, but lung stage parasites, despite binding the anti-membrane antiserum, were refractory to both humoral and cellular cytotoxicity. The significance of antigenic identity is discussed in relation to the concept of concomitant immunity.     

AMINOHEXANE BISPHOSPHONATE SUPPRESSES BONE TURNOVER IN POSTMENOPAUSAL WOMEN MORE RAPIDLY THAN OESTROGEN-GESTAGEN THERAPY

Although animal studies suggest that there may be major differencesbetween the effects of bisphosphonates and ovarian hormoneson skeletal metabolism, whether this also holds for their actionsin patients is unknown. To address this question, we comparedthe effects of 12 weeks treatment with HRT on bone turnovermarkers in osteopenic postmenopausal women with those of anamino-bisphosphonate. Women within 15 yr of the menopause, witha lumbar and/or femoral neck bone mineral density 1 S.D. belowthe predicted value, received either oestradiol valerate 2 mgand dydrogesterone 5 mg (E/D; n = 16) or aminohexane bisphosphonate400 mg (AHBP; n =9). Urine and serum samples were collectedon two separate occasions before starting treatment, and 1,2, 4, 8 and 12 weeks afterwards. To assess bone resorption,we measured the urinary deoxypyridinoline/creatinine ratio (DPD/crea),while serum alkaline phosphatase (ALP), osteocalcin and C-terminalpropeptide of type I collagen (CICP) were analysed to assessbone formation. Repeated measures analysis of variance revealeda highly significant decrease in DPD/crea over the treatmentperiod. Furthermore, this pattern of response differed significantlybetween the two treatment groups, since DPD/crea was maximallysuppressed within 2 weeks of starting AHBP, while E/D showedlittle decrease until 8 weeks. AHBP was also found to suppressALP, osteocalcin and CICP more rapidly than E/D, the formerreducing these markers by 8 weeks, while E/D caused little inhibitioneven by 12 weeks. We conclude that, in the doses used in thisstudy, AHBP appears to suppress bone turnover significantlymore rapidly than E/D, suggesting that clinically importantdifferences may exist in the effects of bisghosphonates andovarian hormones on bone metabolism. KEY WORDS: Bisphosphonate, Oestrogen, Bone turnover, Postmenopausal women