Vegan Diet and Bone Health—Results from the Cross-Sectional RBVD Study

Scientific evidence suggests that a vegan diet might be associated with impaired bone health. Therefore, a cross-sectional study (n = 36 vegans, n = 36 omnivores) was used to investigate the associations of veganism with calcaneal quantitative ultrasound (QUS) measurements, along with the investigation of differences in the concentrations of nutrition- and bone-related biomarkers between vegans and omnivores. This study revealed lower levels in the QUS parameters in vegans compared to omnivores, e.g., broadband ultrasound attenuation (vegans: 111.8 ± 10.7 dB/MHz, omnivores: 118.0 ± 10.8 dB/MHz, p = 0.02). Vegans had lower levels of vitamin A, B2, lysine, zinc, selenoprotein P, n-3 fatty acids, urinary iodine, and calcium levels, while the concentrations of vitamin K1, folate, and glutamine were higher in vegans compared to omnivores. Applying a reduced rank regression, 12 out of the 28 biomarkers were identified to contribute most to bone health, i.e., lysine, urinary iodine, thyroid-stimulating hormone, selenoprotein P, vitamin A, leucine, α-klotho, n-3 fatty acids, urinary calcium/magnesium, vitamin B6, and FGF23. All QUS parameters increased across the tertiles of the pattern score. The study provides evidence of lower bone health in vegans compared to omnivores, additionally revealing a combination of nutrition-related biomarkers, which may contribute to bone health. Further studies are needed to confirm these findings.     

Modulation of DNA repair processes by arsenic and selenium compounds

Nickel, cadmium, cobalt and arsenic compounds are well known carcinogens to humans and experimental animals. In addition to the induction of mainly oxidative DNA damage, they interfere with nucleotide and base excision repair (BER) at low, non-cytotoxic concentrations. In case of arsenic, an inactivation of DNA repair has also been observed for the trivalent and pentavalent methylated metabolites, with the strongest effects exerted by MMA(III) and DMA(III). As potential molecular targets, interactions with so-called zinc finger proteins involved in DNA repair and/or DNA damage signaling have been identified. For example, arsenite suppresses poly(ADP-ribosyl)ation at extremely low, environmentally relevant concentrations. Also, Fpg and XPA involved in BER and NER, respectively, are inactivated by arsenite, MMA(III) and DMA(III). Nevertheless, an interaction with the zinc finger structures of DNA repair proteins may also occur by essential trace elements such as certain selenium compounds, which appear to exert anticarcinogenic properties at low concentrations but may compromise genetic stability at higher concentrations.     

The Children’s Sleep Comic: Psychometrics of a Self-rating Instrument for Childhood Insomnia

The Children’s Sleep Comic is a standardized self-report questionnaire for assessing insomnia in children ages 5–11 years. The goal of the present study is to introduce a revised version of this measure and to present psychometrics and a cut-off score. Therefore, the revised Children’s Sleep Comic, the Sleep Self Report, the Children’s Sleep Habits Questionnaire, and the Child Behavior Checklist were applied to a sample of 393 children and their parents. Of the parents who participated voluntarily, a subsample (n = 176) was interviewed on the phone to diagnose their children with sleep disorders according to the International Classification of Sleep Disorders, if applicable. The results indicated that the Children’s Sleep Comic is a reliable self-rating instrument for diagnosing childhood insomnia. Internal consistency was α = 0.83; and convergent and divergent validity were adequate. The child-friendly format can foster a good therapeutic relationship, and thus establish the basis for successful intervention.     

A scoping review of mentorship of health personnel to improve the quality of health care in low and middle-income countries

Background

Most Low and Middle-Income Countries are facing a crisis in human resources for health which compromises their ability to meet health related targets outlined by the Sustainable Development Goals. The crisis is not limited to the availability of health personnel but also the quality of care and the training and development of the workforce. To address these challenges, evidence based education strategies are urgently required. Mentorship has been found to improve health personnel performance in High-Income Countries however, little is known about its role in Low and Middle-Income Countries. To address this gap in understanding, we conducted a scoping review of the current literature.

Methods

CINAHL, EMBASE and OVID Medline were systematically searched along with grey literature for peer-reviewed research papers specific to the research question. A six-step scoping review framework was utilised to identify the relevant literature and summarise the pertinent findings.

Results

The initial search identified 592 records, and five papers, reporting on four studies, were retained for data charting and extraction. All four studies described a positive effect of mentorship on the quality of care outcomes. The results are collated according to features of the intervention including mentor training, mentor-mentee ratios, mentorship model, intervention intensity and key findings in terms of outcome measures.

Conclusions

This review identifies a paucity of evidence of mentorship in this context however, current evidence supports the assertion that effective mentorship contributes to the improvement of certain quality of care outcomes. The features of successful mentorship interventions are outlined and the implications are discussed in the context of existing evidence.

     

No differences in DNA damage and antioxidant capacity between intervention groups of healthy, nonsmoking men receiving 2, 5, or 8 servings/day of vegetables and fruit

The effects of different intake levels of vegetables and fruit (VF) on some cancer-relevant biomarkers such as DNA damage and oxidative stress were investigated. In a randomized controlled trial, 64 nonsmoking male subjects were asked to consume a diet with 2 servings of VF/day for 4 wk. Then subjects were randomly assigned to 1 of 3 groups with either a low (2 servings/day), medium (5 servings/day), or high (8 servings/day) intake level of VF for another 4 wk. At the end of study, the plasma lutein, zeaxanthin, alpha-carotene, and beta-carotene but not cryptoxanthin and lycopene concentrations were significantly higher in subjects consuming 8 servings/day than in those receiving 2 servings/day. Different levels of VF consumption and plasma carotenoid concentrations did not result in differences in the levels of endogenous DNA strand breaks, oxidative DNA damage, antigenotoxic capacity of lymphocytes, plasma markers for lipid peroxidation (malondialdehyde, 8-iso-prostaglandin-F2alpha) and antioxidant capacity [trolox-equivalent antioxidant capacity assay]. Thus, although consumption of 8 servings vs 2 servings/day of VF for 4 wk significantly increased the carotenoid level in plasma, there were no differences in DNA damage, lipid peroxidation, and antioxidant capacity markers among healthy, well-nourished, nonsmoking men.     

‘12 tips for teaching environmental sustainability to health professionals’

Abstract

Background: As recognition of the health impacts of climate change and other environmental challenges increases, so too does the need for health care professionals to practice healthcare sustainably. Environmental sustainability in healthcare extends beyond our traditional understanding of environmental health, which is often limited to environmental hazards and disease. Health services, professional organizations, and training institutions are increasingly forming climate and sustainability position statements and policies accordingly. To prepare future health professionals for global environmental change, environmental sustainability must be meaningfully integrated into health curricula.

Aim: To provide educators with 12 tips for integrating environmental sustainability into health professional education.

Methods: The authors reviewed the literature relating to climate change, environmental sustainability and health, and health professional education. By combining findings from this search with reflections on their own experience in clinical and public health teaching across nursing and midwifery, paramedicine, medicine, and public health, the authors developed recommendations for integrating environmental sustainability into health professional education.

Results: These 12 tips can be used to teach students and qualified health professionals in nursing, allied health, and medicine to practice healthcare in an environmentally sustainable manner.

Conclusions: Empowering health professionals to practice environmentally sustainable healthcare has economic, social, health, and environmental benefits. Teaching environmental sustainability to health professionals enhances existing learning by updating curricula with the latest evidence of how environmental determinants of health are rapidly changing and enables both educators and students to make an important contribution to safeguarding human health, the environment, and healthcare for future generations.     

The Nutritional Supply of Iodine and Selenium Affects Thyroid Hormone Axis Related Endpoints in Mice

Selenium and iodine are the two central trace elements for the homeostasis of thyroid hormones but additional trace elements such as iron, zinc, and copper are also involved. To compare the primary effects of inadequate intake of selenium and iodine on the thyroid gland, as well as the target organs of thyroid hormones such as liver and kidney, mice were subjected to an eight-week dietary intervention with low versus adequate selenium and iodine supply. Analysis of trace element levels in serum, liver, and kidney demonstrated a successful intervention. Markers of the selenium status were unaffected by the iodine supply. The thyroid gland was able to maintain serum thyroxine levels even under selenium-deficient conditions, despite reduced selenoprotein expression in liver and kidney, including deiodinase type 1. Thyroid hormone target genes responded to the altered selenium and iodine supply, whereas the iron, zinc, and copper homeostasis remained unaffected. There was a notable interaction between thyroid hormones and copper, which requires further clarification. Overall, the effects of an altered selenium and iodine supply were pronounced in thyroid hormone target tissues, but not in the thyroid gland.