bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracellular products from Mycobacterium spp. in fish
Authors: Chen S.‐C. , Adams A. , Richards R.H.
Published: November 2003

Mycobacterium spp. isolated from food and ornamental fish in Thailand (TB1, TB40, TB267 and TB268), and the type strains Mycobacterium marinum (NCIMB 1298), M. fortuitum (NCIMB 1294) and M. chelonae (NCIMB 1474) were cultured in Long’s medium, Eagle’s minimum essential medium, Sauton’s medium and modified Sauton’s medium. The latter enabled excellent growth and production of extracellular products (ECP) from TB 40, TB267, TB268 and M. marinum NCIMB 1298 in particular, whereas growth and production of ECP for all strains was limited in Long’s medium. SDS‐PAGE protein profiles of ECPs from 14‐day culture supernatants showed major bands at 65 and <14 kDa. After 2 days culture at the higher temperature of 37°C (heat shock), the production of ECP from all mycobacteria strains except M. marinum averaged approximately four‐ to 10‐fold higher than from strains cultured for 14 days at 28°C. Enzyme testing for the type strains indicated only mucinase activity for M. marinum, while lipase and RNase activities were detected for M. chelonae and M. fortuitum. Protease and DNase activities could not be detected for any of the Mycobacterium spp. tested. The medium lethal dose (LD50) of ECP to rainbow trout and Nile tilapia was greater than 400 μg protein fish–1.
A study of feral carp, Cyprinus carpio L., exposed to Microcystis aeruginosa at Lake Mokoan, Australia, and possible implications for fish health
Authors: Carbis C R , Rawlin G T , Grant P , Mitchell G F , Anderson J W , McCauley I
Published: November 2003

Feral carp, Cyprinus carpio L., were collected at bimonthly intervals for 12 months from Lake Wellington, where there was no evidence of significant growth of Microcystis aeruginosa. Various blood parameters of these carp were measured to ascertain the normal range values for feral carp in this region. A similar study was conducted at Lake Mokoan, where M. aeruginosa formed a visible scum that contained detectable levels of microcystins for 4 consecutive months. Carp were taken from Lake Mokoan each month, and the histology and blood biochemistry of the fish were examined for indications of microcystin toxicity. During February, March and April, 66% of the carp from Lake Mokoan had livers with widespread hepatocyte atrophy, and 37% of the fish had gills with pinpoint necrosis, epithelial ballooning, folded lamellar tips and exfoliation of the lamellar epithelium. Compared to carp from Lake Wellington, the serum aspartate aminotransferase activity and the serum bilirubin concentrations of carp from Lake Mokoan were elevated during January, February, March and April. The data were consistent with impaired hepatocyte function in some carp from Lake Mokoan. Serum sodium and chloride concentrations in carp from Lake Mokoan were lower than those for carp at Lake Wellington from December to April, indicating that most carp from Lake Mokoan had difficulty maintaining cation‐anion homeostasis during this period. Nevertheless, carp at Lake Mokoan always appeared healthy, and no mortalities were reported.
The contribution of specific dietary patterns to energy and nutrient intakes in 7–8‐year‐old Scottish schoolchildren. II. Weekday lunches
Authors: Ruxton C.H.S. , Kirk T.R. , Belton N.R.
Published: November 2003

The role of weekday lunches eaten by 136 7–8‐year‐old Scottish schoolchildren was investigated. Energy and nutrient intakes were estimated using the 7‐day weighed inventory method and the nutritional contribution of school, packed and home lunches was expressed as a percentage of mean daily intakes. Comparisons were made between the average school lunch and Caroline Walker Trust guidelines and between school, packed and home lunches. Weekday lunches contributed around one‐quarter to one‐third of daily energy intakes, the greatest contribution to energy and nutrient intakes coming from packed lunches. The nutrient profile of school meals was poor in relation to Caroline Walker Trust guidelines and poor compared with the nutrient profile of school lunches reported by Nelson & Paul in 1983. Children taking school meals regularly had lower daily intakes of percentage energy from carbohydrate and higher intakes of percentage energy from fat. The results from this paper suggest that changes in school meals are required in order to provide a model upon which schoolchildren can base their eating patterns.
Nutritional support in HIV infection: the use of enteral feeding to achieve weight gain and meet nutritional requirements in a patient with AIDS
Authors: Noble Carole
Published: November 2003

This case study reports the progress of a 23‐year‐old woman with AIDS with inadequate food intake due to painful swallowing. Enteral nutritional support was provided for 118 days and a weight gain of 23.3 kg was achieved in 133 days. This demonstrates that enteral nutritional support can help to maintain nutritional status and facilitate weight gain in people with AIDS.
Breakfast habits of different groups of Spanish schoolchildren
Authors: Ortega R.M. , Requejo A.M. , Redondo R. , López‐Sobaler A.M. , Andrés P. , Ortega A. , Quintas E. , Izquierdo M.
Published: November 2003

A questionnaire was used to investigate the schoolday and holiday breakfast habits of a group of 742 pupils (420 boys and 322 girls) aged between 9 and 13 years. The subjects attended four different schools in Madrid with populations of medium and medium–high socioeconomic level. Most pupils (53%) ate dairy products and cereals for breakfast and 10% also ate fruit: breakfasts that could be considered adequate or satisfactory. However, it was also observed that 17% of boys and 33% of girls took only dairy products at breakfast. In most cases (98%) this was limited to a glass of milk, an intake insufficient to start the day. Three per cent of boys and 5% of girls took no breakfast at all. Boys in general and the younger children of the sample spent more time at breakfast than girls or older children. They also included a wider variety of foods in their breakfasts. Most of the schoolchildren had breakfast at home (95%), either alone (42%) or with their brothers and sisters (43%). Only 25% had breakfast with their parents. Breakfast made a contribution of 15.6±0.4% to the recommended daily intake of energy. In 88% of cases, the contribution of breakfast was lower than 25% of total calories, the advisable level for this meal. During holidays the percentage of children who took no breakfast decreased to 2% of boys and 1% of girls. However, the differences observed between holidays and working days were not great. Perhaps the most important difference lies in the time spent eating breakfast, 10.8±0.3 minutes on schooldays and 20±0.6 minutes during holidays (P<0.001). The modification of dietary habits to increase the quantity and variety of foods consumed before starting daily activity probably has a positive impact on physical and intellectual performance. It would also help in the attainment of better nutritional status and better health.
Comparison of nutritional status of pre‐school children at day care centres and at home from different socioeconomic backgrounds in Beirut
Authors: Baba Nahla , Shaar Khuzama , Ismail Leila El‐Sheikh , Adra Nada
Published: November 2003

This study investigated the effect of attending day care centres on the nutritional status of 818 pre‐school children under 5 years of age in comparison with home based children, taking into consideration their social class. A random sample of 10 high class (HCD) and low class day care centres (LCD) was selected, in addition to a random sample of houses in high class (HCR) and low class residential areas (LCR) in Beirut. Anthropometric measurements and dietary intake data were collected. Attending day care centres, regardless of social class, showed that children in HCD and LCD had significantly greater height for age than home based children. When stratified by social class, a higher proportion of LCR had severe and mild stunting in comparison with their LCD counterparts. For high class children, being home based did not result in adverse effects on growth to the same extent as children from low socioeconomic backgrounds. Dietary intake data showed deficiencies in most nutrients in both day care and home based children reflecting the same differences observed in the anthropometric data, i.e. a better consumption of nutrients by children in day care centres, particularly in LCD vs. LCR. Findings from this study show that day care service results in a better nutritional status for children and its effects are more pronounced in those from lower socioeconomic groups.
Moderate amounts of n‐3 fatty acid enriched seafood products are effective in lowering serum triglycerides and blood pressure in healthy subjects
Authors: Gustafsson Inga‐Britt , Öhrvall Margareta , Ekstrand Bo , Vessby Bengt
Published: November 2003

A double‐blind cross‐over study was conducted during two 3‐week periods. Two series of seafood products were prepared, one containing n‐3 fatty acids derived from fish oil triglyceride concentrate and one containing n‐6 rich sunflower oil in identical amounts. These products were added to the subjects» ordinary diet. After a wash‐out period of at least 4 weeks they switched over to the other diet. Twenty‐three subjects with borderline high blood lipids participated, five women and 19 men, with a mean age of 48±9 years. The inclusion of the n‐3 enriched seafood products in the diet caused significant reductions of serum triglycerides (25%) and of the systolic blood pressure of 3.7%. An increase in the proportion of long‐chain fatty acids in the serum phospholipids after the fish oil period was pronounced. Positive effects were seen on insulin and free fatty acid concentrations with a reduction of 37% of free fatty acids on the fish oil period and of 18.6% of serum insulin concentration. An increase of malondialdehyde concentration in plasma by 21% was seen during the fish oil period. The positive effects on the serum triglyceride and blood pressure are interesting from the viewpoint of public health with regard to the risk of the cardiovascular disease.
Production and validation of a food frequency questionnaire to estimate dietary fat intake
Authors: Paisley C.M. , Lloyd H.M. , Brown W. , Mela D.J.
Published: November 2003

A quantitative 92‐item food frequency questionnaire (FFQ), using photographs to estimate portion size, was developed from a 180‐item FFQ and validated by comparison with weighed dietary records of 80 adults. The main aim of the FFQ was to classify subjects according to their fat intake as a percentage of total energy intake. Correlation coefficients and classification of individuals into thirds for fat (g), percentage energy from fat and total energy, showed good agreement between the FFQ and the diet record. There was significant difference in the mean percentage energy from fat but not in grams of fat or total energy intake estimated by the two methods. Intra‐class correlation coefficients indicated a significant relationship between an individuals» percentage energy from fat estimated by the FFQ and diet records. These results suggest that the FFQ was suitable for classifying individuals into groups based on their percentage energy from fat and for estimating the actual average fat and energy intake of groups, and that the FFQ may be useful for estimating the percentage energy from fat for an individual.
Composition of diet in relation to fat intake of children aged 1–7 years
Authors: Ylönen K. , Virtanen S.M. , Ala‐Venna E. , Räsänen L.
Published: November 2003

Very little data are available on the diet of Finnish pre‐school children from the last decade. In this study, food consumption data for 77 1–7‐year‐old Finnish children were collected by means of 3‐day estimated food records. In the younger age group (<4 years), on average 15% of total energy was supplied by protein, 36% by fat, 49% by carbohydrates and 14% by sucrose. In the older age group (≥4 years), the proportions were 15%, 34%, 51% and 17%, respectively. Compared with the Nordic nutrition recommendations, the average proportions of fat and sucrose were too high and those of carbohydrate too low. Intakes of vitamins and minerals met or exceeded the recommended allowances, except for iron in the younger age group, and vitamin D in both age groups. Energy and nutrient intakes were compared among children with different proportions of fat in their diet (less than 30%, 30–34%, 35–39%, 40% or more of total energy). There was no difference in the energy intake per kg of body weight between the fat intake groups, and with respect to vitamin and mineral intakes the only differences were in the intakes of vitamin C and selenium. Only in the lowest fat intake group were the proportions of fat, saturated fatty acids and carbohydrates and the intake of cholesterol in accordance with or close to the recommendations. The results of this study support the growing evidence of the nutritional adequacy of a balanced, low‐fat diet for pre‐school children.
The public response to an offer on national television of information about infant diets
Authors: Miller Siobhan
Published: November 2003

A national television report, highlighting the potential problems of «healthy eating» diets in young children, attracted 1033 requests for further information from the public. Requests came from all parts of the UK, particularly the South. There was genuine concern about this topic, especially with respect to vegetarian diets. Practical difficulties in supplying information after television broadcasts are also discussed.
Elderly patients» meal patterns—a retrospective study
Authors: Sidenvall Birgitta , Lennernäs Maria , Ek Anna‐Christina
Published: November 2003

The aim of this study was to examine possible causes of malnutrition in geriatric patients on admission to hospital by evaluation and comparison of their meal pattern between periods of working, retirement and hospitalization, respectively. Forty‐five consecutive patients aged 60 years or older participated. By use of modified dietary history interviews, a retrospective assessment of food intake was carried out. A qualitative system for meal classification was then applied. In the retirement period there was a strong reduction in daily eating frequency when compared to working and hospital periods. Thus, the daily intake and also distribution of energy and nutrients seem to be reduced during retirement, which might lead to nutritional deficiency.
Educating the dietitians of the future
Authors: Judd P.A.
Published: November 2003

The role and sphere of influence of dietitians has expanded markedly over the last decade, and education and training of dietitians must similarly expand in order to prepare them for their current and future work. The educational initiatives which have been put in place in both pre‐ and post‐registration training in order to facilitate this process are described, together with proposals for changes in the structure and content of dietetics pre‐registration training in the UK.
Community nutrition and dietetics: a survey of nutrition group members in 1995
Authors: Adamson A.J. , Cowburn G.
Published: November 2003

In 1995 the Community Nutrition Group (CNG) of the British Dietetic Association (BDA) celebrated its 21st birthday. Enormous development in community nutrition and dietetics has taken place in these 21 years. Membership of the CNG now stands at 493, representing 12% of the membership of the BDA. In December 1995 a questionnaire was sent to all members of the CNG, of whom 73% completed the questionnaire. Information collected included work structures; aspects of work which had increased or decreased during the past 5 years and the proportion of time allocated to specific community nutrition activities. The results show that there has been an increase in the number of dietitians working in the community (average reported increase of 1.78 whole time equivalents). The main area of growth has been in all aspects of primary care (clinical, health promotion and training). Other areas of growth include community clinical work, training, health promotion and community development. The concern that the nutrition facilitation role of the dietitian in the community is being dominated by clinical work is not supported; 51% of CNG members» time is spent in nutrition facilitation, 37% in clinical work. Dietitians working in the community must continue to work to demonstrate the effectiveness of their nutrition facilitation role to secure continued funding.
Nutrition education in schools—educating the children
Authors: Passmore Sandra
Published: November 2003

There have been considerable changes within health, education and education catering (school meals) services in the last 15 years. This has had a significant impact on the quantity and quality of education that today's schoolchildren receive about nutrition. Schools educate children both through the formal National Curriculum and through the «hidden curriculum». This paper considers the place of nutrition in both, and the links between them. School nutrition action groups are presented as an approach to linking both the formal and informal curriculum
Estimates of food intake and dietary habits in a random sample of adolescents in south‐east Spain
Authors: Pérez‐Llamas F. , Garaulet M. , Nieto M. , Baraza J.C. , Zamora S.
Published: November 2003

Dietary habits and food intake of the six basic food groups (milk, meats, cereals, fruits, vegetables and fats) were investigated in a random sample of 206 adolescents (aged 10–15 years) from a region of south‐east Spain (Murcia). Adolescents were interviewed on their recall of food intake over the previous 24 h. The results showed a very low consumption of vegetables, some deficiencies in the intake of the milk and fruits, and an excessive intake of fats. Intake of foods belonging to the cereal and meat groups was adequate, agreeing with the recommendations for the adolescent population. Within the meat group, the distribution of foods consumed was not satisfactory; an excessive consumption of meats and sausages was observed, while the intake of fish and pulses was insufficient. In our study, nutritional advice was given to mothers and adolescents. The use of Spanish portions from the six basic food groups proved to be a very helpful method to popularize the principles of balanced diet in our population. Our results seem to indicate some nutritional imbalances in the diets of the adolescents in the study, especially deficits in fibre and calcium and an excess in saturated fats. The study reveals that although Murcia is a typically Mediterranean Region, the characteristics of the diet of Murcian adolescents are quite different in some respects from the typical alimentary habits of the Mediterranean diet.
Cystic fibrosis—what nutritional knowledge do patients have?
Authors: McCabe Helen
Published: November 2003

As cystic fibrosis (CF) is diagnosed in childhood, it is important that patients are educated from an early age on the importance of their diet and on the application of enzymes. The Royal Victoria Infirmary Trust employs a paediatric dietitian to provide dietetic advice to patients with CF and their families. The aim of this study was to investigate basic nutritional knowledge and enzyme usage of a small group of children aged 10–16 years with CF, who regularly attend the Regional Cystic Fibrosis Clinic at the Royal Victoria Infirmary as outpatients. The results from two questionnaires demonstrated that a reasonable background of knowledge existed across the sample. However, there were many examples where basic questions were unanswered, and perhaps more importantly, there was a lot of confusion about enzyme application. Whether this lack of knowledge directly contributes towards adverse levels of health in individual patients was outside the scope of this study. It is intended that future work in this area will examine the hypothesis that lack of nutritional knowledge is a contributory factor to poor patient health.
Eating habits of 11–14‐year‐old schoolchildren living in less affluent areas of Liverpool, UK
Authors: Johnson B. , Hackett A. F.
Published: November 2003

Aim: To provide baseline data concerning the eating habits of young adolescents which will enable trends to be identified, the factors affecting food choice to be explored and a programme of intervention to be designed and evaluated.Methods: A dietary screening survey, delivered by computer, was completed by 707 schoolchildren aged 11–14 years attending schools in two of the least affluent areas of Liverpool. Eating habits were compared to two previous studies which used an identical computerized dietary survey method.Results: The results suggest that many children chose the least desirable foods, which is likely to result in them eating a poor quality diet. The most popular foods included snack foods such as crisps, chocolates and sweets, and sugared fizzy drinks and chips. A number of trends were noted: there was a decrease in the reported consumption of added sugar and high‐fibre cereals, and an increase in the use of low‐fat milk. Boys claimed to be more active than girls, and there was an inverse relationship between physical activities and watching TV and playing computer games in girls. The results showed similar eating patterns and physical activity levels to those from other more complex studies.Conclusion: The responses of the children indicated, at the very least, some increasing awareness of healthy eating messages, but whether changes in behaviour were occurring is less clear. There is still, however, scope for further positive change in eating habits and the survey will be repeated at regular intervals to examine trends.
The Heartbeat Award Scheme: an evaluation of catering practices
Authors: Warm D. L. , Rushmere A. E. , Margetts B. M. , Kerridge L. , Speller V. M.
Published: November 2003

The Heartbeat Award Scheme was launched in England in 1990 by the Health Education Authority as part of the national strategy to reduce the incidence of coronary heart disease. To date there has been no formal evaluation of the impact the award has had on catering practices. This study aimed to compare the differences between those premises with and without the award with regard to their catering practices. All Heartbeat premises (497) within the former Wessex region, along with 495 control premises without the award, were sent postal questionnaires. A total of 380 premises with the award and 306 premises without responded, representing a response rate of 77% and 62%, respectively. Respondents were grouped into one of three categories: public eating places, workplaces or educational establishments. Differences were found between award and non‐award holders, particularly with regard to the provision of healthy food, including brown rice and semi/skimmed milk, healthy options available to the consumer and commitment to healthy eating. While this research suggests that the award scheme may be increasing consumer choice, it is not possible to draw conclusions about the impact of the scheme on eating habits.
Pre‐registration education and training for dietitiansReport and recommendations from the British Dietetic Association/CPSM Dietitians Board Joint Working Party, February 1996
Authors: Judd Patricia , Butson Sylvia , Hunt Paula , Lewis Brynda , Micklewright Ann , Pearson Gill , Tredger Jackie
Published: November 2003

The following report was presented to the Dietitian's Board of the Council for Professions Supplementary to Medicine (CPSM) and the Education Committee of the British Dietetic Association (BDA) in March 1996. It outlines the process by which the working group examined pre‐registration education and training for dietitians in the light of their current and future role in the UK, together with the recommendations made for changes in training. These proposals were agreed by the Dietitians Board and British Dietetic Association in March 1997 and a new working group will be convened to develop detailed guidelines for education and training.
Does television affect teenagers’ food choices?
Authors: Woodward D. R. , Cumming F. J. , Ball P. J. , Williams H. M. , Hornsby H. , Boon J. A.
Published: November 2003

Objective: To explore whether food choices are linked to the extent of television watching among teenagers.Design: A representative state‐wide sample of 2082 junior high school students (aged 12–15 years) was surveyed cross‐sectionally in Tasmania, Australia. Respondents completed a printed questionnaire, which asked inter alia how much time subjects spent watching television, how frequently they consumed each of 22 foods, their socio‐demographic characteristics and their local dietary milieu (i.e. the frequency of usage of each food by parents and friends).Results: Respondents watched television for an average of 3.3 h per day (s.d. 1.9 h). For 18 of the 22 foods, there was a significant (P<0.01) linear relation between hours of television watched per day and frequency of consumption of the food. For 10 of the 22 foods, it remained significant even after the addition of several predictor variables reflecting socio‐demographic characteristics and the frequency of consumption of the food by parents and friends. Students who watched television more extensively tended to eat ‘healthy’ foods less often and ‘unhealthy’ foods more often.Conclusion: The results suggest possible dietary explanations for previous reports linking television watching to obesity and hypercholesterolaemia. In addition, they suggest that a high level of television watching might be a useful screening indicator of an unhealthy diet.
Feeding problems in infants and young children with chronic lung disease
Authors: Martin M. , Shaw N. J.
Published: November 2003

Aim: To determine the frequency and nature of feeding problems in infants with oxygen dependent chronic lung disease (CLD).Methods: A questionnaire regarding the feeding history of the infant was administered to parents of infants with CLD and a control group.Results: Forty‐seven infants with CLD and 35 control infants were studied. Fewer infants in the CLD group fed well once established on milk feeds compared to the control group (49% vs. 77%; P<0.05) and a greater number had significant vomiting under the age of 6 months when compared to controls (66% vs. 37%; P<0.05). The CLD group had a significantly higher incidence of feeding problems compared to the controls, including recurrent spitting out of food (34% vs. 3%), refusal of food (38% vs. 26%) or gagging on food (47% vs. 6%). Twenty‐three per cent of infants in the CLD group required enteral feeding beyond 3 months of age, and 19% had a second episode of enteral feeding.Conclusion: The incidence of feeding problems in infants with CLD is high. Strategies aimed at reducing these problems need to be identified and evaluated.
Nutrition knowledge of clinic nurses in Lebowa, South Africa: implications for nutrition services delivery
Authors: Kgaphola M. S , Wodarski L. A , Garrison M. E. B
Published: November 2003

Background: Nutrition‐related health problems are prevalent in South Africa, particularly in the black communities in the Homelands and black rural areas. Lebowa, one of the Homelands in the Northern Transvaal province, has inadequate nutrition services, without qualified nutrition professionals. The responsibility of nutrition care in Lebowa rests with clinic or community health nurses, who have limited nutrition training.

Aim: To determine the current nutrition knowledge of clinic nurses in Lebowa.

Method: Clinic nurses (n=99) in Lebowa answered a 40‐item nutrition knowledge test (NKT) and five demographic questions.

Results: The general performance of the clinic nurses on the NKT was poor, 14±3.8 (35%) answers correct, with scores ranging from 4 to 25 (10% to 63%) answers correct.

Conclusion: Considering the responsibility the nurses are entrusted with regarding nutrition care, the current nutrition knowledge of clinic nurses is a cause for concern. The results of this study provide a basis for nutrition education efforts directed at community health nurses.
Nasogastric tube audit: standard setting and review of specifications
Authors: Dewar H
Published: November 2003

This paper describes the procedure and outcome of an audit exercise designed to identify the equipment of choice from among the nasogastric (NG) tubes available on the UK market. In order to assess some of these in a systematic way, a working party of dietitians and nurses was established. Standards expected from a NG tube were set and agreed. These were then used to evaluate seven tubes to see which reached the agreed standard. This was not an exhaustive survey of all available tubes on the market, but a selection of those commonly available.

Among the seven tubes investigated, the Corslo®Merck tube was found to be the NG tube of choice in Oxfordshire. Future reassessments will be required as new NG tubes become available.
The nutrient intake of elderly men living alone and their attitudes towards nutrition education
Authors: Charlton K
Published: November 2003

Aims: A cross‐sectional study was undertaken among elderly men living alone in Sunderland to (1) assess their dietary intake and food habits, (2) to identify factors which influence their food choice, and (3) to investigate perceived needs regarding nutrition education activities.Methods: A random sample of 66 men, aged 70 years and over was drawn from members of luncheon clubs (n=33) and residents of sheltered housing accommodation (n=33). Dietary intake was assessed using a validated semi‐quantified food frequency questionnaire (FFQ).Results: Intake of all nutrients, with the exception of energy, vitamin D and fibre was adequate. Almost half of the subjects (47%) had energy intakes below the EAR, and the majority tended towards underweight, as indicated by the age‐adjusted reference standards for BMI. Taste and enjoyment were the factors which most influenced food choice. The main identified source of nutrition information was the media, followed by relatives and friends. Only half of the subjects perceived that they would benefit from nutrition education and 58% reported a willingness to participate in such activities if they were available.Conclusion: The findings suggest that although most subjects were aware of the role of dietary factors in the maintenance of an optimal health status, this age group is not a receptive audience for nutrition education activities. The targeting of elderly men living alone presents a challenge to nutrition educators.
The validity of household budget survey (HBS) data: estimation of individual food availability in an epidemiological context
Authors: Zintzaras E. , Kanellou A. , Trichopoulou A. , Nelson M.
Published: November 2003

Household budget surveys (HBS) are conducted in most European countries and they represent a unique source of dietary data. However, the information on food availability is at the family level, which limits the investigation of the dietary habits of individuals. The key stages required to establish the validity of HBS data at the household and individual level are reviewed. Using examples from British data, the paper identifies some of the limitations and valid applications of HBS data. A statistical method is proposed to estimate the food availability of household members of different types, for example different age groups, based on the family composition. The validity of the method is presented by using British data from the National Food Survey and the National Diet and Nutrition Survey.
The cost and availability of healthy food choices in southern Derbyshire
Authors: Barratt J.
Published: November 2003

There has been general agreement among experts over the last decade on what constitutes a healthy diet for the prevention of many of the major causes of morbidity and mortality in the UK, and for the treatment of diabetes mellitus and hyperlipidaemias. People are generally aware of the link between diet and health, but there is concern that foods which need to be included in the diet for it to meet current recommendations may be difficult to find and expensive. The 7‐day intake of an adult woman, which matched many of the current diet targets (including those of NACNE, the Department of Health and the British Diabetic Association), was costed in supermarkets in southern Derbyshire in 1990, 1992 and 1994, and also in smaller retail outlets in 1994. Whilst the availability of foods making up a healthy diet has improved in supermarkets in southern Derbyshire over the years of the study, and the cost to supermarket shoppers is coming down, a healthy diet is still more expensive than the average diet. Also, those who shop with smaller retailers (usually those on lower incomes and at higher risk of diet related disease) will still have difficulty finding some food items, and will find a healthy diet prohibitively expensive.
Cheilitis granulomatosa—an unusual diet for an unusual disorder
Authors: Booth J.
Published: November 2003

A case of cheilitis granulomatosa, a rare inflammatory disorder of unknown origin is reported. The condition produces non‐tender, persistent swelling of one or both lips and primarily affects young adults. The patient had a positive patch test to salicylate and cinnamaldehyde, and was therefore treated with an exclusion diet avoiding these substances. After 4.5 months on the exclusion diet, a 75% reduction in symptoms was reported.
Prevalence of malnutrition after major surgery
Authors: Edington J. , Kon P. , Martyn C. N.
Published: November 2003

Since Butterworth first published his paper ‘The skeleton in the hospital closet’ in 1974, it has been known that malnutrition is a significant factor in determining the outcome of illness for many patients (Butterworth, 1974). However, the problem still exists 20 years after this publication appeared. Those who undergo major surgery are at greater risk of malnutrition than most because of the stress and the concomitant increase in metabolic rate caused by the surgery. This paper reports the prevalence of malnutrition in patients who had undergone major surgery within 6 weeks of being surveyed and who were living in the community under their general practitioner's care. One hundred and twenty‐three patients (74 men and 49 women) took part in the survey. A total of 13 (10.6%) patients were malnourished, 10 (8.1%) mildly and 3 (2.4%) severely malnourished. The problem was more prevalent in those who had undergone genito‐urinary and gastrointestinal surgery, of whom 33% (2 out of 6) and 20.6% (7 out of 34), respectively, were malnourished. Surprisingly, there was a significantly higher proportion of women in the malnourished than in the non‐malnourished group (P=0.047). Furthermore, malnourished patients were significantly younger than non‐malnourished patients (P=0.034). In surgical patients, pre‐operative nutritional assessment, a course of feeding prior to surgery in malnourished patients, and early post‐operative feeding in all patients, could help to reduce the incidence of malnutrition in post‐operative patients, and consequently reduce the cost to the National Health Service (NHS).
The social and community involvement of older Australians with intellectual disabilities
Authors: Ashman A. F. , Suttie J. N.
Published: November 2003

This paper describes the involvement of older people with intellectual disabilities in residential‐and community–based activities and programmes. The 446 participants v/ere selected from a national database of people of 55 years of age and over with intellectual disabilities in Australia. The data indicate that participants made infrequent use of public amenities and social and recreational facilities. With the exception of those living with relatives, most had limited contact with family and friends. The discussion draws attention to the need for independence training which will enable the current generation of middle‐aged people with an intellectual disability to make decisions and choices about social and community activities.
Composite versus multiple‐rating scales in the assessment of psychopathology in people with mental retardation
Authors: Havercamp S. M. , Reiss S.
Published: November 2003

This study tested the hypothesis that separate ratings of frequency and duration add significant information to ratings of problem severity in the assessment of psycho‐pathology In people with mental retardation. The Reiss Screen was modified to require ratings of problem severity, frequency and duration for each of 38 maladaptive behaviours. The 171 adolescents and adults were rated by caretakers and supervisory staff on the modified Reiss Screen. The three ratings were found to be very highly intercorrelated. Moreover, multiple linear regression analyses revealed that the ratings of frequency and duration did not add significant information to that provided by ratings of problem severity in the prediction of psychiatric diagnosis in the person's case file. The results support the use of composite scaling over multiple‐ratings in the assessment of psycho‐pathology in persons with mental retardation.
The relevance of Vygotsky's theory of the ‘zone of proximal development’ to the assessment of children with intellectual disabilities
Authors: Rutland A. F. , Campbell R. N.
Published: November 2003

This paper reports a study which investigated the relevance of Vygotsky's concept of the ‘zone of proximal development’(ZPD) to the assessment of children with intellectual disabilities. The ZPD is the difference between a child's actual level of development shown by unassisted performance, and his or her potential level as indicated by assisted performance. This study aimed to test the validity of measuring the ZPD both among children with intellectual disabilities and In the area of map use. The results are discussed in terms of their bearing on the issues of assessment, instruction and the concept of intellectual disability.
Maladaptive behaviour in Prader‐Willi syndrome in adult life
Authors: Clarke D. J. , Boer H. , Chung M. C. , Sturmey P. , Webb T.
Published: November 2003

Thirty adults with Prader‐Willi syndrome (PWS) were compared with 30 adults with non‐specifrc learning disability matched for age, sex and severity of mental retardation. Maladaptive behaviors was assessed with the Aberrant Behavior Checklist (ABC), a 58‐item structured Interview which rates behaviors from 0 (not a problem) to 3 (severe problem) and which yields five factors (I) irritability, agitation; (II) lethargy, withdrawal; (III) stereotypic behavior; (IV) hyperactivity, non–compliance; and (V) inappropriate speech). The PWS sample had significantly higher factor I (P < 0.001) and factor V (P < 0.05) scores. The PWS sample had mean scores above 1 for 17 ABC items; the contrast subjects had no mean scores above I. The factor I scores for the PWS sample were similar to those of inpatients in hospital facilities for adults with mental retardation and mental illness or severely challenging behaviors. The results support previous work, and extend it by suggesting that temper tantrums, self‐injury, impulsiveness, lability of mood, inactivity and repetitive speech are characteristic behaviours in PWS in adult life. Studies of the reasons for heterogeneity in behaviors are now needed.
Population prevalence of psychopathology in children and adolescents with intellectual disability: I rationale and methods
Authors: Einfeld S. L. , Tonge B. J.
Published: November 2003

Our knowledge of the epidemiology of psychopathology in children and adolescents with intellectual disability (ID) is hampered by a number of factors. These include the relative scarcity of studies of children rather than adults, the study of non‐epidemiological samples such as those in institutions or those attending psychiatric clinics, a lack of standardized methods of assessment of psychopathology, studies with numbers too small to provide adequate confidence intervals around identified prevalence rates, insufficient detail concerning symptoms or syndromes as well as disorder, and a lack of consistent data concerning the effects of basic demographic variables such as age, sex and IQ. Despite these limitations, it is clear that psychopathology is several times more prevalent in children and adolescents with ID than in those without this disability. This paper reviews findings from previous studies and describes the methodology of a new study using the Developmental Behaviour Checklist.
Population prevalence of psychopathology in children and adolescents with intellectual disability: II epidemiological findings
Authors: Einfeld S. L. , Tonge B. J.
Published: November 2003

This paper reports findings from an epidemiologically derived population in a multicentre study in NSW, Australia. The design of this study is described in the accompanying paper. Those with mild intellectual disability (ID) were likely to have been underascertained, but identification and participation rates for those with more severe ID were high. The study found that in the regions surveyed 40.7% of those with ID and aged between 4 and 18 could be classified as having severe emotional and behaviour disorder or as being psychiatrically disordered. The profoundly intellectually handicapped had lower levels of disturbance overall compared with those with mild, moderate and severe ID. The level of ID affected scores on a number of behavioural dimensions, with disruptive and antisocial behaviours more prominent in the mild ID group, and ‘self–absorbed’ and ‘autistic’ behaviours more prominent in those with severe ID. Age and sex did not affect prevalence, a finding that is in contrast to that found in general child psychopathology. The study found that fewer than 10% of children with intellectual disability and major psychiatric disorder had received specialist assistance.
Prevalence of intellectual disability in northern Sydney adults
Authors: Beange H. , Taplin J. E.
Published: November 2003

The prevalence of intellectual disability, defined as IQ 70, was determined in a population of adults aged 20–50 years who lived in the northern suburbs of Sydney, Australia. Case finding was carried out in the community, and all those ascertained were interviewed and psychometrically assessed. The overall prevalence was 3.31 per thousand with severe intellectual disability (IQ < 55) 2.19 per thousand and mild (IQ 56–70) M. 12 per thousand. Down's syndrome had a frequency of 0.96 per thousand. Thirty‐eight per cent of the total group were living in institutional care.
Community care for adults with learning disability and their carers: needs and outcomes from the Leicestershire register
Authors: McGrother C W. , Hauck A. , Bhaumik S. , Thorp C. , Taub N.
Published: November 2003

A cross‐sectional study, based on an epidemiological register, was carried out to describe the prevalence of disabilities, felt needs and use of services for adults with learning disability and to compare outcomes of reported morbidity, stress and satisfaction among their informal carers. Subjects included 2117 adults and 982 carers known to specialist services in Leicestershire. Behavioural and psychological problems and epilepsy were the main disabilities in adults. The leading unmet needs reported by residential carers were for daycare and other forms of residence, and those reported by informal carers were for financial help, long‐term social support, respite care and housing adaptations. Informal carers reported 40% more limiting health disorders compared to the general population, with depression almost four times more common among female carers. Divisions between health and social care are causing inequality and hardship. Lifelong informal carers need options for independence. The increase over time in the prevalence of adults with severe learning disabilities adds to the evidence that more resources for care are needed. Epidemiological registers and methods should be developed to aid purchasing and provision for this client group.
Effects of smoking cessation on insulin and cardiovascular risk factors – a controlled study of 4 months' duration
Authors: NILSSON P. , LUNDGREN H. , SÖDERSTRÖM M. , FAGERSTRÖM K‐O. , NILSSON‐EHLE P.
Published: November 2003

Objectives. To investigate the effects on serum lipids, plasma fibrinogen, plasma insulin, plasma C‐peptide and blood glucose, of smoking cessation after 4 months. To develop a group‐based smoking intervention programme in primary health care.

Setting. Twenty health centres in primary health care in southern Sweden.

Subjects. Four hundred habitual smokers (>10 cigarettes per day‐1, >10 years), recruited by advertisement in local papers.

Intervention. The smokers were randomized, after stratification for age and sex, to one intervention group (n=200) and one control group (n=200). The intervention group was offered supportive group sessions and free nicotine supplementation (patches, chewing gum).

Main outcome measures. All participants were investigated at the start and after 4 months (medical history, physical examination, laboratory evaluation). Blood samples were drawn for determination of glucose, insulin and C‐peptide, both in the fasting state and during an oral glucose tolerance test (OGTT), and for measurement of lipoproteins, fibrinogen, nicotine and cotinine.

Results. In the intervention group 98 of the subjects (48%) had quit smoking after 4 months. They were compared with the 156 subjects in the control group (91%) who were still daily smokers during the whole period. There were no significant differences in any variable between the two (total) experimental groups at baseline. Plasma nicotine and cotinine decreased (P<0.001) in the intervention group following smoking cessation, and weight increased by 2.7 kg. In the intervention group HDL‐cholesterol increased by 11% (P<0.001), whereas HbA1c increased by 2% (P<0.05) only in the control group. No changes occurred in levels of glucose, insulin, C‐peptide and fibrinogen.

Conclusion. The smoking cessation programme had a success rate of almost 50% over 4 months. Smoking cessation was associated with a marked increase in HDL‐cholesterol levels but did not affect glucose tolerance. A concomitant weight increase may have blunted any independent beneficial effect of smoking cessation on glucose metabolism.
A multicentre comparison of once‐daily subcutaneous dalteparin (low molecular weight heparin) and continuous intravenous heparin in the treatment of deep vein thrombosis
Authors: LUOMANMÄKI K. , GRANKVIST S. , HALLERT C. , JAURO I. , KETOLA K. , KIM H. C. , KIVINIEMI H. , KOSKIVIRTA H. , SÖRSKOG L. , VILKKO P.
Published: November 2003

Objectives. To compare the efficacy and safety of the low molecular weight heparin (LMWH) dalteparin with unfractionated heparin (UFH) in the acute treatment of DVT patients who had not previously received UFH.

Design. An open randomized multicentre trial with blinded analysis of venograms.

Setting. Seven hospitals in Sweden, Finland and the USA.

Subjects. A total of 330 patients, of 20 years or older, with suspected DVT, verified using venography.

Interventions. Fixed‐dose dalteparin (200 IU kg‐1) given as a once‐daily subcutaneous injection, or aPTT adjusted i.v. UFH infusion for 6 to 10 days.

Main outcome measures. Change in Marder score in patients with confirmed DVT and two evaluable venograms; PE, bleeding events and follow‐up.

Results. Marder scores improved in 51% (95% CI 42–60%) of 92 patients treated with dalteparin and in 62% (95% CI 53–70%) of 98 patients treated with UFH (P =0.152). One dalteparin‐treated patient had a PE confirmed by V/Q scan; another had progressive thrombosis with swelling in the affected limb. Bleeding complications occurred in six patients in each group. One patient treated with dalteparin and five treated with UFH died during the 6‐month follow‐up period as a result of underlying malignancy or heart disease. The 6‐month recurrence rate was low with both treatments (dalteparin, 3/97; UFH, 2/103).

Conclusions. Fixed‐dose subcutaneous dalteparin given once daily from the start of treatment is of equivalent efficacy and safety to conventional UFH therapy in the routine management of DVT.