Associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders: an analysis of data from the 2008/09 New Zealand Adult Nutrition Survey.

PURPOSE: To investigate associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders. METHODS: Dietary patterns were identified using factor analysis in adults 15 years plus (n = 4657) using 24-h diet recall data from the 2008/09 New Zealand Adult Nutrition Survey. Multivariate regression was used to investigate associations between dietary patterns and age, gender and ethnicity. After controlling for demographic factors, associations between dietary patterns and food insecurity, deprivation, education, and smoking were investigated. Associations between dietary patterns and body mass index and waist circumference were examined adjusting for demographic factors, smoking and energy intake. RESULTS: Two dietary patterns were identified. 'Healthy' was characterised by breakfast cereal, low fat milk, soy and rice milk, soup and stock, yoghurt, bananas, apples, other fruit and tea, and low intakes of pies and pastries, potato chips, white bread, takeaway foods, soft drinks, beer and wine. 'Traditional' was characterised by beef, starchy vegetables, green vegetables, carrots, tomatoes, savoury sauces, regular milk, cream, sugar, tea and coffee, and was low in takeaway foods. The 'healthy' pattern was positively associated with age, female gender, New Zealand European or other ethnicity, and a secondary school qualification, and inversely associated with smoking, food insecurity, area deprivation, BMI and waist circumference. The 'traditional' pattern was positively associated with age, male gender, smoking, food insecurity and inversely associated with a secondary school qualification. CONCLUSIONS: A 'Healthy' dietary pattern was associated with higher socio-economic status and reduced adiposity, while the 'traditional' pattern was associated with lower socio-economic status.

Measuring patients' perceptions of nursing care.

Each year pain disables approximately 50 million Americans. This study determined the relationships among pain management and patients' and nurses' perceptions of quality nursing care. This study was a secondary analysis of data for 91 patients, with additional data collected. How patients perceive their nursing care may correlate with how well their pain is managed.

Key roles for GRB2-associated-binding protein 1, phosphatidylinositol-3-kinase, cyclooxygenase 2, prostaglandin E2 and transforming growth factor alpha in linoleic acid-induced upregulation of lung and breast cancer cell growth.

The distribution of omega-6 and omega-3 polyunsaturated fatty acid (PUFA) intake in Western diets is disproportionate, containing an overabundance of the omega-6 PUFA, linoleic acid (LA; C18:2). Increased enrichment with LA has been shown to contribute to the enhancement of tumorigenesis in several cancer models. Previous work has indicated that phosphatidylinositol 3-kinase (PI3K) may play a key role in LA-induced tumorigenesis. However, the modes by which LA affects carcinogenesis have not been fully elucidated. In this study, a mechanism for LA-induced upregulation of cancer cell growth is defined. LA treatment enhanced cellular proliferation in BT-474 human breast ductal carcinoma and A549 human lung adenocarcinoma cell lines. Enrichment of LA increased cyclooxygenase (COX) activity and led to increases in prostaglandin E2 (PGE2), followed by increases in matrix metalloproteinase (MMP) and transforming growth factor alpha (TGF-α) levels, which are all key elements involved in the enhancement of cancer cell growth. Further investigation revealed that LA supplementation in both BT-474 breast and A549 lung cancer cell lines greatly increased the association between the scaffolding protein GRB2-associated-binding protein 1 (Gab1) and epidermal growth factor receptor (EGFR), although Gab1 protein levels were significantly decreased. These LA-induced changes were associated with increases in activated Akt (pAkt), a downstream signaling component in the PI3K pathway. Treatment with inhibitors of EGFR, PI3K and Gab1-specific siRNAs reversed the upregulation of pAkt, as well as the observed increases in cell proliferation by LA in both cell lines. A549 xenograft assessment in athymic nude mice fed high levels of LA exhibited similar increases in EGFR-Gab1 association and increased levels of pAkt, while mice fed with high levels of the omega-3 PUFA, docosahexaenoic acid (DHA; C22:6), demonstrated an opposite response. The involvement of Gab1 in LA-induced tumorigenesis was further defined utilizing murine cell lines that express high levels of Gab1. Significant increases in cell proliferation were observed with the addition of increasing concentrations of LA. However, no changes in cell proliferation were detected in the murine paired cell lines expressing little or no Gab1 protein, establishing Gab1 as major target in LA-induced enhancement of tumorigenesis.

A simultaneous analysis of nursing care quality and cost.

The simultaneous evaluation of quality and the cost of health care can provide information that is useful for guiding quality improvement activities while minimizing or reducing cost. Despite the evidence of concern for health care costs, a long history of concern for health care quality, and numerous efforts to evaluate the quality and cost of health care simultaneously, current methods have been relatively ineffective in decreasing or containing costs. Simultaneous monitoring of cost and quality indicators can be used to compare differences between the cost of prevention and the cost of failure and can be utilized to determine areas where failure costs can be decreased.

A computer-based patient record: Emory's approach.

The replacement of the paper medical record at Emory will be gradual over the next several years. We foresee milestone events after which portions of the patient record are no longer retained in paper form. As these milestones are identified, the HIM professionals at the three institutions will begin the formidable task of managing the transition to a paperless system. Evaluation of business processes and the skill sets needed by staff members can be accomplished and a plan for each phase of transition developed.