Validity of an updated nutrition literacy assessment instrument with the new nutrition facts panel.

The Nutrition Literacy Assessment Instrument (NLit) measures nutrition literacy, including a subscale for ability to interpret nutrition fact panels (NFP). Recent redesign of the NFP in the US was issued to improve usability. This study aimed to determine reliability of the NLit subscale using two NFP versions. A 35-item survey was administered to 48 attendees with very low incomes. Surveys included previously validated NLit numeracy questions referencing the Current NFP (C-NFP), demographic and financial literacy questions, and the same NLit numeracy questions referencing the New NFP (N-NFP). NLit numeracy between the C-NFP and N-NFP were related (r = 0.842, p < .001), and N-NFP showed excellent reliability (Cronbach-α = 0.815). Mean NLit numeracy scores for the C-NFP and N-NFP were 53.5% and 55.5%, respectively (p = .437). Exchanging the N-NFP for the C-NFP in the NLit maintains strong reliability. Similar numeracy scores between C-NFP and N-NFP suggest the redesign may not be easier to read.

The feasibility of using pedometers for self-report of steps and accelerometers for measuring physical activity in adults with intellectual and developmental disabilities across an 18-month intervention.

BACKGROUND: Improving physical activity in adults with intellectual and developmental disabilities (IDDs) is recommended to improve weight loss and general health. However, in order to determine the success of physical activity interventions, identification of feasible methods for assessment of physical activities is necessary. The purpose of this study is to assess the feasibility of adults with IDD to track daily steps and wear an accelerometer. METHODS: Overweight/obese adults with mild to moderate IDD followed a diet and physical activity program for 18 months. All participants were asked to wear a pedometer and track steps daily by using a pedometer and to provide accelerometer data for 7 days at baseline, 6, 12 and 18 months. Adherence to the pedometer protocol and plausibility of the number of recorded steps were assessed, and these measures along with average wear time of the accelerometer were recorded. RESULTS: Data were collected from 149 participants (36.5 ± 12.2 years of age, 57% female). Participants recorded a step value on 81.5% of days across the 18-month study, with 40.9% of written days classified as plausible. When wearing the accelerometer, 26.8% of participants met the recommended 4-day/10-h wear time criterion at baseline, and 22.6, 24.8 and 18.8% met the criterion at 6, 12 and 18 months, respectively. CONCLUSIONS: Adults with IDD will adhere reasonably well to wearing a pedometer long term, but may be unable to record the step data accurately. Furthermore, adults with IDD have poor compliance with accelerometer protocols, and future studies should determine if a shorter wear time protocol would produce valid data in this population.

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program.

OBJECTIVE: To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. METHOD: Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. RESULTS: At 14.1+/-10.8 months following completion of treatment, survey respondents were on average 12.6+/-12.6 kg, or 11.3+/-10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. CONCLUSIONS: Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

Caregivers' effect on weight management in adults with intellectual and developmental disabilities.

INTRODUCTION: Caregivers of adults with IDD often play a large role in the ability of adults with IDD to lose weight. OBJECTIVE: The purpose of this study was to determine to examine the effects of the caregivers' perceived burdens and self-efficacy and their relationship to an individual (family member or paid staff) on weight changes across a weight management intervention for adults with IDD. METHODS: Overweight/obese adults with mild to moderate IDD, along with assigned caregivers who served as their study partner, were randomized to an 18-month weight management intervention. The living environment and caregiver relationship were assessed at baseline. Caregivers completed questionnaires regarding perceived hassles, uplifts, and self-efficacy in helping the participant follow a weight management intervention. RESULTS: 147 adults with IDD (∼57% women and ∼16% minorities) were included in data analysis. After 18 months, there were no differences in weight loss between participants who had a family member as their study partner and those who had a paid assistant as their study partner (-5.5 ± 5.2% vs. -5.6± 5.3% p = 0.16). However, paid assistants reported more hassles with following the diet intervention at 6 months (p < 0.05). Participants who had a paid assistant as their study partner were more likely to have multiple study partners during the study, which was correlated with smaller weight loss. CONCLUSION: While caregivers are important for weight management of adults with IDD, the caregiver's relationship to the participant does not affect weight change in an intervention.

A virtual reality intervention (Second Life) to improve weight maintenance: Rationale and design for an 18-month randomized trial.

Despite the plethora of weight loss programs available in the US, the prevalence of overweight and obesity (BMI≥25kg/m(2)) among US adults continues to rise at least, in part, due to the high probability of weight regain following weight loss. Thus, the development and evaluation of novel interventions designed to improve weight maintenance are clearly needed. Virtual reality environments offer a promising platform for delivering weight maintenance interventions as they provide rapid feedback, learner experimentation, real-time personalized task selection and exploration. Utilizing virtual reality during weight maintenance allows individuals to engage in repeated experiential learning, practice skills, and participate in real-life scenarios without real-life repercussions, which may diminish weight regain. We will conduct an 18-month effectiveness trial (6 months weight loss, 12 months weight maintenance) in 202 overweight/obese adults (BMI 25-44.9kg/m(2)). Participants who achieve ≥5% weight loss following a 6month weight loss intervention delivered by phone conference call will be randomized to weight maintenance interventions delivered by conference call or conducted in a virtual environment (Second Life®). The primary aim of the study is to compare weight change during maintenance between the phone conference call and virtual groups. Secondarily, potential mediators of weight change including energy and macronutrient intake, physical activity, consumption of fruits and vegetables, self-efficacy for both physical activity and diet, and attendance and completion of experiential learning assignments will also be assessed.

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery.

C-reactive protein and other markers of inflammation among patients undergoing HELP LDL apheresis.

Studies reveal important prognostic relationships between C-reactive protein (CRP) and atherosclerotic complications. A prospective trial of familial hypercholesterolemic patients treated with Heparin-induced Extra-corporeal Low-Density Lipoprotein Precipitation (HELP, B. Braun Melsungen) therapy was undertaken to evaluate the short- and long-term effects on CRP. Four patients received LDL apheresis therapy on an alternate week basis for 6 months. Pre- and post-treatment serum high sensitivity (hs) CRP levels (IMx(R), Abbott Laboratories), LDL-C, triglycerides, and fibrinogen were measured. Pre- and post-treatment mean serum levels of LDL-C were 281+/-76 and 98+/-34 mg/dl; triglycerides 191+/-64 and 123+/-50 mg/dl; fibrinogen 332+/-46 and 117+/-31 mg/dl, respectively. Before and after apheresis mean serum levels of hsCRP were 8.99+/-7.88 and 3.15+/-3.16 mg/ml, respectively, representing a 65% decrease. After 6 months of therapy, pre-treatment hsCRP showed an overall mean level decrease of 49%. Preliminary results indicate that LDL apheresis results in a rapid and long-term decrease of serum hsCRP levels.

Sequence analysis of the equine H7 influenza virus haemagglutinin gene.

The nucleotide sequences of ten haemagglutinin genes of representative H7N7 equine influenza viruses isolated between 1956 and 1977 have been determined by primer extension sequencing. Their nucleotide and deduced amino acid sequences demonstrate a high degree of homology. These equine viruses can be divided into two distinct subgroups, the prototype-like, and a group comprising the early American isolates and the remaining equine viruses. The equine H7 haemagglutinins form a quite distinct group compared to H7 haemagglutinins isolated from other species. Each of these equine H7 haemagglutinins possess a tetrabasic amino acid cleavage site separating the HA1 and HA2 domains but, in addition, all ten contain a nine amino acid insertion prior to the tetrabasic sequence. The haemagglutinin glycoproteins of all ten viruses are capable of cleavage activation in virus infected primary chicken embryo fibroblast cells.

A single-radial haemolysis technique for measurement of antibody to influenza virus neuraminidase in equine sera.

A modified single-radial-haemolysis (SRH) test for measurement of antibody to influenza virus neuraminidase (NA) is described. The test requires treatment of sheep erythrocytes with butanol to increase sensitivity. In comparative assays, SRH was found to be more sensitive than the conventional neuraminidase-inhibition test. The SRH test was reproducible, specifically measured antibody to influenza NA and was easy to use. SRH antibody responses in ponies vaccinated with bivalent equine influenza vaccine were shown to be vaccine dose-related but were lower in magnitude and shorter in duration than comparable anti-haemagglutinin responses.

Primer extension dideoxy chain termination nucleotide sequencing of partially purified RNA virus genomes: a technique for investigating low titre viruses with extensive genome secondary structure.

A modified version of the primer extension dideoxy chain termination nucleotide sequencing technique (Sanger et al., 1977) is described. This method has advantages over existing molecular cloning and primer extension techniques in that it allows the genome of RNA viruses to be directly sequenced from partially purified RNA preparations. Thus, viruses growing at unacceptably low titres in tissue culture can now be partially purified from infected mouse brain and sequenced. The technique also incorporates steps for the denaturation of secondary structure which has previously provided difficulties for primer extension sequencing.

Evidence of vertical transmission of Ross River and Sindbis viruses (Togaviridae: Alphavirus) by mosquitoes (Diptera: Culicidae) in southeastern Australia.

Ross River and Sindbis viruses were isolated from Aedes camptorhynchus adults reared from immatures collected from a salt marsh in coastal Victoria, indicating the existence of field vertical transmission. These first isolations of an arbovirus from adult mosquitoes reared from field-collected immatures in Australia indicates one mechanism for arbovirus maintenance in temperate regions.

Neonatal treatment with TRH affects development, learning, and emotionality in the rat.

Rats that received injections of TRH from Days 2-7 postnatally ran faster to a palatable food reward than controls at 33-37 days of age. Rats treated with TRH were less emotional and more active in an open field both as pups and as adults. There were few notable differences in developmental measures except that the teeth erupted earlier in control animals. Weights of glands and brain parts showed that ovaries, testes, pineal gland, and hypothalamus were heavier in treated animals. The results indicated that TRH given early in life may affect adult behavior by reducing emotionally.

Issues related to participation in worksite health promotion: a preliminary study.

PURPOSE: The purpose of this study was to identify characteristics associated with participation in worksite-based health promotion activities. DESIGN: Follow-up interviews were used to identify demographic, attitudinal, and behavioral differences among three employee groups. Reasons employees chose not to participate in health promotion activities were also explored. SETTING: All respondents were employed at a large midwestern university and were eligible to participate in free onsite health fairs and health promotion programs. SUBJECTS: A stratified random sample of 89 nonparticipants, health fair participants, and behavior change program participants was interviewed. MEASURES: The interview was comprised of questions related to demographic information, personal health habits, physical activity, perceived health status, perceived self-efficacy, worksite norms, health promoting lifestyle factors, and knowledge about health promotion activities. RESULTS: ANOVA and chi-squared comparisons revealed few group differences. Graduate students and employees with advanced degrees were most likely to take part in health fairs. Behavior change program participants were older, clerical-technical staff members, and women. Faculty members were least likely to participate. A lack of time was the most often cited reason for nonparticipation. CONCLUSIONS: The study was retrospective and the analyses limited due to low statistical power. The results suggest that different groups of employees are attracted to different types of health promotion activities.

Expression and processing of nonstructural proteins of the human astroviruses.

The human astroviruses (HAst) are increasingly recognized as an important cause of gastroenteritis. These viruses contain a 6.8-kb positive-sense, single-stranded RNA molecule that is infectious when transfected into permissive cells. The HAst gene 1 is composed of two open reading frames (ORFs 1a and 1b) connected by a ribosomal frameshift. Gene 1 is predicted to encode two nonstructural polyproteins (pp 1a and pp 1ab), and analysis of the HAst gene 1 sequence has resulted in predictions of a serine proteinase within the ORF1a polyprotein. However, none of the gene 1 proteins have been identified. To examine the expression and processing of the HAst2 gene 1 polyprotein, we have translated pp 1a and pp 1ab in vitro. These ongoing studies will provide the foundation for correlating gene 1 expression in vitro with proteins expressed in virus-infected cells.

Processing of the MHV-A59 gene 1 polyprotein by the 3C-like proteinase.

The 3C-like proteinase of mouse hepatitis virus (MHV-3CLpro) is predicted to cleave at least 10 sites in the gene 1 polyprotein, resulting in processing of proteinase, polymerase and helicase proteins from the polyprotein. We have used E. coli expressed recombinant 3CLpro (r3CLpro) to define cleavage sites in carboxy-terminal region of the ORF 1a polyprotein. Polypeptides containing one or more putative 3CLpro cleavage site were translated in vitro from subcloned regions of gene 1, and the polypeptides were incubated with r3CLpro. Analysis of the cleavage products confirmed several putative cleavage sites, as well as identifying cleavage sites not previously predicted by analysis of the MHV sequence. Antibodies directed against a portion of the ORF 1a polyprotein were used to probe virus infected cells, and detected proteins that correspond to the cleavage sites used by 3CLpro in vitro. These results suggest that MHV 3CLpro cleaves at least 7 sites in the ORF 1a polyprotein, and that the specificity of 3CLpro for cleavage site dipeptides may be broader than previously predicted.

Bovine lactoferrin binds to insulin-like growth factor-binding protein-3.

Insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3) has been shown to have IGF independent actions that appear to be mediated by specific IGFBP-3 binding proteins located on cell membranes. We show here using Western ligand blotting, a number of mammary membrane proteins that bind 125I-labeled rhIGFBP-3. Immunoprecipitation studies demonstrated that the >70 kDa protein was identified from bovine mammary microsomes as bovine lactoferrin (bLf). In addition to being a secretory protein, Lf is tightly associated with cellular membranes. Labeled rhIGFBP-3 was shown to bind to commercially purchased and processed apo- or holo-human or bLf, but not bovine transferrin (bTf). Binding of [125I]rhIGFBP-3 to other positively charged proteins was not detected nor was binding to rhIGFBP-5 or other mammary-secreted IGFBPs observed. Reciprocal specific binding of [125I]bLf to rhIGFBP-3 was shown, but [125I]bTf did not show binding to rhIGFBP-3. While [125I]rhIGF-II does not bind to bLf, unlabeled rhIGF-II was shown to compete with [125I]bLf for rhIGFBP-3 binding. More detailed analysis by dot blot showed that Lf competes (ED(50)=3 microg/ml) or displaces (ED(50)=1mg/ml) bound [125I]rhIGF-II from dot blotted rhIGFBP-3. In vitro studies with a bovine primary mammary epithelial cell culture showed that all-trans-retinoic acid stimulates the appearance of bovine IGFBP-3 and bLf in the conditioned media and that [125I]rhIGFBP-3 could be utilized to detect conditioned media bLf. These findings reveal a novel role for bLf, binding to IGFBP-3 and perhaps disassociating IGFBP-3:IGF when in high concentration.

Identification of IGF binding proteins in bovine milk and the demonstration of IGFBP-3 synthesis and release by bovine mammary epithelial cells.

Insulin-like growth factor system components are synthesized and secreted by mammary epithelial cells and multiple IGF binding proteins (IGFBP) are found in milk of various species. This study was conducted to identify the IGFBP in bovine milk, to compare them with those found in blood, and to identify the cell(s) responsible for mammary IGFBP synthesis. Bovine blood, milk, and cell culture-conditioned media were analyzed and characterized with Western ligand blot procedures for specific IGFBP. Electrophoresis and [125I]IGF-II ligand blot analyses of the samples indicated that, unlike serum and mammary primary cell culture-conditioned media, milk required removal of casein in order to accurately disclose all IGFBP. Immunoprecipitation studies identified IGFBP-2, -3, -4, and -5 in blood, milk, and primary cell culture conditioned media. The IGFBP were present at higher concentrations in serum than in milk, and milk concentrations were greater than that shown in conditioned media from primary cultures of bovine mammary cells. Northern analysis detected IGFBP-3 messenger RNA in extracts from fresh tissue and cells in culture, and in situ hybridization studies with fresh tissue utilizing probes for IGFBP-3 and alphaS1-casein showed that the mRNA for IGFBP-3 is predominant in the secretory epithelial cells, when compared to other tissue cell types.

Insulin-like growth factor (IGF)-I and -II and IGF binding proteins in serum and mammary secretions during the dry period and early lactation in dairy cows.

Concentrations of IGF-I and IGF-II, and IGF binding proteins (IGFBP) in serum and mammary gland secretions were surveyed during the dry period and early lactation of 30 Holstein cows. Although there was a threefold drop in the concentration of IGF-I in serum from the last week of the dry period to parturition (81 +/- 7 to 24 +/- 3 ng/ml, P less than .01), there was no significant change in serum IGF-II concentration during this period (150 +/- 17 vs 173 +/- 13 ng/ml, P greater than .05). Furthermore, a 57% increase in serum IGF-I was observed from the last week of lactation to the second week of drying off (100 +/- 5 to 157 +/- 8 ng/ml, P less than .05). Changes in serum IGF-II were not observed (126 +/- 11 vs 150 +/- 10 ng/ml, respectively; P greater than .05). Although IGF-I, IGF-II, and IGFBP concentrations in mammary secretions peaked 2 wk before parturition (2.95 +/- 1.1, 1.83 +/- .6, and 7.27 +/- .76 micrograms/ml, respectively), total output/quarter was highest in colostrum (394 +/- 119, 295 +/- 132, and 2,680 +/- 1,967 micrograms/quarter, respectively). Weekly milking of two individual quarters during the dry period did not affect (P greater than .05) IGF-I or IGF-II concentration (ng/ml) or total output (microgram/quarter) and milk yield in colostrum and milk (2 wk and 7 wk) compared with the ipsilateral quarter. The data support the hypothesis that IGF-I may be transported by the mammary gland epithelium. Furthermore, the secretion mechanisms of IGF-I, IGF-II, and IGFBP by the gland may be related to each other.

Arginine supplementation increases weight gain, depresses antibody production, and alters circulating leukocyte profiles in preruminant calves without affecting plasma growth hormone concentrations.

The hypothesis that dietary L-arginine (L-Arg) supplementation would increase growth hormone (GH) secretion and antibody production in preruminant calves was tested. Sixteen newborn calves were randomly assigned to either Arg+ or Arg- treatment groups. Both groups were fed a single dose of Colostrx within 6 h after birth followed by milk replacer twice daily until weaning. Beginning with the Colostrx feeding, calves in the Arg+ group were supplemented with L-arginine at 500 mg kg x BW(-1) x d(-1), and the Arg- group received equivalent, but unsupplemented, diets. All calves were immunized against keyhole limpet hemocyanin (KLH) on d 4 and received a booster vaccination on d 14. The Arg+ treatment increased (P < .05) plasma L-Arg and urea concentrations an average of 2.8-fold and 26%, respectively, during the 4-wk supplementation period. Average daily gain (ADG) of Arg+ calves was increased (P < .10) during wk 1, 3, and 5 of life. The Arg+ treatment depressed (P < .05) total and KLH-specific IgG concentrations in plasma and caused a decrease (P < .01) in circulating leukocyte numbers. Differential counts revealed that the decrease in circulating leukocyte numbers was due to decreases in absolute numbers of lymphocytes, monocytes, and neutrophils. The Arg+ diet did not affect mean plasma GH concentrations during the first 3 wk of life, but GH mean concentrations were decreased (P < .01) during wk 4 due to depressed (P < .10) pulse amplitudes. The decrease in GH mean concentrations during wk 4 was paralleled by lower (P < .10) plasma IGF binding protein-3 concentrations. These data show that supplementary L-Arg does not increase plasma GH concentrations, but it increases ADG, depresses KLH antibody production, and alters circulating leukocyte populations in preruminant calves.

Weight management for individuals with intellectual and developmental disabilities: rationale and design for an 18 month randomized trial.

Weight management for individuals with intellectual and developmental disabilities (IDD) has received limited attention. Studies on weight management in this population have been conducted over short time frames, in small samples with inadequate statistical power, infrequently used a randomized design, and have not evaluated the use of emerging effective dietary strategies such as pre-packaged meals (PMs). Low energy/fat PMs may be useful in individuals with IDD as they simplify meal planning, limit undesirable food choices, teach appropriate portion sizes, are convenient and easy to prepare, and when combined with fruits and vegetables provide a high volume, low energy dense meal. A randomized effectiveness trial will be conducted in 150 overweight/obese adults with mild to moderate IDD, and their study partners to compare weight loss (6 months) and weight maintenance (12 months) between 2 weight management approaches: 1. A Stop Light Diet enhanced with reduced energy/fat PMs (eSLD); and 2. A recommended care reduced energy/fat meal plan diet (RC). The primary aim is to compare weight loss (0-6 months) and weight maintenance (7-18 months) between the eSLD and RC diets. Secondarily, changes in chronic disease risk factors between the eSLD and RC diets including blood pressure, glucose, insulin, LDL-cholesterol, and HDL-cholesterol will be compared during both weight loss and weight maintenance. Finally, potential mediators of weight loss including energy intake, physical activity, data recording, adherence to the diet, study partner self-efficacy and daily stress related to dietary change will be explored.