PERSPECTIVE: Health Economic Interests at NIMH and NIDA to Improve Delivery of Behavioral Health Services.

BACKGROUND: Effective financing mechanisms are essential to ensuring that people can access and utilize effective treatments and services. Financing mechanisms are needed not only to pay for the delivery of those treatments and services, but also ancillary costs, while also keeping care affordable. AIMS: This article highlights key areas of the interest of the National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA) in supporting applied health economics and health care financing research. Specifically, this article discusses the long-range impact of NIH's earlier investments in applied health economics research, and NIH's ongoing efforts to communicate its interests in health economics research. We discuss the 2023 NIMH-NIDA-sponsored health economics conference, and the ideas presented there for developing and assessing innovative behavioral health care financing models; three of the presented papers were recently published in the Journal of Mental Health Policy and Economics. METHODS: We describe the history and impact of NIMH- and NIDA-sponsored economic research and identify current research interests as identified in the NIMH and NIDA Strategic Plans and recent funding announcements. We examine themes presented at the NIMH-NIDA Health Economics conference. The conference included over 300 participants from 20 countries, from six continents. RESULTS: The topics highlighted at the conference highlight the ways in which NIH-funded research has promoted the development of innovative health care financing methods, both from the supply side (e.g., providers and payers) and demand side (e.g., service users and families). Invited speakers discussed the findings from NIH-supported research in the topic areas of payment and financing, behavioral economics and social determinants of health. Keynote speakers highlighted emerging topics in the field, including the economics of health equity, biases in mental health models in health care, and value-based insurance design. DISCUSSION: We demonstrate a resurgence of and explicit interest in health economics and policy research at NIMH and NIDA. However, more work is needed in order to design funding mechanisms that fully provide access to and facilitate use of effective evidence-based practices to improve mental health outcomes. For example, it is important that policy and health economic research projects include decision makers who will be the end users of data and study results, to ensure that results can be meaningfully put into practice. IMPLICATIONS FOR HEALTH CARE: Designing effective and efficient funding mechanisms can help ensure that service users have access to effective treatments and that clinicians and provider organizations are adequately compensated for their work. IMPLICATIONS FOR HEALTH POLICIES: Federal, state, and local policies, as well as policies of payers and health care organizations, can influence the type of care that is supported and incentivized. IMPLICATIONS FOR FURTHER RESEARCH: As demonstrated by the research interests as outlined in their respective Strategic Plans and funding announcements, NIMH and NIDA continue to fund health economic and policy research that aims to improve health care access, quality and outcomes for people with or at risk of developing behavioral health conditions in the US and around the world.

A survey of cost, access and outcomes for cannabinoid-based medicinal product use by Australians with endometriosis.

People with endometriosis use cannabis to manage their symptoms. This study aimed to identify costs, modes of administration, product composition, and self-reported effectiveness for those accessing medicinal cannabis in Australia. There were 192 survey responses analysed. Most (63.5%) used a 'cannabis clinic' doctor, incurring an initial consultation cost of $100-$200+ (10.2% Medicare bulk-billed) and median cannabinoid medicine costs of $300AUD per month. Cost was a major barrier to access, necessitating reducing dosage (76.1%) and/or consuming illicit cannabis (42.9%), despite a prescription. Most (77%) medical consumers used two or more cannabis products, with delta-9-tetrahydrocannabinol predominant oil and flower products most frequently prescribed.

Policies, Guidelines, and Practices Supporting Women's Menstruation, Menstrual Disorders and Menopause at Work: A Critical Global Scoping Review.

(1) Objectives: This paper presents a scoping review of global evidence relating to interventions (i.e., policies, practices, guidelines, and legislation) aimed at supporting women to manage menstruation, menstrual disorders, and menopause at work. (2) Methods: Databases including Medline (Ebsco), CINAHL (Ebsco), Scopus, Web of Science, APA PsychInfo (Ebsco), Humanities International Complete (Ebsco), Academic Search Premier (Ebsco), HeinOnline and OSH Update, and Google Scholar were searched in May 2022. (3) Results: Of 1181 unique articles screened, 66 articles are included. Less half of the articles (42%, 28/66) presented/reviewed an intervention related to women's workplace health. A total of 55 out of the 66 articles are set across 13 countries with the remaining 12 articles described as multi-country studies or reviews. Half of the articles presenting/reviewing an intervention were grey literature, with several undertaken in UK and EU member countries. Interventions focusing on supporting women with menopause at work were the most common (43%, 12/28), followed by menstruation (25%, 7/28) and menstrual disorders (7%, 2/28). Across the reviewed articles, recommendations were categorised as adjustments to the physical work environment, information and training needs, and policy and processes. Few articles explicitly presented or affirmed a design-process and/or evaluation tied to their intervention. In lieu of design-process, this review categorises the rationales driving the development of an intervention as: pronatalist, economic rationalism, gendered occupational health concern, cultural shift towards gender equity objectives, and efforts to reduced shame and stigma. (4) Conclusions: There is a growing body of evidence aimed at understanding women's experiences of managing their menstrual and reproductive health in the workplace and how this impacts their work/career trajectories. However, little research is explicitly concerned with exploring or understanding interventions, including their design or evaluation. Most articles report menopause guidelines and are typically confined to the UK and EU-member countries. Despite the prevalence of menstrual disorders (e.g., endometriosis and polycystic ovarian syndrome (PCOS)) there is limited literature focused on how women might be supported to manage symptoms associated with these conditions at work. Accordingly, future policies should consider how women can be better supported to manage menstruation and menstrual disorders at work and recognise the importance of co-design during policy development and post-intervention evaluation. Further research needs to be undertaken on the impact of workplace policies on both employers and employees.

To each their own: a review of individual differences and metaphorical perspectives on time.

How do people talk-and potentially think-about abstract concepts? Supported by abundant linguistic evidence, Conceptual Metaphor Theory posits that people draw upon concrete concepts to structure abstract ones via metaphorical connections. Often, the source domain for a metaphor draws upon embodied physical experience, as in the time is space system, whereby representations in the domain of time are thought to arise from experiences of navigating through, orienting within, and observing motion in space. In recent years, psychological evidence has suggested that the connections between space and time are indeed conceptual; however, many gaps in our understanding of the workings of metaphor remain. Notably, until recently, the unique variations in the ways in which people experience metaphor have been largely overlooked, with much research falling prey to what Dabrowska has identified as one of the 'deadly sins' of cognitive linguistics: to ignore individual differences. By focusing on two widely studied metaphors for time, Moving Time and Moving Ego, this review article shines a spotlight on the varied ways in which people draw on their embodied and enculturated experiences, along with 'human experience' on an individual level and the contexts within which they use metaphor. In doing so, it highlights the importance for metaphoric conceptualization of variation across languages, across contexts, and across individuals, suggesting that while the use and interpretation of metaphor may begin with cross-domain connections, they are but part of the story.

Cognitive Science: Piecing Together the Puzzle.

Alongside significant gains in our understanding of the human mind, research in Cognitive Science has produced substantial evidence that the details of cognitive processes vary across cultures, contexts, and individuals. In order to arrive at a more nuanced account of the workings of the human mind, in this letter we argue that one challenge for the future of Cognitive Science is the integration of this evidence of variation with findings which can be generalized.

Prevalence of Childhood Trauma in a Community-Based Mental Health Clinic.

A large number of individuals in the US have experienced childhood trauma. However, little is known about the prevalence of trauma in a diverse patient population entering treatment in a community mental health center. To assess early trauma in this population, the Adverse Childhood Experience (ACEs) questionnaire was administered to 856 participants over a nine-month period. 40% reported four or more ACEs. Among high scorers, emotional abuse, physical abuse and emotional neglect were the most prevalent ACE experiences. High mean ACE sum scores were observed among patients with PTSD, depression, impulse disorder and substance use disorder. Having a higher ACE sum score was associated with a greater number of co-occurring psychiatric disorders. Characterizing ACEs by patient sociodemographic attributes and psychiatric diagnoses extracted from the electronic medical records (EMR) can benefit therapeutic interventions. These findings indicate a need for creating more trauma-informed settings with knowledgeable, trained staff.

Neurocritical Care Performance Measures Derived from Electronic Health Record Data are Feasible and Reveal Site-Specific Variation: A CHoRUS Pilot Project.

BACKGROUND: We evaluated the feasibility and discriminability of recently proposed Clinical Performance Measures for Neurocritical Care (Neurocritical Care Society) and Quality Indicators for Traumatic Brain Injury (Collaborative European NeuroTrauma Effectiveness Research in TBI; CENTER-TBI) extracted from electronic health record (EHR) flowsheet data. METHODS: At three centers within the Collaborative Hospital Repository Uniting Standards (CHoRUS) for Equitable AI consortium, we examined consecutive neurocritical care admissions exceeding 24 h (03/2015-02/2020) and evaluated the feasibility, discriminability, and site-specific variation of five clinical performance measures and quality indicators: (1) intracranial pressure (ICP) monitoring (ICPM) within 24 h when indicated, (2) ICPM latency when initiated within 24 h, (3) frequency of nurse-documented neurologic assessments, (4) intermittent pneumatic compression device (IPCd) initiation within 24 h, and (5) latency to IPCd application. We additionally explored associations between delayed IPCd initiation and codes for venous thromboembolism documented using the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) system. Median (interquartile range) statistics are reported. Kruskal-Wallis tests were measured for differences across centers, and Dunn statistics were reported for between-center differences. RESULTS: A total of 14,985 admissions met inclusion criteria. ICPM was documented in 1514 (10.1%), neurologic assessments in 14,635 (91.1%), and IPCd application in 14,175 (88.5%). ICPM began within 24 h for 1267 (83.7%), with site-specific latency differences among sites 1-3, respectively, (0.54 h [2.82], 0.58 h [1.68], and 2.36 h [4.60]; p < 0.001). The frequency of nurse-documented neurologic assessments also varied by site (17.4 per day [5.97], 8.4 per day [3.12], and 15.3 per day [8.34]; p < 0.001) and diurnally (6.90 per day during daytime hours vs. 5.67 per day at night, p < 0.001). IPCds were applied within 24 h for 12,863 (90.7%) patients meeting clinical eligibility (excluding those with EHR documentation of limiting injuries, actively documented as ambulating, or refusing prophylaxis). In-hospital venous thromboembolism varied by site (1.23%, 1.55%, and 5.18%; p < 0.001) and was associated with increased IPCd latency (overall, 1.02 h [10.4] vs. 0.97 h [5.98], p = 0.479; site 1, 2.25 h [10.27] vs. 1.82 h [7.39], p = 0.713; site 2, 1.38 h [5.90] vs. 0.80 h [0.53], p = 0.216; site 3, 0.40 h [16.3] vs. 0.35 h [11.5], p = 0.036). CONCLUSIONS: Electronic health record-derived reporting of neurocritical care performance measures is feasible and demonstrates site-specific variation. Future efforts should examine whether performance or documentation drives these measures, what outcomes are associated with performance, and whether EHR-derived measures of performance measures and quality indicators are modifiable.

Clinical Validation of a Novel T-Cell Receptor Sequencing Assay for Identification of Recent or Prior Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

BACKGROUND: While diagnostic, therapeutic, and vaccine development in the coronavirus disease 2019 (COVID-19) pandemic has proceeded at unprecedented speed, critical gaps in our understanding of the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain unaddressed by current diagnostic strategies. METHODS: A statistical classifier for identifying prior SARS-CoV-2 infection was trained using >4000 SARS-CoV-2-associated T-cell receptor (TCR) ß sequences identified by comparing 784 cases and 2447 controls from 5 independent cohorts. The T-Detect COVID (Adaptive Biotechnologies) assay applies this classifier to TCR repertoires sequenced from blood samples to yield a binary assessment of past infection. Assay performance was assessed in 2 retrospective (n = 346; n = 69) and 1 prospective cohort (n = 87) to determine positive percent agreement (PPA) and negative percent agreement (NPA). PPA was compared with 2 commercial serology assays, and pathogen cross-reactivity was evaluated. RESULTS: T-Detect COVID demonstrated high PPA in individuals with prior reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection (97.1% 15+ days from diagnosis; 94.5% 15+ days from symptom onset), high NPA (∼100%) in presumed or confirmed SARS-CoV-2 negative cases, equivalent or higher PPA than 2 commercial serology tests, and no evidence of pathogen cross-reactivity. CONCLUSIONS: T-Detect COVID is a novel T-cell immunosequencing assay demonstrating high clinical performance for identification of recent or prior SARS-CoV-2 infection from blood samples, with implications for clinical management, risk stratification, surveillance, and understanding of protective immunity and long-term sequelae.

PERSPECTIVE: Current US COVID-19 Pandemic Substance Use Research and Ideas for Research That May Help Us Learn More.

BACKGROUND: The COVID-19 pandemic likely had and will continue to have severe implications for those who use addictive substances, have substance use disorders, or use substance use related health care services. Policy and services research, particularly health economics research, can illuminate these effects on individuals, uncover the effects of the rapidly imposed changes in policy on how services were delivered, promote efficient and effective provision of services, and inform responses to future pandemics. AIMS OF THE STUDY: To identify potential substance use related effects of COVID-19 and pandemic mitigation policies, highlight themes in current research, and suggest areas for further high-quality policy and services research, with an emphasis on health economics research. METHODS: Review of recent published commentaries, government documents, and initial research findings to describe potential impacts, and review of current COVID-19 related research grants funded by the United States National Institutes of Health to identify themes. RESULTS: Potential impacts include increased risk for and severity of COVID-19 illness among those who use substances, mitigation measures causing increased substance use and development of use disorders, and fundamental changes in the way treatment is provided. Current research may provide initial findings that may be useful in generating hypotheses for future rigorous research. DISCUSSION: Research on these and other areas could enhance our fundamental understanding of the needs of individuals who use substances and how to best address those needs in the most efficient, effective way. Though this brief review highlights some areas of potential interest, its focus is mainly on treatment and on the United States context. Research on additional services and contexts likely could inform advances as well. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Health care providers rapidly and under considerable stress made needed changes that likely mitigated SARS-CoV-2 transmission. Rigorous research can help determine what worked best and for whom, what could be kept, and what might better be discarded. IMPLICATIONS FOR HEALTH POLICIES: Research on the effects of mitigation policies may inform the development of policies to reduce negative effects when addressing future pandemics, whether to permanently allow at least some substance use treatment flexibilities, and whether research on other restrictive policies might lead to improvement. IMPLICATIONS FOR FURTHER RESEARCH: This extraordinary event brought into sharp relief the numerous vulnerabilities of those who use substances and those with substance use disorders while also leading to vast changes in the services that address them. Rigorous research into those effects could result in significant improvements in policy and practice.

Artists on the edge of the world: An integrated approach to the study of Magdalenian engraved stone plaquettes from Jersey (Channel Islands).

The Upper Palaeolithic is characterised by the appearance of iconographic expressions most often depicting animals, including anthropomorphic forms, and geometric signs. The Late Upper Palaeolithic Magdalenian saw a flourishing of such depictions, encompassing cave art, engraving of stone, bone and antler blanks and decoration of tools and weapons. Though Magdalenian settlement exists as far northwest as Britain, there is a limited range of art known from this region, possibly associated with only fleeting occupation of Britain during this period. Stone plaquettes, flat fragments of stone engraved on at least one surface, have been found in large quantities at numerous sites spanning the temporal and geographical spread of the Magdalenian, but they have been absent so far from the archaeological record of the British Isles. Between 2015 and 2018, ten fragments of stone plaquettes extensively engraved with abstract designs were uncovered at the Magdalenian site of Les Varines, Jersey, Channel Islands. In this paper, we report detailed analyses of these finds, which provide new evidence for technologies of abstract mark-making, and their significance within the lives of people on the edge of the Magdalenian world. These engraved stone fragments represent important, rare evidence of artistic expression in what is the far northern and western range of the Magdalenian and add new insight to the wider significance of dynamic practices of artistic expression during the Upper Palaeolithic.

The morphological affinity of the Early Pleistocene footprints from Happisburgh, England, with other footprints of Pliocene, Pleistocene, and Holocene age.

Fossil hominin footprints provide a direct source of evidence of locomotor behavior and allow inference of other biological data such as anthropometrics. Many recent comparative analyses of hominin footprints have used 3D analytical methods to assess their morphological affinities, comparing tracks from different locations and/or time periods. However, environmental conditions can sometimes preclude 3D digital capture, as was the case at Happisburgh (England) in 2013. Consequently, we use here a 2D geometric morphometric approach to investigate the evolutionary context of the Happisburgh tracks. The comparative sample of hominin tracks comes from eight localities that span a broad temporal range from the Pliocene to Late Holocene. The results show disparity in the shapes of tracks ascribed to hominins from the Pliocene (presumably Australopithecus afarensis), Pleistocene (presumably Homo erectus and Homo antecessor), and Holocene (Homo sapiens). Three distinct morphological differences are apparent between time samples: changes in adduction of the hallux, changes in the shape and position of the medial longitudinal arch impression, and apparent changes in foot proportions. Linear dimensions classified the potential H. antecessor tracks from Happisburgh as being most similar to the presumed H. erectus prints from Ileret. We demonstrate using 2D geometric morphometric methods and linear dimensions that the Happisburgh tracks are morphologically similar to other presumed Homo tracks and differ from the Laetoli footprints. The probable functional implications of these results fit well with previous comparative analyses of hominin tracks at other sites.

Can co-speech gestures alone carry the mental time line?

Time and space have been shown to be interlinked in people's minds. To what extent can co-speech gestures influence thinking about time, over and above spoken language? In this study, we use the ambiguous question "Next Wednesday's meeting has been moved forward two days, what day is it on now?" to show that people either respond "Monday" or "Friday," depending on gesture. We manipulated both language (using either the adverb "forward," or the adverb "backward") and gesture (forward and backward movement), thus creating matches and mismatches between speech and gesture. Results show that the speech manipulation exerts a stronger influence on people's temporal perspectives than gesture. Moreover, the effect of gesture disappears completely for certain hand shapes and if non-movement language is used ("changed by two days" as opposed to "moved by two days"). We additionally find that the strength of the gesture effect is moderated by likability: When people like the gesturer, they are more prone to assuming their perspective, which completely changes the meaning of forward and backward gestural movements. Altogether, our results suggest that gesture does play a role in thinking about time, but this role is auxiliary when compared with speech, and the degree to which gesture matters depends on one's social relation to the gesturer. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Economic analysis in behavioral health: Toward application of standardized methodologies.

Health care remains the most expensive sector in the U.S. economy, now accounting for nearly 1 in every 5 dollars spent. The purpose of health care is to improve the health of populations. However, formal medical care is one of many alternatives for improving health. In order to make better use of scarce resources, cost-effectiveness methodologies have been developed to evaluate how to produce the most health within the constraints of available resources. Standardized cost-effectiveness methodologies are now commonly used in the evaluation of medical therapies and new technologies. However, these methods have rarely been employed for the evaluation of behavioral interventions. Behavioral interventions often use measures that are not generally applied in other areas of health outcomes research. A consequence of neglecting to employ standardized cost-effectiveness analysis is that behavioral, psychological, and environmental interventions may be left out of resource allocation discussions. The purpose of this paper is to review standardized approaches to cost-effectiveness analysis and to encourage their use for the evaluation of behavioral intervention programs. Application of standardized methods of cost-effectiveness analysis will allow direct comparisons between investing in behavioral interventions programs in comparison to a wide range of other alternatives. The methods are general and can be used to estimate the cost-effectiveness of social and environmental interventions in addition to traditional medical and surgical treatments. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The variation in hectolitre weight of wheat grain fed with or without enzyme supplementation influences nutrient digestibility and subsequently affects performance in pigs.

A 2 × 2 factorial experiment was conducted to investigate the effect of feeding a wheat-based diet of two different hectolitre weights (66 vs. 74 kg/hl), achieved through different agronomical conditions, with or without the supplementation of a ß-glucanase and ß-xylanase enzyme mix on young pigs. The parameter categories which were assessed included growth performance, coefficient of apparent total tract digestibility (CATTD), faecal consistency, faecal microbial populations and faecal volatile fatty acid (VFA) concentrations. Sixty-four pigs (11.6 kg SD 0.97) were assigned to one of four dietary treatments: (T1) low hectolitre weight wheat diet, (T2) low hectolitre weight wheat diet containing 0.1 g/kg ß-glucanase and ß-xylanase enzyme supplement, (T3) high hectolitre weight wheat diet and (T4) high hectolitre weight wheat diet containing 0.1 g/kg ß-glucanase and ß-xylanase enzyme supplement. The inclusion of wheat was 500 g/kg in the diet. The low hectolitre weight grain had a higher level of zearalenone, aflatoxin and ochratoxin contamination compared to the high hectolitre weight grain. The high hectolitre weight wheat had a higher gross energy (GE), crude protein (CP) and lysine contents compared to the low hectolitre weight wheat. Pigs offered the low hectolitre weight diet had a lower average daily gain (ADG) (p < 0.001), a lower gain to feed (G:F) ratio (p < 0.001) and a higher faecal score (more diarrhoea) (p < 0.001) compared to pigs offered the high hectolitre weight. The low hectolitre weight diet had a reduced CATTD (p < 0.05) of nitrogen (N) and gross energy (GE) compared with pigs offered the high hectolitre weight diet. In conclusion, the higher level of mycotoxins and lower content of GE, CP and lysine in the low-quality wheat reduced ADG and the CATTD of nutrients in pigs offered this diet. The inclusion of a ß-glucanase and ß-xylanase enzyme mix had no effect on growth performance or nutrient digestibility.

The effect of 25-hydroxyvitamin D3 and phytase inclusion on pig performance, bone parameters and pork quality in finisher pigs.

The objective of this study was to investigate the effects of supplementing both phytase and 25-hydroxyvitamin D3 (25-OH-D3) on pig performance, nutrient digestibility, carcass characteristics, bone parameters and pork quality in finisher pigs. The experimental design was a 2 × 2 factorial comprising of four dietary treatments. One hundred and twenty pigs (60 male, 60 female) were blocked according to live weight and sex and allocated to the following dietary treatments: low P (4.81 g/kg) diet (basal) (T1); low P diet + phytase (T2); low P diet + 25-OH-D3 (T3) and low P diet + phytase + 25-OH-D3 (T4). Pigs supplemented with phytase had a lower average daily feed intake (ADFI) (2.45 kg vs. 2.59 kg; p < 0.05) and lower feed conversion ratio (FCR) (2.74 kg/kg vs. 2.85 kg/kg; p < 0.05) compared to pigs offered the nonphytase diets. Pigs offered phytase diets had a higher (p < 0.05) coefficient of apparent total tract digestibility (CATTD) of ash, phosphorous (P) and calcium (Ca) compared with pigs offered the nonphytase supplemented diets. Pigs offered the 25-OH-D3 diets had a higher CATTD of N and ash. Pigs offered the phytase diets had increased (p < 0.05) bone DM, ash, Ca, P and density compared to the nonphytase diets. There was a significant interaction (p < 0.05) between phytase and 25-OH-D3 on cook loss. Pigs offered 25-OH-D3 had increased cook loss over the basal diet; however, there was no effect on cook loss when phytase and 25-OH-D3 were offered in combination compared to the phytase only diet. Pigs offered 25-OH-D3 exhibited higher (p < 0.05) Warner Bratzler shear force values and lower (p < 0.05) pork lightness (L*) surface colorimeter values. In conclusion, there was no benefit to offering a combination of phytase and 25-OH-D3 on pig performance, bone parameters or pork quality.

The use of synthetic and natural vitamin D sources in pig diets to improve meat quality and vitamin D content.

This study investigated the effects of synthetic and natural sources of vitamin D biofortification in pig diets on pork vitamin D activity and pork quality. One hundred and twenty pigs (60 male, 60 female) were assigned to one of four dietary treatments for a 55 d feeding period. The dietary treatments were (1)50 µg vitamin D3/kg of feed; (2)50 µg of 25-hydroxvitamin D3/kg of feed (25-OH-D3); (3)50 µg vitamin D2/kg of feed; (4)50 µg vitamin D2-enriched mushrooms/kg of feed (Mushroom D2). The pigs offered the 25-OH-D3 diet exhibited the highest (P < 0.001) serum total 25-hydroxyvitamin D concentration and subsequently exhibited the highest (P < 0.05) Longissimus thoracis (LT) total vitamin D activity. Mushroom D2 and 25-OH-D3 supplementation increased pork antioxidant status. The vitamin D2-enriched mushrooms improved (P < 0.05) pig performance, carcass weight and LT colour. In conclusion, 25-OH-D3 is the most successful source for increasing pork vitamin D activity, while Mushroom D2 may be a new avenue to improve animal performance and pork quality.

Vitamin D-biofortified beef: A comparison of cholecalciferol with synthetic versus UVB-mushroom-derived ergosterol as feed source.

This study investigates dietary fortification of heifer feeds with cholecalciferol and ergocalciferol sources and effects on beef total vitamin D activity, vitamer, respective 25-hydroxymetabolite contents, and meat quality. Thirty heifers were allocated to one of three dietary treatments [(1) basal diet + 4000 IU of vitamin D3 (Vit D3); (2) basal diet + 4000 IU of vitamin D2 (Vit D2); and (3) basal diet + 4000 IU of vitamin D2-enriched mushrooms (Mushroom D2)] for a 30 day pre-slaughter period. Supplementation of heifer diets with Vit D3 yielded higher (p < 0.001) Longissimus thoracis (LT) total vitamin D activity (by 38-56%; p < 0.05) and serum 25-OH-D concentration (by 20-36%; p < 0.05), compared to that from Vit D2 and Mushroom D2 supplemented animals. Irrespective of vitamin D source, carcass characteristics, sensory and meat quality parameter were unaffected (p > 0.05) by the dietary treatments. In conclusion, vitamin D3 biofortification of cattle diets is the most efficacious way to enhance total beef vitamin D activity.

Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science.

Over a decade ago, the Society for Prevention Research endorsed the first standards of evidence for research in preventive interventions. The growing recognition of the need to use limited resources to make sound investments in prevention led the Board of Directors to charge a new task force to set standards for research in analysis of the economic impact of preventive interventions. This article reports the findings of this group's deliberations, proposes standards for economic analyses, and identifies opportunities for future prevention science. Through examples, policymakers' need and use of economic analysis are described. Standards are proposed for framing economic analysis, estimating costs of prevention programs, estimating benefits of prevention programs, implementing summary metrics, handling uncertainty in estimates, and reporting findings. Topics for research in economic analysis are identified. The SPR Board of Directors endorses the "Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science."

Cholecalciferol supplementation of heifer diets increases beef vitamin D concentration and improves beef tenderness.

This study investigated the effects of cholecalciferol (vitamin D3) supplementation on beef vitamin D activity, beef tenderness and sensory attributes. Thirty heifers were randomly allocated to one of three finishing dietary treatments [(T1) basal diet+0IU vitamin D3; (T2) basal diet+2000IU vitamin D3; and (T3) basal diet+4000IU vitamin D3] for a 30day period pre-slaughter. Vitamin D3 supplementation linearly increased serum 25-hydroxyvitamin D3 (25-OH-D3) concentrations (R2=0.48), Longissimus thoracis (LT) total vitamin D activity (R2=0.78) as well as individually vitamin D3 (R2=0.84) and 25-OH-D3 (R2=0.75). The highest vitamin D3 inclusion diet (T3) had a 42% increase (P<0.001) in LT vitamin D activity compared to the intermediate diet (T2) and a 145% increase over the lowest level diet (T1). Vitamin D3 supplementation decreased LT shear (P<0.05) force values after 14days chilling. Sensory parameters were not affected (P>0.05). In conclusion, through short-term vitamin D3 supplementation of cattle diets, beef vitamin D activity can successfully be enhanced.

Vitamin D-enhanced eggs are protective of wintertime serum 25-hydroxyvitamin D in a randomized controlled trial of adults.

BACKGROUND: Despite numerous animal studies that have illustrated the impact of additional vitamin D in the diet of hens on the resulting egg vitamin D content, the effect of the consumption of such eggs on vitamin D status of healthy individuals has not, to our knowledge, been tested. OBJECTIVE: We performed a randomized controlled trial (RCT) to investigate the effect of the consumption of vitamin D-enhanced eggs (produced by feeding hens at the maximum concentration of vitamin D3 or serum 25-hydroxyvitamin D [25(OH)D3] lawfully allowed in feed) on winter serum 25(OH)D in healthy adults. DESIGN: We conducted an 8-wk winter RCT in adults aged 45-70 y (n = 55) who were stratified into 3 groups and were requested to consume ≤2 eggs/wk (control group, in which status was expected to decline), 7 vitamin D3-enhanced eggs/wk, or seven 25(OH)D3-enhanced eggs/wk. Serum 25(OH)D was the primary outcome. RESULTS: Although there was no significant difference (P > 0.1; ANOVA) in the mean preintervention serum 25(OH)D in the 3 groups, it was ∼7-8 nmol/L lower in the control group than in the 2 groups who consumed vitamin D-enhanced eggs. With the use of an ANCOVA, in which baseline 25(OH)D was accounted for, vitamin D3-egg and 25(OH)D3-egg groups were shown to have had significantly higher (P ≤ 0.005) postintervention serum 25(OH)D than in the control group. With the use of a within-group analysis, it was shown that, although serum 25(OH)D in the control group significantly decreased over winter (mean ± SD: -6.4 ± 6.7 nmol/L; P = 0.001), there was no change in the 2 groups who consumed vitamin D-enhanced eggs (P > 0.1 for both). CONCLUSION: Weekly consumption of 7 vitamin D-enhanced eggs has an important impact on winter vitamin D status in adults. This trial was registered at clinicaltrials.gov as NCT02678364.