Acute assessment of an aspalathin-enriched green rooibos (Aspalathus linearis) extract with hypoglycemic potential.

Rooibos, an endemic South African plant, known for its use as herbal tea, has potential as an antidiabetic herbal product, following recent demonstration of the glucose lowering effect of its major flavonoid, the dihydrochalcone C-glucoside aspalathin. The purpose of this study was to confirm antidiabetic activity for rooibos extract high in aspalathin content. An extract (SB1) was selected after screening for high aspalathin content and α-glucosidase inhibition activity. On-line HPLC-biochemical detection confirmed α-glucosidase inhibitory activity for aspalathin. In vitro the extract induced a dose response increase in glucose uptake (5 × 10⁻5 to 5 µg/ml) on C2C12 myotubules. Aspalathin was effective at 1, 10 and 100 µM, while rutin was effective at 100 µM. In the Chang cells only the extract was effective. In vivo the extract sustained a glucose lowering effect comparable to metformin over a 6h period after administration (25mg/kg body weight (BW)) to STZ-induced diabetic rats. In an oral glucose tolerance test the extract (30 mg/kg BW) was more effective than vildagliptin (10mg/kg BW), a dipeptidyl peptidase-4 inhibitor. An aspalathin-rutin mixture (1:1; m/m) dosed at 1.4 mg/kg BW, but not the single compounds separately, reduced blood glucose concentrations of STZ-induced diabetic rats over a 6h monitoring period. The improved hypoglycemic activity of the aspalathin-rutin mixture and the extract illustrated synergistic interactions of polyphenols in complex mixtures.

Development of multidimensional scales to measure key leaders' perceptions of community capacity and organizational capacity for teen pregnancy prevention.

This study discusses the development of scales to measure key leaders' self-reported involvement in community capacity building, perceptions of organizational capacity for teen pregnancy prevention, and the relationship between capacity and teen pregnancy rates. Data were collected from 1,516 key leaders across a rural southern state. Findings indicate that key leaders' perceptions of organizational capacity are related to their involvement in community capacity building efforts and community capacity is associated with teen pregnancy rates. This research represents progress toward measuring community and organizational capacity and may be used to inform future work focusing on developing quantitative measures of community capacity.

Production and feeding strategies for phosphorus management on dairy farms.

Long-term accumulation of soil phosphorus (P) is becoming a concern on some watersheds heavily populated with animal feeding facilities, including dairy farms. Management changes in crop production and feeding may help reduce the accumulation of excess P, but farm profitability must be maintained or improved to assure adoption of such changes. Whole-farm simulation was used to evaluate the long-term effects of changes in feeding, cropping, and other production strategies on P loading and the economics of 100-cow and 800-cow dairy farms in southeastern New York. Simulated farms maintained a long-term P balance if the following occurred: 1) animals were fed to meet recommended minimum amounts of dietary P, 2) the cropping strategy and land base supplied all of the forage needed, 3) all animals were fed a high forage diet, and 4) replacement heifers were produced on the farm to utilize more forage. The most easily implemented change was to reduce the supplemental mineral P fed to that required to meet current NRC recommended amounts, and this provided an annual increase in farm profit of about $22/cow. Intensifying the use of grassland and improving grazing practices increased profit along with a small reduction in excess P. Conversion from dairy production to heifer raising or expansion from 100 cows to a 250-cow "state-of-the-art" confinement facility (with a 70% increase in land area) were also profitable options. These options provided a long-term P balance for the farm as long as the production and use of forage was maximized and minimum dietary P amounts were those recommended by the NRC. Thus, management changes can be made to prevent the long-term accumulation of soil P on dairy farms while improving farm profitability.

High-value renewable energy from prairie grasses.

Projected economic benefits of renewable energy derived from a native prairie grass, switchgrass, include nonmarket values that can reduce net fuel costs to near zero. At a farm gate price of $44.00/dry Mg, an agricultural sector model predicts higher profits for switchgrass than conventional crops on 16.9 million hectares (ha). Benefits would include an annual increase of $6 billion in net farm returns, a $1.86 billion reduction in government subsidies, and displacement of 44-159 Tg/year (1 Tg = 1012 g) of greenhouse gas emissions. Incorporating these values into the pricing structure for switchgrass bioenergy could accelerate commercialization and provide net benefits to the U.S. economy.

Assessment of clinical partner violence screening tools.

OBJECTIVE: To compare the Women's Experience with Battering Scale (WEB) with the Index of Spouse Abuse-Physical Scale (ISA-P) as screening tools to identify intimate partner violence (IPV). METHODS: We conducted a large cross-sectional survey of women age 18 to 65 attending one of two family practice clinics from 1997 to 1998. All women completed both the WEB and the ISA-P and a telephone interview. We figured agreement estimates between the two tools, used stratified analyses to evaluate attributes of those more likely to screen as battered or physically assaulted, and compared associations between the WEB and ISA-P and a range of mental and physical health indicators known to be associated with IPV. RESULTS: 18% of 1152 eligible women surveyed had experienced IPV in a current or most recent intimate relationship with a male partner; 17% had been battered (WEB+), and 10% had been physically assaulted (ISA-P+). Had we used the ISA-P alone to assess IPV, we would have missed almost 45% of IPV. As anticipated, the ISA-P was more strongly associated with IPV-associated injuries and number of physician visits in the last year. The WEB was more strongly associated with self-perceived mental health, anxiety, depression, drug abuse, and low social support. CONCLUSION: Clinicians need validated screening tools to rapidly and reliably screen patients for IPV. Most screening tools assess physical violence and injury without considering the more chronic experience of battering and the psychological terror associated with this violence. The WEB may identify more abused women than tools measuring physical assaults.

Assessment of the accuracy of matrix representation with parsimony analysis supertree construction.

Despite the growing popularity of supertree construction for combining phylogenetic information to produce more inclusive phylogenies, large-scale performance testing of this method has not been done. Through simulation, we tested the accuracy of the most widely used supertree method, matrix representation with parsimony analysis (MRP), with respect to a (maximum parsimony) total evidence solution and a known model tree. When source trees overlap completely, MRP provided a reasonable approximation of the total evidence tree; agreement was usually > 85%. Performance improved slightly when using smaller, more numerous, or more congruent source trees, and especially when elements were weighted in proportion to the bootstrap frequencies of the nodes they represented on each source tree ("weighted MRP"). Although total evidence always estimated the model tree slightly better than nonweighted MRP methods, weighted MRP in turn usually out-performed total evidence slightly. When source studies were even moderately nonoverlapping (i.e., sharing only three-quarters of the taxa), the high proportion of missing data caused a loss in resolution that severely degraded the performance for all methods, including total evidence. In such cases, even combining more trees, which had positive effects elsewhere, did not improve accuracy. Instead, "seeding" the supertree or total evidence analyses with a single largely complete study improved performance substantially. This finding could be an important strategy for any studies that seek to combine phylogenetic information. Overall, our results suggest that MRP supertree construction provides a reasonable approximation of a total evidence solution and that weighted MRP should be used whenever possible.

Association between level of delivery hospital and neonatal outcomes among South Carolina Medicaid recipients.

OBJECTIVE: The purpose of this study was to examine relationships between level of delivery hospital and neonatal mortality rate, length of stay, and Medicaid reimbursement. STUDY DESIGN: This was a retrospective cohort study of 2560 infants with birth weights between 500 and 1499 g who were born between 1991 and 1995 to South Carolina mothers and whose care was covered by Medicaid. RESULTS: The relative risk of neonatal death for infants born in level I and II hospitals (relative risk, 1.9; 95% confidence interval, 1.6-2.2) but not level II hospitals with 24-hour neonatology coverage (relative risk, 1.2; 95% confidence interval, 0.7-1.9) was higher than that for infants born in level III hospitals. Compared with infants born in level III hospitals mean length of stay was longer and Medicaid reimbursement was similar for infants born in level I and II hospitals. Among infants born in level II hospitals with 24-hour neonatology coverage length of stay was shorter and Medicaid reimbursement was lower. CONCLUSION: Infants born in level I and II hospitals had higher neonatal mortality rates and longer stays than did infants born in level III hospitals, despite similar Medicaid reimbursement.

1988 National Maternal and Infant Health Survey: methods and response characteristics.

OBJECTIVES: The 1988 National Maternal and Infant Health Survey (NMIHS) was conducted by the National Center for Health Statistics to study factors related to poor pregnancy outcome, such as adequacy of prenatal care; inadequate and excessive weight gain during pregnancy; maternal smoking, drinking, and drug use; and pregnancy and delivery complications. METHODS: The NMIHS is a nationally representative sample of 11,000 women who had live births, 4,000 who had late fetal deaths, and 6,000 who had infant deaths in 1988. Questionnaires were mailed to mothers based on information from certificates of live birth, reports of fetal death, and certificates of infant death. Information supplied by the mother, prenatal care providers, and hospitals of delivery was linked with the vital records to expand knowledge of maternal and infant health in the United States. RESULTS: The response rates in all three components of the NMIHS differed according to the mothers' characteristics. Mothers were more likely to respond if they were 20-39 years of age, were white, were married, had fewer than four children, entered prenatal care early, had more prenatal visits, had more years of education, or resided in the Midwest Region. The percent of respondents was lower for teenage mothers, mothers of races other than white, and mothers with four or more children, little prenatal care, or fewer years of education. Mothers whose infants weighed less than 2,500 grams were less likely to respond in the live-birth and infant-death components than mothers whose infants weighed 2,500 grams or more. CONCLUSIONS: The NMIHS will provide an invaluable tool for researchers and practitioners seeking solutions to perinatal and obstetric problems.

Guidelines for assessment and treatment of sexual dysfunction.

This article presents a diagnostic and treatment planning guide that can be used when a patient complains of a sexual problem. The basic principles are summarized in the form of a grid. The axes of the grid represent "problem focus" and "influencing variables." The grid can be used to aid in diagnosis, to assess the severity of a sexual problem, to suggest a direction for treatment, and to guide referral.

Assessment of wound contamination during surgery: a preliminary report comparing vertical laminar flow and conventional theatre systems.

As part of an on-going trial comparing wound infection in "ultra-clean" air and conventional theatres, wound contamination is assessed by a simple wash-out technique. The importance of wound contamination in relation to subsequent wound infection is emphasized. The wash-out technique used is simple to perform and minimizes the risk of contamination. The preliminary results confirm that cleaner air does result in less contaminated wounds.