Prevalence and predictors of parental concern for children's weight from 2002 to 2012.

OBJECTIVES: Public health initiatives to increase parental awareness about children's obesity have become more prominent in the past decade. These initiatives may contribute to increased concern in parents for their children's weight, even if their children are at a healthy weight. The aim of the present study was to document trends in parental (N = 365; 67.9% female) concern for their children's weight from 2002 to 2012 using surveys on health and eating behaviors. STUDY DESIGN: Participants (N = 365) were parents who completed surveys in 2002 and were followed up in 2012 as part of a longitudinal epidemiological study of eating attitudes and behavior. METHODS: McNemar's test and logistic regression models estimated changes in and predictors of parental concern. RESULTS: In 2002, 36.5% of participants indicated concern for their children's weight, which rose to 54.4% in 2012. Parents of overweight children were more likely to report concern than parents of average-weight children at baseline and 10-year follow-up. However, concern increased significantly even among parents of average-weight children, rising from 28.7% to 41.6% (McNemar's test statistic: 8.20, P = .002). Secondary analyses revealed that parents' baseline drive for thinness predicted increased likelihood of concern in these parents (odds ratio: 1.10, P = .04). CONCLUSION: Findings support the need for future research to examine consequences of societal messages about pediatric obesity.

Treatment of aplastic anaemia with lower-dose anti-thymocyte globulin produces similar response rates and survival as per standard dose anti-thymocyte globulin schedules.

BACKGROUND: Aplastic anaemia (AA) is a rare acquired bone marrow failure syndrome resulting from the immune-mediated destruction of haemopoietic stem cells. For adults in whom first-line haemopoietic progenitor cell transplantation is not feasible, combination anti-thymocyte globulin (ATGAM) plus cyclosporine A is standard therapy; however, there are minimal data available regarding the optimal ATGAM dosage in terms of efficacy and survival. AIMS: Our institutions have historically used different dosing protocols of ATGAM in the treatment of AA. We aimed to review the outcome of AA patients treated with these protocols and compare them to the published literature. METHODS: We conducted a retrospective study of 31 adults who received first-line ATGAM for AA and compared response rates and survival between cohorts who received standard (40 mg/kg/day D1-4) versus lower-dose (15 mg/kg/day D1-5) ATGAM schedules. RESULTS: There were similar rates of response (64 vs 71%, P = 1.0), relapse (33 vs 33%, P = 1.0), transformation (14 vs 24%, P = 0.66) or infection (43 vs 47%, P = 1.0), respectively, between standard and lower-dose cohorts. At a median follow up of 24 months, there was no statistical difference between standard and lower-dose cohorts in either event-free (42.2 vs 64.7%, P = 0.91) or overall survival (73.1 vs 88.2%, P = 0.75). CONCLUSION: Our experience suggests that lower-dose ATGAM at 15 mg/kg/day D1-5 as treatment of AA produces similar responses and outcomes as per standard-dose ATGAM schedules. Prospective trials comparing ATGAM dose schedules in AA are warranted.

A multicentre retrospective comparison of central nervous system prophylaxis strategies among patients with high-risk diffuse large B-cell lymphoma.

BACKGROUND: Central nervous system (CNS) relapse in diffuse large B-cell lymphoma (DLBCL) is a devastating complication; the optimal prophylactic strategy remains unclear. METHODS: We performed a multicentre, retrospective analysis of patients with DLBCL with high risk for CNS relapse as defined by two or more of: multiple extranodal sites, elevated serum LDH and B symptoms or involvement of specific high-risk anatomical sites. We compared three different strategies of CNS-directed therapy: intrathecal (IT) methotrexate (MTX) with (R)-CHOP 'group 1'; R-CHOP with IT MTX and two cycles of high-dose intravenous (IV) MTX 'group 2'; dose-intensive systemic antimetabolite-containing chemotherapy (Hyper-CVAD or CODOXM/IVAC) with IT/IV MTX 'group 3'. RESULTS: Overall, 217 patients were identified (49, 125 and 43 in groups 1-3, respectively). With median follow-up of 3.4 (range 0.2-18.6) years, 23 CNS relapses occurred (12, 10 and 1 in groups 1-3 respectively). The 3-year actuarial rates (95% CI) of CNS relapse were 18.4% (9.5-33.1%), 6.9% (3.5-13.4%) and 2.3% (0.4-15.4%) in groups 1-3, respectively (P=0.009). CONCLUSIONS: The addition of high-dose IV MTX and/or cytarabine was associated with lower incidence of CNS relapse compared with IT chemotherapy alone. However, these data are limited by their retrospective nature and warrant confirmation in prospective randomised studies.

Sleep disruption in tetraplegia: a randomised, double-blind, placebo-controlled crossover trial of 3 mg melatonin.

STUDY DESIGN: Randomised, double-blind, placebo-controlled crossover trial of melatonin supplementation to people with complete tetraplegia. OBJECTIVES: To investigate the effect that 3 mg melatonin supplementation has on objective and subjective sleep, quality of life and mood of people living with complete tetraplegia. SETTING: Austin Hospital Sleep Laboratory and participants' homes, Melbourne, Victoria, Australia. METHODS: Two week run-in followed by 3 week nightly administration of 3 mg melatonin or placebo, 2-week washout and further 3 week administration of the opposite treatment. Four testing sessions were conducted; the last nights of the run-in, treatment and washout periods. Testing sessions involved recording full polysomnography, completing a questionnaire battery and collecting urine and blood samples. The questionnaires assessed mood, sleep symptoms and health-related quality of life, and the urine and plasma samples assayed 6-sulphatoxymelatonin (aMT6s) and melatonin levels, respectively. A sleep diary was completed throughout the study. RESULTS: Eight participants (mean (s.d.): age 49.5 years (16), postinjury 16.9 years (7.1)) were recruited in which seven concluded the protocol. Endogenous-circulating melatonin was significantly higher (P < or = 0.01) following melatonin (urine: 152.94 µg h(-1) (74.51), plasma: 43,554.57 pM (33,527.11)) than placebo (urine: 0.86 µg h(-1) (0.40), plasma: 152.06 pM (190.55)). Subjective sleep improved significantly following melatonin specifically for duration of sleep per night and psychological wellbeing. Objective sleep showed a significant increase in light sleep with melatonin, with all other sleep parameters being unchanged. CONCLUSION: These results suggest that increasing melatonin in people with complete tetraplegia is beneficial, especially for subjective sleep. Investigation of the pharmacokinetics of melatonin metabolism in this population is warranted. SPONSORSHIP: This project is proudly supported by the Transport Accident Commission.

Perceived barriers and enablers to physical activity participation in people with Alopecia Areata: a constructivist grounded theory study.

BACKGROUND: Alopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions. METHODS: The study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved. RESULTS: The constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance. CONCLUSION: The findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model.

Endocrine and ingestive behavioral responses to fluid deprivation in sheep chronically exposed to ethanol.

Endocrine responses to fluid deprivation/restoration and preference for ethanol solution vs. water were assessed in sheep maintained for 5 months on a 10% ethanol solution as their sole source of fluid. Blood pressure, body weight, plasma composition and hormone levels of the alcohol maintained sheep were all within a normal range, except for high plasma concentrations of ANG II and ALDO. During fluid deprivation, AVP concentration increased and fluid-deprived sheep displayed a natriuresis and then a rehydration anti-natriuresis. Sheep did not drink the 10% ethanol solution avidly upon fluid restoration, preferring to drink steadily over the following 24 h; there was an associated increase in blood alcohol concentration (BAC). PRC, ANG II and ALDO all increased throughout the fluid restoration period, whereas plasma AVP and ANP gradually fell. In a separate experiment when water was also supplied to the sheep, they preferred water to 10% ethanol; however, alcohol intake was not eliminated. Overall, this degree of chronic consumption of 10% ethanol solution did not appear to adversely affect physiological mechanisms concerned with body fluid homeostasis after fluid deprivation conditions.

The relationship between physical activity levels and symptoms of depression, anxiety and stress in individuals with alopecia Areata.

BACKGROUND: Alopecia Areata (AA) is an autoimmune condition that is characterised by non-scarring hair loss. Its aesthetic repercussions can lead to profound changes in psychological well-being. Although physical activity (PA) has been associated with better mental health outcomes in diverse populations, the association in individuals with AA has not been established. The aim of this study was to examine the associations between PA and mental health outcomes in individuals with AA to inform intervention strategies for this specific population. METHODS: A cross-sectional study was conducted among individuals who were diagnosed with AA. A total of 83 respondents aged (40.95 ± 13.24 years) completed a self-report questionnaire consisting of International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Depression and Anxiety Stress Scale (DASS-21). Three-way contingency Chi-square analyses were used to determine the associations between PA, mental health outcomes and participants with hair loss of more than 50% on the scalp. RESULTS: 81.9% of the participants did not meet PA guidelines. Participants with hair loss of more than 50% on the scalp, and who did not meet PA guidelines, were significantly more likely to experience symptoms of severe depression (p = .003), moderate anxiety (p = .04) and mild stress (p = .003) than those who met guidelines CONCLUSION: Findings suggest that increased PA participation in AA individuals with severe hair loss is associated with improved mental health status. Intervention efforts for this specific population should consider barriers and enablers to PA participation as they face challenges that differ from the general population.

Combination antithymocyte globulin and soluble TNFalpha inhibitor (etanercept) +/- mycophenolate mofetil for treatment of steroid refractory acute graft-versus-host disease.

Antitumor necrosis factor-alpha antibodies are increasingly being used for the treatment of steroid-refractory acute graft-versus-host disease (GVHD) complicating allogeneic stem cell transplantation. We retrospectively reviewed the outcomes of 16 patients with refractory acute predominantly visceral GVHD treated with combination antithymocyte globulin (ATG), tacrolimus and etanercept +/- mycophenolate mofetil (MMF) at our institution. Overall response rate (CR+PR) was 81%, with median survival post commencing salvage immunosuppression 224 days (range 20-1216 days). In total, eight patients (50%) died, including from progressive GVHD in two cases (13%), infection in five (31%) and relapse of underlying malignancy in one (6%). In comparison to our previous experience of ATG+tacrolimus as treatment for refractory visceral GVHD, both response rate and overall survival were improved with addition of etanercept, with no apparent increase in infectious complications. As such, use of etanercept in combination with ATG +/- MMF for treatment of steroid refractory acute GVHD appears to be associated with high response rates, significant survival and no unexpected toxicity. Further study of this immunosuppression combination in a larger cohort of patients in this setting is indicated.

An examination of the association between eating problems, negative mood, weight and sleeping quality in young women and men.

The aim of this study was to determine if low mood influenced the association between eating problem symptoms and self report sleeping quality in a large group of young women and men. A group of 381 female and male undergraduate students completed a set of self-report inventories in order to test a model developed for this study observing the association between eating problems, low mood, restricted dieting, weight and self-reported sleeping quality using a path analysis model. The model that best fit the data indicated that eating problem symptoms were associated with low mood and low mood was related to sleeping quality. There was also a direct association between eating problems and sleeping quality but this was reduced by the presence of low mood in the equation. There were no other direct relationships with sleeping quality but there was an association between low mood and low weight. There were also differences reported between men and women on sleeping quality suggesting that women in this sample reported more sleeping difficulties than men. In all this research demonstrates with a large non-clinical sample the links between eating problems, mood and sleeping difficulties.

Daily restricted feeding effects on the circadian activity rhythms of the stripe-faced dunnart, Sminthopsis macroura.

The effect of daily restricted feeding (RF) on the circadian wheel-running activity rhythms of the stripe-faced dunnart (Sminthopsis macroura) was examined. Dunnarts were presented with a 2-h meal in the middle of the light period of a 14:10 light:dark (LD) cycle and during constant dim light (LL). No meal-anticipatory activity (AA) was observed in any of the dunnarts during the experiment. This contrasts with previous work where AA has been reported in dunnarts subjected to RF. In LL, RF acted as a weak zeitgeber for the circadian activity rhythms of the dunnart. Evidence supporting this observation was the fact that 4/8 dunnarts' activity rhythms were entrained by RF, 2 showed relative coordination, and 1 exhibited bouncing phenomenon. In other species of marsupials and in rats, it has been proposed that RF entrains a food-entrainable pacemaker, which, in turn, entrains, via coupling, the suprachiasmatic-based, light-entrainable pacemaker. The findings of the present study differ from those reported previously in that no observable AA was entrained but the light-entrainable pacemaker was entrained by RF. In the dunnart, it remains to be determined whether RF directly entrains the light-entrainable pacemaker or whether RF entrains a food-entrainable pacemaker and in turn, via coupling, the light-entrainable pacemaker.

Impact of stem cell donation modality on normal donor quality of life: a prospective randomized study.

As part of a previously reported trial comparing granulocyte-colony stimulating factor (G-CSF) stimulated bone marrow and peripheral blood stem cells (PBSCs) in allogeneic stem cell transplantation, we included a questionnaire to compare donor morbidity and long-term complications between the two donation procedures. Bone marrow donation was associated with significantly more donors experiencing localized pain at the donation site compared to PBSC collection. However, this was not associated with any increased delay in returning to normal activity. Although a minority of bone marrow donors suffered chronic pain at the donation site, no serious long-term side effects relating to G-CSF stimulated stem cell donation were identified.

Circadian wheel running activity rhythms in two strains of domestic rabbit.

Results from experiments on two strains of domestic rabbit show that despite their hopping gait, circadian locomotor rhythms can be successfully measured using running wheels specially designed for large laboratory mammals. Three female rabbits of an English outbred strain were monitored in a 13:11 light:dark (LD) cycle and in constant light (LL), while 12 Dutch-Himalayan rabbits were monitored in a 14:10 LD cycle and constant dark (DD). Much stronger rhythms were observed in the latter strain, which under LD conditions showed individuals with patterns that varied from nocturnal (n = 5), diurnal (n = 4), crepuscular (n = 1), and predominantly arrhythmic (n = 2). In DD, 10 rabbits showed strong free-running rhythms, five with tau (tau) less than 24 h and five longer. The predominantly arrhythmic activity pattern in the remaining two made estimation of tau difficult. Differences in circadian patterns both under LD and DD were unrelated to sex. Results show that locomotor rhythms of the rabbit can be measured using the running wheel, the traditional apparatus of chronobiology. However, the experiments suggest also that the large-bodied breed of rabbits that tend towards obesity, such as the English outbred strain, are relatively inactive and that smaller, more active breeds such as the Dutch-Himalayan may be more suitable for studying circadian rhythmicity if the running wheel is employed.

Phase-response curve to 1-hour light pulses for the marsupial, Dasyuroides byrnei.

Most Australian marsupials are nocturnal and consequently it might be expected that the circadian system of this group may be similar to the circadian system of nocturnal rodents. Ten male kowaris (Dasyuroides byrnei) were allowed to free-run in constant darkness and were subsequently administered 1-hour light pulses (1000 lux) at known circadian times in their cycles at intervals of greater than 2 weeks. Changes in the phase of the kowari's circadian rhythm of wheel-running were measured when their rhythms reached a new steady-state after each light pulse and these data were used to construct a phase-response curve to light for the species. The kowari PRC exhibited essentially the same characteristics as those reported for the nocturnal rodents and the marsupial species Sminthopsis macroura. It appears that the kowari entrains its circadian rhythms to light/dark cycles via the discrete phase shifting mechanism as described in nocturnal rodents.

The hispid cotton rat (Sigmodon hispidus) as an experimental host for the bovine liver fluke (Fasciola hepatica).

The results of a study testing the susceptibility of the hispid cotton rat, Sigmodon hispidus, to infection with Fasciola hepatica are described. Ten cotton rats were placed into one of four test groups, one uninfected control or three animals each receiving two, five, or 10 F. hepatica metacercariae. Three of nine (33%) became infected, and two of these animals carried the infection to patency. At necropsy one animal had two mature F. hepatica within the common bile duct, and the other harbored a single fluke. Gross and microscopic changes, primarily of the liver, associated with infection are described, as are fecal egg counts throughout the duration of infection.

Deoxynivalenol-contaminated wheat in swine diets.

Two studies were conducted using Fusarium graminearum-infected (scabby) wheat containing 6.8 ppm deoxynivalenol (DON), commonly called vomitoxin, substituted for normal wheat in starter pig diets to give varying levels of DON. After 3 wk on experimental treatments, one-half of the pigs in trial one were sacrificed to evaluate the effects of DON on heart, kidney, spleen and liver. Analyses for DON residues in these tissues were also performed. The remaining 16 pigs were placed on a conventional diet for 4 wk to evaluate effects of DON on subsequent animal performance. A different sample of scabby wheat containing 4.9 ppm of DON was substituted for sorghum grain in growing-finishing pig diets to give varying concentrations of DON. At the end of the 42-d feeding period, eight pigs were slaughtered to evaluate the effects of DON on selected tissues. Results of the three trials suggest that feed intake was reduced when DON concentrations in the swine diets neared or exceeded 1 ppm. No apparent signs of disease, including vomiting, were observed in experimental animals. Histological evaluation revealed no significant lesions or abnormalities related to DON ingestion in tissues examined. Traces of DON (8 to 28 ppb, wet weight) were found in kidney, liver, spleen and heart of starter pigs consuming the diets containing DON up to time of slaughter. No DON was found in tissues of growing-finishing pigs that were withdrawn from feed about 12 h before slaughter.

Reducing particle size of corn in lactation diets from 1,200 to 400 micrometers improves sow and litter performance.

One hundred primiparous sows were used to determine the effects of particle size of corn in lactation diets on sow and litter performance. The sows were fed a corn-soybean meal-based diet with the corn ground to 1,200, 900, 600, or 400 microns. Particle size of corn had no influence on sow BW or backfat loss (P > .30), subsequent weaning-to-estrus interval (P > .40), or percentage of sows returning to estrus (P > .09). However, ADFI was increased (linear effect, P < .04) as particle size was reduced from 1,200 to 400 microns. Pig survivability was not affected (P > .30) but litter BW gain was increased by 11% when sows were fed diets with 400 vs 1,200 microns corn (linear effect, P < .05). Apparent digestibilities of DM, N, and GE were increased by 5, 7, and 7%, respectively, as particle size was reduced from 1,200 to 400 microns (linear effects, P < .001). Intake of DE was increased 14% (13.7 to 15.6 Mcal/d) as corn particle size was reduced from 1,200 to 400 microns. Intakes of digestible DM and N also were increased (11 and 14%, respectively), whereas fecal excretions of DM and N were decreased by 21 and 31%, respectively (linear effects, P < .001). Reducing particle size increased severity of ulceration and keratinization (nonzero correlations of P < .04 and P < .004, respectively) in the esophageal region of the stomach, although the changes were not associated with reduced sow performance.(ABSTRACT TRUNCATED AT 250 WORDS)