Increased homozygosity due to endogamy results in fitness consequences in a human population.

Recessive alleles have been shown to directly affect both human Mendelian disease phenotypes and complex traits. Pedigree studies also suggest that consanguinity results in increased childhood mortality and adverse health phenotypes, presumably through penetrance of recessive mutations. Here, we test whether the accumulation of homozygous, recessive alleles decreases reproductive success in a human population. We address this question among the Namibian Himba, an endogamous agro-pastoralist population, who until very recently practiced natural fertility. Using a sample of 681 individuals, we show that Himba exhibit elevated levels of "inbreeding," calculated as the fraction of the genome in runs of homozygosity (FROH). Many individuals contain multiple long segments of ROH in their genomes, indicating that their parents had high kinship coefficients. However, we do not find evidence that this is explained by first-cousin consanguinity, despite a reported social preference for cross-cousin marriages. Rather, we show that elevated haplotype sharing in the Himba is due to a bottleneck, likely in the past 60 generations. We test whether increased recessive mutation load results in observed fitness consequences by assessing the effect of FROH on completed fertility in a cohort of postreproductive women (n = 69). We find that higher FROH is significantly associated with lower fertility. Our data suggest a multilocus genetic effect on fitness driven by the expression of deleterious recessive alleles, especially those in long ROH. However, these effects are not the result of consanguinity but rather elevated background identity by descent.

The effectiveness of personalised food choice advice tailored to an individual's socio-demographic, cognitive characteristics, and sensory preferences.

Personalised dietary advice has become increasingly popular, currently however most approaches are based on an individual's genetic and phenotypic profile whilst largely ignoring other determinants such as socio economic and cognitive variables. This paper provides novel insights by testing the effectiveness of personalised healthy eating advice concurrently tailored to an individual's socio-demographic group, cognitive characteristics, and sensory preferences. We first used existing data to build a synthetic dataset based on information from 3654 households (Study 1a), and then developed a cluster model to identify individuals characterised by similar socio-demographic, cognitive, and sensory aspects (Study 1b). Finally, in Study 2 we used the characteristics of 8 clusters to build 8 separate personalised food choice advice and assess their ability to motivate the increased consumption of fruit and vegetables and decreased intakes of saturated fat and sugar. We presented 218 participants with either generic UK Government "EatWell" advice, advice that was tailored to their allocated cluster (matched personalised), or advice tailored to a different cluster (unmatched personalised). Results showed that, when compared to generic advice, participants that received matched personalised advice were significantly more likely to indicate they would change their diet. Participants were similarly motivated to increase vegetable consumption and decrease saturated fat intake when they received unmatched personalised advice, potentially highlighting the power of providing alternative food choices. Overall, this study demonstrated that the power of personalizing food choice advice, based on a combination of individual characteristics, can be more effective than current approaches in motivating dietary change. Our study also emphasizes the viability of addressing population health through automatically delivered web-based personalised advice.

Do health education initiatives assist socioeconomically disadvantaged populations? A systematic review and meta-analyses.

BACKGROUND: Health education interventions are considered critical for the prevention and management of conditions of public health concern. Although the burden of these conditions is often greatest in socio-economically disadvantaged populations, the effectiveness of interventions that target these groups is unknown. We aimed to identify and synthesize evidence of the effectiveness of health-related educational interventions in adult disadvantaged populations. METHODS: We pre-registered the study on Open Science Framework https://osf.io/ek5yg/ . We searched Medline, Embase, Emcare, and the Cochrane Register from inception to 5/04/2022 to identify studies evaluating the effectiveness of health-related educational interventions delivered to adults in socio-economically disadvantaged populations. Our primary outcome was health related behaviour and our secondary outcome was a relevant biomarker. Two reviewers screened studies, extracted data and evaluated risk of bias. Our synthesis strategy involved random-effects meta-analyses and vote-counting. RESULTS: We identified 8618 unique records, 96 met our criteria for inclusion - involving more than 57,000 participants from 22 countries. All studies had high or unclear risk of bias. For our primary outcome of behaviour, meta-analyses found a standardised mean effect of education on physical activity of 0.05 (95% confidence interval (CI) = -0.09-0.19), (5 studies, n = 1330) and on cancer screening of 0.29 (95% CI = 0.05-0.52), (5 studies, n = 2388). Considerable statistical heterogeneity was present. Sixty-seven of 81 studies with behavioural outcomes had point estimates favouring the intervention (83% (95% CI = 73%-90%), p < 0.001); 21 of 28 studies with biomarker outcomes showed benefit (75% (95%CI = 56%-88%), p = 0.002). When effectiveness was determined based on conclusions in the included studies, 47% of interventions were effective on behavioural outcomes, and 27% on biomarkers. CONCLUSIONS: Evidence does not demonstrate consistent, positive impacts of educational interventions on health behaviours or biomarkers in socio-economically disadvantaged populations. Continued investment in targeted approaches, coinciding with development of greater understanding of factors determining successful implementation and evaluation, are important to reduce inequalities in health.

Back pain, mental health and substance use are associated in adolescents.

BACKGROUND: During adolescence, prevalence of pain and health risk factors such as smoking, alcohol use and poor mental health all rise sharply. The aim of this study was to describe the relationship between back pain and health risk factors in adolescents. METHODS: Cross-sectional data from the Healthy Schools Healthy Futures study, and the Australian Child Wellbeing Project was used, mean age: 14-15 years. Children were stratified according to back pain frequency. Within each strata, the proportion of children that reported drinking alcohol or smoking or that experienced feelings of anxiety or depression was reported. Test-for-trend analyses assessed whether increasing frequency of pain was associated with health risk factors. RESULTS: Data was collected from ~2500 and 3900 children. Larger proportions of children smoked or drank alcohol within each strata of increasing pain frequency. The trend with anxiety and depression was less clear, although there was a marked difference between the children that reported no pain, and pain more frequently. CONCLUSION: Two large, independent samples show adolescents that experience back pain more frequently are also more likely to smoke, drink alcohol and report feelings of anxiety and depression. Pain appears to be part of the picture of general health risk in adolescents.

Telephone-based weight loss support for patients with knee osteoarthritis: a pragmatic randomised controlled trial.

OBJECTIVE: To determine the effectiveness of telephone-based weight loss support in reducing the intensity of knee pain in patients with knee osteoarthritis, who are overweight or obese, compared to usual care. DESIGN: We conducted a parallel randomised controlled trial (RCT), embedded within a cohort multiple RCT of patients on a waiting list for outpatient orthopaedic consultation at a tertiary referral hospital in NSW, Australia. Patients with knee osteoarthritis, classified as overweight or obese [body mass index (BMI) between ≥27 kg/m2 and <40 kg/m2] were randomly allocated to receive referral to an existing non-disease specific government funded 6-month telephone-based weight management and healthy lifestyle service or usual care. The primary outcome was knee pain intensity measured using an 11-point numerical rating scale (NRS) over 6-month follow-up. A number of secondary outcomes, including self-reported weight were measured. Data analysis was by intention-to-treat according to a pre-published analysis plan. RESULTS: Between May 19 and June 30 2015, 120 patients were randomly assigned to the intervention (59 analysed, one post-randomisation exclusion) or usual care (60 analysed). We found no statistically significant between group differences in pain intensity [area under the curve (AUC), mean difference 5.4, 95%CI: -13.7 to 24.5, P = 0.58] or weight change at 6 months (self-reported; mean difference -0.4, 95%CI: -2.6 to 1.8, P = 0.74). CONCLUSIONS: Among patients with knee osteoarthritis who are overweight, telephone-based weight loss support, provided using an existing 6-month weight management and healthy lifestyle service did not reduce knee pain intensity or weight, compared with usual care. TRIAL REGISTRATION NUMBER: ACTRN12615000490572.

Factors associated with the implementation of a vegetable and fruit program in a population of Australian elementary schools.

Implementation of vegetable and fruit programs in schools is less than optimal. This study aimed to identify, using a theoretical framework, factors associated with implementation of a school vegetable and fruit program; that provides a time in class for children to consume a piece of vegetable or fruit they have brought from home. Three hundred and three randomly selected school principals across the state of New South Wales, Australia responded to a 25-min telephone survey. Principals were asked if their school had implemented a vegetable and fruit program, and which of 12 factors from Damschroder's consolidated framework for implementation research had facilitated or impeded implementation. Multiple logistic regression models examined the association between such factors and program implementation. Seventy-eight percent of schools had a vegetable and fruit program. Schools were significantly more likely to implement the program if the principal believed that: the program was effective (OR = 2.97; P < 0.02); they had sufficient resources to implement the program (OR = 4.22; P < 0.0001); the program would not be difficult to implement (OR = 10.16; P< 0.0001) and that the program was as important as other school priorities (OR = 2.45; P < 0.02). Realizing the intended benefits of vegetable and fruit programs requires widespread implementation by schools. Consideration of principal beliefs about the program effectiveness, resources, difficultly and relative importance in program implementation strategies appear key to increasing program implementation.

Identification of roles for the SNARE-associated protein, SNAP29, in mouse platelets.

Platelets are critical for maintaining vascular hemostasis, but also play a major role in the formation of occlusive cardiovascular and cerebrovascular thrombi under disease conditions. Secretion of platelet alpha and dense granules is a requirement for efficient thrombus formation. Understanding and targeting the mechanisms of secretion is important to aid the development of effective antithrombotics. SNAP29 is a tSNARE found in platelets, but whose role has not been defined. Using a platelet-specific SNAP29 knockout mouse model, we assessed the role of SNAP29 in platelet secretion and function under standardized conditions and also in in vitro and in vivo thrombosis. The data showed no major defects in SNAP29-null platelets, but revealed a minor defect in α-granule secretion and a significant increase in embolization rate of thrombi in vivo. These data suggest that SNAP29 contributes to the regulation of platelet α-granule secretion and thrombus stability, possibly partially masked by functional redundancy with other tSNAREs, such as SNAP23.

Endothelial function and insulin sensitivity during acute non-esterified fatty acid elevation: Effects of fat composition and gender.

BACKGROUND AND AIMS: We have reported that adverse effects on flow-mediated dilation of an acute elevation of non-esterified fatty acids rich in saturated fat (SFA) are reversed following addition of long-chain (LC) n-3 polyunsaturated fatty acids (PUFA), and hypothesised that these effects may be mediated through alterations in insulin signalling pathways. In a subgroup, we explored the effects of raised NEFA enriched with SFA, with or without LC n-3 PUFA, on whole body insulin sensitivity (SI) and responsiveness of the endothelium to insulin infusion. METHODS AND RESULTS: Thirty adults (mean age 27.8 y, BMI 23.2 kg/m(2)) consumed oral fat loads on separate occasions with continuous heparin infusion to elevate NEFA between 60 and 390 min. For the final 150 min, a hyperinsulinaemic-euglycaemic clamp was performed, whilst FMD and circulating markers of endothelial function were measured at baseline, pre-clamp (240 min) and post-clamp (390 min). NEFA elevation during the SFA-rich drinks was associated with impaired FMD (P = 0.027) whilst SFA + LC n-3 PUFA improved FMD at 240 min (P = 0.003). In males, insulin infusion attenuated the increase in FMD with SFA + LC n-3 PUFA (P = 0.049), with SI 10% greater with SFA + LC n-3 PUFA than SFA (P = 0.041). CONCLUSION: This study provides evidence that NEFA composition during acute elevation influences both FMD and SI, with some indication of a difference by gender. However our findings are not consistent with the hypothesis that the effects of fatty acids on endothelial function and SI operate through a common pathway. This trial was registered at clinical trials.gov as NCT01351324 on 6th May 2011.

Adoption of obesity prevention policies and practices by Australian primary schools: 2006 to 2013.

Despite significant investment in many countries, the extent of schools' adoption of obesity prevention policies and practices has not been widely reported. The aims of this article are to describe Australian schools' adoption of healthy eating and physical activity policies and practices over an 8-year period and to determine if their adoption varies according to schools' size, geographic or socio-economic location. Between 2006 and 2013, a representative randomly selected cohort of primary schools (n = 476) in New South Wales, Australia, participated in four telephone interviews. Repeated measures logistic regression analyses using a Generalised Estimating Equation (GEE) framework were undertaken to assess change over time. The prevalence of all four of the healthy eating practices and one physical activity practice significantly increased, while the prevalence of one physical activity practice significantly decreased. The adoption of practices did not differ by school characteristics. Government investment can equitably enhance school adoption of some obesity prevention policies and practices on a jurisdiction-wide basis. Additional and/or different implementation strategies may be required to facilitate greater adoption of physical activity practices. Ongoing monitoring of school adoption of school policies and practices is needed to ensure the intended benefits of government investment are achieved.

Effects of feed form and dietary coarse ground corn on broiler live performance, body weight uniformity, relative gizzard weight, excreta nitrogen, and particle size preference behaviors.

In this 14-d cage study, the effects of feed form (mash and crumble) and 6 coarse ground corn ( CC: ) inclusions [0, 10, 20, 30, 40, and 50% CC that replaced fine corn ( FC: )] on broiler live performance, BW uniformity, gizzard weight, excreta nitrogen, and particle size preference were investigated. The geometric mean diameter by mass ( DGW: ) of mash diets increased from 422 µm to 431, 471, 509, 542, and 640 µm, respectively, as the percentage of CC increased. Feed intake and BW were decreased by CC and mash at 7 d. Interactions between feed form and CC were observed for feed conversion ratio ( FCR: ) at 7 d of age (P < 0.01), and feed intake (P < 0.05), BW (P < 0.01), and gizzard weight (P < 0.01) at 14 d of age. Feed intake for all CC inclusions in crumble diets was similar and exceeded (P < 0.01) that of mash diets at 14 d. Among mash diets, the 10 and 30% CC feed intake was greater (P < 0.05) than 40 and 50% CC with 0 and 20% CC intermediate. Crumble diets produced a similar BW but greater 14-d BW than mash diets (P < 0.01). Within mash diets, 40 and 50% CC produced a smaller BW (P < 0.01). The FCR at 7 d of CC inclusions in crumble diets was improved (P < 0.01) versus the same CC in mash diets. Within mash diets, 40% CC performed poorer than 0, 10, 20, and 30% CC diets with 50% CC diet intermediate (P < 0.01). Crumble diets improved FCR at 14 d, but CC worsened FCR. Gizzard weight at 14 d was not affected by CC in crumble diets, while it increased with CC in mash diets (P < 0.01). Excreta nitrogen was increased (P < 0.01) by crumble diets. These data demonstrated that pelleting and crumbling reduced the impact of CC, produced a more consistent feed intake, and reduced selective feeding, and that CC stimulated gizzard weight in a linear manner in mash diets.

Effects of dietary coarsely ground corn and litter type on broiler live performance, litter characteristics, gastrointestinal tract development, apparent ileal digestibility of energy and nitrogen, and intestinal morphology.

The objectives of this study were to evaluate the effects of the dietary inclusion of 2 coarsely ground corn (CC) levels (0 or 50%) in diets of broilers reared on 2 litter types (new wood shavings or used litter) on live performance, litter characteristics, gastrointestinal tract (GIT) development, apparent ileal digestibility (AID) of energy and nitrogen (N), and intestinal morphology. No interaction effects between CC level and litter type were observed on live performance. No litter effect was observed on live performance. Dietary inclusion of 50% CC increased BW at 35 d (P<0.01) and improved cumulative feed conversion ratio (FCR) at 35 and 49 d of age (P<0.01). The 50% CC treatment increased absolute and relative gizzard weight (P<0.01) and decreased jejunum unit weight (g/cm) (P<0.01). The new litter treatment (litter N) increased absolute and relative proventriculus weight (P<0.05) but did not affect gizzard weight. An interaction effect between CC level and litter type was observed for litter N, where the 50% CC treatment reduced litter N regardless of litter type (P<0.01), but litter N was reduced by new litter only among birds fed 0% CC (P<0.05). The 50% CC inclusion increased litter pH (P<0.05) and improved the AID of energy and N by 6.8% (P<0.01) and 3.5% (P<0.05), respectively. The 50% CC treatment increased jejunum villi tip width (P<0.05) and villi surface area (P<0.01), and decreased the muscularis layer thickness (P<0.01), whereas new litter increased jejunum villi and ileum villi height (P<0.05), jejunum villi surface area (P<0.01), and the ratio of jejunum villi height to crypt depth (P<0.01). This study showed that birds fed pelleted and screened diets containing 50% CC exhibited improved BW, FCR, and AID of energy and N, in conjunction with altered morphology of the GIT and intestinal mucosa. Litter type affected some GIT traits and functions but did not affect live performance.

Evaluation of litter type and dietary coarse ground corn inclusion on broiler live performance, gastrointestinal tract development, and litter characteristics.

Two 49 d floor pen studies were conducted to evaluate the effects of litter type and dietary coarse ground corn (CC) inclusion on broiler live performance, gastrointestinal tract (GIT) development, and litter characteristics. Experiment 1 was a 2×2 factorial arrangement of 2 genders (male or female) and 2 CC levels (0 or 50%). From 15 to 35 d, the addition of CC decreased feed intake (P<0.01) and BW gain (P<0.05) of males but not females. The inclusion of CC decreased feed intake (P<0.01) and BW gain (P<0.01) from 0 to 49 d but improved adjusted feed conversion ratio (AdjFCR) from 35 to 49 d (P<0.05). Male broilers exhibited better live performance than females during the study as evidenced by greater feed intake (P<0.01) and BW gain (P<0.01), and improved FCR (P<0.01), but with increased mortality (P<0.05). The inclusion of CC increased relative gizzard weight (P<0.01) and decreased relative proventriculus weight (P<0.01) at 49 d. Experiment 2 was a 2×2 factorial arrangement of 2 CC levels (0 or 50%) and 2 litter types (ground old litter or new wood shavings litter). The inclusion of CC decreased feed intake throughout the experiment without affecting final BW when only males were used and improved FCR after 25 d (P<0.01). New litter improved FCR from 1 to 14 d (P<0.01). At 49 d, the birds fed the CC diet had reduced excreta nitrogen (P<0.05) and litter moisture (P<0.05). In conclusion, 50% CC inclusion initially produced negative effects on live performance that became positive as BW increased. The effects of CC became evident at an earlier age for males. New litter had only a marginal benefit on broiler live performance.

Effect of dietary coarsely ground corn on broiler live performance, gastrointestinal tract development, apparent ileal digestibility of energy and nitrogen, and digesta particle size distribution and retention time.

Dietary structural material has been reported to improve broiler live performance and gastrointestinal tract (GIT) function. In this 50 d cage study, the effects of coarsely ground corn (CC) inclusion on broiler live performance, GIT development, apparent ileal digestibility (AID) of energy and nitrogen (N), and digesta particle size distribution and retention time were investigated. This study included 3 CC inclusions (0, 25, and 50% fine corn [FC] replaced by CC), with 6 replicate cages of 10 birds per treatment. The feed conversion ratio (FCR) at 35 and 42 d was improved (P<0.01) as the dietary inclusion of CC increased without effect on feed intake. The 50% CC diet increased absolute and relative gizzard weight at 42 d of age as compared to diets with 0 and 25% CC (P<0.01). Dietary CC increased absolute proventriculus weight at 28 d of age (P<0.05). A numerically lower gizzard digesta pH (P<0.08) was observed at 28 d but not 42 d of age, and there was no difference in proventriculus, jejunum, or ileum digesta pH at 28 or 42 d of age. The 25 and 50% CC treatments increased the digesta retention time at 30 and 45 d of age (P<0.05 and P<0.01, respectively). The 25 and 50% CC treatments improved AID of energy by 7.1 and 8.2%, respectively, when compared with the 0% CC treatment, and they improved AID of N by 12.2 and 12.4%, respectively (P<0.01). The digesta particles in the jejunum exhibited a similar distribution, with a dgw (geometric mean diameter by mass) of 218, 204, and 181 µm when 0, 25, of 50% CC diets were consumed, respectively. In conclusion, birds fed pelleted and screened diets that contained 25 and 50% CC exhibited increased BW, improved FCR, and increased AID of energy and N, which was probably due to enhanced gizzard development and greater digesta retention time.

Calf birth weight, gestation length, calving ease, and neonatal calf mortality in Holstein, Jersey, and crossbred cows in a pasture system.

Holstein (HH), Jersey (JJ), and crosses of these breeds were mated to HH or JJ bulls to form purebreds, reciprocal crosses, backcrosses, and other crosses in a rotational mating system. The herd was located at the Center for Environmental Farming Systems in Goldsboro, North Carolina. Data for calf birth weight (CBW), calving ease (0 for unassisted, n=1,135, and 1 for assisted, n=96), and neonatal calf mortality (0 for alive, n=1,150, and 1 for abortions recorded after mid-gestation, stillborn, and dead within 48 h, n=81) of calves (n=1,231) were recorded over 9 calving seasons from 2003 through 2011. Gestation length (GL) was calculated as the number of days from last insemination to calving. Linear mixed models for CBW and GL included fixed effects of sex, parity (first vs. later parities), twin status, and 6 genetic groups: HH, JJ, reciprocal F(1) crosses (HJ, JH), crosses >50% Holsteins (HX) and crosses >50% Jerseys (JX), where sire breed is listed first. The CBW model also included GL as a covariate. Logistic regression for calving ease and neonatal calf mortality included fixed effects of sex, parity, and genetic group. Genetic groups were replaced by linear regression using percentage of HH genes as coefficients on the above models and included as covariates to determine various genetic effects. Year and dam were included as random effects in all models. Female calves (27.57±0.54 kg), twins (26.39±1.0 kg), and calves born to first-parity cows (27.67±0.56 kg) had lower CBW than respective male calves (29.53±0.53 kg), single births (30.71±0.19 kg), or calves born to multiparous cows (29.43±0.52 kg). Differences in genetic groups were observed for CBW and GL. Increased HH percentage in the calf increased CBW (+9.3±0.57 kg for HH vs. JJ calves), and increased HH percentage in the dams increased CBW (+1.71±0.53 kg for calves from HH dams vs. JJ dams); JH calves weighed 1.33 kg more than reciprocal HJ calves. Shorter GL was observed for twin births (272.6±1.1 d), female calves (273.9±0.6 d), and for first-parity dams (273.8±0.6 d). Direct genetic effects of HH alleles shortened GL (-3.5±0.7 d), whereas maternal HH alleles increased GL (2.7±0.6 d). Female calves had lower odds ratio (0.32, confidence interval=0.10-0.99) for neonatal calf mortality in second and later parities than did male calves. Maternal heterosis in crossbred primiparous dams was associated with reduced calf mortality.

The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review.

INTRODUCTION: Lifestyle factors are expected to contribute to the persistence and burden of low-back pain (LBP). However, there are no systematic reviews on the (cost-)effectiveness of combined lifestyle interventions for overweight or obese people with LBP. AIM: To assess whether combined lifestyle interventions are (cost-)effective for people with persistent LBP who are overweight or obese, based on a systematic review. DESIGN: Systematic review METHOD: PubMed, Cochrane, Embase, CINAHL, PsycINFO and the Wiley/Cochrane Library were searched from database inception till January 6th 2023. Two independent reviewers performed study selection, data-extraction and risk of bias scoring using the Cochrane RoB tool 2 and/or the Consensus Health Economic Criteria list. GRADE was used to assess the level of certainty of the evidence. RESULTS: In total 2510 records were screened, and 4 studies on 3 original RCTs with 216 participants were included. Low certainty evidence (1 study) showed that combined lifestyle interventions were not superior to usual care for physical functioning, pain and lifestyle outcomes. Compared to usual care, moderate certainty evidence showed that healthcare (-$292, 95%CI: 872; -33), medication (-$30, 95% CI -65; -4) and absenteeism costs (-$1000, 95%CI: 3573; -210) were lower for the combined lifestyle interventions. CONCLUSION: There is low certainty evidence from 3 studies with predominantly small sample sizes, short follow-up and low intervention adherence that combined lifestyle interventions are not superior to physical functioning, pain and lifestyle outcomes compared to usual care, but are likely to be cost-effective.

Effects of feeding strategy on milk production, reproduction, pasture utilization, and economics of autumn-calving dairy cows in eastern North Carolina.

A balance among stocking rate (SR), pasture management, and supplementary feeding is required to optimize overall farm performance and profitability in pasture-based dairying. Beginning in September 2003, a seasonal, autumn-calving, pasture-based farming system was established to address the effects of feeding strategy (FS; i.e., a unique combination of stocking and supplementation rate) on productive, reproductive, and economic performance of lactating herds over 3 yr. Eighty lactating cows (1/3 Holsteins, 1/3 Jerseys, and 1/3 crosses of those breeds) were randomly assigned to either a lesser stocking, lesser supplementation group [LSR; 2.2 cows/ha, 6.3 kg of dry matter (DM) of a corn-based concentrate consumed daily, n=40] or a greater stocking, greater supplementation group (HSR; 3.3 cows/ha, 9.2 kg of DM of a corn-based concentrate consumed daily, n=40). Pasture/forage crop rotations included annual ryegrass and sorghum-Sudan (50%), annual ryegrass and bermudagrass (20%), and a tall fescue-white clover pasture (30%). Pre- and postgrazing herbage mass values and grazing intervals (3,347±255.8 kg of DM/ha, 1,861±160.6 kg of DM/ha, 23.6±1.9 d) did not differ between FS. The nutritive value of fresh and conserved forages was similar between feeding strategies, except for acid detergent fiber in freshly grazed bermudagrass (29.6 vs. 26.3% of DM for LSR and HSR, respectively). Cows on HSR tended to spend more time on an adjacent feeding area where conserved forages were offered (85 vs. 61 d/yr) as opposed to grazing paddocks (204 vs. 228 d/yr). Lactation performance was greater for HSR; cows on HSR produced 10.8% more milk fat and 6.3% more milk protein than cows on LSR. Holstein cows produced the greatest amounts of mature-equivalent milk, but did not differ from crossbred cows in terms of energy-corrected milk, and mature-equivalent fat and protein yields. Reproductive efficiency did not differ among feeding strategy, but breed differences were observed; conception rates at first and all services, as well as pregnancy rates, were greater for Jersey and crossbred cows compared with Holsteins. The greater stocking rate required additional supplemental concentrate and time away from grazing paddocks, but reproductive efficiency was similar and overall lactation performance was greater. The greater stocking rate resulted in increased productivity and greater income over feed costs per unit of land.

"It's second best": A mixed-methods evaluation of the experiences and attitudes of people with musculoskeletal pain towards physiotherapist delivered telehealth during the COVID-19 pandemic.

BACKGROUND: Musculoskeletal physiotherapy practice rapidly adopted telehealth during the COVID-19 pandemic, providing a unique opportunity to evaluate the experiences and attitudes of people who would not usually engage with these services. METHODS: A sequential mixed-methods study recruited people with musculoskeletal pain conditions accessing Australian private practice physiotherapist services. Part 1 involved an online survey of telehealth services accessed, treatments and resources provided, self-reported global change in condition, and attitudes toward telehealth. Part 2 involved semi-structured interviews with a subset of survey participants, exploring experiences and attitudes towards telehealth. Quantitative data was reported descriptively. Qualitative data was evaluated using inductive thematic analysis. RESULTS: 172 participants responded to the survey, and 19 were interviewed. 95% accessed video-based telehealth, and 85% reported condition improvement. 84% agreed it was an efficient use of their time, 75% agreed it was financially viable, and 73% agreed their condition was accurately diagnosed. 62% percent believed telehealth should be less expensive than in-person services. Qualitative analysis revealed four themes (17 subthemes), including (i) telehealth had value, but generally perceived as inferior to in-person care; (ii) challenges related to assessment, diagnosis, 'hands on' treatment, observation, communication, and technology; (iii) advantages to access safe, expert, and convenient care; and (iv) importance of supportive technology, including video and supplementary resources. CONCLUSION: Physiotherapist telehealth services provided to people with musculoskeletal pain during the pandemic was valued. However, telehealth was generally perceived as inferior to traditional in-person care, and may be best used as part of a hybrid model of care.

Trans fatty acids and weight gain.

Increasing rates of obesity have stimulated research into possible contributing factors, including specific dietary components such as trans fatty acids (TFAs). This review considers the evidence for an association between TFA intake and weight gain. It concludes that there is limited but consistent evidence from epidemiological studies, and from a primate model, that increased TFA consumption may result in a small additional weight gain. Data from a long-term study in a primate model suggest that TFA may have a greater adipogenic effect than cis monounsaturated fatty acids; however, there are currently inadequate mechanistic data to provide a comprehensive and plausible explanation for any such metabolic differences between the types of fatty acids.

Effects of dietary fat modification on insulin sensitivity and on other risk factors of the metabolic syndrome--LIPGENE: a European randomized dietary intervention study.

BACKGROUND: Excessive energy intake and obesity lead to the metabolic syndrome (MetS). Dietary saturated fatty acids (SFAs) may be particularly detrimental on insulin sensitivity (SI) and on other components of the MetS. OBJECTIVE: This study determined the relative efficacy of reducing dietary SFA, by isoenergetic alteration of the quality and quantity of dietary fat, on risk factors associated with MetS. DESIGN: A free-living, single-blinded dietary intervention study. SUBJECTS AND METHODS: MetS subjects (n = 417) from eight European countries completed the randomized dietary intervention study with four isoenergetic diets distinct in fat quantity and quality: high-SFA; high-monounsaturated fatty acids and two low-fat, high-complex carbohydrate (LFHCC) diets, supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) (1.2 g per day) or placebo for 12 weeks. SI estimated from an intravenous glucose tolerance test (IVGTT) was the primary outcome measure. Lipid and inflammatory markers associated with MetS were also determined. RESULTS: In weight-stable subjects, reducing dietary SFA intake had no effect on SI, total and low-density lipoprotein cholesterol concentration, inflammation or blood pressure in the entire cohort. The LFHCC n-3 PUFA diet reduced plasma triacylglycerol (TAG) and non-esterified fatty acid concentrations (P < 0.01), particularly in men. CONCLUSION: There was no effect of reducing SFA on SI in weight-stable obese MetS subjects. LC n-3 PUFA supplementation, in association with a low-fat diet, improved TAG-related MetS risk profiles.

Proceedings of the Rank Forum on Vitamin D.

The Rank Forum on Vitamin D was held on 2nd and 3rd July 2009 at the University of Surrey, Guildford, UK. The workshop consisted of a series of scene-setting presentations to address the current issues and challenges concerning vitamin D and health, and included an open discussion focusing on the identification of the concentrations of serum 25-hydroxyvitamin D (25(OH)D) (a marker of vitamin D status) that may be regarded as optimal, and the implications this process may have in the setting of future dietary reference values for vitamin D in the UK. The Forum was in agreement with the fact that it is desirable for all of the population to have a serum 25(OH)D concentration above 25 nmol/l, but it discussed some uncertainty about the strength of evidence for the need to aim for substantially higher concentrations (25(OH)D concentrations>75 nmol/l). Any discussion of 'optimal' concentration of serum 25(OH)D needs to define 'optimal' with care since it is important to consider the normal distribution of requirements and the vitamin D needs for a wide range of outcomes. Current UK reference values concentrate on the requirements of particular subgroups of the population; this differs from the approaches used in other European countries where a wider range of age groups tend to be covered. With the re-emergence of rickets and the public health burden of low vitamin D status being already apparent, there is a need for urgent action from policy makers and risk managers. The Forum highlighted concerns regarding the failure of implementation of existing strategies in the UK for achieving current vitamin D recommendations.