Perceived recollection of frequent exposure to foods in childhood is associated with adulthood liking.

Food preferences and habits learned at a young age can influence adulthood dietary patterns and weight, but the mechanism remains to be elucidated. We investigated the effect of perceived recollections of early food experiences on current liking for those foods by 670 college students. We showed that the perceived recollection of frequent consumption of foods in childhood was significantly related to current liking for the vast majority of the foods, including nutritious foods such as vegetables. Similarly, parental encouragement and modeling was positively related with current liking, even for foods that were disliked in childhood. Additionally, perceived recollections of parental restriction or forced consumption were significantly negatively related with current liking. Lastly, we demonstrated that perceived recollections by college students of childhood eating practices were in moderate agreement with those of their parents, lending credibility to the retrospective survey methodology in determining long-term effects of exposure on current food habits. These findings show that the perceived recalled frequency of consumption of foods is one determinant of the food preferences of adults, demonstrating a long-term effect of frequency of exposure, a finding consistent with experimentally controlled short-term studies. Frequent exposure to foods in childhood could be a simple and effective way for parents and caregivers to instill healthy eating habits in children.

Validity of the Australian Recommended Food Score as a diet quality index for Pre-schoolers.

BACKGROUND: Diet quality tools provide researchers with brief methods to assess the nutrient adequacy of usual dietary intake. This study describes the development and validation of a pediatric diet quality index, the Australian Recommended Food Scores for Pre-schoolers (ARFS-P), for use with children aged two to five years. METHODS: The ARFS-P was derived from a 120-item food frequency questionnaire, with eight sub-scales, and was scored from zero to 73. Linear regressions were used to estimate the relationship between diet quality score and nutrient intakes, in 142 children (mean age 4 years) in rural localities in New South Wales, Australia. RESULTS: Total ARFS-P and component scores were highly related to dietary intake of the majority of macronutrients and micronutrients including protein, ß-carotene, vitamin C, vitamin A. Total ARFS-P was also positively related to total consumption of nutrient dense foods, such as fruits and vegetables, and negatively related to total consumption of discretionary choices, such as sugar sweetened drinks and packaged snacks. CONCLUSION: ARFS-P is a valid measure that can be used to characterise nutrient intakes for children aged two to five years. Further research could assess the utility of the ARFS-P for monitoring of usual dietary intake over time or as part of clinical management.

Occupational exposures, smoking and airway inflammation in refractory asthma.

BACKGROUND: The influence of occupation and ex/passive smoking on inflammatory phenotype is not well understood. The aim of this study was to examine the relationship between occupation, past smoking and current passive smoking and airway inflammation in a population of adults with refractory asthma. METHODS: Sixty-six participants with refractory asthma were characterised. Occupational exposure to asthma causing or worsening agents were identified with an asthma-specific job exposure matrix. Exposure to passive cigarette smoke was determined by questionnaire and exhaled carbon monoxide assessment. The carbon content of macrophages was assessed in a sub-group of participants. RESULTS: Nineteen participants had smoked previously with low smoking pack years (median 1.7 years). Ex-smokers more commonly lived with a current smoker (26% vs. 9%, p = 0.11) and were more likely to allow smoking inside their home (26% vs. 4%, p = 0.02) compared to never smokers. Twenty participants had occupations with an identified exposure risk to an asthmagen; thirteen had exposures to irritants such as motor vehicle exhaust and environmental tobacco smoke. Sputum neutrophils were elevated in participants with asthma who had occupational exposures, particularly those who were diagnosed with asthma at a more than 30 years of age. CONCLUSIONS: Sputum neutrophils are elevated in refractory asthma with exposure to occupational asthmagens. In addition to older age, exposure to both environmental and occupational particulate matter may contribute to the presence of neutrophilic asthma. This may help explain asthma heterogeneity and geographical variations in airway inflammatory phenotypes in asthma.

An application of a diabetes knowledge scale for low-literate Hispanic/Latinos.

PURPOSE: The threefold purpose of this study is to assess diabetes knowledge among Hispanic/Latinos attending a culturally sensitive, empowerment-based, diabetes self-management education program; second, to examine the utility of the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) scale as an assessment tool for this population; and third, to assess the relationship between hemoglobin A1C and knowledge improvement in the intervention group. METHOD: A prospective, quasi-experimental, repeated-measure design tested pre- and post-A1C and diabetes knowledge using the SKILLD scale. The sample consisted of 71 in the intervention group and 64 controls. RESULTS: Most participants were female, marginally acculturated, and, on average, 60 years of age. Both groups were similar in baseline diabetes knowledge score (median 6 out of 10), and higher literacy was significantly related to increased baseline knowledge. The intervention group significantly improved at follow-up compared with the controls: Participants in the intervention with low baseline knowledge scores had a mean follow-up score of 5.6; those with a high baseline score had a mean score of 7.6. The intervention cohort scored significantly better in knowing why to see an eye doctor, what are normal fasting blood glucose and A1C, and understanding long-term diabetes complications. Increased knowledge of a normal fasting blood glucose level had a significant effect on follow-up A1C in the intervention group. CONCLUSION: The intervention favorably affects diabetes knowledge, and the SKILLD scale has utility with low-literate Hispanic/Latinos. The significant impact on A1C by diabetes knowledge gain shows that the empowerment-based diabetes self-management education was successful for this ethnic population.

The effect of ocular blinkers on the horses' reactions to four different visual and audible stimuli: results of a crossover trial.

OBJECTIVE: To determine the effect of ocular blinkers on driving horses' reactions to visual and audible stimuli. DESIGN: Balanced crossover trial with horses randomly assigned to either wear blinkers or not wear blinkers first or second, then subjected to repeated sequences of four distinct stimuli (chain rattle, cap gun, umbrella opening, and shaking of an aluminum can containing coins). Two weeks later, this process was repeated with the ordering of wearing blinkers reversed. ANIMAL STUDIED: Eight driving horses of various breeds. PROCEDURES: Responses were recorded quantitatively as inter-beat times (the time between each heart beat in msec) and qualitatively via video recording. Statistical analysis of the first 10 s of inter-beat times poststimulus assessed the effect of the presence of blinkers, order of blinker application and stimulus type using a linear regression model with a random effect for horse. RESULTS: Wearing blinkers is significantly associated with a decrease in the inter-beat times (increase in heart rate) when they are worn by horses experiencing an unfamiliar sound. However, wearing blinkers is significantly associated with an increase in the inter-beat times (decrease in heart rate) when worn by horses experiencing a primarily visual, familiar stimulus. CONCLUSIONS AND CLINICAL RELEVANCE: Trained driving horses, when they wear blinkers, have a decrease in inter-beat time (an increase in heart rate) when there is an unfamiliar sound. This may have relevance to horses who have limited vision caused by trauma or disease.

Outcome of minimally invasive surgical treatment of heartworm caval syndrome in dogs: 42 cases (1999-2007).

OBJECTIVE: To report the outcome of minimally invasive surgical treatment of heartworm caval syndrome in a series of dogs and to provide information on long-term survival of patients with this condition. DESIGN: Retrospective case series. ANIMALS: 42 client-owned dogs with a diagnosis of heartworm caval syndrome. PROCEDURES: Information on history, clinical, laboratory, and diagnostic imaging findings and treatment was obtained from medical records. When possible, additional follow-up information was obtained through telephone interviews with referring veterinarians and owners. RESULTS: Of the 42 dogs with caval syndrome, 21 underwent minimally invasive surgical treatment consisting of transvenous heartworm extraction. Two of the 21 dogs died during the procedure, and after surgery, 4 died. Following induction of anesthesia, heartworms migrated into the distal portion of the pulmonary artery in 1 dog; therefore, extraction was not attempted. Transvenous heartworm extraction was completed successfully in 14 dogs, and all 14 of these dogs were discharged from the hospital. Mean follow-up time in these 14 dogs was 24.4 +/- 17.7 months with a range of 2 to 56 months. At the time of final follow-up, 10 of these 14 dogs had survived at least 18 months and 7 had survived > 24 months. By the end of the study, 1 dog was lost to follow-up and 3 had been euthanatized for unrelated reasons. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the study reported here suggest that dogs with caval syndrome that undergo successful transvenous heartworm extraction and survive to discharge have a good long-term prognosis.

Day-to-Day variation of the urine protein: creatinine ratio in female dogs with stable glomerular proteinuria caused by X-linked hereditary nephropathy.

BACKGROUND: Interpretation of serial urine protein:creatinine (UPC) values is confounded by a lack of data regarding random biologic variation of UPC values in dogs with stable glomerular proteinuria. HYPOTHESIS: That there is minimal day-to-day variability in the UPC of dogs with unchanging proteinuria and the number of measurements needed to reliably estimate UPC varies with the magnitude of proteinuria. ANIMALS: Forty-eight heterozygous (carrier) female dogs with X-linked hereditary nephropathy (XLHN) causing stable proteinuria. METHODS: Urine samples were obtained daily by cystocentesis for 3 consecutive days on 183 occasions (549 samples). The UPC was measured for each sample with a single dry-film chemistry auto-analyzer. Data were analyzed retrospectively by a power of the mean model because the variance of UPC values within the 3-day evaluation periods increased as the magnitude of proteinuria increased. RESULTS: To demonstrate a significant difference (P < .05) between serial values in these proteinuric dogs, the UPC must change by at least 35% at high UPC values (near 12) and 80% at low UPC values (near 0.5). One measurement is adequate to reliably estimate the UPC when UPC <4, but 2-5 determinations are necessary at higher UPC values. CONCLUSIONS AND CLINICAL IMPORTANCE: These guidelines for interpretation of serial UPC values in female dogs with XLHN may also be helpful for interpretation of UPC values in dogs with other glomerulopathies.

Fruit and vegetable intake assessed by food frequency questionnaire and plasma carotenoids: a validation study in adults.

Dietary validation studies of self-reported fruit and vegetable intake should ideally include measurement of plasma biomarkers of intake. The aim was to conduct a validation study of self-reported fruit and vegetable intakes in adults, using the Australian Eating Survey (AES) food frequency questionnaire (FFQ), against a range of plasma carotenoids. Dietary intakes were assessed using the semi-quantitative 120 item AES FFQ. Fasting plasma carotenoids (α- and ß-carotene, lutein/zeaxanthin, lycopene and cryptoxanthin) were assessed using high performance liquid chromatography in a sample of 38 adult volunteers (66% female). Significant positive correlations were found between FFQ and plasma carotenoids for α-carotene, ß-carotene and lutein/zeaxanthin (52%, 47%, 26%, p < 0.001, 0.003, 0.041; respectively) and relationships between plasma carotenoids (except lycopene) and weight status metrics (BMI, waist circumference, fat mass) were negative and highly significant. The results of the current study demonstrate that carotenoid intakes as assessed by the AES FFQ are significantly related to plasma concentrations of α-carotene, ß-carotene and lutein/zeaxanthin, the carotenoids commonly found in fruit and vegetables. Lower levels of all plasma carotenoids, except lycopene, were found in individuals with higher BMI. We conclude that the AES can be used to measure fruit and vegetable intakes with confidence.

The comparative validity and reproducibility of a diet quality index for adults: the Australian Recommended Food Score.

Adult diet quality indices are shown to predict nutritional adequacy of dietary intake as well as all-cause morbidity and mortality. This study describes the reproducibility and validity of a food-based diet quality index, the Australian Recommended Food Score (ARFS). ARFS was developed to reflect alignment with the Australian Dietary Guidelines and is modelled on the US Recommended Food Score. Dietary intakes of 96 adult participants (31 male, 65 female) age 30 to 75 years were assessed in two rounds, five months apart. Diet was assessed using a 120-question semi-quantitative food frequency questionnaire (FFQ). The ARFS diet quality index was derived using a subset of 70 items from the full FFQ. Reproducibility of the ARFS between round one and round two was confirmed by the overall intraclass correlation coefficient of 0.87 (95% CI 0.83, 0.90), which compared favourably to that for the FFQ at 0.85 (95% CI 0.80, 0.89). ARFS was correlated with FFQ nutrient intakes, particularly fiber, vitamin A, beta-carotene and vitamin C (0.53, 95% CI 0.37-0.67), and with mineral intakes, particularly calcium, magnesium and potassium (0.32, 95% CI 0.23-0.40). ARFS is a suitable brief tool to evaluate diet quality in adults and reliably estimates a range of nutrient intakes.

Reproducibility and comparative validity of a food frequency questionnaire for Australian adults.

BACKGROUND: Food frequency questionnaires (FFQ) are used in epidemiological studies to investigate the relationship between diet and disease. There is a need for a valid and reliable adult FFQ with a contemporary food list in Australia. AIMS: To evaluate the reproducibility and comparative validity of the Australian Eating Survey (AES) FFQ in adults compared to weighed food records (WFRs). METHODS: Two rounds of AES and three-day WFRs were conducted in 97 adults (31 males, median age and BMI for males of 44.9 years, 26.2 kg/m(2), females 41.3 years, 24.0 kg/m(2). Reproducibility was assessed over six months using Wilcoxon signed-rank tests and comparative validity was assessed by intraclass correlation coefficients (ICC) estimated by fitting a mixed effects model for each nutrient to account for age, sex and BMI to allow estimation of between and within person variance. RESULTS: Reproducibility was found to be good for both WFR and FFQ since there were no significant differences between round 1 and 2 administrations. For comparative validity, FFQ ICCs were at least as large as those for WFR. The ICC of the WFR-FFQ difference for total energy intake was 0.6 (95% CI 0.43, 0.77) and the median ICC for all nutrients was 0.47, with all ICCs between 0.15 (%E from saturated fat) and 0.7 (g/day sugars). CONCLUSIONS: Compared to WFR the AES FFQ is suitable for reliably estimating the dietary intakes of Australian adults across a wide range of nutrients.

Dietary Intake Is Related to Multifactor Cardiovascular Risk Score in Obese Boys.

Cardiovascular disease (CVD) originates in childhood and early identification of risk factors provides an early intervention opportunity. The aim was to identify children at higher risk using a CVD risk score, developed from factors known to cluster in childhood. Risk was scored as very high (≥97.5th centile), high (≥95th), moderate (≥90th) or threshold (<90th) using normal pediatric reference ranges for 10 common biomedical risk factors. These were summed in a multifactor CVD risk score and applied to a sample of 285 observations from 136 overweight Australian children (41% male, aged 7-12 years). Strength of associations between CVD risk score and individual biomedical and dietary variables were assessed using univariate logistic regression. High waist circumference (Odds Ratio: 5.48 [95% CI: 2.60-11.55]), body mass index (OR: 3.22 [1.98-5.26]), serum insulin (OR: 3.37 [2.56-4.42]) and triglycerides (OR: 3.02 [2.22-4.12]) were all significantly related to CVD risk score. High intakes of total fat (OR: 4.44 [1.19-16.60]), sugar (OR: 2.82 [1.54-5.15]) and carbohydrate (OR 1.75 [1.11-2.77]) were significantly related to CVD risk score in boys only. This multifactor CVD risk score could be a useful tool for researchers to identify elevated risk in children. Further research is warranted to examine sex-specific dietary factors related to CVD risk in children.

Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?

OBJECTIVE: This study explores how better outdoor environments may produce cost benefits for assisted living providers by raising occupancy levels through increased resident satisfaction and word-of-mouth referrals. BACKGROUND: Older adults who spend even minimal time outdoors may reap substantial health benefits. However, many existing outdoor areas in assisted living facilities are reportedly underutilized, in part because of design issues. Providers may be more willing to improve outdoor areas if they produce cost benefits for provider organizations. METHODS: This study used data from a recent assisted living survey to assess the relationship between satisfaction with outdoor spaces, time spent outdoors, and resulting improvements in mood. A financial analysis was developed to estimate potential benefits from improved outdoor areas attributable to increased occupancy and decreased marketing costs associated with increased word-of-mouth referrals. RESULTS: Increasing resident satisfaction with outdoor areas (from approximately 29% to 96%) results in residents spending more time outdoors (increase of 1½ hours per week per resident) and improved psychological well-being (12% increase in feeling better). This greater overall satisfaction leads to 8% more residents willing to refer potential residents to their community. Because word-of-mouth referrals by current residents are a major factor in resident recruitment, improving outdoors areas leads to an estimated 4% increase in new residents, resulting in over $170,000 of increased revenue per year for a community of 100 residents. CONCLUSIONS: Improved outdoor space can provide substantial cost benefits for assisted living providers. Increasing resident well-being and satisfaction, and thereby generating additional word-of-mouth referrals, can result in higher occupancy levels. KEYWORDS: Outdoor environments, assisted living, cost benefits, resident satisfaction, occupancy levels, seniors, rental income, word-of-mouth referralPreferred Citation: Rodiek, S., Boggess, M. M., Lee, C., Booth, G. J., & Morris, A. (2013). Can better outdoor environments lead to cost benefits in assisted living facilities through increased word-of-mouth referrals? Health Environments Research & Design Journal 6(2), pp. 12-26.

Retrospective review of carvedilol administration in 38 dogs with preclinical chronic valvular heart disease.

OBJECTIVES: Report the effect of carvedilol administration on clinical and echocardiographic parameters and outcome in dogs with preclinical (ACVIM Stage B) chronic valvular heart disease (CVD). ANIMALS, MATERIALS AND METHODS: Retrospective case series of 38 client-owned dogs. Demographic, physical examination and diagnostic imaging findings, blood pressure (BP), administration details and outcome were obtained from medical records of dogs receiving carvedilol for preclinical CVD. When possible, additional follow-up information was obtained through telephone interviews with referring veterinarians and owners. RESULTS: Baseline data and follow-up were evaluated. Median and interquartile range (IQR) for age and weight were 8.6 (7.2-10.8) years and 8.5 (7.6-9.6)kg. 14/38 were male; 33/38 were Cavalier King Charles Spaniels; 33/38 had Stage B2 CVD. The initial dose of carvedilol was 0.31 (0.26-0.35)mg/kg PO twice daily. The carvedilol dose achieved following up titration was 1.11 (0.81-1.32)mg/kg twice daily. No adverse effects were recorded during up titration. Median survival for all dogs was 48.5 months with a 95% CI of 38.3-58.6. CONCLUSIONS: This study suggests that carvedilol at the dose reported herein is well tolerated in small breed dogs with preclinical CVD. Prospective studies to evaluate efficacy are warranted.

Effect of oral administration of pimobendan in cats with heart failure.

OBJECTIVE: To determine the effect of PO administration of pimobendan on clinical and echocardiographic variables and survival time in cats with heart failure characterized by ventricular systolic dysfunction. DESIGN: Retrospective cohort study. ANIMALS: 27 client-owned cats (16 male and 11 female) with heart failure, treated with pimobendan (mean ± SD dosage, 0.26 ± 0.08 mg/kg [0.118 ± 0.036 mg/lb], PO, q 12 h). PROCEDURES: Information on medical history, laboratory results, diagnostic imaging findings, treatments received, and survival time were obtained from medical records of cats that received pimobendan because of cardiac disease. When possible, additional follow-up information was obtained through telephone interviews with referring veterinarians and owners. RESULTS: The mean ± SD age of all 27 cats was 8.9 ± 5.2 years. All cats had received several cardiac medications. Types of heart disease represented included unclassified cardiomyopathy (CM; n = 11 [41%]), dilated CM (8 [30%]), arrhythmogenic right ventricular CM (4 [15%]), congenital heart disease (3 [11 %]), and hypertrophic CM with regional hypokinesis (1 [4%]). All cats had ventricular systolic dysfunction. One cat with systolic anterior motion of the mitral valve became severely hypotensive after initial administration of pimobendan and was excluded from the survival analysis. Median survival time was 167 days (95% confidence interval, 32 to 339 days). CONCLUSIONS AND CLINICAL RELEVANCE: Pimobendan appeared to be well tolerated in cats with heart failure characterized by ventricular systolic dysfunction of various etiologies. Cats with systolic anterior motion of the mitral valve may develop systemic hypotension when treated with pimobendan. Additional studies are needed to establish dosages for pimobendan and its effects before it can be recommended for treatment of cats with CHF.

An empowerment-based diabetes self-management education program for Hispanic/Latinos: a quasi-experimental pilot study.

PURPOSE: The purpose of this pilot study was to evaluate the effects of a culturally sensitive, empowerment-based diabetes self-management education program for Spanish-speaking Hispanic/Latinos. METHODS: A prospective quasi-experimental repeated measures design tested the effectiveness of the ¡Si, Yo Puedo Controlar Mi Diabetes! diabetes self-management education program. In sum, 144 persons residing in 2 Texas counties at the Texas-Mexico border (Starr and Hidalgo) served as participants. Two groups were formed, an intervention and a control (wait list). Clinical (A1C), cognitive, attitudinal, behavioral, and cultural assessments were collected at baseline and 3 months. RESULTS: Demographic characteristics for the intervention and control groups were similar. Both groups were predominately female, low income, older than 40 years, and minimally acculturated. Baseline and posttest findings showed that the intervention group had a significant reduction in A1C values; median difference was 0.3 (n = 45), especially for those with higher baseline values. Participants in the intervention group also improved in their self-efficacy and self-care scores. CONCLUSIONS: Findings from the study suggest that additional dissemination of a diabetes self-management education program for Spanish-speaking Hispanic/Latinos is warranted to improve clinical outcomes and associated diabetes self-efficacy and self-care behaviors.

Peripheral neuropathy in military aircraft maintenance workers in Australia.

OBJECTIVE: This study aimed to examine possible persisting peripheral neuropathy in a group who undertook fuel tank repairs on F-111 aircraft, relative to two contemporaneous comparison groups. METHODS: Vibration perception threshold (VPT) was tested using biothesiometry in 614 exposed personnel, compared with two unexposed groups (513 technical trades and 403 nontrades). Regression modeling was used to examine associations, adjusting for possible confounders. RESULTS: We observed that 26% of participants had chronic persistent increased VPT in the great toe. In contrast, statistically significant higher VPT of the great toe was observed in the comparison groups; however, the effect was small, about 1/4 the magnitude of diabetes. Age, height, and diabetes were all significant and strong predictors in most models. CONCLUSION: This study highlights chronic persisting peripheral neuropathy in a population of aircraft maintainers.