The effect of medical nutrition therapy on changes in dietary knowledge and DASH diet adherence in older adults with cardiovascular disease.

OBJECTIVE: To examine the effect of MNT on dietary knowledge of older adults at baseline, 6 months and 12 months and to assess the effect of dietary knowledge on change in DASH diet adherence from baseline to 12 months. DESIGN: Data for the analysis come from a controlled, randomized prospective design conducted from 2003-2005 with the outcome measures taken pre-, mid-, and post-intervention. SETTING: Data were collected from participants in their homes in an urban community in North Carolina. PARTICIPANTS: Participants (N=147) were adults aged 60+ with a diagnosis of hypertension and/or hyperlipidemia. INTERVENTION: Intervention recipients received three sessions of MNT throughout the 1 year study period. The control group received nutrition information at enrollment. MEASUREMENTS: Participants completed a dietary knowledge questionnaire and a 24 dietary recall at baseline, 6 months, and 12 months. Instrumental variables models with participant fixed effects were used to determine the impact of MNT on dietary knowledge and dietary knowledge on DASH diet adherence. RESULTS: Among those who received MNT, dietary knowledge increased from baseline to twelve months (p<.01). Changes in dietary knowledge were not associated with changes in DASH adherence from baseline to 12 months (p=0.44). CONCLUSIONS: The MNT administered was effective at improving dietary knowledge, but not at improving DASH adherence. Three MNT sessions may be insufficient to change behavior. Integrating behavioral change theory and cultural sensitivity to MNT may improve diet adherence among diverse older adults.

Frequent transmission of immunodeficiency viruses among bobcats and pumas.

With the exception of human immunodeficiency virus (HIV), which emerged in humans after cross-species transmissions of simian immunodeficiency viruses from nonhuman primates, immunodeficiency viruses of the family Lentiviridae represent species-specific viruses that rarely cross species barriers to infect new hosts. Among the Felidae, numerous immunodeficiency-like lentiviruses have been documented, but only a few cross-species transmissions have been recorded, and these have not been perpetuated in the recipient species. Lentivirus seroprevalence was determined for 79 bobcats (Lynx rufus) and 31 pumas (Puma concolor) from well-defined populations in Southern California. Partial genomic sequences were subsequently obtained from 18 and 12 seropositive bobcats and pumas, respectively. Genotypes were analyzed for phylogenic relatedness and genotypic composition among the study set and archived feline lentivirus sequences. This investigation of feline immunodeficiency virus infection in bobcats and pumas of Southern California provides evidence that cross-species infection has occurred frequently among these animals. The data suggest that transmission has occurred in multiple locations and are most consistent with the spread of the virus from bobcats to pumas. Although the ultimate causes remain unknown, these transmission events may occur as a result of puma predation on bobcats, a situation similar to that which fostered transmission of HIV to humans, and likely represent the emergence of a lentivirus with relaxed barriers to cross-species transmission. This unusual observation provides a valuable opportunity to evaluate the ecological, behavioral, and molecular conditions that favor repeated transmissions and persistence of lentivirus between species.