Effects of whole-grain rye porridge with added inulin and wheat gluten on appetite, gut fermentation and postprandial glucose metabolism: a randomised, cross-over, breakfast study.

Whole-grain rye foods reduce appetite, insulin and sometimes glucose responses. Increased gut fermentation and plant protein may mediate the effect. The aims of the present study were to investigate whether the appetite-suppressing effects of whole-grain rye porridge could be enhanced by replacing part of the rye with fermented dietary fibre and plant protein, and to explore the role of gut fermentation on appetite and metabolic responses over 8 h. We conducted a randomised, cross-over study using two rye porridges (40 and 55 g), three 40-g rye porridges with addition of inulin:gluten (9:3; 6:6; 3:9 g) and a refined wheat bread control (55 g), served as part of complete breakfasts. A standardised lunch and an ad libitum dinner were served 4 and 8 h later, respectively. Appetite, breath hydrogen and methane, glucose, insulin and glucagon-like peptide-1 (GLP-1) responses were measured over 8 h. Twenty-one healthy men and women, aged 23-60 years, with BMI of 21-33 kg/m2 participated in this study. Before lunch, the 55-g rye porridges lowered hunger by 20 % and desire to eat by 22 % and increased fullness by 29 % compared with wheat bread (P<0·05). Breath hydrogen increased proportionally to dietary fibre content (P<0·05). Plasma glucose after lunch was 6 % lower after the 55-g rye porridges compared with wheat bread (P<0·05) and correlated to breath hydrogen (P<0·001). No differences were observed in ad libitum food intake, insulin or GLP-1. We conclude that no further increase in satiety was observed when replacing part of the rye with inulin and gluten compared with plain rye porridges.

Measurement of covalent bond formation in light-curing hydrogels predicts physical stability under flow.

Photocrosslinking hydrogels are promising for tissue engineering and regenerative medicine, but challenges in reaction monitoring often leave their optimization subject to trial and error. The stability of crosslinked gels under fluid flow, as in the case of a microfluidic device, is particularly challenging to predict, both because of obstacles inherent to solid-state macromolecular analysis that prevent accurate chemical monitoring, and because stability is dependent on size of the patterned features. To solve both problems, we obtained 1H NMR spectra of cured hydrogels which were enzymatically degraded. This allowed us to take advantage of the high-resolution that solution NMR provides. This unique approach enabled the measurement of degree of crosslinking (DoC) and prediction of material stability under physiological fluid flow. We showed that NMR spectra of enzyme-digested gels successfully reported on DoC as a function of light exposure and wavelength within two classes of photocrosslinkable hydrogels: methacryloyl-modified gelatin and a composite of thiol-modified gelatin and norbornene-terminated polyethylene glycol. This approach revealed that a threshold DoC was required for patterned features in each material to become stable, and that smaller features required a higher DoC for stability. Finally, we demonstrated that DoC was predictive of the stability of architecturally complex features when photopatterning, underscoring the value of monitoring DoC when using light-reactive gels. We anticipate that the ability to quantify chemical crosslinks will accelerate the design of advanced hydrogel materials for structurally demanding applications such as photopatterning and bioprinting.

An experimental study on the effectiveness of a mutual support group for family caregivers of a relative with dementia in mainland China.

When caring for an older relative with dementia, family members experience considerable distress and burden. Literature reviews show that supportive group interventions for these caregivers have significant positive effects on improving their distress and quality of life, but not consistent and conclusive. Limited research is found in Asian populations. This study tested the effectiveness of a 12-session bi-weekly mutual support group program for Chinese family caregivers of a relative with dementia in Hong Kong, when compared with standard family support service. An experimental study with pre- and post-test, parallel groups design was conducted. A randomized sample of 78 family caregivers, 39 in each of the experimental and control groups, from one regional dementia care center participated in the study. A protocol was specifically designed by an advanced practice nurse to guide the mutual support group process and the facilitator and peer leader training, based on evidence from the literature on family support group intervention in Western countries. The results of ANOVA tests indicated that the mutual support group participants had significantly greater improvements in distress levels and quality of life than the control group. There were only mild changes in the demands for mental health services in both groups at post-test. These findings support the effectiveness of mutual support groups to offer psychosocial support to Chinese family caregivers in dementia care beyond routine community mental health care.

Randomized controlled trial of a dementia care programme for families of home-resided older people with dementia.

AIM: This paper reports a study to examine the effectiveness of a 6-month dementia care programme for Chinese families living with and caring for a relative with dementia, compared with routine family support services in Hong Kong. BACKGROUND: Recognizing the adverse psychosocial health effects inherent in dementia care, different psychosocial interventions provided preliminary evidence of their effectiveness in improving family members' knowledge and skills in caregiving and delaying dementia sufferers' illness deterioration and institutionalization. Little is known about the effects of such interventions for family caregivers' psychosocial health conditions, particularly in non-Western populations. METHODS: A randomized controlled trial was conducted with 92 Chinese families of a relative with dementia in two dementia care centres in Hong Kong. They were randomly selected from a dementia client list and then randomly assigned to receive either the dementia family care programme (n=46), or routine care only (n=46). Clients' symptoms and institutionalization, and caregivers' quality of life, burden and social support at recruitment, 1 week, and 12 and 18 months following intervention were measured and compared between the study groups using repeated measures MANOVAS followed by Helmert's contrast tests. Data was collected over a period of 24 months, between September 2007 and August 2009. RESULTS: Results of the MANOVAS and contrast tests indicated that at 18-month follow-up, participants in the family programme reported significantly greater improvements in clients' symptoms and institutionalization rates, and caregivers' quality of life and burden, when compared with their counterparts in the routine care group. CONCLUSION: These findings provide evidence that the dementia care family programme can improve the psychosocial functioning of both clients with dementia and their family caregivers in a Chinese population. Further research is recommended to investigate whether this intervention can also apply to families with different socio-economic backgrounds and across cultures.

A Chinese version of the Psychotic Symptom Rating Scales: psychometric properties in recent-onset and chronic psychosis.

The purpose of this study was to test the reliability, validity, and factor structure of a Chinese version of the Psychotic Symptom Rating Scale (PSYRATS) in 198 and 202 adult patients with recent-onset and chronic psychosis, respectively. The PSYRATS has been translated into different language versions and has been validated for clinical and research use mainly in chronic psychotic patients but not in recent-onset psychosis patients or in Chinese populations. The psychometric analysis of the translated Chinese version included assessment of its content validity, semantic equivalence, interrater and test-retest reliability, reproducibility, sensitivity to changes in psychotic symptoms, internal consistency, concurrent validity (compared to a valid psychotic symptom scale), and factor structure. The Chinese version demonstrated very satisfactory content validity as rated by an expert panel, good semantic equivalence with the original version, and high interrater and test-retest (at 2-week interval) reliability. It also indicated very good reproducibility of and sensitivity to changes in psychotic symptoms in line with the symptom severity measured with the Positive and Negative Syndrome Scale (PANSS). The scale consisted of four factors for the hallucination subscale and two factors for the delusion subscale, explaining about 80% of the total variance of the construct, indicating satisfactory correlations between the hallucination and delusion factors themselves, between items, factors, subscales, and overall scale, and between factors and relevant item and subscale scores of the PANSS. The Chinese version of the PSYRATS is a reliable and valid instrument to measure symptom severity in Chinese psychotic patients complementary to other existing measures mainly in English language.

Targeted metabolomics reveals differences in the extended postprandial plasma metabolome of healthy subjects after intake of whole-grain rye porridges versus refined wheat bread.

SCOPE: We previously found that whole-grain (WG) rye porridges suppressed appetite and improved glucose metabolism. This study aimed to investigate potential plasma metabolites that may be related to differences in those appetite and glucose responses. METHODS AND RESULTS: Twenty-one health subjects consumed six isocaloric breakfasts in a randomized cross-over study. Plain WG rye porridges (40 and 55 g), rye porridge enriched with different inulin: gluten proportions (9:3 g; 6:6 g; 3:9 g), and a 55 g refined wheat bread (control) were served as part of complete breakfast, followed by a standardized lunch. NMR metabolomics assessed 36 plasma metabolites and short chain fatty acids were measured by GC-MS from baseline up to 8 h. Pre-lunch plasma essential amino acids reflected protein composition and post-lunch plasma short chain fatty acids varied with fiber content in breakfasts. No correlations were observed between measured metabolites and glucose, insulin, or appetite responses. CONCLUSIONS: Differences in protein and fiber contents in breakfasts altered postprandial plasma amino acids and short chain fatty acids, respectively, but were unrelated to appetite and glucose responses. Further studies are warrant to identify the underlying mechanisms for the beneficial effects on appetite and second meal glucose responses after rye-based foods.

Effects of unfermented and fermented whole grain rye crisp breads served as part of a standardized breakfast, on appetite and postprandial glucose and insulin responses: a randomized cross-over trial.

BACKGROUND: Whole grain rye products have been shown to increase satiety and elicit lower postprandial insulin response without a corresponding change in glucose response compared with soft refined wheat bread. The underlying mechanisms for these effects have not been fully determined The primary aim of the study was to investigate if whole grain rye crisp bread compared to refined wheat crisp bread, elected beneficial effects on appetite and postprandial insulin response, similarly as for other rye products. METHODS: In a randomized cross-over trial, 23 healthy volunteers, aged 27-70 years, BMI 18-31.4 kg/m2, were served a standardized breakfast with unfermented whole grain rye crisp bread (uRCB), fermented whole grain rye crisp bread (RCB) or refined wheat crisp bread (WCB), Appetite was measured using a visual analogue scale (VAS) until 4 h after breakfast. Postprandial glucose and insulin were measured at 0-230 min. Breads were chemically characterized including macronutrients, energy, dietary fiber components, and amino acid composition, and microstructure was characterized with light microscopy. RESULTS: Reported fullness was 16% higher (P<0.001), and hunger 11% and 12% lower (P<0.05) after ingestion of uRCB and RCB, respectively, compared with WCB. Postprandial glucose response did not differ significantly between treatments. Postprandial insulin was 10% lower (P<0.007) between 0-120 min but not significantly lower between 0-230 min for RCB compared with WCB. uRCB induced 13% (P<0.002) and 17% (P<0.001) lower postprandial insulin response between 0-230 min compared with RCB and WCB respectively. CONCLUSION: Whole grain rye crisp bread induces higher satiety and lower insulin response compared with refined wheat crisp bread. Microstructural characteristics, dietary fiber content and composition are probable contributors to the increased satiety after ingestion of rye crisp breads. Higher insulin secretion after ingestion of RCB and WCB compared with uRCB may be due to differences in fiber content and composition, and higher availability of insulinogenic branched chain amino acids. TRIAL REGISTRATION: ClinicalTrials.gov NCT02011217.

The mindfulness-based psychoeducation program for Chinese patients with schizophrenia.

OBJECTIVES: This study tested the effectiveness of a mindfulness-based psychoeducation program for Chinese outpatients with schizophrenia over an 18-month follow-up. The program is a psychoeducational program that addresses patients' awareness and knowledge of schizophrenia and builds skills for illness management. METHODS: A multisite controlled trial was conducted with 96 Chinese patients with schizophrenia in Hong Kong. They were randomly assigned to either the mindfulness-based psychoeducation program or usual psychiatric care. The patients' mental and psychosocial functioning, insights into illness, and rehospitalization rates were measured at recruitment and at three and 18 months postintervention. RESULTS: Compared with those in usual care, the patients in the mindfulness psychoeducation program showed significantly greater improvements in their illness insights, symptom severity, functioning, and number and length of rehospitalizations at the 18-month follow-up. CONCLUSIONS: The findings provide evidence that the mindfulness-based education program can improve Chinese schizophrenia sufferers' psychosocial functioning and reduce their illness relapse.

An exploratory study of parents' perceived educational needs for parenting a child with learning disabilities.

PURPOSE: This exploratory, qualitative study was conducted to explore Chinese couples' perceived educational needs for parenting a child with specific learning difficulties (SLD). METHODS: We recruited a purposive sample of 25 couples who were caring for a child with SLD at home from one regional child mental health center in Hong Kong. Data were collected from individual couples via audio-taped, semi-structured interviews between April and June 2011. Each interview lasted for about an hour. We analyzed the interview data using qualitative content analysis, as suggested by Graneheim and Lundman (2004). RESULTS: Four identified categories of parents' perceived educational needs were information needs for caregiving, a variety of health concerns with themselves and their child, inadequate psychosocial support, and perceived stigma attached to help-seeking. These results reveal challenges and information for mental health professionals in providing effective educational and psychosocial support and culture-specific health care for these families and their children with learning disabilities. CONCLUSION: Our findings indicate a few important educational needs of parents in caring for a child with SLD that might be underestimated by mental health professionals and teachers, such as psychological support and information needs. To facilitate effective parenting, holistic and individualized needs assessment and education should be provided to address each parent's biopsychosocial and cultural needs in relation to caregiving.

The schizophrenia care management program for family caregivers of Chinese patients with schizophrenia.

OBJECTIVES: This study tested the effectiveness of a schizophrenia care management program for family caregivers of Chinese patients with schizophrenia in Hong Kong. METHODS: A multisite controlled trial was conducted with 92 patient-caregiver dyads. They were randomly assigned to either the schizophrenia care management program or to usual care. The patients' symptoms, functioning, and length of rehospitalization and their families' perceived social support, expressed emotion, and functioning were measured at recruitment and at one month and 15 months after the intervention. RESULTS: Compared with families in the usual care group, families in the schizophrenia care management program reported significantly greater improvements in families' and patients' functioning and caregivers' perceived social support and decreases in the number and length of patients' rehospitalization. CONCLUSIONS: The findings provide evidence that the multidisciplinary schizophrenia care program can improve the psychosocial functioning of patients and their families and social support of caregivers.

Psychometric properties of a Chinese version of the critical care family needs inventory.

The Critical Care Family Needs Inventory (CCFNI) was developed to measure family needs of patients with critical illness. However, testing of the CCFNI has not been undertaken for a Chinese-speaking population. The purpose of this study was to assess the psychometric properties of a Chinese version of the CCFNI in a sample of Chinese family members of critically ill patients. Translation into Chinese and reverse translation were completed before administering the questionnaire. The findings show that the Chinese version addressed adequately the original concepts and dimensions, and demonstrated a high level of equivalence with the original version. High internal consistencies (alpha = .80-.92) of the scale and its subscales were found. Principal components factor analysis supported the existence of a five-factor structure. The Chinese version also demonstrated high sensitivity to family needs in terms of severity of illness and satisfactory correlations with theoretically related constructs. These findings support the potential of the Chinese version to be used as a diagnostic tool in assessment of family needs of Chinese patients.