Effect of nutrition improvement project on morbidity from infectious diseases in preschool children in Vietnam: comparison with control commune

OBJECTIVE: To evaluate the effect of a nutrition improvement project based on home garden production and nutrition education on morbidity from acute respiratory infection and diarrhoeal disease in preschool children. DESIGN: The morbidity survey comprised five data collections undertaken by trained interviewers to ascertain the incidence and severity of respiratory infections and the incidence of diarrhoeal disease in children in two communes. SETTING: A project commune and a control commune in Vietnam. SUBJECTS: Preschool children to 6 years of age living in the project commune Khai Xuan (average 469 children) and the control commune Ching Cong (average 251 children). MAIN OUTCOME MEASURES: Differences between the two communes over time in the incidence and severity of respiratory infections and the incidence of diarrhoeal disease. RESULTS: In Khai Xuan there was a significant reduction (P < 0.0001) in the incidence of respiratory infections (from 49.5% to 11.2%) and diarrhoeal infections (18.3% to 5.1%); the incidence of pneumonia and severe pneumonia was also significantly reduced (P < 0.0001). In Ching Cong there was no significant change in the incidence and severity of respiratory disease nor in the incidence of diarrhoeal disease. CONCLUSIONS: These findings emphasise the successful health outcome of a nutrition project based on household food production and nutrition education and the value of evaluating nutrition projects by reference to measurable health outcomes.     

Assessment of emotional, externally induced and restrained eating behaviour in nine to twelve-year-old obese and non-obese children

Are there differences in eating behaviour between obese and non-obese children? Using the parent version of the Dutch Eating Behaviour Questionnaire (DEBQ-parent version), the results of the present study suggest an affirmative answer to this question. The scores for obese children were significantly higher on the scales for emotional, external and restrained eating behaviour. Relationships were found between emotional eating and negative feelings of physical competence; between external eating and negative feelings of self-worth; and between both eating styles and various aspects of problem behaviour. No relationship was found between external eating and locus of control. Higher scores on both scales were associated with greater caloric intake. These findings suggest that DEBQ can be used as a screening instrument for assessing eating styles of obese children.     

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.     

Assessment of upper-extremity function in children with spastic diplegia before and after selective dorsal rhizotomy

The upper-extremity function of 26 children (mean age 6.0 years) with spastic diplegia was assessed prior to and one year following selective dorsal rhizotomy (SDR). No significant change was found in upper extremity range of motion, muscle tone, or strength (MMT). A significant increase was noted in grasp strength bilaterally which could not be explained simply on the basis of maturation. Manipulation patterns were noted to improve significantly one year after SDR; however, this was proposed to be a maturation rather than intervention effect. Standardized test results revealed no significant improvement in functional hand use when the scores of children with spastic diplegia were compared with age-matched norms, to control for the effect of maturation. The significant improvement found in ability to toilet, dress and undress independently was most likely due to the effect of SDR on lower-extremity muscle tone. Further investigation with a matched control group would provide a conclusive result regarding the effect of SDR on upper extremity function and assist in understanding the maturation of hand function in children with spastic diplegia.     

Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions

We have previously shown that eating disorders are a compulsive behaviour disease, characterized by frequent recall of anorexic thoughts. Evidence suggests that memory is a neocortical neuronal network, excitation of which involves the hippocampus, with recall occurring by re-excitement of the same specific network. Excitement of the hippocampus by glutamate-NMDA receptors, leading to long-term potentiation (LTP), can be blocked by ketamine. Continuous block of LTP prevents new memory formation but does not affect previous memories. Opioid antagonists prevent loss of consciousness with ketamine but do not prevent the block of LTP. We used infusions of 20 mg per hour ketamine for 10 h with 20 mg twice daily nalmefene as opioid antagonist to treat 15 patients with a long history of eating disorder, all of whom were chronic and resistant to several other forms of treatment. Nine (responders) showed prolonged remission when treated with two to nine ketamine infusions at intervals of 5 days to 3 weeks. Clinical response was associated with a significant decrease in Compulsion score: before ketamine, mean +/- SE was 44.0 +/- 2.5; after ketamine, 27.0 +/- 3.5 (t test, p = 0.0016). In six patients (non-responders) the score was: before ketamine, 42.8 +/- 3.7; after ketamine, 44.8 +/- 3.1. There was no significant response to at least five ketamine treatments, perhaps because the compulsive drive was re-established too soon after the infusion, or because the dose of opioid antagonist, nalmefene, was too low.     

Brief group psychoeducation for bulimia nervosa: Assessing the clinical significance of change.

41 women with bulimia nervosa completed a brief intervention that was designed to promote symptom management. Cutoff scores for the determination of reliable and clinically significant change were calculated for several psychometric instruments that are commonly used as outcome measures in the field of eating disorders. Using these statistical procedures to assess therapeutic change, this study documents the diversity of outcomes that individuals reported following their participation in the intervention. As expected, there was a differential reporting of clinically significant change in favor of specific eating psychopathology relative to personality features and associated psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of microbiology in the study of hygiene behaviour

Faecal indicator bacteria have been used to measure levels of hygiene in a variety of settings. This paper describes a study in northern Botswana which used the isolation of faecal indicator bacteria in combination with other quantitative and qualitative techniques to gain information regarding hygiene behaviour. The microbiological samples included, samples from stored drinking water and water sources; eating plates; infant feeding bottles; dishcloths and the fingertips of carers and children. Water was usually clean at source but contaminated after storage. Presumptive faecal coliforms contaminated 31% of the eating plates, 29% of the dishcloths and 40% of the infant feeding bottles. Many of the presumptive faecal coliform isolates were not identified as Escherichia coli, indicating the need for further research into methodologies appropriate for isolating E. coli in tropical climates.     

Restriction of washing and its effect to the normal human skin flora. Quantitative and qualitative investigations of the aerobic skin flora (author's transl)

The behaviour of the aerobic skin flora of the flexor sides of the forearms, under a three-week restriction of washing, was investigated in twenty-four patients for its quantitative and qualitative aspects. The combined scrabbing-washing method was used as described by Burtenshaw with Ringer's solution. After a three-week restriction of washing, using the Wilcoxon-Test, statistically no significant changes in the total number of microorganisms were found in areas investigated in the intermittent sampling of the skin flora. A three-week restriction of washing in the region of the flexor sides of the forearms does not induce significant changes in the composition of the normal aerobic skin flora. The percentage of differences in the total number of bacteria fluctuates up to the mark in wide limits; statements about standard deviations are not permitted because of the technical and experimental conditions. There was no shifting of the Resident flora to other groups of bacteria in the patients under study. Pathogenic microorganisms could not be found in higher numbers after the second sampling.     

Respiratory syncytial virus bronchiolitis

Respiratory syncytial virus (RSV) bronchiolitis is associated with the clinical signs and symptoms of small airway obstruction. A major public health problem throughout the world, this condition is responsible for significant morbidity and mortality. Management is primarily preventive, through strict hand washing, avoidance of exposure during the respiratory illness season and intravenously administered prophylactic anti-RSV Immune globulin, especially in selected small infants with underlying cardiopulmonary disease. Supportive measures, including fluid hydration, good nutrition, aerosolized bronchodilators and steroids, may be helpful. Ribavirin may be useful in severely ill children or those with underlying cardiopulmonary disease. A significant number of patients have recurrent episodes of bronchiolitis and wheezing, and may develop asthma later in life. Avoidance of exposure to tobacco smoke, cold air and air pollutants is also beneficial to long-term recovery from RSV bronchiolitis. A number of vaccines to prevent this infection are currently being studied.     

Challenging behaviour in children with learning disabilities

This article outlines the initial stages of an ongoing experiment to evaluate the comparative efficacy of two different therapeutic interventions--behaviour modification and gentle teaching--in the management of challenging behaviour in children who have learning disabilities. Using a workshop approach, parents are taught the principles and practice of one of these two interventions to enable better management of their child's challenging behaviour. A range of intervention outcomes are then compared with those of a control group. Preliminary analysis of data has been conducted on information gathered from those parents (n = 24) who attended the gentle teaching workshop only. The results indicate that brief intervention training in gentle teaching can have a positive impact upon the challenging behaviour of the child.     

Comments on "Two classic behaviour modification patients: a decade later."

Comments on the article by G. G. Sherwood and J. E. Gray (see record 2007-01479-012) which followed-up on two "classic" patients treated by the current author in his original behaviour modification unit. The major point made by Sherwood and Gray can be characterized by one of their own statements, "our findings are sufficient to indicate that behaviours extinguished in a controlled environment can re-emerge in a different setting." This comment reflects what is currently one of the most important issues in the evaluation of any therapeutic approach, namely the issue of generalization. A follow-up evaluation assumes that behaviour after behavioural intervention takes places in a vacuum. That is to say, it somehow assumes that the individual is no longer in interaction with his current environment and is, therefore, impervious to change. Of course, that is not the ease. Hence, the individual's behaviour will continue to change as a function of his interaction with his current environment, and his history since the behavioural intervention. In fact, the follow-up information offered by the Sherwood and Gray suggests that the re-emergence of old behaviours is very much related to the contingencies in the patients' current situation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual behaviour in untreated and treated coeliac patients

BACKGROUND: Sexual behaviour is often altered in chronic illness. AIM: To evaluate sexual behaviour in coeliac patients before and after treatment with a gluten-free diet. PATIENTS: Fifty-five adults with coeliac disease and 51 age- and sex-matched healthy controls. METHODS: Routine clinical and laboratory work-up was used for diagnosis of coeliac disease. Age of first sexual intercourse, prevalence of individuals who were sexually active, frequency of intercourse, reduction in sexual desire, difficulty in attaining orgasm, pain during intercourse, and prevalence of individuals defining themselves as satisfied with their sexual life were investigated by an anonymous, self-administered questionnaire administered before and after one year's treatment with a gluten-free diet in coeliac patients, and only once in controls. Analyses included clinical conditions, demographic and socio-economic data. RESULTS: Compared with controls, untreated coeliac patients had a significantly lower frequency of intercourse and a lower prevalence of individuals satisfied with their sexual life. Patients with overt and subclinical coeliac disease did not show significant differences for any indices of sexual behaviour. Compared with untreated conditions, coeliac patients after one year of treatment had improved values for all indices of sexual behaviour: differences were significant for frequency of intercourse and prevalence of individuals satisfied with their sexual life. CONCLUSION: Untreated coeliac disease, even in its subclinical presentation, is associated with disorders in sexual behaviour which are improved by the dietary treatment.     

Testing mediators of intervention effects in randomized controlled trials: An evaluation of two eating disorder prevention programs.

The authors investigated mediators hypothesized to account for the effects of 2 eating disorder prevention programs using data from 355 adolescent girls who were randomized to a dissonance or a healthy weight intervention or an active control condition. The dissonance intervention produced significant reductions in outcomes (body dissatisfaction, dieting, negative affect, bulimic symptoms) and the mediator (thin-ideal internalization), change in the mediator correlated with change in outcomes and usually occurred before change in outcomes, and intervention effects became significantly weaker when change in the mediator was partialed, providing support for the hypothesized mediators and this new approach to testing mediation in randomized trials. Findings provide somewhat less support for the hypothesis that change in healthy eating and exercise would mediate the healthy weight intervention effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up.

Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students (mean age = 15.7 years, SD = 1.1) with body image concerns were randomized to the 4-session dissonance-based prevention program or an educational brochure control condition, wherein school counselors and nurses were responsible for participant recruitment and intervention delivery. Results: Dissonance-intervention participants showed greater reductions in thin-ideal internalization, body dissatisfaction, and eating disorder symptoms; change in thin-ideal internalization predicted change in body dissatisfaction and symptoms; change in body dissatisfaction predicted change in symptoms; and all indirect effects were significant. Change in thin-ideal internalization fully mediated the effects of intervention condition on change in body dissatisfaction and partially mediated the effects on symptoms; change in body dissatisfaction partially mediated the effect of intervention condition on change in symptoms. Conclusions: Findings provided support for the intervention theory of this eating disorder prevention program over longer term follow-up, extending the evidence base for this effective intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Motivational enhancement therapy and self-help treatment for binge eaters.

The aims of this study were to evaluate whether a single session of motivational enhancement therapy (MET) would increase participant readiness to change, improve the efficacy of self-help treatment for binge eaters, and improve participant compliance with the self-help manual. Method: Participants with bulimia nervosa or binge eating disorder were randomly assigned either to attend a 1-hr MET session prior to receiving the self-help manual (n = 45) or to receive the self-help manual only (n = 45). Participants were followed for 4 months for assessment of self-reported eating disorder outcome and compliance. Results: The MET intervention resulted in increased readiness to change for binge eating compared with the self-help-only (SH) condition. Few differences were found between the MET condition and the SH condition for changes in eating attitudes and frequency of binge eating and compensatory behaviors. No significant effects were found for compliance. Discussion: This research adds to the literature regarding the use of brief motivational interventions to enhance readiness for change in populations with eating disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of long-term fibre supplementation on weight maintenance in weight-reduced women

OBJECTIVE: To investigate whether fibre supplementation is effective in weight-reduced subjects for maintenance of weight-loss in the long-term. DESIGN: Longitudinal, randomly assigned intervention study with supplementation of 20 g of water soluble fibre (guar gum) daily for 14 months after an energy-restricted period of two months (VLCD). SUBJECTS: Thirty-one female, obese subjects (age: 41.4 +/- 7.4 y: BMI 33.2 +/- 3.7 kg/m-2); 20 subjects were supplemented with fibre and 11 subjects served as the control group. MEASUREMENTS: Body weight (BW), blood lipids and blood pressure, anthropometry, and eating behaviour were measured before the VLCD (0), after VLCD (2), and at 4, 10, and 16 months. RESULTS: The fibre group with at least 80% compliance (group A) and the control group showed the same weight regain response after VLCD. The fibre consuming group with 50-80% compliance (group B) differed with respect to relapse. The rate and amount of BW regain was significantly higher for group B. After 14 months group B had returned to baseline levels, whereas group A and the control group showed a tendency to a lower BW than at baseline (P = 0.09). No effect of fibre supplementation was found on blood lipids, blood pressure and energy intake. Eating behaviour characteristics changed during the intervention and might explain differences in weight maintenance. CONCLUSIONS: No effect of 14 months fibre supplementation was found on weight maintenance in weight-reduced subjects. Guar gum intake did not result in reduction of blood pressure or cholesterol, or in suppression of energy intake.     

Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women

The effect of various hand washing regimens on transfer of bacterial contaminants from the hands to a hydrogel contact lenses was evaluated. Each of 47 subjects performed 5 different hand washing procedures, and then handled a new, sterile hydrogel contact lens. The lenses were cultured to determine colony-forming units (CFUs) and microbial identity. Median CFUs on lenses handled after washing with water, soap and water, or soap and water followed by towel drying were higher than the median CFU for lenses handled after no hand washing. The median CFU for lenses handled after soap and water washing followed by an alcohol wipe was not different from the no washing group. The majority of the contaminants were identified as Staphylococcus epidermidis. These results show that ordinary hand washing alone does not decrease, and may even increase, the amount of contaminants transferred from the hands to a hydrogel lens. Use of an alcoholic wipe after hand washing reverses this effect. Hand washing is still recommended in contact lens hygiene for removal of more pathogenic contaminants.     

Effectiveness of an Internet-based program for reducing risk factors for eating disorders.

This study evaluated an Internet-delivered computer-assisted health education (CAHE) program designed to improve body satisfaction and reduce weight/shape concerns—concerns that have been shown to be risk factors for the development of eating disorders in young women. Participants were 60 women at a public university randomly assigned to either an intervention or control condition. Intervention participants completed the CAHE program Student Bodies. Measures of body image and disordered eating attitudes were assessed at baseline, postintervention, and 3-month follow-up. At follow-up, intervention participants, compared with controls, reported a significant improvement in body image and a decrease in drive for thinness. This program provides evidence for the feasibility and effectiveness of providing health education by means of the Internet. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diminished hyperaemic response of the hepatic artery to portal venous occlusion (the buffer response) in Asian hybrid minipigs: a comparison of the response to that observed in dogs

This study is part of a larger study of the effect of integrity-promoting care in a Swedish nursing home ward. Compared with assessments on a control ward, improvements were found in the patients' behaviour and in the quality of care after a three-month intervention period. This paper reports on parts of a questionnaire survey on the nursing staff's opinions of their working conditions and demented patients. Most staff members on both the intervention ward and the control ward found their jobs meaningful, engaging and stimulating, but they also felt that they had a heavy work-load. Most of the staff members experienced mental strain because of the patients' disturbed behaviour. Many did not think that the care on their ward would have been good enough for their own close relatives, if they had been suffering from dementia. Only slight changes were found in the staff members opinions after the intervention.