The Nutritional Content of Main Course Ready-meals Aimed at Children Aged 12 Months to 3 Years.

Background: Rapid changes to dietary and lifestyle patterns have transformed the home and food environment with an increased trend towards convenience in home food preparation and ready-meal availability [1]. Despite the widespread use of convenience foods, there is a lack of research into the nutritional quality of convenience foods for young children. This study examined the nutritional content of ready-meals for children aged 12 months to 3 years. The objectives of this study were to (i) investigate the nutritional quality of ready-meals, on sale in the UK market for children aged 12 months to 3 years, comparing their nutrition labelling information to dietary standards, (ii) identify the nutrition claims on the packaging of ready-meals for this age group and (iii) determine whether the nutrition claims identified met European Union legislation. Methods: A sample of main course ready-meals (n=38) marketed to children aged 12 months to 3 years from five brands, available in the UK was assessed. One ready-meal represents only a proportion of energy and nutrients consumed per day, therefore dietary standards were obtained taking 30% of age-appropriate dietary reference values (DRVs). The energy, protein and sodium content of these ready-meals were compared to the calculated dietary standards using one sample t-tests. Descriptive analysis was performed on all nutritional information (energy, carbohydrate, sugars, protein, fat, saturated fat, fibre, sodium and iron) collected. Nutrition claims were validated against legislative requirements [2,3,4]. Results: All ready-meals examined were significantly lower in energy (p=0.000) and higher in protein (p=0.000) compared to the dietary standards. Sodium was significantly higher than the dietary standard in three brands; brand 1 (p=0.000), 3 (p=0.004) and 5 (p=0.03), with brand 5 containing only 65mg less than the DRV (500mg) for total daily allowance. Four of the nutrition claims made across the brands were assessed - “no added salt”, “no added sugar”, “low salt” and “source of iron”. Only brand 1 and 5 did not meet legislation for “no added salt” as the ready-meals contained more than the amount of sodium per 100g permitted. All other nutrition claims conformed to legislative requirements; however the majority of ready-meals from brand 1 did contain ingredients with added salt and/or sugar e.g. mustard or sun-dried tomato, despite claims of “no added salt/sugar” and this could misinform consumers. Discussion: The ready-meals investigated did not meet calculated dietary standards and although the majority of nutrition claims displayed on the packaging did meet legislation, some claims did not and there were claims that could mislead consumers. There is paucity in research into the nutritional quality of convenience foods for young children and therefore comparisons between this study and other work cannot be drawn. Furthermore, since comprehensive dietary standards are unavailable for this age group, it is difficult to fully assess the nutritional adequacy of these ready-meals. Conclusion: The development of nutritional standards and transparent nutrition claim legislation would enable practitioners to fully assess the adequacy of children’s diets and enable consumers to make healthier food choices.

Regulation of salt and volume transport along the nephron during acute systolic hypertension

DISCUSSION Acute regulation of sodium pump activity There is a burgeoning literature on mechanisms responsible for short term regulation of Na,K-ATPase activity (Aperia et al, 1996, 1994; Boron et al, 1997; Bertorello & Katz, 1993). Pathways linked to both generation of protein kinase C (PKC) and/or cyclic-AMP dependent protein kinase A are postulated to regulate Na,K-ATPase activity by changing the alpha catalytic subunit phosphorylation status. However, phosphorylation has been associated with both decreased activity (Aperia et al, 1994; Chibalin et al, 1995; Middleton et al, 1993; Satoh et al, 1993a, 1993b), and increased activity (Carranza et al, 1996a, 1996b), and no change in activity (Boron et al, 1997). There is also evidence that PKC causes a withdrawal of sodiuln pumps from the basolateral membranes even if there is mutation of the phosphorylation site (Boron et al, 1997). Proximal tubule Na,K-ATPase activity is also inhibited (whether directly or indirectly is not known) by activation of phospholipase A2 which stimulates production of arachidonate metabolites of cytochrome P-450 such as 20-HETE (Aperia et al, 1996; Nowicki et al, 1997; Ominato et al, 1996). Although the precise signaling mechanisms re main to be elucidated for the responses to altered blood pressure, our results indicate that the inhibition of the sodium pump activity in PT is due to structural modification of the pump itself or an associated regulator, rather than solely mediated by trafficking of active pumps to a new location, because the data demonstrate. significant changes in total ATPase activity that persist through membrane fractionation and phase partitioning, and our results implicate a role of cat P45O aa metabolism to 20-HETE in the response(Zhang et al, 1998) Altered natriuretic responses in hypertension As discussed in the introduction, an altered natriuretic response to an elevation in blood pressure is the hallmark of hypertension. The Spontaneously Hypertensive Rat (SHR)has numerous renal defects that could account for the development of hypertension. In regards to this project, the PT of SHR fail to respond normally to the natriuretic hormone dopamine (Kinoshita et al, 1989), and they have enhanced tubuloglomerular feedback (TGF) response (reviewed in Cowley & Roman, 1997). Our results indicate a distribution of apical sodium transportes in SHR is the same as in acutely hypertensive SD (Magyar et al, 1997), In summary, our findings to date suggest that the dynamic regulation of proximal tubule and loop of Henle sodium transport by fluctuations in blood pressure may be mediated by changes in sodium transporter characteristics at both the apical and basolateral membranes: 1) by reversible inhibition of basolateral Na,K-ATPase activity in the PT and activation in the TALH, and 2) relocation of a set of apical proteins, including NHE-3 and NaPi, consistent with redistribution to intermicrovillar cleft region and/or internalization to endosomal pools in the PT. The reciprocal modulation of Na,K-ATPase activity in PT and TALH contributes the driving force for activating TGF, while minimizing changes in delivery of salt and water to the hormone sensitive distal nephron.

Taller de sexualidad y afectividad como una alternativa de educacion sexual dirigida a adolescentes / Workshop on sexuality and its effectiveness as an alternative to sexual education directed to adolescents

We present the experience accumulated during 3 years of having performed 10 workshops related to the topics of Sexuality and Affection, offered to 175 adolescents between the ages of 13 and 19 years, from public schools within the Panamá, City Metropolitan Area and who correspond to different socioeconomical strata. Analytical information provided from the results of two questionnaires related to knowledge about the two topics, applied prior to and after the workshops is also offered

Síndrome de hiperestimulación ovárica / Ovarian hyperstimulation syndrome

The author discusses the etiology and pathophysiology of the Ovarian Hyperstimulation Syndrome (OHS) and its relationship with Polycystic Ovarian Disease, in which it occurs more frequently. He presents the clinical histories of five patients who, in a period of two years, developed this syndrome in three different degrees of severity, while undergoing therapy for ovulatory infertility. The clinical history of one patient, who developed the most severe manifestations of OHS, is discussed in detail. The author emphasizes the difficulties that can be faced in trying to prevent the OHS, particularly because of probably inherited characteristics which may explain why not all patients with the same risk factors develop the OHS

Historia de la planificación familiar en las mujeres que optan por la esterilización quirúrgica en la Caja de Seguro Social de Panamá / The history of family planning among women who opt for surgical sterilization in the Social Security Fund of Panama

In this study, the previous history of family planning and prior usage of contraceptive methods are analyzed, in a sample of 175 women who voluntarily opted for surgical sterilization as a permanent method of fertility regulation, in the Panamanian Social Security System. A questionnaire was applied during the second trimester of pregnancy, by which information would be gathered in regard to knowledge, usage and adverse effects of the contraceptive methods used prior to the intervention. Results showed that 99% of the sample had heard, on some occasion about oral contraceptives (OC) and, in lesser proportion to intrauterine devices (IUD), barrier methods and hormonal inyectables. The first contraceptive method used, and the one of longest usage, was the combined OC, of which 43% begun between 17 and 25 years of age. In contrast, 7.4% initiated contraception with IUD, from the age of 26 years. The health personnel constituted the major source of recommendation for contraceptive usage and, despite the fact that 37% of the sample did not use contraception prior to the last pregnancy, over half of the subjects responded that combined OC were considered as the most secure method

Factores psicológicos que inciden en la toma de decisión de la esterilización quirúrgica y probables cambios posteriores / The psychological factors that affect the making of a decision for surgical sterilization and the likely later changes

The practice of female surgical sterilization in Panama during the past decades, motivated the realization of this study, to determine the factors which caused women to use this permanent contraceptive method, and to see if regrets later occurred after that decision, in the sterilized women. A sample of 151 women were selected, between the ages of 28 and 45 years, concurrently pregnant and with 2 or more living children at the moment of the study. Psychological tests were applied during three different phases (pre-operatively and subsequently 12 and 24 months, post operatively). Results showed that female sterilization did not cause long term complications, and amongst the majority of women conforming the sample, a stable psychological profile was found up to 24 months after the interventions, with a significant improvement in the last evaluation of the social adaptation variable, in comparison to the pre-operative assessment

Cerclaje cervical / Cervical cerclage

The author studies the result of cervical cerclage carried out by him on seven multi-pregnant women (between 10-28 weeks gestation, of whom five had not borne any children) and on one woman who is pregnant for the first time (twins, at 12 weeks gestation) because of threatened abortion which usually would occur in the second trimester of the pregnancy, due to shortening and premature opening of the cervical os which leads to the protrusion of the membranes with interruption of the pregnancy. The author describes his patients' symptoms and signs, the week of pregnancy at which the operation was performed, vaginally, the urgent conditions which prompted the operation, the frequency of abortion and the condition of the child at the end of the pregnancy