The challenges posed by equine arboviruses.

Equine populations worldwide are at increasing risk of infection by viruses transmitted by biting arthropods, including mosquitoes, biting midges (Culicoides), sandflies and ticks. These include the flaviviruses (Japanese encephalitis, West Nile and Murray Valley encephalitis), alphaviruses (eastern, western and Venezuelan encephalitis) and the orbiviruses (African horse sickness and equine encephalosis). This review provides an overview of the challenges faced in the surveillance, prevention and control of the major equine arboviruses, particularly in the context of these viruses emerging in new regions of the world.

Potential vectors of equine arboviruses in the UK.

There is growing concern about the increasing risk of disease outbreaks caused by arthropod-borne viruses (arboviruses) in both human beings and animals. There are several mosquito-borne viral diseases that cause varying levels of morbidity and mortality in horses and that can have substantial welfare and economic ramifications. While none has been recorded in the UK, vector species for some of these viruses are present, suggesting that UK equines may be at risk. The authors undertook, therefore, the first study of mosquito species on equine premises in the UK. Mosquito magnet traps and red-box traps were used to sample adults, and larvae were collected from water sources such as tyres, buckets, ditches and pools. Several species that are known to be capable of transmitting important equine infectious arboviruses were trapped. The most abundant, with a maximum catch of 173 in 72 hours, was Ochlerotatus detritus, a competent vector of some flaviviruses; the highest densities were found near saltmarsh habitats. The most widespread species, recorded at >75 per cent of sites, was Culiseta annulata. This study demonstrates that potential mosquito vectors of arboviruses, including those known to be capable of infecting horses, are present and may be abundant on equine premises in the UK.

Healthy midlife Canadian women: how bone health is considered in their food choice systems.

BACKGROUND: The incidence of osteoporosis is predicted to increase as Western populations age. Diet is considered to be an important modifiable factor in bone health, yet the diets of many women are insufficient in calcium and vitamin D, which comprise two key nutrients for bone health. This focus group study explored ways in which midlife women consider bone health in their personal food choice systems. METHODS: Data were obtained in six audio-recorded focus groups from a total of 36 women from upper, middle and lower income neighbourhoods. Open and axial coding and thematic analysis revealed shared and unique themes across and within the income groups. Use of member checks, peer debriefing, and independent and team data analysis enhanced rigour in the findings. RESULTS: All participants were aware of osteoporosis. Most women idealised making simple food decisions and eating for 'holistic' health, but not specifically for bone health. Most midlife women were not motivated to change their diets, few had deliberately increased their intake of calcium and vitamin D through foods and supplements, and few others had simplified their food decisions. CONCLUSIONS: Midlife women in the present study did not make eating for bone health a priority in their food choice systems. Instead, women wanted to eat for 'holistic' health, and only by implication bone health.

The clearance kinetics of autologous RhD-positive erythrocytes coated ex vivo with novel recombinant and monoclonal anti-D antibodies.

Anti-D is given routinely to pregnant RhD-negative women to prevent haemolytic disease of the fetus and newborn. To overcome the potential drawbacks associated with plasma-derived products, monoclonal and recombinant forms of anti-D have been developed. The ability of two such antibodies, BRAD-3/5 monoclonal anti-D IgG (MAD) and rBRAD-3/5 recombinant anti-D IgG (RAD), to clear RhD-positive erythrocytes from the circulation was compared using a dual radiolabelling technique. Six RhD-positive males received autologous erythrocytes radiolabelled with (99m)Tc and (51)Cr and coated ex vivo with MAD and RAD. Blood samples were collected up to 1 h following intravenous injection, and percentage dose of radioactivity in the samples determined. Three different levels of coating were used on three separate occasions. No significant differences between MAD and RAD were observed in the initial clearance rate constant at any dose level. The log[activity]-time clearance plots were curved, showing a reduction in the clearance rate constant with time. This reduction was more marked for RAD than for MAD. The results support a dynamic model for the clearance of antibody-coated erythrocytes that may have wider relevance for the therapeutic use of antibodies.

Growing up: perspectives of children, families and service providers regarding the needs of older children with perinatally-acquired HIV.

Children with perinatally-acquired HIV are living into adolescence and adulthood. As this is a relatively new phenomenon, there is a paucity of research highlighting the complex issues that arise for these children. This qualitative case-study examines the needs of a select group of older children (9-16 years old) with perinatally-acquired HIV in the province of British Columbia, Canada through focus groups and interviews conducted with ten HIV-infected children, 11 family members and 11 service providers. The needs of this population are diverse, reflecting its heterogeneity. However, participants consistently highlighted issues of stigma, sexual health and mental health as major areas of current and future concern. Continued support, education and future planning in these areas are necessary for older HIV-infected children as they transition out of childhood.

Integration and individuality in healthy eating: meanings, values, and approaches of childless, dual earner couples.

INTRODUCTION AND OBJECTIVES: Although considered to be an important component of food choice, perceptions and practices regarding healthy eating vary between people and change over the life-course. The purpose of this paper is to examine integration and individuality in healthy eating meanings, values, and approaches of individuals in childless, dual earner couples. MATERIALS AND METHODS: Fourteen participants (from seven couples) were recruited using notices and snowball sampling. Food journals and individual interviews were used to explore the nature of and negotiations between partners' healthy eating values and approaches. Data were analysed through iterative procedures that included coding, thematic analysis and memo writing. RESULTS: Participants presented individual healthy eating values and approaches based on their own experiences with food over time. Cohabitation resulted in a continuum of healthy eating negotiation outcomes, including congruent values and approaches, congruent values but divergent approaches, and divergent values and approaches. In combination with other salient factors, cohabitation provides an opportunity for improving healthy eating approaches. DISCUSSION: Cohabitation has the potential to lead to positive changes in healthy eating approaches. Practitioners need to tailor messages for clients' specific needs and encourage change in the direction of the partner with the healthier eating approach.

Canadian dietitians' views and practices regarding obesity and weight management.

OBJECTIVE: To provide insight into Canadian dietitians' attitudes and practices regarding obesity and weight management. DESIGN: Cross-sectional mail survey of a stratified random sample of members of Canadian dietetic associations. SUBJECTS: A total of 514 dietitians (74% of those surveyed), 350 (69%) of whom actively counselled overweight/obese clients. MEASUREMENTS: Participants received a questionnaire to assess dietitians' attitudes regarding obesity and overweight, views regarding their role in weight management, counselling practices, and the criteria used to judge success. Demographic variables were collected. RESULTS: Most dietitians believed that obesity contributes to morbidity and mortality, and that small weight losses produced important health benefits. However, 80% agreed that health indicators other than weight loss should be the focus of obesity management, and 55% specifically recommended that clients not weigh themselves. Instead, weight management was promoted by recommending healthy eating and increased physical activity. Three-quarters agreed that they are the profession best trained to manage obesity but two-thirds believed their time would be better spent preventing rather than managing obesity. Dietitians most valued education received from on-the-job support and mentoring from other dietitians. Participants reported wanting to learn more about motivational and behavioural modification counselling techniques. CONCLUSIONS: Canadian dietitians follow a lifestyle approach to weight management. Studies are required to formally assess the effectiveness of various aspects of this approach.

Oncologists' and naturopaths' nutrition beliefs and practices.

PURPOSE: Despite the widespread use of complementary and alternative therapies by persons with cancer, little is known about how the understandings of complementary and alternative practitioners of these therapies compare with those of conventional physicians. The broad purpose of this research was, thus, to explore the beliefs of physicians and complementary and alternative health practitioners, their use of scientific and other types of evidence, and their counseling practices. The specific issue addressed was the beliefs and practices of oncologists and naturopaths regarding the role of diet in breast cancer prevention and treatment. DESCRIPTION OF STUDY: A qualitative research design was used, involving in-depth semistructured interviews with 10 oncologists and 11 naturopaths. Interviews were tape-recorded, transcribed verbatim, and analyzed using qualitative methods. RESULTS: The oncologists believed that there is little evidence of a role for diet in breast cancer prevention and treatment, citing the lack of evidence from randomized controlled trials. They reported that they provide only general advice on healthy eating to patients. The naturopaths believed that diet is strongly implicated in breast cancer development, prevention, and treatment. They justified this belief by using scientific evidence from a variety of types of studies, logic or common sense, and their clinical experiences. Naturopaths reported that they provide patients with specific suggestions for foods to avoid or to emphasize in diets. CLINICAL IMPLICATIONS: The differences in the advice provided by oncologists and naturopaths are associated with different decision-making or knowledge construction systems. Educating patients about these differences will help patients to make more informed healthcare choices.

Comparison of flow cytometric assays with isotopic assays of (51)chromium-labeled cells for estimation of red cell clearance or survival in vivo.

BACKGROUND: A comparison was made between flow cytometric and conventional radioisotopic assays in the determination of the clearance or survival of small volumes of (51)chromium-labeled D+ red cells after injection into volunteers. STUDY DESIGN AND METHODS: Four clearance studies were performed using 4 mL of autologous D+ cells coated with anti-D at two concentrations (5 or 10 microg anti-D/mL red cells) transfused to two subjects at separate times. Five survival studies were carried out using 5 mL of frozen-thawed D+ cells transfused to five D- subjects with no detectable anti-D. Sequential blood samples were taken for gamma counting and flow cytometry. Several methods were used to stain the transfused red cells, and the data were analyzed by using three flow cytometers. RESULTS: The determination of red cell clearance or survival by radioactivity measurements gave results consistent with published data. However, none of the flow cytometric assays exhibited the necessary sensitivity or accuracy in quantitation of the rare events to provide reliable data for the calculation of the initial clearance rate, the red cell half-life, or the mean cell lifespan, although rough estimates of red cell clearance were obtained in some subjects. This inability to accurately enumerate rare fluorescence-labeled cells was due mainly to the presence of "background" events, which were a considerable problem in some samples, when the coating level of anti-D was less than 3000 molecules of IgG per cell. CONCLUSION: Flow cytometry may enable the crude estimation of the percentage of small volumes (<5 mL) of transfused D+ red cells, but in this study it was found that this method was not sufficiently accurate to determine the initial clearance rate, red cell half-life, or mean cell lifespan. If the proportion of transfused cells in the recipient is about 0.2 percent or less, the use of radioisotopes for labeling cells for quantitative in vivo red cell clearance or survival data should remain the method of choice.

Filipino women living in Canada: constructing meanings of body, food, and health.

This qualitative study explored the understandings of body size, food and eating, and health held by Filipino women living in Canada. Women (n = 11) aged 19 to 30 years old who were born in the Philippines and living in British Columbia participated in individual interviews where they discussed their beliefs and practices relating to their body, food, and health. Informants' comments reflected contrasting "Canadian" and "Filipino" meanings. Canadian beliefs emphasized the desirability of thinness, "watching" intake of fat, rice, and junk food, and minimizing disease risk. Filipino beliefs valued fatness, "just eating" fat and rice, and maximizing disease resistance. While most informants appeared to have adopted the Canadian values, Filipino beliefs continued to be of some significance in their lives. These findings demonstrate the socially constructed nature of health beliefs and illustrate how members of a minority ethnic group negotiate among conflicting cultural beliefs about body size, food and health.

Lower-fat menu items in restaurants satisfy customers.

OBJECTIVE: To evaluate a restaurant-based nutrition program by measuring customer satisfaction with lower-fat menu items and assessing patrons' reactions to the program. DESIGN AND SETTING: Questionnaires to assess satisfaction with menu items were administered to patrons in eight of the nine restaurants that volunteered to participate in the nutrition program. One patron from each participating restaurant was randomly selected for a semistructured interview about nutrition programming in restaurants. SUBJECTS: Persons dining in eight participating restaurants over a 1-week period (n = 686). STATISTICAL ANALYSES PERFORMED: Independent samples t tests were used to compare respondents' satisfaction with lower-fat and regular menu items. Two-way analysis of variance tests were completed using overall satisfaction as the dependent variable and menu-item classification (ie, lower fat or regular) and one of eight other menu item and respondent characteristics as independent variables. Qualitative methods were used to analyze interview transcripts. RESULTS: Of 1,127 menu items rated for satisfaction, 205 were lower fat, 878 were regular, and 44 were of unknown classification. Customers were significantly more satisfied with lower-fat than with regular menu items (P < .001). Overall satisfaction did not vary by any of the other independent variables. Interview results indicate the importance of restaurant during as an indulgent experience. CONCLUSIONS: High satisfaction with lower-fat menu items suggests that customers will support restaurant providing such choices. Dietitians can use these findings to encourage restaurateurs to include lower-fat choices on their menus, and to assure clients that their expectations of being indulged are not incompatible with these choices.

A pharmacokinetic/pharmacodynamic model for the action of anti-D immunoglobulin in effecting circulatory clearance of Rh D+ red cells.

A dynamic model of the action of anti-D immunoglobulin in effecting clearance of Rh D-positive red cells from the circulation of D-negative subjects is presented. The pharmacokinetics of the redistribution of anti-D between injection site, intravascular and extravascular spaces following either intramuscular or intravenous administration is included, also the reaction of anti-D with D-positive red cells in the intravascular space and subsequent circulatory clearance of antibody-coated cells. Numerical computer modelling methods have been used to obtain solutions of the model, using kinetic rate constants which have been derived from previously published experimental data. Selected solutions are presented, chosen for their relevance to (i) clinical situations in which anti-D is used to prevent Rh D immunization of D-negative subjects and (ii) determination of some of the properties of anti-D antibodies which are important for effecting circulatory clearance of D-positive red cells.

Fingerprinting of glycans as their 2-aminoacridone derivatives by capillary electrophoresis and laser-induced fluorescence.

Capillary electrophoresis and laser-induced fluorescence detection have been used to fingerprint the 2-aminoacridone derivatives of complex glycans released from bovine fetuin and human IgG monoclonal antibodies. The utility of this method in distinguishing between N- and O-linked oligosaccharides and in determining the presence of sialic acid residues in glycan mixtures at an early stage of analysis has been demonstrated.

Human Rh D monoclonal antibodies (BRAD-3 and BRAD-5) cause accelerated clearance of Rh D+ red blood cells and suppression of Rh D immunization in Rh D- volunteers.

The use of prophylactic anti-D to prevent Rh D immunization in Rh D- women and subsequent hemolytic disease in Rh D+ infants is widespread, but has led to shortages of the anti-D Ig. With the aim of substituting monoclonal anti-D for Rh D prophylaxis, we have compared the abilities of monoclonal and polyclonal anti-D to clear Rh D+ red blood cells (RBCs) infused into Rh D- male volunteers and to suppress Rh D immunization. Two human monoclonal antibodies (MoAbs), BRAD-3 (IgG3) and BRAD-5 (IgG1), produced from stable Epstein-Barr virus-transformed B-lymphoblastoid cell lines, were selected because of their proven in vitro activity in promoting RBC lysis in antibody-dependent cell-mediated cytotoxicity assays. RBC clearance was assessed by intravenous injection of 3 mL of 51chromium-labeled D+ RBCs into 27 volunteers 48 hours after intramuscular injection of monoclonal or polyclonal anti-D. Further 3-mL injections of unlabeled D+ cells were administered at 6 and 9 months to induce immunization. Blood samples were taken throughout the 12-month period of study for the serologic detection of anti-D. The mean half-life (t50%) of RBCs in 7 recipients of 300 micrograms BRAD-5 (5.9 hours) was similar to that in 8 recipients of 500 IU polyclonal anti-D (5.0 hours), whereas D+ cells were cleared more slowly in some of the 8 subjects injected with 300 micrograms BRAD-3 (mean t50% 12.7 hours) and in 1 individual administered 100 micrograms BRAD-3 (t50% 41.0 hours). The rate of RBC clearance in both groups administered 300 micrograms monoclonal anti-D correlated with the amount of antibody bound per cell, determined by flow cytometry. There was no evidence of primary immunization having occurred in any subject after 6 months of follow-up. Five of 24 subjects produced anti-D after one or two further injections of RBCs, confirming that they were responders who had been protected by the monoclonal or polyclonal anti-D administered initially. Four of these responders were recipients of monoclonal anti-D (3 BRAD-3, 1 BRAD-5). One individual who received BRAD-5 produced accelerated clearance of D+ RBCs at the third unprotected RBC challenge but did not seroconvert. This study shows that the human MoAbs BRAD-3 and BRAD-5 can prevent Rh D immunization, and indicates that they may be suitable replacements for the polyclonal anti-D presently used in prophylaxis of Rh D hemolytic disease of the newborn.(ABSTRACT TRUNCATED AT 400 WORDS)

Clearance of Rh D-positive red cells with monoclonal anti-D.

Two human monoclonal antibodies, one IgG3 and one IgG1, with anti-Rh D specificity, were tested for their ability to clear red cells. Samples of red cells from 12 D-positive subjects were sensitised in vitro with various amounts of antibody, the number of antibody molecules bound to the cells was estimated, and the cells were reinjected into the donor's circulation. Both antibodies mediated clearance but substantially fewer IgG3 than IgG1 antibody molecules were required to produce a given rate of clearance. The IgG3 antibody was slightly more effective than polyclonal anti-D, as judged by comparison with previously published results. Since there is believed to be an association between the rate of red cell clearance by anti-D and the ability of the antibody to suppress D immunisation, the IgG3 monoclonal antibody may prove suitable for the immunoprophylaxis of Rh D haemolytic disease.

Effect of biosynthetic human growth hormone on insulin action in individual tissues of the rat in vivo.

Excessive endogenous production or exogenous administration of human growth hormone (hGH) causes insulin resistance at both the hepatic and extrahepatic levels. However, which extrahepatic tissues are involved have not been defined. We have examined the diabetogenic action of authentic biosynthetic hGH on whole body glucose disposal, hepatic glucose output, and glucose metabolism in individual peripheral tissues. The use of a highly purified preparation of the hormone allowed us to examine the isolated effects of 22K hGH. The euglycemic hyperinsulinemic (approximately 100 mU/L) clamp plus 3H-2-deoxyglucose technique was used to quantitate the effects of hGH on insulin action in vivo. Administration of biosynthetic hGH at a dose of 10 IU/kg/24 h for 48 hours in male Wistar rats (approximately 340 g) produced a highly significant decrease in the steady state clamp glucose infusion rate (GIR) when compared with controls (8.1 +/- 0.6 v 18.7 +/- 0.7 mg/kg/min, P less than .001), reduced insulin-mediated suppression of hepatic glucose output (Ra) (3.9 +/- 0.6 v 0.7 +/- 0.3 mg/kg/min, P less than .05) and a decreased clamp glucose disposal rate (Rd) (12.0 +/- 0.4 v 18.10 +/- 1.1 mg/kg/min, P less than .001). There was a significant decrease in insulin-mediated glucose uptake as indicated by tissue accumulation of [3H]-2-deoxyglucose phosphorylation in diaphragm and hindlimb muscles. Insulin action was more substantially reduced in muscles (approximately 50%) than in adipose tissues (approximately 20%). These studies confirm that the diabetogenic action of hGH in the rat is due to a combination of inhibition of insulin suppression of hepatic glucose output and inhibition of the uptake and subsequent utilization of glucose in skeletal muscles.

Partial amino acid sequence of osteocalcin from an extinct species of ratite bird.

Osteocalcin the major gamma carboxyglutamic acid containing protein of vertebrate bone has been purified from the bones of a specimen of Pachyornis elephantopus, a species of the extinct class of New Zealand ratite birds, the moas. The sequence of the N-terminal region of moa osteocalcin was determined using gas phase N-terminal sequencing. The N-terminal sequences of the ostrich and rhea osteocalcins were also determined. Alignment of the N-terminal sequence of osteocalcin from the extinct moa against the osteocalcins of the extant ostrich, rhea and emu reveals the homology amongst the ratite species is greater than the homology with the chicken osteocalcin.

Dietary guidelines for prevention of cancer: are they justified?

Although dietary guidelines for reduction of cancer risk have been issued and well publicized, there is still controversy within the scientific community about whether such guidelines are appropriate. Given that the scientific evidence of a causal role for diet in carcinogenesis is suggestive but not conclusive, is it more responsible to promulgate guidelines that might be ineffective or to delay communicating findings to the public until all the evidence is in-a process that could take decades? Because the public is already familiar with guidelines intended to minimize the risk of cancer, how should they be promoted by health professionals given the strength of the evidence on which they are based?