Culinary nutrition course equips future physicians to educate patients on a healthy diet: an interventional pilot study.

BACKGROUND: Poor-quality diet is associated with one in five deaths globally. In the United States, it is the leading cause of death, representing a bigger risk factor than even smoking. For many, education on a healthy diet comes from their physician. However, as few as 25% of medical schools currently offer a dedicated nutrition course. We hypothesized that an active learning, culinary nutrition experience for medical students would improve the quality of their diets and better equip them to counsel future patients on food and nutrition. METHODS: This was a prospective, interventional, uncontrolled, non-randomized, pilot study. Ten first-year medical students at the Wayne State University School of Medicine completed a 4-part, 8-h course in culinary-nutritional instruction and hands-on cooking. Online assessment surveys were completed immediately prior to, immediately following, and 2 months after the intervention. There was a 100% retention rate and 98.8% item-completion rate on the questionnaires. The primary outcome was changes in attitudes regarding counselling patients on a healthy diet. Secondary outcomes included changes in dietary habits and acquisition of culinary knowledge. Average within-person change between timepoints was determined using ordinary least squares fixed-effect models. Statistical significance was defined as P ≤ .05. RESULTS: Participants felt better prepared to counsel patients on a healthy diet immediately post-intervention (coefficient = 2.8; 95% confidence interval: 1.6 to 4.0 points; P < .001) and 2 months later (2.2 [1.0, 3.4]; P = .002). Scores on the objective test of culinary knowledge increased immediately after (3.6 [2.4, 4.9]; P < .001) and 2 months after (1.6 [0.4, 2.9]; P = .01) the intervention. Two months post-intervention, participants reported that a higher percentage of their meals were homemade compared to pre-intervention (13.7 [2.1, 25.3]; P = .02). CONCLUSIONS: An experiential culinary nutrition course may improve medical students' readiness to provide dietary counselling. Further research will be necessary to determine what effects such interventions may have on the quality of participants' own diets.

A pilot study of the association between sleep disturbance in children with liver transplants and parent and family health-related quality of life.

OBJECTIVE: To investigate the relationship between sleep disturbance in children with liver transplants and parent and family health-related quality of life (HRQOL). METHOD: 47 parents of children with liver transplants completed measures of child sleep and family HRQOL. Relationships between sleep and HRQOL and differences in HRQOL between groups with scores above and below the cutoff on a pediatric sleep measure were examined. RESULTS: Parents endorsed higher rates of sleep-related breathing disorder (SRBD) and restless legs syndrome and periodic limb movements during sleep (RLS/PLMS) and lower HRQOL compared with published data. Significant correlations were found between SRBD and RLS/PLMS and HRQOL, and significant group differences in HRQOL were found between groups above and below the cutoff for behavior problems and RLS/PLMS. CONCLUSION: There are significant relationships between symptoms of SRBD and RLS/PLMS in children with liver transplants and family HRQOL. Behavior problems may account for these strong relationships.

Modeling interindividual differences in spontaneous internal desynchrony patterns.

A physiologically based mathematical model of a putative sleep-wake regulatory network is used to investigate the transition from typical human sleep patterns to spontaneous internal desynchrony behavior observed under temporal isolation conditions. The model sleep-wake regulatory network describes the neurotransmitter-mediated interactions among brainstem and hypothalamic neuronal populations that participate in the transitions between wake, rapid eye movement (REM) sleep, and non-REM (NREM) sleep. Physiologically based interactions among these sleep-wake centers and the suprachiasmatic nucleus (SCN), whose activity is driven by an established circadian oscillator model, mediate circadian modulation of sleep-wake behavior. When the sleep-wake and circadian rhythms are synchronized, the model simulates stereotypically normal human sleep-wake behavior within the limits of individual variation, including typical NREM-REM cycling across the night. When effects of temporal isolation are simulated by increasing the period of the sleep-wake cycle, the model replicates spontaneous internal desynchrony with the appropriate dependence of multiple features of REM sleep on circadian phase. In temporal isolation experiments, subjects have exhibited different desynchronized sleep-wake behaviors. Our model can generate similar ranges of desynchronized behaviors by variations in the period of the sleep-wake cycle and the strength of interactions between the SCN and the sleep-wake centers. Analysis of the model suggests that similar mechanisms underlie several different desynchronized behaviors and that the phenomenon of phase trapping may be dependent on SCN modulation of REM sleep-promoting centers. These results provide predictions for physiologically plausible mechanisms underlying interindividual variations in sleep-wake behavior observed during temporal isolation experiments.