Oral vitamin D3 supplementation for chronic plaque psoriasis: a randomized, double-blind, placebo-controlled trial.

PURPOSE: The management of psoriasis remains a challenge for dermatologist and patient. This study aimed to determine whether vitamin D3 supplementation improves psoriasis compared to placebo. MATERIALS AND METHODS: In a randomized, doubled-blind, placebo-controlled trial, 101 participants ≥18 years with psoriasis were grouped by severity and allocated to 100,000 International Units (IU) vitamin D3/month for 12 months (200,000 IU at baseline; n = 67) or an identical placebo (n = 34). Psoriasis Area and Severity Index (PASI) and serum 25(OH)D concentrations were assessed at 3-monthly intervals. The primary outcome was the difference in PASI between groups over time. The relationship between 25(OH)D and PASI across the sample was also considered in a post hoc analysis. RESULTS: PASI did not differ between groups at any time (group F(1, 104) = 0.48, p = .49; group*time F(4, 384) = 0.26, p = .90). However, 25(OH)D increased in both groups, rendering these findings inconclusive. A significant inverse relationship existed between PASI and 25(OH)D, with elevation of 25(OH)D by up to 125 nmol/L associated with mild decreases in PASI (estimated range of decrease 0-2.6; p = .002). CONCLUSIONS: A direct benefit of vitamin D3 supplementation for psoriasis could not be determined. However, these findings suggest a relationship between 25(OH)D and psoriasis severity, at least in some subgroups. Australian New Zealand Clinical Trials Registry #12611000648921.

The New Zealand PUFA semiquantitative food frequency questionnaire is a valid and reliable tool to assess PUFA intakes in healthy New Zealand adults.

The health benefits of PUFA are well established. There is no valid tool or complete fatty acid database to assess PUFA intake in New Zealand (NZ). This study aimed to develop, validate, and test the reproducibility of a NZ-specific PUFA FFQ. A semiquantitative NZ PUFA FFQ was developed based on a validated Australian PUFA FFQ. The Australian fatty acid database was adapted to include NZ-specific data for major PUFA sources. Healthy participants from Auckland, NZ (n = 48) provided fasting blood samples for erythrocyte PUFA analysis, completed the NZ PUFA FFQ and a 3-d weighed food record (WFR), and repeated the NZ PUFA FFQ 3 mo later (n = 42). Relative validity was evaluated by assessing the triangular relationship among the NZ PUFA FFQ, WFR, and erythrocyte PUFA using the methods of triads [EPA, DHA, total omega-3 (n-3) long-chain (LC) PUFA only] and by comparing, correlating, cross-classifying into quintiles and assessing agreement using Bland-Altman plots of intakes between the NZ PUFA FFQ and WFR. Reproducibility was assessed by comparing and correlating intakes between repeat administrations of the NZ PUFA FFQ. The NZ PUFA FFQ effectively estimated EPA [ρ(QT) = 0.72 (95% CI: 0.49, 0.89)], DHA [ρ(QT) = 0.72 (95% CI: 0.53, 0.95)], and total (n-3) LCPUFA [ρ(QT) = 0.68 (95% CI: 0.47, 0.89)] intakes and was comparable with the WFR for other PUFA except docosapentaenoic acid. Repeated implementation of the NZ PUFA FFQ showed agreement for PUFA intakes. The NZ PUFA FFQ is a valid and reliable tool to measure PUFA intake in healthy NZ adults.

Altering the trajectory of anxiety in at-risk young children.

OBJECTIVE: Increasing evidence for the importance of several risk factors for anxiety disorders is beginning to point to the possibility of prevention. Early interventions targeting known risk for anxiety have rarely been evaluated. The authors evaluated the medium-term (3-year) effects of a parent-focused intervention for anxiety in inhibited preschool-age children. METHOD: The study was a randomized controlled trial of a brief intervention program provided to parents compared with a monitoring-only condition. Participants were 146 inhibited preschool-age children and their parents; data from two or more assessment points were available at 3 years for 121 children. Study inclusion was based on parent-reported screening plus laboratory-observed inhibition. The six-session group-based intervention included parenting skills, cognitive restructuring, and in vivo exposure. The main outcome measures were number and severity of anxiety disorders, anxiety symptoms, and extent of inhibition. RESULTS: Children whose parents received the intervention showed lower frequency and severity of anxiety disorders and lower levels of anxiety symptoms according to maternal, paternal, and child report. Levels of inhibition did not differ significantly based on either parent report or laboratory observation. CONCLUSIONS: This brief, inexpensive intervention shows promise in potentially altering the trajectory of anxiety and related disorders in young inhibited children.

Innovative approaches to reducing nurses' distractions during medication administration.

BACKGROUND: Contributing factors to medication errors include distractions, lack of focus, and failure to follow standard operating procedures. The nursing unit is vulnerable to a multitude of interruptions and distractions that affect the working memory and the ability to focus during critical times. Methods that prevent these environmental effects on nurses can help avert medication errors. METHODS: A process improvement study examined the effects of standard protocols and visible signage within a hospital setting. The project was patterned after another study using similar techniques. Rapid Cycle Testing was used as one of the strategies for this process improvement project. Rapid Cycle Tests have become a part of the newly adopted Define, Measure, Analyze, Improve, and Control steps at this particular hospital. RESULTS: As a result, a medication administration check-list improved focus and standardized practice. Visible signage also reduced nurses' distractions and improved focus. CONCLUSION: The results provide evidence that protocol checklists and signage can be used as reminders to reduce distractions, and are simple, inexpensive tools for medication safety.

Prevention and early intervention of anxiety disorders in inhibited preschool children.

This article reports results from an early intervention program aimed at preventing the development of anxiety in preschool children. Children were selected if they exhibited a high number of withdrawn/inhibited behaviors--one of the best identified risk factors for later anxiety disorders--and were randomly allocated to either a 6-session parent-education program or no intervention. The education program was group based and especially brief to allow the potential for public health application. Children whose parents were allocated to the education condition showed a significantly greater decrease in anxiety diagnoses at 12 months relative to those whose parents received no intervention. However, there were no significant effects demonstrated on measures of inhibition/withdrawal. The results demonstrate the value of (even brief) very early intervention for anxiety disorders, although these effects do not appear to be mediated through alterations of temperament.