The Long-Term Effects of Ethanol and Corticosterone on the Mood-Related Behaviours and the Balance Between Mature BDNF and proBDNF in Mice.

In this study, we aimed to establish the effects of chronic corticosterone (CORT) and ethanol administration on mood-related behaviour and the levels of mature brain-derived neurotrophic factor (mBDNF) and its precursor protein proBDNF in mice. C57BL6 male and female mice received drinking water (n = 22), 1% ethanol in drinking water (n = 16) or 100 µg/ml corticosterone in drinking water (containing 1% ethanol, n = 18) for 4.5 weeks. At the end of experimental protocol, the open field test (OFT) and elevated plus maze test were performed. Brain and adrenal tissues were collected and mBDNF and proBDNF were measured by ELISA assays. We found that the mice fed with corticosterone and ethanol developed anxiety-like behaviours as evidenced by reduced time in the central zone in the OFT compared with the control group. Both proBDNF and mBDNF were significantly decreased in the corticosterone and ethanol groups compared with the control group in the prefrontal cortex, hippocampus, hypothalamus and adrenal. The ratio of proBDNF/mBDNF in prefrontal cortex in the corticosterone group was increased compared with the ethanol group. Our data suggest that the ratio of proBDNF/mBDNF is differentially regulated in different tissues. Ethanol and corticosterone downregulate both mBDNF and proBDNF and alter the balance of proBDNF/mBDNF in some tissues. In conclusion, the ethanol and corticosterone may cause abnormal regulation of mBDNF and proBDNF which may lead to mood disorders.

Secondary analysis of anthropometric data from a South African national food consumption survey, using different growth reference standards.

The National Center for Health Statistics (NCHS) references were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS) of South Africa. Since then, however, The Centers for Disease Control and Prevention (CDC) 2000 reference and the World Health Organization (WHO) 2006 standards were released. It was anticipated that these reference and standards may lead to differences in the previous estimates of stunting, wasting, underweight and obesity in the study population. The aim was to compare the anthropometric status of children using the 1977 NCHS, the 2000 CDC growth references and the 2006 WHO standards. All children 12-60 months of age with a complete set of anthropometric data were included in the analyses. Data for 1,512 children were analysed with SAS 9.1 for Windows. A Z-score was calculated for each child for weight-for-age (W/A), weight-for-length/height (W/H), length/height-for-age (H/A) and body mass index (BMI)-for-age, using each of the three reference or standards for comparison. The prevalence of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the WHO standards compared to the NCHS and the CDC references. The higher than previously established prevalence of stunting at 20.1% and combined overweight/obesity at 30% poses a challenge to South African policy makers to implement nutrition programmes to decrease the prevalence of both stunting and overweight. The 2006 WHO growth standard should be the standard used for assessment of growth of infants and children younger than 5 years in developing countries.

The prevalence of dietary-related complementary and alternative therapies and their perceived usefulness among cancer patients.

BACKGROUND: The present study aimed to directly assess and compare the usage, benefits and side-effects of dietary-related complementary and alternative medicine (CAM) use among adult cancer patients and non-cancer adults in Norwich, UK. METHODS: Self-administered questionnaires were completed by 98 cancer patients and 92 non-cancer adults to compare demographics, types of CAM usage with reasons, benefits, side-effects and CAM information sources. The groups were matched for gender, age, marital status, education and household income. The mean ages were 62.7 and 59.7 years, respectively, with slightly more female than male participants. RESULTS: CAM use was high in both groups (47% in cancer and 53% in non-cancer respondents, P > 0.05). The most widely-used diet-related CAM among both groups was the large intake of fruit, vegetables and juice, multivitamins, fish oils and glucosamine. Fish oil intake was significantly higher in the non-cancer group (P < 0.05), whereas selenium and beta-carotene supplements were significantly higher in the cancer group (P < 0.01 and P = 0.02, respectively). The main reasons for using CAM were to boost the immune system and to improve quality of life (P > 0.05). Reported benefits included increased optimism and hope for the cancer group and increased optimism and pain relief for the non-cancer group. CONCLUSIONS: Diet-related CAM is used frequently by both cancer patients and non-cancer adults, with many reported benefits and few reported side-effects. Significant differences between the groups included a higher prevalence of fish oil used by the non-cancer group, and a higher use of selenium and beta-carotene supplements in the cancer group.

Consumer Testing of the Preliminary Paediatric Food-Based Dietary Guidelines (PFBDG) Among Mothers with Infants Younger Than 6 Months in Selected Urban and Rural Areas in the Western Cape

Aim: To determine the comprehensibility of the preliminary paediatric food-based dietary guidelines (PFBDG) for infants younger than 6 months in South Africa.Methods: This qualitative study used focus group discussions held in the Western Cape to evaluate the comprehensibility and the understandability of the preliminary PFBDG. Groups were convened according to area of residence (rural; urban formal and urban informal) and ethnicity (white; coloured and black) to reflect the Western Cape population. Focus group discussions were conducted in the participant's home language; namely Afrikaans; eng or Xhosa. The purposive sample included 89 women with infants younger than 6 months divided in 20 groups.Results: In general; mothers understood the guidelines and could reportedly implement them; but constraints such as having to go back to work; being tired and not having enough breast-milk were volunteered. There were very few problems regarding the PFBDG terminology except with the word 'regularly' in the context of the oral hygiene guideline. With regard to the breast-feeding guideline there was some confusion over whether other foods could be included while breast-feeding. Suggestions were made to include 'only' in the breast-feeding guideline. Some of the participants did not know anything about cleaning the infant's mouth; and suggested it be changed to the overall hygiene of the infant. Conclusion: The findings from this study indicate that it may be possible to use one set of dietary guidelines for infants younger than 6 months for all ethnic groups living in the Western Cape; provided that these guidelines are accompanied by supportive documentation citing examples and reasons for the implementation of the guidelines. ecommendations were made for the PFBDG Work Group to revise the preliminary PFBDG for infants younger than 6 months for implementation and further action

Development of the South African renal exchange lists

Objective: The objective of this developmental study was the development of renal exchange lists for the South African population with renal failure.Subjects and design: A questionnaire was circulated to South African renal dietitians to establish the format and composition of the proposed exchange lists. Foodfinder 3 was used for assessment of nutrient composition of foods; and the NRIND Food Quantities Manual was used for assessment of portion sizes. Results from the Food Consumption Study were used to identify food items frequently consumed by the South African population; and dietitians with knowledge of the eating habits of Moslem; Indian; white; black and coloured groups were consulted regarding the inclusion of cultural foods. Portion sizes were determined by protein content of foods. The preliminary exchange lists were circulated for comment and tested for a period of 1 year. Results: Many new food items were added during revision of the exchange lists. Portion sizes were adapted to be more realistic; and in some cases additional sub-groups were added. Foodfinder 3 and renal exchange list values for all food items included in the exchange lists were then compared; and this showed highly significant correlations for all nutrients concerned. There was no significant difference between mean nutrient values for the two methods; with the exception of protein; the content of which was consistently and significantly underestimated by a mean of 0.1 g per food item. This underestimation is not considered to be of clinical importance. Conclusion: In this study renal exchange lists were developed for use in South African persons with renal failure. Despite the small but significant underestimation of protein content; the lists appear to be of sufficient precision for use in clinical practice

Nutritional management of chronic renal failure by dietitians - the South African experience

Objective: The objective of this descriptive study was to assess the practices of South African dietitians regarding the dietary treatment of patients with chronic renal failure. Subjects and design: A questionnaire was mailed to 600 randomly selected dietitians registered with the Health Professions Council of South Africa. Practices were compared to international standards for pre-dialysis; haemodialysis (HD) and peritoneal dialysis (PD) patients. Results: A 26 response rate was obtained; with only 28 of these dietitians indicating that they counsel renal patients. The majority of dietitians met the international dietary recommendations; but a substantial number deviated from them. This was especially evident in PD patients; where the deviation ranged from 20 (4 dietitians) in the case of energy and phosphate; to 55 (11 dietitians) in the case of calcium. Parameters used for the assessment of nutritional status included body mass index (45of dietitians); serum albumin (44); clinical examinations (43); bioelectrical impedance (37) and diet history (36). Methods used to monitor dietary compliance included biochemistry; dietary history; anthropometric measurements and clinical investigation. The most frequently used approaches in the management of protein-energy malnutrition included supplemental drinks (86) and dietary enrichment at household level (76). Conclusion: Although the majority of dietitians met international standards for most nutrients; there was some variation and uncertainty. Ongoing education will enable South African dietitians to treat renal patients competently and with confidence

Nutritional status of renal transplant patients.

OBJECTIVE: To assess the effect of renal transplantation on the nutritional status of patients. DESIGN: Prospective descriptive study. SETTING: Renal Transplant Clinic at Tygerberg Hospital, Western Cape. SUBJECTS: Fifty-eight renal transplant patients from Tygerberg Hospital were enrolled in the study. The sample was divided into two groups of 29 patients each: group 1, less than 28 months post-transplant; and group 2, more than 28 months post-transplant. OUTCOME MEASURES: Nutritional status assessment comprised biochemical evaluation, a dietary history, anthropometric measurements and a clinical examination. RESULTS: Serum vitamin B6 levels were below normal in 56% of patients from group 1 and 59% from group 2. Vitamin B6 intake, however, was insufficient in only 14% of patients from group 1 and 10% from group 2. Serum vitamin C levels were below normal in 7% of patients from group 1 and 24% from group 2, while vitamin C intake was insufficient in 21% and 14% of patients from groups 1 and 2 respectively. Serum magnesium levels were below normal in 55% of patients from group 1, and in 28% from group 2. Serum albumin and cholesterol levels increased significantly during the post-transplant period in the total sample (P = 0.0001). There was also a significant increase in body mass index (P = 0.0001) during the post-transplant period. CONCLUSIONS: Several nutritional abnormalities were observed, which primarily reflect the side-effects of immunosuppressive therapy. The causes, consequences and treatment of the vitamin B6 and vitamin C deficiencies in renal transplant recipients need further investigation.

Protein-energy malnutrition as a risk factor for increased morbidity in long-term hemodialysis patients.

This prospective nonintervention single-center study was undertaken to investigate the role of protein-energy malnutrition (PEM) as a risk factor for morbidity in patients on long-term hemodialysis. Thirty-seven patients from the renal unit of Tygerberg Hospital, Tygerberg, South Africa, were studied for a mean period of 26 months. Morbidity was the main outcome and was defined as the number of hospitalizations and days of hospitalization per patient per year. Investigations included 4-monthly determinations of interdialytic protein catabolic rate (PCR), dietary intake of protein and energy, blood levels of albumin and urea, lymphocyte count, adequacy of dialysis (Kt/V), body weight, intradialytic weight loss, fat mass (FM), fat-free mass (FFM), body mass index (BMI), and bone-free arm muscle area (BF-AMA). A PEM composite score was derived from postdialysis serum albumin, BF-AMA, FM, FFM, and BMI. All-cause morbidity as defined by number of hospitalizations (see text for other definitions of morbidity) showed a significant correlation with the mean and baseline PEM score (P <.01), and a negative correlation with predialysis and postdialysis serum albumin (P <.05) and age (P <.05). There was no significant relationship with PCR, percentage intradialytic weight loss, Kt/V, reuse of dialyzer, period on maintenance hemodialysis, sex, race, and type of dialyzer membrane. When "only infection-related" morbidity was considered, the factors that showed a significant correlation were the mean (P <. 001) and baseline PEM score (P <.01), and percentage intradialytic weight loss (P <.01). There was no significant deterioration in the nutritional status of patients followed up for at least 24 months. It is concluded that infection-related morbidity was associated most strongly with the PEM score and the percentage intradialytic weight loss. The results suggest that PEM is one of the important contributing factors to morbidity, possibly via an effect on the immune system and infection.

Effects of bovine somatotropin and ruminally undegraded protein on feed intake, live weight gain, and mohair production by yearling Angora wethers.

Yearling Angora wethers (n = 24; 24+/-1.0 kg BW) were used in an experiment with a 2 x 2 factorial arrangement of treatments to investigate effects of bovine somatotropin (bST) treatment and dietary level of ruminally undegraded protein on DMI, ADG, and mohair production. Untreated casein (UC) or casein treated with formaldehyde (TC) was included at 7% DM of a diet containing 11% CP and 46% concentrate. A slow-release bST form was administered weekly to deliver 0 (Control) or 100 microg/ (kg BW.d) of bST. Plasma concentrations of bST and IGF-I were increased (P < .05) during the 7-d period following bST injection. Ruminal fluid ammonia N concentration was lower (P < .01) for TC than for UC before feeding (6.6 vs 7.5 mg/dL) and 4 h later (8.2 vs 12.2 mg/dL), and total VFA concentration was lower (P < .01) for TC than for UC. Treatment with bST decreased (P = .08) DMI with UC (1.15 vs .91 kg/d) and increased (P = .08) DMI with TC (.95 vs 1.06 kg/d). Formaldehyde treatment of casein increased ADG (65, 74, 55, and 91 g/d; P = .03) and clean fleece production (P < .01; 14.1, 17.3, 15.0, and 18.4 g/d for UC-Control, TC-Control, UC-bST, and TC-bST, respectively), with no effect of bST during the 8-wk period of treatment or for the 8 wk thereafter (P > .10). In conclusion, with yearling Angora wethers, bST does not seem useful to enhance mohair production and may not alter effects of dietary level of ruminally undegradable protein on mohair production.

Heat energy for growing goats and sheep grazing different pastures in the summer.

Angora goat, Spanish goat, and Suffolk x Rambouillet sheep wethers (20 of each type; 30.4+/-.57, 31.3+/-.93, and 32.4+/-1.08 kg BW for Angora goats, Spanish goats, and sheep, respectively) were used to investigate influences of animal type and two grass-based pasture treatments on heat energy during summer grazing (mid-August through September in Oklahoma). The improved pasture treatment consisted of .7-ha paddocks primarily of Old World bluestem and johnsongrass, whereas the native pasture treatment entailed 10.8-ha paddocks dominated by big and little bluestems and indiangrass. Grasses were 95 to 100% of diets for the improved pasture treatment and 71 to 95% for the native pasture treatment; forbs were 2 to 25%, and shrubs were less than 4% of diets for the native pasture treatment. Metabolizable energy intake was similar (P > . 10) between pasture treatments but differed (P <.01) among animal types: 79, 99, and 113 kcal/(kg(.75) BW.d) for Angora goats, Spanish goats, and sheep, respectively; SE 7.1. Heat energy estimated via CO2 entry rate was affected by pasture treatment ( P = .08) and animal type (P < .001): improved pasture treatment 109, 132, and 151 kcal/(kg(.75) BW.d); native pasture treatment 126, 138, and 163 kcal/(kg(.75) BW.d) for Angora goats, Spanish goats, and sheep, respectively. Likewise, daylight grazing time was greater (P = .04) for the native than for the improved pasture treatment and differed (P < .01) among animal types: improved pasture treatment 5.3, 4.7, and 6.7 h; native pasture treatment 6.0, 5.7, and 8.1 h for Angora goats, Spanish goats, and sheep, respectively. In conclusion, heat energy during summer grazing of grass-based paddocks was less for goats than for sheep, and animal type can affect the increase in heat energy as energy intake and grazing time increase.

The effect of bovine somatotropin treatment on production of lactating angora does with kids.

Fourteen Angora does (35+/-2 kg), each with a single kid and in the first month of lactation, were used to determine ongoing (Period 1) and residual (Period 2) effects of chronic bovine somatotropin (bST) treatment. Specifically, we sought to determine whether chronic bST treatment was capable of improving milk yield, and thus kid growth, and mohair production of nursing does. The experiment consisted of a 2-wk pretreatment period, 5 wk of weekly subcutaneous treatment of slow-release bST (n = 7; Period 1), and a 4-wk posttreatment period (Period 2). The weekly dose of bST was calculated to release 100 microg/(kg BW.d(-1)). To estimate milk production, kids were separated from the does daily for 5 h, and their BW was recorded before and after suckling. The difference in BW was taken as milk production for 5 h. Fiber growth was measured by shearing does at the start of the experiment and at the end of Periods 1 and 2. Dry matter intake and BW of does were not affected by bST (P>.05). Average daily gain of kids that were suckling bST-treated does was higher (P<.05) than for kids of untreated does during Period 1 (184 vs. 139 g/d) but not during Period 2 (140 vs. 136 g/d; P>.10). Treatment with bST did not affect (P>.10) milk composition or clean fleece production in either period. Injection of bST did not affect (P>.10) plasma concentrations of glucose (mean = 49.5 mg/dL), urea N (mean = 19 mg/dL), total protein (mean = 72.5 g/d), or NEFA (mean = 122 microEq/L). During the period of bST treatment, plasma concentrations of somatotropin and IGF-I were increased (P<.05), concentrations of thyroxine and cortisol were decreased (P<.10), and plasma insulin levels were unchanged (P>.10) by bST. In conclusion, treatment of Angora dams with bST did not change DMI or mohair growth, but it improved growth of their kids.

Energy expenditure by dry and lactating Alpine does estimated by entry rate of carbon dioxide.

Four dry and four lactating (wk 6 of lactation) Alpine does [50.5 +/- 2.2 and 45.9 +/- 2.2 kg of initial body weight (BW), respectively] that consumed a 67% alfalfa diet for ad libitum intake were used 1) to compare estimates of CO2 entry rate (via continuous infusion of NaH13CO3 into the peritoneum) based on continuous saliva collection with simpler, more reliable, and less laborious sampling of urine, serum, or breath; 2) to determine effects of lactation state on CO2 entry rate and total heat production, and 3) to compare three published equations used to predict total heat production (megajoules per kilogram of BW0.75) from CO2 entry rate (liters of CO2 per kilogram of BW0.75) based on saliva samples. The entry rate of CO2 calculated from 13CO2 concentration in saliva was less variable than that determined from urine, serum, or breath samples (SE = 2.0, 4.7, 4.2, and 5.6 L/kg of BW0.75 per d, respectively); therefore, saliva samples were used to estimate total heat production. The entry rate of CO2 was 34% greater for lactating does than for dry does. Total heat production calculated from each equation was linearly related to metabolizable energy intake. Estimated heat production during feed deprivation was 0.196, 0.431, and 0.311 MJ/kg of BW0.75 per d, and estimated metabolizable energy used for maintenance was 475, 755, and 818 kJ/kg of BW0.75 per d for the three published equations. In conclusion, saliva appeared to be more suitable to estimate CO2 entry rate than did urine, serum, or breath; CO2 entry rate was appreciably greater for lactating does than for dry does; and published equations to predict total heat production from CO2 entry rate warrant careful consideration.

Supplemented low-protein diets--are they superior in chronic renal failure?

Twenty-two patients with chronic renal failure were randomly assigned to a conventional low-protein diet containing 0.6 g protein/kg/day or a very-low-protein diet containing 0.4 g protein/kg/day supplemented with essential amino acids; they were followed up for 9 months. There were no significant changes in body mass index, arm muscle area, percentage body fat, serum albumin and transferrin levels in any of the groups; neither was there any difference between the groups in respect of these parameters. Renal function, as measured by the reciprocal of serum creatinine over time, stabilised in both groups during intervention, with no significant difference between the groups. There was however no correlation between changes in renal function and changes in blood pressure, or dietary intake of protein, phosphorus, cholesterol, polyunsaturated and saturated fatty acids. There were also no significant changes and no significant differences between the groups in serum levels of parathyroid hormone and alkaline phosphatase, urine cyclic adenosine monophosphate, tubular reabsorption of phosphate, and the theoretical renal threshold for phosphate. The results of this study suggest that the supplemented very-low-protein diet was not superior to the conventional low-protein diet in terms of its effect on protein-energy status, renal function and biochemical parameters of renal osteodystrophy.

[The change from a territorial nursing service design to a matrix nursing service design]. / Die verandering van'n territoriale verpleegdiensontwerp na'n matriksverpleegdiensontwerp.

In this study two decentralised organisational designs in nursing management were investigated. The purpose of the study was to investigate the effect of two different designs, namely the territorial and matrix designs, on the attitudes and perceptions of nurses towards their work. An explorative descriptive multi-phase study was conducted. The attitudes and perceptions of nurses were assessed by means of the Michigan Organisational Assessment Scale, during the territorial design and after changing to a matrix design. An analysis of the data showed a positive and statistically significant change in attitudes and perceptions in the matrix design, and therefore the directional hypothesis was accepted. Recommendations include further refinement of the matrix design, as well as training and accompaniment of nurse managers to implement the principles.