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CVD and associated metabolic diseases are linked to chronic inflammation, which can be modified by diet. The objective of the present study was to determine whether there is a difference in inflammatory markers, blood metabolic and lipid panels and lymphocyte gene expression in response to a high-fat dairy food challenge with or without milk fat globule membrane (MFGM). Participants consumed a dairy product-based meal containing whipping cream (WC) high in saturated fat with or without the addition of MFGM, following a 12 h fasting blood draw. Inflammatory markers including IL-6 and C-reactive protein, lipid and metabolic panels and lymphocyte gene expression fold changes were measured using multiplex assays, clinical laboratory services and TaqMan real-time RT-PCR, respectively. Fold changes in gene expression were determined using the Pfaffl method. Response variables were converted into incremental AUC, tested for differences, and corrected for multiple comparisons. The postprandial insulin response was significantly lower following the meal containing MFGM (P < 0·01). The gene encoding soluble epoxide hydrolase (EPHX2) was shown to be more up-regulated in the absence of MFGM (P = 0·009). Secondary analyses showed that participants with higher baseline cholesterol:HDL-cholesterol ratio (Chol:HDL) had a greater reduction in gene expression of cluster of differentiation 14 (CD14) and lymphotoxin β receptor (LTBR) with the WC+MFGM meal. The protein and lipid composition of MFGM is thought to be anti-inflammatory. These exploratory analyses suggest that addition of MFGM to a high-saturated fat meal modifies postprandial insulin response and offers a protective role for those individuals with higher baseline Chol:HDL.
There is international interest in the training of psychological therapists to deliver evidence-based treatment for common mental health problems. The UK Improving Access to Psychological Therapies (IAPT) programme, one of the largest training initiatives, relies on competent therapists to successfully deliver cognitive behaviour therapy (CBT) and promote good patient outcome.
To evaluate an IAPT CBT training course by assessing if trainees’ clinical skills improve during training and reach competency standards, and to report patient outcome for submitted training cases. To investigate a possible relationship between trainee competence and patient outcome. To explore professional differences during training.
CBT trainee (n = 252) competence was assessed via audio recordings of therapy sessions at the beginning, middle and end of training. Patient pre- to post-treatment outcomes were extracted from submitted training cases (n = 1927). Differences in professional background were examined across competence, academic final grade and tutorial support.
CBT trainees attained competence by the end of the course with 77% (anxiety recordings) and 72% (depression recordings) improving reliably. Training cases reported pre- to post-treatment effect sizes of 1.08–2.26 across disorders. CBT competence predicted a small variance in clinical outcome for depression cases. Differences in professional background emerged, with clinical psychologists demonstrating greater competence and higher academic grades. Trainees without a core professional background required more additional support to achieve competence.
Part of a new CBT therapist workforce was successfully trained to deliver relatively brief treatment effectively. Trainees without a core profession can be successfully trained to competence, but may need additional support. This has implications for workforce training.
A time dependent x-ray diagnostic technique based on the fast rise time characteristics of unitary crystals is demonstrated, and a correction for decay time is determined for anthracene crystals. The method has a probable time resolution capability better than 10 picoseconds. The shape of the x-ray pulse emitted by laser-generated plasmas is measured by this method and found to be similar to the shape of the laser pulse for laser pulse widths of 1.5-3.5 nanoseconds.
Introduction: To describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: Retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over 6 years (2010-2016). Primary data analyses included dosing and duration of infusion, rates of pre- and post-infusion analgesic administration, and final diagnoses. Secondary data included pre- and post-infusion pain scores and rates of side effects. Results: 104 patients were enrolled in the study. Average dosing of ketamine infusion was 11.26 mg/hr, the mean duration of infusion was 135.87 minutes with 38% increase in patients not requiring post-infusion analgesia. The average decrease in pain score was 5.04. There were 12 reported adverse effects with nausea being the most prevalent. Conclusion: Continuous intravenous SDK infusion has a role in controlling pain of various etiologies in the ED with a potential to reduce need for co-analgesics or rescue analgesic administration. There is a need for more robust, prospective, randomized trials that will further evaluate the analgesic efficacy and safety of this modality across wide range of pain syndromes and different age groups in the ED.
To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes.
Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as ‘healthy’ or ‘unhealthy’ using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson’s correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes.
Rural AI reservations and AN villages.
AI/AN (n 2484) with type 2 diabetes.
Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β=0·078, P=0·0007; males: β=0·139, P<0·0001).
Health professionals working with AI/AN diagnosed with type 2 diabetes should offer food choice strategies during difficult times and recognize that males may be more likely than females to select unhealthy foods when distressed.
We support John Doris's criticism of “reflectivism” but identify three shortcomings: (1) his neglect of humans' evolved predispositions and tendencies, (2) his failure to appreciate that identity and responsibility arise first from parsing our world ontologically, in a process we call “existential framing,” and (3) a potentially alarming implication of his “dialogic” model of identity formation: if identity is negotiated across diverse social situations, why isn't dissociative identity disorder more common?
Wet feeding beneficially affects feed intake and growth rates of poultry in hot climates (Forbes 2003). Fermenting liquid feeds for pigs has been shown to reduce microbial contamination of the feed (Beal et al., 2002) and this could be an added advantage in hot climates. The most desired property of fermented feed is a high lactic acid concentration produced by lactic acid bacteria (LAB) as the fermenting organisms. This high lactic acid concentration resulting in a low pH is responsible for the antimicrobial activity of fermented feeds. This activity is important for food and environmental safety. Grain sorghum is widely used as a food and animal feed cereal in many parts of Africa, Asia and the semi-arid tropics world-wide. It is recognised that differences in the colour of sorghum varieties are due mainly to their concentration of polyphenol compounds mainly tannins. These compounds have some antimicrobial properties and may affect the activity of lactic acid bacteria used to ferment liquid feeds. Little is known about the lactic acid fermentation of sorghum grain for fermented feeds in monogastric nutrition. The present study was designed to compare the fermentation of red and white sorghum with LAB for inclusion as a component of poultry diets.
Due to the practical advantages of fermenting the carbohydrate-rich cereal component of fermented feeds separately and combining it with the protein-rich components just before feeding (Beal et al., 2005; Moran et al., 2006), it is desirable to have a high lactic acid concentration in the fermented cereal component so as to minimise the dilution effect on the acid concentration and pH of the feed when mixed with the protein-rich component at feeding. With the same cereal substrate and lactic acid bacteria (LAB), a key factor that might influence lactic acid production is the particle sizes produced at milling which could affect the amount of sugars available for microbial enzymatic fermentation. Further more, Anguita et al. (2006) indicated that technological processing of ingredients promotes higher starch hydrolysis in addition to increasing the amount of soluble non-starch polysaccharides and modifications in the physicochemical properties depending on the nature of the feed ingredients. The present study was designed to investigate the effect of particle size on fermentation of sorghum for poultry feed.
The large storage proteins of soya bean, glycinin and pconglycinin are relatively indigestible in their native state. Even when partially denatured by heat treatments these proteins may not be utilised fully by young pigs. Glycinin in particular has been implicated in causing immune hypersensitivity reactions that can lead to gut damage. Partial hydrolysis of these large proteins may increase their digestibility and improve the nutritional value of both raw and heat treated soya bean meals. The increased protein digestibility in humans of fermented soya foods compared with soya bean flour has been attributed to partial proteolysis by microbial proteases produced by the fermenting organisms. The objective of this study was to assess the proteolytic action of a microbial protease P#4 (Finnfeeds International Marlborough) on raw and autoclaved soya with a view to its inclusion into liquid diets for grower/finisher pigs.
Increasing scientific awareness of health and production promoting intestinal bacteria has enhanced the use of probiotic bacteria as active functional ingredients in animal and human nutrition. Strict selection criteria, suggested by Edens (2003), for potential probiotics in order to achieve well established and positive probiotic effects have been engaged, including the safety for the host and the capacity of the strains to be viable as well as metabolically active within the gastrointestinal tract (GI). In vitro methods have been used for screening potential probiotic strains using a dynamic model that mimics in vivo GI conditions as closely as possible. The objective of this study was to isolate, characterise and further select beneficial lactobacillus strains in an attempt to predict candidates that could be used in vivo as chicken probiotic adjuncts.
Attempts to improve nutrient utilization by the incorporation of proteolytic enzymes into dry diets for pigs have met with limited success (Dierick and Decuypere 1994) Liquid feeding provides an ideal environment for optimizing the action of feed additive enzymes, and an opportunity to pre-treat individual dietary components. Raw soya has a poor nutritive value and there is potential for improving the nutritional status by partial hydrolysis of native proteins that largely resist mammalian digestive tract enzymes. Such enzyme treatments may also improve protein availability in cooked soya. The objective of this experiment was to assess the effectiveness of pre-treating raw and autoclaved soya with a microbial protease on the growth performance of grower/finisher pigs.
The assessment of the potential usefulness of enzymes as animal feed additives or treatments requires an understanding not only of the effect an enzyme has on its target substrate but also on the digestibility of that substrate. In vivo digestibility studies are expensive, time consuming and often involve invasive procedures that necessitate premature slaughtering of experimental animals. Preliminary laboratory screening methods can be used to indicate potential beneficial treatments prior to undertaking animal trials. The objective of this study was to assess the effect of protease pre-treatment of four differently processed soyabean meals on the digestibility of protein using an in vitro digestibility of nitrogen (Boisen and Fernandez 1997) technique as a screening method. The assumption implicit in this objective was that, if protease pre-treatment did not improve in vitro digestibility, it was unlikely to improve in vivo digestibility.
Contamination of pig feed with enteric pathogens such as salmonellae has implications for the dissemination of salmonellosis in pigs and subsequent spread of these organisms through the food chain to humans. Liquid feed has the potential to be a vector for enteropathogens unless it is sterilised. However, if liquid feed is fermented with lactic acid bacteria (LAB), the production of lactic acid and consequent reduction in pH have an antimicrobial effect that can eliminate potential pathogens from the feed. The objective of this study was to determine whether the temperature at which fermented liquid feed (FLF) is fermented and maintained and the length of fermentation time affect the ability of Salmonellae to survive in the feed.
Much of the phosphorus in feed ingredients is unavailable to the pig because it is locked up in phytic acid and phytates, which the pig cannot digest. Raw ingredients that have not been heat-treated contain endogenous phytases which can be activated by steeping in water prior to inclusion in liquid feed for pigs. This results in an increase in soluble phosphorus due to the hydrolysis of phytic acid and phytates, and hence an increase in the phosphorus available to the pig. However, with heat-treated ingredients such as soyabean meal (SBM) endogenous enzymes are destroyed during processing. In liquid feed systems steeping combinations of raw materials may have an advantageous affect on the availability of phosphorus as the endogenous phytases of the cereal component of the diet may hyrolyse phytates present in SBM. In wheat the phytate phosphorus and phytase is concentrated in the aleurone layer of the grain (Eeckhout and De Paepe 1994). Therefore, the addition of wheatfeed to liquid feed may increase the amount of endogenous wheat phytase present and hence the amount of soluble P released during steeping. The amount of phosphorus that is available to the pig from these raw ingredients is 30%, 42% and 66% of the total phosphorus for SBM, wheat and wheatfeed respectively (Ewing 1997). The objective of this study was to determine the effect of steeping SBM with wheat, wheatfeed or a combination of the two on the release of soluble phosphorus.
There is a considerable body of information on the voluntary feed intake of pigs fed on dry diets. However, there is a paucity of information on the factors affecting feed intake of pigs fed liquid diets. Pigs have a limit to their volumetric intake and will normally maximise dry matter intake when fed dry diets, ad libitum. For pigs fed dry feed the requirement for water per unit of dry matter will be dependent upon the composition of the feed and the requirement for renal clearance of nitrogen and minerals. What is not clear, is whether presenting the feed mixed with water results in excessive water intake that produces a point loading of the stomach, which in turn limits voluntary feed intake, i.e. whether physical bulk limitations override the normal homeostatic control. Therefore, it is not possible to extrapolate from data generated with dry fed pigs and anticipate voluntary intake of pigs fed dilute liquid diets. The aim of this study was to determine the effect of dry matter concentration of liquid feed on feed intake and growth performance of grower-finisher pigs.
The control of enteropathogens at farm level is an important aspect of food safety. Contamination of poultry carcasses and eggs with human enteropathogens such as Salmonella spp and Campylobacter spp and subsequent dissemination through in the food chain continues to be a public health concern. In pigs, surveillance studies have shown that feeding liquid diets, and particularly fermented liquid diets reduces the incidence of Salmonella positive herds. Liquid pig feed fermented with lactic acid bacteria for 24 h at 30°C contains ca 200 mMol L-1 of lactic acid and has a pH of 3.8-4.0. This renders the feed resistant to contamination by potential pathogens and, when challenged with high doses of Salmonella or E. coli these organisms are rapidly eliminated from the feed (Beal et al 2002). Feeding fermented liquid feed (FLF) to pigs lowers the gastric pH to 4 or less, reduces the coliform population and increases the lactic acid bacteria: coliform ratio (LAB: Coli) in the gut (van Winsen et al 2001, Scholten et al 2002). The objective of this study was to determine if similar beneficial effects on the gut microflora could be achieved in poultry fed fermented mash diets.