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Whole grain cereal breakfast consumption has been associated with beneficial effects on glucose and insulin metabolism as well as satiety. Pearl millet is a popular ancient grain variety that can be grown in hot, dry regions. However, little is known about its health effects. This study investigated the effect of a pearl millet porridge (PMP) compared with a well-known Scottish oats porridge (SOP) on glycaemic, gastrointestinal, hormonal and appetitive responses. In a randomized, two way crossover trial, 26 healthy participants consumed two iso-energetic/volumetric PMP or SOP breakfast meals, served with a drink of water. Blood samples for glucose, insulin, GLP-1, GIP and PYY, gastric volumes and appetite ratings were collected for two hours postprandially, followed by an ad libitum meal and food intake records for the remainder of the day. The incremental area under the curve (iAUC2h) for blood glucose was not significantly different between the porridges (p ˃ 0.05). The iAUC2h gastric volume was larger for PMP compared with SOP (p = 0.045). The iAUC2h GIP concentration was significantly lower for PMP compared with SOP (p = 0.001). Other hormones and appetite responses were similar between meals. In conclusion, this study reports, for the first time, data on glycaemic and physiological responses to a pearl millet breakfast, showing that this ancient grain could represent a sustainable, alternative, with health-promoting characteristics comparable to oats. GIP is an incretin hormone linked to triacylglycerol absorption in adipose tissue, therefore the lower GIP response for PMP may be an added health benefit.
The feeding of high fibre diets to sows prior to ovulation has been shown to have beneficial effects on embryo viability, leading to a possible increase in piglet litter size. This trial was conducted to look at the effect of feeding sows a high fibre diet from mid lactation until breeding on subsequent litter size on a commercially run farm. The sows used were either Large White or Large White x Landrace in genotype and ranged from parity 1 to 7. The sows were allocated to receive either a cereal-based control diet (C), or a high fibre diet (HF) of similar specification but containing unmolassed sugar beet pulp (USBP) at a 20% inclusion rate during lactation and 40% from weaning to oestrus. The diets were fed from day 11 of lactation until oestrus. The sows were inseminated at oestrus and then fed a standard gestation diet until farrowing. The trial was conducted over a 3-month period and in total 198 sows received the HF diet with the rest of the sows over the 3-month period acting as controls (496) on the cereal-based diet. The effect of the diet on total litter size and the number of piglets born alive per sow was analysed in a general linear model (Minitab release 12.1). The combined results for both breed types showed that sows fed the HF diet had a significantly higher number of piglets born (12.37 ± 0.27 versus 11.41 ± 0.26, P<0.01) and a higher number of piglets born alive (11.47 ± 0.26 versus 10.85± 0.26, P<0.01) compared to 130 control fed sows matched for farrowing week. The difference in piglet litter size was still apparent when all the control sows farrowing over the 3 month trial period were included in the statistical analysis, with values of 12.47 ± 0.27 versus 11.79 ± 0.15 (P<0.05) for total number of piglets born and 11.77 ± 0.26 versus 11.16 ± 0.14 (P<0.05) for the number of piglets born alive for the HF and control diet respectively. Based on the results from this trial and previous studies, feeding a diet with a high content of USBP during late lactation and prior to insemination can increase the total number of piglets in the litter and the number of piglets born alive. This effect is less marked in crossbred sows with high baseline performance.
Although the need for pigs to lie down on long journeys is not in question, there is evidence that they may not choose to do so on journeys of less than 3h (Hunter et al., 1994). These observations were undertaken to determine how pigs in the 95 to 100 kg weight range behaved on short journeys. A three-tier floating-deck vehicle with weld-mesh flooring was used because the popularity of three-deck vehicles is increasing (Riches et al., 1996).
Genetic selection has increased pig lean tissue growth rate, the most extreme animals comprising the ‘sire’ lines of breeding stock. However such improvement has not been without cost in other areas of production. Sire line sows are characterised by smaller litters with poorer pre-weaning growth rates than dam line sows of the same breed. The aim of this experiment was to determine whether reduced pre-weaning growth rate of sire line piglets was due to poor lactation performance of the sow or reduced vitality of sire line piglets.
Pre-weaning mortality is a major source of economic loss to the pig industry which despite improvements in husbandry and farrowing crate design remains about 10% of piglets borne alive. The causes of death are multi-factorial (Varley, 1995) but a large proportion may be due to low neonatal vigor. Commercial pig diets do not normally contain long chain n-3 fatty acids, a deficiency of which has been implicated in reduced visual and neural development in premature human babies and in experimental animals. The objectives of the present experiment were to quantify the causes of piglet mortality in sows of modern genotype and to determine the effects of salmon oil supplementation of the diet of the sow, providing long-chain n-3 fatty acids, on this mortality.
Due to their extremely small luminosity compared to the stars they orbit, planets outside our own Solar System are extraordinarily difficult to detect directly in optical light. Careful photometric monitoring of distant stars, however, can reveal the presence of exoplanets via the microlensing or eclipsing effects they induce. The international PLANET collaboration is performing such monitoring using a cadre of semi-dedicated telescopes around the world. Their results constrain the number of gas giants orbiting 1–7 AU from the most typical stars in the Galaxy. Upgrades in the program are opening regions of “exoplanet discovery space” – toward smaller masses and larger orbital radii – that are inaccessible to the Doppler velocity technique.
To determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals.
Secondary analysis of publicly available HAI data for calendar year 2013.
We assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals. We assessed data for the 6 HAIs reported by hospitals to the Centers for Disease Control and Prevention (CDC).
Data were analyzed for 4,561 hospitals representing 88% of registered community and federal government hospitals in the United States. Healthcare-associated infection data are only useful for comparing hospitals if they are available for multiple hospitals within a geographic region. We found that data availability differed by HAI. Clostridium difficile infections (CDI) data were most available, with 82% of geographic regions (ie, hospital referral regions) having >50% of hospitals reporting them. In contrast, 4% of geographic regions had >50% of member hospitals reporting surgical site infections (SSI) for hysterectomies, which had the lowest availability. The ability of HAI data to differentiate hospitals differed by HAI: 72% of hospital referral regions had at least 1 pair of hospitals with statistically different risk-adjusted CDI rates (SIRs), compared to 9% for SSI (hysterectomy).
HAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI. CDI and catheter-associated urinary tract infection (CAUTI) are more likely to differentiate hospitals than the other publicly reported HAIs.
Hospital-acquired infection (HAI) data are reported to the public on the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website. We previously found that public understanding of these data is poor. Our objective was to develop an improved method for presenting HAI data that could be used on the CMS website.
Randomized controlled trial comparing understanding of data presented using the current CMS presentation strategy versus a new strategy.
A 760-bed tertiary referral hospital.
A total of 61 patients were randomly selected within 24 hours of admission.
Participants were shown HAI data as presented on the CMS Hospital Compare website (control arm) or data formatted using a new method (experimental arm).
No statistically significant demographic differences were identified between study arms. Although 47% percent of participants said a website for comparing hospitals would have been helpful, only 10% had ever used such a website. Participants viewing data using the new presentation strategy compared hospitals correctly 56% of the time, compared with 32% in the control arm (P=.0002).
Understanding of HAI data increased significantly with the new data presentation method compared to the method currently used on the CMS Hospital Compare website. Many participants expressed interest in a website for comparing hospitals. Improved methods for presenting CMS HAI data, such as the one assessed here, should be adopted to increase public understanding.
The outstanding feature of the last triennium was most certainly the abrupt generalisation of the use of array detectors, particularly CCDs (charge coupled devices). The latter pervade all subdivisions of instrumental astronomy. The gains achieved by their high quantum efficiency, their stability, their capability of delivering immediately recordable signals which can be processed by appropriate computational means, have been the cause of spectacular progress regarding the photometric precision of weak signal measurements.
The acute effects of active and seated video gaming on energy intake (EI), blood glucose, plasma glucagon-like peptide-1 (GLP-17–36) and subjective appetite (hunger, prospective food consumption and fullness) were examined in 8–11-year-old boys. In a randomised, crossover manner, twenty-two boys completed one 90-min active and one 90-min seated video gaming trial during which food and drinks were provided ad libitum. EI, plasma GLP-17–36, blood glucose and subjective appetite were measured during and following both trials. Time-averaged AUC blood glucose was increased (P=0·037); however, EI was lower during active video gaming (1·63 (sem 0·26) MJ) compared with seated video gaming (2·65 (sem 0·32) MJ) (P=0·000). In a post-gaming test meal 1 h later, there were no significant differences in EI between the active and seated gaming trials. Although estimated energy expenditure was significantly higher during active video gaming, there was still no compensation for the lower EI. At cessation of the trials, relative EI (REI) was significantly lower following active video gaming (2·06 (sem 0·30) MJ) v. seated video gaming (3·34 (sem 0·35) MJ) (P=0·000). No significant differences were detected in time-averaged AUC GLP-17–36 or subjective appetite. At cessation of the active video gaming trial, EI and REI were significantly less than for seated video gaming. In spite of this, the REI established for active video gaming was a considerable amount when considering the total daily estimated average requirement for 8–11-year-old boys in the UK (7·70 MJ).
Public reporting of hospital quality data is a key element of US healthcare reform. Data for hospital-acquired infections (HAIs) are especially complex.
To assess interpretability of HAI data as presented on the Centers for Medicare and Medicaid Services Hospital Compare website among patients who might benefit from access to these data.
We randomly selected inpatients at a large tertiary referral hospital from June to September 2014. Participants performed 4 distinct tasks comparing hypothetical HAI data for 2 hospitals, and the accuracy of their comparisons was assessed. Data were presented using the same tabular formats used by Centers for Medicare and Medicaid Services. Demographic characteristics and healthcare experience data were also collected.
Participants (N=110) correctly identified the better of 2 hospitals when given written descriptions of the HAI measure in 72% of the responses (95% CI, 66%–79%). Adding the underlying numerical data (number of infections, patient-time, and standardized infection ratio) to the written descriptions reduced correct responses to 60% (55%–66%). When the written HAI measure description was not informative (identical for both hospitals), 50% answered correctly (42%–58%). When no written HAI measure description was provided and hospitals differed by denominator for infection rate, 38% answered correctly (31%–45%).
Current public HAI data presentation methods may be inadequate. When presented with numeric HAI data, study participants incorrectly compared hospitals on the basis of HAI data in more than 40% of the responses. Research is needed to identify better ways to convey these data to the public.
Infect. Control Hosp. Epidemiol. 2016;37(2):182–187
The present study examined the acute effects of active gaming on energy intake (EI) and appetite responses in 8–11-year-old boys in a school-based setting. Using a randomised cross-over design, twenty-one boys completed four individual 90-min gaming bouts, each separated by 1 week. The gaming bouts were (1) seated gaming, no food or drink; (2) active gaming, no food or drink; (3) seated gaming with food and drink offered ad libitum; and (4) active gaming with food and drink offered ad libitum. In the two gaming bouts during which foods and drinks were offered, EI was measured. Appetite sensations – hunger, prospective food consumption and fullness – were recorded using visual analogue scales during all gaming bouts at 30-min intervals and at two 15-min intervals post gaming. In the two bouts with food and drink, no significant differences were found in acute EI (MJ) (P=0·238). Significant differences were detected in appetite sensations for hunger, prospective food consumption and fullness between the four gaming bouts at various time points. The relative EI calculated for the two gaming bouts with food and drink (active gaming 1·42 (sem 0·28) MJ; seated gaming 2·12 (sem 0·25) MJ) was not statistically different. Acute EI in response to active gaming was no different from seated gaming, and appetite sensations were influenced by whether food was made available during the 90-min gaming bouts.
Background: A randomized controlled trial has shown that supervised, facility-based exercise training is effective in improving glycemic control in type 2 diabetes. However, these programs are associated with additional costs. This analysis assessed the cost-effectiveness of such programs.
Methods: Analysis used data from the Diabetes Aerobic and Resistance Exercise (DARE) clinical trial which compared three different exercise programs (resistance, aerobic or a combination of both) of 6 months duration with a control group (no exercise program). Clinical outcomes at 6 months were entered for individual patients into the UKPDS economic model for type 2 diabetes adapted for the Canadian context. From this, expected life-years, quality-adjusted life-years (QALYs) and costs were estimated for all patients within the trial.
Results: The combined exercise program was the most expensive ($40,050) followed by the aerobic program ($39,250), the resistance program ($38,300) and no program ($31,075). QALYs were highest for combined (8.94), followed by aerobic (8.77), resistance (8.73) and no program (8.70). The incremental cost per QALY gained for the combined exercise program was $4,792 compared with aerobic alone, $8,570 compared with resistance alone, and $37,872 compared with no program. The combined exercise program remained cost-effective for all scenarios considered within sensitivity analysis.
Conclusions: A program providing training in both resistance and aerobic exercise was the most cost-effective of the alternatives compared. Based on previous funding decisions, exercise training for individuals with diabetes can be considered an efficient use of resources.