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Issue 136 - 27 May 2010

Articles

JOURNAL: Nutrition Reviews

1. The energy balance equation: looking back and looking forward are two very different views
By Schoeller, Dale A. Nutrition Reviews, May 2009, Vol. 67 Issue 5: p249-254
Abstract:
The energy balance equation has served as an important tool for the study of bioenergetics. It is based on one of the most fundamental properties of thermodynamics and has been invaluable in understanding the interactions of energy intake, energy expenditure, and body composition. Recently, however, the obesity epidemic has extended the use of the equation to the creation of public health messages for preventing or even reversing secular trends in body mass index. This usage often fails to consider how changes in any one term of the equation can lead to accommodations in one or both of the other two terms. It is concluded that research and public health messages should not simply consider how interventions affect just energy expenditure or energy intake, but rather how they affect the balance or gap between energy intake and expenditure. [ABSTRACT FROM AUTHOR]

2. Vegetarian and vegan diets in type 2 diabetes management
By Barnard, Neal D. et al. Nutrition Reviews, May 2009, Vol. 67 Issue 5: p255-263
Abstract:
Vegetarian and vegan diets offer significant benefits for diabetes management. In observational studies, individuals following vegetarian diets are about half as likely to develop diabetes, compared with non-vegetarians. In clinical trials in individuals with type 2 diabetes, low-fat vegan diets improve glycemic control to a greater extent than conventional diabetes diets. Although this effect is primarily attributable to greater weight loss, evidence also suggests that reduced intake of saturated fats and high-glycemic-index foods, increased intake of dietary fiber and vegetable protein, reduced intramyocellular lipid concentrations, and decreased iron stores mediate the influence of plant-based diets on glycemia. Vegetarian and vegan diets also improve plasma lipid concentrations and have been shown to reverse atherosclerosis progression. In clinical studies, the reported  acceptability of vegetarian and vegan diets is comparable to other therapeutic regimens. The presently available literature indicates that vegetarian and vegan diets present potential advantages for the management of type 2 diabetes. [ABSTRACT FROM AUTHOR]

3. Funding food science and nutrition research: financial conflicts and scientific integrity
By Rowe, Sylvia et al. Nutrition Reviews, May 2009, Vol. 67 Issue 5: p264-272
Abstract:
There has been significant public debate about the susceptibility of research to biases of various kinds. The dialogue has extended to the peer-reviewed literature, scientific conferences, the mass media, government advisory bodies, and beyond. While biases can come from myriad sources, the overwhelming focus of the discussion, to date, has been on industry-funded science. Given the critical role that industry has played and will continue to play in the research process, the International Life Sciences Institute (ILSI) North America Working Group on Guiding Principles has, in this paper, set out proposed conflict-of-interest guidelines, regarding industry funding, for protecting the integrity and credibility of the scientific record, particularly with respect to health, nutrition, and food-safety science. Eight principles are enumerated, specifying ground rules for industry-sponsored research. The paper, which issues a challenge to the broader scientific community to address all bias issues, is only a first step; the document is intended to be dynamic, prompting ongoing discussion and refinement. The Guiding Principles are as follows. In the conduct of public/private research relationships, all relevant parties shall: 1) conduct or sponsor research that is factual, transparent, and designed objectively; according to accepted principles of scientific inquiry, the research design will generate an appropriately phrased hypothesis and the research will answer the appropriate questions, rather than favor a particular outcome; 2) require control of both study design and research itself to remain with scientific investigators; 3) not offer or accept remuneration geared to the outcome of a research project; 4) prior to the commencement of studies, ensure that there is a written agreement that the investigative team has the freedom and obligation to attempt to publish the findings within some specified time-frame; 5) require, in publications and conference presentations, full signed disclosure of all financial interests; 6) not participate in undisclosed paid authorship arrangements in industry-sponsored publications or presentations; 7) guarantee accessibility to all data and control of statistical analysis by investigators and appropriate auditors/reviewers; and 8) require that academic researchers, when they work in contract research organizations (CRO) or act as contract researchers, make clear statements of their affiliation; require that such researchers publish only under the auspices of the CRO. [ABSTRACT FROM AUTHOR]

4. Fatty acids and cardiovascular disease
By Lecerf, Jean-Michel. Nutrition Reviews, May 2009, Vol. 67 Issue 5: p273-283
Abstract:
Fatty acids have been classified into “good” or “bad” groups according to their degree of unsaturation or whether they are “animal fat” or “vegetable fat”. Today, it appears that the effects of fatty acids are complex and vary greatly according to the dose and the nature of the molecule. Monounsaturated fatty acids are still considered as having a “neutral” status, but any benefits may be related to the chemical environment of the source food or the associated overall food pattern. Controversy surrounds omega-6 polyunsaturated fatty acids, because even though they lower LDL cholesterol levels, excessive intakes do not appear to be correlated with cardiovascular benefit. The omega-3 fatty acids are known to exert cardiovascular protective effects. Dairy fat and its cardiovascular impact are being evaluated. This review examines the existing literature on the relationships between the different fatty acids and cardiovascular disease. [ABSTRACT FROM AUTHOR]

5. Into the matrix: regulation of the iron regulatory hormone hepcidin by matriptase-2
By Knutson, Mitchell D. Nutrition Reviews, May 2009, Vol. 67 Issue 5: p284-288
Abstract:
Matriptase-2 is a recently identified membrane-bound, cell-surface serine protease expressed primarily in liver. Mutations in matriptase-2 in mice and humans cause iron-deficiency anemia that responds poorly to iron therapy. The poor response results from an inability to decrease hepcidin production during iron deficiency. Cell culture studies reveal that matriptase-2 inhibits hepcidin induction by cleaving membrane hemojuvelin, a potent activator of hepcidin transcription. As a novel suppressor of hepcidin expression, matriptase-2 emerges as a possible candidate for therapeutic interventions aimed at treating disorders of iron metabolism.
[ABSTRACT FROM AUTHOR]

6. Vitamin D and tuberculosis
By Chocano-Bedoya, Patricia & Ronnenberg, Alayne G. Nutrition Reviews, May 2009, Vol. 67 Issue 5: p289-293
Abstract:
Tuberculosis is highly prevalent worldwide, accounting for nearly two million deaths annually. Vitamin D influences the immune response to tuberculosis, and vitamin D deficiency has been associated with increased tuberculosis risk in different populations. Genetic variability may influence host susceptibility to developing active tuberculosis and treatment response. Studies examining the association between genetic polymorphisms, particularly the gene coding for the vitamin D receptor (VDR), and TB susceptibility and treatment response are inconclusive. However, sufficient evidence is available to warrant larger epidemiologic studies that should aim to identify possible interactions between VDR polymorphisms and vitamin D status. [ABSTRACT FROM AUTHOR]

7. Nutrition Updates
By D'Anci, Kris. Nutrition Reviews, May 2009, Vol. 67 Issue 5: p294-296
Abstract:
The article presents abstracts regarding nutrition which include the macronutrient composition of weight loss diets and long-term weight loss, a research on the maternal vitamin B12 status and neural tube defects, and the functions of folic acid supplements and risks of prostate cancer.

JOURNAL: Aging & Mental Health

8. Contextual memory and encoding strategies in young and older adults with and without depressive symptoms
By Bisol Balardin, Joana et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p313-318
Objectives:
This study examines the role of depressive symptoms associated with age on contextual memory and how this association could impair the use of strategic instructions during encoding.
Method: Young and older controls and older adults with depressive symptoms performed memory recognition tests for item and context. Results: Memory results indicated that mild depressive symptoms did not aggravate the age-related contextual memory pattern, but interfered with the magnitude of the memory enhancement provided by specific encoding instructions when compared with young adults. These between-group differences in the use of memory strategies were eliminated with the inclusion of the performance on Wisconsin Card Sorting Test as a covariate.
Conclusion: Mild depressive symptoms were associated with an impaired ability to use incidental memory strategies at encoding, suggesting the need for further investigation on the effects of non-clinical depressive symptomatology on cognitive decline in aging. [ABSTRACT FROM AUTHOR]

9.Psychological distress and its correlates in older care-dependent persons living at home
By Thygesen, Elin et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p319-327

Objectives: This study examined psychological distress in older people receiving home nursing care. The influence of risk factors and personal resources on their perceived psychological distress was also examined.
Method: A linear regression analysis was applied in a cross-sectional sample of 214 patients aged 75 years and older Psychological distress was measured using the General Health Questionnaire (GHQ). The independent variables were sex, education, age, living arrangement, household composition, reported illnesses, Barthel ADL Index, self-rated health, Subjective Health Complaints, Clinical Dementia Rating Scale, Sense of Coherence and Revised Social Provision Scale.
Results: Of the 214 participants, 23 (10.7%) reported experiencing psychological distress using a cutoff point of 4 or more on a GHQ case score. Sense of coherence, education and subjective health complaints were the only factors that were significantly related to psychological distress in the multivariate analysis.
Conclusion: The general level of psychological distress was low. Low psychological distress was related to an inner strength conceptualized as sense of coherence. Commonly reported risk factors such as sex, household composition and perceived social support, and objective measures of somatic and mental health and bodily dysfunctions were not related to psychological distress. Suggested reasons for this are greater acceptance of bodily and functional shortcomings and of changes related to goal achievement in old age, according to the model of selective optimization with compensation. [ABSTRACT FROM AUTHOR]

10. Do improvements in emotional distress correlate with becoming more mindful? A study of older adults
By Splevins, Kate et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p328-335
Objectives:
The study aimed (1) to investigate changes in older adults' emotional wellbeing (specifically depression anxiety and stress levels) and mindful ability following a mindfulness-based cognitive therapy (MBCT) course; (2) to explore correlations between mindfulness (measured as an overall ability and as individual components; observe, describe, act with awareness and accept without judgement) and changes in depression, anxiety and stress levels.
Method: Twenty-two participants took an eight-week MBCT course. Levels of depression, anxiety and stress were recorded pre- and post-intervention, as was mindfulness ability (measured both as an overall ability and as individual components).
Results: Significant improvements in emotional wellbeing and mindfulness were reported post-MBCT, with large to moderate effect sizes. Increased mindfulness was moderately and significantly associated with improved emotional wellbeing. Increases on all four components of mindfulness were positively associated with greater emotional wellbeing, however only act with awareness and accept without judgement were significantly correlated (with reduced depression). Older adults in our sample reported higher scores on observe and act with  awareness than other populations.
Conclusion: This study adds to a growing evidence-base indicating the efficacy of MBCT for depression, anxiety and stress, and extends these finding to older adults. This study found older adults to have elevated levels of certain facets of mindfulness and recommendations are made for researching the possibility that mindfulness may be an extension of the developmental process. [ABSTRACT FROM AUTHOR]

11. Age differences in goals: Implications for health promotion
By Zhang, Xin et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p336-348
Objectives:
Socioemotional selectivity theory postulates that, as people age, they prioritize emotionally meaningful goals. This study investigated whether these age differences in goals are reflected in how younger (aged 18-36, n = 111) and older adults (aged 62-86, n = 104) evaluated, remembered information from and were persuaded by health messages.
Method: Participants were randomly assigned to read health pamphlets with identical factual information but emphasizing emotional or non-emotional goals.
Results: Findings showed that health messages that emphasized emotional goals, but not those that emphasized future-oriented or neutral goals, were better remembered, were evaluated more positively and led to greater behavioral changes among older adults, but not younger adults.
Conclusion: These findings suggest that health messages targeting older adults may be more effective if they are framed in ways that emphasize love and caring. [ABSTRACT FROM AUTHOR]

12. Depression literacy among Chinese stroke survivors
By Lee, A. C. K. et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3, p349-356
Objectives:
Mental health literacy is fundamental to the pursuit of health. Little is known about patients' literacy levels regarding depression even though it is common among elderly stroke survivors. This paper will report the level of mental health literacy and thematic constructs of depression interpreted by a group of stroke survivors.
Method: Qualitative data on patients' understanding of 'depression' in Chinese were translated and analyzed by an academic and a researcher separately to identify emerging constructs using a thematic approach. Out of 214 ischemic stroke older adults, aged 50+, 85 were able to explain the term in their own words after their first stroke attack.
Results: The majority of stroke patients (60%, 129 out of 214) had never heard of depression and only four referred to it as a medical disease. Only a third would like to learn more about depression. Older Chinese adults depicted depression mainly by using words in the cognitive and affective domains, but the descriptors used were mostly non-specific and might not match the diagnostic criteria for depression or the commonly used screening tools.
Conclusion: Low mental health literacy among older patients indicated that much more work needs to be done in health promotion and education on depression literacy. [ABSTRACT FROM AUTHOR]

13.  Predictive value of age for coping: the role of self-efficacy, social support satisfaction and perceived stress
By Trouillet, Raphaël et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3:p357-366
Objectives:
The present study was prompted by the lack of agreement on how coping changes with age. We postulate that the effect of age on coping is mediated by coping resources, such as self-efficacy, perceived stress and social support satisfaction.
 Method: The participants in the study were community dwelling and aged between 22 and 88 years old. Data were collected using the General Self Efficacy Scale, the Social Support Questionnaire, the Perceived Stress Scale, the Geriatric Depression Scale, the Social Readjustment Rating Scale (life-events) and the Way of Coping Checklist.
Results: We performed path analyses for two competitive structural models: M1 (age does not directly affect coping processes) and M2 (age directly affects coping processes). Our results supported a modified version of M2. Age was not found to predict either of two coping strategies: problem-focused coping is predicted by self-efficacy and social support satisfaction; emotion-focused coping is predicted by social support satisfaction and perceived stress.
Discussion: Changes in coping over the lifespan reflect the effectiveness with which a person's adaptive processes deal with age-associated changes in self-referred beliefs and environment perception.
[ABSTRACT FROM AUTHOR]

14. Personal and social resources and adaptation to chronic vision impairment over time
By Reinhardt, Joann P. et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p367-375
Objectives:
To examine the effect of personal (coping strategies and locus of control) and social resources (family and friendship support) on adjustment to chronic vision impairment in older adults at baseline (rehabilitation service application), 6 months, and 18 months later.
Method: 313 community dwelling, English speaking older adult applicants to a vision rehabilitation agency in the northeast were interviewed in their homes following informed consent.
Results: A larger portion of variability was accounted for in positive compared to negative outcomes. Greater use of acceptance coping, less use of wishfulness coping, lower endorsement of chance locus of control, and higher family support were associated with better baseline adaptation, yet these predictors had little effect on short- or
long-term change in adaptation. Higher friendship support predicted increased adaptation to vision loss at both follow-up points. Friendship support was also associated with decreased depression at Time 3, and lower use of  wishfulness was related to decreased depression at Time 2.
Conclusion: Results showed differential effects for positive versus negative outcome variables, short- versus long-term adaptation, personal and social resources, and within social resources, for family versus friendship support. [ABSTRACT FROM AUTHOR]

15. Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults
By Nyunt, Ma Shwe Zin et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p376-382
Background:
Few studies have evaluated the validation of 15-item Geriatric Depression Scale (GDS-15) in a heterogeneous population with different age, ethnicity and comorbidities of elderly users of social services in the community.
Aims: To assess the criterion validity and reliability of the GDS-15 and its equivalence across different gender, age groups, ethnicity and different comorbidities in community living elderly and nursing homes residents.
Method: A validation sample of non-demented 4253 elderly (age = 60 years), who regularly use community based care corner, senior activity center, day care center, sheltered homes and nursing homes were interviewed using the GDS-15 Structured clinical interview (SCID) was used to make DSM-IV diagnosis of major depressive disorder (MDD).
Results: The overall sensitivity and specificity were 0.97 and 0.95, respectively (area under curve, AUC was 0.98). The overall Cronbach's alpha was 0.80, and intraclass coefficient of test--retest reliability over 2 weeks was 0.83 and inter-rater reliability was 0.94 (intra-class) and 0.99 (Cohen's kappa). Although some items in the GDS-15 appeared to be biased by gender, age and ethnicity, there were no clinically significant differences in test performance among different age, gender, ethnicity and comorbidities at cutoff of 4/5.
Conclusions: The GDS-15 was a reliable and valid screening for MDD across different age, gender, ethnicity and chronic illness status in the community and social service setting. [ABSTRACT FROM AUTHOR]

16. Dementia care and labour market: The role of job satisfaction
By Vernooij-Dasssen, Myrra J. et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p383-390

Objectives: A labour shortage in the dementia care sector is to be expected in the near future in the Netherlands and in many other European states. The objective of this study is to analyse why people quit or avoid jobs in dementia care.
Method: An integrative analysis was used to study reports, articles, and Website information on the dementia care labour market.
Results: The main reason for quitting a (dementia) care job was the lack of job satisfaction. Job satisfaction was reduced by a lack of appreciation and professionals' own dissatisfaction about the quality of care they were able to provide. Effects of staff training on job satisfaction, quality of dementia care, and patient functioning are promising.
Conclusion: Job satisfaction is the main cause of quitting (dementia) care jobs. It might also be the key to solving problems in the dementia care labour market. Considering health-care workers as precious capital and taking adequate measures to enhance job satisfaction might contribute to a better image of dementia care. The
following hypothesis has been derived from our results: enhancement of job satisfaction will prevent professional caregivers from quitting jobs and improve the quality of care and patient outcomes. [ABSTRACT FROM AUTHOR]

17.  Long-term effects of the British evacuation of children during World War 2 on their adult mental health
By Rusby, James S. M. et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p391-404
Objectives:
This study of 870 respondents aged 62-72 years investigates possible long-term effects on adult mental health due to temporary childhood separation by evacuation in the United Kingdom during World War 2.
Method: Using univariate and multivariate analyses associations were examined between upbringing, evacuation experience and certain life-course variables with the lifetime incidence of depression and clinical anxiety, and also with the dependency and self-critical factors of the Depressive Experiences Questionnaire (DEQ) (Blatt, S.J., D'Affitti, J.P., & Quinlan, D.M. (1976). Experiences of depression in normal young adults. Journal of Abnormal Psychology, 85, 383-389.) were examined by univariate and multivariate analyses.
Results: Those evacuated at a young age, 4-6 years, or who received poor foster care, were found to be at a greater risk of depression and clinical anxiety, with high levels of self-criticism. Compared to other groups respondents evacuated at 13-15 years age, who received good care, had reduced incidences of both affective disorders, comparable to those who were not evacuated. The quality of home nurture was also found to be significantly associated with both disorders. Structural equation models for each sex based on those variables significantly associated with depression explained 45% of the variance of the incidence of depression for males and 25% for females. The models also confirmed the relatively high levels of dependency for females and their vulnerability to these levels in terms of depression.
Conclusion: The study demonstrated significant associations between childhood experiences and lifespan mental health, reinforcing the importance of knowledge of childhood history in the clinical treatment of older adults.[ABSTRACT FROM AUTHOR]

18. Subjective age, PTSD and physical health among war veterans
By Solomon, Zahava et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p405-413

Objectives: To examine the contribution of posttraumatic stress disorder (PTSD) and physical health to subjective age among war veterans.
Method: The sample included 502 veterans of the first Lebanon War who were assessed 20 years after the war by a series of self-report questionnaires. Data analyses included descriptive statistics,
hierarchical and logistic regressions.
Results: Veterans with PTSD reported older subjective age than veterans without PTSD. Furthermore, both PTSD and general physical health contributed to subjective age, above and beyond
chronological age and negative life events. Among the physical health problems, memory problems and weight gain were found to contribute to older age identity. In addition, the relation between general physical health and subjective age was stronger among veterans without PTSD than among veterans with PTSD.
Discussion: Possible explanations, clinical implications for integrative therapy for elderly PTSD victims, and recommendations for future research are presented. [ABSTRACT FROM AUTHOR]

19. Domiciliary and day care services: Why do people with dementia refuse?
By Durand, Marianne et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p414-419
Objective:
To explore the reasons given for refusal of day services, and to examine the relationship between willingness to accept day services and clinical variables.
Method: Fifty people with dementia who lived alone and had refused day services were interviewed.
Results: The most common reasons for reluctance to attend day services were the belief that they did not need day services, that they liked being on their own, and the belief that they would not enjoy it. People who persistently refused day services tended to have additional worries about meeting new people, losing their independence and being institutionalised. Fifty-four per cent of people with dementia who lived alone and had refused day services scored six or more on the Cornell Scale for Depression in Dementia,
suggesting possible presence of major depression.
Conclusion: In patients with dementia who live alone and refuse day services, their misconceptions about day services and possibility of undiagnosed depression need further exploration. [ABSTRACT FROM AUTHOR]

20. A small-scale study comparing the impact of psycho-education and exploratory psychotherapy groups on newcomers
to a group for people with dementia
By Cheston, Richard et al. Aging & Mental Health, May 2009, Vol. 13 Issue 3: p420-425
Background:
The importance of providing emotional support to people newly diagnosed as having dementia is now widely recognised. However, the evidence base for this work is limited, so that it is difficult to draw conclusions either about whether this form of work is effective or which form of intervention might be most suitable for people with dementia.
Objectives: This study compared the effectiveness of exploratory psychotherapy and psycho-educational group interventions for new group members.
Methodology: Participants had received a diagnosis of Dementia of the Alzheimer's type or a similar form of dementia and had a mild level of cognitive impairment. Interventions occurred in ten, weekly sessions with participants attending either a psychotherapy or a psycho-educational group, each of which were facilitated by the same team of clinicians, and had the same amount of therapist contact. Data relating to levels of mood was collected at the start and at the end of the group intervention from eight participants in each arm of the study. Data collection occurred independently from the intervention by a researcher who was blind to the form of intervention.
Results: There was a significant interaction between mode of therapy and levels of depression and a borderline significant interaction between therapy type and levels of anxiety. However, once the low affect level of participants in the psycho-educational groups was controlled for, differences between the interventions were non-significant.
Discussion: Although the results that can be drawn from this study are limited, nevertheless it supports previous research indicating that a 10-week group psychotherapy intervention can be effective in reducing levels of depression for people with a mild level of dementia. [ABSTRACT FROM AUTHOR]<

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