Abstract Background Food choices have an important impact on health. Preparation methods, including home cooking, are associated with food choices, and evidence suggests that home cooking may be ...linked to dietary and health benefits. Little is known about how and why people choose to cook and their experience of cooking; previous qualitative research has often been limited in perspective. We aimed to develop an in-depth understanding of home cooking practices, experiences, and perceptions among adults in North East England. Methods A matrix including sociodemographic characteristics, cooking skills, and interest in cooking was used to purposively sample adult participants for semi-structured qualitative interviews. Participants took photographs of their interactions with food to develop photographic food diaries, which were used as prompts during photo-elicitation interviews. Transcripts were analysed with the framework method. Findings Interviews were conducted to data saturation with 18 adults (five men, 13 women), aged approximately 20–80 years. Practices varied widely, from complete reliance on pre-prepared foods to frequently producing complex meals prepared entirely from basic ingredients. Key themes emerged about identity (eg, roles), the process of cooking (eg, skills), and situational drivers (eg, necessity). Resources also affected home cooking behaviour, in terms of time, money, and facilities. Participants' cooking practices generally reflected compromises between varied competing demands and challenges in life. Both personal motivations to cook and the influence of others on cooking experiences and perceptions were important determinants. Most people seemed overall to be content with their home cooking behaviour, although they ideally aspired to cook more often and more extensively from basic ingredients. Interpretation Our findings indicate that home cooking is complex, with heterogeneous practices, experiences, and perceptions both between individuals and within the same individual over time, in response to shifting priorities and circumstances. Transferability of the results might be limited by the regional participant sample. Focusing interventions on life-transition points at which priorities and circumstances alter could prove to be an effective strategy to encourage home cooking. Interventions should be carefully targeted to stimulate personal motivation and social norms, to avoid complacency about changes in home cooking behaviour. Funding This report is independent research arising from a doctoral research fellowship (DRF-2014-07-020) for SDHM, supported by the National Institute for Health Research (NIHR). JA and MLW received funding from the Centre for Diet and Activity Research.
Objective To compare neurocognitive test performance of children with primary hypertension with that of normotensive controls. Study design Seventy-five children (10-18 years of age) with newly ...diagnosed, untreated hypertension and 75 frequency-matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed. Parents completed rating scales of executive function and the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (PSQ-SRBD). Results Hypertension and control groups did not differ significantly in age, sex, maternal education, income, race, ethnicity, obesity, anxiety, depression, cholesterol, glucose, insulin, and C-reactive protein. Subjects with hypertension had greater PSQ-SRBD scores ( P = .04) and triglycerides ( P = .037). Multivariate analyses showed that hypertension was independently associated with worse performance on the Rey Auditory Verbal Learning Test (List A Trial 1, P = .034; List A Total, P = .009; Short delay recall, P = .013), CogState Groton Maze Learning Test delayed recall ( P = .002), Grooved Pegboard dominant hand ( P = .045), and Wechsler Abbreviated Scales of Intelligence Vocabulary ( P = .016). Results indicated a significant interaction between disordered sleep (PSQ-SRBD score) and hypertension on ratings of executive function ( P = .04), such that hypertension heightened the association between increased disordered sleep and worse executive function. Conclusions Youth with primary hypertension demonstrated significantly lower performance on neurocognitive testing compared with normotensive controls, in particular, on measures of memory, attention, and executive functions.
Objective To determine the relations between hypertension and parental ratings of behavior and executive functions in children with primary hypertension and to examine the potential moderating ...influence of obesity. Study design Hypertensive and normotensive control groups were matched for age, sex, race, intelligence quotient, maternal education, household income, and obesity. Parents completed the Child Behavior Checklist to assess Internalizing and Externalizing problems and the Behavior Rating Inventory of Executive Function to assess behavioral correlates of executive function. Results Thirty-two hypertensive subjects and 32 normotensive control subjects (aged 10 to 18 years) were enrolled. On the Child Behavior Checklist, hypertensives had higher Internalizing T-scores (53 vs 44.5, P = .02) with 37% falling within the clinically significant range vs 6% of control subjects ( P = .005). Internalizing score increased with increasing body mass index percentile in hypertensive but not normotensive subjects. Hypertensives had worse Behavior Rating Inventory of Executive Function Global Executive Composite T-scores compared with control subjects (50 vs 43, P = .009). Conclusions Children with both hypertension and obesity demonstrate higher rates of clinically significant internalizing problems, and hypertensives (irrespective of obesity) demonstrate lower parental ratings of executive function compared with normotensive control subjects.
Objective To determine the change in parental ratings of executive function and behavior in children with primary hypertension after anti-hypertensive therapy. Study design Parents of subjects with ...untreated hypertension and control subjects completed the Behavior Rating Inventory of Executive Function (BRIEF) to assess behavioral correlates of executive function and the Child Behavior Checklist (CBCL) to assess internalizing and externalizing behaviors. Subjects with hypertension subsequently received anti-hypertensive therapy to achieve casual blood pressure (BP) <95th percentile. After 12 months, all parents again completed the BRIEF and CBCL. Results Twenty-two subjects with hypertension and 25 normotensive control subjects underwent both baseline and 12-month assessments. The BP of subjects with hypertension improved (24-hour systolic BP SBP load: mean baseline versus 12-months, 60% versus 25%, P < .001). Parent ratings of executive function improved from baseline to 12 months in the subjects with hypertension (BRIEF Global Executive Composite T-score, Δ = –5.9, P = 0.001), but not in the normotensive control subjects (Δ = –0.36, P = .83). In contrast, T-scores on the CBCL Internalizing and Externalizing summary scales did not change significantly from baseline to 12 months in either subjects with hypertension or control subjects. Conclusions Children with hypertension demonstrated improvement in parental ratings of executive function after 12 months of anti-hypertensive therapy.
Objective To differentiate developmental encephalopathies by creating a novel quantitative phenotyping tool. Study design We created the Developmental Encephalopathy Inventory (DEI) to differentiate ...disorders with complex multisystem neurodevelopmental symptoms. We then used the DEI to study the phenotype features of 20 subjects with FOXG1 disorder and 11 subjects with MECP2 disorder. Results The DEI identified core domains of fine motor and expressive language that were severely impaired in both disorders. Individuals with FOXG1 disorder were overall more severely impaired. Subjects with FOXG1 disorder were less able to walk, had worse fine motor skills, more disability in receptive language and reciprocity, and had more disordered sleep than did subjects with MECP2 disorder ( P < .05). Covariance, cluster, and principal component analysis confirmed a relationship between impaired awareness, reciprocity, and language in both disorders. In addition, abnormal ambulation was a first principal component for FOXG1 but not for MECP2 disorder, suggesting that impaired ambulation is a strong differentiating factor clinically between the 2 disorders. Conclusions We have developed a novel quantitative developmental assessment tool for developmental encephalopathies and propose this tool as a method to identify and illustrate core common and differential domains of disability in these complex disorders. These findings demonstrate clear phenotype differences between FOXG1 and MECP2 disorders.
Objective To assess whether oral ketamine is safe at higher dosages for sedating children and whether it may be an option for the control of chronic pain in children. Study design A prospective study ...was performed on 12 children with chronic pain to identify the maximum tolerated dosage of oral ketamine. Participants were given 14 days of oral ketamine, 3 times daily, at dosages ranging from 0.25-1.5 mg/kg/dose. Participants were assessed for toxicity and for pain severity at baseline and on day 14 of treatment. Results Two participants, both treated at 1.5 mg/kg/dose, experienced dose-limiting toxicities (sedation and anorexia). One participant, treated at 1 mg/kg/dose, opted to stop ketamine treatment due to new pain on treatment. Nine participants completed their course of ketamine treatment. Of these 12 children, 5 experienced improvement in their pain scores, 2 with complete resolution of pain, lasting >4 weeks off ketamine treatment. Conclusion Oral ketamine at dosages of 0.25-1 mg/kg/dose appears to be safe when given for 14 days to children with chronic pain.
C-Reactive Protein Levels in African Americans Hébert, James R., ScD; Wirth, Michael, PhD; Davis, Lisa, MEd ...
American journal of preventive medicine,
October 2013, Letnik:
45, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Background Chronic inflammation is linked to poor lifestyle behaviors and a variety of chronic diseases that are prevalent among African Americans, especially in the southeastern U.S. Purpose The ...goal of the study was to test the effect of a community-based diet, physical activity, and stress reduction intervention conducted in 2009–2012 on reducing serum C-reactive protein (CRP) in overweight and obese African-American adults. Methods An RCT intervention was designed jointly by members of African-American churches and academic researchers. In late 2012, regression (i.e., mixed) models were fit that included both intention-to-treat and post hoc analyses conducted to identify important predictors of intervention success. Outcomes were assessed at 3 months and 1 year. Results At baseline, the 159 individuals who were recruited in 13 churches and had evaluable outcome data were, on average, obese (BMI=33.1 ±7.1) and had a mean CRP level of 3.7 (±3.9) mg/L. Reductions were observed in waist-to-hip ratio at 3 months (2%, p =0.03) and 1 year (5%, p <0.01). In female participants attending ≥60% of intervention classes, there was a significant decrease in CRP at 3 months of 0.8 mg/L ( p =0.05), but no change after 1 year. No differences were noted in BMI or interleukin-6. Conclusions In overweight/obese, but otherwise “healthy,” African-American church members with very high baseline CRP levels, this intervention produced significant reductions in CRP at 3 and 12 months, and in waist-to-hip ratio, which is an important anthropometric predictor of overall risk of inflammation and downstream health effects. Trial registration This study is registered at www.clinicaltrials.gov NCT01760902.
Hypertensive adults demonstrate decreased performance on neurocognitive testing compared with that of normotensive controls. There is now emerging, preliminary evidence that children with ...hypertension also manifest neurocognitive differences when compared with normotensive controls, findings postulated to potentially represent early signs of hypertensive target organ damage to the brain. However, reports in children to date have been limited to database and single-center studies. We have established an ongoing, prospective, multicenter study of neurocognition in children with primary hypertension. This article outlines the study methods, with particular attention to the unique challenges in this area of clinical research. We highlight aspects of the study design that are specifically designed as solutions to these challenges.
Management strategies for CLN2 disease Williams, Ruth E., DM, FRCPCH; Adams, Heather R., PhD; Blohm, Martin, MD ...
Pediatric neurology,
04/2017, Letnik:
69
Journal Article
Recenzirano
Odprti dostop
Abstract CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, autosomal recessive, pediatric-onset, rapidly progressive neurodegenerative lysosomal storage disorder caused by TPP1 enzyme ...deficiency, and is characterized by language delay, seizures, rapid cognitive and motor decline, blindness and early death. No management guidelines exist and there is a paucity of published disease-specific evidence to inform clinical practice, which currently draws upon experience from the field of childhood neurodisability. Twenty-four disease experts were surveyed on CLN2 disease management and a subset met to discuss current practice. Management goals and strategies are consistent among experts globally, and are guided by the principles of pediatric palliative care. Goals and interventions evolve as the disease progresses, with a shift in focus from maintenance of function early in the disease to maintenance of quality of life. A multidisciplinary approach is critical for optimal patient care. This work represents an initial step towards development of consensus-based management guidelines for CLN2 disease.
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