Home stimulation, development, and nutritional status of children under 2 years of age in the highlands of Madagascar

BACKGROUND

The Vakinankaratra region of Madagascar has a high burden of child undernutrition which, in addition to poor psychosocial stimulation, is a strong risk factor of poor child development. However, there are limited studies evaluating the relations between developmental deficits, child nutrition outcomes, and home stimulation in the region. The purpose of this study was to assess the development of children aged 11-13 months in relation to their nutritional status and to examine parental home stimulation attitudes and practices in the Vakinankaratra region.

METHODS

Cognitive (n = 36), language (n = 36), motor (n = 36), and socioemotional (n = 76) development were assessed using the Bayley Scales of Infant and Toddler Development III. Household stimulation environment was evaluated using the family care indicators survey. Stunting (length-for-age z-score < - 2) and underweight (weight-for-age z-score < - 2) were determined using the 2006 WHO growth standards. Perceptions of and barriers to greater home stimulation for children were collected using focus group discussions among parents and in-depth interviews with community nutrition agents.

RESULTS

Almost all mothers reported that parent-child interaction with talk and play was very important. Alarmingly high stunting rates (> 69%) were observed in this subsample. Limited time and tiredness were the major barriers to home stimulation mentioned by parents and confirmed by key informants. Children had a very limited variety of play materials, and most of the mothers used household objects (75%) and materials from outside the house (71%) as children's toys. Composite cognitive [mean (SD): 60 (10.3)], motor [61.9 (13.4)], language [62 (13.2)], and socioemotional [85.1 (17.9]) scores were low. Fine motor, cognitive, and receptive and expressive language scores were correlated [0.4 < r < 0.7, p < 0.05].

CONCLUSIONS

The very high stunting rates and very low performance on cognitive, motor, language, and socioemotional development assessments of children in the Vakinankaratra region require urgent attention.

Process Evaluation of Two Interventions to Improve Health Environments in Family Child Care Homes

Early care and education (ECE) environments influence children's lifelong health behaviors, growth, and development. Although the number of interventions to improve health in ECE environments is increasing, few have been designed for and tested in family child care homes (FCCHs). This study reports the process evaluation of two interventions to improve FCCH health environments, both part of Happy Healthy Homes, a matched-attention randomized-controlled intervention trial conducted in Oklahoma FCCHs. Participating child care providers received one of two multicomponent interventions: (a) an intervention focused on enhancing the quality of the nutrition environment, self-efficacy, and practices or (b) an intervention focused on improving providers' environmental health literacy, self-efficacy, and practices. Guided by "Implementation" constructs of the RE-AIM framework (i.e., reach, effectiveness, adoption, implementation, maintenance), intervention report forms and participant tracking were used to assess intervention dose delivered and interventionist-perceived challenges and successes to implementation. Interviews were conducted to obtain participant feedback after the intervention. Dose delivered was high for both interventions overall and across individual sessions, and provider feedback was positive. Implementation challenges and strengths identified for both interventions may be useful for further enhancing intervention appropriateness and success, particularly for interventions with FCCHs. Process evaluation findings indicate that the two Happy Healthy Home interventions can be conducted with high delivery and are well attended and considered to be valuable to FCCH providers.

Analysis of a State Police Academy Menu Cycle for Dietary Quality and Performance Nutrition Adequacy

Law enforcement officers have high rates of overweight and obesity. With diet as a leading risk factor, training academies present an opportunity for early-career nutrition intervention. Our purpose was to determine the dietary quality (DQ) and performance nutrition adequacy of a state police academy's cafeteria menu. This cross-sectional content analysis included six weeks (three daily meals, Monday-Friday) of a police academy menu. Nutrient content was determined by portioning menus, gathering food specifications, and performing nutrient analysis. DQ was assessed using the Healthy Eating Index (HEI) 2015. Statistical analyses included independent t-tests and Cohen's d. The total HEI score was 54/100. Subcomponent scores indicating adequacy included added sugar (5/5), total protein (4.97/5) and whole fruits (4.77/5). Seafood/plant proteins (0.33/5), fatty acid ratio (1.31/5), and dairy scores (1.59/10) needed significant improvement. The menu met the recommended intake for 13 of 19 nutrients investigated. Nutrients that did not meet adequacy were calories (% mean difference, needs-menu = 36.7%), carbohydrates (52.3%), vitamins D (82.5%) and E (66.7%), magnesium (44.1%), and potassium (41.8%). The academy menu leaves room for improvement in DQ and shortfall nutrients. By increasing low scores, the overall DQ of the menu will increase and supplement missing nutrients.

Systematic Review of the Impact of Nutrition and Physical Activity on Cardiovascular Disease Risk Among Firefighters

Objectives

The objective of this systematic review was to summarize the literature on non-occupational cardiovascular disease (CVD) risk factors experienced by firefighters, specifically those related to nutrition, physical fitness, and physical activity.

Methods

Two electronic databases (PubMed and Scopus) were used for this review. Search terms included those related to CVD, nutrition, physical fitness, and physical activity among firefighters. The PRISMA checklist was followed to ensure a rigorous review. The Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research was also used for critical appraisal of the included studies. The review process was performed by one researcher and is in the process for a second independent researcher to reduce bias.

Results

Twenty-six (n = 26) articles were included in the final qualitative synthesis (4 nutrition, 4 nutrition and physical fitness/activity, and 18 physical fitness/activity). The outcomes were that firefighters do not engage in regular physical activity, tend to have substandard fitness levels and poor dietary habits, and work in a poor food environment. These factors have been shown to relate with higher prevalence of CVD and its indicators. These studies also suggest that firefighters want information, programs, and resources related to improving nutrition and physical activity to reduce CVD.

Conclusions

Among firefighters, numerous studies exist regarding increased CVD risk related to inadequate physical fitness and activity levels, however, few studies address the role of a healthy diet in the development of CVD risk. This review is beneficial for public health practitioners, researchers, and fire service leaders, as it provides insight into the need to further investigate how diet affects CVD risk among the firefighting population.

Funding Sources

None.

Perinatal Depression and Breastfeeding: A Mixed Methods Study Among South Sudanese Refugees in the West Nile Region in Uganda

Objectives

The specific study objectives were: 1) to identify perceived common stressors among parents in refugee settlements, 2) to analyze the associations of perinatal depression and early initiation of breastfeeding and 3) to analyze the associations between perinatal depression and exclusive breastfeeding.

Methods

Qualitative study participants were mothers (n = 66) and fathers (n = 49) who compromised eight focus group discussions (FGDs): four mothers FGDs, two fathers FGDs, two mothers and fathers FGDs. Two FGDs with Village Health Team and six individual interviews with key informants also were conducted. Thematic analysis was used in NVivo, v. 12. Quantitative study participants (n = 390) were pregnant mothers who were enrolled in a community-based randomized control study. Perinatal depression was measured using Patient Health Questionnaire-9 during 3rd trimester and postpartum. Early initiation and exclusive breastfeeding were assessed using WHO guidelines. SAS, v. 9.4, was used to conduct logistic regressions to analyze perinatal depression and breastfeeding and models were adjusted for confounders.

Results

Five themes related to common stressors among refugees included: marital conflict and violence, other violence and conflict, lack of basic needs, inadequate health care, issues involving childbirth, and issues involving children. Over two-thirds (66.3%) of mothers breastfed within one hour after birth and 55.5% exclusively breastfed. Antenatal depression occurred in 19.9% of participants and 23.5% had postpartum depression. Antenatal depression was not significantly associated with early initiation of breastfeeding or exclusive breastfeeding. Postpartum depression was associated with significantly lower odds of breastfeeding within an hour after birth [AOR 0.35 (0.21- 0.61), p-value &lt; 0.001] and of exclusive breastfeeding [AOR 0.44 (0.26–0.74), p-value &lt; 0.01].

Conclusions

Screening and treatment for perinatal depression during antenatal and postnatal care is important for refugee mothers. Interventions aiming to improve breastfeeding among refugees may also consider addressing postpartum depression.

Funding Sources

Supported by a grant from the Nestlé Foundation for the study of problems of nutrition in the world, Lausanne, Switzerland and Oklahoma State University Foundation Marilynn Thoma Chair and Humphreys Grant.

Maternal Peer Support Through a Caregroup Model Improves Complementary Feeding of Infants by Refugee Mothers in Post-Emergency Settlements in the West-Nile Region in Uganda

Objectives

Introduction: Infant complementary feeding in refugee settlements remains inadequate, amidst declining humanitarian aid. However, there is limited evidence for interventions to address these nutrition challenges in the refugee settlements. Objective: Examine the effects of peer-led integrated nutrition education on infant feeding by South Sudanese refugee mothers in the West-Nile region in Uganda.

Methods

A community-based randomized control study enrolled 390 pregnant mothers in the 3rd trimester as baseline for a peer-led nutrition education intervention using the caregroup model. Two groups (moms-only and moms & dads combined) comprised treatments with a control group. Higher scores on the Medical Outcomes Study (MOS) Social Support Index were used as a proxy for better maternal social support. Infant complementary feeding was assessed using the 2021 WHO guidelines. Multivariable logistic regression models determined effects of the interaction of maternal social support by group over time on infant feeding practices. The models were adjusted for maternal and infant confounders.

Results

Maternal age (mean ± SD) was 27.7 ± 5.1 years while the infant birthweight was 3.1 ± 0.5 kg. Higher maternal social support positively affected timely introduction of solid and semi-solid foods in moms-only (β = 0.11, p = .011) and moms & dads (β = 0.11, p = .001) groups. Positive intervention effects were noted on infant minimum dietary diversity for both the moms-only group (β = 0.06, p = .01) and the moms & dads group (β = 0.03, p = .001), but no effect was observed between maternal social support and infant minimum meal frequency. However, higher maternal social support in both moms-only and moms & dads groups influenced meeting the minimum acceptable diet (β = 0.07, p = .016 and β = 0.04, p = .026 respectively) and consumption of eggs and/or flesh foods (β = 0.11, p &lt; .0001 and β = 0.05, p = .004).

Conclusions

A maternal peer support integrated nutrition education program improved complementary feeding of infants in post-emergency settlements. Enhanced maternal social support in nutrition-sensitive programs may benefit infants in post-emergency settlements in the West-Nile region in Uganda.

Funding Sources

A grant from the Nestlé Foundation for the Study of Problems of Nutrition in the World, Switzerland.

Impact of Child Nutrition Programs Offered in Schools on Daily Nutrition and Dietary Quality

Objectives

The average Healthy Eating Index-2015 (HEI) score for children 2–17 years of age is 53.9 out of 100. HEI scores for dietary quality directly and positively impact children's health, academic performance, and their futures. Because school Child Nutrition Programs (CNPs) impact a large proportion of US children, it is important to evaluate these programs to determine the nutrition they are providing to children, as well as their impact on dietary quality. Thus, the purpose of this study is to determine the overall nutrition provided by the four CNPs that can be implemented consistently and collectively each school day [School Breakfast Program (SBP), National School Lunch Program (NSLP), Fresh Fruit and Vegetable Program (FFVP), and the Afterschool Snack Program (ASSP)] and to determine the dietary quality score achieved collectively by serving each of these four CNPs.

Methods

This cross-sectional content analysis included four-week sample cycle menus for each of CNPs offered to elementary-aged children. Sample menus for breakfast (SBP) and lunch (NSLP) were actual cycle menus from the Cooking for Kids program. Sample menus for FFVP and ASSP were created by two researchers, who are CNP experts. Nutrient content was determined using nutrient analysis software. Dietary quality scores were determined using the HEI-2015.

Results

The proportion of daily nutrient needs met by the combined menus ranged from 0.15% to 403.7%, with an average proportion of 124.0%. The menus exceeded child daily nutrient needs for 18 of the 30 nutrients and met at least 50% of needs for 8 nutrients. The combined menus had an average 29.4-point (54.5%) higher HEI score compared to the average HEI score of the 2–17 year-old US child's diet (p = 0.002). Significant differences in HEI scores between the combined menus and the diet of the average US child included whole grains, dairy, added sugar, and total score favoring higher dietary quality in the combined menus (p < 0.05).

Conclusions

The results of the current study support why school districts should implement all four CNPs (SBP, NSLP, FFVP, ASSP) within their schools if possible, especially in low-income areas where children may not be provided with adequate nutrition outside of school, to provide children with the highest dietary quality meal patterns and to greatly contribute to children's daily nutrient needs.

Funding Sources

None.

Analysis of a State Police Academy Menu Cycle for Dietary Quality and Performance Nutrition Adequacy

Objectives

Current literature suggests law enforcement officers have high rates of obesity. With diet as a leading risk factor, early career nutrition interventions could be beneficial in establishing long-term healthy eating habits. Thus, the purpose of this study was to determine the diet quality (DQ) and performance nutrition adequacy of a state police academy's dining facility menu.

Methods

This cross-sectional content analysis included six weeks (three daily meals, Monday–Friday) of a state police academy's dining facility menu. Nutrient content was determined by meeting with the dining facility manager, portioning menus, gathering food specifications from purchase orders, and then performing nutrient analysis. DQ was assessed using the Healthy Eating Index-2015 (HEI). Independent t-test and Cohen's d determined differences between menu nutrient content and performance nutrient needs.

Results

The mean (±SD) total HEI score for the six-week menu was 54 ± 9.55 out of 100. Subcomponent scores of total protein (4.97 out of 5) and whole fruits (4.77 out of 5) indicate adequacy. Total fruit (3.19 out of 5), whole grains (6.10 out of 10), total vegetable (3.77 out of 5), and dark greens and legumes (3.51 out of 5) scores could be improved. Seafood and plant proteins (0.33 out of 5), fatty acid ratio (1.31 out of 5), and dairy (1.59 out of 10) scores were low. The menu met recommended intake for 13 of 19 subcomponents investigated. Subcomponents that did not meet adequacy were calories (% mean difference, needs – menu = 36.7%), carbohydrates (% mean difference = 52.3%), vitamins D (% mean difference = 82.5%) and E (% mean difference = 66.7%), magnesium (% mean difference = 44.1%), and potassium (% mean difference = 41.8%).

Conclusions

The academy menu is adequate in most performance-related nutrients, but also leaves room for improvement in DQ and shortfall nutrients. By focusing on increasing low HEI subcategory scores, overall DQ of the menu will increase and could potentially simultaneously make up for inadequate nutrients. To optimize current and future performance and health, police academies should consider evaluating their menus and ensuring adequacy and high DQ.

Funding Sources

None.

Family child care home providers' self-reported nutrition and physical activity practices, self-efficacy, barriers and knowledge: baseline findings from happy healthy homes

OBJECTIVE

Describe nutrition and physical activity practices, nutrition self-efficacy and barriers and food programme knowledge within Family Child Care Homes (FCCH) and differences by staffing.

DESIGN

Baseline, cross-sectional analyses of the Happy Healthy Homes randomised trial (NCT03560050).

SETTING

FCCH in Oklahoma, USA.

PARTICIPANTS

FCCH providers (n 49, 100 % women, 30·6 % Non-Hispanic Black, 2·0 % Hispanic, 4·1 % American Indian/Alaska Native, 51·0 % Non-Hispanic white, 44·2 ± 14·2 years of age. 53·1 % had additional staff) self-reported nutrition and physical activity practices and policies, nutrition self-efficacy and barriers and food programme knowledge. Differences between providers with and without additional staff were adjusted for multiple comparisons (P < 0·01).

RESULTS

The prevalence of meeting all nutrition and physical activity best practices ranged from 0·0-43·8 % to 4·1-16·7 %, respectively. Average nutrition and physical activity scores were 3·2 ± 0·3 and 3·0 ± 0·5 (max 4·0), respectively. Sum nutrition and physical activity scores were 137·5 ± 12·6 (max 172·0) and 48·4 ± 7·5 (max 64·0), respectively. Providers reported high nutrition self-efficacy and few barriers. The majority of providers (73·9-84·7 %) felt that they could meet food programme best practices; however, knowledge of food programme best practices was lower than anticipated (median 63-67 % accuracy). More providers with additional staff had higher self-efficacy in family-style meal service than did those who did not (P = 0·006).

CONCLUSIONS

Providers had high self-efficacy in meeting nutrition best practices and reported few barriers. While providers were successfully meeting some individual best practices, few met all. Few differences were observed between FCCH providers with and without additional staff. FCCH providers need additional nutrition training on implementation of best practices.

Child Development in a Region of Madagascar With High Child Undernutrition

Objectives

The Vakinankaratra region of Madagascar has a high burden of child undernutrition, a strong risk factor for poor child development. The purpose of this preliminary study was to assess the household stimulation environment and to evaluate the development of 11 to 13 month-old toddlers from this agriculturally-productive area with some of the highest young-child stunting rates in the world.

Methods

Stunting (length-for-age z-score &lt; -2) and underweight (weight-for-age z-score &lt; -2) were determined using the 2006 WHO growth standards. Household stimulation environment was evaluated using the Family Care Indicators scales. The Bayley Scales of Infant and Toddler Development III were used to directly evaluate development of 36 toddlers (mean age 11.9 mo). Age-appropriate, increasingly difficult tasks are provided by the Bayley Scales to assess cognition, language, and motor skills. Socioemotional development also was evaluated using a questionnaire individually administered to the primary caregivers of 76 toddlers (mean age 11.7 mo).

Results

More than two-thirds (69%) of young children in the sample were stunted and 11% were underweight. Most mothers used household objects (75%) and materials from outside the house (71%) as children's toys such as makeshift balls made of plastic wraps. Common adult-infant interactions were talking and playing. In most households, adults told stories or read a book to children only once a week at most. However, these interactions were limited by other responsibilities of the parents. Scoring of the Bayley scales is adjusted to provide composite scores with a mean of 100 for each domain for each age group. Below average scores were determined in our sample as follows: cognitive [mean (SD): 60 (10.3)], motor [61.9 (13.4)], language [62 (13.2)], and socioemotional [85.1 (17.9]). Although in this small sample there were no statistical differences based on nutritional status, development scores for fine motor, cognitive, and receptive and expressive language were correlated [0.4 &lt; r &lt; 0.7, p &lt; 0.05].

Conclusions

The very high stunting rates and very low cognitive, motor, language, and socioemotional scores of young children in the Vakinankaratra region require urgent attention.

Funding Sources

This study was funded by the Marilynn Thoma Chair in Human Sciences at Oklahoma State University.

Relationship Between Body Mass Index and Health and Occupational Performance Among Law Enforcement Officers, Firefighters, and Military Personnel: A Systematic Review

Objectives

The prevalence of overweight and obesity among tactical populations is estimated at 70–75%, which may negatively impact health and performance. Since the relationship between BMI and health and performance is not well studied in tactical populations, the purpose of this study was to systematically review available literature on the relationship between BMI and health and performance among law enforcement officers (LEO), firefighters, and military personnel.

Methods

Literature searches were conducted in PubMed and SCOPUS using combinations of search terms: body mass index, health*, cardiovascular disease, heart disease, heart attack, myocardial infarction, heart failure, stroke, hypertension, cancer, diabetes, performance, physical fitness test*, physical training, fitness test*, injur*, law enforcement, police, trooper, firefighter, military, soldier, airmen, and sailor. Included studies used BMI as an adiposity assessment; involved cardiovascular disease (CVD), cancer, diabetes (T2DM), performance testing, and injuries among US LEOs, firefighters, or military personnel; and involved peer-reviewed primary research between 2000–2020. Review studies; studies on other tactical populations, retirees, and trainees; and studies using BMI as a covariate were excluded. Included articles were critically appraised using the Academy of Nutrition and Dietetics Quality Criteria Checklist.

Results

Twenty-seven articles were included. Overall quality was neutral. Nine studies found BMI was positively associated with CVD risk factors. Studies involving BMI and cancer were lacking. One study found BMI was positively associated with T2DM risk. Five studies on occupational/physical performance and twelve studies on injury found a higher BMI was often indicative of decreased performance and increased risk of injury in general, but protective against stress fractures.

Conclusions

Higher BMI was often associated with negative health and performance outcomes among tactical populations, especially when beyond the overweight classification. Public health practitioners should focus efforts on improving nutrition and physical activity to promote a healthy BMI among these individuals.

Funding Sources

None.

Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study

BACKGROUND

Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar.

OBJECTIVES

This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6-23 mo in the Vakinankaratra region of Madagascar.

METHODS

Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than -2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach.

RESULTS

Maternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers' workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding.

CONCLUSIONS

Integrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.

Complementary Feeding Practices and Child Growth in a Region with a High Burden of Child Undernutrition in Madagascar

Objectives

The Vakinankaratra region of Madagascar has the highest stunting rates of the country, yet it is one of most agriculturally productive regions. The purpose of this study was to assess maternal complementary feeding practices and their association with child growth.

Methods

Data from a cross-sectional study of 391 mothers and their infants aged 6–23 months were analyzed. The WHO infant and young child feeding (IYCF) indicators were used to assess complementary feeding practices. A questionnaire for collection of sociodemographic information and 24-hour dietary recall was translated and pre-tested before data collection. Child length and weight were converted to length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) using the 2006 WHO Growth Standards. Linear regression models were conducted while adjusting for survey design and confounding variables.

Results

Stunting (69.4%) and undernutrition (23.4%) rates were very high. The proportion of children achieving minimum dietary diversity (35.8%), minimum acceptable diet (30.2%) and consuming flesh foods (14.1%) were low. Higher dietary diversity score was associated with increased LAZ [β = 0.2, P &lt; 0.05, R2 = 0.16] in 9–11 months infants only. Consuming flesh foods was associated only with higher WAZ [β = 0.41, P &lt; 0.01, R,2 = 0.10]. None of the indicators were associated with WLZ.

Conclusions

Complementary feeding practices were suboptimal in the Vakinankaratra region. Although crucial for optimal growth, improving feeding practices alone may not be sufficient to reduce the high prevalence of child undernutrition in the region.

Funding Sources

This study was funded by the Marilynn Thoma Chair in Human Sciences at Oklahoma State University.

Maternal Social Support Is Associated with Child Complementary Feeding, and Household Food Security in the Vakinankaratra Region, Madagascar

Objectives

There is limited research on the associations between maternal social support and household food security and child feeding practices in Madagascar. Our study examined the association between maternal social support, household food security, and feeding practices among mothers of children 6 - 24 months in the Vakinankaratra region, Madagascar.

Methods

This cross-sectional study included 344 mother-child dyads. The Medical Outcomes Study (MOS) Social Support Index was used for maternal social support scores. A mean score of &gt;4 was considered optimal social support with ≤2 as none or little support. Food insecurity scores were determined using the Household Food Insecurity Access Scale (HFIAS). Complementary feeding practices were assessed using the World Health Organization (WHO) IYCF guidelines. Logistic and linear regression models tested the association between social support, complementary feeding practices, and household food insecurity. The models were adjusted for household, maternal and child confounders. Statistical significance was set at P &lt; 0.05.

Results

Almost half of the mothers (49.1%) were supported by their spouses, although only 37.8% of mothers had optimal social support. Less than half of infants (36.34%) met minimum dietary diversity (≥4 of 7 food groups). Mothers with optimal social support had lower household food insecurity (b = −0.85, P = 0.016, R,2 = 0.10) in the adjusted models. Furthermore, children of mothers with higher social support were more likely to meet minimum dietary diversity scores (AOR = 2.36 [1.21–4.56], P = 0.021) and to achieve the minimum adequate diet (AOR = 2.32 [1.17–4.61], P = 0.018). Although maternal social support was significantly associated with child minimum meal frequency in the bivariate analysis, it became nonsignificant in the final adjusted model (AOR = 1.70 [0.93–3.11], P = 0.387).

Conclusions

Increased maternal social support was significantly associated with household food security, child dietary diversity, and diet adequacy. Integrating parental peer support in nutrition interventions may be effective in improving food security, and child feeding practices in the Vakinankaratra region of Madagascar.

Funding Sources

This study was funded by Oklahoma State University.

“What We Are Going to Eat Today, We Are Looking for It Today”: Exploring Barriers and Enablers of Optimal Complementary Feeding in Madagascar

Objectives

Complementary feeding practices in Madagascar are inadequate. The purpose of this study was to identify maternal barriers to and enablers of optimal child feeding practices in the Vakinankaratra region of Madagascar.

Methods

Seven focus group discussions with mothers (n = 46) who had a child aged 6–23 months and eight in-depth interviews were conducted with community health workers (6), a nurse (1), and a program field monitor (1) in Malagasy, the local language. Discussions were transcribed verbatim, then back-translated into English. The average length of the interviews was 50 minutes. The translated transcripts from the discussions and interviews were analyzed using NVivo v.12 and a thematic analysis approach was used.

Results

Poverty, lack of money, and limited food availability were mentioned by the mothers as obstacles to adequate complementary feeding practices. Lack of time because of work as well as heavy workload also were cited as problems. Mothers generally decide alone on what food to give to their infants, with little to no help from spouse or relatives. All mothers considered their children's health and giving them appropriate complementary foods as important. Another potential enabler was that mothers trust the community health workers and usually ask them for help and/or information on child feeding. The key informants confirmed all of the mothers’ responses.

Conclusions

Interventions that aim to improve feeding practices in the Vakinankaratra region should address food insecurity and improve households’ income. Strengthening the local infrastructures with the community health workers appears to be important when aiming to reinforce appropriate feeding practices.

Funding Sources

This study was funded by the Marilynn Thoma Chair in Human Sciences at Oklahoma State University.

Acceptability of Best Practice School Lunches by High School-Aged Participants in an Offer Setting

Objectives

A major barrier to improving school lunch dietary quality (DQ) is perceived low acceptability, currently investigated through participation, selection, and plate waste in school settings. The purpose of this study was to investigate differences in acceptability of NSLP-qualifying school lunches of high [Healthy Eating Index (HEI) = 90–95/100, best practice school lunch, BPSL] and moderate (HEI = 75/100, typical school lunch, TSL) DQ in a controlled offer setting by high school-aged children.

Methods

This randomized crossover trial included a convenience sample of 40 high school-aged students recruited from local National School Lunch Program (NSLP)-participating schools. Instruments included hunger scale, selection record, taste test survey, and weighted plate waste assessment. Participants were randomized into three groups, attending three meal conditions in a different order. Meal conditions (MC) had two options for each NSLP meal component: 1) BPSL/BPSL, 2) TSL/TSL, 3) BPSL/TSL. Data analysis included descriptive statistics, Cronbach's alpha, one-way ANOVA, ANCOVA, chi-squared, and regression analysis.

Results

Preliminary analysis showed one significant difference in acceptability between MC, for grain % plate waste (P &lt; 0.001), such that MC1 was significantly greater than MC2 and MC3 (ps &lt; 0.017, mean differences = 27.0% and 26.8%, respectively).

Conclusions

Preliminary results suggest minimal differences in acceptability between BPSL and TSL amongst high school students.

Funding Sources

Oklahoma State University.

Variability in Dietary Quality of an Elementary School Lunch Menu with Changes in National School Lunch Program Nutrition Standards

Objectives

There have been numerous changes to the National School Lunch Program (NSLP) nutrition standards over the past 10 years. The Healthy Hunger-Free Kids Act (HHFKA, 2010) presumably improved dietary quality (DQ) of reimbursable school meals from previous standards, while Child Nutrition Program Flexibilities (CNP Flexibilities, 2017) appear to decrease DQ. However, this variability in DQ has not been quantified. Thus, the purpose of this study was to determine differences in nutrient content and DQ between elementary school lunch menus meeting recent NSLP nutrition standards, School Meal Initiatives (SMI, 1995), HHFKA (2012), and CNP Flexibilities (2017), as well as with evidence-based school lunch best practices implemented (BP).

Methods

A base menu, deemed typical by expert opinion, was portioned per three versions of NSLP nutrition standards (SMI, HHFKA, CNP Flexibilities) and BP for elementary schoolchildren, and analyzed for nutrient content and DQ using ESHA Food Processor and The Healthy Eating Index (HEI) 2015. Statistical analyses included one-way ANOVA, Kruskal-Wallis, and Dunnett's test. The level of significance was set at P &lt; 0.0083.

Results

The BP menu had significantly higher whole fruit (317%) and whole grain (669%) HEI scores than the SMI menu. The BP and HHFKA menus had higher refined grain (156%) and added sugar (2%) HEI scores than the SMI menu. The SMI menu had lower total vegetable (49-50%) and saturated fat (43-51%) HEI scores compared to all other menus. Results were significant (ps &lt; 0.0083).

Conclusions

This study provides important information for guiding future policy towards further improving NSLP nutrition standards in their mission to provide healthy food to children, combatting malnutrition and obesity. Continuing to improve NSLP policy has the potential to impact the health, academic performance, and future of US children through higher DQ school lunches.

Funding Sources

None.

The Management of Childhood Intracranial Tumours and the Role of the Ophthalmologist

OBJECTIVE

This study looked at a single paediatric neuro-oncology centre's experience of childhood intracranial tumours seen in the ophthalmology clinic over an approximately five-year period. This was used to analyse the role of the ophthalmologist in their long term follow up.

METHODS

A database was compiled of all children discussed at the neuro-oncology multi-disciplinary team (MDT) meeting between January 2012 and April 2017. All children who had an intracranial tumour determined by histology or suspected on neuro-imaging, who had also been seen in the ophthalmology clinic, were included. A retrospective case review was performed to create a record for each child.

RESULTS

The database contained 129 children of which 82 (64%) were boys and 47 (36%) were girls. Of these 89 (69%) had a histological diagnosis and 40 (31%) had a tumour suspected on neuroimaging. The most common tumour locations were the posterior fossa (n = 54, 42%), diencephalon (n = 20, 16%) and the visual pathways (n = 17, 13%). Papilloedema at first presentation was only found in 39 (30%) children. The most common other neuro-ophthalmic manifestations were non-paralytic strabismus (n=33), sixth nerve palsy (n=19) and seventh nerve palsy (n=12). Non-paralytic strabismus was a presenting symptom in only one case. There were 13 ophthalmic surgical procedures required for these children, the most common being strabismus surgery.

CONCLUSION

We report the types and locations of paediatric intracranial tumours seen in the ophthalmology clinic as well as their neuro-ophthalmic manifestations. Only 30% presented with papilloedema and approximately 10% required an ophthalmic surgical procedure.

Interventions to promote healthy environments in family child care homes in Oklahoma-Happy Healthy Homes: study protocol for a randomized controlled trial

BACKGROUND

Early childhood is a critical period of development. Caregivers, including providers of early care and education (ECE), have a substantial influence on the health of young children. Family child care homes (FCCHs), which are small, licensed ECE businesses operated out of the residences of providers, are important settings for promoting child health. However, to date, few interventions to promote the health of children have been developed for FCCHs. The purpose of this article is to describe the protocol for Happy Healthy Homes, a pilot interdisciplinary, community-based study to improve FCCH environments and the health of children in Oklahoma. We describe the development and evaluation of two interventions to be tested in a matched attention randomized controlled trial: 1) a nutrition intervention aimed at enhancing the nutritional quality of meals served to young children, incorporating the Child and Adult Care Food Program best practices, and improving nutritional self-efficacy of providers; and 2) an environmental intervention aimed at increasing providers' environmental health literacy, self-efficacy for integrated pest management (IPM), and awareness of less toxic cleaning practices and FCCH provider cleaning behaviors.

METHODS

Both interventions are informed by common theoretical principles and are matched in attention (i.e., 6 h), format (i.e., two individual 90-min educational home visits and a 3-h small group class) and materials (i.e., tool kit of educational materials and supplies tailored to the allocated intervention). A randomized trial of both interventions is currently underway with 52 FCCH providers in the Oklahoma City metropolitan area who participate in the Child and Adult Care Food Program. Observed and self-reported measures will be collected at baseline, and 3 months and 12 months after baseline measurements. Randomization to one of the two interventions will occur after baseline data collection.

DISCUSSION

This study aims to support FCCH providers in creating healthier FCCH environments for nutrition and environmental health. Successful completion will provide critical information about the nutritional quality and the environmental health of children in FCCHs, as well as much needed evidence about the efficacy of two community-based interventions to improve the nutrition and environmental health of children in home-based ECE settings.

TRIAL REGISTRATION

Clinicaltrials.gov, NCT03560050 . Retrospectively registered on 23 May 2018.

Women's Empowerment Measures and Their Association with Child Dietary Diversity and Child Nutritional Status: Findings from DHS Form Eight East African Countries (P10-007-19)

Objectives

Research on the efficacy of women's empowerment measures to improve child dietary diversity Scores (CDDS) and child nutritional status in the East African region is limited. Our study examined the association between maternal economic autonomy, social-familial freedom, self-esteem, health decisiveness and legal empowerment and CDDS, length-for-age z scores (LAZ), weight-for-height z scores (WHZ) and weight-for-age z scores (WAZ).

Methods

The most recent Demographic and Health Surveys (DHS) data from eight countries in the East African Region were used; (Burundi 2016–2017, Ethiopia 2016, Kenya 2014, Malawi 2015–2016, Rwanda 2014–2015, Tanzania 2015–2016, Uganda 2016 and Zambia 2013–2014). Mother (15–49 years) and index child (6–23 months) dyads data was used as the main inclusion criteria. Frequency statistics described selected child, maternal, household and women's empowerment characteristics. Logistic and linear regression models tested the association between each of the women's empowerment measures and CDDS, and child nutritional status respectively. The models were adjusted for household, maternal and child covariates. Statistical significance was set at P < 0.05.

Results

Over half (>55.5%) of the mothers in their respective countries had control over health-related decisions. Most of the mothers (>58.7%) perceived that domestic violence was wrong. Significant bivariate associations were observed between specific women's empowerment measures with CDDS in all countries except Malawi and Uganda. After adjustment in multivariate models, the economic empowerment domain remained significantly associated with CDDS in Ethiopia, Kenya and Tanzania, and the legal empowerment domain remained significantly associated with CDDS in five of eight countries. Individual women's empowerment measures remained significantly associated with higher LAZ, WAZ and WHZ each in a different combination within four of the eight countries.

Conclusions

Women's empowerment measures were associated with higher child dietary diversity score and better child nutritional status in these East African Countries. Interventions aimed at improving CDDS and child nutrition outcomes should include promotion of women's empowerment across multiple dimensions.

Funding Sources

This study had no funding sources.

Targeted Metabolomics Reveals Abnormal Hepatic Energy Metabolism by Depletion of β-Carotene Oxygenase 2 in Mice

β-carotene oxygenase 2 (BCO2) is a carotenoid cleavage enzyme located in the inner mitochondrial membrane. Ablation of BCO2 impairs mitochondrial function leading to oxidative stress. Herein, we performed a targeted metabolomics study using ultrahigh performance liquid chromatography-tandem mass spectroscopy and gas chromatography-mass spectroscopy to discriminate global metabolites profiles in liver samples from six-week-old male BCO2 systemic knockout (KO), heterozygous (Het), and wild type (WT) mice fed a chow diet. Principal components analysis revealed distinct differences in metabolites in the livers of KO mice, compared to WT and Het mice. However, no marked difference was found in the metabolites of the Het mouse liver compared to the WT. We then conducted random forest analysis to classify the potential biomarkers to further elucidate the different metabolomics profiles. We found that systemic ablation of BCO2 led to perturbations in mitochondrial function and metabolism in the TCA cycle, amino acids, carnitine, lipids, and bile acids. In conclusion, BCO2 is essential to macronutrient and mitochondrial metabolism in the livers of mice. The ablation of BCO2 causes dysfunctional mitochondria and altered energy metabolism, which further leads to systemic oxidative stress and inflammation. A single functional copy of BCO2 largely rescues the hepatic metabolic homeostasis in mice.

Determinants of stunting in children under 5 years in Madagascar

Madagascar is among countries where the prevalence of stunting is dramatically high in under 5 years old children. This study investigated the determinants of child stunting based on the UNICEF framework on the causes of malnutrition. A cutoff at 24 months was used to separate the child population into two groups. By using the latest Demographic and Health Survey (2009), logistic regressions were performed to determine the variables associated with stunting. In 2009, 40.1% of the 1,863 children aged 0-23 months and 53.9% of the 2,911 children aged 24-59 months were stunted contributing to the 48.5% overall stunting prevalence in the sample. Girls were less likely to be stunted (adjusted odds ratio with confidence interval [AOR] = 0.69 [0.55-0.88] and 0.84 [0.72-0.97], p < 0.01) than boys; the risk of stunting increased with age. Regarding underlying predictors, increased maternal height was associated with lower odds of stunting in both age groups (AOR = 0.75 [0.68-0.83] and 0.69 [0.61-0.77], p < 0.001). Children living in households using iodized salt (>15 ppm) had lower risk of stunting in the younger group (AOR = 0.76 [0.61-0.94], p < 0.05). Children living in urban areas were less likely to be stunted in both age groups (AOR = 0.67 [0.51-0.88] and 0.73 [0.59-0.90] respectively, p < 0.01]. Region of residence was also a significant basic factor for stunting. This study contributes to the understanding of the determinants of child stunting in Madagascar. The results confirmed the need for specific interventions for each of the two age groups.

Preschoolers can distinguish between healthy and unhealthy foods: the all 4 kids study

OBJECTIVE

To determine changes in preschoolers' ability to distinguish between healthy and unhealthy foods and stated food preferences after participation in a nutrition education program.

DESIGN

Pre-post comparison/intervention study with sites clustered based on center size and language.

SETTING

Preschool classrooms.

PARTICIPANTS

A total of 191 preschoolers from Nevada and 128 from Connecticut, New Jersey, and Oklahoma.

INTERVENTION

All 4 Kids, a 24-lesson program taught by trained instructors.

MAIN OUTCOME MEASURES

Pre- and post-assessment sum scores for identifying 18 foods; stated preference for, and distinguishing between, healthy vs unhealthy choice from 9 food pairs using a newly designed tool.

ANALYSIS

t tests; multiple linear and logistic regression models.

RESULTS

There was a statistically significant improvement in identification scores from pre- to post-study for both groups from Nevada (P < .001). For preference and distinguishing between healthy and unhealthy foods, no differences were noted at pretest. At posttest, significantly more intervention than comparison preschoolers indicated a preference for healthier foods (P < .006) and an ability to distinguish them (P < .03). Outcome comparison between Nevada and 3 states demonstrated generalizability of the study tool.

CONCLUSIONS AND IMPLICATIONS

Participation in All 4 Kids resulted in preschoolers' increased understanding of healthy foods and changed their stated food preferences.

Determinants of fruit and vegetable availability in Hispanic head start families with preschool-aged children living in an urban midwestern area

OBJECTIVE

Determine relationships between self-efficacy, decisional balance, and processes of change and Stages of Change (SOC) related to fruit and vegetable (FV) availability among Hispanic Head Start parents.

DESIGN

A 2-phase descriptive study with mixed methodology.

SETTING

Two Head Start sites in a city in the midwestern United States.

PARTICIPANTS

Convenience sample of Hispanic Head Start parents/guardians recruited to complete a FV survey and focus groups.

MAIN OUTCOME MEASURES

Amount of FV served; distribution of participants between SOC; level of self-efficacy, decisional balance, and use of cognitive and behavioral processes.

ANALYSIS

Analysis of variance was conducted using the SOC as the independent variable and Transtheoretical Model construct scales as dependent variables. Significance was set at P < .05. Focus groups were analyzed using content analysis.

RESULTS

Of the 113 participants, 60% were in pre-action stages. Compared to those of parents in higher stages, intentions of parents in lower stages to serve more FV were impeded by cost and preparation time (P = .028). Focus groups confirmed low self-efficacy as the common barrier to serving more FV.

CONCLUSIONS AND IMPLICATIONS

Nutrition education for low-income Hispanic parents should include components focused on increasing self-efficacy and minimizing perceived barriers; quick and tasty FV recipes; shopping for economical FV; and promoting parental role modeling.

Mass spectrometry for monitoring protease reactions

More than 560 genes are annotated as proteases in the human genome. About half of the genes are not or are only marginally characterized. Over the past decade, mass spectrometry has become the basis for proteomics, especially for protein identification, performed in a high-throughput manner. This development was also very fruitful for exploring the complex systems associated with protease functions, as briefly reviewed here. Mass spectrometry is an ideal tool for monitoring protease reactions, as will be highlighted in this review.

Comparison of Bacillus monooxygenase genes for unique fatty acid production

This paper reviews Bacillus genes encoding monooxygenase enzymes producing unique fatty acid metabolites. Specifically, it examines standard monooxygenase electron transfer schemes and related domain structures of these fused domain enzymes on route to understanding the observed oxygenase activities. A few crystallographic analyses of the standard bearer enzyme P450(BM-3) are discussed to try to rationalize the common chemistries of this important enzyme family. Detailed P450(BM-3) enzyme activities toward different substrates and the unique substrate-specific primary oxidation products are examined. A few orthologs to the recurring P450(BM-3) enzyme as well as related small single-to-triple nucleotides changed mutants are also discussed. Finally, preliminary data characterizing unique in vivo-based primary and secondary products of a novel ortholog, the ALA2 strain, are presented. This later strain synthesizes several unique multi-oxidized reaction products that require additional study to further understand. It is hoped that a better understanding of these oxygenase reactions, particularly the ALA2 strain, will allow for realistically priced production of target multiple-oxygenated compounds with potential uses as specialty chemicals or as therapeutic agents.

C4.4A as a candidate marker in the diagnosis of colorectal cancer

C4.4A is a member of the Ly-6 family with restricted expression in non-transformed tissues. C4.4A expression in human cancer has rarely been evaluated. Thus, it became important to explore C4.4A protein expression in human tumour tissue to obtain an estimate on the frequency of expression and the correlation with tumour progression, the study focusing on colorectal cancer. The analysis of C4.4A in human tumour lines by western blot and immunoprecipitation using polyclonal rabbit antibodies that recognize different C4.4A epitopes revealed C4.4A oligomer and heavily glycosylated C4.4A isoform expression that, in some instances, inhibited antibody binding and interaction with the C4.4A ligand galectin-3. In addition, tumour cell lines released C4.4A by vesicle shedding and proteolytic cleavage. C4.4A was expressed in over 80% of primary colorectal cancer and liver metastasis with negligible expression in adjacent colonic mucosa, inflamed colonic tissue and liver. This compares well with EpCAM and CO-029 expression in over 90% of colorectal cancer. C4.4A expression was only observed in about 50% of pancreatic cancer and renal cell carcinoma. By de novo expression in colonic cancer tissue, we consider C4.4A as a candidate diagnostic marker in colorectal cancer, which possibly can be detected in body fluids.

Radiobiological results from the Bacillus subtilis Biostack experiments within the Apollo and the ASTP space flights

In order to check the results of earlier Biostack experiments, new experimental techniques were developed for the Biostack III experiment in the Apollo-Soyuz test project (ASTP). These techniques resulted in an increased accuracy of localization down to 0.2 micrometers for the determination of the impact parameter, accompanied by an increase in the sample size available for biological investigation. In addition, colony forming ability, metabolic mutations, and mutations affecting UV- and x-ray sensitivity were rendered observable by these methods. The biological and physical results obtained so far from the evaluation of the Bacillus subtilis experiment within Biostack III confirm and extend the findings of the previous Biostack experiments. They also add to the questions about the mechanisms of action of the radiation field under investigation, since the observed effects cannot be interpreted in terms of standard concepts.

Results of the Bacillus subtilis unit of the Biostack II experiment: physical characteristics and biological effects of individual cosmic HZE particles

The effectiveness of cosmic HZE-particles on unicellular procaryotic, organisms was studied on Bacillus subtilis spores, which were accommodated in the Biostack I and II experiments on board Apollo 16 and 17. Identification of the spores that were hit was achieved by using the Biostack sandwich construction and by precise microscopical measurements of tracks of particles. Germination, outgrowth and the rate of cellular elongation were investigated. A method was developed to determine the charge of each individual HZE particle that penetrated a spore and its energy loss in the region of hit. An attempt was made to establish a connection between these physical characteristics and the biological effects produced.

Automatic patient registration in computer assisted maxillofacial surgery

In this paper, a new approach for patient registration in computer assisted maxillofacial surgery is presented. The method uses a unique structure of markers embedded in a reference frame for the automatic detection of the coordinate system of the medical imaging data during the surgical intervention. With the new method, the inaccurate and time consuming process of manually identifying markers in the data volume and manually teaching them to a navigation system can be replaced. The method and algorithms for the automatic marker detection are described in this paper. Experiments with 45 data sets of patients proove the robustness, usability and safety of the new method. The method has been integrated into the navigation system RoboDent for dental implant surgery.

Multiple regions of ETO cooperate in transcriptional repression

In acute myeloid leukemias (AMLs) with t(8;21), the transcription factor AML1 is juxtaposed to the zinc finger nuclear protein ETO (Eight-Twenty-One), resulting in transcriptional repression of AML1 target genes. ETO has been shown to interact with corepressors, such as N-CoR and mSin3A to form complexes containing histone deacetylases. To define regions of ETO required for maximal repressor activity, we analyzed amino-terminal deletions in a transcriptional repression assay. We found that ETO mutants lacking the first 236 amino acids were not affected in their repressor activity, whereas a further deletion of 85 amino acids drastically reduced repressor function and high molecular weight complex formation. This latter mutant can still homodimerize and bind to N-CoR but shows only weak binding to mSin3A. Furthermore, we could show that a "core repressor domain" comprising nervy homology region 2 and its amino- and carboxyl-terminal flanking sequences recruits mSin3A and induces transcriptional repression. These results suggest that mSin3A and N-CoR bind to ETO independently and that both binding sites cooperate to maximize ETO-mediated transcriptional repression. Thus, ETO has a modular structure, and the interaction between the individual elements is essential for the formation of a stable repressor complex and efficient transcriptional repression.

Saliva from cheese bite yields DNA profile of burglar: a case report

Physical evidence in the form of a high quality bite mark was discovered on a piece of yellow cheese found at the scene of a crime. The cheese had been frozen by police for 10 days after recovery and before submission to the laboratory for testing. The double swab technique was used to collect DNA samples. A sample of the suspect's blood was obtained. Using PCR-based DNA typing at ten STR loci, (Profiler Plus, Perkin Elmer-Applied Biosystems) it was determined that the DNA from the cheese originated from the suspect. This case illustrates the importance of a) always considering human bite marks as both physical and biological evidence, and b) attempting DNA recovery in any case in which minute traces of saliva may be present, even in situations involving bacteria-rich foods.

Identification of a skeleton using DNA from teeth and a PAP smear

Identification of unknown living or deceased persons using dental treatment records is an established forensic technique. However, some cases remain unidentified, especially when antemortem dental records are not available for comparison to postmortem dental records. Cytological smears have been previously reported to be potential sources of DNA reference samples which can be compared to DNA recovered from found human remains. The case described here involves an adult skeleton which exhibited extensive, complex dental restorative treatment. A putative identification of the found skeleton as a missing woman was established using circumstantial evidence found at the scene. However, it became important to establish a positive identification using reliable scientific methods. When it was discovered that antemortem dental records were not available because the treatment was completed in another country and the treating dentist could not be found, cytological smears stained with Papanicolaou (PAP) stain obtained from the putative decedent's medical records were used as a reference DNA sample. DNA was recovered from the teeth of the skeleton using cryogenic grinding. Comparison of the genotypes resulted in the conclusion that the DNA originated from the same source. The use of PAP smears in this way is seen as a valuable resource in cases where positive identification using traditional dental and medical records is not possible.

Recovery of DNA from human teeth by cryogenic grinding

DNA has been previously recovered from human teeth for RFLP and PCR-based forensic analysis. In some cases, the maximum amount of undisturbed tooth structure is required for ulterior forensic analysis. But, in most cases, following comprehensive documentation, it is possible to section the tooth longitudinally or horizontally, or crush it to access the DNA-rich core. This technical report describes an alternative method to recover DNA from whole extracted human molar teeth. A 6700 freezer mill was used to pulverize 20 teeth under frozen preparation in liquid nitrogen and sterile conditions. The mean yield of DNA was 30.9 micrograms (18.4 micrograms DNA per gm tooth powder). The resulting fine powder was subjected to organic extraction and subsequently quantified using slot blot hybridization. Aliquots were successfully amplified at three short tandem repeat polymorphic loci. The technique is simple and relatively rapid. Isolation of the samples during pulverization minimizes the risk of contamination.

Effect of volatile methyl jasmonate on the oxylipin pathway in tobacco, cucumber, and arabidopsis

The effect of atmospheric methyl jasmonate on the oxylipin pathway was investigated in leaves of tobacco (Nicotiana tabacum L.), cucumber (Cucumis sativa L.), and Arabidopsis thaliana (L.). Differential sensitivities of test plants to methyl jasmonate were observed. Thus, different concentrations of methyl jasmonate were required for induction of changes in the oxylipin pathway. Arabidopsis was the least and cucumber the most sensitive to methyl jasmonate. Methyl jasmonate induced the accumulation of lipoxygenase protein and a corresponding increase in extractable lipoxygenase activity. Atmospheric methyl jasmonate additionally induced hydroperoxide lyase activity and the enhanced production of several volatile six-carbon products. It is interesting that lipid hydroperoxidase activity, which is a measure of hydroperoxide lyase plus allene oxide synthase plus possibly other lipid hydroperoxide-metabolizing activities, was not changed by methyl jasmonate treatment. Methyl jasmonate selectively altered the activity of certain enzymes of the oxylipin pathway (lipoxygenase and hydroperoxide lyase) and increased the potential of leaves for greatly enhanced six-carbon-volatile production.

Accumulation of type I fish antifreeze protein in transgenic tobacco is cold-specific

Expression of fish antifreeze protein (AFP) genes in plants is a possible means of increasing their frost resistance and freeze tolerance. Initial work involved transfer into tobacco of an AFP gene from winter flounder which codes for the alanine-rich, alpha-helical Type I AFP. Plants were transformed with a gene construct in which the preproAFP cDNA was inserted between the cauliflower mosaic virus 19S RNA promoter and the nopaline synthetase polyadenylation site. Although transgenic plants produced AFP mRNA, no AFP was detected on western blots. Re-evaluation of AFP expression in these transgenic plants showed that AFP accumulated to detectable levels only after exposure of the plant to cold. Extracts of plants incubated at 4 degrees C for 24 h contained a protein which co-migrated with winter flounder proAFP and was cross-reactive to Type I AFP antisera. Two other minor protein bands of slightly higher apparent M(r) also cross-reacted with the antisera and are thought to represent processing intermediates. The proAFP was unique to the transgenic plants and was absent in extracts taken prior to cold exposure. AFP levels increased over the first 48 h of cold incubation then remained stable. Since the alpha-helix content of Type I AFP has been shown to decrease markedly at warmer temperatures, we postulate that Type I AFP stability in transgenic plants is dependent on its secondary structure.

Elbow joint restriction: effect on functional upper limb motion during performance of three feeding activities

This study was conducted to quantify and compare changes in upper limb joint motion during different feeding tasks when the elbow joint was restricted. Ten male and nine female volunteer subjects age 18 to 50 years participated; all were healthy, right dominant, with no upper limb pathology. A splint was used to restrict elbow joint motion. Three feeding tasks under both unrestricted and restricted conditions were randomly assigned; motion was recorded by a video-based three-dimensional motion analysis system. Elbow restriction resulted in significantly (p < .05) larger arcs of motion in shoulder flexion and internal rotation. Differences between feeding types were similar during both unrestricted and restricted conditions. Increased shoulder joint motion resulting from elbow joint restriction may require greater activity of shoulder girdle muscles increasing the risk of soft tissue problems and degenerative joint disease. Decisions regarding elbow immobilization should take into consideration potential effects upon total upper limb motion.

[Results of radiotherapy in recurrent colorectal tumors]

65 patients are presented who have been irradiated at the Radiologic University Hospital of M unster for recurrences of colorectal carcinomas primarily operated upon. In 54 cases the recurrence was located in the small pelvis, in 6 cases within the anastomotic region. The other patients showed cutaneous manifestations or an infestation of adjacent intestinal segments. Apart from the volume occupied by the tumor, the symptoms were above all marked pains. In 62% (40 patients), these pains could be controlled. 30% (19 patients) reported a considerable subjective improvement and 32% (21 patients) a marked diminution of pains. In 20% (13 patients) no modification was achieved, and 12 patients reported a deterioration of troubles. A prolonged survival time after irradiation of the recurrence was observed in those patients irradiated with a focal dose of more than 40 Gy.

Localization and track evaluation of HZE particles

A new method of track-etching was developed called "individual etching", allowing increased accuracy of the localization whereby a latent track is developed under microscopic control. The influence of the humidity of the detectors at the beginning of the etch process was investigated. This influence consists in an increase of bulk and track etching rate. The scattering in experimental data, which is mostly attributed to the inhomogeneity of the material, can be partially explained by this effect, especially the difference in isotopic resolution between accelerator experiments and cosmic-ray flights.