How much is '5-a-day'? A qualitative investigation into consumer understanding of fruit and vegetable intake guidelines.

BACKGROUND: Despite the known health benefits of fruit and vegetables (FV), population intakes remain low. One potential contributing factor may be a lack of understanding surrounding recommended intakes. The present study aimed to explore the understanding of FV intake guidelines among a sample of low FV consumers. METHODS: Six semi-structured focus groups were held with low FV consumers (n = 28, age range 19-55 years). Focus groups were recorded digitally, transcribed verbatim and analysed thematically using nvivo (QSR International, Melbourne, Australia) to manage the coded data. Participants also completed a short questionnaire assessing knowledge on FV intake guidelines. Descriptive statistics were used to analyse responses. RESULTS: The discussions highlighted that, although participants were aware of FV intake guidelines, they lacked clarity with regard to the meaning of the '5-a-day' message, including what foods are included in the guideline, as well as what constitutes a portion of FV. There was also a sense of confusion surrounding the concept of achieving variety with regard to FV intake. The sample highlighted a lack of previous education on FV portion sizes and put forward suggestions for improving knowledge, including increased information on food packaging and through health campaigns. Questionnaire findings were generally congruent with the qualitative findings, showing high awareness of the '5-a-day' message but a lack of knowledge surrounding FV portion sizes. CONCLUSIONS: Future public health campaigns should consider how best to address the gaps in knowledge identified in the present study, and incorporate evaluations that will allow the impact of future initiatives on knowledge, and ultimately behaviour, to be investigated

The development of multiple phases of superposed rifting in the Turkana Depression, East Africa: evidence from receiver functions

The Turkana Depression in Eastern Africa separates the elevated plateaus of East Africa to the south and Ethiopia-Yemen to the north. It remains unclear whether the Depression lacks dynamic mantle support, or if the entire East Africa region is dynamically supported and the Depression compensated isostatically by thinned crust. Also poorly understood is how Miocene-Recent extension has developed across the Depression, connecting spatially separated magmatic rift zones in Ethiopia and Kenya. Receiver function analysis is used to constrain Moho depth and bulk-crustal V P /V S ratio below new seismograph networks in the Depression, and on the northern Tanzania craton. Crustal thickness is ∼40 km below northern Uganda and 30–35 km below southern Ethiopia, but 20–30 km below most of the Depression, where mass-balance calculations reveal low elevations can be explained adequately by crustal thinning alone. Despite the fact that magmatism has occurred for 45 Ma across the Depression, more than 15 Ma before East African Rift (EAR) extension initiated, bulk crustal V P /V S across southern Ethiopia and the Turkana Depression (∼1.74) is similar to that observed in areas unaffected by Cenozoic rifting and magmatism. Evidence for voluminous lower crustal intrusions and/or melt, widespread below the Ethiopian rift and Ethiopian plateau to the north, is therefore lacking. These observations, when reviewed in light of high stretching factors (β ≤ 2.11), suggest Cenozoic extension has been dominated until recently by faulting and plate stretching, rather than magma intrusion, which is likely an incipient process, operating directly below seismically-active Lake Turkana. Early-stage EAR basins to the west of Lake Turkana, with associated stretching factors of β ≈ 2, formed in crust only moderately thinned during earlier rifting episodes. Conversely, ∼23 km-thick crust beneath the Kino Sogo Fault Belt (KSFB) has small offset faults and thin sedimentary strata, suggesting almost all of the observed stretching occurred in Mesozoic times. Despite the KSFB marking the shortest path between focused extensional zones to the north and south, seismicity and GPS data show that modern extension is localized below Lake Turkana to the west. Failed Mesozoic rift zones, now characterized by thinned crust and relatively refractory mantle lithosphere, are being circumnavigated, not exploited by EAR rifting

A High Polyphenol Diet Improves Psychological Well-Being: The Polyphenol Intervention Trial (PPhIT).

Mental ill health is currently one of the leading causes of disease burden worldwide. A growing body of data has emerged supporting the role of diet, especially polyphenols, which have anxiolytic and antidepressant-like properties. The aim of the present study was to assess the effect of a high polyphenol diet (HPD) compared to a low polyphenol diet (LPD) on aspects of psychological well-being in the Polyphenol Intervention Trial (PPhIT). Ninety-nine mildly hypertensive participants aged 40-65 years were enrolled in a four-week LPD washout period and then randomised to either an LPD or an HPD for eight weeks. Both at baseline and the end of intervention, participants' lifestyle and psychological well-being were assessed. The participants in the HPD group reported a decrease in depressive symptoms, as assessed by the Beck Depression Inventory-II, and an improvement in physical component and mental health component scores as assessed with 36-Item Short Form Survey. No differences in anxiety, stress, self-esteem or body image perception were observed. In summary, the study findings suggest that the adoption of a polyphenol-rich diet could potentially lead to beneficial effects including a reduction in depressive symptoms and improvements in general mental health status and physical health in hypertensive participants

Health-related quality of life impact of cobimetinib in combination with vemurafenib in patients with advanced or metastatic BRAFV600 mutation-positive melanoma

Background: In the coBRIM study, cobimetinib plus vemurafenib (C+V) significantly improved survival outcomes vs placebo and vemurafenib (P+V) in patients with advanced/metastatic BRAF(V600)-mutated melanoma. An analysis of health-related quality of life (HRQOL) from coBRIM is reported.Methods: Patients completing the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) at baseline and >= 1 time point thereafter constituted the analysis population. Change from baseline >= 10 points was considered clinically meaningful.Results: Mean baseline scores for all QLQ-C30 domains were similar between arms. Most on-treatment scores for QLQ-C30 domains were also comparable between arms. A transient deterioration in role function in cycle 1 day 15 (C1D15; -14.7 points) in the P+V arm and improvement in insomnia in the C+V arm at C2D15 (-12.4 points) was observed. Among patients who experienced a >= 10-point change from baseline (responders), between-group differences were greatest for insomnia (16%), social functioning (10%), fatigue (9%) and pain (7%), all favouring C+V. Diarrhoea, photosensitivity reaction, pyrexia, and rash did not meaningfully affect global health status (GHS). Serous retinopathy was associated with a transient decrease in GHS at C1D15 assessment.Conclusions: In patients with advanced/metastatic BRAFV600-mutated melanoma, treatment with C+V maintained HRQOL compared with P+V, with superior efficacy

A Report Card on Urban Erosion and Sedimentation Control in North Carolina

In 1973 North Carolina enacted what has become one of the most stringent erosion and sedimentation control programs in the nation. This article discusses how a survey of 128 construction sites in North Carolina turned up evidence that practice falls short of state goals to curb urban erosion and sedimentation. The authors then discuss policy options to remedy these shortcomings

Distributed urban drag parameterization for sub‐kilometre scale numerical weather prediction

A recently developed, height-distributed urban drag parameterization is tested with the London Model, a sub-kilometre resolution version of the Met Office Unified Model over Greater London. The distributed drag parameterization requires vertical morphology profiles in form of height-distributed frontal area functions, which capture the full extent and variability of building heights. London’s morphology profiles are calculated and parameterised by an exponential distribution with the ratio of maximum to mean building height as parameter. A case study evaluates the differences between the new distributed drag scheme and the current London Model set-up using the MORUSES urban land-surface model. The new drag parameterization shows increased horizontal spatial variability in total surface stress, identifying densely built-up areas, high-rise building clusters, parks and the river. Effects on the wind speed in the lower levels include a lesser gradient and more heterogeneous wind profiles, extended wakes downwind of the city centre, and vertically growing perturbations that suggest the formation of internal boundary layers. The surface sensible heat fluxes are under-predicted, which is attributed to difficulties coupling the distributed momentum exchange with the surface-based heat exchange

Blockade of T-cell activation by dithiocarbamates involves novel mechanisms of inhibition of nuclear factor of activated T cells.

Dithiocarbamates (DTCs) have recently been reported as powerful inhibitors of NF-kappaB activation in a number of cell types. Given the role of this transcription factor in the regulation of gene expression in the inflammatory response, NF-kappaB inhibitors have been suggested as potential therapeutic drugs for inflammatory diseases. We show here that DTCs inhibited both interleukin 2 (IL-2) synthesis and membrane expression of antigens which are induced during T-cell activation. This inhibition, which occurred with a parallel activation of c-Jun transactivating functions and expression, was reflected by transfection experiments at the IL-2 promoter level, and involved not only the inhibition of NF-kappaB-driven reporter activation but also that of nuclear factor of activated T cells (NFAT). Accordingly, electrophoretic mobility shift assays (EMSAs) indicated that pyrrolidine DTC (PDTC) prevented NF-kappaB, and NFAT DNA-binding activity in T cells stimulated with either phorbol myristate acetate plus ionophore or antibodies against the CD3-T-cell receptor complex and simultaneously activated the binding of AP-1. Furthermore, PDTC differentially targeted both NFATp and NFATc family members, inhibiting the transactivation functions of NFATp and mRNA induction of NFATc. Strikingly, Western blotting and immunocytochemical experiments indicated that PDTC promoted a transient and rapid shuttling of NFATp and NFATc, leading to their accelerated export from the nucleus of activated T cells. We propose that the activation of an NFAT kinase by PDTC could be responsible for the rapid shuttling of the NFAT, therefore transiently converting the sustained transactivation of this transcription factor that occurs during lymphocyte activation, and show that c-Jun NH2-terminal kinase (JNK) can act by directly phosphorylating NFATp. In addition, the combined inhibitory effects on NFAT and NF-KB support a potential use of DTCs as immunosuppressants

Prevention and management of excessive gestational weight gain: a survey of overweight and obese pregnant women

Background - Excessive gestational weight gain is associated with adverse infant, childhood and maternal outcomes and research to develop interventions to address this issue is ongoing. The views of women on gestational weight gain and the resources they would consider helpful in addressing this are however largely unknown. This survey aimed to determine the views of newly pregnant women, living in areas of social disadvantage, on 1) their current body weight and potential gestational weight gain and 2) the resources or interventions they would consider helpful in preventing excessive gestational weight gain. Methods - A convenience sample of overweight and obese pregnant women living in Fife, UK, were invited to complete a short anonymised questionnaire at their 12 week booking visit. Results - 428 women, BMI>25 kg/m2, completed the questionnaire. Fifty-four per cent of respondents were obese (231) and 62% were living in areas of mild to moderate deprivation. Over three-quarters of participants felt dissatisfied with their current weight (81%). The majority of women (60%) expressed some concern about potential weight gain. Thirty-nine percent were unconcerned about weight gain during their pregnancy, including 34 women (19%) who reported having retained weight gained in earlier pregnancies. Amongst those concerned about weight gain advice on physical activity (41%) and access to sports/leisure facilities were favoured resources (36%). Fewer women (12%) felt that group sessions on healthy eating or attending a clinic for individualised advice (14%) would be helpful. "Getting time off work" was the most frequently cited barrier (48%) to uptake of resources other than leaflets. Conclusions- These data suggest a lack of awareness amongst overweight and obese women regarding excessive gestational weight gain. Monitoring of gestational weight gain, and approaches for its management, should be formally integrated into routine antenatal care. Barriers to the uptake of resources to address weight gain are numerous and must be considered in the design of future interventions and services