Evaluation of protein source at breakfast on energy metabolism, metabolic health, and food intake: a pilot study

Over 30% of adults in the U.S. are obese. A primary contributor to obesity is an unhealthy diet related to imbalanced macronutrients. Diets higher in protein (PRO) rather than carbohydrate (CHO) are associated with increased energy expenditure (EE) and reduced food intake. The objective of this pilot study was to determine if protein source at breakfast influences EE in young men (n = 4; ages 18-35). Participants consumed three isocaloric (whey (WP), pea (PP), beef (BP); 275 kcal, 62% PRO, 23% CHO, 15% Fat) drinks in a randomized, crossover design study with a one-week washout period (time between the administration of each treatment to control for potential interactions). Each test day EE, appetite, and cravings were assessed at 0, 15, 30, 60, 120, 180, and 240 min following consumption. Data were analyzed using 2-way analysis of variance (ANOVA) for effects of protein source over time and one-way ANOVA for area under the curve (niAUC). Resting EE niAUC was 8% lower in BP vs PP and 5% lower vs WP. Thermic effect of feeding niAUC was 77% lower in BP vs WP; PP was 43% lower than WP. Carbohydrate oxidation was higher (31%) with PP compared to WP with no difference between BP and WP. Fat oxidation was 23% higher in WP vs BP and PP. The WP was most satiating. Participants had a higher craving for sweet foods following PP and a higher desire for snacks following BP. Food intake posttreatment was similar in calories and macronutrient distribution. Lack of significant difference among measurements suggests that protein source is not a predictor of postprandial EE, appetite response, or food intake

Evidence-based selection of environmental factors and datasets for measuring multiple environmental deprivation in epidemiological research

This Environment and Human Health project aims to develop a health-based summary measure of multiple physical environmental deprivation for the UK, akin to the measures of multiple socioeconomic deprivation that are widely used in epidemiology. Here we describe the first stage of the project, in which we aimed to identify health-relevant dimensions of physical environmental deprivation and acquire suitable environmental datasets to represent population exposure to these dimensions at the small-area level. We present the results of this process: an evidence-based list of environmental dimensions with population health relevance for the UK, and the spatial datasets we obtained and processed to represent these dimensions. This stage laid the foundations for the rest of the project, which will be reported elsewhere

Losing a Limb, Regaining Independence: A Systematic Review of Occupational Therapy Interventions for Lower Extremity Amputations

Primary Focus: Rehab, Disability & Participation Learning Objectives: Describe lower extremity residual limb care interventions within the scope of occupational therapy Explain the prevalence of individuals who sustain a lower extremity amputation and understand the impact on the U.S. health-care system Identify lower extremity residual limb care interventions to maximize occupational performance Abstract: The purpose of this presentation is to report findings of a systematic review regarding residual limb care interventions supporting increased occupational performance in adults post lower extremity amputation. A systematic review was completed utilizing PubMed, CINHAL, and OTseeker. Inclusion criteria included articles with a sample of adults (mean age of 18-64 years old) with all levels of lower extremity amputations resulting from various etiologies. In addition, these articles were published within the past 10 years and in the English language. Exclusion criteria included articles that contained interventions outside of the scope of occupational therapy practice, systematic reviews, and meta-analyses. Two million people in the U.S. are currently living with limb loss. Hospital costs associated with amputees in 2009 totaled 8.3 billion dollars. Approximately half of individuals with amputations due to vascular disease will require an additional amputation within 2-3 years (Amputee Coalition, 2016). Although there is evidence on surgical techniques and physical therapy’s role in rehabilitation of lower extremity amputations, there is limited evidence to support occupational therapy’s unique role (Robinson, Sansam, Hirst, & Neumann, 2010). However, occupational therapists can provide valuable interventions to improve participation in all activities of daily living (Klarich & Brueckner, 2014). Critical appraisals of eligible articles were performed to identify themes and clinical implications utilizing quantitative and qualitative critical review forms. Four themes concluded from the literature associated with residual limb care interventions and their impact on occupational performance included education, health-care costs, pain, and skin integrity. These findings present implications for occupational therapy research, education, and practice in regards to advocating for occupational therapy’s role in the continuum of care for individuals with lower extremity amputation, and the implementation of interventions to increase occupational performance and decrease health-care costs. This presentation material is of intermediate level and targeted for an audience of occupational therapists and occupational therapy assistants with experience working with individuals with lower limb amputations. References: Amputee Coalition. (2016). Limb loss statistics. Retrieved from http://www.amputee-coalition/limb-loss-resource-center/resources-by-topic/limb-loss-statistics/limb-loss-statistics/ Robinson, V., Sansam, K., Hirst, L., & Neumann, V. (2010). Major lower limb amputation -- what, why and how to achieve the best results. Orthopaedics & Trauma, 24(4), 276-285 10p. doi:10.1016/j.mporth.2010.03.017 Klarich, J., & Brueckner, I. (2014). Amputee rehabilitation and preprosthetic care. Physical Medicine and Rehabilitation Clinics of North America, 25(1), 75-91. doi:10.1016/j.pmr.2013.09.005 Presentation: 31:5

Using multi-agency, multi-professional collaboration to reduce serious violence and organized crime

Serious violence and organized crime have been rising both nationally and in Sheffield, contributing significantly to increasing knife and gun crime, which results in threats to community safety and well-being. A multi-agency project with stakeholders across all levels of command and co- located operational staff was established to undertake collaborative activity that would protect the public by pursuing offenders as well as preparing for and preventing serious violence and organized crime: Fortify. Using a 4P approach, Fortify worked across professional and organizational boundaries to disrupt serious violence and organized crime. Relationships between partners have improved substantially through increased communication and understanding of the different roles, perspectives, and levers of each partner. A recent Home Office locality review applauded our partnership. Intelligence sharing has improved, leading to increased disruptive activity, including increased seizure of money, drugs, and firearms, as well as more arrests and safeguarding referrals. The number of mapped Organized Crime Groups (OCGs) operating across the city has reduced from 19 to 12. Processes and procedures have improved, reducing duplication and holding of information in silos. Community groups are more engaged, allowing us to address serious violence and organized crime in partnership. We propose to undertake action research with the involvement of all partners to provide more robust evaluation of our initial findings. We have found that collaboration between Police and Partners increases collective responsibility and facilitates success in tackling serious violence and organized crime

Clues to the blues: Predictors of self-reported mental and emotional health among older African American men

The mental health needs of aging African American men have been overlooked and few studies have distinguished between more severe clinically diagnosable mental health challenges and less severe emotional states for this population. African American men may not identify with or internalize the terminology of “depression” despite exhibiting the symptom criteria. This exploratory cross-sectional study examined correlates of “downheartedness” as an alternative indicator of emotional health. The authors examined the self-reported responses of 1,666 older African American men on a baseline questionnaire from a larger longitudinal study. Demographic, physical, mental and emotional health, and health system factors were examined as possible correlates of downheartedness. The mean age of participants was 73.6 years and 74.8% of men described themselves as “downhearted and blue” most or all of the time while only 18.5% of them reported feeling moderate to severe anxiety or depression. When other factors were controlled, mobility problems (odds ratio [OR] = 2.36), problems getting health care (OR = 2.69), having a doctor who never listens (OR = 2.18), physical or mental problems that interfere with social activities (OR = 1.34), accomplishing less due to physical health (OR = 1.35), and accomplishing less due to mental/emotional health (OR = 1.57) were all associated with greater odds of being downhearted. The current findings indicate that this sample more closely identified with language accurately describing their emotional health state (i.e., downhearted) and not with clinical mental health terminology (i.e., depression) that may be culturally stigmatized.Southeast Michigan Partners Against Cancer and the Centers for Medicare and Medicade Services (CMS; Award 1 AO CMS 3000068)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/164714/1/Mitchell et al 2017_Clues to the Blues Predictors of.pdfDescription of Mitchell et al 2017_Clues to the Blues Predictors of.pdf : Main articl

The association between green space and cause-specific mortality in urban New Zealand: an ecological analysis of green space utility

<b>Background:</b> There is mounting international evidence that exposure to green environments is associated with health benefits, including lower mortality rates. Consequently, it has been suggested that the uneven distribution of such environments may contribute to health inequalities. Possible causative mechanisms behind the green space and health relationship include the provision of physical activity opportunities, facilitation of social contact and the restorative effects of nature. In the New Zealand context we investigated whether there was a socioeconomic gradient in green space exposure and whether green space exposure was associated with cause-specific mortality (cardiovascular disease and lung cancer). We subsequently asked what is the mechanism(s) by which green space availability may influence mortality outcomes, by contrasting health associations for different types of green space. <b>Methods:</b> This was an observational study on a population of 1,546,405 living in 1009 small urban areas in New Zealand. A neighbourhood-level classification was developed to distinguish between usable (i.e., visitable) and non-usable green space (i.e., visible but not visitable) in the urban areas. Negative binomial regression models were fitted to examine the association between quartiles of area-level green space availability and risk of mortality from cardiovascular disease (n = 9,484; 1996 - 2005) and from lung cancer (n = 2,603; 1996 - 2005), after control for age, sex, socio-economic deprivation, smoking, air pollution and population density. <b>Results:</b> Deprived neighbourhoods were relatively disadvantaged in total green space availability (11% less total green space for a one standard deviation increase in NZDep2001 deprivation score, p < 0.001), but had marginally more usable green space (2% more for a one standard deviation increase in deprivation score, p = 0.002). No significant associations between usable or total green space and mortality were observed after adjustment for confounders. <b>Conclusion</b> Contrary to expectations we found no evidence that green space influenced cardiovascular disease mortality in New Zealand, suggesting that green space and health relationships may vary according to national, societal or environmental context. Hence we were unable to infer the mechanism in the relationship. Our inability to adjust for individual-level factors with a significant influence on cardiovascular disease and lung cancer mortality risk (e.g., diet and alcohol consumption) will have limited the ability of the analyses to detect green space effects, if present. Additionally, green space variation may have lesser relevance for health in New Zealand because green space is generally more abundant and there is less social and spatial variation in its availability than found in other contexts

Mutations in the EPHA2 gene are a major contributor to inherited cataracts in South-Eastern Australia.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Congenital cataract is the most common cause of treatable visual impairment in children worldwide. Mutations in many different genes lead to congenital cataract. Recently, mutations in the receptor tyrosine kinase gene, EPHA2, have been found to cause congenital cataract in six different families. Although these findings have established EPHA2 as a causative gene, the total contribution of mutations in this gene to congenital cataract is unknown. In this study, for the first time, a population-based approach was used to investigate the frequency of disease causing mutations in the EPHA2 gene in inherited cataract cases in South-Eastern Australia. A cohort of 84 familial congenital or juvenile cataract index cases was screened for mutations in the EPHA2 gene by direct sequencing. Novel changes were assessed for segregation with the disease within the family and in unrelated controls. Microsatellite marker analysis was performed to establish any relationship between families carrying the same mutation. We report a novel congenital cataract causing mutation c.1751C.T in the EPHA2 gene and the previously reported splice mutation c.2826-9G.A in two new families. Additionally, we report a rare variant rs139787163 potentially associated with increased susceptibility to cataract. Thus mutations in EPHA2 account for 4.7% of inherited cataract cases in South-Eastern Australia. Interestingly, the identified rare variant provides a link between congenital and age-related cataract