Tailored education for older patients to facilitate engagement in falls prevention strategies after hospital discharge—A pilot randomized controlled trial

Background The aims of the study were to evaluate the effect of providing tailored falls prevention education in hospital on: i) engagement in targeted falls prevention behaviors in the month after discharge: ii) patients’ self-perceived risk and knowledge about falls and falls prevention strategies after receiving the education. Methods A pilot randomized controlled trial (n = 50): baseline and outcome assessments conducted by blinded researchers. Participants: hospital inpatients 60 years or older, discharged to the community. Participants were randomized into two groups. The intervention was a tailored education package consisting of multimedia falls prevention information with trained health professional follow-up, delivered in addition to usual care. Outcome measures were engagement in falls prevention behaviors in the month after discharge measured at one month after discharge with a structured survey, and participants’ knowledge, confidence and motivation levels before and after receiving the education. The feasibility of providing the intervention was examined and falls outcomes (falls, fall-related injuries) were also collected. Results Forty-eight patients (98%) provided follow-up data. The complete package was provided to 21 (84%) intervention group participants. Participants in the intervention group were significantly more likely to plan how to safely restart functional activities [Adjusted odds ratio 3.80, 95% CI (1.07, 13.52), p = 0.04] and more likely to complete other targeted behaviors such as completing their own home exercise program [Adjusted odds ratio 2.76, 95% CI (0.72, 10.50), p = 0.14] than the control group. The intervention group was significantly more knowledgeable, confident and motivated to engage in falls prevention strategies after receiving the education than the control group. There were 23 falls (n = 5 intervention; n = 18 control) and falls rates were 5.4/1000 patient days (intervention); 18.7/1000 patient days (control). Conclusion This tailored education was received positively by older people, resulted in increased engagement in falls prevention strategies after discharge and is feasible to deliver to older hospital patients. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry; ACTRN12611000963921 on 8th November 2011

Livestock Growth Hormones: They're Safe

There is widespread evidence that the use of somatotropin or growth hormone to improve milk and pork production is safe. An independent committee appointed by The National Institutes of Health concluded that, "The evidence clearly indicates that the overall composition and nutritional quality of milk and meat from bST-treated cows is equal to that from untreated cows." Similarly, the FDA has concluded that the use of bST presents no increased health risk to consumers. In addition, there is compelling evidence to indicate that somatotropin poses no increased health risk to the ta rget animal. Thus, treatment of farm animals with somatotropin is not only an effective technology for increasing productive efficiency but one that poses no increased health risk for either the consumer or the target animal

Manipulation of adiposity by somatotropin and β-adrenergic agonists: a comparison of their mechanisms of action

A major objective of Animal Science is to develop feasible strategies to reduce lipid accretion during growth of meat animals. Historically, this objective has been sought because of the importance of reducing the quantity of nutrients used to produce body fat and the need to produce lower-fat meat. A fact of long-standing is that an animal’s feed efficiency decreases as the proportion of fat increases in body-weight gain. Thus, reducing fat deposition will improve feed efficiency (i.e. lower the feed:gain ratio) and, hence, increase productive efficiency (gaidfeed). A reduction in fat content of fresh meat also will benefit consumers who wish to decrease their intake of saturated fatty acids (SFA). A reduction in total fat intake to less than 30% of energy and SFA intake to less than 10% of energy is advised in the USA because of the positive relationship that exists between the quantity of SFA consumed and an elevation in plasma low-densitylipoprotein-cholesterol (LDL-C) which is a major risk factor for coronary heart disease (for review, see Kris-Etherton et al. 1988).During the past 10 years remarkable progress has been made in identifying feasible and effective strategies to reduce lipid accretion (Etherton & Kensinger, 1984; Boyd & Bauman, 1989; Etherton & Smith, 1991). The two strategies most likely to be used in production agriculture involve administering somtatotropin (ST) or p-adrenergic agonists to meat animals. In the present paper our current understanding of the mechanisms whereby ST and the P-agonists reduce adipose tissue growth will be reviewed

Dietary α-linolenic acid reduces inflammatory and lipid cardiovascular risk factors in hypercholesterolemic men and women

α-Linolenic acid (ALA) reduces cardiovascular disease (CVD) risk, possibly by favorably changing vascular inflammation and endothelial dysfunction. Inflammatory markers and lipids and lipoproteins were assessed in hypercholesterolemic subjects (n = 23) fed 2 diets low in saturated fat and cholesterol, and high in PUFA varying in ALA (ALA Diet) and linoleic acid (LA Diet) compared with an average American diet (AAD). The ALA Diet provided 17% energy from PUFA (10.5% LA; 6.5% ALA); the LA Diet provided 16.4% energy from PUFA (12.6% LA; 3.6% ALA); and the AAD provided 8.7% energy from PUFA (7.7% LA; 0.8% ALA). The ALA Diet decreased C-reactive protein (CRP, P \u3c 0.01), whereas the LA Diet tended to decrease CRP (P = 0.08). Although the 2 high-PUFA diets similarly decreased intercellular cell adhesion molecule-1 vs. AAD (-19.1% by the ALA Diet, P \u3c 0.01; -11.0% by the LA Diet, P \u3c 0.01), the ALA Diet decreased vascular cell adhesion molecule-1 (VCAM-1, -15.6% vs. -3.1%, P \u3c 0.01) and E-selectin (-14.6% vs. -8.1%, P \u3c 0.01) more than the LA Diet. Changes in CRP and VCAM-1 were inversely associated with changes in serum eicosapentaenoic acid (EPA) (r = -0.496, P = 0.016; r = -0.418, P = 0.047), or EPA plus docosapentaenoic acid (r = -0.409, P = 0.053; r = -0.357, P = 0.091) after subjects consumed the ALA Diet. The 2 high-PUFA diets decreased serum total cholesterol, LDL cholesterol and triglycerides similarly (P \u3c 0.05); the ALA Diet decreased HDL cholesterol and apolipoprotein Al compared with the AAD (P \u3c 0.05). ALA appears to decrease CVD risk by inhibiting vascular inflammation and endothelial activation beyond its lipid-lowering effects

Dietary α-linolenic acid inhibits proinflammatory cytokine production by peripheral blood mononuclear cells in hypercholesterolemic subjects

Background: Atherosclerosis is a chronic inflammatory disease. We previously reported that a diet high in α-linolenic acid (ALA) reduces lipid and inflammatory cardiovascular disease risk factors in hypercholesterolemic subjects. Objective: The objective was to evaluate the effects of a diet high in ALA on serum proinflammatory cytokine concentrations and cytokine production by cultured peripheral blood mononuclear cells (PBMCs) from subjects fed the experimental diets. Design: A randomized, controlled, 3-diet, 3-period crossover study design was used. Hypercholesterolemic subjects (n = 23) were assigned to 3 experimental diets: a diet high in ALA (ALA diet; 6.5% of energy), a diet high in linoleic acid(LA diet; 12.6% of energy), and an average American diet (AAD) for 6 wk. Serum interleukin (IL)-6, IL-1β, and tumor necrosis factor-α (TNF-α) concentrations and the production of IL-6, IL-1β, and TNF-α by PBMCs were measured. Results: IL-6, IL-1β, and TNF-α production by PBMCs and serum TNF-α concentrations were lower (P \u3c 0.05 and P \u3c 0.08, respectively) with the ALA diet than with the LA diet or AAD. PBMC production of TNF-α was inversely correlated with ALA (r = -0.402, P = 0.07) and with eicosapentaenoic acid (r = -0.476, P = 0.03) concentrations in PBMC lipids with the ALA diet. Changes in serum ALA were inversely correlated with changes in TNF-α produced by PBMCs (r = -0.423, P \u3c 0.05). Conclusions: Increased intakes of dietary ALA elicit antiinflammatory effects by inhibiting IL-6, IL-1β, and TNF-α production in cultured PBMCs. Changes in PBMC ALA and eicosapentaenoic acid (derived from dietary ALA) are associated with beneficial changes in TNF-α release. Thus, the cardioprotective effects of ALA are mediated in part by a reduction in the production of inflammatory cytokines. © 2007 American Society for Nutrition