Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.

Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events

An evaluation of portion size estimation aids precision, ease of use and likelihood of future use

AbstractObjectiveThe present study aimed to evaluate the precision, ease of use and likelihood of future use of portion size estimation aids (PSEA).DesignA range of PSEA were used to estimate the serving sizes of a range of commonly eaten foods and rated for ease of use and likelihood of future usage.SettingFor each food, participants selected their preferred PSEA from a range of options including: quantities and measures; reference objects; measuring; and indicators on food packets. These PSEA were used to serve out various foods (e.g. liquid, amorphous, and composite dishes). Ease of use and likelihood of future use were noted. The foods were weighed to determine the precision of each PSEA.SubjectsMales and females aged 18–64 years (n 120).ResultsThe quantities and measures were the most precise PSEA (lowest range of weights for estimated portion sizes). However, participants preferred household measures (e.g. 200 ml disposable cup) – deemed easy to use (median rating of 5), likely to use again in future (all scored either 4 or 5 on a scale from 1=‘not very likely’ to 5=‘very likely to use again’) and precise (narrow range of weights for estimated portion sizes). The majority indicated they would most likely use the PSEA preparing a meal (94 %), particularly dinner (86 %) in the home (89 %; all P&lt;0·001) for amorphous grain foods.ConclusionsHousehold measures may be precise, easy to use and acceptable aids for estimating the appropriate portion size of amorphous grain foods.</jats:sec

Estimation of the dietary requirement for vitamin D in healthy adults

Background: Knowledge gaps have contributed to considerable variation among international dietary recommendations for vitamin D.Objective: We aimed to establish the distribution of dietary vitamin D required to maintain serum 25-hydroxyvitamin D [25(OH)D] concentrations above several proposed cutoffs (ie, 25, 37.5, 50, and 80 nmol/L) during wintertime after adjustment for the effect of summer sunshine exposure and diet.Design: A randomized, placebo-controlled, double-blind 22-wk intervention study was conducted in men and women aged 20&ndash;40 y (n = 238) by using different supplemental doses (0, 5, 10, and 15 &micro;g/d) of vitamin D3 throughout the winter. Serum 25(OH)D concentrations were measured by using enzyme-linked immunoassay at baseline (October 2006) and endpoint (March 2007).Results: There were clear dose-related increments (P &lt; 0.0001) in serum 25(OH)D with increasing supplemental vitamin D3. The slope of the relation between vitamin D intake and serum 25(OH)D was 1.96 nmol&middot;L&ndash;1&middot;&micro;g&ndash;1 intake. The vitamin D intake that maintained serum 25(OH)D concentrations of &gt;25 nmol/L in 97.5% of the sample was 8.7 &micro;g/d. This intake ranged from 7.2 &micro;g/d in those who enjoyed sunshine exposure, 8.8 &micro;g/d in those who sometimes had sun exposure, and 12.3 &micro;g/d in those who avoided sunshine. Vitamin D intakes required to maintain serum 25(OH)D concentrations of &gt;37.5, &gt;50, and &gt;80 nmol/L in 97.5% of the sample were 19.9, 28.0, and 41.1 &micro;g/d, respectively.Conclusion: The range of vitamin D intakes required to ensure maintenance of wintertime vitamin D status [as defined by incremental cutoffs of serum 25(OH)D] in the vast majority (&gt;97.5%) of 20&ndash;40-y-old adults, considering a variety of sun exposure preferences, is between 7.2 and 41.1 &micro;g/d.<br /

Connectivity between the central nucleus of the amygdala and the bed nucleus of the stria terminalis in the non-human primate: neuronal tract tracing and developmental neuroimaging studies

The lateral division of the bed nucleus of the stria terminalis (BSTL) and central nucleus of the amygdala (Ce) form the two poles of the ‘central extended amygdala’, a theorized subcortical macrostructure important in threat-related processing. Our previous work in nonhuman primates, and humans, demonstrating strong resting fMRI connectivity between the Ce and BSTL regions, provides evidence for the integrated activity of these structures. To further understand the anatomical substrates that underlie this coordinated function, and to investigate the integrity of the central extended amygdala early in life, we examined the intrinsic connectivity between the Ce and BSTL in non-human primates using ex vivo neuronal tract tracing, and in vivo diffusion-weighted imaging and resting fMRI techniques. The tracing studies revealed that BSTL receives strong input from Ce; however, the reciprocal pathway is less robust, implying that the primate Ce is a major modulator of BSTL function. The sublenticular extended amygdala (SLEAc) is strongly and reciprocally connected to both Ce and BSTL, potentially allowing the SLEAc to modulate information flow between the two structures. Longitudinal early-life structural imaging in a separate cohort of monkeys revealed that extended amygdala white matter pathways are in place as early as 3 weeks of age. Interestingly, resting functional connectivity between Ce and BSTL regions increases in coherence from 3 to 7 weeks of age. Taken together, these findings demonstrate a time period during which information flow between Ce and BSTL undergoes postnatal developmental changes likely via direct Ce->BSTL and/or Ce <-> SLEAc <-> BSTL projections