Long-term efficacy of a tele-health intervention for acute coronary syndrome patients with depression: 12-month results of the MoodCare randomized controlled trial

Depression is common after a cardiac event; however it often remains untreated. Previously, we reported the efficacy and feasibility of a 6-month tele-health programme (MoodCare), which integrates depression management into a cardiovascular disease (CVD) risk reduction programme for Acute Coronary Syndrome (ACS) patients with low mood. Here, we evaluate the long-term efficacy of the programme at 12-month follow-up.

Treatment of type 2 diabetes with antioxidant vitamin C therapy

High dose vitamin C supplementation significantly improved insulin sensitivity in skeletal muscle of people with type 2 diabetes. This clinically relevant improvement corresponded with improvements in vitamin C and oxidative stress levels in skeletal muscle. Vitamin C supplementation could be an effective adjunct therapy in people with type 2 diabetes.

Effects of omega-3 PUFA on the vitamin E and glutathione antioxidant defense system in individuals at ultra-high risk of psychosis

BACKGROUND: Oxidative stress and impaired antioxidant defenses are reported in schizophrenia and are associated with disturbed neurodevelopment, brain structural alterations, glutamatergic imbalance, increased negative symptoms, and cognitive impairment. There is evidence that oxidative stress predates the onset of acute psychotic illness. Here, we investigate the effects of omega-3 PUFA on the vitamin E and glutathione antioxidant defense system (AODS). METHOD: In 64 help-seeking UHR-individuals (13-25 years of age), vitamin E levels and glutathione were investigated before and after 12 weeks of treatment with either 1.2g/d omega-3 (PUFA-E) or saturated fatty acids (SFA-E), with each condition also containing 30.4mg/d alpha-tocopherol to ensure absorption without additional oxidative risk. RESULTS: In multivariate tests, the effects on the AODS (alpha-tocopherol, total glutathione) were not significantly different (p=0.13, p=0.11, respectively) between treatment conditions. According to univariate findings, only PUFA-E caused a significant alpha-tocopherol increase, while PUFA-E and SFA-E caused a significant gamma- and delta-tocopherol decrease. Total glutathione (GSHt) was decreased by PUFA-E supplementation. CONCLUSION: Effects of the PUFA-E condition on the vitamin E and glutathione AODS could be mechanisms underlying its clinical effectiveness. In terms of the vitamin E protection system, PUFA-E seems to directly support the antioxidative defense at membrane level. The effect of PUFA-E on GSHt is not yet fully understood, but could reflect antioxidative effects, resulting in decreased demand for glutathione. It is still necessary to further clarify which type of PUFA/antioxidant combination, and in which dose, is effective at each stage of psychotic illness.

Fetuin B is a secreted hepatocyte factor linking steatosis to impaired glucose metabolism

 Liver steatosis is associated with the development of insulin resistance and the pathogenesis of type 2 diabetes. We tested the hypothesis that protein signals originating from steatotic hepatocytes communicate with other cells to modulate metabolic phenotypes. We show that the secreted factors from steatotic hepatocytes induce pro-inflammatory signaling and insulin resistance in cultured cells. Next, we identified 168 hepatokines, of which 32 were differentially secreted in steatotic versus non-steatotic hepatocytes. Targeted analysis showed that fetuin B was increased in humans with liver steatosis and patients with type 2 diabetes. Fetuin B impaired insulin action in myotubes and hepatocytes and caused glucose intolerance in mice. Silencing of fetuin B in obese mice improved glucose tolerance. We conclude that the protein secretory profile of hepatocytes is altered with steatosis and is linked to inflammation and insulin resistance. Therefore, preventing steatosis may limit the development of dysregulated glucose metabolism in settings of overnutrition. Meex et al. use proteomic approaches to identify steatosis as a factor that changes protein secretion in hepatocytes. Secreted factors from steatotic hepatocytes caused insulin resistance and inflammation. One secreted protein, fetuin B, was identified as a hepatokine that is increased in type 2 diabetes and causes impaired glucose metabolism.

A single-blind, randomised controlled trial on the effects of lithium and quetiapine monotherapy on the trajectory of cognitive functioning in first episode mania: A 12-month follow-up study

BACKGROUND: Cognitive deficits have been reported during the early stages of bipolar disorder; however, the role of medication on such deficits remains unclear. The aim of this study was to compare the effects of lithium and quetiapine monotherapy on cognitive performance in people following first episode mania. METHODS: The design was a single-blind, randomised controlled trial on a cohort of 61 participants following first episode mania. Participants received either lithium or quetiapine monotherapy as maintenance treatment over a 12-month follow-up period. The groups were compared on performance outcomes using an extensive cognitive assessment battery conducted at baseline, month 3 and month 12 follow-up time-points. RESULTS: There was a significant interaction between group and time in phonemic fluency at the 3-month and 12-month endpoints, reflecting greater improvements in performance in lithium-treated participants relative to quetiapine-treated participants. After controlling for multiple comparisons, there were no other significant interactions between group and time for other measures of cognition. CONCLUSION: Although the effects of lithium and quetiapine treatment were similar for most cognitive domains, the findings imply that early initiation of lithium treatment may benefit the trajectory of cognition, specifically verbal fluency in young people with bipolar disorder. Given that cognition is a major symptomatic domain of bipolar disorder and has substantive effects on general functioning, the ability to influence the trajectory of cognitive change is of considerable clinical importance.

Vitamin C and E supplementation prevents some of the cellular adaptations to endurance-training in humans

BACKGROUND: It is clear that reactive oxygen species (ROS) produced during skeletal muscle contraction have a regulatory role in skeletal muscle adaptation to endurance exercise. However, there is much controversy in the literature regarding whether attenuation of ROS by antioxidant supplementation can prevent these cellular adaptations. Therefore, the aim of this study was to determine whether vitamin C and E supplementation attenuates performance and cellular adaptations following acute endurance exercise and endurance training. METHODS: A double-blinded, placebo-controlled randomized control trial was conducted in eleven healthy young males. Participants were matched for peak oxygen consumption (VO2peak) and randomly allocated to placebo or antioxidant (vitamin C (2×500mg/day) and E (400IU/day)) groups. Following a four-week supplement loading period, participants completed acute exercise (10×4min cycling at 90% VO2peak, 2min active recovery). Vastus lateralis muscle samples were collected pre-, immediately-post- and 3h-post-exercise. Participants then completed four weeks of training (3 days/week) using the aforementioned exercise protocol while continuing supplementation. Following exercise training, participants again completed an acute exercise bout with muscle biopsies. RESULTS: Acute exercise tended to increase skeletal muscle oxidative stress as measured by oxidized glutathione (GSSG) (P=0.058) and F2-isoprostanes (P=0.056), with no significant effect of supplementation. Acute exercise significantly increased mRNA levels of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α), mitochondrial transcription factor A (TFAM) and PGC related coactivator (PRC), with no effect of supplementation. Following endurance training, supplementation did not prevent significantly increased VO2peak, skeletal muscle levels of citrate synthase activity or mRNA or protein abundance of cytochrome oxidase subunit 4 (COX IV) (P<0.05). However, following training, vitamin C and E supplementation significantly attenuated increased skeletal muscle superoxide dismutase (SOD) activity and protein abundance of SOD2 and TFAM. CONCLUSION: Following acute exercise, supplementation with vitamin C and E did not attenuate skeletal muscle oxidative stress or increased gene expression of mitochondrial biogenesis markers. However, supplementation attenuated some (SOD, TFAM) of the increased skeletal muscle adaptations following training in healthy young men.

Factors related to the accuracy of self-reported dietary intake of children aged 6 to 12 years elicited with interviews: a systematic review

BACKGROUND: Understanding the relationship between children's dietary consumption and health is important. As such, it is crucial to explore factors related to the accuracy of children's reports of what they consumed. OBJECTIVE: The objective was to evaluate factors related to the accuracy of self-reported dietary intake information elicited by interview methods from children aged 6 to 12 years. METHODS: A systematic review of English articles using PsycINFO, PsycARTICLES, PsycEXTRA, PsycBOOKS, CINAHL Complete, Global Health, and MEDLINE Complete was performed. Search terms included interview, diet, children, and recall; studies were limited to those published from 1970 onward. Additional studies were identified using the reference lists of published articles. Studies that assessed children's dietary intake using direct observation, doubly labeled water, or the double-portion method and compared it with their recall of that intake (unassisted by parents) using an interview were included. RESULTS: The 45 studies that met the inclusion criteria showed that specific interview techniques designed to enhance children's recall accuracy had little effect. Rather, the timing of the interview appeared most important: The shorter the retention interval between children's consumption and their recall, the more accurate their memories. Children's age, body mass index, social desirability, food preferences, and cognitive ability were also related to accuracy. CONCLUSIONS: Factors related to the accuracy of children's dietary reporting should be taken into consideration when asking about consumption. Further research is required to examine whether other interview techniques, such as those developed to enhance children's recall of repeated staged events, can improve children's dietary reporting accuracy.

Predictors of adherence to a 12-week exercise program among men treated for prostate cancer: ENGAGE study

Understanding the factors that influence adherence to exercise programs is necessary to develop effective interventions for people with cancer. We examined the predictors of adherence to a supervised exercise program for participants in the ENGAGE study - a cluster randomized controlled trial that assessed the efficacy of a clinician-referred 12-week exercise program among men treated for prostate cancer. Demographic, clinical, behavioral, and psychosocial data from 52 participants in the intervention group were collected at baseline through self-report and medical records. Adherence to the supervised exercise program was assessed through objective attendance records. Adherence to the supervised exercise program was 80.3%. In the univariate analyses, cancer-specific quality of life subscales (role functioning r = 0.37, P = 0.01; sexual activity r = 0.26, P = 0.06; fatigue r = -0.26, P = 0.06, and hormonal symptoms r = -0.31, P = 0.03) and education (d = -0.60, P = 0.011) were associated with adherence. In the subsequent multivariate analysis, role functioning (B = 0.309, P = 0.019) and hormonal symptoms (B = -0.483, P = 0.054) independently predicted adherence. Men who experienced more severe hormonal symptoms had lower levels of adherence to the exercise program. Those who experienced more positive perceptions of their ability to perform daily tasks and leisure activities had higher levels of adherence to the exercise program. Hormonal symptoms and role functioning need to be considered when conducting exercise programs for men who have been treated for prostate cancer.

Ocular exposure to UV-B in sunlight: the Melbourne Visual Impairment Project model

Quantification of ocular exposure to ultraviolet-B radiation (UV-B) has become an important public health issue, with reports that the ozone layer is being depleted worldwide. Ocular exposure to UV-B is determined by ambient UV-B levels, the duration of outdoor exposure, the proportion of ambient UV-B that reaches the eye, and the use of ocular protection. We have developed a simplified model for quantifying lifetime ocular UV-B exposure that can be used in large epidemiological surveys. Exposure to UV-B is assessed and quantified using a model based on personal exposure over the six summer months. Data available for a population-based sample of 1150 people in the age range 40-98 years revealed a distribution in average annual lifetime ocular UV-B exposure similar to that reported in a previous study on which this model is based, and also demonstrate that people can recall lifetime personal behaviour related to ocular protection. It takes 12 minutes on average to collect these data. This model can be employed by researchers worldwide for uniform assessment of ocular UV-B exposure.