Food Cent$: Educating mothers with a mental illness about nutrition

People with a mental illness can have deficits in a range of areas, including food skills. Mothers who have a mental illness and have residential care of their children are particularly vulnerable to experiencing food insecurity. The food skills programme known as Food Cent$ is a new way of spending money on food using the 10-plan, so that people can learn to balance their diet and their food budget. Occupational therapists in a mental health rehabilitation service incorporated the use of Food Cent$ into a parenting programme for mothers with a mental illness. A pilot study was conducted to identify whether the Food Cent$ programme influenced behaviours and attitudes towards food and food selection and preparation and reduced grocery expenditure. The participants were six mothers with a mental illness who had children under 5 years of age in their care. A focus group was conducted to gain insight into the experiences of mothers who had attended the programme. Supermarket receipts were collected before and after the project to determine changes in dietary practices. The results indicated that attending Food Cent$ contributed to an improvement in dietary intake, food selection and preparation, and grocery expenditure. Further research is required into the effectiveness of this programme with other target groups likely to experience food insecurity.

Warranty and optimal reliability improvement through product development

For products sold with warranty, the warranty servicing cost can be reduced by improving product reliability through a development process. However, this increases the unit manufacturing cost. Optimal development must achieve a trade-off between these two costs. The outcome of the development process is uncertain and needs to be taken into account in the determination of the optimal development effort. The paper develops a model where this uncertainty is taken into account. (C) 2003 Elsevier Ltd. All rights reserved.

A randomized trial of aggressive lipid reduction for improvement of myocardial ischemia, symptom status, and vascular function in patients with coronary artery disease not amenable to intervention

PURPOSE: To determine the effects of aggressive lipid lowering on markers of ischemia, resistance vessel function, atherosclerotic burden, and Symptom status in patients with symptomatic coronary artery disease. METHODS: Sixty consecutive patients with coronary artery disease that was unsuitable for revascularization were assigned randomly to either usual therapy of lipids for patients with a low-density lipoprotein (LDL) cholesterol target level <116 mg/dL, or to a, more aggressive lipid-lowering strategy involving up to 80 mg/d of atorvastatin, with a target LDL cholesterol level <77 mg/dL. The extent and severity of inducible ischemia (by dobutamine echocardiography), vascular function.(brachial artery reactivity), atheroma burden (carotid intima-media thickness), and symptom status were evaluated blindly at baseline and after 12 weeks of treatment. RESULTS: After 12 weeks of treatment, patients in the aggressive therapy group had a significantly greater decrease in mean (+/- SD) LDL cholesterol level than those in the usual care group (29 +/- 38 mg/dL vs. 7 +/- 24 mg/dL, P = 0.03). Patients in the aggressive therapy group had a reduction in the number of ischemic wall segments (mean between-group difference of 1.3; 95% confidence interval: 0.1 to 2.0; P = 0.04), flow-mediated dilatation (mean between-group difference of 5.9%; 95% confidence interval: 2.5% to 9.4%; P = 0.001), and angina score after 12 weeks. There were no significant changes in atherosclerotic burden in either group. CONCLUSION: Patients with symptomatic coronary artery disease who are treated with aggressive lipid lowering have improvement of symptom status and ischemia that appears to reflect improved vascular function but not atheroma burden. Am J Med. 2003;114:445-453. (C) 2003 by Excerpta Medica Inc.