The influence of chronic conditions and the environment on pubertal development. An example from medieval England

Adolescence is a unique period in human development encompassing sexual maturation (puberty) and the physical and psychological transition into adulthood. It is a crucial time for healthy development and any adverse environmental conditions, poor nutrition, or chronic infection can alter the timing of these physical changes; delaying menarche in girls or the age of peak height velocity in boys. This study explores the impact of chronic illness on the tempo of puberty in 607 adolescent skeletons from medieval England (AD 900-1550). A total of 135 (22.2%) adolescents showed some delay in their pubertal development, and this lag increased with age. Of those with a chronic condition, 40.0% (n=24/60) showed delay compared to only 20.3% (n=111/547) of the non-pathology group. This difference was statistically significant. A binary logistic regression model demonstrated a significant association between increasing delay in pubertal stage attainment with age in the pathology group. This is the first time that chronic conditions have been directly associated with a delay in maturation in the osteological record, using a new method to assess stages of puberty in skeletal remains.

The Hugh Sinclair Unit of Human Nutrition – 20 years of research 1995–2015

The Hugh Sinclair Unit of Human Nutrition (HSUHN) at the University of Reading was founded in October 1995 with the appointment of Christine Williams OBE as the first Hugh Sinclair Chair in Human Nutrition. This was made possible by the competitively won funds from the estate and legacy of the late Professor Hugh Macdonald Sinclair (1910–1990). The vision for the newly established HSUHN was to ‘strengthen the evidence base for dietary recommendations for prevention of degenerative chronic diseases’. This has remained the research focus of the HSUHN under the leadership of Professors Christine Williams (1995–2005), Ian Rowland (2006–2013) and Julie Lovegrove (2014-present). Our mission is to improve population health and evaluate mechanisms of action for the effects of dietary components on health, which reflects Hugh Sinclair’s life ambition within nutritional science. Over the past 20 years, the HSUHN has developed an international reputation within the nutrition science community, and in recognition of the 20th anniversary, this paper highlights Hugh Sinclair’s contributions to the field of nutrition and key research achievements by members of the Unit.

Interactions between nutrition and infections with Haemonchus contortus and related gastro-intestinal nematodes in small ruminants

Interactions between host nutrition and feeding behaviour are central to understanding the pathophysiological consequences of infections of the digestive tract with parasitic nematodes. The manipulation of host nutrition provides useful options to control gastrointestinal nematodes as a component of an integrated strategy. Focused mainly on the Hameonchus contortus infection model in small ruminants, this chapter (i) illustrates the relationship between quantitative (macro- and micro-nutrients) and qualitative (plant secondary metabolites) aspects of host nutrition and nematode infection, and (ii) shows how basic studies aimed at addressing some generic questions can help provide solutions, despite the considerable diversity of epidemiological situations and breeding systems.

Brief behavioural activation for adolescent depression: working with complexity and risk

Given the long-term negative outcomes associated with depression in adolescence, there is a pressing need to develop brief, evidence based treatments that are accessible to more young people experiencing low mood. Behavioural Activation (BA) is an effective treatment for adult depression, however little research has focused on the use of BA with depressed adolescents, particularly with briefer forms of BA. In this article we outline an adaptation of brief Behavioral Activation Treatment of Depression (BATD) designed for adolescents and delivered in eight sessions (Brief BA). This case example illustrates how a structured, brief intervention was useful for a depressed young person with a number of complicating and risk factors.

Prevalence of Vitamin D Insufficiency in Brazilian Adolescents

Background/Aims: Cutaneous sun exposure and dietary vitamin D intake are important determinants of vitamin D status. The objective of the present study was to evaluate the vitamin D status of a group of healthy adolescent students living in Brazil. Methods: One hundred and thirty-six adolescents, 64 boys and 72 girls, aged 16-20 years old, living in a rural town in the state of Sao Paulo, Brazil, participated in this study. Results: The mean dietary vitamin D intake was 140 (120-156) IU/day [3.5 (3.0-3.9) mu g/day]. Only 14.9% of the students met the daily adequate intake recommendation of vitamin D. Only 27.9% practice physical activity outdoors and 17.6% of the adolescents apply sunscreen daily. The mean 25(OH)D concentration was 73.0 (22.0) nmol/l [29.2 (8.8) ng/ml]. Vitamin D insufficiency was observed in 60% of adolescents. Conclusions: The present study suggests that even in a sunny climate like Brazil the prevalence of vitamin D insufficiency in adolescents is high. Most likely this is due to low intakes of vitamin D in this group. Due to the limited extent of natural dietary sources of vitamin D, a policy of vitamin D food fortification should be considered in the future, and in the meantime greater use of vitamin D supplements in this population group should be encouraged to provide the increased amounts of this essential nutrient for optimal health. Copyright (C) 2009 S. Karger AG, Basel

Nutrition in Transition: Dietary Patterns of Rural Amazonian Women During a Period of Economic Change

Objectives: The goal of this study was to understand the relationship between economic change (wage labor, retirement, and the Bolsa Familia program) and dietary patterns in the rural Amazon and to determine the extent to which these changes followed the pattern of the nutrition transition. Methods: The study was longitudinal. The weighed-inventory method and economic interviews were used to collect data on dietary intake and household economics in a sample of 30 and 52 women in 2002 and 2009, respectively. Twenty of the women participated in both years and make-up the longitudinal sub-sample. Comparative statistics were used to identify changes in dietary patterns over time and multiple linear regressions were used to explore the relationship between economics, subsistence strategies, and diet. Results: There was a significant decline in kcal (P < 0.01) and carbohydrate (P < 0.01) but no change in protein intake over time in both the larger and smaller, longitudinal subsample. The percent of energy, carbohydrate, protein, and fat purchased increased in the larger and longitudinal samples (P <= 0.02) and there was an increase in refined carbohydrate and processed, fatty-meat consumption over time. The abandonment of manioc gardens was associated with increased dependence on purchased food (P = 0.03) while receipt of the Bolsa Familia was associated with increased protein intake and adequacy (P = 0.02). Conclusions: The dietary changes observed are only in partial agreement with predictions of the nutrition transition literature. The relationship between the economic and diet changes was shaped by the local context which should be considered when implementing CCT programs, like the Bolsa Familia. Am. J. Hum. Biol. 23:458-469, 2011. (C) 2011 Wiley-Liss, Inc.

Changes in extracellular levels of glutamate in the nucleus accumbens after ethanol-induced behavioral sensitization in adolescent and adult mice

Repeated administration of low doses of ethanol gradually increases locomotor responses to ethanol in adult Swiss mice. This phenomenon is known as behavioral sensitization. However, we have shown that adolescent Swiss mice show either behavioral tolerance or no sensitization after repeated ethanol injections. Although the mesolimbic dopamine system has been extensively implicated in behavioral sensitization, several studies have demonstrated an important role of glutamatergic transmission in this phenomenon. In addition, relatively few studies have examined the role of developmental factors in behavioral sensitization to ethanol. To examine the relationship between age differences in behavioral sensitization to ethanol and the neurochemical adaptations related to glutamate within nucleus accumbens (NAc), in vivo microdialysis was conducted in adolescent and adult Swiss mice treated with ethanol (1.8 g/kg) or saline for 15 days and subsequently challenged with an acute dose (1.8 g/kg) of ethanol 6 days later. Consistent with previous findings, only adult mice demonstrated evidence of behavioral sensitization. However, ethanol-treated adolescent mice demonstrated a 196.1 +/- 40.0% peak increase in extracellular levels of glutamate in the NAc after ethanol challenge in comparison with the basal values, whereas ethanol-treated adult mice demonstrated a 52.2 +/- 6.2% reduction in extracellular levels of glutamate in the NAc after ethanol challenge. These observations suggest an age-dependent inverse relationship between behavioral and glutamatergic responses to repeated ethanol exposure. (C) 2011 Elsevier Inc. All rights reserved.

Environmental modulation of ethanol-induced locomotor activity: Correlation with neuronal activity in distinct brain regions of adolescent and adult Swiss mice

Drug abuse is a concerning health problem in adults and has been recognized as a major problem in adolescents. induction of immediate-early genes (IEG), such as c-Fos or Egr-1, is used to identify brain areas that become activated in response to various stimuli, including addictive drugs. It is known that the environment can alter the response to drugs of abuse. Accordingly, environmental cues may trigger drug-seeking behavior when the drug is repeatedly administered in a given environment. The goal of this study was first to examine for age differences in context-dependent sensitization and then evaluate IEG expression in different brain regions. For this, groups of mice received i.p. ethanol (2.0 g/kg) or saline in the test apparatus, while other groups received the solutions in the home cage, for 15 days. One week after this treatment phase, mice were challenged with ethanol injection. Acutely, ethanol increased both locomotor activity and IEG expression in different brain regions, indistinctly, in adolescent and adult mice. However, adults exhibited a typical context-dependent behavioral sensitization following repeated ethanol treatment, while adolescent mice presented gradually smaller locomotion across treatment, when ethanol was administered in a paired regimen with environment. Conversely, ethanol-treated adolescents expressed context-independent behavioral sensitization. Overall, repeated ethanol administration desensitized IEG expression in both adolescent and adult mice, but this effect was greatest in the nucleus accumbens and prefrontal cortex of adolescents treated in the context-dependent paradigm. These results suggest developmental differences in the sensitivity to the conditioned and unconditioned locomotor effects of ethanol. (C) 2008 Elsevier B.V. All rights reserved.

Repeated administration of caffeine increases femproporex-induced locomotor activity in adolescent and adult rats

Caffeine and femproporex are psychostimulants drugs widely consumed in Brazil. Behavioral sensitization is defined as an augmentation in the behavioral effect of a psychostimulant upon re-administration. Repeated administration of a psychostimulant produces behavioral sensitization to that drug and cross-sensitization to other drugs. We investigated whether repeated administration of caffeine increases femproporex-induced locomotor activity in adolescent and adult rats. Forty-eight adolescent (postnatal day 27) and 32 adult (postnatal day 60) received i.p. injections of caffeine (CAF) (10.0 mg/kg) (adolescent N = 24; adult N = 16)) or saline (adolescent N = 24; adult N = 16) once daily for ten days. Three days following the last injection each group was subdivided and received a challenge injection of femproporex (2.0 mg/kg i.p) or saline. Locomotor activity was recorded for 1 hour in 5 - minute intervals. Our results showed that repeated injections of caffeine increased femproporex - induced locomotor activity in adult and adolescent rats.

Effects of adolescent exposure to cocaine on locomotor activity and extracellular dopamine and glutamate levels in nucleus accumbens of DBA/2J mice

Adolescents differ from adults in their acute sensitivity to several drugs of abuse, but little is known about the long-term neurobehavioral effects of adolescent drug exposure. To explore this further, we evaluated the locomotor responses to repeated cocaine administration in adolescent and adult male DBA/2J mice and alterations in extracellular levels of dopamine (DA) and glutamate (GLU) in the nucleus accumbens (NAc) in response to a subsequent cocaine challenge. Adolescent and adult mice were treated daily with saline or cocaine (10 mg/kg, i.p) for 9 consecutive days. Ten days following the last injection, animals were implanted with microdialysis probes and 24 h later microdialysis samples were collected before and after an acute cocaine challenge. Adolescents but not adults demonstrated development of behavioral sensitization to cocaine. Microdialysis procedures revealed that cocaine-treated mice displayed greater peak increases in extracellular DA in response to a subsequent cocaine challenge as compared to saline-treated mice, in contrast with lower peak increases in extracellular GLU. While adults exhibited greater peaks in extracellular DA in response to cocaine than adolescents did, adolescent mice presented a more rapid onset of peak extracellular DA levels than adults. Our results indicate differences in the behavioral and neurochemical responses to cocaine in adolescent versus adult mice, which may be relevant to the increased risk of developing addiction in humans who are exposed to drugs of abuse during adolescence. (C) 2007 Elsevier B.V. All rights reserved.

Palliativa patienters livskvalitet vid behandling med parenteral nutrition : en litteraturöversikt

Syfte: Litteraturöversiktens syfte var att belysa vilken påverkan parenteral nutrition har på livskvaliteten hos palliativa patienter. Metod: Denna studie har genomförts som en litteraturöversikt. Vetenskapliga artiklar har insamlats från databaserna Cinahl, Medline och Pubmed. Totalt fann författarna 12 vetenskapliga artiklar som svarade mot litteraturstudiens syfte. De utvalda artiklarna var både kvantitativa och kvalitativa. Kvalitetsgranskningen utfördes med hjälp av granskningsmallar och artiklarna som lade grunden till resultatet motsvarade medel till hög kvalitet. Resultat: Resultatet visade på att flertalet patienter kände en trygghet och lättnad när den parenterala nutritionen introducerades. Patienterna ansåg att vetskapen att deras nutritionsbehov blev tillfredsställt gjorde att de inte behövde vara rädda för att svälta ihjäl. De upplevde en ökad livskvalitet då de slapp oroa sig för födointaget och orkade medverka mera aktivt i det sociala familjelivet. Flertalet av patienterna uppgav en förbättrad livskvalitet när möjlighet gavs att få parenteral nutrition i hemmet trots att det innebar inskränkningar i familjelivet. De uppgav även en ökad styrka till att hantera bland annat sjukdomssymtom och behandlingsbiverkningar. Den parenterala nutritionen gav i vissa fall problem med biverkningar, men de flesta patienterna skattade ändå livskvaliteten högre av att få näringsdroppet. Resultatet visade även på att om den parenterala nutritionen sattes in i ett tidigt skede kunde en förbättring av nutritionsstatusen ske och patienterna behöll sin kroppsvikt under en något längre tid. Det resulterade i en ökad skattning av livskvaliteten. De sista veckorna i livet hade näringsdroppet ingen mätbar positiv effekt.

Egenvård i nutrition till personer med hjärtsvikt.

Syfte:            Syftet med denna litteraturstudie var att studera hur personer med hjärtsvikt kan få en förbättrad nutrition genom egenvård. Metod:          Studien genomfördes som en litteraturöversikt. Artiklarna söktes via databaserna CINAHL och PubMed. Resultat:       Studiens resultat innehöll 10 artiklar med kvantitativ ansats. En förutsättning för att personer med hjärtsvikt ska klara sin egenvård och ges möjlighet att förbättra sin nutrition är utbildning. Utbildningsmetoder som i föreliggande litteraturstudie har visat sig fungera är att kombinera skriftlig och muntlig utbildning. Undervisningen bör innehålla information om vilken typ av mat personer med hjärtsvikt behöver äta samt varför. En god följsamhet till givna riktlinjer nås genom att ge personer med hjärtsvikt individuellt anpassad information samt att uppföljning sker och information ges kontinuerligt. Slutsats:        Det är mycket viktigt att hälso- och sjukvårdspersonal kombinerar muntlig och skriftlig information vid utbildning inom nutrition riktad till personer med hjärtsvikt för att stärka deras egenvård. Hälso- och sjukvårdspersonal bör se till att kontinuerlig uppföljning sker för att optimera följsamheten.  

Sjuksköterskors erfarenheter av parenteral nutrition för patienter i livets slutskede : En litteraturöversikt

Bakgrund: Tidigare forskning har visat att parenteral nutrition ges till patienter som befinner sig i livets slutskede även om den medicinska nyttan är oklar. Syfte: Att genom en vetenskaplig litteraturöversikt beskriva sjuksköterskors erfarenheter av vad som är betydelsefullt i arbetet med parenteral nutrition för patienter i livets slutskede. Metod: Examensarbetet är utformat som en litteraturöversikt. Tretton artiklar med kvalitativ och kvantitativ design valdes ut. Artiklarna söktes på databaserna CINAHL och Pubmed Resultat: Delaktighet i vårdteam var av stor betydelse, ett fungerade samarbete där sjuksköterskan ville och fick möjlighet att arbeta som omvårdnadsansvarig upplevdes av sjuksköterskan resultera i god personcentrerad vård. Erfarenhet och egna känslor spelar en betydande roll i hur mycket sjuksköterskan vågar och vill vara delaktig i beslut angående PN i livets slutskede, och vilken relation som skapas med patientens närstående. Slutsats: Ökad kunskap om parenteral nutrition i livets slutskede och personcentrerad vård behövs för att sjuksköterskorna ska våga vara aktivt delaktig och stärka patienten i livets slutskede.

Tough, sensitive and sincere : how adolescent boys manage masculinities and emotions

This study aimed to explore adolescent boys’ views of masculinity and emotion management and their potential effects on well-being. Interviews with 33 adolescent boys aged 16–17 years in Sweden were analysed using grounded theory. We found two main categories of masculine conceptions in adolescent boys: gender-normative masculinity with emphasis on group-based values, and non-gender-normative masculinity based on personal values. Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite their expressions contrasting each other. Non-gender-normative masculinity included an orientation towards sincerity emphasising the personal values of the boys; emotions were expressed more independently of peer group norms. Our findings suggest that different masculinities and the expression of emotions are strongly intertwined and that managing emotions is vital for well-being.