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Pulses are a healthy, sustainable, low cost food, but consumption levels are low for a variety of reasons, including practical and cooking concerns. This work aimed to explore barriers and facilitators towards pulse consumption and increasing consumption, and the potential value of cooking suggestions and recipes for changing these perceptions. Two qualitative studies were undertaken. In Study 1, 21 participants (10 males, 11 females, of a range of ages, cooking responsibilities, and experiences with pulses) were interviewed both before and after receiving cooking suggestions and recipes. In Study 2, 12 participants (2 males, 10 females, as above) were interviewed once after trying recipes. Interviews were audio-recorded, transcribed, and analysed using thematic analysis. Seven themes described barriers and facilitators towards pulse consumption: 'Enjoyment and Sensory properties'; 'Benefits and Recommendations'; 'Practical Concerns'; 'Cooking Concerns'; 'Compatibility with current diet'; 'Personal Influences'; and 'External Influences'. Some similar themes also referred to increasing consumption: 'Willingness'; 'Awareness, Knowledge of Benefits'; 'Knowledge of Cooking and Practical Concerns'; and 'Compatibility with current diet'. Cooking suggestions and recipe use resulted in themes on 'Awareness'; 'Willingness, Trying New Things'; 'Small Changes'; and facilitators associated with 'Enjoyment, Sensory Properties, Practical Concerns, Benefits' and 'Knowledge, Cooking Ideas and Confidence, Incorporation, Cooking Solutions'. Barriers related to 'Risk and Preconceptions'; 'Awareness, but' inaction and additional considerations were also found. Our findings demonstrate a positive role for pulse consumption for increased experience, familiarity, and confidence with preparing, cooking, and consuming these healthy and sustainable foods., Competing Interests: The authors have no interests to declare., (© The Author(s) 2024.)

Background: No previous studies have reported predictors and moderators of outcome of psychological therapies for depression experienced by adults with intellectual disabilities (IDs). We investigated baseline variables as outcome predictors and moderators based on a randomised controlled trial where behavioural activation was compared with guided self-help., Methods: This study was an exploratory secondary data analysis of data collected during a randomised clinical trial. Participants (n = 161) were randomised to behavioural activation or guided self-help and followed up for 12 months. Pre-treatment variables were included if they have previously been shown to be associated with an increased risk of having depression in adults with IDs or have been reported as a potential predictor or moderator of outcome of treatment for depression with psychological therapies. The primary outcome measure, the Glasgow Depression Scale for Adults with Learning Disabilities (GDS-LD), was used as the dependant variable in mixed effects regression analyses testing for predictors and moderators of outcome, with baseline GDS-LD, treatment group, study centre and antidepressant use as fixed effects, and therapist as a random effect., Results: Higher baseline anxiety (mean difference in outcome associated with a 1 point increase in anxiety 0.164, 95% confidence interval [CI] 0.031, 0.297; P = 0.016), lower performance intelligence quotient (IQ) (mean difference in outcome associated with a 1 point increase in IQ 0.145, 95% CI 0.009, 0.280; P = 0.037) and hearing impairment (mean difference 3.449, 95% CI 0.466, 6.432; P = 0.024) were predictors of poorer outcomes, whilst greater severity of depressive symptoms at baseline (mean difference in outcome associated with 1 point increase in depression -0.160, 95% CI -0.806, -0.414; P < 0.001), higher expectation of change (mean difference in outcome associated with a 1 point increase in expectation of change -1.013, 95% CI -1.711, -0.314; p 0.005) and greater percentage of therapy sessions attended (mean difference in outcome with 1 point increase in percentage of sessions attended -0.058, 95% CI -0.099, -0.016; P = 0.007) were predictors of more positive outcomes for treatment after adjusting for randomised group allocation. The final model included severity of depressive and anxiety symptoms, lower WASI performance IQ subscale, hearing impairment, higher expectation of change and percentage of therapy sessions attended and explained 35.3% of the variance in the total GDS-LD score at 12 months (R 2  = 0.353, F 4, 128  = 17.24, P < 0.001). There is no evidence that baseline variables had a moderating effect on outcome for treatment with behavioural activation or guided self-help., Conclusions: Our results suggest that baseline variables may be useful predictors of outcomes of psychological therapies for adults with IDs. Further research is required to examine the value of these potential predictors. However, our findings suggest that therapists consider how baseline variables may enable them to tailor their therapeutic approach when using psychological therapies to treat depression experienced by adults with IDs., (© 2023 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Dietary consumption contributes significantly to the environmental impacts of daily life. Changes to consumption are required, but limited work investigates the reasoning underlying relevant dietary choices. This study aimed to explore public understanding of sustainable diets and any willingness or attempts to make changes towards sustainability in a sample of the UK population. A qualitative approach was used. Twenty-one participants (10 males; predominantly young adults; with a range of living circumstances and cooking responsibilities) were interviewed. Interviews were analysed using inductive thematic analysis. Four themes were identified that related to understanding sustainable diets: 'Consistent with the definition by the Food and Agriculture Organisation of the United Nations (FAO)', 'Multiple benefits', 'Unsure' and 'Competing Interests'. Four themes related to making changes: 'Willing, but unsure', 'Small easy changes', 'Enablers' and 'Barriers'. An additional theme 'COVID-19 pandemic' reflected the period when the work was done (February-May 2021). Within these themes, participants were able to define sustainable eating in a manner that was consistent with and incorporated aspects of the definition by the FAO, could identify sustainable actions that they were undertaking or could undertake, and considered these to be beneficial, but there was a lot of uncertainty, and alternative or competing definitions and actions were also given. Participants were also willing to make changes to make their diet more sustainable, and preferences were expressed for small easy changes of high impact, but there was again considerable uncertainty as to what changes to make. Caution due to the small and select sample is required, but suggestions from this work include increasing awareness and knowledge of the environmental impacts of dietary choices, focusing on small easy changes of likely impact and personal benefit, and increasing availability and accessibility to sustainable diets., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Health professionals were trained to deliver adapted psychological interventions for depression to people with learning disabilities and depression alongside a supporter. Exploring the delivery of psychological interventions can help increase access to therapy., Method: Twenty-seven participants took part in six focus groups, and the data were subject to a Framework Analysis., Results: The structure and focus of the manualised therapies, and the use of specific techniques were perceived as key to service-user engagement. Supporters' involvement was valued by therapists if they had a good relationship and regular contact with the individual they supported. Regular clinical supervision was regarded as vital in understanding their role, assessing progress and delivering the interventions., Conclusions: The findings highlight that health professionals can embrace a focussed therapeutic role and increase access to psychological therapies for people with intellectual disabilities., (© 2021 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Objective: This study investigated the impact of recipe and single-use herb/spice packet provision on egg intake and protein intake in community-dwelling individuals aged over 55 years., Design: Using a randomised-controlled intervention design, 100 older adults were randomised to receive (n 53) or not receive (n 47) high-protein egg-based recipes and herb/spice packets through the post for 12 weeks, from June to December 2016. Egg intake, protein intake, adverse events, lean body mass and functional measures of lean body mass were measured at baseline, after the 12 weeks and after a further 12 weeks., Setting: Bournemouth, UK., Participants: Community-dwelling older adults., Results: Intention-to-treat data were analysed using regression, controlling for various demographic and lifestyle characteristics. Ninety-three individuals (intervention, n 50; control, n 43) completed assessments at all three time points. Egg intakes increased by end of intervention in both groups (mean: 4-5 eggs/month). After a further 12 weeks, higher egg intakes were sustained in the intervention group, while egg intakes in the control group returned to baseline levels (between-group difference: β = -0·124, P = 0·047). No differences were found in other measures (largest β = -0·106, P = 0·12)., Conclusions: The provision of high-protein egg-based recipes and single-use herb/spice packets over 12 weeks increased egg intakes up to 12 weeks after end of intervention. Other factors may explain increased egg intakes during the intervention, but the sustained effects most plausibly result directly from recipe provision. Limited effects in other measures suggest that the recipes may have replaced as opposed to added to existing protein intakes.

Rabbits have been a popular pet and research species world-wide. In many clinical and research situations, controlling inflammation is necessary for the health of these animals. One of the first drugs commonly employed in veterinary medicine to suppress inflammatory responses is corticosteroids. Unfortunately, steroid use in rabbits is not universally accepted as they are perceived, based on their potent immunosuppressant activity, to negatively impact quality of life. This is may be due, in part, to the lack of well-developed dosing protocols in these animals. This study evaluated the impact of a 5-day IM dexamethasone (Dex, 0.5 mg/kg) protocol on the immunity and clinical health of the New Zealand rabbit. Through two experiments separated by a 10-day washout period, experiment 1 comprised 5-days of dosing with bleedings on day 0, 3, 5 and 7, where experiment 2 consisted of 5-days of dosing with bleedings on day 0, 3 and 5. Animals were monitored twice daily for changes in clinical health. Hematology, T cell subset phenotype, leukocyte cell cycle, histopathology, phagocytosis and oxidative formation were evaluated. Consistent with other species, 5-day dosing with Dex suppressed leukocytes, in particular the T cells (p ≤ 0.003). Interestingly, rabbits failed to show any adverse clinical signs throughout the entire study. This would imply that a 5-day IM Dex (0.5 mg/kg) dosing protocol is well tolerated by New Zealand white rabbits and could be used in rabbits suffering from inflammatory conditions or disease as long as the animal's immune status is closely monitored., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Aims: We aimed to assess the use of and attitudes towards cannabis use (medicinal and recreational) by people with IBD in New Zealand., Methods: People with IBD were invited to complete an anonymous online questionnaire. Participants were recruited via postal mail using a hospital database of patients with IBD (developed by the Gas-troenterology Department at Dunedin Public Hospital) and via online recruitment (advertised on the Crohn's and Colitis New Zealand website, Facebook page and e-mail list). Inclusion criteria were ages 18+ and self-reported confirmed IBD diagnosis., Results: In total, 378 participants completed the questionnaire, with 334 eligible responses. Partici-pants were predominantly New Zealand European (84%) and female (71%). Sixty-one percent of re-spondents had CD and 34% UC. Overall, 51% of respondents reported having ever used cannabis. Of those, 63% reported use as recreational and 31% for reduction of IBD symptoms. Users were more likely to be younger (on average by 6.4 years), with on-going symptoms, unemployed or self-employed and current or ex-smokers. There were no differences by disease status or severity. Symp-toms most reported as improved by cannabis use were abdominal pain/cramping, nausea/vomiting and loss of appetite. Fifty-four percent of participants reported that if cannabis were legal, they would request it for medicinal use to help manage their symptoms., Conclusions: Overall, our research aligns with previous observational research that reports im-provements in symptoms of IBD with cannabis use. Studies of a higher evidence level (eg, RCTs) would be needed to guide prescribing. In the meantime, this research provides useful background to clini-cians about patients' views and experiences., Competing Interests: Nil.

Background: As the economic impact of dementia on health and social care increases, governments require disease-specific epidemiological data that will help inform spending and policy decisions. The aim of this study is to examine predictors of mortality in dementia in consecutive referrals to a New Zealand (NZ) memory service that includes Māori, Pacific Islander, and NZ European patients., Methods: Date of birth, sex, ethnicity, living situation, cognitive function, dementia subtype, dementia severity, physical comorbidity, and medication data were collected from electronic health records. The resulting data set was linked to administrative data on mortality and last hospital contact dates to allow time-dependent survival analyses., Results: The risk of death in people with dementia was increased by age (adjusted HR per year 1.08, 95%CI:1.05-1.12) and lower cognitive score at baseline (adjusted HR for severe impairment:2.54, 95% CI:1.25-5.16), and was reduced by cholinesterase inhibitors (adjusted HR:0.54, 95% CI:0.34-0.88). Compared to NZ Europeans (HR:1.19, 95% CI:0.63-2.25), antipsychotics increased the risk of death three-fold in Māori (adjusted HR:3.62, 95% CI:0.79-16.7) and Pacific Islanders (adjusted HR:2.54, 95%CI:1.10-5.85)., Conclusions: Further research is required to elucidate the mechanisms underlying the survival rates in Māori and Pacific Islanders living with dementia in NZ,and their increased risk of death if antipsychotics are used., (© 2020 John Wiley & Sons Ltd.)

Over half of cutaneous melanoma tumors have BRAF V600E/K mutations. Acquired resistance to BRAF inhibitors (BRAFi) remains a major hurdle in attaining durable therapeutic responses. In this study we demonstrate that ~50-60% of melanoma cell lines with vemurafenib resistance acquired in vitro show activation of RhoA family GTPases. In BRAFi-resistant melanoma cell lines and tumors, activation of RhoA is correlated with decreased expression of melanocyte lineage genes. Using a machine learning approach, we built gene expression-based models to predict drug sensitivity for 265 common anticancer compounds. We then projected these signatures onto the collection of TCGA cutaneous melanoma and found that poorly differentiated tumors were predicted to have increased sensitivity to multiple Rho kinase (ROCK) inhibitors. Two transcriptional effectors downstream of Rho, MRTF and YAP1, are activated in the Rho High BRAFi-resistant cell lines, and resistant cells are more sensitive to inhibition of these transcriptional mechanisms. Taken together, these results support the concept of targeting Rho-regulated gene transcription pathways as a promising therapeutic approach to restore sensitivity to BRAFi-resistant tumors or as a combination therapy to prevent the onset of drug resistance.

Purpose: To test the impact of a nudge strategy (dish of the day strategy) and the factors associated with vegetable dish choice, upon food selection by European adolescents in a real foodservice setting., Methods: A cross-sectional quasi-experimental study was implemented in restaurants in four European countries: Denmark, France, Italy and United Kingdom. In total, 360 individuals aged 12-19 years were allocated into control or intervention groups, and asked to select from meat-based, fish-based, or vegetable-based meals. All three dishes were identically presented in appearance (balls with similar size and weight) and with the same sauce (tomato sauce) and side dishes (pasta and salad). In the intervention condition, the vegetable-based option was presented as the "dish of the day" and numbers of dishes chosen by each group were compared using the Pearson chi-square test. Multivariate logistic regression analysis was run to assess associations between choice of vegetable-based dish and its potential associated factors (adherence to Mediterranean diet, food neophobia, attitudes towards nudging for vegetables, food choice questionnaire, human values scale, social norms and self-estimated health, country, gender and belonging to control or intervention groups). All analyses were run in SPSS 22.0., Results: The nudging strategy (dish of the day) did not show a difference on the choice of the vegetable-based option among adolescents tested (p = 0.80 for Denmark and France and p = 0.69 and p = 0.53 for Italy and UK, respectively). However, natural dimension of food choice questionnaire, social norms and attitudes towards vegetable nudging were all positively associated with the choice of the vegetable-based dish. Being male was negatively associated with choosing the vegetable-based dish., Conclusions: The "dish of the day" strategy did not work under the study conditions. Choice of the vegetable-based dish was predicted by natural dimension, social norms, gender and attitudes towards vegetable nudging. An understanding of factors related to choosing vegetable based dishes is necessary for the development and implementation of public policy interventions aiming to increase the consumption of vegetables among adolescents.

Objective: The number of Asian New Zealanders with dementia is growing. The objective of this study was to explore with a group of Asian health care professionals about public attitudes towards dementia in Asian communities in New Zealand, the stigma of dementia, and how best to develop culturally appropriate services for Asian people and families living with dementia., Methods: A focus group was conducted with a group of bilingual Asian health care professionals. A topic guide was developed based on the discussion at a prior meeting with the Cross Cultural Interest Group. The data were independently analysed by three researchers using the thematic qualitative methodology., Results: Eleven overseas-born Asian health care professionals (Chinese: n = 9, 82%) participated in the focus group. Four main themes emerged from the data: (a) cultural interpretations of dementia; (b) stigma; (c) filial piety; and (d) inequity in the availability of resources., Conclusion: Our findings suggest that much work is needed to destigmatise dementia in New Zealand Asian communities, through psychoeducation, public awareness, and the availability of readily accessible services that can meet their cultural and language needs., (© 2019 John Wiley & Sons, Ltd.)

Objective: Modelling has previously been demonstrated to encourage healthy eating, but the importance of modelling the behaviour versus modelling the positive consequences of the behaviour is unknown. This work investigated the impact of modelling carrot intake (the behaviour) and modelling carrot enjoyment (the positive consequences) on subsequent liking and consumption of carrots and sweetcorn., Methods: 155 children aged 7-10 years were randomized to hear a story where fictional characters consumed a picnic with either: no mention of carrot sticks (control) (N = 45); mention of carrot sticks that all characters ate (modelling intake) (N = 60); or mention of carrot sticks that the characters like (modelling enjoyment) (N = 50). Carrot and sweetcorn liking and intake were measured before and after the story during a 5 min task., Results: Carrot liking and intake after a story were higher following the story modelling carrot enjoyment compared to the stories not modelling enjoyment (smallest β = 0.16, p = 0.05), and in those with higher pre-story carrot liking and intake (smallest β = 0.25, p < 0.01). Sweetcorn liking and intake after a story were associated with pre-story sweetcorn liking and intake (smallest β = 0.28, p < 0.01), and sweetcorn intake was lower following the story modelling carrot enjoyment compared to the stories not modelling enjoyment (β = -0.17, p = 0.04)., Conclusions: These findings demonstrate a role for modelling enjoyment to encourage vegetable liking and intake, although effects sizes were small. These findings also suggest a benefit from modelling the positive consequences of a behaviour for encouraging healthy food intake in children, while limited effects were found for modelling the behaviour itself., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: No studies have explored the acceptability of Behavioural Activation and Guided Self-Help interventions for depression with people who have intellectual disabilities., Method: Twenty-five participants were purposively sampled from participants taking part in a trial comparing Behavioural Activation with a Guided Self-Help intervention. A framework analysis was used to analyse interviews covering participants' expectations and views of therapy., Results: Participants were largely positive about both interventions. However, they identified specific aspects of each intervention which they had found helpful. All participants valued the therapeutic relationship. The participants also had a number of criticisms and suggestions for improving the therapies. A common concern was the time-limited nature of the interventions and a wish for longer-term help. Overall, both sets of participants felt the interventions had relevance for their wider lives., Conclusions: The participants reported having positive engagement with the therapies but expressed a wish for longer-term supportive relationships., (© 2019 John Wiley & Sons Ltd.)

Aim: The present study aimed to explore the impact that changes in behavioural symptoms of people living with dementia have on professional caregiver and resident relationships., Method: A total of 21 interviews were carried out with professional caregivers of people living with dementia. A grounded theory approach was used to investigate everyday experiences of provision of professional care in dementia settings, focussing specifically on the effect of behavioural change on such relationships., Results: A core category emerged from this analysis: 'Developing behaviour in dementia impacts relationships on a personal and professional level'., Discussion: Professionals have recognized as part of their everyday practice an eventual deterioration in relationships between themselves as professional caregivers and the residents, but also between the residents and their family members and among residents themselves. Importantly, understanding patients' behaviour and behavioural change was identified as a crucial factor to achieve and sustain good relationships between professionals and residents suffering with dementia.

Background: Clinicians recommend including carers or others in a supporting role in the therapy as an important adaptation of psychological therapies for people with intellectual disabilities. This nested qualitative study from a larger trial explored supporters' experiences of supporting people with intellectual disabilities receiving behavioural activation or guided self-help therapies for depression., Method: Twenty-one purposively sampled supporters were interviewed. The semi-structured interviews were subject to framework analysis, covering expectations of therapy, views of therapy sessions, relationships with therapist and participant, and perceived changes., Results: Supporters were positive about both therapies and reported both therapy-specific and nonspecific therapeutic factors that had significant positive impacts on people's lives. Most supporters reported their involvement contributed to the interventions' effectiveness, and helped establish closer relationships to the people they were supporting., Conclusions: The presence of supporters within psychological therapies for people with intellectual disabilities can be an effective adaptation to therapies for this population., (© 2018 John Wiley & Sons Ltd.)

Background: Depression is the most prevalent mental health problem among people with learning disabilities., Objective: The trial investigated the clinical effectiveness and cost-effectiveness of behavioural activation for depression experienced by people with mild to moderate learning disabilities. The intervention was compared with a guided self-help intervention., Design: A multicentre, single-blind, randomised controlled trial, with follow-up at 4, 8 and 12 months post randomisation. There was a nested qualitative study., Setting: Participants were recruited from community learning disability teams and services and from Improving Access to Psychological Therapies services in Scotland, England and Wales., Participants: Participants were aged ≥ 18 years, with clinically significant depression, assessed using the Diagnostic Criteria for Psychiatric Disorders for use with Adults with Learning Disabilities. Participants had to be able to give informed consent and a supporter could accompany them to therapy., Interventions: BeatIt was a manualised behavioural activation intervention, adapted for people with learning disabilities and depression. StepUp was an adapted guided self-help intervention., Main Outcome Measures: The primary outcome measure was the Glasgow Depression Scale for people with a Learning Disability (GDS-LD). Secondary outcomes included carer ratings of depressive symptoms and aggressiveness, self-reporting of anxiety symptoms, social support, activity and adaptive behaviour, relationships, quality of life (QoL) and life events, and resource and medication use., Results: There were 161 participants randomised (BeatIt, n  = 84; StepUp, n  = 77). Participant retention was strong, with 141 completing the trial. Most completed therapy (BeatIt: 86%; StepUp: 82%). At baseline, 63% of BeatIt participants and 66% of StepUp participants were prescribed antidepressants. There was no statistically significant difference in GDS-LD scores between the StepUp (12.94 points) and BeatIt (11.91 points) groups at the 12-month primary outcome point. However, both groups improved during the trial. Other psychological and QoL outcomes followed a similar pattern. There were no treatment group differences, but there was improvement in both groups. There was no economic evidence suggesting that BeatIt may be more cost-effective than StepUp. However, treatment costs for both groups were approximately only 4-6.5% of the total support costs. Results of the qualitative research with participants, supporters and therapists were in concert with the quantitative findings. Both treatments were perceived as active interventions and were valued in terms of their structure, content and perceived impact., Limitations: A significant limitation was the absence of a treatment-as-usual (TAU) comparison., Conclusions: Primary and secondary outcomes, economic data and qualitative results all clearly demonstrate that there was no evidence for BeatIt being more effective than StepUp., Future Work: Comparisons against TAU are required to determine whether or not these interventions had any effect., Trial Registration: Current Controlled Trials ISRCTN09753005., Funding: This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 22, No. 53. See the NIHR Journals Library website for further project information., Competing Interests: Christopher Williams reports personal fees from Taylor and Francis (Abingdon, UK) and from Five Areas Ltd (Clydebank, UK) outside the submitted work and is president of the British Association for Behavioural and Cognitive Psychotherapies (BABCP). Sally-Ann Cooper reports grants from the National Institute for Health Research Health Technology Assessment programme during the conduct of the study.

Background: Strong evidence links the consumption of a Mediterranean diet (MD) with a reduced cardiovascular disease (CVD) risk; however, there is uncertainty as to whether non-Mediterranean regions will adopt this diet. The present qualitative research aimed to investigate attitudes towards a MD in individuals at high CVD risk in a Northern European population. This information is needed to inform development of MD interventions in non-Mediterranean high-risk populations., Methods: Focus groups (n = 12) were held with individuals at high CVD risk from Northern Europe (≥2 CVD risk factors, aged ≥50 years, no established CVD/type 2 diabetes). Attitudes to dietary change towards a MD were explored. Data were analysed using inductive thematic analysis., Results: Sixty-seven adults participated (60% female, mean age 64 years). There was some awareness of the term MD but limited knowledge of its composition. Barriers to general dietary change were evident, including perception of expense, concern over availability, expectation of time commitment, limited knowledge, lack of cooking skills, amount and conflicting nature of media information on diets, changing established eating habits and resistance to dietary change. Barriers specific to MD adoption were also identified, including perceived difficulty living in a colder climate, perceived impact on body weight, acceptability of a MD and cultural differences., Conclusions: Knowledge of a MD was limited in this Northern European sample at high CVD risk. In addition to general barriers to dietary change, barriers specific to a MD were identified. These findings have implications for the development of interventions aiming to promote MD adoption in non-Mediterranean populations., (© 2017 The British Dietetic Association Ltd.)

Various interventions have previously been found to increase protein intakes in older adults, but in free-living individuals, compensation for increased intakes at one meal may easily negate these effects resulting in limited long term benefit. This study investigated the impact of adding sauce to an older person's lunch meal on intakes at that meal, at the following meal and overall (lunch + evening meal). Using a repeated measures design, 52 participants consumed both a lunch meal with sauce and the same lunch meal without sauce on two separate occasions, and intake at this meal and at the following meal were measured. In all participants analysed together, the addition of sauce resulted in increased protein intakes at the lunch meal. Individual differences were also found, where for some individuals (n = 26), the addition of sauce resulted in significantly higher protein and energy intakes at the lunch meal (12.3 g protein, 381 kJ) and overall (11 g protein, 420 kJ), compared to the no-sauce condition, while for some individuals (n = 19), the sauce manipulation resulted in lower protein and energy intakes (lunch: 7 g protein, 297 kJ; overall: 7 g protein, 350 kJ). Compensation for earlier intakes was low (0-17%) for both groups. These findings demonstrate the possible value of adding sauce to an older person's meal for increasing intakes, and demonstrate a need for attention to individual differences. This study also confirms previous findings of limited compensation in older adults, but extends earlier studies to demonstrate limited compensation for the protein consumed in a complete meal in healthy older adults., (Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.)

Background: Food product labels based on the WHO 5-a-day fruit and vegetable (FV) message are becoming increasingly common, but these labels may impact negatively on complementary or subsequent FV consumption. This study aimed to investigate the impact of a '3 of your 5-a-day' versus a '1 of your 5-a-day' smoothie product label on subsequent FV consumption., Methods: Using an acute experimental design, 194 participants (90 males, 104 females) were randomised to consume a smoothie labelled as either '3 of your 5-a-day' (N = 97) or '1 of your 5-a-day' (N = 97) in full, following a usual breakfast. Subsequent FV consumption was measured for the rest of the day using 24-h recall. Usual FV consumption was also assessed via 24-h recall for the day before the study., Results: Regression analyses revealed a significantly lower subsequent FV consumption following smoothies displaying the '3 of your 5-a-day' label compared to the '1 of your 5-a-day' label (Beta = - 0.15, p = 0.04). Secondary analyses revealed these effects to be driven mainly by changes to consumption in usual high FV consumers, in females and in vegetable as opposed to fruit consumption., Conclusions: These findings demonstrate a role for label information in food intake, and the potential negative impacts of an exaggerated food product label on healthy food consumption and healthy dietary profiles.

Background: There are consistent, evidence-based global public health recommendations to reduce intakes of free sugars. However, the corresponding evidence for recommending reduced exposure to sweetness is less clear., Objective: Our aim was to identify and review the published evidence investigating the impact of dietary exposure to sweet-tasting foods or beverages on the subsequent generalized acceptance, preference, or choice of sweet foods and beverages in the diet., Design: Systematic searches were conducted to identify all studies testing relations of variation in exposure to sweetness through foods and beverages with subsequent variation in the generalized acceptance, preference, or choice of sweetened foods or beverages, in humans aged >6 mo., Results: Twenty-one studies met our inclusion criteria, comprising 7 population cohort studies involving 2320 children and 14 controlled trials involving 1113 individuals. These studies were heterogeneous in study design, population, exposure, and outcomes measured, and few were explicitly designed to address our research question. The findings from these were inconsistent. We found equivocal evidence from population cohort studies. The evidence from controlled studies suggests that a higher sweet taste exposure tends to lead to reduced preferences for sweetness in the shorter term, but very limited effects were found in the longer term., Conclusions: A small and heterogeneous body of research currently has considered the impact of varying exposure to sweet taste on subsequent generalized sweet taste preferences, and this evidence is equivocal regarding the presence and possible direction of a relation. Future work should focus on adequately powered studies with well-characterized exposures of sufficient duration. This review was registered with PROSPERO as CRD42016051840, 24 November 2016.

Background: Epidemiological and randomised controlled trial evidence demonstrates that adherence to a Mediterranean diet (MD) can reduce cardiovascular disease (CVD) risk. However, methods used to support dietary change have been intensive and expensive. Peer support has been suggested as a possible cost-effective method to encourage adherence to a MD in at risk populations, although development of such a programme has not been explored. The purpose of this study was to use mixed-methods to determine the preferred peer support approach to encourage adherence to a MD., Methods: Qualitative (focus groups) and quantitative methods (questionnaire and preference scoring sheet) were used to determine preferred methods of peer support. Sixty-seven high CVD risk participants took part in 12 focus groups (60% female, mean age 64 years) and completed a questionnaire and preference scoring sheet. Focus group data were transcribed and thematically analysed., Results: The mean preference score (1 being most preferred and 5 being least preferred) for group support was 1.5, compared to 3.4 for peer mentorship, 4.0 for telephone peer support and 4.0 for internet peer support. Three key themes were identified from the transcripts: 1. Components of an effective peer support group: discussions around group peer support were predominantly positive. It was suggested that an effective group develops from people who consider themselves similar to each other meeting face-to-face, leading to the development of a group identity that embraces trust and honesty. 2. Catalysing Motivation: participants discussed that a group peer support model could facilitate interpersonal motivations including encouragement, competitiveness and accountability. 3. Stepping Stones of Change: participants conceptualised change as a process, and discussed that, throughout the process, different models of peer support might be more or less useful., Conclusion: A group-based approach was the preferred method of peer support to encourage a population at high risk of CVD to adhere to a MD. This finding should be recognised in the development of interventions to encourage adoption of a MD in a Northern European population.

Background: This project aimed to understand the details of the 5-a-day fruit and vegetable (FV) message (which foods are included, portion sizes, the need for variety, reasons for consumption) least known by UK consumers, and most associated with low FV consumption., Methods: Study 1 assessed FV consumption, knowledge of the details of the message, and relationships between these, using a short questionnaire administered face-to-face to an opportunity sample of one large UK city. Study 2 assessed the same variables using a comprehensive postal questionnaire administered across the UK to a representative population sample., Results: Five hundred and seven respondents completed Study 1 and 247 respondents completed Study 2. The majority of individuals in both studies were aware of the 5-a-day message and could recount this correctly. In both studies, however, knowledge of the details of the message was low, and lower knowledge was associated with lower FV consumption. Respondents had lowest knowledge of the details of the message related to portion sizes and the need for variety. However, FV consumption was not independently associated with knowledge of any one aspect of the message., Conclusions: These findings suggest that, although most of the UK population sampled were aware of the 5-a-day FV message and could recount this correctly, details of the 5-a-day FV message were not well known, and that FV consumption was related to this knowledge. These findings suggest that strategies to increase FV consumption will benefit from increasing UK consumers' knowledge of the details of the 5-a-day FV message., (© 2017 The British Dietetic Association Ltd.)

Background: Psychological therapies are first-line interventions for depression, but existing provision is not accessible for many adults with intellectual disabilities. We investigated the clinical and cost-effectiveness of a behavioural activation intervention (BeatIt) for people with intellectual disabilities and depression. BeatIt was compared with a guided self-help intervention (StepUp)., Methods: We did a multicentre, single-blind, randomised, controlled trial with follow-up at 4 months and 12 months after randomisation. Participants aged 18 years or older, with mild to moderate intellectual disabilities and clinically significant depression were recruited from health and social care services in the UK. The primary outcome was the Glasgow Depression Scale for people with a Learning Disability (GDS-LD) score at 12 months. Analyses were done on an intention-to-treat basis. This trial is registered with ISCRTN, number ISRCTN09753005., Findings: Between Aug 8, 2013, and Sept 1, 2015, 161 participants were randomly assigned (84 to BeatIt; 77 to StepUp); 141 (88%) participants completed the trial. No group differences were found in the effects of BeatIt and StepUp based on GDS-LD scores at 12 months (12·03 [SD 7·99] GDS-LD points for BeatIt vs 12·43 [SD 7·64] GDS-LD points for StepUp; mean difference 0·26 GDS-LD points [95% CI -2·18 to 2·70]; p=0·833). Within-group improvements in GDS-LD scores occurred in both groups at 12 months (BeatIt, mean change -4·2 GDS-LD points [95% CI -6·0 to -2·4], p<0·0001; StepUp, mean change -4·5 GDS-LD points [-6·2 to -2·7], p<0·0001), with large effect sizes (BeatIt, 0·590 [95% CI 0·337-0·844]; StepUp, 0·627 [0·380-0·873]). BeatIt was not cost-effective when compared with StepUp, although the economic analyses indicated substantial uncertainty. Treatment costs were only approximately 3·6-6·8% of participants' total support costs. No treatment-related or trial-related adverse events were reported., Interpretation: This study is, to our knowledge, the first large randomised controlled trial assessing individual psychological interventions for people with intellectual disabilities and mental health problems. These findings show that there is no evidence that BeatIt is more effective than StepUp; both are active and potentially effective interventions., Funding: National Institute for Health Research., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Despite the known health benefits of fruit and vegetables (FV), population intakes remain low. One potential contributing factor may be a lack of understanding surrounding recommended intakes. The present study aimed to explore the understanding of FV intake guidelines among a sample of low FV consumers., Methods: Six semi-structured focus groups were held with low FV consumers (n = 28, age range 19-55 years). Focus groups were recorded digitally, transcribed verbatim and analysed thematically using nvivo (QSR International, Melbourne, Australia) to manage the coded data. Participants also completed a short questionnaire assessing knowledge on FV intake guidelines. Descriptive statistics were used to analyse responses., Results: The discussions highlighted that, although participants were aware of FV intake guidelines, they lacked clarity with regard to the meaning of the '5-a-day' message, including what foods are included in the guideline, as well as what constitutes a portion of FV. There was also a sense of confusion surrounding the concept of achieving variety with regard to FV intake. The sample highlighted a lack of previous education on FV portion sizes and put forward suggestions for improving knowledge, including increased information on food packaging and through health campaigns. Questionnaire findings were generally congruent with the qualitative findings, showing high awareness of the '5-a-day' message but a lack of knowledge surrounding FV portion sizes., Conclusions: Future public health campaigns should consider how best to address the gaps in knowledge identified in the present study, and incorporate evaluations that will allow the impact of future initiatives on knowledge, and ultimately behaviour, to be investigated., (© 2016 The British Dietetic Association Ltd.)

Background: Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits., Purpose: These analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality., Methods: Data from the PRIME Study (N = 6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support., Results: Following initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR = 1.24, p < 0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR = 1.14, p = 0.04). Of the behaviors included, the most significant contribution to outcomes was found for smoking, but a role was also found for fruit and vegetable intakes and high alcohol consumption., Conclusions: These findings demonstrate well-known associations between depression, hostility, and mortality and suggest the potential importance of behaviors in explaining these relationships.

Background: The current technique for locating nonpalpable breast lesions is wire localization (WL). Radioactive seed localization and intraoperative ultrasound were developed to improve difficulties with WL. The SAVI SCOUT surgical guidance system was developed to improve these methods. The SCOUT system is a non-radioactive, FDA-cleared medical device that uses electromagnetic wave technology to provide real-time guidance during excisional breast procedures., Methods: Consenting patients underwent localization and excision using an implantable electromagnetic wave reflective device (reflector) and a detector handpiece with a console. Using image guidance, the reflector was placed up to 7 days before the surgical procedure. The primary end points of the study were successful reflector placement, localization, and retrieval. The secondary end points were percentage of clear margins, reexcision rates, days of placement before excision, and physician comparison with WL., Results: This study analyzed 50 patients. The reflectors were placed under mammographic guidance (n = 18, 36 %) or ultrasound guidance (n = 32, 64 %). Of the 50 patients, 10 (20 %) underwent excisional biopsy and 40 (80 %) had a lumpectomy. The lesion and reflector were successfully removed in all 50 patients, and no adverse events occurred. Of the 41 patients who had in situ and/or invasive carcinoma identified, 38 (93 %) had clear margins and 3 (7 %) were recommended for reexcision., Conclusions: These data suggest that the SCOUT system is safe and effective for guiding the excision of nonpalpable breast lesions and a viable alternative to standard localization options. A larger prospective, multi-institution trial of SCOUT currently is underway to validate these findings.

Protein intakes in the older population can be lower than recommended for good health, and while reasons for low protein intakes can be provided, little work has attempted to investigate these reasons in relation to actual intakes, and so identify those of likely greatest impact when designing interventions. Questionnaires assessing: usual consumption of meat, fish, eggs and dairy products; agreement/disagreement with reasons for the consumption/non-consumption of these foods; and several demographic and lifestyle characteristics; were sent to 1000 UK community-dwelling adults aged 65 years and over. In total, 351 returned questionnaires, representative of the UK older population for gender and age, were suitable for analysis. Different factors were important for consumption of the four food groups, but similarities were also found. These similarities likely reflect issues of particular concern to both the consumption of animal-based protein-rich foods and the consumption of these foods by older adults. Taken together, these findings suggest intakes to be explained by, and thus that strategies for increasing consumption should focus on: increasing liking/tastiness; improving convenience and the effort required for food preparation and consumption; minimizing spoilage and wastage; and improving perceptions of affordability or value for money; freshness; and the healthiness of protein-rich foods.

n-3 Polyunsaturated fatty acids (n-3PUFAs) may be beneficial for anxiety and depression under stressful conditions. Studies however, typically utilise physical or sudden physiological stress, while gradual physiological stress is also relevant to human conditions. Using deoxycorticosterone acetate (DOCA) administration to induce gradual physiological stress, this study investigated the impact of n-3PUFAs under gradual physiological stress in rats. Animals (aged 2 months) (N=8-12/group) received daily injections of DOCA or vehicle and were concurrently fed a high n-3PUFA or control diet for eight weeks. Behavioural measures were taken throughout. Behavioural tests and physiological measures were conducted after six and eight weeks respectively. DOCA administration decreased plasma renin, plasma proteins and relative adrenal weight, and increased water intake, relative kidney weight, and anxiety in the open field. These findings demonstrate disruptions to the renin-angiotensin-aldosterone system, a result of mild physiological stress, that also impact on anxiety behaviours. No effects of n-3PUFAs were found., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Our previous laboratory and clinical data suggested that one mechanism underlying the development of platinum resistance in ovarian cancer is the acquisition of DNA methylation. We therefore tested the hypothesis that the DNA hypomethylating agent 5-aza-2'-deoxycytodine (decitabine) can reverse resistance to carboplatin in women with relapsed ovarian cancer., Methods: Patients progressing 6-12 months after previous platinum therapy were randomised to decitabine on day 1 and carboplatin (AUC 6) on day 8, every 28 days or carboplatin alone. The primary objective was response rate in patients with methylated hMLH1 tumour DNA in plasma., Results: After a pre-defined interim analysis, the study closed due to lack of efficacy and poor treatment deliverability in 15 patients treated with the combination. Responses by GCIG criteria were 9 out of 14 vs 3 out of 15 and by RECIST were 6 out of 13 vs 1 out of 12 for carboplatin and carboplatin/decitabine, respectively. Grade 3/4 neutropenia was more common with the combination (60% vs 15.4%) as was G2/3 carboplatin hypersensitivity (47% vs 21%)., Conclusions: With this schedule, the addition of decitabine appears to reduce rather than increase the efficacy of carboplatin in partially platinum-sensitive ovarian cancer and is difficult to deliver. Patient-selection strategies, different schedules and other demethylating agents should be considered in future combination studies.

The present research explored whether visualising engaging in a health behaviour resulted in increased intentions to engage in that behaviour, when combined with an informational health message. Further, the effects of the visual perspective (first-person vs. third-person) used to visualise the health behaviour were explored. In an online questionnaire study employing a 2 × 3 between-participants experimental design, participants (N = 532) read vs. did not read an informational health message about the benefits of increasing fruit consumption, then visualised (from first-person vs. third-person perspective) vs. did not visualise themselves increasing their fruit consumption. Intentions to increase fruit consumption were assessed, as were potential mediating variables. The results indicated that visualisation (irrespective of perspective) did not result in increased intentions when it was not combined with the health message. However, when participants had read the health message, visualisation resulted in significantly stronger intentions, and the first-person perspective was significantly more effective than the third-person perspective. The beneficial effect of visualisation, and the first-person perspective, on intentions was mediated by increased self-efficacy and action planning. Findings are discussed in relation to existing research on visualisation and perspective, and in terms of practical applications for health promotion efforts.

Background: Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality, possibly as a result of the different methodologies used to measure depression and analyse relationships. This analysis investigated the association between depression, CVD incidence (CVDI) and mortality from CVD (MCVD), smoking related conditions (MSRC), and all causes (MALL), in a sample data set, where depression was measured using items from a validated questionnaire and using items derived from the factor analysis of a larger questionnaire, and analyses were conducted based on continuous data and grouped data., Methods: Data from the PRIME Study (N=9798 men) on depression and 10-year CVD incidence and mortality were analysed using Cox proportional hazards models., Results: Using continuous data, both measures of depression resulted in the emergence of positive associations between depression and mortality (MCVD, MSRC, MALL). Using grouped data, however, associations between a validated measure of depression and MCVD, and between a measure of depression derived from factor analysis and all measures of mortality were lost., Limitations: Low levels of depression, low numbers of individuals with high depression and low numbers of outcome events may limit these analyses, but levels are usual for the population studied., Conclusions: These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the measurement used and method of analysis. Different findings based on methodology present clear problems for the elucidation and determination of relationships. The differences here argue for the use of validated scales where possible and suggest against over-reduction via factor analysis and grouping., (Crown Copyright © 2013 Published by Elsevier B.V. All rights reserved.)

The present study investigated the value of two repeated exposure interventions for increasing intakes of fruit in older people. A total of ninety-five participants (aged 65 years and over) were randomised to receive either one (E1), five (E5) or five plus (E5+) exposures to fruit over a 5-week period. Fruit exposures occurred in community-based church and social groups, through fruit-tasting sessions involving familiar fruits and novel fruit products and dishes (E1, E5, E5+), and through fruit provision (E5+). Daily intakes of fruit and vegetables were assessed before and after all interventions. Liking for all fruits was also measured during repeated exposure (E5, E5+). In low consumers of fruit (one portion/d or less), fruit intakes increased significantly in the repeated exposure groups (E5, E5+) (t(30) = 5·79, P< 0·01), but did not change in the E1 group (t(16) = 0·29, P= 0·78). No differences were found between E5 and E5+ groups (F(3,87) = 1·22, P= 0·31). Similar effects were also found in fruit and vegetable intakes. No effects were found in other participants. Also, no changes in liking were found. These findings suggest that compared to single exposure, repeated exposure to fruit via fruit-tasting sessions once per week for 5 weeks in a community setting significantly improved fruit intakes, and fruit and vegetable intakes in older low consumers of fruit, although no benefits of additional fruit provision were found. Repeated exposure was also easy to implement, of low cost and enjoyable.

Background and Purpose: To date, the association between depressive symptoms and the risk of cardiovascular diseases remains controversial. We investigated prospectively, within the same population, the time course of the association between baseline depressive symptoms and first stroke or coronary heart disease event., Methods: In the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study, a multicenter, observational, prospective cohort, 9601 men from France and Northern Ireland were surveyed for the occurrence of first coronary heart disease (n=647) and stroke events (n=136) over 10 years. At baseline, the fourth quartile of a 13-item modified Center for Epidemiological Studies questionnaire was used to define the presence of depressive symptoms. We sought the best time-dependent function to assess the association between depressive symptoms and outcomes. Thus, the hazard ratios were estimated by a Cox proportional hazard model after splitting the follow-up before and after 5 years of follow-up time periods., Results: Depressive symptoms at baseline were associated with coronary heart disease in the first 5 years of follow-up (hazard ratio, 1.43; 1.10-1.87) and with stroke in the second 5 years of follow up (hazard ratio, 1.96; 1.21-3.19) after adjustment for age, study centers, baseline socioeconomic factors, traditional vascular risk factors, and antidepressant treatment. The association was even stronger for ischemic stroke (n=108; hazard ratio, 2.48; 1.45-4.25)., Conclusions: The current study suggests that in healthy, European, middle-aged men, baseline depressive symptoms are associated with an increased risk of coronary heart disease in the short-term, and for stroke in the long-term.

Several short-term studies have investigated the effects of a vegetable oil emulsion on subsequent food intake, although findings have been inconsistent. This work aimed to review all studies, and investigate differences in study outcomes based on methodology. All known studies were identified. Data were abstracted from published studies (n = 7). Details of unpublished studies were gained from investigators/sponsors (n = 5), or were unavailable for reasons of confidentiality (n = 4). Available data were combined using meta-analyses. A combined appetite suppressant effect of the emulsion compared with control was found for test meal intake at approximately 4, 12 and 36 h post-treatment: smallest combined mean difference (random effects model) = 0.53 MJ (95% confidence interval 0.20, 0.86), P < 0.01. However, considerable heterogeneity (variability) between study results was also found (smallest I(2) = 94%, P < 0.01), questioning the predictive validity of the above findings. Meta-regression suggested this heterogeneity to be related to differences in the processed nature of the product, treatment dose and in particular year of study (smallest B = 0.54, 95% confidence interval 0.06, 1.03, P = 0.04), although again heterogeneity was found. The only consistent finding was a lack of effect on food intake 4 h post-preload in studies conducted after 2003. These results suggest a small but inconsistent appetite suppressant effect of the vegetable oil emulsion. However, due to the large heterogeneity, no definitive conclusions can be drawn., (© 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.)

Previous research suggests that n-3 PUFA may play a role in bone health. The present analysis aimed to investigate the impact of n-3 PUFA supplementation on bone resorption in adult men and women. Serum samples from 113 mild-moderately depressed individuals (twenty-six males and eighty-seven females, aged 18-67 years) randomised to receive 1·48 g EPA+DHA/d (n 53) or placebo (n 60) for 12 weeks as part of a large recent randomised controlled trial were assayed for n-3 PUFA status and a bone resorption marker, C-terminal cross-linking telopeptide of type 1 collagen (β-CTX). Regression analyses revealed that n-3 PUFA status following supplementation was associated with randomisation (placebo/n-3 PUFA) (B = 3·25, 95 % CI 2·60, 3·91, P < 0·01). However, β-CTX status following supplementation was not associated with randomisation (B = - 0·01, 95 % CI - 0·03, 0·04). Change in β-CTX status was also not associated with change in n-3 PUFA status (B = - 0·002, 95 % CI - 0·01, 0·01). These findings provide no evidence for an association between n-3 PUFA supplementation (1·48 g EPA+DHA/d) for 12 weeks and bone resorption in humans assessed by β-CTX, and suggest that n-3 PUFA supplementation may be unlikely to be of benefit in preventing bone loss.

Gene promoter hypermethylation is recognised as an important mechanism by which genes may be silenced both physiologically and in disease states. This mechanism of gene silencing has been shown to play a role in many common human tumours. A number of methods are available for the detection of promoter hypermethylation, including the methylation-specific polymerase chain reaction (PCR), bisulphite sequencing, and pyrosequencing. Pyrosequencing is a reproducible method for obtaining data on the methylation status of DNA. It also has the advantage of providing quantitative data regarding the amount of methylation present in multiple CpGs in a given sample. The technique is based on the bisulphite conversion of unmethylated cytosine to uracil and subsequent amplification by PCR. The technique is also appropriate for use on DNA extracted from formalin-fixed paraffin-embedded tissue.

Unlabelled: Polyaromatic hydrocarbons, including benzo[a]pyrene (BP), are major tobacco carcinogens. Their carcinogenic effects require metabolic activation by cytochrome p450 (CYP) enzymes. Relative CYP isoform expression is related to tissue-specific tobacco-related squamous cell carcinoma (SCC) susceptibility. There have been conflicting reports regarding relative CYP1A1 and CYP1B1 oral expression, and information regarding CYP1B1 expression in oral tissues is limited. To quantify BP- and tobacco-induced CYP1A1 and CYP1B1 expression in oral SCC cells and oral mucosa., Study Design: Real-time qPCR was performed to measure (1) BP-induced CYP1A1 and CYP1B1 mRNA expression in seven oral/other head and neck SCC cell lines (2) CYP1A1 and CYP1B1 mRNA expression in gingiva from 22 smokers and 24 nonsmokers. SCC lines exhibited either similar induction of both isoforms or preferential CYP1A1 induction (CYP1A1-to-CYP1B1 ratios 0.8-4.3). In contrast, gingival tissues from smokers exhibited preferential CYP1B1 induction. Marked interindividual variation in CYP1A1 and CYP1B1 expression was observed among smokers. In vitro conditions may not account for factors that modulate expression in vivo. Interindividual variation in inducible CYP1A1 and CYP1B1 expression may account in part for variation in tobacco-related oral SCC risk.

Selected biochemical evidence suggests a potential role for n-3 long-chain PUFA (n-3PUFA) in the regulation of mood and behaviour. The present paper reviews the relevant evidence, to date, from epidemiological studies, clinical studies and intervention trials. Most evidence is available investigating a role for n-3PUFA in depression, depressive illness and suicidal behaviour, but work is also available on anxiety and anxiety-related disorders, fatigue and fatigue-related disorders, aggression, hostility and anti-social behaviour, inattention, impulsivity and attention deficit hyperactivity disorder and schizophrenic disorders. For all these aspects of mood and behaviour, the evidence available is currently limited and highly inconsistent, both in terms of study methodology and study findings. There is a clear need for further work in this area.

Previous research suggests that low n-3 long-chain polyunsaturated fatty acid (n-3PUFA) status is associated with higher levels of depression in clinical populations. This analysis aimed to investigate the relationship between depressed mood and n-3PUFA status in a non-clinical population. The analysis was conducted on data collected as part of a large randomized controlled trial investigating the impact of n-3PUFA supplementation on depressed mood in a community-based population. On entry into the trial, data on depressed mood were collected using the Depression, Anxiety and Stress Scales (DASS) and the Beck Depression Inventory (BDI). Plasma concentrations of various n-3PUFAs and n-6 long-chain polyunsaturated fatty acids (n-6PUFAs) were obtained from fasting venous blood samples, and various demographics were also measured. Using regression, there was no evidence of an association between either measure of depressed mood and any of the measures of n-3PUFA status or of n-6PUFA:n-3PUFA ratios. Clear associations were also not found when demographic factors were included in the analyses. These findings suggest that n-3PUFAs may not have a role in the aetiology of minor depression. This is also consistent with the results of other studies that have not demonstrated an association between depressed mood and n-3PUFA status in non-clinical populations and epidemiological studies that have not demonstrated an association between depressed mood and n-3PUFA intake in these populations.

Previous studies have suggested an association between depressed mood and the dietary intake of fish. In all cases, however, dietary fish intake has been considered at the exclusion of all other aspects of the diet. This analysis investigates associations between depressed mood and dietary fish intake, while also concurrently investigating intake of a number of other dietary components. The analysis is conducted on data from 10,602 men from Northern Ireland and France screened for inclusion into the PRIME cohort study. Depressed mood was assessed using a self-report questionnaire based on the Welsh Pure Depression sub-scale of the Minnesota Multiphasic Personality Inventory, diet was assessed using a Food Frequency Questionnaire, and limited demographics were also measured. Using regression, depressed mood is initially inversely associated with dietary fish intake. On inclusion of all other dietary variables, the strength of this relationship reduces but remains, and significant associations with a number of other foods are also found. On additional inclusion of all demographic variables, the strength of the above relationships again reduces, and associations with various measures of socio-economic status and education are also significant. These findings suggest that depressed mood is associated with fish intake both directly, and indirectly as part of a diet that is associated with depression and as part of a lifestyle that is associated with depression. Additional support for these conclusions is also provided in the pattern of associations between depressed mood and diet in the two countries. The relative contributions of fish intake to depressed mood both directly and indirectly are yet to be determined. However, while diet is not measured and until lifestyle can be adequately measured, the potential roles of diet and lifestyle in the association between depressed mood and dietary fish intake should not be ignored.

It has previously been suggested that the association between Type A behaviour and coronary heart disease (CHD) may be mediated through diet. This analysis investigates associations between Type A behaviour and diet, with particular focus on foods high in saturated fats and cholesterol (cake, cheese, eggs and fried potatoes), foods high in unsaturated fats (fish and nuts), and fruit and vegetables. The analysis was conducted on data collected from 10,602 men from Northern Ireland and France screened for inclusion in the PRIME cohort study. Type A behaviour was measured using the Framingham Type A Behaviour Patterns Questionnaire, diet was measured using a Food Frequency Questionnaire and various demographic details were also assessed. Levels of Type A behaviour and intakes of all food groups were similar to previous studies. Using regression, Type A behaviour was significantly associated with diet, and specifically with a higher consumption of cheese and vegetables in Northern Ireland, and a higher consumption of cake, fish and vegetables in France. These associations are most plausibly explained as a result of lifestyle, although the possibility of independent associations between Type A behaviour and diet remains. The work is limited by the use of questionnaires, but the findings available suggest that Type A behaviour is unlikely to be associated with the consumption of a diet that has previously been linked to CHD. These findings suggest that any association between Type A behaviour and CHD is unlikely to be mediated through diet.

This study investigated the effects of sweet taste and energy on subsequent short-term appetite in female habitual high and low consumers of artificially-sweetened beverages. The study was based on the proposal that effects of sweet taste on appetite may differ as a result of the habitual experience of sweetness with or without energy. Following a repeated measures design, 10 female habitual high and 10 female habitual low consumers of artificially-sweetened beverages consumed a non-sweet/low-energy, sweet/low-energy, and sweet/high-energy preload, and cumulative test meal intake (gram, kJ.), cumulative total intake (gram, kJ.), and subjective perceptions of appetite were subsequently assessed. Different effects of sweet taste were found in habitual high and low consumers of artificially-sweetened beverages. Low consumers of artificially-sweetened beverages demonstrated an increase in appetite in response to sweet taste, whereas high consumers did not. Effects of energy on appetite did not differ between consumers. The effects of energy are unsurprising. The effects of sweet taste, however, are of interest. The lack of response to sweet taste in high consumers of artificially-sweetened beverages can be explained as a result of the repeated experience of sweetness without energy by these consumers. This lack of response suggests an adaptation to sweet taste as a result of the habitual dietary pattern of these consumers.

Purpose: The DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine (decitabine) induces DNA demethylation and re-expression of epigenetically silenced genes, and increases carboplatin sensitivity of tumor xenograft models. We designed a clinical study to determine the feasibility of delivering a dose of decitabine, combined with carboplatin, that would be capable of producing equivalent biologic effects in patients with solid tumors., Patients and Methods: In a two-stage design, 33 patients received escalating doses of decitabine administered as a 6-hour infusion on day 1 followed by carboplatin, area under the concentration-time curve (AUC) 5 (cohort 1) and AUC 6 (cohort 2), on day 8 of a 28-day cycle. Pharmacodynamic analyses included 5-methyl-2'-deoxycytidine levels, MAGE1A CpG island methylation, and fetal hemoglobin (HbF) expression., Results: The major toxicity was myelosuppression. Dose limiting toxicities, prolonged grade 4 neutropenia (one patient), and sepsis and grade 3 anorexia/fatigue (one patient), were seen in two of four patients treated with decitabine 135 mg/m2 and carboplatin AUC 5. Dose limiting toxicity comprising neutropenic sepsis (one patient) and grade 3 fatigue (one patient) was seen in two of 10 patients treated at decitabine 90 mg/m2 and carboplatin AUC 6. Decitabine induced dose-dependent, reversible demethylation in peripheral-blood cells (PBCs) maximally at day 10. Furthermore, decitabine 90 mg/m2 induced demethylation of the MAGE1A CpG island in PBCs, buccal cells, and tumor biopsies, as well as elevation of HbF expression., Conclusion: Decitabine can be combined safely with carboplatin at a dose and schedule that causes epigenetic changes equivalent to or greater than that observed in mice with carboplatin-sensitized xenografts. The recommended dose/schedule for phase II trials is decitabine 90 mg/m2 (day 1) followed by carboplatin AUC 6 (day 8) every 28 days.

This study investigated the relationship between restrained eating and poor psychological health, and the importance of pleasure normally associated with eating in this relationship. Pleasure normally associated with eating, restrained eating, and anxiety, depression and satisfaction with life were assessed concurrently by questionnaire. A relationship between restrained eating and poor psychological health was found--greater restrained eating was significantly independently associated with greater anxiety (B=1.099, p<0.01). Furthermore, pleasure associated with eating was an important moderator in this relationship--greater pleasure associated with eating combined with greater restrained eating was also significantly independently associated with greater anxiety (B=1.067, p=0.02). No effects were found for depression or satisfaction with life. These findings suggest that the pleasure normally associated with eating is important in the relationship between restrained eating and poor psychological health. Subsidiary exploratory analyses also suggest that the relationship between restrained eating and poor psychological health, and the importance of pleasure in that relationship, may differ in males and females.

The development of liking for flavours through conditioning has so far been widely demonstrated in the laboratory. The impact of conditioning in the real world however is yet to be reported. This study investigated the development of liking for flavours through conditioning in the real world as part of everyday life. The study investigated the development of liking for four novel flavoured yoghurts paired with energy (high energy/low energy) and energy requirement (high energy requirement/low energy requirement). Liking was assessed before and after conditioning conducted in the laboratory using traditional laboratory procedures and in the real world using new interactive technology. Following conditioning, liking was found to develop for novel flavoured yoghurts when consumed in a state of high energy requirement. Furthermore, effects were comparable in the laboratory and in the real world. These findings suggest that likings for flavours can be conditioned in the real world as part of every day life as well as in the laboratory. This finding suggests that conditioning is a useful and valid explanation for the development of likings for flavours in everyday life.

It has previously been suggested that the perceived pleasantness of a food item in any situation may be directly related to the physiological usefulness of that item to the consumer in that situation. This study investigated changes in the perceived pleasantness of fluids before and after fluid loss through exercise-an everyday situation in which physiological need can alter. Total of 40 exercisers achieving high fluid loss (Group H) and 41 exercisers achieving low fluid loss (Group L) rated seven fluids of varying osmolality, electrolyte content, and energy content on measures of pleasantness, before and after exercise. After fluid loss compared to before fluid loss, perceived pleasantness of all fluids increased (F(1,79)=14.58, p<0.01), and effects were greater in Group H compared to Group L (F(1,79)=8.29, p<0.01). Perceived pleasantness was also significantly higher for fluids of lowest osmolality (F(6,474)=2.14, p<0.05), and effects were again greater in Group H compared to Group L (F(6,474)=2.10, p<0.05). Both findings suggest that perceived pleasantness is related to physiological usefulness, and can be demonstrated in everyday situations.

Introduction: Effects of sweet taste on short-term appetite are still being actively researched. This study investigates the proposal that the effects of sweet tastes on appetite may differ as a result of differing habitual experiences of sweetness with or without energy., Methods: Effects of sweet tastes on appetite were investigated in habitual high and low consumers of sweet/low-energy beverages. Sweet taste was manipulated in a preload lunch and appetite was subsequently measured using test meal intake and subjective ratings of general and specific appetites., Results: The effects of the sweet and nonsweet lunch on short-term appetite differed significantly in high and low consumers of sweet/low-energy beverages, in subjective ratings of appetite for something sweet [consumer x preload x time interaction F(12,126) = 2.68, P = 0.003] and appetite for something savoury [consumer x preload x time interaction F(12,126) = 3.17, P = 0.001]. Effects in low consumers of sweetness without energy demonstrate close association between taste and energy, whereas effects in high consumers suggest a dissociation between taste and energy in these consumers., Discussion: These findings provide a further indication that the short-term control of appetite varies according to the habitual pattern of dietary intake. The long-term experience of sweetness without energy influences appetite for sweet and savoury tastes.

This study investigated reported body weight, concerns about body weight and eating styles in habitual heavy users (consume>825 ml/day) and habitual non-users of artificially sweetened beverages (ASBs). Groups of habitual heavy users (N=51) and non-users (N=69) were compared on measures of weight using self-reported body mass index (BMI), and measures of weight concern and eating style using the Dutch Eating Behaviors Questionnaire (DEBQ), the Yale Eating Patterns Questionnaire (YEPQ), and the Eating Disorder Inventory (EDI). Habitual heavy users reported higher body weights (BMI), greater concerns about weight and greater tendencies toward certain eating styles, when compared to non-users. Using logistic regression, 82% of respondents were correctly classified as heavy or non-users of ASBs using body mass index and body-weight concerns. Associations between a heavy use of ASBs and certain eating styles can be explained by association with high body weights and concerns about body weight.