• A 1-h time interval between a meal containing iron and consumption of tea attenuates the inhibitory effects on iron absorption: a controlled trial in a cohort of healthy UK women using a stable iron isotope.

      Ahmad Fuzi, Salma F.; Koller, Dagmar; Brugrabber, Sylvaine; Pereira, Dora I. A.; Dainty, Jack R.; Mushtaq, Sohail; University of Chester; Elsie Widdowson Laboratory, Cambridge; University of East Anglia; University Putra Malaysia (American Society for Nutrition, 2017-10-18)
      Background: Tea has been shown to be a potent inhibitor of nonheme iron absorption, but it remains unclear whether the timing of tea consumption relative to a meal influences iron bioavailability. Objective: The aim of the study was to investigate the effect of a 1-h time interval of tea consumption on nonheme iron absorption in an iron-containing meal in a cohort of iron-replete, nonanemic female subjects with the use of a stable isotope (57Fe). Design: Twelve women (mean 6 SD age: 24.8 6 6.9 y) were administered a standardized porridge meal extrinsically labeled with 4 mg 57Fe as FeSO4 on 3 separate occasions, with a 14-d time interval between each test meal (TM). The TM was administered with water (TM-1), with tea administered simultaneously (TM-2), and with tea administered 1 h postmeal (TM-3). Fasted venous blood samples were collected for iron isotopic analysis and measurement of iron status biomarkers. Fractional iron absorption was estimated by the erythrocyte iron incorporation method. Results: Iron absorption was 5.7% 6 8.5% (TM-1), 3.6% 6 4.2% (TM-2), and 5.7% 6 5.4% (TM-3). Mean fractional iron absorption was found to be significantly higher (2.2%) when tea was administered 1 h postmeal (TM-3) than when tea was administered simultaneously with the meal (TM-2) (P = 0.046). An w50% reduction in the inhibitory effect of tea (relative to water) was observed, from 37.2% (TM-2) to 18.1% (TM-3). Conclusions: This study shows that tea consumed simultaneously with an iron-containing porridge meal leads to decreased nonheme iron absorption and that a 1-h time interval between a meal and tea consumption attenuates the inhibitory effect, resulting in increased nonheme iron absorption. These findings are not only important in relation to the management of iron deficiency but should also inform dietary advice, especially that given to those at risk of deficiency. This trial was registered at clinicaltrials.gov as NCT02365103.
    • A 12-week prospective randomized controlled trial to investigate the effects of aerobic training on type 2 diabetes patients

      Sykes, Kevin; Yeung, Tin L. V.; Ko, Gary T. C.; University College Chester (Weston Medical Publishing, 2004)
      This study was undertaken to investigate the effects of a 12-week aerobic exercise program in the management of patients with type 2 diabetes. A prospective randomized controlled trial with repeated measures was conducted. Thirty-six Hong Kong Chinese patients with type 2 diabetes (mean age, 58.1 yr) were randomized into Group 1 (exercise, n = 24) and Group 2 (controls, n = 16). Assessments at baseline and at three months included anthropometry, body fat measurement, biochemistry, six-minute walking distance (6MWD) assessment, exercise capacity, and SF-36® quality of life assessment (QualityMetric Inc., Lincoln, RI). Blood glucose was monitored before and after each exercise session. The immediate response to one hour of moderate aerobic exercise was a significant decrease in blood glucose (10.4 ± 3.5 mmol/L to 7.1 ± 2.7 mmol/L, p < 0.05). After 12 weeks, significant differences were noted between the groups in 6MWD (498 ± 128 m versus 299 ± 75 m, p = 0.000), exercise capacity in terms of metabolic equivalent units (5.1 ± 1.0 METs versus 2.8 ± 0.8 METs, p = 0.001), and insulin sensitivity (1.7 ± 1.0 S1 versus 4.3 ± 2.5 S1, p = 0.048). Group 1 also demonstrated an increase in HDL (1.16 ± 0.30 mmol/L to 1.27 ± 0.33 mmol/L, p = 0.002), lower body weight (67.3 ± 12.8 kg to 66.9 ± 12.8 kg, p = 0.045), lower body mass (26.5 ± 4.6 BMI to 26.3 ± 4.6 BMI), reduced glycosylated hemoglobin HbA1c) (8.1 ± 1.3 percent to 7.7 ± 1.0 percent), and improved quality of life. In contrast, participants in Group 2 showed a significant decrease in the SF-36 social functioning domain (p = 0.035), lowered scores in all eight quality of life domains, and no changes in other variables. We conclude that moderate aerobic exercise should be advocated in the management of patients with type 2 diabetes.
    • A call for action on the development and implementation of new methodologies for safety assessment of chemical-based products in the EU – A short communication

      Knight, Derek J.; Deluyker, Hubert; orcid: 0000-0002-3490-8661; Chaudhry, Qasim; Vidal, Jean-Marc; orcid: 0000-0002-4422-5880; de Boer, Alie
      Safety assessment of chemicals and products in the European Union (EU) is based on decades of practice using primarily animal toxicity studies to model hazardous effects in humans. Nevertheless, there has been a long-standing ethical concern about using experimental animals. In addition, animal models may fail to predict adverse effects in humans. This has provided a strong motivation to develop and use new approach methodologies and other alternative sources of evidence. A key challenge for this is integration of evidence from different sources. This paper is a call for action with regard to development, validation, and implementation of modern safety assessment approaches for human health assessment by means of focused applied research and development with three strands: (a) to improve screening and priority setting, (b) to enhance and partially replace animal studies under the current regulatory schemes and eventually (c) to fully replace animal studies, while achieving at least the same level of protection. For this gradual but systematic replacement of animal studies, a long-term concerted and coordinated effort with clear goals is needed at EU level, as a societal and political choice, to plan and motivate research and innovation in regulatory safety assessment.
    • Abortion 'on the NHS': The National Health Service and abortion stigma

      Astbury-Ward, Edna; University of Chester (BMJ journals, 2015-03-05)
      Before the creation of the National Health Service (NHS), the health of the British nation was in a perilous state and hospitals survived on the philanthropy of rich benefactors. Following its introduction on 5 July 1948, the NHS was the biggest and most expensive social reform of the era.1 It was founded on three core principles: that it should meet the needs of everyone, that it should be free at the point of delivery, and that its use should be based on clinical need, not ability to pay. These principles govern the NHS today. The NHS should not discriminate against anyone who requires health care. Yet abortion care remains almost the only acute health need not comprehensively provided for within the NHS.2 In England and Wales in 2013, 98% (185 331) of all abortions were funded by the NHS,3 but only 34% of abortions took place in NHS settings. The majority were in the independent sector, funded by the NHS.4 This is in sharp contrast to Scotland, where in 2013 only 40 women out of 12 447 (0.3%) had their abortions in a non-NHS setting.5 The question is why?
    • Acculturation and Food Intake Among Ghanaian Migrants in Europe: Findings From the RODAM Study

      Boateng, Daniel; Danquah, Ina; Holdsworth, Michelle; Mejean, Caroline; Terragni, Laura; Powell, Katie; Schulze, Matthias B.; Owusu-Dabo, Ellis; Beune, Erik; Agyemang, Charles; et al.
      Abstract Objective This study examined the role of migration and acculturation in the diet of Ghanaian migrants in Europe by (1) comparing food intake of Ghanaian migrants in Europe with that of Ghanaians living in Ghana and (2) assessing the association between acculturation and food intake. Design Data from the cross-sectional multicenter study Research on Obesity and Diabetes among African Migrants were used. Food intake was assessed using a Ghana-specific food propensity questionnaire (134 items and 14 food groups); foods were grouped based on a model of dietary change proposed by Koctürk-Runefors. Setting Ghana, London, Amsterdam, and Berlin. Participants A total of 4,534 Ghanaian adults living in Ghana and Europe, with complete dietary data. Of these, 1,773 Ghanaian migrants had complete acculturation data. Main Outcome Measure Food intake (the weighted intake frequency per week of food categories). Analysis Linear regression. Results Food intake differed between Ghanaians living in Ghana and Europe. Among Ghanaian migrants in Europe, there were inconsistent and small associations between acculturation and food intake, except for ethnic identity, which was consistently associated with intake only of traditional staples. Conclusions and Implications Findings indicate that migration is associated with dietary changes that cannot be fully explained by ethnic, cultural, and social acculturation. The study provides limited support to the differential changes in diet suggested by the Koctürk-Runefors’ model of dietary change.
    • Accumulating aerobic exercise for effective weight control

      Sykes, Kevin; Leong, Lau; Cotterrell, Mary; Chester College of Higher Education (Royal Society of Health, 2004-01-01)
      The article discusses a study to compare the effects of different patterns of regular treadmill walking and cycle ergometry on body weight, body composition, waist and hip circumferences in overweight adult Singaporean females.
    • Acute and chronic effects of beetroot supplementation on blood pressure and arterial stiffness in humans

      Mushtaq, Sohail; Turner, Emma; University of Chester
      Dietary supplementation of beetroot juice, containing nitrate- a potent vasodilation agent, has been shown to be vasoprotective( 1 ), and dose dependent decreases in blood pressure (BP) have been previously demonstrated(2,3). To our knowledge there has been only one study investigating the effect of beetroot supplementation in humans on arterial stiffness, measured using pulsewave velocity (PWV) and, although there was no effect of supplementation on PWV, there was a significant reduction due to beetroot supplementation in acute diastolic BP (3hrs, P = 0·023)( 4 ). A double-blind, randomised, cross-over intervention trial was carried out in a cohort of 12 healthy male participants (mean age (SEM) = 43 (2·1) yrs, BMI = 27·8 (1·1) kg.m2) who underwent both beetroot juice and placebo supplementation for 14 days. The aim of the study was to assess the effect of 6·45 mmol of nitrate in a concentrated 70 ml beetroot drink (James White Ltd, Ipswich, UK) on systolic and diastolic BP, mean arterial pressure (MAP) and arterial stiffness (PWV, aortic augmentation index (Aix), brachial Aix) in humans. BP and arterial stiffness measurements weretaken using PWV (Arteriograph, TensioMed,Hungary). Measurements were taken intriplicate at baseline, 3 hours post-supplementation (either beetroot juice orplacebo) and post-intervention (day 15). This was followed by a 7-day washoutperiod before participants were transferred to the alternate supplement. Table 1 shows that there was no significant acute or short term effect of beetroot juice supplementation on the parameters measured when compared to placebo. However, there was a significant decrease in systolic BP (P = 0·009), diastolic BP (P = 0·035), MAP (P = 0·017), aortic and brachial AIX (P = 0·042 and 0·041 respectively), 3hours post beetroot supplementation. These results confirm previous findings( 4 ) that beetroot supplementation does not have an acute or short term effect on arterial stiffness measures. However, acute effects on arterial stiffness and BP within the beetroot juice supplementation group were observed. Further large scale studies on dietary nitrate supplementation and cardiovascular health are required to further assess efficacy.
    • Adherence to exercise in later life: How can exercise on prescription programmes be made more effective?

      Thurston, Miranda; Green, Ken; University College Chester (Oxford University Press, 2004-09-01)
      A broad consensus has emerged in relation to the desirability of promoting exercise among a variety of ‘at risk’ groups via ‘exercise on prescription’ (EoP) schemes, as an alternative to orthodox, biomedical approaches to the management of health problems. Underpinning the rationale for such schemes is the notion that they can act as vehicles for encouraging long-term adherence to exercise. Whilst there is a common sense appeal to using EoP schemes to promote exercise, research to date suggests that evidence of their impact is limited. This paper attempts to make sense of these findings in the light of recent debates about adult lifestyles and exercise. More specifically, it brings work in the sociology of leisure to bear on the topic, on the premise that any study of adults' propensity towards sustainable physical activity needs to be viewed as an aspect of their lives ‘in the round’. Such an analysis points up the value of synthesizing perspectives from across the disciplinary divide in order to shed light on particular ‘problems’, which obviate the necessity for further empirical work. The paper concludes by identifying a number of implications for public health policy and practice with respect to the matter of encouraging lifelong participation in sport and exercise in general, and via EoP schemes in particular. One such implication is the development of a model for understanding participation that shifts the emphasis away from a focus on motivation and behaviour change per se towards satisfaction and enjoyment through the development of skills and relationships. Reconceptualizing the matter of participation in this way is likely to lead not only to a more realistic appreciation of what can be expected from EoP schemes, but also a more adequate understanding of adherence to exercise in later life.
    • Antibacterial activity of Manuka honey and its components: An overview

      Johnston, Matthew; McBride, Michael; Dahiya, Divakar; Owusu-Apenten, Richard K.; Nigam, Poonam S.; University of Chester, University of Ulster (AIMS Press, 2018-11-27)
      The importance of honey for medicinal purposes is well documented in some of the world’s oldest literature. Honey is well known and studied for its antimicrobial properties. The medicinal properties in honey originate from the floral source used by bees. Manuka honey is a dark monofloral honey rich in phenolic content, and currently it is gaining much attention for its antimicrobial activity. Researchers have found that honey is effective against a wide range of pathogens. The antibacterial potency of Manuka honey was found to be related to the Unique Manuka Factor (UMF) rating, which is correlated with the methylglyoxal and total phenols content. It is reported that different types of Manuka honey have differing effects and Gram-negative bacteria are more resistant than Gram-positive bacteria. Bacterial resistance to honey as antimicrobial agent has yet to be identified, possibly due to the presence of a complex mixture of methylglyoxal and other components. Honey is also reported to alter a bacterium’s shape and size through septal ring alteration, which affects cell morphology and growth. Research has shown that Manuka honey of different UMF values has medicinal properties of interest and it can be beneficial when used as a combination treatment with other antimicrobial agents
    • Antioxidant and genoprotective activity of selected cucurbitaceae seed extracts and LC–ESIMS/MS identification of phenolic components

      Yasir, Muhammad; Sultana, Bushra; Nigam, Poonam S.; Owusu-Apenten, Richard K.; University of Agriculture, Faisalabad, Pakistan; University of California; Ulster University (Elsevier, 2015-11-30)
      Cucurbitaceae are one of most widely used plant species for human food but lesser known members have not been examined for bioactive components. The purpose of this study was to evaluate the antioxidant and genoprotective activities from three cucurbitaceae seeds extracts and to identify phenolic components by LC–ESIMS/MS analysis. From the results, the yield of seeds extract was 20–41% (w/w) and samples had 16–40% total phenols as gallic acid equivalents (GAE). Compared with methanol solvent, using acidified methanol led to increased extraction yield by 1.4 to 10-fold, higher phenolic content (149.5 ± 1.2 to 396.4 ± 1.9 mg GAE/g), higher DPPH radical quenching and enhanced enoprotective activity using the pBR322 plasmid assay. LC–ESI-MS/MS analysis led to identification of 14–17 components, based on authentic standards and comparison with literature reports, as mainly phenolic acids and esters, flavonol glycosides. This may be the first mass spectrometric profiling of polyphenol components from cucurbitaceae seeds.
    • Antioxidant, Anticancer and Antibacterial Activity of Withania somnifera Aqueous Root Extract

      Barnes, D. A.; Barlow, R.; Nigam, Poonam S.; Owusu-Apenten, Richard K.; University of Chester, University of Ulster (Sciencedomain international, 2015-11-10)
      Aims: To evaluate total antioxidant capacity, anticancer activity and antibacterial effects Withania somnifera aqueous-root extracts. Study Design: In vitro study. Place of Study: School of Biomedical Sciences, Ulster University, UK. Methodology: Total antioxidant capacity (TAC) of whole powder and freeze dried W. somnifera aqueous-root extracts was determined using FRAP, DPPH, Folin and ABTS assays. Anticancer activity was accessed using MDA-MB-231 breast cells and Sulforhodamine B staining for cell viability. Antibacterial activity was by disk diffusion assay with penicillin, amoxicillin and streptomycin as positive controls. Results: The TAC for W. somnifera extract was 86, 47, 195,or 443 gallic acid equivalents per 100g dry basis (mgGAE/ 100 g) using FRAP, DPPH, Folin or ABTS assays, respectively. Corresponding TAC values for freeze dried W. somnifera aqueous-root extract were, 418, 553, 1898 or, 1770 (mgGAE/100 g). W. somnifera aqueous-root extract inhibited MDA-MB-231 cell proliferation in a dose-dependent manner with IC50 = 0.19 mg/ml (21 µM GAE). Nil antibacterial effects were detected for freeze dried W. somnifera extract (0-1 mg/ml) across six species of bacteria tested. Conclusion: Withania somnifera root water extract showed significant antioxidant and anticancer activity for MDA-MB-231 breast cancer cells but no antibacterial activity under the conditions of this study.
    • Antioxidant, Anticancer and Antimicrobial, Effects of Rubia cordifolia Aqueous Root Extract

      Barlow, R.; Barnes, D. A.; Campbell, Anna M.; Nigam, Poonam S.; Owusu-Apenten, Richard K.; University of Chester, University of Ulster (Sciencedomain international, 2015-11-10)
      Aims: To evaluate the total antioxidant capacity (TAC) of Rubia cordifolia root extracts, to test anticancer activity against MDA-MB-231 breast cancer cell lines, and to evaluate antimicrobial activity of the same extract versus six Gram-positive and negative bacteria. Study Design: In vitro. Place of Study and Duration: School of Biomedical Sciences, Ulster University, July 2014-Sept 2015. Methodology: TAC was tested using ABTS, DPPH, FRAP and Folin assays and values were expressed as mg-gallic acid equivalents per 100 g (GAE/100 g) of sample. Anticancer properties were examined against MDA-MB-231 breast cancer cell lines using Sulforhodamine B assay. Antimicrobial activity was examined using a disk diffusion assay with three Gram-positive (Staphylococcus epidermidis, Staphylococcus aureus and Bacillus cereus) and three Gram-negative (Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi) bacteria. Results: TAC of dry extracts of Rubia cordifolia ranged from 523±43 to 4513±208 (mg GAE mg/100 g) depending on the method of analysis, ABTS> FRAP> Folin > DPPH methods. R. cordifolia dry extract showed cytotoxicity against MDA-MB-231 with IC50 = 44 µg/ml or 5.1µM GAE. No antimicrobial activity was observed against the three Gram-positive, or three Gram-negative bacterial species using the water extract or R. cordifolia. Conclusion: R. cordifolia aqueous extract possess high total antioxidant capacity but values depend on the method of analysis. R. cordifolia extract inhibits MDA-MB-231 breast cancer cells proliferation but nil anti-bacterial activity was observed for three Gram-positive and three Gram-negative bacterial strains tested.
    • Arabinoxylans from rice bran and wheat immunomodulatory potentials: a review article

      Fadel, Abdulmannan; Plunkett, Andrew; Li, Weili; Ranneh, Yazan; Tessu Gyamfi, Vivian Elewosi; Salmon, Yasser; Nyaranga, Rosemarie Roma; Ashworth, Jason (Emerald, 2018-02-12)
    • Arabinoxylans: Bioactivities in Relation to Their Molecular Structure

      Li, Weili; Zhang, Zhengxiao; Smith, Christopher J.; University of Chester; Manchester Metropolitan University (Bentham Science, 2017-03-09)
      Arabinoxylans are a group of compounds with a basic structure consisting of a xylose backbone with arabinose side chains. Variations in structure occur as a result of variations in the xylose chain length, the ratio of arabinose to xylose and the introduction of alternative side-chains. This allows for an enormous potential range of structures. Arabinoxylans are major components of the cell walls of cereals. They have been reported to have numerous health benefits. This chapter presents a systematic description of the molecular features of arabinoxylans and relates these to the different extraction technologies used to obtain them. The proposal, that their immune modulation activity is related to their molecular weight and structure, is presented. Results demonstrating the effects of various arabinoxylans in various in vitro immunological tests are discussed.
    • Are urological patients at increased risks of developing haemostatic complications following shock wave lithotripsy (SWL) for solitary unilateral kidney stones?

      Thomas-Wright, S. J.; Banwell, Joseph; Mushtaq, Sohail; Williams, R.; Abdulmajed, I.; Shergill, Iqbal; Hughes, Stephen F.; University of Chester; Wrexham Maelor Hospital (Elsevier, 2014-04-01)
      INTRODUCTION & OBJECTIVES: During the past two years there has been an increase in the number of patients undergoing shock wave lithotripsy (SWL) in Welsh hospitals (United Kingdom) for solitary unilateral kidney stones. Serious complications of SWL include haematuria, acute kidney injury and sepsis. Currently, there are no simple blood tests available, which can predict complications following SWL. Here we have tested the hypothesis that SWL will result in changes to haemostatic function, increase endothelial and haemostatic involvement postoperatively. MATERIAL & METHODS: In this pilot study, ten patients undergoing SWL for solitary unilateral kidney stones, were recruited (n=10). From patients (6 male and 4 female) aged between 31-70 years (mean=50 years), venous blood samples were collected pre-operatively (baseline), at 30 minutes, 120 minutes and 240 minutes postoperatively. Specific haemostatic biomarkers [D-dimer, von Willebrand Factor (vWF), Prothrombin time and sE-selectin] were measured. RESULTS: D-dimer and vWF concentrations were significantly increased from baseline at 240 minutes postoperatively (p=0.05 and <0.01 respectively). Prothrombin time and sE-selectin parameters were not significantly changed following SWL. CONCLUSIONS: The observed increase in D-dimer and vWF concentrations suggests that these markers would provide a more clinically relevant assessment of the extent of haemostatic involvement due to surgery. Analysis of such markers, have the potential to improve the detection of complications occurring postoperatively, such as haematuria and acute kidney injury.
    • Aspartame in conjunction with carbohydrate reduces insulin levels during endurance exercise

      Siegler, Jason; Howell, Keith; Vince, Rebecca; Bray, James W.; Towlson, Chris; Peart, Daniel; Mellor, Duane; Atkin, Stephen; University of Western Sydney ; University of York ; University of Hull ; University of Hull ; University of Hull ; University of Hull ; University of Chester ; University of York (01/08/2012)
      As most sport drinks contain some form of non-nutritive sweetener (e.g. aspartame), and with the variation in blood glucose regulation and insulin secretion reportedly associated with aspartame, a further understanding of the effects on insulin and blood glucose regulation during exercise is warranted. Therefore, the aim of this preliminary study was to profile the insulin and blood glucose responses in healthy individuals after aspartame and carbohydrate ingestion during rest and exercise. Each participant completed four trials under the same conditions (45 min rest + 60 min self-paced intense exercise) differing only in their fluid intake: 1) carbohydrate (2% maltodextrin and 5% sucrose (C)); 2) 0.04% aspartame with 2% maltodextrin and 5% sucrose (CA)); 3) water (W); and 4) aspartame (0.04% aspartame with 2% maltodextrin (A)). Insulin levels dropped significantly for CA versus C alone (43%) between pre-exercise and 30 min, while W and A insulin levels did not differ between these time points. Aspartame with carbohydrate significantly lowered insulin levels during exercise versus carbohydrate alone.
    • The BACPR standards and core components for cardiovascular prevention and rehabilitation 2012

      Jones, Jenni; Buckley, John P.; Furze, Gill; Doherty, Patrick; Speck, Linda; Connolly, Susan; Hinton, Sally; British Association for Cardiovascular Prevention and Rehabilitation ; University of Chester ; British Association for Cardiovascular Prevention and Rehabilitation ; British Association for Cardiovascular Prevention and Rehabilitation (British Association for Cardiovascular Prevention and Rehabilitation, 2012)
      This booklet sets out the seven core standards that patients, health care professionals, and commissioners should expect from a high quality cardiac rehabilitation programme.
    • Bioavailability of Orally Administered Active Lipid Compounds from four Different Greenshell™ Mussel Formats

      Miller, Matthew R.; Kruger, Marlena C.; Wynne, Chris; Waaka, Devonie; Li, Weili; Frampton, Chris; Wolber, Fran M.; Eason, Charles; Cawthron Institute; Massey University; Christchurch Clinical Studies Trust (CSST); University of Chester; University of Otago; (Emerald Publishing Limited, 2018-02-02)
      Abstract: Greenshell™ mussel (GSM, Perna canaliculus) is New Zealand’s most important aquaculture species. They are a good source of long chain-polyunsaturated fatty acids (n-3 LC PUFA). Beyond a traditional food product, GSMs are also sold as mussel powders and oil extract formats in the nutraceutical markets. In this study, a four-sequence, single dose, randomized crossover human trial with eight evaluable healthy male participants was undertaken to determine the bioavailability of the n-3 LC PUFA in four different GSM formats (oil, powder, food ingredient and half-shell unprocessed whole mussel) by measuring area under the curve (AUC) and maximal concentration (CMax). Blood samples were collected at baseline and up to 48 h after initiation of product consumption in each administration period. There were minor differences between the bioavailability of FA (fatty acid) between the different GSM formats. Eicosapentaenoic acid (EPA) peak concentrations and plasma exposures were significantly lower with GSM oil compared to GSM half-shell and GSM powder formats, which resulted in AUC0–48 for the intake of GSM half-shell mussel and GSM powder being significantly higher than that for GSM oil (p = 0.013, f= 4.84). This equated to a 20.6% and 24.3% increase in the amount of EPA present in the plasma after consumption of half-shell mussels and mussel powder respectively compared to GSM oil. GSM oil produced the shortest median time to maximal plasma n-3 LC PUFA concentration of all evaluated products demonstrated by a shorter maximum measured plasma concentration (TMax = 5 h). Docosahexaenoic acid (DHA) and n-3 LC PUFA plasma exposure parameters were statistically comparable across the four GSM products evaluated.
    • Biochemical assessment of patients following ketogenic diets for epilepsy: current practice in the UK and Ireland

      Schoeler, Natasha; Simpson, Zoe; Whiteley, Victoria; Nguyen, Patty; Meskell, Rachel; Lightfoot, Kathryn; Martin-McGill, Kirsty; Olpin, Simon; Ivison, Fiona
      Objective: Biochemical assessment is recommended for patients prior to initiating and following a ketogenic diet (KD). There is no published literature regarding current practice in the UK and Ireland. We aimed to explore practice in comparison to international guidelines, determine approximate costs of biochemical testing in KD patients across the UK and Ireland, and promote greater consistency in KD services nationally. Methods: A survey was designed to determine the biochemical tests requested for patients at baseline, 3-, 6-, 12-, 18- and 24-months+ on KD. The survey was circulated to 39 centres across the UK and Ireland. Results: 16 centres completed the survey. Full blood count, electrolytes, calcium, liver function tests (LFTs), lipid profile and vitamin D were requested at all centres at baseline, in keeping with international guidelines. Bicarbonate, total protein and urinalysis were less consistently requested. Magnesium and zinc were requested by all centres, despite not being specifically recommended for pre-diet evaluation in guidelines. Urea and electrolyte profiles and some LFTs were consistently requested at follow-up, in accordance with guidelines. Other LFTs and renal tests, full blood count, lipid profile, acylcarnitine profile, selenium, vitamin D and urinalysis were less consistently requested at follow-up. The mean costs of the lowest and highest number of tests requested at baseline in our participating centres was £167.54 and £501.93; the mean costs of the lowest and highest number of tests requested at 3-month follow-up was £19.17 and £450.06. Significance: Biochemical monitoring of KD patients varies widely across the UK and Ireland and does not fully correspond to international best practice guidelines. With an ongoing drive for cost-effectiveness within healthcare, further work is needed to streamline practice whilst ensuring patient safety.
    • Blacon Sure Start parent satisfaction survey

      Barrow, Marjorie; Rouse, Julia; Thurston, Miranda; Chester College of Higher Education (Unversity College Chester, 2003-11)
      This report evaluates Sure Start in Blacon during 2003.