Provision of a snack at school could help alleviate the micronutrient malnutrition that is common among schoolchildren in developing countries. The Child Nutrition Project was designed to compare the efficacy of three school snacks in improving growth and cognitive function of children in rural Kenya. The snacks provided approximately 20% of the children's energy requirement, and were composed of equicaloric portions of githeri (a vegetable stew) alone (Energy group), githeri plus milk (Milk group) or githeri plus meat (Meat group). A fourth group of children served as Controls. When nutrient intakes from three, 24-h dietary recalls collected before feeding were compared to three, 24-h recalls conducted after feeding began, intakes of vitamin B-12, riboflavin, vitamin A and calcium increased more in the Milk group than in the Control group, whereas intakes of vitamin B-12, vitamin A, calcium, available iron and available zinc increased more than those of Controls for children in the Meat group. At most of the time points examined, total energy intake increased more for the Meat group than for the other two feeding groups, because the additional energy provided by the Milk and Energy snacks was partially balanced by a decrease in the energy content of foods consumed at home. This decrease did not occur to the same extent for the Meat group, so both dietary quantity and dietary quality improved. For the Milk group, only dietary quality improved. For the Energy group, there were no significant changes in the total day's diet compared to the Control group.

This study assessed the effect of a brief intervention aimed at reducing HIV-related stigma among service providers in China. From December 2005 to June 2006, 138 service providers from four county hospitals in the Yunnan province of China were randomly assigned into either an intervention or a control condition. HIV stigma reduction concepts were conveyed through participatory small group activities, including role-plays, games, group discussions, and testimony by an HIV advocate. Participants were assessed at baseline before the intervention, and at 3- and 6-month follow-ups. Data were analyzed using a logistic regression mixed-effects model. Service providers in the brief intervention condition were significantly more likely to report better protection of patients' confidentiality and right to HIV testing, lower levels of negative feelings toward people living with HIV/AIDS, and more accurate understanding and practice of universal precautions. This brief intervention pilot showed potential in reducing HIV stigma and discrimination among service providers in China. Further intervention trials are needed to test the efficacy and long-term outcomes of this intervention.

Objectives The objective of the intervention was to reduce service providers’ stigmatizing attitudes and behaviors toward people living with HIV. Methods The randomized controlled trial was conducted in 40 county-level hospitals in 2 provinces of China between October 2008 and February 2010. Forty-four service providers were randomly selected from each hospital, yielding a total of 1760 study participants. We randomized the hospitals to either an intervention condition or a control condition. In the intervention hospitals, about 15% of the popular opinion leaders were identified and trained to disseminate stigma reduction messages. Results We observed significant improvements for the intervention group in reducing prejudicial attitudes (P < .001), reducing avoidance intent towards people living with HIV (P < .001), and increasing institutional support in the hospitals (P = .003) at 6 months after controlling for service providers’ background factors and clinic-level characteristics. The intervention effects were sustained and strengthened at 12 months. Conclusions The intervention reduced stigmatizing attitudes and behaviors among service providers. It has the potential to be integrated into the health care systems in China and other countries.

Background To identify risk factors for lower quality of life (QOL) among low-income women with breast cancer (BC), with an emphasis on the impact of patient-physician communication. In addition, we examined ethnic/racial group differences in QOL change over time. Methods A longitudinal study was conducted among 921 low-income women with BC. Patients were interviewed at 6-, 18-, 36- and 60- months after BC diagnosis. Mixed-effect regression models were performed to investigate predictors for and time effects on QOL. The main outcomes included the Medical Outcomes Study Health Survey Short Form 36 Mental Component Summary score (SF-36 MCS), SF-36 Physical Component Summary score (SF-36 PCS) and the Ladder of Life scale. Chief independent variables included physician information-giving and patient self-efficacy in interacting with physicians. Results There were no significant changes over time in QOL except for physical functioning, with survivors reporting a significant decrease over time (P<0.0001). Mean SF-36 MCS and PCS scores were lower than national general population norms at all time points. Both patient self-efficacy in interacting with physicians and physician information-giving were positively associated with SF-36 MCS (P=0.03, P=0.02, respectively) and Ladder of Life (P=0.01, P=0.03, respectively). Less acculturated Latinas reported higher SF-36 MCS and PCS scores (P<0.0001, P=0.01, respectively) and better global QOL (P<0.0001) than whites. Conclusion Low-income women with BC experienced poor physical and mental health. The results suggest that QOL among low-income women with BC would be enhanced by interventions aimed at empowering patients in communicating with physicians and increasing physician information giving.

Introduction Vasoactive Intestinal Peptide (VIP) is a 28-amino acid neuropeptide that belongs to the secretin-glucagon superfamily of peptides and has 68% homology with PACAP. VIP is abundantly expressed in the central and peripheral nervous system and in the gastrointestinal tract, where it exercises several physiological functions. Previously, it has been reported that VIP regulates feeding behavior centrally in different species of vertebrates such as goldfishes, chicken, and rodents. Additional studies are necessary to analyze the role of endogenous VIP on the regulation of appetite/satiety together with feeding behavior, metabolic hormone release, body mass composition and energy balance. Aims To elucidate the physiological pathways by which VIP regulates appetite/satiety, feeding behavior, metabolic hormones and body mass composition. Methods VIP deficient (VIP −/−) and age-matched wild-type (WT) littermates were weekly monitored from 5 to 22 weeks of age using a whole body composition EchoMRI analyzer. Food intake and feeding behavior were analyzed using the BioDAQ automated monitoring system. Plasma levels of metabolic hormones including active-ghrelin, GLP-1, leptin, PYY, pancreatic polypeptide (PP), adiponectin, and insulin were measured in fasting as well as in postprandial conditions. Results The genetic lack of VIP led to a significant reduction of body weight and fat mass and to an increase of lean mass as the mice aged. Additionally, VIP−/− mice had a disrupted pattern of circadian feeding behavior resulting in an abolished regular nocturnal/diurnal feeding. These changes were associated with an altered secretion of adiponectin, GLP-1, leptin, PYY and insulin in VIP−/− mice. Our data demonstrates that endogenous VIP is involved in the control of appetite/satiety, feeding behavior, body mass composition and in the secretion of six different key regulatory metabolic hormones. Conclusions Our data show that endogenous VIP is involved in the control of appetite/satiety, feeding behavior, body mass composition and in the secretion of six key regulatory metabolic hormones. VIP plays a key role in the regulation of body weight and mass composition phenotype by significantly enhancing body weight and fat mass accumulation. Therefore, VIP signaling is critical for the modulation of appetite/satiety and body mass phenotype and is suggested to be a target for future treatment of obesity.