Heart and ovarian allografts from C57BL/6 to BALB/c mice had a significantly longer survival time in recipients treated 6 hours/day with HBO starting 48 hours prior to transplantation and continuing until allograft rejection than did those in untreated mice. Exposure to normobaric oxygen beginning 48 hours prior to transplantation also prolonged ovarian allograft survival, but did not have a statistically significant effect on survival of heart allografts. Exposure to HBO 6 hours/day beginning 24 hours after transplantation and continuing until the rejection of the allografts did not prolong the survival time of these tissues. Treatment of the recipients with hyperbaric air starting 48 hours prior to transplantation did not increase the survival time of either heart or ovarian allografts. Control grafts in syngeneic recipients functioned for at least 30 days after transplantation indicating that the transplantation technique and post-operational animal care were satisfactory.

A group of interrelated studies from these laboratories have shown that various cell-mediated and humoral immune processes were altered in rodents exposed to prolonged hyperbaric oxygen. The study here reported is based upon these findings and was undertaken to determine whether hyperoxygenemia would suppress cell-mediated rejection of foreign tissues and acceptance of xenogeneic tumor transplants. A Fischer 344 rat lymphoma (NRL 1871) was implanted intraperitoneally into C57BL/6, DBA/2 and BALB/c mice. Implants produced fatal neoplasms in 13 of 43 C57BL/6 and 6 of 18 DBA/2 mice given daily HBO for 30· days starting one day after implantation. None of the 17 BALB/c recipients given the same regimen of oxygen developed tumors nor did 117 untreated, tumor recipients observed over a period of 60 to 100 days. The xenogeneic growths metastasized extensively even after cessation of HBO therapy. The histologic appearance of these growths was identical with that of the parent lymphoma and they could be transplanted back to Fischer 344 rats but not to normal or HBO treated mice syngeneic with the primary xenogeneic host.

C-reactive protein, a normally occurring plasma protein, may become elevated as much as 3,000-fold during disease states involving acute inflammation or tissue damage. Through its binding to phosphorylcholine, in the presence of calcium, C-reactive protein has been shown to potentiate the activation of the classical and alternative complement pathways and stimulate phagocytosis as well as inhibit certain platelet and T cell reactivities. Its interaction with the various substances that are an integral part of immunological surveillance implies an important role for C-reactive protein in the host reaction to defense, disease and inflammation. The possible significance of this role is discussed.

Background: Black Africans in developed countries have a higher prevalence of diet-related chronic diseases. However, dietary and anthropometry data is limited, particularly on sub-groups such as Ghanaians in the UK. Objectives: To determine the habitual diet and body composition of first generation Ghanaian migrants, to validate a food frequency questionnaire specific for Ghanaians, find the ideal body image of Ghanaians and the body size most attractive to Ghanaian males and to conduct a nutrition intervention programme using the Black Churches as a setting. Methodology: Cross-sectional survey. Participants were volunteers and first generation Ghanaian migrant who were congregants of Black Churches in London (n=288). Information on dietary intake was obtained from multiple repeated 24-hour recalls in a sub-sample (n=68) of the survey participants. The food frequency questionnaire was developed using the most commonly reported foods and portion sizes, field tested, shortened and then validated with multiple 24hr recalls (n=68). Information was also collected on height, weight, waist circumference, waist to hip ratio and percentage body fat which was measured using a portable bioelectric impedance analyzer (n=212). Participants from London (n=45) and Ghana (n=79) completed questionnaires to collect information on their ideal size and other body-shape related questions using the Figure Rating Scale (FRS). The nutrition intervention programme (n=76) was developed with input from participants through focus groups and the Obesity Clinic at the London Metropolitan University. Participants were assigned to either the intervention or control group and information on socio-demography, dietary intake and anthropometric measurements were taken at baseline, 6 weeks and at 3 months to evaluate the effectiveness of the intervention programme. Results: Energy and the percentage energy from fat intake of Ghanaian migrants (1987 kcal, fat 35.3%) was similar to that of the host population (1972kcal, fat 35.4%) but carbohydrate and fibre intake was different (carbohydrate 50.1%, fibre 16.4g vs 48.1%, 13.9g) for migrant Ghanaians and host population respectively. Energy under-reporting was 31% for this survey and was associated with gender and body mass index. The food frequency questionnaire performed well relative to 7 multiple 24-hour recalls with correlations increasing after adjusting for energy (protein r= 0.71, fat r=0.69, carbohydrate r=0.54, fibre r=0.69). Participants were correctly classified in the same (34%) or adjacent quartile (54%) for most nutrients with only 3% to 9% of participants mis-classified into opposite quartiles. Bland-Altman plots were within limits of agreement for all the macro-nutrients. The prevalence of overweight and obesity was higher in female migrant Ghanaians using body mass index (67%) compared to the host population (58%) but prevalence was lower when percentage body fat was used (female 40%). There was a cultural shift in acceptability of overweight and obese body sizes and shapes among Ghanaians with 60% of Ghanaian males preferring Ghanaian females with a normal body size. The nutrition intervention programme was conducted over 6 weeks and changes were observed in energy (intervention - 250kcal vs -135kcal (NS)) and fat intake (intervention -3.8g (p=0.04) vs control -2.1g (NS). Waist circumference decreased by 2.2cm (p=0.05) for the intervention group after 6 weeks. After 3 months fat intake decreased by 7.3g (p=0.000) for the intervention group and 10.4g (p=0.04) for the control group. Changes in anthropometry still persisted after 3 months for body weight (-2.3kg, p=0.001), body mass index (-1.4kg/m², p=0.001) waist circumference (-3.3cm, p=0.04) and % body fat (-2.0%, p=0.01) for the intervention group. Changes in anthropometry were also observed in the control group for weight (-0.9kg, p=0.05), waist circumference (-1.9cm, p=0.006) and waist-hip ratio (-0.1, p=0.03). Conclusion: The dietary intake of Ghanaian migrants in the UK is similar to the host population. The food frequency questionnaire developed specifically for this population is an adequate dietary assessment tool. Ghanaian males preferred females with normal body sizes. The prevalence of overweight and obesity is higher in female migrant Ghanaians compared to the host population and the Black Churches are an effective setting for the delivery of nutrition intervention programmes.

Atopic dermatitis (eczema) is a psychosomatic chronic skin condition. Onset of the condition usually occurs in early life. Some people however, do develop it much later. Even though studies have demonstrated high levels of psychological disturbance and maladjustment among most people with AD, some others still do not, suggesting that a certain level of variability exists in the way people adjust to their skin condition. The goal of the present study was to identify the factors that determine adjustment to AD and account for this variability. Existing studies on this topic have considered factors such as: age of onset of the condition, demographic characteristics, disease severity and visibility, cognitive representations of illness and condition appraisals. Most of these studies however are limited in the explanations that they offer. Drawing upon the schema theory model of personality development and psychopathology, the present study proposes that adjustment to AD is mediated by personality-level structures (self-schemas) that have their origins in early experiences. Design: A cross-sectional design was employed with three groups: a) patients with an early onset of atopic dermatitis (n = 130), b) patients with a late onset (n = 76) and c) people with no chronic medical condition (n = 74). Method: All groups completed the Young Parenting Inventory- Revised, and the Young Schema Questionnaire-Short Form 3. The two atopic dermatitis groups also completed the Adjustment to Chronic Skin Disease Questionnaire. Results suggest that: a) people with an early and a late onset of atopic dermatitis were presented with a certain schematic profile that differentiated them from participants in the control groups; b) a certain pattern of early parenting experiences was linked to the development of this schematic profile and c) this schematic profile predicted high levels of dysfunctional coping and difficulties in adjustment. Findings have a clear relevance to the practice of Counselling Psychology. Limitations of the study and clinical implications are discussed.

Diabetes is a progressive multi-factorial metabolic syndrome with serious short and long term complications affecting many of organs with high increasing prevalence in the world. Using herbs and their derivatives for treating diabetes has a long history in many traditional cultures across the world. Molecules and compounds were isolated from herbs are the basis of many therapeutics which we are using in medicine for treating a variety of health conditions. The seeds of fenugreek, Trigonella foenum graecum, commonly used as a spice in Middle Eastern countries and widely used in South Asia and Europe, are known to have anti-diabetic properties. In 1979, Hardman identified an unusual amino acid (2S, 3R, 4S) 4-hydroxyisoleucine (4HO-Ile) in a fenugreek seed extract as an active compound in fenugreek seed. It was so far found only in fenugreek seed, which is responsible for its anti-diabetic properties. Studies on 4-hydroxyisoleucine effects on type 2 diabetes and insulin resistant animal models revealed that it has anti-diabetic properties of enhancing insulin secretion under hyperglycaemic conditions, and increasing insulin sensitivity. Unfortunately, the available published researches for 4-hydroxyisoleucine are limited and its mechanism of actions is not clear. Here we describe for the first time the anti-diabetic activity of 4-hydroxyisoleucine in a model of type 1 diabetes as all the previous works focused on 4-hydroxyisoleucine activity in type 2 diabetes and insulin resistant condition. Treatment of streptozotocin-treated type 1 diabetes rats, where levels of insulin are much reduced, by 65%, compared to normal animals, with daily doses of 4-hydroxyisoleucine at 50 mg/kg/day for four weeks could reduce plasma glucose in the diabetic group. Moreover the high levels of lipids (cholesterol, HDL, III LDL and triglyceride) and uric acid in the diabetic rats, could be restored to levels found in non-diabetic controls by the treatment with 4-hydroxyisoleucine. These results demonstrate that 4-hydroxyisoleucine has significant anti-diabetic activities in type 1 diabetes as well as previously studied type 2 diabetes and insulin resistance model that are independent of insulin. The findings suggest the potential of 4HO-Ile as an adjunct to diabetes treatment and for type 1 as well as type 2 diabetes. To investigate the insulin-independent effects of 4-hydroxyisoleucine further, the cell based experiments were designed to assess the effect of 4-hydroxyisoleucine on cellular glucose uptake and ATP content after one day incubation. Isoleucine was added to the experiment as a positive control because firstly it has some level of anti-diabetic properties according to previously published studies and secondly it has similar molecular backbone as 4-hydroxyisoleucine. BRIN-BD 11, a functional and glucose responsive pancreatic beta cell, was selected as a cell model which is not insulin-responsive and dependent on the insulin signalling pathway for glucose uptake. Use of the model provides the opportunity to study the mechanisms of action of both 4-hydroxyisoleucine and isoleucine independently. We adopted a unique approach using inhibitors to target suggested pathway and molecules within the cell which may be involved in both 4-hydroxyisoleucine and isoleucine mechanism of actions. The results revealed that 4- hydroxyisoleucine and isoleucine could increase glucose uptake in BRIN-BD 11 cells, but as previously suggested, 4-hydroxyisoleucine activity is in direct correlation with glucose concentration. 4-hydroxyisoleucine has higher activity in higher concentrations of glucose. 4-hydroxyisoleucine increased the glucose uptake much greater than isoleucine at 11mM and 22mM concentration of glucose in IV cell culture medium. Endpoint measurements of ATP content of the BRIN-BD11 cells did not show any significant changes between 4-hydroxyisoleucine and isoleucine groups and control as well as an insulin level measurement in culture medium after 24 hours. The results showed that there are substantial differences between isoleucine and 4-hydroxyisoleucine mechanisms of action unlike their similar glucose uptake stimulatory effect which is greater in 4-hydroxyisoleucine. 4-hydroxyisoleucine activity strongly dependent on new protein synthesis and GLUT 1 activity. GLUT 1 is widely available in most of the cells and it controls the basal glucose uptake independent of insulin. The connection between GLUT 1 and 4-hydroxyisoleucine effect in cellular level, supports the idea that 4-hydroxyisoleucine utilises the glucose basal consumption and uptake of cells. Mitochondrial calcium channel signalling inhibition affects 4-hydroxyisoleucine and isoleucine functionality as well as inhibition of mitochondria pyruvate carrier. Real time monitoring of cell metabolism by Seahorse XF-24 autoanalyser after 24 hours incubation with 4-hydroxyisoleucine and isoleucine revealed that both 4-hydroxyisoleucine and isoleucine activities are strongly dependent on mitochondrial respiration but 4-hydroxyisoleucine significantly up-regulates glycolysis which is not affected by isoleucine. The connection between mitochondria calcium signalling and contradictory behaviour of 4-hydroxyisoleucine and isoleucine support the very important role of mitochondria in their mechanisms of action.

The recent development of biological therapies has revolutionized medical treatment for psoriatic arthritis. To date, research studies have focused on the treatment effects of biologics from a quantitative perspective using generic quality of life measures. An understanding of how treatment with biologics is experienced in the lives of psoriatic patients themselves therefore remains lacking. This study investigated the lived experience of psoriatic arthritis patients receiving biological therapy by employing Interpretative Phenomenological Analysis (IPA) to access this experience. Analysis of the data highlighted that receiving biologics for psoriatic arthritis was experienced as life-changing, but also required participants to make sense of the many unknowns surrounding treatment in regard to future effectiveness and long-term side effects of biologics. Participants experienced a biomedical focus on disease and treatment effects alone as not taking into account the significant psychological impact that having psoriatic arthritis and being treated with biologics can have on sufferers’ lives. Three master themes were identified: new lease of life, living with the fear of the unknown, and the importance of seeing the disease and the person. It is argued that this research extends the current knowledge base in counselling psychology on the psychological aspects of skin conditions such as psoriasis to what it is like to have both psoriasis and arthritis, whilst also being relevant to counselling psychologists working with psychological aspects of medical conditions, which is proposed to hold a promising future for the field.

Multiple sclerosis is an inflammatory and demyelinating multifactorial disease that results from the interplay between environmental factors and a susceptible genetic background. Omega (ω)-3/ω-6 polyunsaturated fatty acids (PUFAs) and some vitamins have been shown to reduce the number and severity of relapses and the overall progression of disability in multiple sclerosis patients, however clinical trials remain inconclusive due to a plethora of reasons. In this randomized, double blinded, placebo controlled trial aiming to provide concrete conclusions for the role of PUFAs and vitamins A and E (both gamma (γ) and alpha (α)) in multiple sclerosis. By measuring the incorporation and changes of the lipid composition in red blood cell (RBC) membranes before and after the dietary intervention, and by correlating the efficacy of the different interventions with disease progression, it was shown that supplementation with these specific molecules (that can either act on their own or synergistically) could probably cause the decrease of arachidonic acid (AA) and linoleic acid (LA) from the RBC membranes and the subsequent substitution by eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These events parallel the clinical observations where this can be correlated with the increased number of relapse activity occurring in the first six months of treatment and later with a prolonged period of remission. Supplementation with the mixture of PUFAs (both ω3 and ω6), vitamin E as gamma tocopherol significantly reduced the annualised relapse rate (ARR) and the risk of sustained disability progression without any reported serious adverse events.

Irritable Bowel Syndrome (IBS) is a common functional bowel disorder thought to effect between 10-20% of the UK population. IBS places much demand on the NHS to fund and treat. It is twice as common for IBS to be found in women compared to men. IBS gender findings are limited. Little is known about how IBS is experienced by men. A qualitative approach examined in-depth subjective accounts of six men who had IBS via semi-structured interviews. Interviews were analysed using Interpretative Phenomenological Analysis (IPA). Findings were interpreted against existing IBS research and literature and using a biopsychosocial framework. Participants experienced IBS as psychologically debilitating which often restricted activities, threatened relational identities and was isolating. Enduring experience of IBS seemed to compromise sense of self, constructs of masculinity and could foster despondency and helplessness with IBS. IBS symptoms frequently seemed unpredictable and illogical to cope with. Participants often conveyed ambivalence about seeking help for IBS. Many participants struggled to get their needs recognised and met in treatment with health professionals. Men had difficulties comprehending the ambiguities of IBS and need to accept and adapt to IBS. Disclosing IBS to others presented risk for incurring poor understanding, stigma and shame. Counselling psychologists could adapt therapeutic styles to build containing, collaborative relationships that better engage men in treatment. Therapeutic interventions could be adapted to better empower men and more adequately respond to their needs with IBS. Subjective differences in IBS presentation and experience implied need to individualise therapeutic treatments. Counselling Psychologists could help men accept the given aspects of IBS and nurture awareness of management responsibilities and abilities to influence IBS. Therapeutic efforts could challenge any stigma or shame about having IBS. Counselling Psychologists could facilitate efforts to maintain a valued sense of self and promote psychological well-being rather than specifically seeking a cure.

Background: The traditional Omani diet of dates, milk, rice, brown bread, fish and vegetables has undergone considerable change, now resembling a Western diet that is high in calories, high glycaemic index carbohydrates, total fat and saturated, trans and omega 6 fatty acids, and low in omega-3 fatty acids and essential micronutrients. The available data on daily food intake and its impact on micro- and macro-nutrients are scanty in the Arab world. Obtaining these data is especially important in light of the growing prevalence of non-communicable diseases (NCDs) - cardiovascular diseases, diabetes, cancer and respiratory diseases - which now account for more than 60% of the global disease burden and mortality, and contribute to more than 50% of annual deaths in Arabian countries, including Oman. Moreover, obesity, an antecedent of NCDs, has reached epidemic proportions in the region. Since NCDs develop gradually during the course of the lifespan, various national and international committees on NCDs have recommended that children and young adults be the primary focus of any action plan that aims to prevent and control non-communicable diseases. Specific aims: The aims of the study are: a) To assess the nutrient intake, body composition, blood lipids, blood pressure, blood glucose and cognitive behaviour of Omani school children; b) To assess the level of Vitamin A, D, E, and Beta Carotene among the Omani school children c) To assess the level of red blood cell fatty acids of Omani school children d) To investigate the effect of fish consumption on red blood cell omega-3 fatty acids and plasma fat-soluble vitamins; e) To investigate the impact of omega-3 fatty acids obtained from fish oil capsule on the red blood cell omega-3 fatty acids and plasma fat-soluble vitamins. Methods: Children ages 9 and 10 years (n = 314) were recruited from three randomly selected schools in the Muscat Governorate. The schools were assigned to a fish, fish oil, or control group and the children were accordingly provided a lightly grilled oily fish, a re-esterified triacylglycerol fish oil capsule, or no fish for 12 weeks. Baseline body weight, height and body mass index were assessed and a non-fasting blood sample collected at baseline and after 12 weeks of intervention. Data on food intake were gathered using a 24-hour recall questionnaire; also collected were data on weight, height, blood pressure, triglycerides and fasting glucose. In addition, teachers completed the National Initiative for Children’s Health Quality Vanderbilt Assessment Scales-Teacher Assessment Scale to assess the prevalence and sub-types of ADHD. Results: At baseline, a significant number of the children had low levels of vitamin D, and omega-3 fatty acids. The low levels of vitamin D and omega-3 fatty acids were ameliorated significantly by fish consumption and fish oil supplementation. In terms of weight, the prevalence of overweight or obesity for the total sample was 28.2% (10%, 46%) and 22.6% (8%, 38%). That is, about one fourth of the study subjects were overweight or obese. With regards to ADHD, the prevalence rate of PIS, PHIS and ADHDCIH among Omani school children was 7.3%, 3% and 8.8%, respectively. After 12 weeks intervention, the children who received fish oil (54.1±17.5 nmol/L; p < 0.001) and fish (49.2±17.4 nmol/L; p < 0.05) had elevated levels of vitamin D than those who did not (42.3±17.5 nmol/L). The fish oil (1.2±0.70 μmol/L) and fish (1.20±0.7 μmol/L) groups also had higher concentrations of beta carotene than the placebo group (0.85±0.43 μmol/L; p < 0.0001). Systolic and diastolic blood pressure (p=0.0001) and plasma triglycerides (p < 0.05) but not HDL, LDL and total cholesterol (p > 0.05) were lower in the fish oil group compared with those who were fed oily fish. Conclusions: This study provides important and underreported data on nutrient intake levels by school children in Arab world. For the first time, these data will be available as a benchmark for future research and health programs in the region. A large number of boys and girls had diets that failed to provide the recommended levels of daily nutrients. This study also indicates that ADHD is relatively common among Omani school children; additional studies are needed to assess the generalisability of these findings. Vitamin D deficiency is prevalent in Omani school children, but can be mitigated with omega-3 fatty acid supplementation. This study also provides evidence that Omani pre-adolescents have a low level n-3 fatty acid index that can be ameliorated by fish oil supplementation or consumption of oily fish. Hence, there is a need for a child-focused program of food fortification, school feeding programmes, targeted intervention with n-3 fatty acid enriched food products, family nutrition education and outdoor activities to alleviate the problem.