The Impact of Structured Support Groups for Pregnant South African Women Recently Diagnosed HIV Positive

The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006. Using a quasi-experimental design, assessments were conducted at baseline and two and eight months post-intervention. A series of random effects regression analyses were conducted, with the three assessment points treated as a random effect of time. At both follow-ups, the rate of disclosure in the intervention group was significantly higher than that of the comparison group (p < 0.001). Compared to the comparison group at the first follow-up, the intervention group displayed higher levels of active coping (t = 2.68, p < 0.05) and lower levels of avoidant coping (t = ?2.02, p < 0.05), and those who attended at least half of the intervention sessions exhibited improved self-esteem (t = 2.11, p < 0.05). Group interventions tailored for newly HIV positive pregnant women, implemented in resource-limited settings, may accelerate the process of adjusting to one's HIV status, but may not have sustainable benefits over time.     

孕中期血清脂联素及胰岛素与子痫前期的相关性研究

目的 探讨孕中期血清脂联素(APN)及胰岛素水平与子痫前期(PE)的相关性.方法 随机选择2009年7月至2010年7月在本院接受产前检查的300例单胎孕妇为研究对象,对其妊娠经过及妊娠结局进行随诊.其中,31例孕晚期时发展为PE,被纳入PE组.对PE组患者按照PE病情分度,将重度子痫前期(SPE)患者纳入SPE组(n-18),轻度子痫前期(MPE)患者,纳入MPE组(n-13),将同时纳入研究孕晚期仍正常的单胎妊娠妇女30例纳入对照组.于24～28孕周时,对SPE组、MPE组和对照组受试者采用放射免疫法(RIA)测定血清APN、胰岛素及其他相关指标,并进行相关分析.SPE组、MPE组与对照组,SPE组与MPE组孕妇年龄、孕龄及孕前体重指数(BMI)比较,差异无统计学意义(P＞0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书).结果 ①SPE组、MPE组与对照组血清APN水平呈上升趋势,SPE组较对照组明显降低,差异有统计学意义(P＜0.01);SPE组与MPE组、MPE组与对照组比较,差异无统计学意义(P＞0.05).②3组孕妇孕中期空腹血糖(FBG),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇( LDLC)和高密度脂蛋白胆固醇(HDLC)水平比较,差异均无统计学意义(P＞0.05).③3组孕妇的血清胰岛素比较,SPE组较对照组明显升高,差异有统计学意义(P＜0.01),SPE组与MPE组、MPE组与对照组比较,差异无统计学意义(P＞0.05).④SPE组血清APN与胰岛素呈负相关(r=-0.50,P＜0.01),其他两组血清APN与胰岛素无相关性(r=0.33,r=-0.02;P＞0.05).SPE组血清APN与收缩压、舒张压呈负相关(r=-0.97,r=-0.94;P＜0.01),与TG呈负相关(r=-0.63,P＜0.01),与HDLC 呈正相关(r=0.54,P＜0.05),与TC和LDLC无相关关系(r=0.03,r=0.18;P＞0.05).SPE组血清胰岛素与收缩压呈正相关(r=0.90,P＜0.05),与TC和TG呈正相关(r=0.59,r=0.73;P＜0.01).MPE 组血清APN与TG呈负相关(r=-0.71,P＜0.01),血清胰岛素与TG呈正相关(r=0.58,P＜0.05).结论 孕中期血清低APN及高胰岛素血症与PE密切相关.     

服刑人员未成年子女心理健康状况和自尊程度的 关系研究

摘要:目的　探讨服刑人员未成年子女心理健康状况和自尊之间的关系,为今后服刑人员未成年子女的心理健康保健工作提供依据。方法　采用心理健康诊断量表和自尊量表对130名服刑人员未成年子女的心理健康状况和自尊程度进行测量。结果　（1）不同性别的未成年子女在心理健康状况和自尊得分上差异无统计学意义（P＞0.05）;（2）不同年龄的未成年子女在心理健康状况和自尊得分上差异有统计学意义（P＜0.05）;（3）不同服刑时间的服刑人员未成年子女在心理健康状况差异有统计学意义（P＜0.05）,在自尊得分上差异无统计学意义（P＞0.05）;（4）不同服刑情况的服刑人员未成年子女在心理健康状况上差异有统计学意义（P＜0.05）,在自尊得分上差异无统计学意义（P＞0.05）;（5）服刑人员未成年子女的自尊程度和学习焦虑、对人焦虑、孤独倾向、身体症状、自责倾向、过敏倾向、恐怖倾向、冲动倾向及心理健康状况均呈显著负相关（P＜0.05）。结论　（1）服刑人员未成年子女心理健康状况受父母服刑时间、服刑情况及年龄的影响。（2）服刑人员未成年子女的年龄越大,其自尊水平越低。（3）服刑人员未成年子女心理健康状况越好,自尊水平越高。     

Measuring the meanings of eating in minority youth

The aim of this study is to present the development of the Meanings of Eating Index (MEI) in a diverse sample of children. Exploratory factor analysis was performed on MEI items. Factors with eigenvalues above 1.0 were retained. Items that loaded on multiple factors or with item-total correlations below 0.50 were discarded. A 24-item, 5-factor scale comprised the final MEI. Personal Negative Emotions and Disturbed Eating were positively associated with frequency of high calorie snack food intake (r = 0.21, p < 0.05; r = 0.33, p < 0.01), and Personal Well Being was positively associated with eating vegetables more frequently (r = 0.20; p < 0.05). Eating on Behalf of Others was negatively associated with frequency of vegetable intake (r = −.20; p < 0.05). Pleasure Eating was not associated with dietary intake. The MEI shows promise as a tool for understanding the affective determinants of dietary intake in minority youth.     

Acute‐phase reactants and plasma trace element concentrations in non‐small cell lung cancer patients and controls

This study examined the effect of an acute‐phase response on plasma trace element concentrations of non‐small cell lung cancer (NSCLC) patients. In normal subjects (n = 13) and NSCLC patients (n = 22), fasting concentrations of albumin, C‐reactive protein, the trace elements iron, zinc, copper, and selenium, and their associated proteins transferrin, albumin, ceruloplasmin, and glutathione peroxidase were measured. The NSCLC patients were subdivided into two equal groups depending on whether they had a C‐reactive protein concentration <35 mg/l (Group 1) or >35 mg/l (Group 2). Circulating zinc, iron, and transferrin concentrations were significantly lower in NSCLC Group 1 than in the control group (p < 0.05). Circulating concentrations of iron, zinc, and the binding proteins transferrin and albumin were significantly lower in NSCLC Group 2 than in the control group and NSCLC Group 1 (zinc not significantly different) (p < 0.01). In contrast, circulating concentrations of copper and its binding protein ceruloplasmin were significantly increased in NSCLC Group 2 compared with NSCLC Group 1 and the control group (p < 0.01). Additionally, plasma selenium and glutathione peroxidase concentrations were significantly lower (p < 0.05) in NSCLC Group 2 than in NSCLC Group 1 and the control group. In the NSCLC patients there were significant negative correlations between concentrations of C‐reactive protein and iron, transferrin, zinc, albumin, and selenium (p < 0.05). Furthermore, there were also significant positive correlations between C‐reactive protein and copper (r = 0.788, p < 0.001) and ceruloplasmin (r = 0.831, p < 0.001) concentrations. The presence of an acute‐phase response has implications for the interpretation of circulating trace element concentrations, the status of patients with NSCLC, and supplementation with trace elements in patients with NSCLC.     

Sex steroids, bone turnover and bone mineral density in pre-, peri-, and postmenopausal women

To examine 1) the relationships between endogenous androgens and bone mineral density (BMD), 2) the relationships between sex-hormone binding globulin (SHBG) and BMD, and 3) the associations of endogenous androgens and SHBG with biochemical markers of bone turnover, a cross-sectional study was carried out in 88 healthy pre-, peri-, and postmenopausal women aged 35 to 74. Measurements of BMD_s at the ultradistal radius and ulna, and the distal radius (using DEXA), estrogens, androgens, deoxypyridinoline (D-Pyr) and intact bone gla protein (I-BGP) were performed. In the multivariate regression models testosterone (T) was positively correlated with BMD at the ultradistal radius and ulna in perimenopausal women, and was positively correlated with BMD at the ultradistal radius and ulna, and the distal radius in postmenopausal women. T was positively associated with I-BGP in premenopausal women (r = 0.65, p < 0.01), and negatively associated with D-Pyr in pre- (r = -0.53, p < 0.05) and postmenopausal women (r = -0.49, p < 0.001). On the other hand, SHBG was negatively correlated with BMD at die ultradistal radius and ulna, and die distal radius in pre- and postmenopausal women in the models. SHBG was positively related to D-Pyr in pre(r = 0.57, p < 0.05) and postmenopausal women (r = 0.41, p < 0.01), and negatively related to I-BGP in postmenopausal women (r = -0.38, p < 0.01). These findings suggest that endogenous androgens may exert positive influences on BMD, and that SHBG may have negative effects on BMD.     

Redox state of adipose tissue for patients with gastric cancer and its connection with the body mass index and distance from the tumor

Excess body weight has been causally linked to an increased risk of different cancer types, including gastric cancer but the mechanisms underlying this relationship are not well understood. Superoxide generation rate, activity of complex I in electron transport chain of mitochondria, activity of matrix metalloproteinase (MMP-2 and 9) of adipose tissues (AT) of patients with gastric cancer in AT located adjacent to tumor (ATAT) and at a distance of 3 cm (ATD) are measured to follow the connection of the redox state with some of the microenvironment indicators (HIF-1α, CD68, Plin5), body mass index (BMI) and cancer metastasis.Superoxide generation rate in ATAT positively correlates with BMI (r = 0.59, p < 0.05) being 4 times higher than in control (p < 0.05). MMP-2, 9 activities in ATAT positively correlate with BMI (r = 0.67, p < 0.05) being 3.3-4.0 higher than in control (p < 0.05). In ATD a statistically significant increase of MMP-2 activity is found. In ATAT for the group of patients with distant metastasis (M1) the superoxide generation rate, MMP-2, 9 activities are about 2 times higher (p < 0.05) than in the subgroup without distant metastases (M0). M1 is also characterized by the increased values of HIF-1α+ (factor 1.25), CD68+ (factor 1.4) and Plin5+ (factor 2.1) compared to M0 category in tumor tissues (p < 0.05). The results can be used for better understanding the mechanism(s) of symbiosis of tumor and adipose tissues as well as serve as a basis for new therapeutic approaches.     

Visceral adipose tissue and markers of the insulin resistance syndrome in obese black and white teenagers

OBJECTIVE: To determine the relationships between visceral and general adiposity, cardiovascular fitness, and markers of the insulin resistance syndrome in obese black and white teenagers. RESEARCH METHODS AND PROCEDURES: Cross-sectional survey of 81 obese 13- to 16-year-old youths. Visceral adipose tissue was measured with magnetic resonance imaging, and percentage body fat was measured with dual-energy X-ray absorptiometry. Cardiovascular fitness was assessed with a submaximal treadmill test. Fasting blood samples were analyzed for lipids/lipoproteins and insulin. Resting blood pressure was obtained using an automated cuff. RESULTS: Visceral adipose tissue was significantly correlated with unfavorable levels of: triacylglycerol (r = 0.27, p < 0.05), total cholesterol (r = 0.27, p < 0.05), high-density lipoprotein cholesterol (r = -0.26, p < 0.05), the ratio of total cholesterol/high-density lipoprotein cholesterol (r = 0.42, p < 0.01), low-density lipoprotein cholesterol (r = 0.27, p < 0.05), apolipoprotein B (r = 0.38, p < 0.01), and systolic blood pressure (r = 0.30, p < 0.01). Multiple regression analyses revealed that visceral adipose tissue was more powerful than percentage body fat for explaining variance in lipoproteins (e.g., for the ratio of total cholesterol/high-density lipoprotein cholesterol, r2 = 0.13, p < 0.01, and for systolic blood pressure, r2 = 0.07, p < 0.05). Ethnicity was the most powerful of the demographic predictors for blood lipids (r2 = 0.15 for triacylglycerol with lower levels in blacks; r2 = 0.10 for high-density lipoprotein cholesterol with higher levels in blacks; r2 = 0.06 for the ratio of total cholesterol/high-density lipoprotein cholesterol with lower levels in blacks). Cardiovascular fitness was not retained as a significant predictor of markers of the insulin resistance syndrome. DISCUSSION: Some of the deleterious relationships between visceral adiposity and markers for the insulin resistance syndrome seen in adults were already present in these obese young people.     

Intramuscular fat and inflammation differ in older adults: The impact of frailty and inactivity

Objectives

Intramuscular adipose tissue (IMAT) is recognized as a negative predictor of both muscle and mobility function in older adults, however the mechanism by which IMAT may negatively influence muscle and mobility function is currently unknown. The release of pro-inflammatory cytokines from IMAT provides a potential reason for these negative associations. To explore this hypothesis we compared IMAT and muscular inflammation in age-and BMI-matched older non-obese frail and non-frail adults. We also sought to examine the relationship between IMAT and inflammation, and muscle and mobility function in this group of older adults.

Design

A case-control sampling was used for this study. Age-and BMI-matched non-obese frail and non-frail individuals (<65 years) were recruited.

Measurements

MRI was used to quantify thigh IMAT and lean tissue. Unilateral muscle biopsies were used to quantify muscular inflammation as represented by interleukin-6 (IL-6) and tumor-necrosis factor alpha (TNF-α). Muscle and mobility function was also measured using a maximal voluntary isometric contraction, six-minute walk, and self-selected gait speed.

Participants

26 older (80.7 +/? 5.4 years) individuals (8 frail and 18 non-frail) were enrolled.

Results

The frail-group had increased IMAT (p<0.01) and decreased lean tissue (p<0.01), and elevated IL-6 muscle mRNA (p=0.02) and IL-6 protein content (p=0.02) compared to the non-frail group. IMAT was significantly associated with IL-6 mRNA (r=0.43, p=.04) and protein expression within the muscle (r=0.41, p= 0.045). IL-6 mRNA was significantly associated with six-minute walk (r=?0.63, p<0.01), and gait speed (r=?0.60, p <0.01) and IL-6 protein was significantly associated with muscle force (r=?0.54, p=0.01), six-minute walk (r=?0.66, p<0.01), and gait speed (r=?0.76, p<0.01). No significant relationships were found for any variables with TNF-α.

Conclusion

Non-obese, older, frail individuals have increased IMAT and muscular inflammation when compared to their non-frail, age- and BMI-matched peers. A significant relationship exists between IMAT and muscle IL-6 expression as well as between IL-6 and muscle and mobility function of these older adults. This IMAT-inflammatory pathway provides a potential link between IMATs and decreased muscle and mobility function.     

Bone mineral density and content during weight cycling in female rats: effects of dietary amylase-resistant starch

Background

Although there is considerable evidence for a loss of bone mass with weight loss, the few human studies on the relationship between weight cycling and bone mass or density have differing results. Further, very few studies assessed the role of dietary composition on bone mass during weight cycling. The primary objective of this study was to determine if a diet high in amylase-resistant starch (RS₂), which has been shown to increase absorption and balance of dietary minerals, can prevent or reduce loss of bone mass during weight cycling.

Methods

Female Sprague-Dawley (SD) rats (n = 84, age = 20 weeks) were randomly assigned to one of 6 treatment groups with 14 rats per group using a 2 × 3 experimental design with 2 diets and 3 weight cycling protocols. Rats were fed calcium-deficient diets without RS₂ (controls) or diets high in RS₂ (18% by weight) throughout the 21-week study. The weight cycling protocols were weight maintenance/gain with no weight cycling, 1 round of weight cycling, or 2 rounds of weight cycling. After the rats were euthanized bone mineral density (BMD) and bone mineral content (BMC) of femur were measured by dual energy X-ray absorptiometry, and concentrations of calcium, copper, iron, magnesium, manganese, and zinc in femur and lumbar vertebrae were determined by atomic absorption spectrophotometry.

Results

Rats undergoing weight cycling had lower femur BMC (p < 0.05) and marginally lower BMD (p = 0.09) than rats not undergoing weight cycling. In comparison to controls, rats fed RS₂ had higher femur BMD (p < 0.01) and BMC (p < 0.05), as well as higher values for BMD and BMC measured at the distal end (p < 0.001 and p < 0.01) and femoral neck (p < 0.01 and p < 0.05). Consistent with these findings, RS₂-fed rats also had higher femur calcium (p < 0.05) and magnesium (p < 0.0001) concentrations. They also had higher lumbar vertebrae calcium (p < 0.05) and magnesium (p < 0.05) concentrations.

Conclusion

Weight cycling reduces bone mass. A diet high in RS₂ can minimize loss of bone mass during weight cycling and may increase bone mass in the absence of weight cycling.     

A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED)

Objectives: We investigated whether a Mediterranean-style diet (MedDiet) supplemented with fish oil can improve mental health in adults suffering depression.

Methods: Adults with self-reported depression were randomized to receive fortnightly food hampers and MedDiet cooking workshops for 3 months and fish oil supplements for 6 months, or attend social groups fortnightly for 3 months. Assessments at baseline, 3 and 6 months included mental health, quality of life (QoL) and dietary questionnaires, and blood samples for erythrocyte fatty acid analysis.

Results: n?=?152 eligible adults aged 18–65 were recruited (n?=?95 completed 3-month and n?=?85 completed 6-month assessments). At 3 months, the MedDiet group had a higher MedDiet score (t?=?3.95, P?<?0.01), consumed more vegetables (t?=?3.95, P?<?0.01), fruit (t?=?2.10, P?=?0.04), nuts (t?=?2.29, P?=?0.02), legumes (t?=?2.41, P?=?0.02) wholegrains (t?=?2.63, P?=?0.01), and vegetable diversity (t?=?3.27, P?<?0.01); less unhealthy snacks (t?=??2.10, P?=?0.04) and red meat/chicken (t?=??2.13, P?=?0.04). The MedDiet group had greater reduction in depression (t?=??2.24, P?=?0.03) and improved mental health QoL scores (t?=?2.10, P?=?0.04) at 3 months. Improved diet and mental health were sustained at 6 months. Reduced depression was correlated with an increased MedDiet score (r?=??0.298, P?=?0.01), nuts (r?=??0.264, P?=?0.01), and vegetable diversity (r?=??0.303, P?=?0.01). Other mental health improvements had similar correlations, most notably for increased vegetable diversity and legumes. There were some correlations between increased omega-3, decreased omega-6 and improved mental health.

Discussion: This is one of the first randomized controlled trials to show that healthy dietary changes are achievable and, supplemented with fish oil, can improve mental health in people with depression.     

留守高中生安全感自尊与生活满意度的关系

目的 考察留守高中生安全感、自尊与生活满意度的关系,为留守高中生的心理健康教育提供依据.方法 采用安全感量表(SQ)、自尊量表(SES)和生活满意度量表(SWLS),对整群抽取的江西省某县城高中277名留守高中生和185名非留守高中生进行问卷调查.结果 留守与非留守高中生在安全感总分及其因子、自尊和生活满意度上差异均无统计学意义(P值均＞0.05);居住在农村的留守高中生人际安全感显著低于居住在城镇的留守高中生(t=1.98,P＜0.05),留守高一学生的生活满意度显著高于高二和高三学生(F=5.259,P＜0.01);留守高中生的安全感各因子、自尊与生活满意度呈显著正相关(r=0.26～0.57).中介效应检验表明,留守高中生的安全感既直接影响生活满意度,也通过自尊作为中介变量间接影响生活满意度.结论 安全感、自尊是影响留守高中生生活满意度的重要因素.     

Physical factors affecting daily walking activities among elderly female residents of a care house

To understand the physical and other factors related to walking among the elderly residents of a Care House for the aged, the total number of steps walked were measured over a period of 1 week (Nov. 6–12. 1994) for 67 female residents (mean age 79 ± 1 years). In addition, walking speed, stride length, and the time to climb 15 steps (stair-climbing time) were measured. To understand the indirect factors such as balance and agility that may control walking, tests were conducted on the subjects’ ability to stand on one leg with eyes open and closed, and jumping reaction time. Results showed a negative correlation between total number of steps and age (r=-0.543, P< 0.01), jumping reaction time (r=-0.258, p<0.05) and stair-climbing time (r=-0.501, P< 0.01). However, a positive correlation was found between total number of steps and stride length (r=0.408, P< 0.01), walking speed (r=0.419, P< 0.01), self-rated health (r= 0.390, P< 0.05) and standing on one leg with eyes closed (r=0.258, P< 0.05). The total number of steps walked and physical factors, particularly physique and balance, were also closely related. The above suggests that a walking habit among elderly persons helps to slow the decline in physical strength, which is necessary to prevent falls. It is also reflected in the person’s awareness of health and may increase the opportunities for leading an active daily life.     

ALCOHOL INTAKE CORRELATED WITH SERUM TRACE ELEMENTS

Alcohol intake and serum copper, selenium, magnesium, iron andzinc were investigated in 85 subjects, 48 males and 37 females.Alcohol intake was measured with a questionnaire probing alcoholintake during the preceding 30 days. Mean average daily intakeamong males was 119.7 g (range 0–622.3 g) and among females32 1 g (range 0–378.5 g), and the mean consumption perdrinking day among males was 208.5 g (range 0–666.7 g)and among females 63.8 g (range 0–63.8 g). Among malesalcohol intake per drinking day correlated positively with serumcopper (r = 0.50; P < 0.001) and negatively with serum selenium(r = -0.49; P < 0.001) and magnesium (r = 0.40; P < 0.01).Likewise, among females alcohol intake per drinking day correlatedpositively with serum copper (r = 0.54; P < 0.01) and negativelywith serum magnesium (r = –0.36; P < 0.05). Serum seleniumconcentration was negatively and significantly correlated withaverage daily intake (r = –0.34; P < 0.05) but notwith intake per drinking day. No significant correlations werefound between alcohol intake and serum zinc or iron levels.Only two men, both abstainers, had abnormally low serum zinclevel, and two other men (average daily alcohol intake <37g) and two women (average daily alcohol intake <15 g) hadabnormally high serum iron level. Alcohol intake was associatedwith high serum copper and low serum magnesium and seleniumlevels.     

Bone response to eccentric versus concentric cycling in adolescents with obesity

ObjectivesBecause adolescents with obesity are susceptible to bone fragility during weight loss (WL), we evaluated the impact of eccentric (ECC) versus classical concentric (CON) training at the same oxygen consumption (${{\displaystyle \dot{\text{V}}\text{O}}}_2$) on bone density, geometry and strength.MethodsThirty five adolescents were included into 2 training (CON and ECC cycling) and a control (CTR, without training) groups. Anthropometry, dual-energy X-ray absorptiometry, hip structural analysis and quantitative bone ultrasound were assessed before and after the 12-week intervention.ResultsThe trainings promoted significant improvements in body mass index, total fat (FM) and lean mass (LM), with better improvements for FM and LM in the ECC group (p < 0.05). Leg LM percentage increased only in the ECC group (p < 0.05). Total body bone mineral content and density increased in both training groups (p < 0.001) with significant time x group interactions only between ECC and CTR (p < 0.05). Buckling ratio at the intertrochanteric region and femoral shaft increased only in CTR and CON groups (p < 0.05). Speeds of sounds at the calcaneum increased only in ECC group (p < 0.01).ConclusionsBone fragility, from a compromised relationship between density, geometry and strength, might be prevented with the ECC modality.     

Is use of hospital services a proxy for morbidity? A small area comparison of the prevalence of arthritis, depression, dyspepsia, obesity, and respiratory disease with inpatient admission rates for these disorders in England.

OBJECTIVES--To examine the relationship between specific types of morbidity, measured by validated survey questions, and hospital service use and mortality to see if the latter two could act as a proxy in health needs assessment, health service planning, and resource allocation in a typical health district. DESIGN--A postal questionnaire was used to provide information about depression, digestive disorders, musculo-skeletal disorders, obesity, respiratory disease, and hip and knee pain. The questions were from survey instruments that have been widely used to derive information about these conditions. The relationships between the prevalence of these specific types of morbidity and appropriate admission and mortality rates were explored using linear regression and Pearson correlation analysis. SETTING--The population of Rotherham health district, England. SUBJECTS--A simple random sample of the residents of each of the 22 electoral wards in Rotherham health district. RESULTS--Responses were obtained from 78% of the 5000 sampled (82% after excluding people who had moved house or died). Significant, positive correlations were found between the prevalence of respiratory disease and the hospital admission and mortality rates for respiratory problems (r = 0.68, p < 0.01 and r = 0.54, p < 0.01) and the prevalence of depression and the admission rate for depression (r = 0.52, p < 0.05). No such relations were found for digestive disease, musculo-skeletal disease, and obesity. For the conditions examined here, hospital service use was a more useful measure than mortality. CONCLUSIONS--Only two diseases (respiratory disease and depression) out of the seven diseases or procedures investigated showed a positive correlation between hospital admission and disease prevalence. But even for these two, the correlations explained less than 50% of the variance. Caution must be exercised when hospital service use is being considered as a proxy for morbidity.     

Na+ channel blockers vs class III antiarrhythmic drugs in treating sustained ventricular tachycardia: reversing and preventing as different electrophysiological mechanisms

METHODS: 169 selected patients with previous AMI and inducible sustained ventricular tachycardia (sVT) at electrophysiological study (EPS) were followed-up prospectively for recurrent sVT during a five year period. At EPS, ventricular effective refractory period (VERP)/action potential duration (APd) ratio, ventricular conduction velocity, excitable gap, cycle length and QRS duration were measured. The patients with inducible sVT at basic programmed stimulation or after isoproterenol infusion (200 micrograms i.v.) underwent drug suppression tests (amiodarone, procamide, propanolol + procamide, amiodarone + propaphenone). On this basis, they were later assigned to 3 different groups: the amiodarone-treated group (n = 112), the procamide-treated group (n = 22) and the nonresponder group (control group, n = 35). RESULTS: After procamide infusion (100 mg/min for 10 min), at fast pacing drive the VERP/APd ratio was significantly increased from baseline levels (p < 0.001), the conduction velocity (Vmax) was significantly depressed (by 25%, p < 0.005), the excitable gap was significantly reduced (p < 0.005, 23% of cycle length) and 71 patients were no longer inducible; during sinus rhythm, Vmax was significantly reduced from baseline values (by 14%, p < 0.05), VERP was only moderately increased and the excitable gap was slightly but significantly prolonged (p < 0.01, 53% of cycle length): 147 patients were still inducible, without significant difference from baseline values. After amiodarone infusion (300 mg/100 ml i.v. over 10 min), Vmax was significantly reduced from baseline levels at fast pacing drive (by 21%, p < 0.001), while the excitable gap did not reduce significantly (34%) from baseline levels and 91 patients were still inducible; during sinus rhythm, conduction velocity was moderately depressed (by 7%, p < 0.05), while VERP was significantly increased from baseline levels (p < 0.002) and the excitable gap was significantly reduced (p < 0.001, 29% of cycle length); only 35 patients were still inducible. In the remaining 134 patients the reset curve showed excitable gaps = 24 +/- 3% of the cycle length. The absolute and relative values of the excitable gap measured in the 35 patients who were still inducible were significantly higher than those measured in patients no longer inducible (p < 0.05). At follow-up, the sVT recurrence rate was: 28% in the amiodarone-treated group, 43% in the procamide-treated group and 36% in the control group: control data were significantly different from the former (p < 0.05) but not from the latter group. Significant correlation was reported between the plasmatic concentration of procamide and amiodarone and the percentage of reduction of Vmax at fast pacing drive (r = 0.79, p < 0.05; r = 0.83, p < 0.01). Resulting variability checked by the analysis of variance showed no significant difference between the two series (p < 0.12638). The development of conduction velocity depression was clearly dose-dependent. Drug suppression test with procamide + propanolol resulted in noninducibility of sVT in 115 patients, with strong significant difference from when the drug was used alone (p < 0.0015). Better results at EPS were obtained by the combination amiodarone + propaphenone, although no additional benefit was reported when compared with amiodarone alone. CONCLUSIONS: In conclusion, antiarrhythmic drugs with class I action may be highly effective in terminating sVI (lidocaine, procamide) but may be ineffective in preventing it or even arrhythmogenic. According to our data, drugs with class III antiarrhythmic action showed significantly different behavior: they were more effective in prolonging refractoriness and reducing the excitable gap at longer cycle lengths and, thus, capable of preventing, rather than terminating. Although statistical difference was reported between the amiodarone-treated group and the control group, the incidence of recurrent sVT remained too high to consider drug therapy as     

A play‐based intervention for children with ADHD: A pilot study

Introduction: Many children with attention deficit hyperactivity disorder (ADHD) have serious social and peer difficulties that can lead to adverse outcomes in adolescence and adulthood. To date, psychosocial treatments have produced poor outcomes in reducing social impairments commonly associated with ADHD. This study aimed to examine the efficacy of a new intervention designed to improve the play and social skills of children with ADHD and their playmates within the natural context of play. Methods: Participants included children (aged 5–11 years) diagnosed with ADHD, age‐matched typically developing playmates (n = 14/group) and parents of children with ADHD. The intervention involved seven weekly video‐recorded free‐play sessions; video feed‐forward/feedback and therapist‐ and peer‐modelling were used to promote social play. The Test of Playfulness was used as a pre‐/post‐test measure. Data were subjected to Rasch analysis to calculate measure scores on interval level; dependant sample t‐test and Cohen‐d calculations were used to measure effect. Results: A dependant samples t‐test revealed that both children with ADHD (t = 8.1; d.f. = 13; P < 0.01) and their playmates (t = 6.9; d.f. = 13; P < 0.01) improved in their social play. Results demonstrated a large effect in improving the social play of children with ADHD (d = 1.5) and their playmates (d = 1.3). Discussion: Results support the use of play, video feed‐forward/feedback techniques, therapist‐ and peer‐modelling and parent involvement as an effective means to develop the social play skills of children with ADHD. Further larger‐scale research is required.     

Effect of smoking status on total energy expenditure

Background

Omentin-1 is a novel adipokine expressed in visceral adipose tissue and negatively associated with insulin resistance and obesity. We aimed to study the effects of weight loss-induced improved insulin sensitivity on circulating omentin concentrations.

Methods

Circulating omentin-1 (ELISA) concentration in association with metabolic variables was measured in 35 obese subjects (18 men, 17 women) before and after hypocaloric weight loss.

Results

Baseline circulating omentin-1 concentrations correlated negatively with BMI (r = -0.58, p < 0.001), body weight (r = -0.35, p = 0.045), fat mass (r = -0.67, p < 0.001), circulating leptin (r = -0.7, p < 0.001) and fasting insulin (r = -0.37, p = 0.03). Circulating omentin-1 concentration increased significantly after weight loss (from 44.9 ± 9.02 to 53.41 ± 8.8 ng/ml, p < 0.001). This increase in circulating omentin after weight loss was associated with improved insulin sensitivity (negatively associated with HOMA value and fasting insulin, r = -0.42, p = 0.02 and r = -0.45, p = 0.01, respectively) and decreased BMI (r = -0.54, p = 0.001).

Conclusion

As previously described with adiponectin, circulating omentin-1 concentrations increase after weight loss-induced improvement of insulin sensitivity.