Alexithymia is associated with low level of vitamin D in young healthy adults

Objective

Vitamin D plays an important role in brain development and functioning. Low levels of vitamin D have been described in several psychiatric and neurologic conditions including autism spectrum disorder. Alexithymia that shows high comorbidity with autism is also present in the general population as well as hypovitaminosis D.

Methods

Here we assessed the relation between alexithymia as measured by the Toronto Alexithymia Scale-20 and vitamin D level in healthy young adults.

Results

We found an inverse correlation between the levels of alexithymia and vitamin D.

Discussion

These data suggest the association between disturbed emotional processing and low levels of vitamin D to be present in young healthy subjects.     

Book Review

Changing the public health

Rcswch Unit in Health .ad Behaviourd Chutge. University of Edinburgh, John Wdey and Son, London, 1989, ISBN 0 471 91976 4.

The new public health

John Ashtw and RowYd Seymour. Open University Press, 1988. ISBN 0 335 15550 2, £6.95.

Infertility services-a desperate case

N d Pfeilu cmd Allison Qukk. Greater London Association of Community Health Councils, 1988.

A new kind of Doctor

Julian Tudor Hart. Merlin Press, 1988. ISBN 085036 299 7, £11.95 (hardback).     

Rodent control in urban communities in Johannesburg,South Africa: from research to action

Introduction:

Rodents are troublesome urban pests, with potentially serious health implications. Preventive efforts require greater understanding of social contexts in which they are prevalent. This study aimed to determine rodent prevalence and identify factors associated with rodent infestations in urban residential settings.

Methods:

The Health, Environment and Development study is a longitudinal panel study conducted in five settlements across Johannesburg. Data on socio-economic status, domestic behaviour and housing quality are collected annually. Logistic regression revealed risk factors for rodent prevalence at household level.

Results:

Rodents are a major household problem in all study areas (prevalence 54%). Factors associated with increased prevalence of rats included lower income, living in informal areas, overcrowding, cracks in dwelling walls and internal damp.

Conclusion:

Socio-economic status, housing quality, domestic behaviour and environmental health services are associated with exposure to rodents in urban Johannesburg communities. This information served as a platform to launch rodent awareness campaigns at study sites.     

Acceleration of reflex maturation and physical development in suckling rats: effects of a maternal diet containing lipids from goat milk

Objective

To investigate the effects of lipids from goat milk containing conjugated linoleic acids on body weight and reflex ontogeny of neonatal rats treated during the prenatal and suckling periods.

Methods

Three groups were studied: soybean oil (S), coconut oil (C), and goat milk lipids (GM). Reflex maturation (palm grasp, righting reflex, cliff avoidance, vibrissae placing, negative geotaxis, auditory startle, and free-fall righting) as well as body weight evolution were recorded during lactation.

Results

Data demonstrated that the lipids from goat milk accelerated body weight evolution as well as all the reflex maturation investigated (P < 0.05).

Discussion

The supply of goat's milk offered to Wistar rats during pregnancy and lactation provided a variety of fatty acids necessary to accelerate the development of offspring.     

Reproductive and maternity health care services in Finland: perceptions and experiences of Somali-born immigrant women

Objective. To explore immigrant Somali women's experiences of reproductive and maternity health care services (RMHCS) and their perceptions about the service providers.

Design. Five focus group discussions were conducted from April 1999 to June 2000 using a purposeful sampling strategy in order to reach multiparous female Somali-born Immigrants with experiences from the maternity health care in Finland.

Participants. A total of 70 married Somali women aged 18–50 and mother of 2–10 children were studied. Among them, 18 came from Kenya, 32 from Mogadishu and 20 from Hargeysa.

Settings. Of the participants, 45 were living in the city of Vantaa, 22 in the city of Helsinki and 13 in the city of Turku.

Results. Participants were satisfied with the RMHCS they received in Finland. Despite their satisfaction, the health care providers' social attitudes towards them were perceived as unfriendly, and communication as poor.

Conclusions. The women's experiences revealed that they have access to good quality RMHCS in Finland. While their experiences are significant, their perceptions are important for physicians, nurses and midwives in order to achieve culturally competent care.     

Synaptophysin and the dopaminergic system in hippocampus are involved in the protective effect of rutin against trimethyltin-induced learning and memory impairment

Objectives

This study aimed to investigate the protective effect of rutin against trimethyltin-induced spatial learning and memory impairment in mice. This study focused on the role of synaptophysin, growth-associated protein 43 and the action of the dopaminergic system in mechanisms associated with rutin protection and trimethyltin-induced spatial learning and memory impairment.

Methods

Cognitive learning and memory was measured by Morris Water Maze. The expression of synaptophysin and growth-associated protein 43 in hippocampus was analyzed by western blot. The concentrations of dopamine, homovanillic acid, and dihyroxyphenylacetic acid in hippocampus were detected using reversed phase high-performance liquid chromatography with electrochemical detection.

Results

Trimethyltin-induced spatial learning impairment showed a dose-dependent mode. Synaptophysin but not growth-associated protein 43 was decreased in the hippocampus after trimethyltin administration. The concentration of dopamine decreased, while homovanillic acid increased in the hippocampus after trimethyltin administration. Mice pretreated with 20 mg/kg of rutin for 7 consecutive days exhibited improved water maze performance. Moreover, rutin pretreatment reversed the decrease of synaptophysin expression and dopamine alteration.

Discussion

These results suggest that rutin may protect against spatial memory impairment induced by trimethyltin. Synaptophysin and the dopaminergic system may be involved in trimethyltin-induced neuronal damage in hippocampus.     

Impaired IQ and academic skills in adults who experienced moderate to severe infantile malnutrition: A 40-year study

Objectives

To evaluate IQ and academic skills in adults who experienced an episode of moderate-to-severe infantile malnutrition and a healthy control group, all followed since childhood in the Barbados Nutrition Study.

Methods

IQ and academic skills were assessed in 77 previously malnourished adults (mean age = 38.4 years; 53% male) and 59 controls (mean age = 38.1 years; 54% male). Group comparisons were carried out by multiple regression and logistic regression, adjusted for childhood socioeconomic factors.

Results

The previously malnourished group showed substantial deficits on all outcomes relative to healthy controls (P < 0.0001). IQ scores in the intellectual disability range (< 70) were nine times more prevalent in the previously malnourished group (odds ratio = 9.18; 95% confidence interval = 3.50–24.13). Group differences in IQ of approximately one standard deviation were stable from adolescence through mid-life.

Discussion

Moderate-to-severe malnutrition during infancy is associated with a significantly elevated incidence of impaired IQ in adulthood, even when physical growth is completely rehabilitated. An episode of malnutrition during the first year of life carries risk for significant lifelong functional morbidity.     

Postnatal protein malnutrition induces neurochemical alterations leading to behavioral deficits in rats: Prevention by selenium or zinc supplementation

Background/objectives

Protein malnutrition (PM) is a worldwide problem affecting brain development in a large number of children. The present study was aimed at studying the perturbations in antioxidant defense system resulting from protein deficiency and to evaluate the preventive effect of Se and Zn on cortex and cerebellum.

Methods

Well-fed (WF) and PM rats were fed on 16 and 5% protein diet, respectively. After 10 weeks, animals were supplemented with Se and Zn at a concentration of 0.15 and 227 mg/l in drinking water for 3 weeks.

Results

PM rats showed significant increase in lipid peroxidation, nitrite, and protein carbonyl levels. Reduction in the activity of antioxidant enzymes, thiol levels, GSH/GSSG ratio, and neurobehavioral deficits were observed in PM groups. Se and Zn supplementation reduced the levels of lipid peroxidation, nitrite, and protein carbonyl and restored the activity of antioxidant enzymes and thiol levels in the cortex and cerebellum of PM rats along with neurobehavioral deficits.

Discussion

The study showed that Se and Zn supplementation might be beneficial in preventing biochemical alterations and neurobehavioral deficits in PM children.     

Racial discrimination,racial/ethnic segregation,and health behaviors in the CARDIA study

Objective

Racial discrimination has been associated with unhealthy behaviors, but the mechanisms responsible for these associations are not understood and may be related to residential racial segregation. We investigated associations between self-reported racial discrimination and health behaviors before and after controlling for individual- and neighborhood-level characteristics; and potential effect modification of these associations by segregation.

Design

We used data from the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study for 1169 African-Americans and 1322 whites. To assess racial discrimination, we used a four category variable to capture the extent and persistence of self-reported discrimination between examination at years 7 (1992–1993) and 15 (2000–2001). We assessed smoking status, alcohol consumption, and physical activity at year 20 (2005–2006). Segregation was examined as the racial/ethnic composition at the Census tract level.

Results

Discrimination was more common in African-Americans (89.1%) than in whites (40.0%). Living in areas with high percentage of blacks was associated with less reports of discrimination in African-Americans but more reports in whites. After adjustment for selected characteristics including individual- and neighborhood-level socioeconomic conditions and segregation, we found significant positive associations of discrimination with smoking and alcohol consumption in African-Americans and with smoking in whites. African-Americans experiencing moderate or high discrimination were more physically active than those reporting no discrimination. Whites reporting some discrimination were also more physically active than those reporting no discrimination. We observed no interactions between discrimination and segregation measures in African-Americans or whites for any of the three health behaviors.

Conclusions

Racial discrimination may impact individuals' adoption of healthy and unhealthy behaviors independent of racial/ethnic segregation. These behaviors may help individuals buffer or reduce the stress of discrimination.     

A Delphi study of occurring information in housing adaptation certificates

Background: Since 1993, the Housing Adaptation Act has provided disabled people the opportunity to receive grants for adapting their homes. A housing adaptation certificate certifying the necessity of adaptations must accompany any application and if information in housing adaptation certificates is not sufficient, the applicant is risking not having necessary housing adaptations.

Objective: The aim of this study was to identify and describe what information is missing, unnecessary or vague, in the housing adaptation certificates; to determine how often this occur, and how problematic this can be for the decision process.

Material and methods: 105 housing adaptation grant managers took part in a three-round Delphi survey.

Results: At least 65% consensus was reached regarding the following six statements: missing information about disability duration, possession of relevant assistive devices, consequences of the disability in housing, prognosis of consequences, who the informant is, or contains preferences for specific solutions. Missing, unnecessary or vague information pose serious or less serious problems and 38–72% of the participants reported that this often or always occur.

Conclusion: Housing adaptation certificates need to be improved.

Significance: The results of this study are used to design a checklist for use by housing adaptation certificate writers.     

Dietary intake of fruits and beta-carotene is negatively associated with amyotrophic lateral sclerosis risk in Koreans: A case-control study

Objectives

Amyotrophic lateral sclerosis (ALS), a rare progressive neurodegenerative disease, has been suggested to have an association with oxidative stress, and thus antioxidant dietary factors may influence pathophysiological mechanisms or the risk of ALS. The purpose of the present study was to investigate the hypothesis that intake of fruits, rich in antioxidant nutrients, is negatively associated with the risk of ALS.

Methods

Seventy-seven Koreans diagnosed with ALS according to the EI Escorial criteria-revised and the same number of age- and sex-matched healthy controls participated in this study. Dietary intake was estimated using the standardized food frequency questionnaire.

Results

Multivariate logistic regression analysis showed that fruit consumption was negatively associated with the risk of ALS, but intake of beef, fish, and fast food were positively associated with the risk of ALS. In addition, the risk of ALS was negatively associated with intake of plant calcium and beta-carotene, while positively associated with intake of total calcium and animal calcium. Intake of vegetables and other antioxidant nutrients had no effect on the risk of ALS in the present study.

Discussion

The intake of fruits and beta-carotene decreases the risk of sporadic ALS in this present study. However, large prospective and interventional studies are needed to confirm the effect of fruits and beta-carotene intake on the risk of ALS.     

Antinociceptive and antiallodynic effects of Momordica charantia L. in tibial and sural nerve transection-induced neuropathic pain in rats

Objective

This study was designed to investigate the ameliorative potential of Momordica charantia L. (MC) in tibial and sural nerve transection (TST)-induced neuropathic pain in rats.

Materials and methods

TST was performed by sectioning tibial and sural nerve portions (2 mm) of the sciatic nerve, and leaving the common peroneal nerve intact. Acetone drop, pin-prick, hot plate, paint-brush, and walking track tests were performed to assess cold allodynia, mechanical and heat hyperalgesia, and dynamic mechanical allodynia and tibial functional index, respectively. The levels of tumour necrosis factor (TNF)-alpha and thio-barbituric acid reactive substances (TBARS) were measured in the sciatic nerve as an index of inflammation and oxidative stress. MC (all doses, orally, once daily) was administered to the rats for 24 consecutive days.

Results

TST led to significant development of cold allodynia, mechanical and heat hyperalgesia, dynamic mechanical allodynia, and functional deficit in walking along with rise in the levels of TBARS and TNF-alpha. Administration of MC (200, 400, and 800 mg/kg) significantly attenuated TST-induced behavioural and biochemical changes. Furthermore, pretreatment of BADGE (120 mg/kg, intraperitoneally) abolished the protective effect of MC in TST-induced neuropathic pain.

Conclusions

Collectively, it is speculated that PPAR-gamma agonistic activity, anti-inflammatory, and antioxidative potential is critical for antinociceptive effect of MC in neuropathic pain.     

Expanding beyond individualism: Engaging critical perspectives on occupation

Background: Perspectives that individualize occupation are poorly aligned with socially responsive and transformative occupation-focused research, education, and practice. Their predominant use in occupational therapy risks the perpetuation, rather than resolution, of occupational inequities.

Aim: In this paper, we problematize taken-for-granted individualistic analyses of occupation and illustrate how critical theoretical perspectives can reveal the ways in which structural factors beyond an individual’s immediate control and environment shape occupational possibilities and occupational engagement.

Method: Using a critically reflexive approach, we draw on three distinct qualitative research studies to examine the potential of critical theorizing for expanding beyond a reliance on individualistic analyses and practices.

Results: Our studies highlight the importance of addressing the socio-historical and political contexts of occupation and demonstrate the contribution of critical perspectives to socially responsive occupational therapy.

Conclusion and significance: In expanding beyond individualistic analyses of occupation, critical perspectives advance research and practices towards addressing socio-political mediators of occupational engagement and equity.     

Effect of Different Obesity Phenotypes on Incidence of Chronic Kidney Disease in Tehranian Adults

Background: The aim of this community-based study is to ascertain the effect of different obesity phenotypes on the incidence of chronic kidney disease in Iranian adults.

Study Design: A prospective cohort study, the Tehran Lipid Glucose Study (TLGS).

Setting and Participants: Adults aged ≥ 20 years with a mean age of 40.38 years (54.8% female) who were free from chronic kidney disease (CKD) at baseline (phase 1) and were followed up at 3 time stages (phases 2, 3, and 4) for a mean duration of 9.4 years to assess the risk for CKD.

Predictor: Obesity phenotypes.

Outcome: Incidence of chronic kidney disease.

Measurements: Glomerular filtration rate (GFR) was estimated from the simplified equation developed using data from the Modification of Diet in Renal Disease (MDRD) Study.

Results: CKD events occurred in 1162 participants. The prevalence of the 2 known obesity phenotypes (metabolically obese normal weight [MONW] and metabolically healthy but obese [MHO]) in the overall population was 3.5% and 8.8%, respectively. According to Kaplan-Meier curves, rates of freedom from CKD in the MHO and MONW obesity phenotypes were 75.3% and 60.6%, respectively (p < 0.0001). Age- and sex-adjusted (model 1) hazard ratios for participants with MHO or MONW obesity phenotype were 1.14 (95% confidence interval [CI], 0.91–1.43) and 1.43 (95% CI, 1.09–1.88), respectively. After further adjustment for confounder variables (model 2), multivariate-adjusted hazard ratios for CKD for participants with MHO or MONW obesity phenotypes were 1.23 (95% CI, 0.93–1.62) and 1.43 (95% CI, 1.08–1.90), respectively.

Conclusion: Adults with the MONW obesity phenotype compared to those with MHO obesity phenotype have a higher risk for incidence of CKD. The results indicate that having a normal weight is not the only factor to protect against incidence of CKD.     

Fish oil protects the peripheral and central nervous systems against cisplatin-induced neurotoxicity

Objective

The protective effects of fish oil (FO) on cisplatin (CP)-induced central and peripheral neurotoxicity were investigated in rats.

Methods

Rats (n = 28) were divided equally into four groups, the first group was kept as a control. In the second and third groups, CP and FO were given at doses of 7 mg/kg and 1 softgel/rat/day, respectively. In the fourth group, CP and FO were given together at the same doses.

Results

Although CP caused significant oxidative damage, via induction of lipid peroxidation and reduction in the antioxidant defense system potency, FO treatment largely reversed these effects. CP also resulted in histopathological damage, such as apoptosis, and electromyographical changes in the sciatic nerve. FO treatment partially prevented the histopathological and electromyographical effects of CP.

Discussion

CP has severe central and peripheral neurotoxic effects in rats and these effects were largely prevented by FO treatment. Thus, it appears that co-administration of FO with CP may be a useful approach to attenuate the negative effects of CP on the nervous system.     

Occupations,perceived stress,and stress-related disorders among women and men in the public sector in Sweden

Background: Stress-related disorders are a public health problem and represent a significant burden to individuals and society. It is, therefore, of importance to regard stress in a wider context and identify risk factors not only at work but in all occupations in everyday life, to prevent ill health.

Aim/objective: The aim of this study was to examine potential associations between everyday occupations, perceived stress, and stress-related disorders as well as potential gender differences.

Material and methods: A survey was mailed to a random selection of 3481 employees in the public sector in Western Sweden. Cox regressions with constant time at risk were used, in order to calculate prevalence ratios (PR) and their 95% confidence intervals (CI).

Results: The results showed a clear association between reporting imbalance between different everyday occupations and both perceived stress and stress-related disorders among men and women.

Conclusion: Imbalance between different everyday occupations seems to be an important risk factor for perceived stress and stress-related disorder among both women and men.

Significance: To enable people to achieve balance between different everyday occupations may be a useful way to prevent stress, stress-related disorders, and sick leave, and to promote better health and well-being.     

Book Reviews

Marketing for health services

Rod Sheaff. Open University Press, Milton Keynes. ISBN 0-335-15427-1 (pbk) £11.99.

Quasi-Markets and Contracts: A market and Heirarchies Perspective on NHS Reform

Will Bartlett. SAUS Publications, University of Bristol, 1991. ISBN 1-873575-05-X.     

Managing occupations in everyday life for people with advanced cancer living at home

Background: People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed.

Objective: To describe and explore how people with advanced cancer manage occupations when living at home.

Material and methods: A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data.

Results: Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations.

Significance: The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.     

Experiences of the return to work process after stroke while participating in a person-centred rehabilitation programme

Background: In Sweden, less than 50% of those getting stroke in working age return to work (RTW). Effective rehabilitation programmes need to be developed and therapeutic aspects understood.

Aim: To explore and describe how persons with stroke experience their RTW process while participating in a person-centred rehabilitation programme focusing on RTW.

Materials and methods: Seven persons with mild or moderate stroke were interviewed twice during the intervention in the vocational training phase using semi-structured interviews. Data were analysed using grounded theory.

Results: Having a coordinator by their side gave support and guidance during the RTW process. Knowledge of stroke, strategies and a straightforward communication created a structure for the RTW process. Expressing one’s own wishes increased opportunities to influence and decide which path to follow in order to reach the goal.

Conclusion: Straightforward, open and recurring communication facilitated the possibility to adapt to the situation. These aspects increased insight and awareness which facilitated the RTW process.

Significance: The findings indicate that a precondition for a fruitful RTW process was that suitable platforms at work were created in which the actors involved could cooperate. This knowledge might also be valuable in the RTW process for people with other diagnosis.