SNAP-Ed Policy,Systems, and Environmental Interventions and Caregivers’ Dietary Behaviors

ObjectiveTo examine dietary behaviors and diet quality among caregivers of children regarding the number of policy, systems, and environmental (PSE) change interventions implemented in their neighborhoods.MethodsHouseholds with incomes ≤185% of the federal poverty level were randomly sampled throughout California. A validated 24-h dietary recall assessment tool was administered by telephone. The independent variable was the number of Supplemental Nutrition Assistance Program Education PSE change interventions per census tract where the caregivers lived.ResultsMost (69.1%) of the 2,222 caregivers were Latino. Policy, systems, and environmental reach predicted decreased intake of sugar-sweetened beverages (P = 0.022, Cohen d = −0.12) and added sugar (P = 0.014, Cohen d = −0.18), and increased Healthy Eating Index–2015 scores (P = 0.046, Cohen d = 0.18), regardless of race and/or ethnicity, age, or reach of Supplemental Nutrition Assistance Program Education direct education.Conclusions and ImplicationsReplication of these methods and findings, and comparisons of dietary outcomes in association with PSE change interventions with and without direct education activities aimed at the same population under study, are encouraged.     

Influenza, Campylobacter and Mycoplasma infections, and hospital admissions for Guillain-Barré syndrome, England

Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in polio-free regions. Considerable evidence links Campylobacter infection with GBS, but evidence that implicates other pathogens as triggers remains scarce. We conducted a time-series analysis to investigate short-term correlations between weekly laboratory-confirmed reports of putative triggering pathogens and weekly hospitalizations for GBS in England from 1993 through 2002. We found a positive association between the numbers of reports of laboratory-confirmed influenza A in any given week and GBS hospitalizations in the same week. Different pathogens may trigger GBS in persons of different ages; among those <35 years, numbers of weekly GBS hospitalizations were associated with weekly Campylobacter and Mycoplasma pneumoniae reports, whereas among those >35 years, positive associations were with influenza. Further studies should estimate the relative contribution of different pathogens to GBS incidence, overall and by age group, and determine whether influenza is a real trigger for GBS or a marker for influenza vaccination.     

Sickness, Healing, and Health Services: social representations, practices, and demands among the Baníwa

The research for this paper was conducted in S?o Gabriel da Cachoeira, in the northwestern Amazon, with the Baníwa indigenous people, in partnership with indigenous organizations, seeking to understand the relations among the group's cosmology, their system of representations of sickness and healing practices, and their transformation through inter-ethnic contact. The recording of myths showed the origin of the diseases and demonstrated the existence of several traditional categories of sickness, guiding traditional healing practices and the incorporation of biomedical knowledge. The Baníwa's cosmology operates like a reception system for biomedical information, which the people grasp according to the logic of mythical thought. Similar cognitive strategies are used to generate the demands that indigenous leaders submit to the Health Councils and Health Services.     

Treatment Practices,Outcomes, and Costs of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis,United States, 2005–2007

To describe factors associated with multidrug-resistant (MDR), including extensively-drug-resistant (XDR), tuberculosis (TB) in the United States, we abstracted inpatient, laboratory, and public health clinic records of a sample of MDR TB patients reported to the Centers for Disease Control and Prevention from California, New York City, and Texas during 2005–2007. At initial diagnosis, MDR TB was detected in 94% of 130 MDR TB patients and XDR TB in 80% of 5 XDR TB patients. Mutually exclusive resistance was 4% XDR, 17% pre-XDR, 24% total first-line resistance, 43% isoniazid/rifampin/rifabutin-plus-other resistance, and 13% isoniazid/rifampin/rifabutin-only resistance. Nearly three-quarters of patients were hospitalized, 78% completed treatment, and 9% died during treatment. Direct costs, mostly covered by the public sector, averaged $134,000 per MDR TB and $430,000 per XDR TB patient; in comparison, estimated cost per non-MDR TB patient is $17,000. Drug resistance was extensive, care was complex, treatment completion rates were high, and treatment was expensive.     

Recalled Sex-typed Behavior in Childhood and Sports’ Preferences in Adulthood of Heterosexual,Bisexual, and Homosexual Men from Brazil,Turkey, and Thailand

This research used interview and questionnaire data from homosexual (n = 177), bisexual (n = 157), and heterosexual (n = 544) men between 20 and 30 years of age among lower class men and university students in three countries: Brazil, Thailand, and Turkey. The main goal of the study was to examine the recalled childhood sex-typed behavior and adult sports preferences that distinguish homosexuals from bisexuals and heterosexuals. In all three cultures and both social groups, homosexual men were almost always more likely as children to have wanted to be a girl, to cross-dress, to play with girls, to do girls’ tasks, and to practice fewer sports. They were also less likely to bully others or to engage in physical fights. As children, homosexual men were more likely to prefer swimming and playing volleyball rather than soccer and, as adults, they preferred watching gymnastics and swimming over soccer. The bisexuals scored intermediate mostly in “desire to be a girl” and “cross-dressing,” although they were much closer to the heterosexuals. These results, coupled with previous cross-cultural research, suggest that cross-gender behavior in childhood may characterize most male homosexuals regardless of their cultural milieu.     

Wheelchairs, walkers, and canes: what does Medicare pay for, and who benefits?

Medicare's role in the distribution of mobility-related assistive technology has not been well documented, yet rapid growth and regional variation in spending, and concerns over "in-the-home" coverage criteria, highlight the need for facts. Using the 2001 Medicare Current Beneficiary Survey, we find that 6.2 percent percent of beneficiaries obtained mobility assistive technology under the Medicare durable medical equipment (DME) benefit. These beneficiaries were disproportionately poor, disabled, and users of both acute and postacute services. Average per item spending ranged from $52 for canes to $6,208 for power wheelchairs. Among beneficiaries who acquired such technology through the DME benefit, these devices comprised just 2 percent of overall Medicare spending.     

Parents’ Depressive Symptoms and Gun,Fire, and Motor Vehicle Safety Practices

Objective This study examined associations between mothers’ and fathers’ depressive symptoms and their parenting practices relating to gun, fire, and motor vehicle safety. Methods Using data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a nationally representative sample of children birth to age five, linear probability models were used to examine associations between measures of parents’ depressive symptoms and their use of firearms, smoke detectors, and motor vehicle restraints. Parents reported use of smoke detectors, motor vehicle restraints, and firearm ownership and storage. Results Results suggest mothers with moderate or severe depressive symptoms were 2 % points less likely to report that their child always sat in the back seat of the car, and 3 % points less likely to have at least one working smoke detector in the home. Fathers’ depressive symptoms were associated with a lower likelihood of both owning a gun and of it being stored locked. Fathers’ depressive symptoms amplified associations between mothers’ depressive symptoms and owning a gun, such that having both parents exhibit depressive symptoms was associated with an increased likelihood of gun ownership of between 2 and 6 % points. Conclusions Interventions that identify and treat parental depression early may be effective in promoting appropriate safety behaviors among families with young children.     

Infant mortality and sociodemographic conditions in Ceará, Brazil, 1991 and 2000

OBJECTIVE: To assess ecological models to describe infant mortality rate in Ceara (Northeastern Brazil) in two different periods of time. METHODS: This was a cross-sectional ecologic study of two years, 1991 and 2000, using non-matching information per municipalities. Estimates on the infant mortality rate of the Instituto de Pesquisas Econ?micas Aplicadas (Institute of Applied Economic Research) have been used. For the remaining indicators different sources of the System of Health Information were used. The main risk factors were assessed using multiple linear regression. RESULTS: In 1991, the variables that predicted infant mortality rate (R2=0.3575) were: small houses (beta=0.0043; rho=0.010), proportion of inhabitants with tap water in the household (beta=-0.0029; rho=0.024), urbanization rate (beta=0.0032; rho=0.004), fecundity rate (beta=0.0351; rho=0.024), the proportion of children working at 10-14 years (beta=0.0049; rho=0.017), proportion of families with income < 1/2 minimum wage (beta=0.0056; rho=0.000), that can read and write (beta=-0.0062; rho=0.031). In the year 2000, the following possible determinants were identified (R2=0.3236): the proportion of children <2 years of age with malnutrition (beta=0.0064; rho=0.024), proportion of households with adequate sanitation (beta=-0.0024; rho=0.010), proportion of women who could read and write (beta=-0.0068; rho=0.044), expenses on health human resources regarding total health expenses (beta=-0.0024; rho=0.027), proportion of the value of the vegetal production in relation to the total of the state (beta=-0.1090; rho=0.001), intensity of poverty (beta=0.0065; rho=0.002), and ageing index (beta=-0.0100; rho=0.006). CONCLUSIONS: Although the variables have not been exactly the same for the evaluated period, determiners of infant mortality have been changing, except for indicators of education, income and sanitation. The overall decrease in fecundity led to a reduction in its discriminating power, and it was replaced by the ageing index. Another tendency observed was the replace of several demographic variables by health care indicators.     

English- and Spanish-speaking Latina Mothers’ Beliefs about Food,Health, and Mothering

Parent beliefs regarding food, health, and child feeding behaviors among Latinos have not been well-documented. A series of eight focus groups were conducted with English-speaking and Spanish-speaking low-income Latina mothers of preschoolers to investigate their beliefs regarding how food and food preparation are related to their children’s health and to their own roles as mothers. Systematic content analysis using NUDIST 6 revealed seven themes discussed by the focus groups. Integration of these themes revealed three major areas of consideration: (1) a lack of connection between the domains of eating, overweight, and health outcomes; (2) the role of parent modeling of eating behaviors; and (3) the use of feeding strategies that may not be conducive to the development of healthy eating behaviors. Furthermore, the data suggest that there are important distinctions among Latinos based on language preference, and that a “one-size-fits-all” approach to modeling Latino mothers’ feeding beliefs may not be appropriate.     

Global construction health and safety--what works, what does not, and why?

The marginalization of construction workers makes them especially vulnerable in terms of poor occupational health and safety standards and lax enforcement, with resulting disabilities. A sound research base is needed to rectify this situation. Efforts to raise awareness of construction hazards and ameliorate them are described.     

Residues of organochlorine insecticides,industrial chemicals,and mercury in eggs and in tissues taken from healthy and emaciated common loons,Ontario, Canada, 1968–1980

Between 1968 and 1980, 98 eggs were collected from active nests of the common loon (Gavia immer) in Ontario. Residues of ?DDT and PCB declined over this period while dieldrin and Hg appeared unchanged. Eggs collected in 1969 and 1970 had significantly thinner shells than eggs from a collection made before 1947. Between 1969 and 1979, 215 common loon carcasses were collected across Ontario, the result of having been drowned or shot or having died of diseases or unknown causes. Chemical analyses of 174 carcasses taken from healthy birds showed that adult loons accumulated higher levels of organochlorine and Hg residues than did juveniles. Tissues with high fat contents contained higher organochlorine levels while kidney, liver, and feathers had the highest Hg levels. Thirty loons were found to be emaciated with visibly lesser amounts of body fat and significantly lower levels of lipids in pectoral muscle tissue. Organochlorine but not Hg residues were one to two orders of magnitude higher in the wet tissues of emaciated birds than healthy birds. Higher residues of organochlorine chemicals were found in the uropygial gland, the oil secreted by this gland and belly and back feathers of emaciated birds when compared to healthy birds. It was concluded that losses of organochlorine chemical residues could occur through this gland. While Hg levels in feathers were elevated, Hg did not accumulate in the uropygial gland or in the secreted oil and was not the route for Hg content in feathers. In emaciated birds, mean brain levels of ?DDT (primarily DDE) were between 25 and 49 Μg/g, dieldrin 0.5 to 1.2 Μg/g, PCB 39 to 63 Μg/g, and mercury 1.0 to 1.8 Μg/g. The mean brain levels in healthy birds were between 0.2 and 0.9 Μg/g ?DDT, 0.01 and 0.05 Μg/g dieldrin, 0.6 and 2.0 Μg/g PCB, and 0.4 and 0.6 Μg/g mercury.     

Female sterilization, AIDS, and medical culture in São Paulo and Porto Alegre, Brazil

This paper explores the factors associated with reproductive choices by HIV-positive pregnant women in two settings in Brazil, and particularly how health care providers and the local medical culture can affect these choices. Requesting and submitting to postpartum sterilization provide the focus of the analysis. The data come from a study conducted in prenatal care services in two cities, S?o Paulo and Porto Alegre. We employed two data collection strategies: collection of information from 427 patient records for HIV-positive women who had received prenatal care, and in-depth interviews with 60 women. While most women in both cities requested tubal ligation after delivery, a much higher proportion of women in Sao Paulo were actually sterilized, as compared to a tiny proportion of women in Porto Alegre. The local medical culture regarding sterilization and organization of prenatal care emerged as important factors for understanding the differences between the two cities.     

Screening and managing cannabis use: comparing GP’s and nurses’ knowledge,beliefs, and behavior

ABSTRACT: BACKGROUND: General practitioners (GPs) and nurses are ideally placed to address the significant unmet demand for the treatment of cannabis-related problems given the numbers of people who regularly seek their care. The aim of this study was to evaluate differences between GPs and nurses' perceived knowledge, beliefs, and behaviors toward cannabis use and its screening and management. METHODS: This study involved 161 nurses and 503 GPs who completed a survey distributed via conference satchels to delegates of Healthed seminars focused on topics relevant to women and children's health. Differences between GPs and nurses were analyzed using chi2- tests and two-sample t-tests, while logistic regression examined predictors of service provision. RESULTS: GPs were more likely than nurses to have engaged in cannabis-related service provision, but also more frequently reported barriers related to time, interest, and having more important issues to address. Nurses reported less knowledge, skills, and role legitimacy. Perceived screening skills predicted screening and referral to alcohol and other drug (AOD) services, while knowing a regular user increased the likelihood of referrals only. CONCLUSIONS: Approaches to increase cannabis-related screening and intervention may be improved by involving nurses, and by leveraging the relationship between nurses and doctors, in primary care.     

Minerals and Sarcopenia; The Role of Calcium,Iron, Magnesium,Phosphorus, Potassium,Selenium, Sodium,and Zinc on Muscle Mass,Muscle Strength,and Physical Performance in Older Adults: A Systematic Review

Introduction

Minerals may contribute to prevent and treat sarcopenia, the age-related loss of muscle mass, muscle strength, and physical performance. So far, there is no comprehensive review on the impact of minerals on sarcopenia outcomes. The aim of this systematic review is to evaluate the role of calcium, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc on muscle mass, muscle strength, and physical performance in older adults.