Mothers’ Intentions to Support Children’s Physical Activity Related to Attention and Implicit Agreement with Advertisements

Background

ParticipACTION’s Think Again campaign targeted mothers who think their children are sufficiently active, yet whose children do not achieve recommended amounts of physical activity.

Purpose

This research examined the relationship of mothers’ intentions to support children’s physical activity with explicit believability and implicit agreement with the Think Again campaign message, attention paid to the advertisement, involvement with the issue, concern regarding children’s inactivity, and attitudes.

Method

Participants were mothers from Edmonton, Canada (N?=?102) who viewed one Think Again advertisement then completed a measure of implicit agreement with the campaign message and questionnaires.

Results

The mothers who paid attention to the message and were concerned for their own children were more likely to intend to act on campaign messages. The majority of participants implicitly agreed that children’s physical inactivity was a problem, but there was less agreement that physical inactivity was a problem for their own children.

Conclusion

Participants automatically tended to agree with campaign messages when the focus was on children in general, but there was greater disagreement when asked about participant’s own children. Why most mothers were not in agreement with the reality of how much physical activity their children needs remains to be determined.     

Spirituality,Religiosity, and Health: a Comparison of Physicians’ Attitudes in Brazil,India, and Indonesia

Background

One of the biggest challenges in the spirituality, religiosity, and health field is to understand how patients and physicians from different cultures deal with spiritual and religious issues in clinical practice.

Purpose

The present study aims to compare physicians’ perspectives on the influence of spirituality and religion (S/R) on health between Brazil, India, and Indonesia.

Method

This is a cross-sectional, cross-cultural, multi-center study carried out from 2010 to 2012, examining physicians’ attitudes from two continents. Participants completed a self-rated questionnaire that collected information on sociodemographic characteristics, S/R involvement, and perspectives concerning religion, spirituality, and health. Differences between physicians’ responses in each country were examined using chi-squared, ANOVA, and MANCOVA.

Results

A total of 611 physicians (194 from Brazil, 295 from India, and 122 from Indonesia) completed the survey. Indonesian physicians were more religious and more likely to address S/R when caring for patients. Brazilian physicians were more likely to believe that S/R influenced patients’ health. Brazilian and Indonesians were as likely as to believe that it is appropriate to talk and discuss S/R with patients, and more likely than Indians. No differences were found concerning attitudes toward spiritual issues.

Conclusion

Physicians from these different three countries had very different attitudes on spirituality, religiosity, and health. Ethnicity and culture can have an important influence on how spirituality is approached in medical practice. S/R curricula that train physicians how to address spirituality in clinical practice must take these differences into account.

     

Experiences of Possession and Paranormal Phenomena Among Women in the General Population: Are They Related to Traumatic Stress and Dissociation?

This study sought to determine the prevalence of experiences of possession and paranormal phenomena (PNP) in the general population and their possible relations to each other and to traumatic stress and dissociation. The study was conducted on a representative female sample recruited from a town in central eastern Turkey. The Dissociative Disorders Interview Schedule, the posttraumatic stress disorder (PTSD) and borderline personality disorder sections of the Structured Clinical Interviews for DSM–IV Axis-I and Personality Disorders, and the Childhood Abuse and Neglect Questionnaire were administered to 628 women. Of these, 127 (20.2%) women reported at least 1 type of PNP and 13 (2.1%) women reported possession. Women with a dissociative disorder reported all types of possession and PNP (except telepathy) more frequently than those without. Whereas women with a trauma history in childhood and adulthood or PTSD reported possession more frequently than those without, PNP were associated with childhood trauma only. Factor analysis yielded 4 dimensions: possession by and/or contact with nonhuman entities, extrasensory communications, possession by a human entity, and precognition. These factors correlated with number of secondary features of dissociative identity disorder and Schneiderian symptoms. Latent class analysis identified 3 groups. The most traumatized group, with predominantly dissociative and trauma-related disorders, had the highest scores on all factors. Notwithstanding their presence in healthy individuals, possession and PNP were associated with trauma and dissociation in a subgroup of affected participants. Both types of experience seem to be normal human capacities of experiencing that may be involved in response to traumatic stress. Given the small numbers, this study should be considered preliminary.     

Prothrombotic State in Asthma Is Related to Increased Levels of Inflammatory Cytokines,IL-6 and TNFα, in Peripheral Blood

Recently, we have reported that asthma is associated with enhanced plasma thrombin formation and impaired fibrinolysis. The mechanisms underlying the prothrombotic state in this disease are unknown. Our aim was to investigate whether prothrombotic alterations in asthmatics are associated with inflammation. We studied 164 adult, white, stable asthmatics and 72 controls matched for age, sex, body mass index (BMI), and smoking. Plasma tumor necrosis factor α (TNFα), interleukin (IL)-6, and serum periostin were evaluated using ELISAs, and their associations with thrombin generation, fibrinolytic capacity, expressed as clot lysis time (CLT), and platelet markers were later analyzed. Asthma was characterized by 62% higher plasma IL-6 and 35% higher TNFα (both, p < 0.0001). Inflammatory cytokines were higher in sporadic and persistent asthmatics compared to controls, also after adjustment for potential confounders. IL-6 was inversely related to the forced expiratory volume in 1 s/vital capacity (FEV₁/VC) spirometry index after correction for age, sex, and BMI. IL-6 and TNFα were associated with C-reactive protein in asthmatics (β = 0.6 [95% CI, 0.54–0.67] and β = 0.33 [95% CI, 0.25–0.41], respectively) and controls (β = 0.43 [95% CI, 0.29–0.57] and β = 0.33 [95% CI, 0.18–0.48], respectively). In asthma, IL-6 and TNFα positively correlated with the endogenous thrombin potential (β = 0.35 [95% CI, 0.28–0.42] and β = 0.15 [95% CI, 0.07–0.23], respectively) but not with CLT or platelet markers. However, TNFα predicted CLT in a multiple linear regression model. Periostin was not associated with any hemostatic parameters. Enhanced thrombin generation is driven in asthma by a systemic inflammatory state mediated by IL-6 and to a lesser extent TNFα, however, not periostin. TNFα might contribute to impaired fibrinolysis.     

Are automatic postural responses in patients with Parkinson’s disease abnormal due to their stooped posture?

 Abnormal automatic postural responses are thought to contribute to balance impairment in Parkinson’s disease. However, because postural responses are modifiable by stance, we have speculated that some postural abnormalities in patients with Parkinson’s disease are secondary to their stooped stance. We have studied this assumption by assessing automatic postural responses in 30 healthy subjects who were instructed either to stand upright or to assume a typical parkinsonian posture. During both conditions, subjects received 20 serial 4°’toe-up’ rotational perturbations from a supporting forceplate. We recorded short-latency (SL) and medium-latency (ML) responses from stretched gastrocnemius muscles and long-latency (LL) responses from shortened tibialis anterior muscles. We also assessed changes in the center of foot pressure (CFP) and the center of gravity (COG). The results were qualitatively compared to a previously described group of patients with Parkinson’s disease who, under these circumstances, typically have large ML responses, small LL responses and insufficient voluntary postural corrections, accompanied by a slow rate of backward CFP displacement and an increased posterior COG displacement. The stooped posture resulted in unloading of medial gastrocnemius muscles and loading of tibialis anterior muscles. Onset latencies of stretch responses in gastrocnemius muscles were delayed in stooped subjects, but the onset of LL responses was markedly reduced. Amplitudes of both ML and LL responses were reduced in stooped subjects. Prestimulus COG and, to a lesser extent, CFP were shifted forwards in stooped subjects. Posterior COG displacement and the rate of backward CFP displacement were diminished in stooped subjects. Voluntary postural corrections were unchanged while standing stooped. These results indicate that some postural abnormalities of patients with Parkinson’s disease (most notably the reduced LL responses) can be reproduced in healthy subjects mimicking a stooped parkinsonian posture. Other postural abnormalities (most notably the increased ML responses and insufficient voluntary responses) did not appear in stooped controls and may contribute to balance impairment in Parkinson’s disease. Received: 16 February 1998 / Accepted: 24 August 1998     

Are planning,working memory,and inhibition associated with individual differences in preschool ADHD symptoms?

The association between executive function (EF; planning, working memory, and inhibition) and individual differences in symptoms of attention deficit hyperactivity disorder (ADHD) was explored in a sample of preschool children. One hundred sixty children (between the ages of 3 years, 0 months and 5 years, 6 months), selected so as to oversample high ADHD scorers, performed 3 tasks previously shown to measure planning (Tower of London), working memory (Noisy Book) and inhibition ("Puppet Says..."). EF measures were reliable (kappa > .77) and were correlated with IQ (rs > .38) and age (rs > .59). Once IQ and age were controlled, planning and working memory (r = .41) were correlated. Planning and working memory were not correlated with inhibition (rs < .20). There was no association between ADHD and working memory or planning (rs < .12). There was a significant negative association between ADHD and conduct problems and inhibition (r = -.30 and r = -.25, respectively). Only the link with ADHD persisted after the effects of other factors were controlled for in a multiple regression. Specific deficits in inhibitory control rather than general EF deficits are associated with ADHD in the preschool period. This association is linear in nature, supporting the idea that ADHD is better seen as a continuum rather than a discrete category. This association provides evidence for Barkley's (1997) view that ADHD is underpinned by inhibitory deficits in the preschool period.     

Patients’ challenges,competencies, and perceived support in dealing with information needs – A qualitative analysis in patients with breast and gynecological cancer

ObjectivesThis study aimed to investigate challenges, competencies, and support in breast and gynecological cancer patients when dealing with information needs and how health literacy as an interplay of these factors might be improved.MethodsSemi-structured interviews were conducted with patients in acute care (n = 19), undergoing rehabilitation (n = 20) or attending self-help groups (n = 16). Interviews were analyzed using content analysis.ResultsChallenges: gain information according to own needs, internet as information source, information evaluation and decisions, doctor-patient communication, situationally limited information processing, difficult access to information. Competencies: self-regulation of information needs, media and social competencies, communication skills in the doctor-patient conversation, internet competencies, self-directed decisions according to own needs, interest/self-efficacy, previous knowledge, trust in the doctor. Support: by professionals (e.g., patient-centered communication), relatives (e.g., support during consultations), peers (e.g., exchange), facilities (e.g., clinics).ConclusionsOur findings provide insight into challenges and competencies relevant to patients’ health literacy and the influence of support. The individuality of the interplay highlights the relevance of an active patient role and patient-centered care.Practice implicationsPatients’ health literacy should be improved in (psycho)oncological work by both reducing challenges (e.g., by communication skills training, involving relatives) and promoting competencies (e.g., by needs- and competence-oriented information offers).     

Neurological disorders and neural regeneration, with special reference to Parkinson’s disease and cerebral ischemia

For many years, it was recognized that brain and spinal cord tissues could not be regenerated once they were damaged. Recently, this concept has been challenged and many basic and clinical studies regarding neural regeneration and transplantation have been reported. In this review, we will summarize the clinical studies using cell transplantation for the treatment of Parkinson’s disease and cerebral ischemia. Then, we will report the recent advancement of basic studies using cell lines and neural stem cells as donor tissue. Cell line grafting can be done by encapsulating desired cell line in semipermeable polymer hollow fibers, and neurotransmitter and neurotrophic factors can be delivered into the brain. Neural stem cells, especially those of adult origin, have the advantage that autologous cell transplantation can be done. The biological features of various types of stem cells have been widely investigated and will be applied to the treatment of neurological disorders through cell transplantation. This article is modified from “Neural regeneration: treatment of Parkinson’s disease and cerebral ischemia,” by the same authors, in Jinkozoki 2007;36:130–133     

The absence of immunoreactivity to donkey’s milk in patients with recurrent aphthous ulcers and immunoreactivity to cow’s milk

Despite the numerous benefits of milk constituents for human health a considerable number of the general population follow a milk-restricted diet due to clinically confirmed or self-assessed adverse reactions to cow’s milk consumption. Recurrent aphthous ulcers (RAU) are currently one of the most common oral disorders, with a worldwide distribution and insufficiently defined etiology, which, among other factors, implies the immunological reaction to food proteins. The aim of this study was to determine the immune-reactivity to donkey’s milk proteins in patients with RAU and compare it to the reactivity towards the proteins from cow’s and goat’s milks, in a set of simultaneous experiments. Levels of serum IgA, IgG and IgE antibodies to the same quantity of the examined antigens were determined by enzyme-linked immunosorbent assay. The results indicate that patients with RAU with increased immunity to cow’s milk proteins could consider the use of donkey’s milk as the best protein source.     

Muscle activation patterns in point-to-point and reversal movements in healthy,older subjects and in subjects with Parkinson’s disease

When young, healthy subjects perform rapid point-to-point and reversal movements over a range of distances, the patterns of muscle activation associated with accelerating the limb toward the target are modulated in the same way for both movement tasks. Differences in patterns of muscle activation for these two movement types are not observed until the deceleration phase of the movements. In this study, we first test the hypothesis that healthy, older subjects and subjects with Parkinsons disease will modulate the pattern of muscle activation in the same way during the acceleration phase of point-to-point and reversal elbow movements. Second, we test the hypothesis that healthy, older subjects and subjects with Parkinsons disease exhibit the same relationship in muscle activation patterns between the two movement types that have been observed for the young in the deceleration phase of the movements. Subjects performed point-to-point and reversal movements initiated in the direction of flexion over three distances (36, 54 and 72 degrees) as fast as possible. Angle, velocity, acceleration and surface EMGs from biceps and triceps were recorded. With respect to the first hypothesis, the EMG, kinetic, and kinematic measures related to the acceleration phase of the movements were modulated in the same way for both movement types in the healthy older subjects. In the Parkinsons disease group, the kinematic and kinetic measures during the acceleration phase of the movements were the same in both movement types; however, the flexor and extensor EMG activation was smaller during reversal movements than during point-to-point movements. With respect to the second hypothesis, in contrast to that found in young subjects, in healthy older subjects, there was no significant difference between the movement types in the flexor EMG activity immediately after the time of peak velocity. This difference between younger and older subjects may be attributed to the fact that older subjects perform both movement types more slowly than do younger subjects. Although subjects with Parkinsons disease also move slowly, the flexor EMG shuts off more abruptly and more completely just after the time of peak velocity during reversal movements than during point-to-point movements. These results show that (1) for healthy subjects, when the task requirements are the same for the two movement types (acceleration phase), muscle activation patterns are modulated in the same way, and (2) both age and disease alter the relationship of muscle activation, kinetics and kinematics between point-to-point and reversal movements.     

Are Inflammatory and Coagulation Biomarkers Related to Sleep Characteristics in Mid-Life Women?: Study of Women's Health Across the Nation Sleep Study

Study Objectives:

Inflammation and pro-coagulation biomarkers may be a link between sleep characteristics and risk for cardiometabolic disorders. We tested the hypothesis that worse sleep characteristics would be associated with C-reactive protein (CRP), fibrinogen, factor VIIc, and plasminogen activator inhibitor (PAI)-1 in a multi-ethnic subsample of mid-life women enrolled in the Study of Women''s Health across the Nation.

Design:

Cross-sectional.

Measurements and Results:

African American, Chinese, and Caucasian women (N = 340) participated in 3 days of in-home polysomnographic (PSG) monitoring and had measures of inflammation and coagulation. Regression analyses revealed that each of the biomarkers were associated with indicators of sleep disordered breathing after adjusting for age, duration between sleep study and blood draw, site, menopausal status, ethnicity, residualized body mass index, smoking status, and medications that affect sleep or biomarkers. Among African American women, those who had higher levels of CRP had shorter PSG-sleep duration and those who had higher levels of fibrinogen had less efficient sleep in multivariate models.

Conclusions:

These results suggest that inflammation and pro-coagulation processes may be an important pathway connecting sleep disordered breathing and cardiometabolic disorders in women of these ethnic groups and that inflammation may be a particularly important pathway in African Americans.

Citation:

Matthews KA; Zheng H; Kravitz HM; Sowers M; Bromberger JT; Buysse DJ; Owens JF; Sanders M; Hall M. Are inflammatory and coagulation biomarkers related to sleep characteristics in mid-life women?: Study of Women''s Health Across the Nation Sleep Study. SLEEP 2010;33(12):1649-1655.     

Are childhood psychiatric histories of bipolar adolescents associated with family history, psychosis, and response to lithium treatment?

OBJECTIVE: To examine if childhood psychiatric diagnoses are associated with family history, psychosis, age, and lithium response. METHOD: Associations among variables, and their contributions to explaining lithium response were examined in 48 bipolar adolescents enrolled in a study of lithium. RESULTS: Presence of a childhood diagnosis was not associated with family psychiatric history or lithium response. Subjects with psychotic features, however, were less likely to have a childhood psychiatric diagnosis, were older, and had a poorer response rate to lithium than subjects without psychosis. DISCUSSION: Heterogeneity within bipolar adolescents may be based on clinical features such as psychosis rather than childhood or family history alone.     

Living with AIDS in Uganda: a qualitative study of patients’ and families’ experiences following referral to hospice

Background

Globally, the majority of people with HIV/AIDS live in sub-Saharan Africa. While the increasing availability of antiretroviral therapy is improving the outlook for many, its effects are yet to reach all of those in need and patients still present with advanced disease. This paper reports findings from qualitative interviews with patients living with AIDS and their caregivers who were receiving palliative care from Hospice Africa Uganda (HAU). We aimed to understand what motivated patients and their families to seek formal healthcare, whether there were any barriers to help- seeking and how the help and support provided to them by HAU was perceived.

Methods

We invited patients with AIDS and their relatives who were newly referred to HAU to participate in qualitative interviews. Patients and carers were interviewed in their homes approximately four weeks after the patient’s enrolment at HAU. Interviews were translated, transcribed and analysed using narrative and thematic approaches.

Results

Interviews were completed with 22 patients (10 women and 12 men) and 20 family caregivers, nominated by patients. Interviews revealed the extent of suffering patients endured and the strain that family caregivers experienced before help was sought or accessed. Patients reported a wide range of severe physical symptoms. Patients and their relatives reported worries about the disclosure of the AIDS diagnosis and fear of stigma. Profound poverty framed all accounts. Poverty and stigma were, depending on the patient and family situation, both motivators and barriers to help seeking behaviour. Hospice services were perceived to provide essential relief of pain and symptoms, as well as providing rehabilitative support and a sense of caring. The hospice was perceived relieve utter destitution, although it was unable to meet all the expectations that patients had.

Conclusion

Hospice care was highly valued and perceived to effectively manage problems such as pain and other symptoms and to provide rehabilitation. Participants noted a strong sense of being “cared for”. However, poverty and a sense of stigma were widespread. Further research is needed to understand how poverty and stigma can be effectively managed in hospice care for patients for advanced AIDS and their families.

     

LDL Receptor–Related Protein-1: A Regulator of Inflammation in Atherosclerosis,Cancer, and Injury to the Nervous System

Low-density lipoprotein receptor–related protein-1 (LRP1) is an endocytic receptor for numerous proteins that are both structurally and functionally diverse. In some cell types, LRP1-mediated endocytosis is coupled to activation of cell signaling. LRP1 also regulates the composition of the plasma membrane and may, thereby, indirectly regulate the activity of other cell-signaling receptors. Given the scope of LRP1 ligands and its multifunctional nature, it is not surprising that numerous biological activities have been attributed to this receptor. LRP1 gene deletion is embryonic-lethal in mice. However, elegant studies using Cre-LoxP recombination have helped elucidate the function of LRP1 in mature normal and pathological tissues. One major theme that has emerged is the role of LRP1 as a regulator of inflammation. In this review, we will describe evidence for LRP1 as a regulator of inflammation in atherosclerosis, cancer, and injury to the nervous system.Low-density lipoprotein (LDL) receptor–related protein-1 (LRP1/CD91) is a type 1 transmembrane protein, which is processed by furin-like endoproteases in the trans-Golgi compartment to generate the mature two-chain structure.^1,2 The 515-kDa α-chain is entirely extracellular and coupled to the cell surface through strong noncovalent interactions with the transmembrane 85-kDa β-chain. Although LRP1 may localize transiently in lipid rafts, the receptor migrates in the plasma membrane to clathrin-coated pits, where it undergoes constitutive endocytosis and recycling with extremely high efficiency.^3–5 In most cells, including macrophages, hepatocytes, and neurons, LRP1-associated ligands dissociate in acidified endosomes and are transferred to lysosomes.^3,4,6 In endothelial cells, LRP1 ligands may undergo transcytosis.^7,8LRP1 is a member of the LDL receptor gene family, which includes receptors such as megalin/LRP2, apolipoprotein E receptor 2/LRP8, and the VLDL receptor. These receptors demonstrate similarities in domain organization and, in some cases, partially overlapping function.⁹ As shown in Figure 1A, the LRP1 α-chain includes four clusters of complement-like repeats (CCRs), numbered from the N-terminus.^9,10 CCR2 and CCR4 contain 8 and 11 complement-like repeats, respectively, and are responsible for most of the ligand-binding activity of LRP1.¹⁰ The LRP1 β-chain includes YxxL and dileucine motifs that serve as principal endocytosis signals¹¹ and two NPxY motifs that function as secondary endocytosis signals and as binding sites for signaling adapter proteins.^11–13Open in a separate windowFigure 1Molecular models showing the organization of structural domains in LRP1 and the docking of a representative ligand to complement-like repeats in LRP1. A: The depicted domains in LRP1 are common to the LDL receptor family. Stars are present in the intracellular region of LRP1 to represent motifs that function as endocytosis signals and/or as docking sites for cell-signaling proteins including NPXY, YxxL, and dileucine. B: A representative LRP1 ligand, the 18-kDa receptor-binding domain of α₂-macroglobulin, which is a free-standing domain in the activated state of the protein, is shown in pink. Two lysine residues in a single α-helix, highlighted in blue, are essential for binding to LRP1. These lysine residues interact with acidic amino acids in the LRP1 complement-like repeats. The fourth and fifth complement-like repeats in CCR2 are shown in orange, and the acidic amino acids in these domains are highlighted in black. The approximate positions of calcium are shown. EGF, epidermal growth factor.The first identified LRP1 ligand was apolipoprotein E–containing β-VLDL.¹⁴ Subsequently, LRP1 was identified as the receptor for activated α₂-macroglobulin (α₂M),¹⁵ bringing forward a considerable body of literature in which LRP1 was referred to as the activated α₂M receptor. Figure 1B shows a model in which the 18-kDa LRP1-binding domain of α₂M (called the receptor-binding domain or RBD) is engaging tandem complement-like repeats from CCR2 of LRP1. As is typical for LRP1-ligand interactions, Lys residues in the structure of the RBD, positioned in parallel orientation within the same α-helix, interact with negatively charged amino acids in the complement-like repeats.^16,17 Hydrophobic residues exposed on the surface of the RBD also may be involved.¹⁶ The integral association of calcium with the complement-like repeats is necessary for structural integrity and function.^1,17Currently identified LRP1 ligands include proteases, protease inhibitor complexes, extracellular matrix proteins, growth factors, toxins, and viral proteins.⁹ LRP1 ligands are present in myelin, including myelin basic protein and myelin-associated glycoprotein (MAG),^18,19 explaining why in the injured central nervous system, LRP1 may participate in the phagocytosis of myelin debris.¹⁸ By binding calreticulin, LRP1 associates with members of the collectin family, including C1q and mannose-binding lectin, and participates in the phagocytosis of apoptotic cells.^20,21 LRP1 also serves as an endocytic receptor for many intracellular proteins released by necrotic cells.²² These LRP1 activities are important because failure to efficiently clear intracellular proteins, apoptotic cells, and cell debris may be associated with the onset of autoimmune disease.²³