Contrasting urban and rural lifestyles of memory CD8+ T cells

Memory CD8(+) T cells in lymphoid tissue exhibit an unexpectedly high apoptosis rate, while memory cells located in several nonlymphoid tissues do not. This may be because the lymphoid CD8(+) memory T cell repertoire is being continuously updated, while the tissue repertoire is more stable.     

Managing Ebola from rural to urban slum settings: experiences from Uganda

BackgroundFive outbreaks of ebola occurred in Uganda between 2000–2012. The outbreaks were quickly contained in rural areas. However, the Gulu outbreak in 2000 was the largest and complex due to insurgency. It invaded Gulu municipality and the slum- like camps of the internally displaced persons (IDPs). The Bundigugyo district outbreak followed but was detected late as a new virus. The subsequent outbreaks in the districts of Luwero district (2011, 2012) and Kibaale (2012) were limited to rural areas.MethodsDetailed records of the outbreak presentation, cases, and outcomes were reviewed and analyzed. Each outbreak was described and the outcomes examined for the different scenarios.ResultsEarly detection and action provided the best outcomes and results. The ideal scenario occurred in the Luwero outbreak during which only a single case was observed. Rural outbreaks were easier to contain. The community imposed quarantine prevented the spread of ebola following introduction into Masindi district. The outbreak was confined to the extended family of the index case and only one case developed in the general population. However, the outbreak invasion of the town slum areas escalated the spread of infection in Gulu municipality. Community mobilization and leadership was vital in supporting early case detection and isolations well as contact tracing and public education.ConclusionPalliative care improved survival. Focusing on treatment and not just quarantine should be emphasized as it also enhanced public trust and health seeking behavior.Early detection and action provided the best scenario for outbreak containment. Community mobilization and leadership was vital in supporting outbreak control. International collaboration was essential in supporting and augmenting the national efforts.     

Physiological stress responses in defensive individuals: Age and sex matter

The association between defensiveness and physiological responses to stress were evaluated in 81 healthy working men and 118 women, aged 20 to 64 years (M=41; SD=11.45). Participants underwent laboratory testing during which they were exposed to interpersonal stressors. Heart rate (HR), heart rate variability (HRV), blood pressure (BP), and salivary cortisol were measured. Defensiveness was evaluated using the Marlowe‐Crowne Social Desirability Scale. In women, higher defensiveness was associated with greater BP and HR reactivity to stress (p<.05). In older men, lower defensiveness was associated with increased systolic BP reactivity to stress (p<.02), delayed HRV recovery (p<.02), and greater salivary cortisol levels (p<.02). In conclusion, greater defensiveness was associated with increased reactivity to stress in women whereas in older men, lower defensiveness was associated with elevated cardiovascular, autonomic, and endocrine responses to stress.     

Physiological responses to acute stress in alloxan and streptozotocin diabetic rats

Physiological responses to acute stress were assessed in alloxan diabetic, streptozotocin diabetic and control laboratory rats. Rats were prepared with indwelling tail artery catheters to allow for direct measurement of mean arterial pressure (MAP, mmHg) and heart rate (HR, beats per minute) and remote sampling of blood. Within 24 hours after surgery, basal values of MAP and HR were determined. Two days after surgery, rats were subjected to 5 minutes of intermittent footshock. Blood samples were collected before footshock stress and immediately and 15 minutes after termination of footshock. Plasma levels of norepinephrine (NE) and epinephrine (EPI) increased significantly above basal values in all animals exposed to acute footshock stress. However, in approximately one-half of alloxan and streptozotocin diabetic rats, plasma levels of EPI under basal conditions and following footshock stress were elevated significantly compared to controls and the remaining diabetic animals. We have denoted these subgroups of diabetic animals as reactive responders (plasma EPI greater than controls) and nonreactive responders (plasma EPI similar to controls), respectively. Plasma levels of NE under basal conditions and following footshock stress were similar in reactive responders and nonreactive responders compared to matched controls. Baseline blood glucose levels were elevated in alloxan and streptozotocin diabetic rats compared to controls. Blood glucose levels increased reliably in all animals following footshock stress. Basal MAPs were reduced significantly in both subgroups of alloxan and streptozotocin diabetic rats compared to matched controls. In contrast, resting HRs were similar between diabetic rats and their corresponding controls.(ABSTRACT TRUNCATED AT 250 WORDS)     

Coping and responses to stress in Navajo adolescents: Psychometric properties of the Responses to Stress Questionnaire

This study tested the factor structure of coping and stress responses in Navajo adolescents and examined the reliability and validity of the Responses to Stress Questionnaire (RSQ; Connor‐Smith, Compas, Wadsworth, Thomsen, & Saltzman, 2000) with this population. Confirmatory factor analyses revealed that a correlated five‐factor model of stress responses using the five factors of the RSQ fit the data well for this group of adolescents. The factor structure of the RSQ did not differ by gender. Internal consistency of the RSQ scales and factors was acceptable, and convergent and discriminant validity were moderate to high. Primary and secondary control engagement coping responses were associated with fewer depressive symptoms in the sample, whereas disengagement coping and involuntary engagement responses were associated with more depressive symptoms. The promising implications for stress and coping research with American Indian adolescents are emphasized. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 391–411, 2004.     

Physiological stress responses in Filipino-American immigrant nurses: the effects of residence time, life-style, and job strain

OBJECTIVE: The purpose of this study was to evaluate the relationship between measures of Americanization (the adoption of American life-style and culture) and physiological measures of stress in Filipino-American immigrants. METHODS: Ambulatory blood pressure monitors and timed urine collections were used to evaluate blood pressure and urinary catecholamine excretion across the work, home, and sleep daily settings among 31 healthy, premenopausal, immigrant Filipino-American women employed as nurses or nurse's aides. Migration history and life-style were evaluated from questionnaire responses. Reported job strain, decision latitude, and psychological demand were obtained from the Job Content Questionnaire. RESULTS: Immigrants who had lived longer in the United States had elevated norepinephrine levels in the work and home settings (p < .05), higher diastolic blood pressure during sleep (p < .01), and lower dips in blood pressure during sleep (p < .05). Job strain measures were not related to blood pressure, catecholamine excretion rates, or residence time in the United States. CONCLUSIONS: The results suggest that indicators of stress increase as a function of time since immigration, although this result is not explained by self-reports of identification with Filipino or American life-style or by measures of job strain.     

Physiological and behavioral responses of New Zealand hypertensive and normotensive rats to stress

A chronic catheter was inserted into the ventral tail artery of adult male New Zealand hypertensive (NZH) and normotensive (NZN) rats to allow for repeated sampling of blood and measurement of blood pressure and heart rate in conscious animals without handling. Two days after surgery, plasma levels of norepinephrine (NE) and epinephrine (EPI) were similar in NZH and NZN rats while resting and undisturbed in their home cages. Mean arterial blood pressure was significantly higher in NZH rats (166±9 mm Hg) than in NZN rats (124±4 mm Hg) but basal heart rates did not differ (345±8 and 342±14 beats/min, respectively). Increments in plasma levels of NE and EPI and in mean arterial blood pressure and heart rate were similar in NZH and NZN rats following transfer to a shock box and immediately and 10 minutes after exposure to 1 minute of intermittent footshock. Male rats of the two strains also did not differ in their behaviors during tests in an open field arena. These results indicated that NZH and NZN rats do not differ with respect to basal or stress-induced increments in sympathetic-adrenal medullary activity or in several behavioral measures. These results are in striking contrast to previous studies with the Okamoto strain of spontaneously hypertensive (SHR) rats and indicate that genetically determined increases in arterial blood pressure are not necessarily associated with sympathetic-adrenal medullary and behavioral hyperresponsivity to stress.     

Conceptualization and measurement of the neighborhood in rural settings: a systematic review of the literature

Interest in the effects of neighborhood context on individual wellbeing has increased in recent years. We now know that neighborhood conditions, such as poverty and deprivation, negatively impact residents. However, most of the extant work has taken an urban focus. Less is known about these processes in rural settings. Neighborhood conceptualizations, such as Census tracts and block groups, are standard in the urban neighborhood effects literature. Yet, rural neighborhoods differ from those in urban regions making it unclear how these conceptualizations would fit. This systematic review seeks to summarize how researchers have conceptualized and measured rural neighborhoods. Keyword searches were performed in a variety of databases to compile all relevant peer‐reviewed articles. After examination, 19 articles fit the review criteria. Conceptualizations fell into five categories: administrative units, distance from home, town segments, local‐actor mapped regions, and nongeographical self‐definitions. Discussion of the merits of each for rural community research is provided. © 2009 Wiley Periodicals, Inc.     

Post-traumatic stress disorder in primary-care settings: prevalence and physicians' detection

BACKGROUND: Little is known about the prevalence of PTSD in primary-care settings and regarding the ability of primary-care physicians to detect PTSD. The current study examines prevalence of PTSD in a national sample of primary-care attenders and primary-care physicians' detection of PTSD and general psychological distress in PTSD patients. METHODS: Data are from a national study of 2975 primary-care attenders in Israel. Demographic data, responses to the GHQ-28, PTSD Inventory and physicians' diagnoses were examined. RESULTS: Twenty-three per cent of all patients who attended clinics (N = 684) reported traumatic events, 39% of whom (males 37%, females 40%) met criteria for PTSD on the PTSD Inventory. Eighty per cent of the males and 92% of the females with PTSD were distressed according to the GHQ. According to physicians, 37% of persons who reported trauma (40% of the women, 32% of the men) suffered from psychological distress. Only 2% of patients meeting PTSD criteria on the self-report measure were given a diagnoses of PTSD by physicians. CONCLUSIONS: Many primary-care patients suffer from PTSD, which is usually accompanied by major psychological distress. Attention by primary-care physicians to a history of trauma could improve physicians' detection of this disabling disorder.     

Physiological responses during escape and non-escape from stress in field independent and field dependent subjects.

Psychophysiological responses (GSP, GSR, heart rate and respiration) were monitored while the subjects viewed stressful stimuli. In balanced order the subjects were exposed to a condition in which they viewed the stimuli for 15 sec and a condition in which they could escape the stimulus. The subjects were divided into four groups according to level of trait anxiety and rod and frame scores. The results suggested that escape from stress produced different patterns of physiological activity than non-escape conditions. The changes were most noticeable for tonic GSP, non-specific GSR and heart rate. Field independent subjects differentiated the conditions physiologically and behaviorally to a greater extent than field independent subjects. It was speculated that field independent subjects are more dependent upon physiological cues to evaluate their perceptions and emotions than field dependent subjects.     

Somatization symptoms in the community: a rural/urban comparison

Somatization is conceptualized as a bodily or somatic expression of psychic distress. Unexplained somatic symptomatology was assessed by use of the National Institute of Mental Health Diagnostic Interview Schedule among community respondents in the Piedmont of North Carolina participating in the Epidemiologic Catchment Area program. Previous literature suggests that somatization is associated with rural residence, less education, lower socioeconomic class, and particular ethnicities. Through use of a multiple regression analysis, lifetime unexplained somatic-symptom counts were regressed on urban residence and other sociodemographic variables. Rural residence was not associated with somatization; rather, somatization was more common among urban residents. The urban/rural differences were greatest among women and high school graduates. Somatization was also associated with being aged 45 to 64, and being separated, widowed, or divorced; it was not associated with race. Overall, somatization was also associated with less education.     

Apolipoprotein polymorphisms and phenotypic variability in American Samoans: Preliminary data

Human apolipoprotein genetic variation is associated with phenotypic variability in body habitus and in lipid and glucose metabolism, interrelated aspects of human physiology. In this study, structural variation at the apolipoprotein E and H loci, documented for 67 residents of American Samoa, was investigated for associations with body habitus, plasma glucose, glycated hemoglobin, pulse rate, and blood pressure. Compared to men with the common APO E*3 allele, those with APO E*2 had higher weight, percent trunk fat, ratio of subscapular to triceps skinfold, and larger subscapular, suprailiac, and medial calf skinfolds; men with the APO E*4 allele had lower weight, body mass index (BMI), upper arm circumference, estimated arm muscle circumference, and a smaller suprailiac skinfold. Such variability by apolipoprotein E types was not observed in Samoan women nor when men and women were combined for analysis with or without statistical control for sex. At the APO H locus, little difference in aspects of body habitus was observed between men carrying the most common APO H*2 allele and the less common APO H*1 allele. Percent trunk fat and the subscapular to triceps skinfold ratio tended to be larger in women with the APO H*1 allele. Plasma glucose and glycated hemoglobin were lower in Samoans with the APO E*2 and E*4 alleles, but higher in those with the APO H*1 allele. Blood pressure and pulse rate were lower and higher, respectively, in those with the APO E*4 allele. The observed associations differ from those observed in Caucasian, Japanese, and Hispanic samples, and support suggestions that associations between apolipoprotein polymorphisms and morphological measures vary across ethnic groups. © 1993 Wiley-Liss, Inc.     

Health literacy in rural and urban populations: A systematic review

ObjectiveThis review assessed whether health literacy differences exist between rural and urban populations and whether rurality is a determinant.MethodsEight online databases were searched using the keywords “health literacy”, “rural” and “urban”, and related terms. Peer-reviewed original research comparing health literacy levels between rural and urban populations were evaluated for strength of evidence. A narrative synthesis summarised the results of included studies.ResultsNineteen articles met inclusion criteria and were of sufficient methodological quality for data extraction. The majority of studies found that urban populations had higher health literacy than rural populations. Differences were more likely to be found in developing than developed countries. Studies that performed covariate analysis indicated that rurality may not be a significant determinant of health literacy.ConclusionEvidence suggests that rurality alone does not explain rural-urban health literacy differences and that sociodemographic factors play important roles.Practice implicationsThese findings could be used to help inform the development of evidence-based interventions specifically for rural populations, at both health policy and clinical levels; for example, by tackling healthcare access challenges. The findings also provide a lens through which to consider efforts to reduce rural-urban health outcome disparities.     

Puberty in modernizing Kazakhstan: a comparison of rural and urban children

BacKGROUND: Data on puberty development are available for several countries but not for Central Asia. AIM: Using data collected during the Kazakhstan Health and Nutrition Survey (KHA-ES), we evaluated the relationship between the living environment (rural vs. urban), ethnicity (Russians vs. Kazakhs) and pubertal status in children living in Kazakhstan. SUBJECTS AND METHODS: Genital (G1-G5), breast (B1-B5) and pubic hair (PH1-PH5) development were evaluated in a sample of 2389 boys and 2416 girls using Tanner's criteria. Age at menarche was evaluated using the 'status quo' and 'recall' methods. RESULTS: Rural children were older than urban children at stages > or =G2 for males and > or =B2 for females, and this difference was more evident for Russian males. Differences levelled out at later stages of development in Kazakh males and in the pooled girls. The living environment was slightly but significantly associated with median age at menarche (12.89 years for urban Kazakhs to 13.43 years for rural Kazakhs). Male and female Kazakhs were older than Russians at stages 4 and 5, especially in the urban area. CONCLUSION: A relationship between pubertal status and the living environment was present in a rapidly modernizing country such as Kazakhstan.