Attitudinal familism predicts weight management adherence in Mexican–American women

Adherence to behavioral weight management programs is often limited, especially among ethnic minority populations. The current study examined whether attitudinal familism, or attention to the needs of family above those of the self, predicted poorer adherence to a behavioral weight management program in Mexican–American women. One-hundred overweight or obese Mexican–American women from the southwestern United States were enrolled in a group-based weight loss treatment. Zero-order correlations indicated that general commitment to attitudinal familism, as measured by the Attitudinal Familism Scale, was significantly negatively associated with calorie and physical activity goal completion and marginally negatively associated with session attendance. The results of the current study indicate that researchers may consider addressing familism when developing tailored weight management interventions for Mexican–American women.     

Fatalism and Cardio-Metabolic Dysfunction in Mexican–American Women

Background

Mexican-American women are disproportionately vulnerable to cardio-metabolic dysfunction and related health conditions such as cardiovascular disease and diabetes. Research shows that low socioeconomic status contributes to this populations excess vulnerability to cardio-metabolic dysfunction, but little is known about the contribution of cultural factors to these associations.

Purpose

The current study explored the association between fatalism and cardio-metabolic dysfunction in a randomly selected community cohort of middle-aged Mexican–American women and examined whether fatalism could be conceptualized as a pathway linking socioeconomic status to cardio-metabolic dysfunction in this population.

Method

Participants included 300 women (ages 40–65), recruited from San Diego communities located near the Mexican border, who completed a self-administered survey battery and underwent a fasting clinical exam between the years 2006 and 2009.

Results

Linear regression analyses and mediation analyses utilizing bootstrapping procedures were performed to test study hypotheses. After controlling for age, menopausal status, and acculturation level, fatalism was associated with cardio-metabolic dysfunction. Although slightly attenuated, this relationship persisted after accounting for socioeconomic status. In addition, individuals of low socioeconomic status displayed more fatalistic beliefs and higher cardio-metabolic dysfunction after accounting for relevant covariates. Finally, the indirect effect of socioeconomic status on cardio-metabolic dysfunction via fatalism reached statistical significance.

Conclusions

Fatalism may be an important independent risk factor for cardio-metabolic dysfunction in Mexican–American women as well as a mechanism linking socioeconomic status to cardio-metabolic health.     

Determinants of vitamin D status in healthy men and women aged 40–80 years

ObjectivesTo determine the contribution of life style and health related factors on vitamin D status in middle-aged and older men and women.Study designA cross-sectional single-center study in 400 male subjects (40–80 years) and 402 postmenopausal female subjects (56–73 years), conducted in a University Medical Center in the central part of the Netherlands (52 degrees northern latitude).Main outcome measuresMedical history, vitamin D, calcium and alcohol intake, physical activity, Body Mass Index, Blood pressure, smoking, total fat body mass and total lean body mass were measured using DEXA. Laboratory analysis included 25-hydroxyvitamin D (25OHD) and sex hormones.ResultsThirty-six percent of men and 51% of women had 25OHD less than 50 nmol/L. In summertime men had significant higher 25OHD as compared to women (81.5 vs 53.3 nmol/L, P = .000) but this difference disappeared come winter. In a saturated model, male gender (B = .16, P = .008), and season (summer vs winter B = .30, P = .000) remained statistically significant. In men, physical activity and season explained 21% of the variance. In women, household physical activity (B = .13, P = .03), sport physical activity (B = .02, P = .02) and estradiol (B = ?.003, P = .048) remained in the model,.ConclusionIn healthy middle-aged and older men and postmenopausal women, male gender and season were important predictors of vitamin D status. In men, physically activity and season, explained 21% of the variance in vitamin D status. In women, physical activity and estradiol explained 9.3% of the variance in vitamin D.     

Sleep duration in Mexican American children: Do mothers’ and fathers’ parenting and family practices play a role?

This study examined parenting styles, parenting practices and family practices that may be associated with weeknight sleep duration among 8‐ to 10‐year‐old Mexican American (MA) children. This cross‐sectional study of MA children used baseline data from a 2‐year cohort study of mother–child pairs (n = 308) with additional data on fathers (n = 166). Children's weeknight sleep duration was accelerometer estimated and averaged for 2 weeknights. Parents reported on their parenting styles and practices regarding food and family food‐related practices. Multivariable linear regression analysis was used to examine sleep duration with parenting styles and practices, and family practices, and adjusting for child gender and body mass index. Model 1 included mothers’ parenting styles and practices; Model 2 included both mothers’ and fathers’ parenting styles and practices. Children's average sleep duration was 9.5 (SD = 0.8) hr. Mothers who used pressure to encourage their children to eat and those who used food to control behavior had children with longer sleep duration (β = 0.21, p < 0.01; β = 0.15, p = 0.03, respectively). Mothers who reported their children ate dinner with the TV on and those who valued eating dinner as a family had children with shorter sleep duration (β = ?0.16, p = 0.01; β = ?0.18, p = 0.01, respectively). Fathers who restricted the amount of food their children ate had children with shorter sleep duration (β = ?0.27, p = 0.01). Mothers’ and fathers’ feeding practices, the child's eating dinner with the TV on, and valuing family dinners, played a role in children's weeknight sleep duration among Mexican American families. Parental feeding practices and family mealtime contexts may have an effect on children's weeknight sleep duration.     

Principal Component Analyses and Scalp Distribution of the Auditory P150–250 and N250–550 to Speech Contrasts in Mexican and American Infants

We report a Principal Component Analysis (PCA) and the scalp distribution of the normalized peak amplitude values for speech-related auditory Event-related Potentials (ERP) P150–250 and N250–550 in 7-, 11-, and 20-month-old American infants learning English and in 10–13-month-old Mexican infants learning Spanish. After assessing the infant auditory ERP P-N complex using PCA, we evaluated the topographic distribution of each of the discriminatory phases to native and non-native CV-syllabic contrasts used in Spanish and English. We found that the first two Principal Components for each contrast type across ages showing a maximization of differences between the P150–250 and the N250–550 waves, explain more than 70% of the variance. The scalp distributions of the P150–250 and N250–550 components also differed, the P150–250 showing a frontal and anterior temporal distribution, and the N250–550 a more posterior distribution. The older infants showed a broader distribution of responses, particularly for the N250–550. There were no differences in the topographies of the components between same-aged Mexican and American infants. We discuss the perceptual/linguistic functions that each component may reflect during development and across the two cultures.     

Association between group A beta-haemolytic streptococci and vulvovaginitis in adult women: a case–control study

Guidelines for the management of vaginal discharge mention Candida albicans, Trichomonas vaginalis, bacterial vaginosis, Chlamydia trachomatis and Neisseria gonorrhoeae as causes and do not recommend full microbiological culture. The role of non-group B beta-haemolytic streptococci in vaginal cultures is unclear, except for group A streptococci that are known to cause vulvovaginitis in children. In a case–control study, we investigated the association between non-group B beta-haemolytic streptococci and vulvovaginitis in adult women. Cases were women with recurrent vaginal discharge from whom a sample was cultured. Controls were asymptomatic women who consented to submitting a vaginal swab. Group A streptococci were isolated from 49 (4.9%) of 1,010 cases and not from the 206 controls (P < 0.01). Isolation rates of group C, F and G streptococci were low and did not differ statistically between cases and controls. Group A beta-haemolytic streptococci are associated with vaginal discharge in adult women. The other non-group B streptococci require more study. For the adequate management of vaginal discharge, culturing is necessary if initial treatment fails. Guidelines should be amended according to these results.     

Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan – a multi-method study

Summary Perinatal depression, due to its high prevalence and associations with disability, poor infant development and family disruption, is a major public health problem in developing countries. In non-literate and poor communities where depression is not recognised and where there are no specialists, developing a culturally acceptable, deliverable psychological intervention that community members find useful, presents special challenges but also opportunities. We describe lessons learned from a multi-method formative study to develop and deliver a psychological intervention to depressed mothers and their infants through non-specialist village based health workers.     

Antiretroviral therapy: When and what to start—An American perspective

The major US treatment guidelines now recommend starting antiretroviral therapy (ART) later in the course of HIV infection because of an increasing awareness of the difficulties associated with these regimens. Most of the data to support this change come from observational cohort studies. When deciding to start ART, several patient-specific factors and other issues should be considered. Because of the many choices for initial ART, clinicians should individualize the choice, taking into account regimen antiretroviral potency, durability, side effects, toxicities, and convenience to ensure a sustained clinical benefit for the patient.     

Cognitive–affective strategies and cortisol stress reactivity in children and adolescents: Normative development and effects of early life stress

This study examined cognitive–affective strategies as predictors of hypothalamic–pituitary–adrenal (HPA) axis responses to a social-evaluative stressor in adolescence as compared to late childhood as a function of early life experiences. Participants included 159 children (9–10 years) and adolescents (15–16 years) divided into two groups based on early care experiences: non-adopted youth raised in their birth families (n = 81) and post-institutionalized youth internationally adopted from orphanage care (n = 78). Youth completed a version of the Trier Social Stress Test modified for use with children and reported on their trait emotion regulation and coping strategies. Children reported more use of suppression and disengagement than adolescents, while adolescents reported more engagement coping strategies. Non-adopted and post-institutionalized youth did not differ in reported strategies. Cognitive reappraisal predicted higher cortisol reactivity in non-adopted children and adolescents, and was not associated with reactivity in the post-institutionalized group. This study has implications for efforts aimed at promoting self-regulation and adaptive stress responses during the transition to adolescence for both typically developing children and children who experienced adverse early care.     

Blood lead levels and growth status among African–American and Hispanic children in Dallas,Texas – 1980 and 2002: Dallas Lead Project II

Objective: The purpose of this investigation is to analyze childhood blood lead levels and growth status (ages 2–12) in Dallas, Texas lead smelter communities in the 1980s and 2002, where smelters operated from 1936 to 1990.

Methods and materials: A sample of convenience study design was used in two cohorts (n=360): 1980–1989 (n=191) and 2002 (n=169). Multivariate analysis of variance and covariance and tandem multiple regressions were used to evaluate the association between stature and blood lead level in two time periods.

Results: In 2002 average child blood lead level (1.6 µg/dL±0.2 SE) was significantly (p<0.001) lower compared to the 1980 cohort mean level (23.6 µg/dL±1.3 SE). Average height and weight in 2002 were 4.5 cm and 4.0 kg greater, respectively, than in 1980. Lowered blood lead level was associated with 3.9 cm, 3.5 kg and 1.1 units greater height, weight and body mass index (BMI), respectively. Cohort effect was associated with greater height (0.6 cm), weight (0.5 kg) and BMI (0.1).

Conclusion: This investigation reports on child growth in a community before and after the transition from high to low blood lead levels over several decades. Using child growth as a proxy, health status of Dallas's lead smelter communities increased markedly over the past two decades, primarily because of lower blood lead levels, while the poverty rate was only marginally lower.     

Secular trends in cranial morphological traits: a socioeconomic perspective of change and sexual dimorphism in North Americans 1849–1960

Background: The human body has undergone significant changes in stature and other areas, which reflect secular trends associated with socioeconomics.

Aim: To analyse cranial morphological traits for deciphering if they are subject to secular trends.

Subjects and methods: Two documented skeletal collections were sampled for a total of 525 individuals from 1849–1960. Cranial morphological traits were scored and input into time series statistics (logistic regression).

Results: In females, nuchal crests have enlarged, while glabella has decreased. In males, supraorbital margins have dulled, while glabella decreased. Sexual dimorphism increased in supraorbital margins.

Conclusion: The patterns in the data here reflect those found in other areas of the skeleton, namely height, as regards to secular trends. These findings can be extended to stature and cranial changes that parallel socioeconomic trends during the Industrial Revolution, antebellum period and after.     

Endoplasmic reticulum stress and oxidative stress: a vicious cycle or a double-edged sword?

The endoplasmic reticulum (ER) is a well-orchestrated protein-folding machine composed of protein chaperones, proteins that catalyze protein folding, and sensors that detect the presence of misfolded or unfolded proteins. A sensitive surveillance mechanism exists to prevent misfolded proteins from transiting the secretory pathway and ensures that persistently misfolded proteins are directed toward a degradative pathway. The unfolded protein response (UPR) is an intracellular signaling pathway that coordinates ER protein-folding demand with protein-folding capacity and is essential to adapt to homeostatic alterations that cause protein misfolding. These include changes in intraluminal calcium, altered glycosylation, nutrient deprivation, pathogen infection, expression of folding-defective proteins, and changes in redox status. The ER provides a unique oxidizing folding-environment that favors the formation of the disulfide bonds. Accumulating evidence suggests that protein folding and generation of reactive oxygen species (ROS) as a byproduct of protein oxidation in the ER are closely linked events. It has also become apparent that activation of the UPR on exposure to oxidative stress is an adaptive mechanism to preserve cell function and survival. Persistent oxidative stress and protein misfolding initiate apoptotic cascades and are now known to play predominant roles in the pathogenesis of multiple human diseases including diabetes, atherosclerosis, and neurodegenerative diseases.     

Which aspects of socio-economic status are related to health in mid-aged and older women?

A population-based study was conducted to validate gender- and age-specific indexes of socio-economic status (SES) and to investigate the associations between these indexes and a range of health outcomes in 2 age cohorts of women. Data from 11,637 women aged 45 to 50 and 9,510 women aged 70 to 75 were analyzed. Confirmatory factor analysis produced four domains of SES among the mid-aged cohort (employment, family unit, education, and migration) and four domains among the older cohort (family unit, income, education, and migration). Overall, the results supported the factor structures derived from another population-based study (Australian Bureau of Statistics, 1995), reinforcing the argument that SES domains differ across age groups. In general, the findings also supported the hypotheses that women with low SES would have poorer health outcomes than higher SES women, and that the magnitude of these effects would differ according to the specific SES domain and by age group, with fewer and smaller differences observed among older women. The main exception was that in the older cohort, the education domain was significantly associated with specific health conditions. Results suggest that relations between SES and health are highly complex and vary by age, SES domain, and the health outcome under study. The research on which this article is based was conducted as part of the Australian Longitudinal Study on Women’s Health (Women’s Health Australia). Kylie Ball is supported by a Public Health Postdoctoral Research Fellowship from the Australian National Health and Medical Research Council, ID 136925.     

Chronic pain and cardiovascular stress responses in a general population: the Tromsø Study

We tested whether cardiovascular stress responsiveness is elevated in individuals experiencing chronic pain in a large general population sample. Blood pressure (BP) and heart rate (HR) were assessed at rest, during the cold pressor test, and during subsequent recovery in 554 individuals reporting daily chronic pain and 3,082 individuals free of chronic pain. After correcting for potential confounds, differences as a function of chronic pain status were noted for only 5 of 23 cardiovascular outcomes despite very high statistical power. Compared to the pain-free group, the chronic pain group displayed higher baseline HR/mean arterial pressure (MAP) ratio (p = .03), greater systolic BP (SBP) reactivity during the cold pressor test (p = .04), and higher HR/MAP ratio (p = .047) and significantly less SBP (p = .017) and MAP (p = .041) return to baseline during recovery. Findings suggest that changes in cardiovascular stress responsiveness associated with chronic pain are of limited clinical significance and unlikely to contribute to increased cardiovascular risk in the chronic pain population.     

Age and distress of women–results of a representative population-based study

Little research has been carried out on prevalence rates of distress (e.g. depression, posttraumatic stress symptoms (PTSS), hopelessness, and burnout) of women in different age groups. The aims of this study were to measure the prevalence rate of depression, posttraumatic stress symptoms, hopelessness, and burnout among women and to clarify the associations between age groups and distress. Cross sectional epidemiological study on women in Sweden (n = 6,000, aged 18–64 years, response rate 64.1%). Measures were questionnaires on socio-economic and work-related characteristics and on depression, posttraumatic stress symptoms, hopelessness, and burnout. Depression was measured with the “General Health Questionnaire” (GHQ), PTSS with the “Posttraumatic Symptom Scale”, hopelessness with the “Hopelessness Scale” and burnout with the “Shiron-Melamed Burnout Questionnaire” (SMBQ). The prevalence rate of depression varied from 12.5% to 14.1%; of posttraumatic stress symptoms from 23.5% to 33.3%; of hopelessness from 11.5% to 16%; and of burnout from 22.9% to 17.1%. Depression was not associated with age group. Hopelessness was associated with age group in univariate analysis bur not in multivariate analysis (OR = 0.7, 95% CI = 0.5–1.0). PTSS and burnout were associated with age group. Both symptoms were higher in the youngest age group, compared to the eldest age group (posttraumatic stress symptoms: OR = 1.6, 95% CI = 1.2, 2.1; burnout: OR = 1.5, 95% CI = 1.1–2.1). Younger women show higher prevalence rates of PTSS and burnout compared to elder women. The higher prevalence rates of PTSS and burnout among younger women may be associated with job strain and/or with violent life events.     

Socio-economic status of the patient and doctor–patient communication: does it make a difference?

This systematic review, in which 12 original research papers and meta-analyses were included, explored whether patients' socio-economic status influences doctor-patient communication. Results show that patients from lower social classes receive less positive socio-emotional utterances and a more directive and less participatory consulting style, characterised by significantly less information giving, less directions and less socio-emotional and partnership building utterances from their doctor. Doctors' communicative style is influenced by the way patients communicate: patients from higher social classes communicate more actively and show more affective expressiveness, eliciting more information from their doctor. Patients from lower social classes are often disadvantaged because of the doctor's misperception of their desire and need for information and their ability to take part in the care process. A more effective communication could be established by both doctors and patients through doctors' awareness of the contextual communicative differences and empowering patients to express concerns and preferences.