Correlates of Non-Concordance between Perceived and Objective Measures of Walkability

Background  Objective and self-reported physical environmental attributes have been related to physical activity. Purpose  We examined the characteristics of adults who are resident in objectively identified high walkable neighborhoods but whose perceptions of neighborhood attributes are not concordant with objective attributes relating to high walkability. Methods  Neighborhood built-environment attributes relating to walkability (dwelling density, intersection density, land use mix, and net retail area) were determined objectively, using Geographic Information System databases; data on corresponding perceptions of local environment attributes (from the Neighborhood Environment Walkability Scale) were derived from a self-completion survey of a socially diverse sample of 2,650 adults aged 19 to 65. Objective and perceived walkability attributes were categorized using median splits, and correlates of non-concordance were determined using multiple logistic regression models. Results  There was a fair overall agreement between objectively determined walkability and perceived walkability (Kappa = 0.35, 95% CI = 0.31–0.39). Among those resident in objectively assessed high walkable areas (n = 1,063), 32.1% perceived them to be low walkable; conversely, 32.7% (n = 1,021) resident in objectively determined low walkability areas perceived them to be high. For residents of objectively determined high walkable areas, the characteristics that differentiated those with perceptions of low walkability (non-concordant perceptions) from those with concordant perceptions of high walkability were: not being university-educated (OR = 1.47, 95% CI = 1.06–2.04); having lower household incomes (OR = 1.54, 95% CI = 1.09–2.17); being overweight (OR = 1.46, 95% CI = 1.03–2.07); and walking fewer days per week for transport (OR = 1.75, 95% CI = 1.11–2.70). Higher walking times and more positive cognitive variables were noted among participants who lived in a neighborhood with low walkability that was perceived as high compared to those who lived in a high walkable environment that was perceived as low walkable. Conclusion  Adults with lower educational attainment and lower incomes, who were overweight, or who were less physically active for transportation purposes, were more likely to misperceive their high walkable neighborhood as low walkable. There is the potential for physical activity promotion and persuasion strategies to address non-concordant perceptions, especially among those who live in high walkable environments but perceive them to be low and also among those who are socially disadvantaged and are less active. Perceptions of environmental attributes may be more strongly correlated with cognitive antecedents and with behavior than are objective measures.     

Suicide attempts by psychiatric patients in acute inpatient, long-stay inpatient and community care

Background: This study examined rates of and risk factors associated with suicide attempts by psychiatric patients under active care. It was especially focussed on the relative rates across three standard treatment settings: acute inpatient care, long-stay inpatient care and community-based care. Methods: A total of 12,229 patients in 13,632 episodes of care were rated on the Health of the Nation Outcome Scales (HoNOS) Item 2. For the purposes of the current investigation, a score of 4 was deemed to indicate a suicide attempt. Results: Incidence densities per 1000 episode days were 5.4 (95% CI = 4.8–6.1) for patients under care in acute inpatient settings, 0.6 (95% CI = 0.5–0.8) for patients under care in long-stay inpatient settings, and 0.5 (95% CI = 0.5–0.6) for patients under care in community-based arrangements. Predictors varied by treatment setting. Risk was elevated for personality disorders across all settings: 22.7 attempts per 1000 episode days (95% CI = 17.2–30.0) in acute inpatient care; 2.1 (95% CI = 1.0–4.5) in long-stay inpatient care; and 2.3 (95% CI = 1.7–3.0) in community-based care. This effect remained after adjustment for demographics. Conclusion: Rates of suicide attempts among psychiatric patients are a major issue facing contemporary mental health care systems, and risk factors vary across different treatment settings. Accepted: 8 October 1999     

Is grand multiparity associated with offsprings' hospital-treated mental disorders? A 28-year follow-up of the North Finland 1966 birth cohort

Background: A child born to a grand multiparous (GMP) mother (i.e. a mother who has undergone six or more deliveries) is at increased risk of perinatal complications, but it is not known whether or not GMP status is associated with child's adulthood mental disorders. Methods: The data were obtained from the unselected, general population Northern Finland 1966 Birth Cohort (n = 11,017). The cohort members (children) were followed up prospectively to the age of 28 years. Using the National Hospital Discharge Register, a total of 89 DSM-III-R schizophrenia cases were identified, as well as 55 other psychoses, 87 personality disorders, 36 cases of alcoholism, 53 depressive disorders, and 67 anxiety and other non-psychotic disorders. The association between the mother's grand multiparity and the offspring's adult hospital-treated psychiatric morbidity was analysed using a continuation ratio model, which is a modification of logistic regression. Odds ratios were adjusted for social class, maternal antenatal depression, and wantedness of pregnancy. Results: A total of 1320 mothers (12%) were GMPs. Maternal GMP status was not associated with offspring's schizophrenia, anxiety or other non-psychotic disorders. The risk of other psychoses (OR 2.3; 95% CI 1.2–4.7), alcoholism (OR 2.0; 95% CI 0.8–4.7) and depressive disorder (OR 2.2; 95% CI 1.0–4.5) was elevated among offspring of GMP mothers. Conclusions: It is possible that the mother's GMP status and the large family size associated with this are causal factors in the development of other psychoses than schizophrenia, alcoholism and depression among adult offspring. Accepted: 20 December 1999     

Physical activity and sleep problems in 38 low- and middle-income countries

ObjectiveAlthough physical activity (PA) is associated with a reduction of a wide range of sleep problems, it remains uncertain whether complying with the international guidelines of 150 min of moderate to vigorous PA per week can reduce sleep problems in adults. This research investigated the relationship between compliance with the PA recommendations of the World Health Organization and sleep problems in 38 low- and middle-income countries (LMICs).MethodsCross-sectional, community-based data from the World Health Survey were analyzed. Adjusted logistic regression analyses were undertaken to explore the relationship between PA levels using the International Physical Activity Questionnaire and self-reported sleep problems (such as difficulties falling asleep, waking up frequently during the night or waking up too early in the morning) in the last 30 days.ResultsAcross 204,315 individuals (38.6 ± 16.1 years; 49.3% males), the overall prevalence (95% CI) of low PA and sleep problems were 29.9% (29.1–30.8%) and 7.5% (7.2–7.9%), respectively. After adjusting for socio-demographics, obesity, chronic physical conditions, depression, and anxiety; not complying with PA recommendations was associated with higher odds for sleep problems overall [odds ratio (OR) = 1.23, 95% CI = 1.10–1.38] as well as across the entire age range: 18–34 years (OR = 1.26; 95% CI = 1.02–1.57); 35–64 years (OR = 1.17; 95% CI = 1.01–1.35); and age ≥65 years (OR = 1.40; 95% CI = 1.11–1.76).ConclusionsNot complying with international PA recommendations is associated with higher odds of sleep problems, independently of depression and anxiety in LMICs. Future longitudinal and interventional studies are warranted to assess whether increasing PA levels may improve sleep problems in this setting.     

Mental health status and related characteristics of Chinese male rural-urban migrant workers

To explore mental health status and related characteristics in a sample of Chinese male rural–urban migrants. Subjects were 1,595 male rural–urban migrant workers selected though a multi-stage sample survey conducted in two cities (Hangzhou and Guangzhou). Data were collected by means of a self-administered questionnaire. Both life and work stressors were examined. Stress and mental health status were measured by the Chinese Perceived Stress Scale (CPSS) and the Chinese Health Questionnaire (CHQ), respectively. Unconditional logistic regression analysis was performed to identify factors associated with probable mental disorders. There are approximately 120 million rural–urban migrants in China. The prevalence of probable mental disorders in the sample population was 24.4% (95% CI: 23.3–25.5%), which was higher than among urban residents (20.2%, 95% CI: 18.8–21.7%). Logistic regression analysis revealed that five characteristics were positively associated with risk for probable mental disorders: originating in the South (OR = 2.00; 95% CI = 1.02, 4.00), higher life stress (OR = 7.63; 95% CI = 5.88, 10.00), staying in the city for 5–9 months each year (OR = 2.56; 95% CI = 1.67, 3.85), higher work stress (OR = 2.56; 95% CI = 1.96, 3.33), and separation from wife (OR = 2.43; 95% CI = 1.61, 3.57). Employment in machinery and transportation (OR = 0.54; 95% CI = 0.36, 0.81) and higher self-worth (OR = 0.42; 95% CI = 0.28, 0.62) were negatively associated. Findings support an urgent need to develop specific policies and programs to address mental health problems among Chinese rural–urban migrants.     

Platelet decline as a predictor of brain injury in HIV infection

An association between platelet decline and increased risk of progression to dementia has been observed in an advanced HIV infection cohort study. This investigation evaluated the prognostic significance of platelet decline for dementia, for psychomotor slowing, and for brain injury, as quantified in vivo, in a much larger population of HIV+ men. Platelet counts and neurocognitive data were available from biannual visits of 2,125 HIV+ men participating in the prospective, Multicenter AIDS Cohort Study from 1984 to 2009. Brain volumetric data were also available from an imaging substudy of 83 seropositive participants aged 50 and older. The association of platelet counts with neurocognitive outcome was assessed using Cox proportional hazard models where change in platelet count from baseline was a time-updated variable. Marked platelet decline was associated with increased risk of dementia in univariate analysis (hazard ratio [HR] = 2.5, 95% confidence interval [CI] = 1.8–3.5), but not after adjustment for CD4 cell count, HIV viral load, age, study site, hemoglobin, race, education, smoking, and alcohol use (HR = 1.4, 95% CI = 0.78–2.5). Platelet decline did not predict psychomotor slowing in either univariate (HR = 0.79, 95% CI = 0.58–1.08) or multivariate (HR = 1.10, 95% CI = 0.73–1.67) analysis. Analysis of brain volumetric data, however, indicated a relationship between platelet decline and reduced gray matter volume fraction in univariate (p = 0.06) and multivariate (p < 0.05) analyses. Platelet decline was not an independent predictor of dementia or psychomotor slowing, after adjusting for stage of disease. Findings from a structural brain imaging substudy of older participants, however, support a possible relationship between platelet decline and reduced gray matter.     

Investigation of TNFA 308G > A and TNFB 252G > A polymorphisms in genetic susceptibility to migraine

We aimed to look for the association of tumor necrosis factor (TNF) gene polymorphisms (TNFA 308G > A, and TNFB 252G > A) in genetic susceptibility to migraine. The pathogenesis of migraine involves many immune-mediated mechanisms in the vascular endothelium. TNF, being a potent immunomodulator and pro-inflammatory cytokine, is suggested to be involved in inflammatory reactions leading to migraine attacks. A total of 216 normotensive migraine patients, 160 tension type headache (TTH) patients and 216 healthy controls (HC) were recruited in the study. The genetic polymorphisms were investigated through SNP association analysis using a matched case control migraine population. Genotyping of TNFA 308G > A polymorphism and TNFB 252G > A was done using ARMS PCR and PCR–RFLP, respectively. A borderline association was observed in TNFA 308GA genotype in migraine patients versus HC (p = 0.043; OR = 1.763; 95% CI = 1.019–3.051). After sub-grouping migraine into migraine with aura (MA) or without aura, significant difference at genotypic (p = 0.015; OR = 2.293; 95% CI = 1.172–4.487) as well as allelic (p = 0.035; OR = 1.955; 95% CI = 1.047–3.651) level was evident. The difference was even more significant in female MA at genotypic (p = 0.006; OR = 2.901; 95% CI = 1.361–6.181) and allelic level (p = 0.017; OR = 2.318; 95% CI = 1.159–4.635) as well as for A allele carriers in MA [p value = 0.020; OR = 2.205 (1.132–4.295)] and female MA (p value = 0.008; OR = 2.741; CI = 1.297–5.792). No association of TNFB252G > A was observed in migraine patients or any subgroups. We did not find any association of TNFA or TNFB gene polymorphisms with TTH. In conclusion, the TNFA 308G > A polymorphism was found to be associated with MA, particularly in females, whereas we could not find any association of TNFB 252G > A polymorphism in genetic susceptibility to migraine on comparing the migraine patients with HC or TTH patients.     

Comparing Psychosocial Predictors of Physical Activity Adoption and Maintenance

Background   Most health behavior models do not distinguish between determinants of behavior adoption and maintenance. Purpose   This study compared psychosocial predictors of physical activity (PA) adoption and predictors of PA maintenance among 205 initially sedentary adults enrolled in a home-based PA promotion trial. Methods   Psychosocial variables were measured at 6 months (at which point 107 participants remained inactive and 98 participants adopted regular PA) and used to predict 12-month PA status (an indicator of PA adoption among those inactive at 6 months and an indicator of PA maintenance among those active at 6 months). Results   Six-month PA status moderated the relationships between 6-month measures of home access to PA equipment (p = .049), self-efficacy (p = .086), and perceived satisfaction (p = .062) and 12-month PA status. Simple effects analyses revealed that home access to PA equipment was predictive of PA adoption (OR = 1.73; 95% CI: 1.05, 2.85), but not PA maintenance (OR = 0.88; 95% CI: 0.58, 1.35), whereas self-efficacy and perceived satisfaction were predictive of PA maintenance (OR = 2.65; 95% CI: 1.55, 4.52; OR = 1.95; 95% CI: 0.93, 4.06), but not PA adoption (OR = 1.50; 95% CI: 0.87, 2.57; OR = 0.82, CI: 0.44, 1.52). Conclusion   Results suggest that these psychosocial variables may operate differently in predicting PA adoption versus maintenance.     

Analysis of association between bleomycin hydrolase and apolipoprotein E polymorphism in Alzheimer’s disease

Alzheimer’s disease (AD) is the leading cause of dementia. Several studies indicate a possible relationship between different genes and Alzheimer’s disease. To further investigate, we have analyzed the association between the bleomycin hydrolase (BLMH) and apolipoprotein E (ApoE) polymorphisms in 93 AD patients and age- and sex-matched 113 controls from the Tunisian population. The frequency of ApoE epsilon 4 allele was found to differ significantly in AD patients compared to the control [29.5% vs. 8.8 (χ ² = 26, df = 1, p < 0.001)] leading to an increased risk of AD in subjects with this allele (OR = 3.29, 95% CI = 1.7–6.5; p = 0.001]. This risk was found to decrease from OR = 8.4, CI = 3.3–23; p < 0.001 in subjects less than 75 years old to OR = 1.2, CI = 1.031–14; p = 0.0297 in subjects 75 years and older. No association was observed between carrying the BLMH-G genotype and AD in ε4 negative or positive subjects.     

Self-reported psychosis-like symptoms and the continuum of psychosis

Background: It has been suggested that psychotic symptoms may be distributed along a continuum that extends from normality through depressive states to schizophrenia with increasing level of severity. This study examined the hypothesis that the severity of positive psychotic symptoms increases from normality, through depression/anxiety states to clinical psychosis. Methods: Consecutive general practice attenders completed a self-report questionnaire of 24 items of delusional ideation and hallucinatory experiences and the GHQ-12. The following groups were compared: (1) subjects with a diagnosis of psychosis (n = 57), (2) GHQ cases (n = 245), and (3) GHQ non-cases (n = 378). Results: Quantitative differences were apparent in the great majority of items on delusional ideation and hallucinatory experiences, in that normals scored lowest, psychosis patients scored highest and GHQ cases scored in between. This pattern of differences was apparent for all dimensions of psychosis-like experiences, including the more “schizophrenic” ones, with the exception of Grandiosity (GHQ cases similar to normals) and Paranormal Beliefs (no differences between the three groups). Conclusions: Similar to findings in aetiological research, phenotypic differences between normal controls, patients with anxiety/depression and patients with psychosis appear quantitative rather than qualitative for core dimensions of psychosis. Accepted: 15 June 1999     

Self-reported depressive symptoms among Chinese adolescents

Previous reports on the prevalence and features of depression among adolescents have been inconsistent. The purpose of the current study was to estimate the prevalence of depression among Chinese adolescents with a standardized instrument. A total of 2462 students, aged 13–22, were sampled from the Shandong province of China. The Zung Self-Rating Depression Scale (SDS) was administered to the subjects in their classrooms. It was shown that the mean SDS score was 44.8 (SD 9.9) and it decreased significantly from the age of 18 upward (F = 31.73, df = 9, P < 0.01). No significant difference was found between males and females (t = 0.70, P > 0.05). Taking 55 as a cut-off score, the prevalence rate of depression was 16.9% (95% CI = 15.4–18.4%). Logistic regression showed that increasing age appeared to decrease the risk for depression. Most of the individual items differed between ages, except for weight loss and constipation. Principal components factor analysis revealed that the characteristics of adolescent depression were depressive/anxious mood, psychomotor retardation, loss of self-esteem, somatic symptoms and decreased appetite and libido. Although the study was based on a large sample using an established instrument, the sample was not from a general adolescent population and case ascertainment was not by clinical diagnosis. Accepted: 25 May 1998     

Association of NAD(P)H:Quinone Oxidoreductase 1 Polymorphism and Alzheimer’s Disease in Chinese

Several lines of evidence support a role of oxidative stress in the pathology of Alzheimer’s disease (AD). NAD(P)H:quinone oxidoreductase 1 (NQO1) catalyzes the two-electron reduction of quinones, preventing their participation in redox cycling and subsequent generation of reactive oxygen species. We examined association between the NQO1 C609T gene polymorphism and sporadic AD in a Chinese population comprising 311 AD patients and 330 controls. Our results showed a higher T-allele frequency in the AD cases compared with the controls. The difference was close to but did not reach statistically significant level [p = 0.059; odds ratio (OR) T versus C = 1.236; 95% confidence interval (95% CI), 0.992–1.540]. A significantly low C/C genotype frequency in the AD cases compared with the controls was detected (p = 0.025; OR C/C versus C/T + T/T = 0.674; 95% CI, 1.049–2.098) and APOE ε4 status analysis revealed significant difference in the APOE ε4 non-carriers (p = 0.036; OR = 0.633; 95% CI, 1.027–2.427). In the ≥65 years samples, significantly low C/C frequency in the AD cases in comparison with the controls was observed in the APOE ε4 non-carriers (p = 0.045; OR = 0.595; 95% CI, 1.010–2.794). These results indicated that the C/C genotype had a possible protective effect against AD development, and the T allele might be a weak risk factor for late onset AD. J-T Bian and H-L Zhao contributed equally to the work.     

Prevalence of and Associations with Waterpipe Tobacco Smoking among U.S. University Students

Background  Although waterpipe tobacco smoking seems to be increasing on U.S. university campuses, these data have come from convenience samples. Purpose  We aimed to determine the prevalence of and associations with waterpipe tobacco smoking among a random sample of students. Methods  We surveyed a random sample of graduate and undergraduate students at a large, urban university. We used multivariate modeling to determine independent associations between belief-related predictors and waterpipe tobacco smoking. Results  Of the 647 respondents, waterpipe smoking was reported in 40.5%, over the past year in 30.6%, and over the past 30 days in 9.5%. Over half of the sample (52.1%) perceived that tobacco smoking from a waterpipe was less addictive than cigarette smoking. In fully adjusted multivariate models, 1-year waterpipe smoking was associated with low perceived harm (OR = 2.54, 95% CI = 1.68, 3.83), low perceived addictiveness (OR = 4.64, 95% CI = 3.03, 7.10), perception of high social acceptability (OR = 20.00, 95% CI = 6.03, 66.30), and high perception of popularity (OR = 4.72, 95% CI = 2.85, 7.82). Conclusions  In this sample, lifetime waterpipe use was as common as lifetime cigarette use. Perception of harm, perception of addictiveness, social acceptability, and popularity were all strongly related to waterpipe smoking.     

<Emphasis Type="Italic">PEMT</Emphasis> G523A (V175M) Is Associated with Sporadic Alzheimer's Disease in a Chinese Population

There is evidence that increased concentrations of circulating homocysteine are associated with Alzheimer's disease (AD). Phosphatidylethanolamine N-methyltransferase (PEMT) is an important catalyst involved in the production of homocysteine. We investigated the association of a functional single nucleotide polymorphism (rs7946) in PEMT with sporadic AD risk in a Han Chinese population that included 386 AD patients and 366 controls. PEMT G523A was genotyped by either sequencing or PCR-restriction fragment length polymorphism analysis. The plasma homocysteine concentrations of 210 subjects were determined by high-performance liquid chromatography. Significant higher frequency of the A allele was detected in AD cases than in controls (A vs. G, p = 0.007, OR = 1.482, 95% CI 1.114–1.972). After adjusting for gender, age/age at onset, and APOE ε4 status, logistic analysis showed rs7946 was associated with AD in a dominant model (AA + GA vs. GG, p = 0.007, OR = 1.596, 95% CI 1.138–2.240). When stratified by APOE ε4 status or gender, the significant difference was only observed in the APOE ε4 non-carriers and in the female subjects, respectively. We did not find a relationship of this polymorphism with plasma homocysteine levels. These results suggested that PEMT G523A is associated with AD and that the A allele is an APOE ε4-independent risk factor for AD among Han Chinese women.     

Social class of origin and cardinal symptoms of schizophrenic disorders over the early illness course

  Background: This study describes the relationship of social class of origin to cardinal symptoms of schizophrenic disorders over the early illness course. Method: The sample of subjects was drawn from the Suffolk County Mental Health Project, a longitudinal epidemiologic study of first-hospitalized subjects with psychotic disorders; the present study focused on patients with schizophrenic disorders. At baseline, subjects were dichotomized into upper/middle and lower social class of origin groups, based on occupation of the head of the household of origin. The patients in both groups were assessed for the major symptoms of schizophrenic disorders using standard structured instruments at both baseline and 6-month follow-up. The 6-month symptom severity levels were compared between the groups, controlling for baseline symptom status and potential confounders. Results: At 6-month follow-up, the upper/middle social class of origin group, as compared to the lower social class of origin group, had lower symptom levels for hallucinations (adjusted OR = 4.88, χ² = 8.49, P = 0.004) and delusions (adjusted OR = 2.46, χ² = 4.16, P = 0.04). There were no notable group differences for any of the negative or thought disorganization symptoms. Conclusions: Social class of origin is associated with positive symptoms of schizophrenia over the early illness course. Accepted: 10 November 1999     

Adult attention deficit hyperactivity disorder is associated with migraine headaches

Attention deficit hyperactivity disorder (ADHD) is now recognized as a common disorder both in child and adult psychiatry. Adult patients with a diagnosis of ADHD (n = 572) and community controls (n = 675) responded to auto-questionnaires rating past and present symptoms of ADHD, co-morbid conditions, including migraine, treatment history and work status. The prevalence of migraine was significantly higher in the patient group compared to the controls (28.3% vs. 19.2%, P < 0.001, OR = 1.67, CI 1.28–2.17). The difference from controls was particularly marked for men (22.5% vs. 10.7%, P < 0.001, OR = 2.43, CI 1.51–3.90) but was also significant for women (34.4% vs. 24.9%, P = 0.008, OR = 1.58, CI 1.13–2.21). In both patients and controls, migraine was associated with symptoms of mood and anxiety disorders. These findings point to a co-morbidity of migraine with ADHD, and it is possible that these patients represent a clinical and biological subgroup of adult patients with ADHD.     

Antidepressant Adequacy and Work Status Among Medicaid Enrollees with Disabilities: A Restriction-based,Propensity Score-adjusted Analysis

This cross-sectional study of adult survey respondents with disability and depression (n = 199) enrolled in Massachusetts’ Medicaid program examined the association of adequately or inadequately prescribed antidepressant treatment and self-reported work status using conditional logistic regression, controlling for age, gender, race, marital status, education, receipt of SSI/SSDI, self-reported disabling condition, and health status. Confounding by severity was addressed by two methods: restriction of our sample and subsequent stratification by propensity score. Individuals receiving adequate antidepressant treatment had an increased odds of working compared to individuals receiving inadequate treatment, both in analyses in which restriction was used to limit confounding (OR = 3.45, 95% CI = 1.15–10.32, P < .03), and in analyses which combined restriction with adjustment by propensity score stratification (OR = 3.04, 95% CI = 1.01–9.62, P < .05). Among this sample of Medicaid enrollees with disability and depression, those receiving adequate antidepressant treatment were significantly more likely to report working.     

Analyzing Theoretical Mechanisms of Physical Activity Behavior Change in Breast Cancer Survivors: Results from the Activity Promotion (ACTION) Trial

Background We previously reported that a physical activity (PA) behavior change intervention based on the theory of planned behavior (TPB) increased PA and quality of life in breast cancer survivors. Purpose To examine the effects of our interventions on TPB variables and to determine if PA at 12 weeks follow-up was mediated by TPB variables at 4 weeks. Methods Breast cancer survivors (N = 377) were randomly assigned to receive either a standard public health recommendation for PA (SR group), a step pedometer alone, or one of two TPB-based behavior change interventions consisting of print materials (alone or combined with a step pedometer). For the purpose of this study, we compared the two TPB-based intervention groups (INT group) to the SR group. Results Compared to the SR group, the INT group reported more favorable changes in instrumental attitude (mean difference = 0.13; 95% CI = −0.01 to 0.23; d = 0.19; p = 0.077), intention (mean difference = 0.33; 95% CI = 0.10 to 0.56; d = 0.33; p = 0.006), and planning (mean difference = 0.39; 95% CI = 0.04 to 0.73; d = 0.26; p = 0.027). Mediation analyses indicated that both planning and intention partially mediated the effects of the intervention on PA at 12 weeks. Conclusions Our TPB-based behavior change intervention resulted in small improvements in the TPB constructs that partially mediated the effects of our intervention on PA behavior. Additional research with the TPB is warranted.     

Loneliness and cardiovascular disease and the role of late‐life depression

Objective

Loneliness and depression have a strong reciprocal influence, and both predict adverse health outcomes at old age. Therefore, this study examines whether loneliness is associated with the presence of cardiovascular diseases taking into account the role of late‐life depression.

Methods

Cross‐sectional data of 477 older adults in the Netherlands Study of Depressed Older Persons were used. Logistic regression analysis was performed to examine the relation between loneliness and cardiovascular disease. Depression was added to the regression model to examine whether depression is an explanatory factor in the association between loneliness and cardiovascular disease. Interaction terms between loneliness and depression and between loneliness and sex were introduced in the regression model to investigate whether depressed and non‐depressed participants, and men and women differed in their association between loneliness and cardiovascular disease.

Results

Of the overall group, 61% were lonely, 28% had a history of cardiovascular disease and 74% were depressed. Loneliness and cardiovascular disease were not associated in the overall group after adjustment for confounders (continuous: odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.98–1.10), p = 0.25; dichotomous: OR = 1.27, 95% CI = 0.80–2.03, p = 0.32). For women, there was an association between loneliness and cardiovascular diseases (continuous: OR = 1.13, 95% CI = 1.06–1.21, p < 0.001; dichotomous: OR = 2.64, 95% CI = 1.50–4.65, p = 0.001), but this association was not present in men (OR = 0.96, 95% CI = 0.88–1.05, p = 0.38). This association remained significant after adjustment for confounders, but it lost significance after adding depression to the model.

Conclusion

For women only, there was an association between loneliness and cardiovascular disease. However, this association was explained by depression, indicating that loneliness in its own right seems not related with cardiovascular disease. Copyright © 2017 John Wiley & Sons, Ltd.     

Association Between the G1001C Polymorphism in the GRIN1 Gene Promoter and Schizophrenia in the Iranian Population

Schizophrenia is a complex genetic disorder to which genetic variation in the glutamatergic signaling pathways is believed to play a substantial role in the etiology of the disease. Association studies have implicated the N-methyl-d-aspartate receptor subunit gene, GRIN1, as a candidate gene for schizophrenia. In this report, we used a case control study to establish the possible association between the G1001C polymorphism in the GRIN1 gene promoter region and schizophrenia in an Iranian cohort of 200 unrelated patients and 200 controls. The allelic and genotypic frequencies of the polymorphism were determined using polymerase chain reaction restriction fragment length polymorphism. Data analysis using logistic regression and the Mantel–Haenszel chi-square test revealed a strong association between the G1001C polymorphism and schizophrenia (CG genotype: odds ratio (OR) = 2.12, 95% confidence interval (CI) 1.34–3.48, P = 0.001 and CC genotype: OR = 29.10, 95% CI 3.40–565.78, P < 0.001). Furthermore, the C allele is significantly associated with an increasing risk of schizophrenia. An erratum to this article can be found at