The Role of Cultural and Family Values on Social Connectedness and Loneliness among Ethnic Minority Elders

Objectives: Ethnic minority elders have high levels of social isolation and loneliness. Assumptions about the family providing enough social support exist in the literature, contradicting ethnic minority elders’ reported levels of isolation and loneliness. While structural barriers influence feelings of isolation and loneliness, limited information exists about the role of cultural factors such as acculturation and family values. Accordingly, this study investigated the roles of acculturation and family values on loneliness and social isolation among ethnic minority elders.

Methods: Ethnic minority elders (N = 123) completed a questionnaire that assessed their social connectedness, measured by social network and levels of loneliness, and structural factors such as income. Additionally, cultural and family values were assessed by acculturation and the ‘family as referents’ dimension of familism, which refers to the belief that family members’ behaviour should meet with familial expectations.

Results: Statistical analysis using hierarchical regression indicated that ‘family as referents’ and acculturation predicted loneliness, but not social network.

Conclusions: This study raises the importance of considering cultural values when investigating predictors of loneliness among ethnic minority elders.

Clinical Implications: Findings highlight the importance of addressing familial expectations in programs aimed at alleviating loneliness among ethnic minority elders.     

Environmental Determinants of Smoking Behaviors: The Role of Policy and Environmental Interventions in Preventing Smoking Initiation and Supporting Cessation

Tobacco control strategies have contributed to substantial declines in smoking in the United States. However, smoking still remains the single largest preventable cause of disease and premature deaths in the country. Despite the continuing challenges of implementing tobacco control strategies and the pervasive influence of the tobacco industry to undermine such strategies, there are now unprecedented opportunities to prevent smoking initiation, facilitate cessation, and protect nonsmokers from secondhand smoke. In this paper, we briefly review the most recent literature discussing key strategies that have proven effective in tobacco control including regulations on marketing and sales of tobacco products, taxation, and smoke-free legislation. We focused on these 3 tobacco control strategies because of their potential to positively influence the environment of both minors and adults regardless of their smoking status. Although research has identified significant individual and social predictors of tobacco use, environmental influences are also important risk factors for tobacco use.     

Association between short sleeping hours and overweight in adolescents: results from a US Suburban High School survey

Insufficient sleep may lead to adverse health effects, influencing body weight. This study quantified the prevalence of short sleep and the association between sleep duration and overweight in a sample of suburban students. Cross-sectional study was conducted in 2004, involving 529 students from Bay High School, Bay Village, OH, USA, using self-administered questionnaires assessing lifestyle and sleep behaviors. Students with a body mass index Z Score >85th percentile for sex and age were deemed overweight. Ninety percent of students reported average sleep time less than 8 h on school nights, with 19% reported less than 6 h of sleep per night. Twenty percent of the sample were overweight. Overweight was significantly associated with the male gender, increased caffeine consumption, and short sleep duration. Compared with students sleeping >8 h, the age and gender-adjusted odds ratio of overweight was 8.53 (95% CI: 2.26, 32.14) for those with <5 h sleep (P = 0.0036); 2.79 (1.03, 7.55) for those with 5–6 h sleep; 2.81 (1.14, 6.91) for those with 6–7 h sleep; and 1.29 (0.52, 3.26) for those with 7–8 h sleep. Short sleep duration was common and associated with overweight with evidence of a “dose–response” relationship. These results confirm a high prevalence of short sleep among suburban high school students and provide additional support suggesting significant association between short sleeping hours and overweight. There are no financial disclosures from any of the authors.     

Ethnic (Black‐White) Contrasts in 24‐Hour Heart Rate Variability in Male Adolescents with High and Low Blood Pressure: The Bogalusa Heart Study

Background: Heart rate variability (HRV) has been used to study autonomic effects on the heart. The time‐domain measure RMSSD (root mean square of successive differences) represents high frequency (HF) changes in HRV reflecting parasympathetic nervous system activity (PS). The frequency‐domain ratio of low to high power (LF/HF) represents sympathetic (SYMP) to PS balance. In adults, increased SYMP tone has been found in hypertensive as compared to normals. The present study was performed to look for differences in HRV by race and between young subjects with high and low levels of diastolic blood pressure (DBP). Methods: Subjects included 34 healthy males age 13–17 years (53% white). Half were selected with K4 DBP < 85th% for height (HT) measured twice, 3–5 years apart. Half had DBP < 15th% for HT. Subjects underwent a physical examination including BP, HT, WT, and ECG prior to Holter monitor application. HRV data was analyzed from 24‐hour Holter recordings obtained during normal activity. Results: The RMSSD was lower in whites compared to blacks for day, night, and 24‐hour average (P ≥ 0.05) with day‐time measurements showing the largest racial difference. This suggests increased PS tone in blacks especially with activity. The LF/HF ratio was higher in whites for all times, reaching significance during the day (all P ≥ 0.05) suggesting SYMP predominance in whites during activity. Subjects with higher levels of DBP had lower RMSSD and higher LF/HF ratio for all times, but these did not reach statistical significance. Conclusions: There is a trend towards SYMP predominance in children with higher DBP. Healthy white adolescents exhibit increased SYMP tone compared to blacks when measured during normal daytime activity.     

Maternal Mental Health and Childhood Asthma among Puerto Rican Youth: The Role of Prenatal Smoking

Rationale. Childhood asthma is a major public health problem, with mainland and island Puerto Rican children having the highest asthma rates of any ethnic group in the United States. Objectives. To examine the relationship between maternal mental health problems, prenatal smoking, and risk of asthma among children in Puerto Rico and the Bronx, New York. Methods. A cross-sectional community-based study was conducted in the South Bronx in New York City and the San Juan Standard Metropolitan Area in Puerto Rico. Participants were Puerto Rican children 5 to 13 years of age and their adult caretakers with probability samples of children 5 to 13 years of age and their caregivers drawn at two sites: the South Bronx in New York City (n = 1,135) and San Juan and Caguas, Puerto Rico (n = 1,351). Measurements. Self-reported maternal mental health, prenatal smoking, and rates of childhood asthma. Results. Maternal mental health problems were associated with significantly higher levels of prenatal smoking, compared with that among women without mental health problems (p < 0.0001). Both maternal mental health problems and prenatal smoking appear to make a contribution to increased odds of asthma among youth. After adjusting for prenatal smoking, the relationship between maternal mental health problems and childhood asthma was no longer statistically significant. Conclusions. Previous research suggests children of Puerto Rican descent are especially vulnerable to asthma. Our results suggest that maternal mental health problems and prenatal smoking are both associated with increased odds of asthma among Puerto Rican youth and that prenatal smoking may partly explain the observed relationship between maternal psychopathology and childhood asthma. Future longitudinal and geographically diverse epidemiological studies may help to identify the role of both maternal mental health problems and prenatal smoking in the health disparities in childhood asthma.     

The Role of Smoking in Allergy and Asthma: Lessons from the ECRHS

The European Community Respiratory Health Survey is an international multicenter cohort study of asthma, allergy, and lung function that began in the early-1990s with recruitment of population-based samples of 20- to 44-year-old adults, mainly in Europe. The aims of the study are broad ranging but include assessment of the role of in utero exposure to tobacco smoke, exposure to environmental tobacco smoke, and active smoking on the incidence, prevalence, and prognosis of allergy and asthma. Cross-sectional and longitudinal analyses looking at these associations have been conducted, sometimes only using information collected in one country, and on other occasions using information collected in all the participating centers. This article summarizes the results from these various publications from this large epidemiologic study.     

Parental Monitoring as a Moderator of the Effect of Family Sexual Communication on Sexual Risk Behavior Among Adolescents in Psychiatric Care

Authors examined if parental monitoring moderated effects of family sexual communication on sexual risk behavior among adolescents in psychiatric care. Seven hundred and eighteen parents reported upon quality of family discussions about sex-related topics and degree to which they monitor teen behavior. Adolescents reported the frequency of their own safe sex practices. Parental monitoring moderated the family communication quality–sexual risk behavior relationship among African American families. African American parents who perceived themselves as capable of open family sexual communication and frequent monitoring had adolescents who reported decreased sexual risk behavior. The moderator model was not supported among Caucasian and Hispanic families and findings did not depend upon gender. For African Americans, findings support the influential role of family processes in development of teen sexual risk behavior and suggest, for parents of teens receiving mental health services, learning communication and monitoring skills may be critical to their adolescent’s sexual health.     

Transition Readiness in Adolescents and Emerging Adults with Diabetes: The Role of Patient-Provider Communication

Transition from pediatric to adult care represents a high risk period for adolescents and emerging adults with diabetes. Fundamental differences between pediatric and adult care delivery models may contribute to increased risk for poor health outcomes. This review provides a brief overview of models of care in pediatric and adult settings and focuses on patient-provider communication content and quality as potential points of intervention to improve transition-related outcomes. This review also highlights disparities in transition and communication for adolescents and emerging adults from racial/ethnic minority groups and discusses recent changes in health care legislation that have significant implications for the transition process. Intervention opportunities include programs to enhance developmentally-appropriate patient-provider interactions and increased attention to promoting transition readiness skills. Improving patient-provider communication may hasten the development of vital self-advocacy skills needed in adult health care systems and, thus, help establish a lasting pattern of positive diabetes self-care.     

The Critical Role of Intimacy in the Sexual Risk Behaviors of Gay and Bisexual Men

Research indicates that high numbers of gay and bisexual men report infrequent or inconsistent condom use, placing them at risk for HIV and other STDs. The present study examined positive and negative condom-related attitudes along three dimensions—risk reduction, pleasure reduction, and intimacy interference—and examined their relative predictive power in determining condom use among a sample of sexually risky gay and bisexual men in New York City. In a multivariate model, both risk reduction and intimacy interference attitudes emerged as significant predictors of unprotected sex; however, the variance accounted for by a model including intimacy interference was almost three times that accounted for by a model including risk reduction alone. These data suggest a pivotal role for intimacy in shaping condom attitudes and behavior among gay and bisexual men. HIV prevention interventions should consider incorporating intimacy as a motivating factor for sexual behavior and a potential barrier to condom use.     

The Role of Laparoscopic Surgery in the Management of Children and Adolescents With Inflammatory Bowel Disease

Although laparoscopic surgery is readily used in the management of inflammatory bowel disease (IBD) in adults, its role in the surgical treatment of IBD in the pediatric population is not well established. The aim of this narrative review was to analyze the published evidence comparing laparoscopic and open resection in the management of children and adolescents with IBD.The Pubmed and Embase databases were searched using the terms “inflammatory bowel disease,” “children,” “adolescents,” “laparoscopic,” and “colectomy.”The review identified 10 appropriate studies. Even though laparoscopic surgery generally resulted in longer operating times (between a mean of 40 and 140 min), benefits included reduced postoperative pain (mean duration of opiate use 3 vs 6 days) and reduced length of stay (median length of stay 5–8 vs 10.5–19 days) compared with open surgery. Postoperative complication rates were similar following both approaches.Due to the limited available data and the small sample size of the published series, definite recommendations are not able to be drawn. Nevertheless, current evidence indicates that laparoscopic colorectal resection is safe and feasible in the management of IBD in the paediatric population, with reductions in postoperative pain and length of hospital stay achievable.     

云南省4县少数民族居民疟疾防治知识调查

目的了解云南省4县少数民族居民认知疟疾防治知识对行为改变的影响。方法采用分层整群不等比例抽样调查方法,问卷调查居民一般情况、疟防常识、蚊帐拥有和使用、求医习惯和疟史等。结果通过发放宣传单、张贴海报等干预措施,少数民族居民的疟防常识知晓程度得到明显改善,拉祜族居民的知识水平提高最大,超过30%的少数民族居民已能掌握疟防常识,同时,少数民族居民使用蚊帐进行个人防护、寻求医疗救助的行为得到培养,超过60%人群拥有蚊帐,但正确使用率仍然较低,仅为15·64%。结论随着少数民族居民对疟防常识认知水平的提高,促进了该类人群健康卫生行为的形成,其成效有待进一步扩大。     

The Role of Executive Functions in Object- and Action-Naming among Older Adults

Background/Study Context: Lexical retrieval abilities and executive function skills decline with age. The extent to which these processes might be interdependent remains unknown. The aim of the current study was to examine whether individual differences in three executive functions (shifting, fluency, and inhibition) predicted naming performance in older adults.

Methods: The sample included 264 adults aged 55–84. Six measures of executive functions were combined to make three executive function composites scores. Lexical retrieval performance was measured by accuracy and response time on two tasks: object naming and action naming. We conducted a series of multiple regressions to test whether executive function performance predicts naming abilities in older adults.

Results: We found that different executive functions predicted naming speed and accuracy. Shifting predicted naming accuracy for both object and action naming while fluency predicted response times on both tests as well as object naming accuracy, after controlling for education, gender, age, working memory span, and speed of processing in all regressions. Interestingly, inhibition did not contribute to naming accuracy or response times on either task.

Conclusion: The findings support the notion that preservation of some executive functions contributes to successful naming in older adults and that different executive functions are associated with naming speed and accuracy.     

信号转导与转录激活因子4的生物学行为及其在动脉粥样硬化形成中的作用

信号转导与转录激活因子4是信号转导与转录激活因子蛋白家族中的一员,它们是一类有着共同结构特点的转录因子蛋白。作为细胞内信号传导分子,信号转导与转录激活因子4参与了机体各类生理和病理过程,包括细胞分化、炎症反应等。近来有研究结果提示,信号转导与转录激活因子4也通过影响固有和获得性免疫反应、平滑肌细胞分布等参与到动脉粥样硬化的进程中,因而,研究信号转导与转录激活因子4在免疫细胞分化和炎症反应中的作用和分子机制可以为阐明动脉粥样硬化的发生机制提供新的思路。     

儿童及青少年血压踏车运动负荷试验的临床意义

对我们在１９８７年进行的踏车血压运动负荷试验的２３６名６～１９岁健康儿童及青少年分别于１９９２年、１９９４年随访血压及踏车运动试验，并采用１９８７年拟定的运动试验阳性标准，对安静收缩血压９０以上百分位（Ｐ）与运动试验阳性者进行横向及纵向分析。得出以下结论：１．１９８７年血压４５～５５Ｐ及≥９０Ｐ组，运动试验阳性率分别为１１．８％及４３．５％；２．三个年度血压均≥９０Ｐ组，两次≥９０Ｐ组及一次≥９０Ｐ组，三次运动试验均阳性的百分比分别为５４．２％，８．２％及２．４％；３．１９８７年血压≥９０Ｐ者按运动试验阳性、阴性分组分析１９９２、１９９４年血压资料，阳性组血压仍保持≥９０Ｐ者为６５．５％、４７．３％，阴性者为２９．２％及２０．３％；４．１９８７年血压≥９０Ｐ者运动试验阳性组中１９９２、１９９４年两年血压均≥９０Ｐ者明显高于阴性组，分别为３４．５％及７．２％；（以上均经统计学处理Ｐ＜０．００１或Ｐ＜０．００５）说明本课题拟定的血压运动负荷试验标准有明确的临床价值。