The validity of subjective measures of body image disturbance

OBJECTIVE: We examined weight dissatisfaction (actual weight minus self-stated ideal weight) and weight goal (normative weight minus self-stated ideal weight) subjective indices in a large clinical sample to determine how the indices discriminate between diagnostic categories and relate to other measures of body image disturbance. METHOD: Approximately 200 anorexic, bulimic, and eating disorder not otherwise specified (NOS) participants reported their self-stated ideal weight and completed the Mizes Anorectic Cognitions (MAC) Questionnaire, Eating Disorders Inventory (EDI), and Restraint Scale-Revised. RESULTS: Compared with bulimic and NOS participants, anorexics reported less weight dissatisfaction but had an ideal weight that is farthest from normative weight. The weight dissatisfaction measure correlates well with other measures of body image disturbance, and both measures show evidence of discriminant validity. DISCUSSION: These two measures highlight the substantial differences in the nature of body image disturbance between the eating disorder diagnostic groups. Theoretical, clinical, and practical implications are discussed.     

Use of the weight efficacy lifestyle questionnaire with African American women: validation and extension of previous findings

While the Weight Efficacy Lifestyle Questionnaire (WEL) shows promise as a measure of self-efficacy for eating control, there is a lack of research examining the psychometric properties of this measure with ethnic minorities. The current study examined the WEL with a sample of 144 overweight and obese African American females. Analyses indicated similar self-efficacy levels compared to predominantly Caucasian samples. Supporting the validity of the WEL, participants undergoing obesity treatment demonstrated modest improvement in WEL scores, while standard care participants showed no changes in self-efficacy over time. Factor analysis indicated a four-factor structure rather than the five factors previously found. The four-factor structure accounted for 61.85% of the variance. Results indicate the WEL may be a valid measure of self-efficacy for overweight and obese African American women, although researchers should be mindful of the variation in scale properties when using the WEL with this population.     

Power and leadership

The author's role as a nurse consultant in a Mental Health Trust in the north of England is particularly interesting because of the peculiar position of the nurse consultant. One of the main components of the role is leadership, yet they are not operational managers so cannot draw on traditional positional power as a way of influencing people. This led the author to explore the concept of power and its implications for leadership. The paper is the result of this exploration: it reviews theories of power and how these can be applied to an understanding of leadership.     

The issue of death and dying

This study brings about a reflection on death and dying, commented as if they had the same meaning. Nowadays, one talks about death as seldom as possible and, by its negation, there appeared the negation of diseases, thus causing the diseased people to become totally dependant on health teams. Technological and scientific advances led to postponing death, and it is possible to temporarily extend what humans decided to call life. This has become the great piece of criticism by scholars that seek to lead death again to its place by trying to bring it again into the center of reflections, analyses and discussions within the most diverse areas.     

An approach to studying social disparities in health and health care

OBJECTIVE: We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care. METHODS: Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relative group size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and "at-risk" groups to identify particular factors warranting attention. RESULTS: We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities. CONCLUSIONS: This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care.     

Effect of acetaminophen on expression and activity of rat liver multidrug resistance-associated protein 2 and P-glycoprotein

We evaluated the effect of acetaminophen (APAP), given as a single, 1g/kg body weight dose, on expression and activity of rat liver multidrug resistance-associated protein 2 (Mrp2) and P-glycoprotein (P-gp), two major canalicular drug transporters. The studies were performed 24h after administration of the drug. APAP induced an increase in plasma membrane content of Mrp2 detected by western blotting, consistent with increased detection of the protein at the canalicular level by immunoflourescence microscopy. In vivo biliary excretion of dinitrophenyl-S-glutathione, a well known Mrp2 substrate, was slightly but significantly increased by APAP, agreeing well with upregulation of the transporter. Basal biliary excretion of oxidized glutathione, an endogenous Mrp2 substrate, was also increased by APAP, likely indicating increased hepatic synthesis as a result of APAP-induced oxidative stress followed by accelerated canalicular secretion mediated by Mrp2. APAP also increased the expression of P-gp detected by western blotting and immunofluorescence microscopy as well as the in vivo biliary secretory rate of digoxin, a model P-gp substrate. Because specific APAP-conjugated metabolites are Mrp2 substrates, we postulate that induction of Mrp2 by APAP may represent an adaptive mechanism to accelerate liver disposition of the drug. In addition, increased Mrp2-mediated elimination of oxidized glutathione may be essential in maintaining the redox equilibrium in the hepatocyte under conditions of APAP-induced oxidative stress.     

Postnatal development of resistance to short-term high-dose toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin in TCDD-resistant and -semiresistant rats

Despite great interspecies differences in adult 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) sensitivity, the toxic potency of TCDD is similar across species in fetal mortality. Han/Wistar (Kuopio; H/W) rats are exceptionally resistant to acute toxicity of TCDD, but show sensitivity to embryotoxicity and teratogenicity. The resistance of adult H/W rats to acute TCDD toxicity is based on a point mutation in the transactivation domain of the aryl hydrocarbon receptor (AHR) and to an unknown gene “B”. This study investigated the time course of postnatal development of resistance to TCDD and the significance of genotypic variation in resistance development. H/W, line A (a new line with the H/W-type mutated AHR), and line B rats (a line with normal AHR but moderately resistant because of gene “B”) were exposed to a single dose of TCDD 2-56 days after birth. H/W and line A rats received 1000 μg/kg; male and female B rats received 200 and 100 μg/kg, respectively. Survival was monitored for 42 days. Interestingly, although TCDD ceased growth and weight gain in all TCDD groups, the younger dosed animals did not seem to reach the body weight of the older dosed animals even in 100 days. The survival results after 42 days showed that line A rats are fairly resistant to TCDD immediately after birth, and their full TCDD resistance develops during the first week of life. The moderate resistance of line B rats develops approximately at the time of weaning. This difference in the time course of resistance development suggests that there are basic differences in pathways mediating resistance in lines A and B rats.     

Continuous therapy with nitroglycerin impairs endothelium-dependent vasodilation but does not cause tolerance in conductance arteries: a human in vivo study

We investigated in healthy humans whether continuous therapy with organic nitrates impairs conduit artery responses to nitroglycerin (GTN) as well as its effects on endothelium-dependent vasodilation. Sixteen young male volunteers were randomized to continuous treatment with either transdermal GTN (0.6 mg/h/24 hrs for 6 days) or no therapy. Endothelium-dependent (flow-mediated) dilatation (FMD) and endothelium-independent (GTN-mediated) dilatation (GMD) of the brachial artery were evaluated before randomization (session 1), after six days of transdermal GTN treatment (session 2), and three hours after withdrawal of transdermal GTN (session 3). In the GTN group, on session 1, 0.4 mg sublingual GTN increased resting brachial artery diameter from 0.40 +/- 0.03 to 0.45 +/- 0.03 cm (P < 0.01). At the time of session 2, this GTN-mediated vasodilation remained unchanged at baseline (0.47 +/- 0.04 cm), with no further significant dilatation in response to either stimulus. On session 3, three hours after patch removal, baseline brachial artery diameter and GMD returned to pretreatment values, but FMD remained blunted (session 1: 8.7 +/- 2.5; session 3: 4.1 +/- 1.7%, P < 0.05). There was no change in these variables in the control group. Our data demonstrate that continuous GTN therapy impairs endothelium-dependent vasodilation in conduit arteries yet does not induce nitrate tolerance.     

Hypericum androsaemum infusion increases tert-butyl hydroperoxide-induced mice hepatotoxicity in vivo

Increasing evidence regarding free radical generating agents indicates that the sustained production of high levels of reactive oxygen species (ROS) can cause hepatotoxicity. Being a short chain analog of lipid peroxide, tert-butyl hydroperoxide (t-BHP) is metabolized into free radical intermediates by cytochrome P450 in hepatocytes, which initiate lipid peroxidation, glutathione depletion and cell damage. The aim of the present study was to evaluate the putative protective effect of Hypericum androsaemum lyophilised infusion against t-BHP-induced mice hepatotoxicity in vivo, which has already been shown to be antioxidant in vitro. However, the results showed that the oral pretreatment with Hypericum androsaemum infusion (4, 20 and 100 mg/kg) for 4 days before a single intraperitoneal dose of t-BHP (1.8 mmol/kg) potentiated the t-BHP-induced hepatotoxicity. In fact, it was observed a potentiation in the depletion of total glutathione and reduced glutathione (GSH) contents and increase in oxidised glutathione (GSSG) level. Also the histopathological evaluation of the mice livers revealed that the infusion raised the incidence of liver lesions induced by t-BHP. These data do not corroborate any effect of Hypericum androsaemum infusion as hepatoprotector, but rather as a potentiator of hepatotoxicity in the present experimental conditions.