Content Analysis of Motivational Counseling Calls Targeting Obesity-Related Behaviors Among Postpartum Women

Our objective was to examine mothers’ perspectives of obesity-related health behavior recommendations for themselves and their 0–6 month old infants. A health educator conducted 4 motivational counseling calls with 60 mothers of infants during the first 6 months postpartum. Calls addressed 5 behaviors for infants (breastfeeding, introduction of solid foods, sleep, TV, hunger cues), and 4 for mothers (eating, physical activity, sleep, TV). We recorded detailed notes from each call, capturing responsiveness to recommendations and barriers to change. Two independent coders analyzed the notes to identify themes. Mothers in our study were more interested in focusing on their infants’ health behaviors than on their own. While most were receptive to eliminating their infants’ TV exposure, they resisted limiting TV for themselves. There was some resistance to following infant feeding guidelines, and contrary to advice to avoid nursing or rocking babies to sleep, mothers commonly relied on these techniques. Return to work emerged as a barrier to breastfeeding, yet facilitated healthier eating, increased activity, and reduced TV time for mothers. The early postpartum period is a challenging time for mothers to focus on their own health behaviors, but returning to work appears to offer an opportunity for positive changes in this regard. To improve weight-related infant behaviors, interventions should consider mothers’ perceptions of nutrition and physical activity recommendations and barriers to adherence.     

Lifecourse approach to racial/ethnic disparities in childhood obesity

Eliminating racial/ethnic disparities in health and health care is a national priority, and obesity is a prime target. During the last 30 y in the United States, the prevalence of obesity among children has dramatically increased, sparing no age group. Obesity in childhood is associated with adverse cardio-metabolic outcomes such as hypertension, hyperlipidemia, and type II diabetes and with other long-term adverse outcomes, including both physical and psychosocial consequences. By the preschool years, racial/ethnic disparities in obesity prevalence are already present, suggesting that disparities in childhood obesity prevalence have their origins in the earliest stages of life. Several risk factors during pregnancy are associated with increased risk of offspring obesity, including excessive maternal gestational weight gain, gestational diabetes, smoking during pregnancy, antenatal depression, and biological stress. During infancy and early childhood, rapid infant weight gain, infant feeding practices, sleep duration, child's diet, physical activity, and sedentary practices are associated with the development of obesity. Studies have found substantial racial/ethnic differences in many of these early life risk factors for childhood obesity. It is possible that racial/ethnic differences in early life risk factors for obesity might contribute to the high prevalence of obesity among minority preschool-age children and beyond. Understanding these differences may help inform the design of clinical and public health interventions and policies to reduce the prevalence of childhood obesity and eliminate disparities among racial/ethnic minority children.     

The implementation of a global fund grant in Lesotho: applying a framework on knowledge absorptive capacity

One of the biggest challenges in scaling up health interventions in sub-Saharan Africa for government recipients is to effectively manage the rapid influx of aid from different donors, each with its own requirements and conditions. However, there is little empirical evidence on how governments absorb knowledge from new donors in order to satisfy their requirements. This case study applies Cuellar and Gallivan's (2006) framework on knowledge absorptive capacity (AC) to illustrate how recipient government organisations in Lesotho identified, assimilated and utilised knowledge on how to meet the disbursement and reporting requirements of Lesotho's Round 5 grant from the Global Fund to Fight AIDS, TB and Malaria (Global Fund). In-depth topic guided interviews with 22 respondents and document reviews were conducted between July 2008 and February 2009. Analysis focused on six organisational determinants that affect an organisation's absorptive capacity: prior-related knowledge, combinative capabilities, motivation, organisational structure, cultural match, and communication channels. Absorptive capacity was mostly evident at the level of the Principal Recipient, the Ministry of Finance, who established a new organisational unit to meet the requirements of Global Fund Grants, while the level of AC was less advanced among the Ministry of Health (Sub-Recipient) and district level implementers. Recipient organisations can increase their absorptive capacity, not only through prior knowledge of donor requirements, but also by deliberately changing their organisational form and through combinative capabilities. The study also revealed how vulnerable African governments are to loss of staff capacity. The application of organisational theory to analyse the interactions of donor agencies with public and non-public country stakeholders illustrates the complexity of the environment that aid recipient governments have to manage.     

Comparison of methyltransferase activities of pair-fed rats given adequate or methyl-deficient diets

The short-term effects of a lipotrope-deficlent (methyl-deficient)diet on tRNA and protein methyltransferase activities have beenstudied using pair-fed male Fischer rats. The activity of liverN2-guanine tRNA methyltransferase II (NMG2) of animals receivingthe methyl-deficient diet (MDD) for 2 weeks was found to beelevated more than 2-fold. This is in agreement with the resultsof earlier experiments in which the animals were fed ad libitum.These data indicate that the effects of lipotrope-deficientdiets on NMG2 activity observed in the earlier studies can beattributed to the nature of the diet, and not to differencesin caloric intake. In the same pair-fed animals, very littleeffect of MDD on the activity of NMG2 of either brain or spleenwas observed. In liver, the activity of one of the enzymes thatcatalyze protein methylation-protein methylase I (S-adenosyl-methionine:protein-arginine N-methyltransferase)-was significantly elevatedin response to the lipotrope-deficient diet. In contrast, theactivities of protein methylase II (S-adenosylmethionine: protein-carboxyO-methyltransferase), from control and experimental animalsdid not differ significantly. Lipotrope-deficient diets arethus seen to induce, within a short period of time, selectivechanges in the activities of some, but not all, of the liverenzymes that catalyze the methylation of tRNA and protein.     

The former transsexual: A case study

The case is presented of a biological male, diagnosed as transsexual, who lived as a female for a considerable period and then returned to the male role. The subject came within days of having genital surgery, deciding to return to the male role after surgery was canceled due to policy changes at a hospital. A number of factors are offered as possible correlatives to the decision to return to the original gender role. These include increase in assertiveness, decrease in gender-role stereotyping, religious conversion, improvement of vocational state, and falling in love. It is suggested that the original diagnosis of transsexualism is not invalidated by the subject's subsequent decision. The relationship between personality characteristics such as passivity and the tendency of such clients to apply rigid stereotypes to gender is discussed. The importance of an extended trial period prior to genital surgery is reinforced by the present case, and it is suggested that increased attention be given to gender-role stereotyping among sex reassignment candidates.This is an expanded version of a paper presented at the Sixth International Gender Dysphoria Symposium, San Diego, California, February 1979.