Influence of Nicotine on Myocardial Stiffness and Fibrosis During Chronic Ethanol Use

Cardiomyopathy related to ethanol abuse is often accompanied by cigarette use. To examine if the major cardioactive component may intensify the abnormal function and composition induced by chronic ethanol, nicotine was administered orally, 2.5 mg bid, to a canine model receiving 36% of calories as ethanol for 6 months (group III). These animals were compared with group II receiving ethanol alone, group IV on nicotine alone, and controls (group I). In the intact, ventilated, anesthetized dog, left ventricular pressures and volumes were measured before and after dextran infusion and related to left ventricular collagen alterations. Basal heart rate, aortic pressure, and ejection fraction were comparable with controls. End-diastolic pressure and diastolic chamber stiffness (KPV) were significantly higher in the basal state and during dextran infusion in the three experimental groups, compared with group I. The increment was largest in the ethanol-nicotine group. Analysis of left ventricular myocardium revealed a rise of collagen concentrations in all three experimental groups, with an interstitial distribution on histochemical examination. Moreover, determination of advanced glycosylation endproducts, as a measure of alterations in collagen cross-links, revealed higher concentrations versus controls. The greater increase of diastolic stiffness in the nicotine-ethanol group occurred despite a similar concentration of fluorescent products as group II. Because the former had a larger increase of collagen concentration, total cross-linked collagen content was presumably greater after the combined use of nicotine-ethanol. Thus, nicotine in relatively high dose when combined with ethanol, elicited a modest further increase in the left ventricular chamber stiffness and collagen concentration.     

Strategies for dismissing dietary risks: insights from user-generated comments online

Communication around chronic dietary risks has proved challenging as dietary health risks are ostensibly met with attenuated perceptions of their likelihood and consequences. In this article, we examine the strategies that an online public use to negotiate risk messages from expert stakeholders that may be incongruent with their own position on a risk. Progressing from conceptualisations of amplification as laid out in the social amplification of risk framework, we are particularly interested in understanding whether and how amplifications of risk may be attributed towards other stakeholders. The article presents an analysis of comments posted on a website oriented to a British audience. These comments were left by members of the public in reply to two online media articles published in 2012 reporting on an epidemiological study carried out in the United States on the risks of red meat consumption. We found that the comments generally expressed resistance to the risk message, embodied in two main strategies. The first strategy was to discount the message itself by deploying rules of thumb that undermined the applicability of the general risk message to the particularities of the individual. The second strategy was to undermine the risks by casting doubt on the credibility of the message source. Together, these strategies allowed the commenters to argue that the risks and the process of communicating them resulted in an exaggerated picture. These findings highlight that by attributing amplification to others, further polarisation of risk views between stakeholders may occur. Thinking about amplification as an attribution provides a distinct and significant conceptual contribution to the study of incongruent risk responses.     

Density and Proximity of Fast Food Restaurants and Body Mass Index Among African Americans

Objectives. The purpose of this study was to address current gaps in the literature by examining the associations of fast food restaurant (FFR) density around the home and FFR proximity to the home, respectively, with body mass index (BMI) among a large sample of African American adults from Houston, Texas.Methods. We used generalized linear models with generalized estimating equations to examine associations of FFR density at 0.5-, 1-, 2-, and 5-mile road network buffers around the home with BMI and associations of the closest FFR to the home with BMI. All models were adjusted for a range of individual-level covariates and neighborhood socioeconomic status. We additionally investigated the moderating effects of household income on these relations. Data were collected from December 2008 to July 2009.Results. FFR density was not associated with BMI in the main analyses. However, FFR density at 0.5, 1, and 2 miles was positively associated with BMI among participants with lower incomes (P ≤ .025). Closer FFR proximity was associated with higher BMI among all participants (P < .001), with stronger associations emerging among those of lower income (P < .013) relative to higher income (P < .014).Conclusions. Additional research with more diverse African American samples is needed, but results supported the potential for the fast food environment to affect BMI among African Americans, particularly among those of lower economic means.Obesity and its associated health conditions are a growing problem in the United States, with obesity prevalence having more than doubled since the 1960s.1 The health care cost of Americans’ growing waistlines is substantial and expected to top $860 billion by 2030.2 Racial/ethnic disparities in obesity are of particular concern for the nation’s health, with African Americans experiencing the highest prevalence of obesity relative to other racial/ethnic groups.1 The National Health and Nutrition Examination Survey from 2009 to 2010 indicated that 38.8% of African American men and 58.5% of African American women were obese compared with 36.2% of non-Hispanic White men and 32.2% of non-Hispanic White women.3 Racial/ethnic disparities have also been cited for body mass index (BMI), with the gap in BMI growth widening between African Americans and Whites in recent decades.4To better understand the factors associated with these trends, researchers and policymakers are paying increased attention to the retail food environment. The growing availability of low-cost, calorie-dense consumables from fast food restaurants (FFRs) is one of the factors implicated in the nation’s rising BMI.5–7 The availability of FFRs may be particularly relevant to the growing racial/ethnic disparities in BMI because several studies support a higher density of FFRs among predominately African American neighborhoods relative to predominately White neighborhoods.8–11 Moreover, at least 1 study reports stronger relations between fast food availability and fast food consumption among non-White versus White populations.12 Thus, African Americans may be more likely to consume fast food if it is available, and it may be more available to them because FFRs tend to be clustered in African American neighborhoods. Not surprisingly, greater fast food consumption is associated with higher BMI.13–15Several studies examined associations between the availability of fast food and BMI. Fast food availability was most commonly conceptualized as the density of FFRs near a person’s home, work, or school environment. Findings about the associations of FFR density with BMI and overweight or obesity status, however, were mixed,5,11 with some studies supporting positive associations,16–19 and others citing null results.14,20 Less commonly, studies conceptualized fast food availability as the proximity of the closest FFR to a person’s home. Studies taking this approach yielded mixed results regarding relations between FFR proximity and fast food consumption,21,22 as well as between FFR proximity and BMI or obesity status.11,23 Unfortunately, most of these studies focused predominately on White populations, and many had methodological limitations (e.g., self-reported BMI) that could have contributed to mixed results.5,11 We found only a single study that focused on an all-African American sample, which yielded null results regarding associations between FFR density and BMI.24 Although this study had several strengths, including a sample of more than 4500 African Americans and investigator-measured BMI, limitations included only 1 conceptualization of FFR availability (FFR density), and the use of Euclidean distances (“as the crow flies”) in density buffer calculation, which may be less realistic than buffers based on road networks (i.e., the only places along which FFRs can be found).5 In addition, we found no previous studies that examined whether associations between FFR availability and BMI were moderated by household income. Because reasons cited for frequent fast food consumption include both accessibility and affordability,6 it might be that relations of FFRs and BMI are stronger among those of lower economic means for whom fast food might be more affordable than other dining options. Therefore, additional research is needed to better understand the relations of fast food availability and BMI among African Americans.The purpose of this study was to address current gaps in the literature by examining the associations of FFR density around the home and FFR proximity to the home, respectively, with BMI among a large sample of African American adults from Houston, Texas. We additionally investigated the moderating effects of household income on these relations.     

The impact of pandemic A(H1N1)pdm09 influenza and vaccine-associated adverse events on parental attitudes and influenza vaccine uptake in young children

Introduction

Parental attitudes towards vaccination significantly influence vaccine uptake. The A(H1N1)pdm09 influenza pandemic was followed in 2010 by an unprecedented increase in febrile reactions in children receiving trivalent inactivated influenza vaccine manufactured by bioCSL. Uptake of TIV in children <5 years in Western Australia (WA) decreased in 2010 and has remained low. The impact of pandemic A(H1N1)pdm09 and adverse-events on parental attitudes towards vaccination is uncertain.

Materials and Methods

A parental attitudes survey towards influenza illness and vaccination was conducted as part of the West Australian Influenza Vaccine Effectiveness study. Vaccination status was assessed by parental interview and confirmed by the national register and/or vaccine providers. Parental attitudes from vaccinated and unvaccinated children and attitudes in 2008–2009 and 2010–2012 were compared. Principal Component Analysis was conducted to determine core attitudes that influenced vaccine uptake.

Results

Vaccination history and parental attitude surveys were available from 2576 children. Parents of fully vaccinated children less frequently stated that influenza was a mild disease, more frequently stated that influenza vaccine was safe and were less frequently worried about vaccine side effects.Uptake of influenza vaccine decreased significantly from 2010 onwards. From 2010, parents were less concerned about severe influenza, but more concerned about vaccine side effects and safety. Despite this significant shift in attitudes towards influenza vaccine, parental acceptance of vaccines on the national immunisation program did not change. Principal Component Analysis revealed that attitudes around vaccine safety and efficacy were the most important attitudes impacting on vaccine uptake.

Conclusions

Parental attitudes to influenza vaccine changed from 2010. Confidence in the WA preschool influenza vaccination program remains low yet appeared unchanged for other vaccines. Restoring public confidence in childhood influenza vaccination is needed before uptake can be improved.     

After-effects of acute alcohol intoxication

Female, Long-Evans hooded rats (N = 10, 4 months of age) were given ethanol via intragastric intubation in doses of 2.0, 3.0 or 4.0 g/kg (repeated measures design). After-effects (hypothermia, free operant activity, motor performance) were measured at six, twelve and sixteen hours, respectively, for the above doses and were compared to the effects observed after the intubation of equivolume amounts of tap water. The after-effects of ethanol on rectal temperature were varied. Both rotarod performance and free operant activity were impaired after each of the above doses of ethanol. Blood ethanol analyses revealed low blood levels of ethanol (range 6.6 +/- 1.5 to 24.6 +/- 3.4 mg/100 ml) at the time behavioral tests were performed. Thus, quantifiable behavioral impairment was observed after blood ethanol values had declined following acute intoxication episodes. These changes may be related to "hangover" symptomatology in man and may serve as a model for investigating the influence of a variety of factors related to drug dosage, rate of ethanol ingestion, type of alcoholic beverage, and prophylactic or acute intervention therapeutics.