Dissatisfaction with body size among low-income, postpartum black women

OBJECTIVE: To explore the body size perceptions of low-income, postpartum Black women. DESIGN: Prospective, exploratory survey using a culturally sensitive figure rating scale, to assess body size perceptions. SETTING: Four inner city clinics in Washington, DC. Participants: Low-income, postpartum Black women (N= 105). METHOD: A validated, culturally sensitive figure rating scale was used to assess perception of current, typical, healthy, and preferred body sizes of participants. Derived scores were used to assess other body image measures. MAIN OUTCOME MEASURES: Measures were mean scores of perceived sizes and derived scores representing body size satisfaction, adherence to typical size, and health ideal size. RESULTS: Over 75% of subjects exhibited dissatisfaction with current body size. The perceived size for the typical (reference) woman was larger and not representative of the perceived healthy or preferred sizes of the sample. No difference between preferred and healthy sizes was observed. CONCLUSIONS: Two thirds of the participants were dissatisfied with their current body size and over half desired weight loss. The lack of difference between preferred and healthy body sizes suggests desire for a body size that meets both cultural standards of attractiveness and personal standards of health. Nursing opportunity for engaging in anticipatory interventions is highlighted.     

Management of cervical intraepithelial neoplasia 2 in adolescent and young women

STUDY OBJECTIVE: To evaluate regression rates among adolescents (aged < or =21) with cervical intraepithelial neoplasia (CIN) 2 managed expectantly and to determine factors associated with disease regression. DESIGN: Cohort study using a colposcopic database of 2,996 women seen between August 1999 and November 2005. SETTING: Colposcopy clinic in urban, tertiary care medical center. PARTICIPANTS: Adolescents with CIN 2. Routine management consisted of two options: immediate treatment or repeat colposcopic evaluation in 6 months. MAIN OUTCOME MEASURES: For those managed conservatively, regression was defined either as a subsequent normal colposcopy and/or biopsy and at least 2 smears read as negative for epithelial abnormality or at least 3 consecutive negative smears if repeat colposcopy was not performed. Demographic information, including age, was assessed to determine possible associations with disease regression. RESULTS: Of the 93 adolescents, 53 (57%) elected to undergo immediate treatment with a diagnostic excisional procedure, and 40 (43%) chose management with colposcopic follow-up. Of those treated, high-grade disease (CIN 2+) was found in 40 (75%). Of the 36 young women followed conservatively (4 were lost to follow-up), regression after a median follow-up time of 378 days was documented in 14 (39%). Of the 22 adolescents not fulfilling our criteria for regression, only 3 had evidence of CIN 2 or worse during follow-up. The remaining 19 had either CIN 1 or mildly abnormal cytologic results. Kaplan-Meier survival estimates indicated younger age (< or =16 years) tended to be associated with decreased time to regression. CONCLUSION: Based on significant regression of CIN 2 among adolescent women, primary management in this population should consist of cytologic and colposcopic follow-up.     

Acute Chorioamnionitis at Term Caused by the Oral Pathogen Fusobacterium Nucleatum

Fusobacterium nucleatum is an oral pathogen associated with preterm birth. Presented is a case of acute chorioamnionitis that progressed to maternal sepsis in a term patient with intact membranes. In addition to its role in periodontal disease and preterm birth, our case demonstrates that intrauterine infection with Fusobacterium nucleatum can result in severe disease at term.     

The Impact of Behavioral Intervention on Family Interactions at Mealtime in Pediatric Cystic Fibrosis

The current study evaluated the impact of a behavioral intervention (Be In Charge!), targeting caloric intake and weight gain in children with CF, on family interactions at mealtime. Forty-five families of children with cystic fibrosis (CF), ages 4 to 12 years, were randomized to Be In Charge! or nutrition education and assessed using the McMaster Mealtime Family Interaction Coding System. No differences were found in family functioning between the two interventions pre- to posttreatment or 1-year follow-up, except for Affect Management. A significantly greater percentage of families receiving Be In Charge! demonstrated improvement in Affect Management from pretreatment to 1-year follow-up. Implications for developing the next generation of behavioral interventions are discussed.     

Physical Activity and Asthma Symptoms among New York City Head Start Children

The coincidence of both an obesity epidemic and an asthma epidemic among children in the United States has suggested that childhood overweight and sedentary lifestyles may be risk factors for asthma development. We therefore conducted a study of those factors among children enrolled in Head Start Centers located in areas of New York City with high asthma hospitalization rates.

Data were gathered from 547 children through an intensive home visit, and physical activity was measured on 463 children using the Actiwatch accelerometer. Data on allergy and asthma symptoms and demographic variables were obtained from parents' responses to a questionnaire and complete data were available from 433 children.

Overall physical activity was highest in warmer months, among boys, among children whose mothers did not work or attend school, and among children of mothers born in the United States. Activity was also positively associated with the number of rooms in the home. The season in which the activity data were collected modified many of the associations between demographic predictor variables and activity levels. Nearly half the children were above the range considered healthy weight. In cross-sectional analyses, before and after control for demographic correlates of physical activity, asthma symptoms were not associated with physical activity in this age group. Comparing the highest quartile of activity to the lowest, the odds ratio for asthma was 0.91 (95% CI = 0.46, 1.80).

However, the novel associations with physical activity that we have observed may be relevant to the obesity epidemic and useful for planning interventions to increase physical activity among preschool children living in cities in the northern United States.     

The Utility of a Composite Biological Endpoint in HIV/STI Prevention Trials

A human immunodeficiency virus (HIV) as a biological endpoint in HIV prevention trials may not be feasible, so investigators have used surrogate biological outcomes. In a multisite trial, the epidemiology of STIs may be different across sites and preclude using one STI as the outcome. This study explored using a composite STI outcome to address that problem. The combined biological endpoint was the incidence of any of six new STIs (chlamydia, gonorrhea, trichomonas (women only), syphilis, herpes simplex virus type 2 infection and HIV) during a 24-month follow up period. We investigated how a composite STI outcome would perform compared to single and dual STI outcomes under various conditions. We simulated outcomes for four populations that represented a wide range of sex and age distributions, and STI prevalences. The simulations demonstrated that a combined biologic outcome was superior to single and dual STI outcomes in assessing intervention effects in 82 % of the cases. A composite biological outcome was effective in detecting intervention effects and might allow more investigations to incorporate multiple biological outcomes in the assessment of behavioral intervention trials for HIV prevention.