Maternal Perceptions of Infant Exercise in the Neonatal Intensive Care Unit

Objective: To identify important factors that influence mothers' perceptions of engaging in exercise with their preterm infants.
Design: Qualitative, semistructured individual interviews.
Setting: Neonatal Intensive Care Unit.
Participants: Thirteen mothers of preterm infants who were in the Neonatal Intensive Care Unit.
Methods: Two researchers conducted interviews with mothers in English or Spanish. Interviews were recorded, transcribed, and analyzed.
Results: Mothers tended to view infant exercise as beneficial but feared for the safety of their infants. They perceived nurses as experts who could safely exercise their infants but feared that they themselves might harm their infants. Factors that influenced their beliefs included previous experiences with infant exercise and views regarding the fragility or the strength of their own infants. Mothers identified nurses, doctors, family members, and research studies as trusted sources of information on exercise efficacy and safety.
Conclusion: Understanding and addressing mothers' perceptions is a crucial component of a nursing intervention that teaches parents to do assisted exercises at home with their preterm infants.     

Psoriasis and the metabolic syndrome

Previous reports have shown a possible association between psoriasis and obesity, ischaemic heart disease, hypertension or diabetes mellitus. However, most of these studies were uncontrolled and were based on small sample sizes. We therefore investigated the association between psoriasis and the metabolic syndrome in a case control study. Case patients were defined as patients with a diagnosis of psoriasis vulgaris. Control patients were subjects who underwent hernioplasty or appendectomy. We used data mining techniques utilizing the database of the southern district of Clalit Health Services. The proportions of patients with diseases that belong to the metabolic syndrome were compared between case and control patients by univariate analyses. chi2 tests were used to compare categorical parameters between the groups. Logistic regression models were used to measure the association between psoriasis and the metabolic syndrome. A total of 340 patients with psoriasis and 6643 controls were included in the study. The mean age of case patients was 47.7 years (SD 10.7 years). There were 50.3% men and 49.7% women. Ischaemic heart disease was present in 23.5% of the patients with psoriasis, compared with 17.2% of the controls (p=0.003). Diabetes mellitus was present in 27.9% of the patients with psoriasis, compared with 19.5% of the controls (p <0.001). Hypertension was present in 44.4% of the patients with psoriasis, compared with 37.2% of the controls (p=0.007). Obesity was present in 29.4% of the patients with psoriasis, compared with 23.5% of the controls (p=0.012). Dyslipidaemia was present in 50.9% of the patients with psoriasis, compared with 44.2% of the controls (p=0.015). The association between psoriasis and the metabolic syndrome was pronounced after the age of 50 years and in men. Multivariate models adjusting for age and gender demonstrated that psoriasis was associated with an increased risk for ischaemic heart disease (odds ratio (OR) 1.4 95% confidence interval (CI) 1.0-1.8), diabetes mellitus (OR 1.5 95% CI 1.2-2.0), hypertension (OR 1.3 95% CI 1.0-1.7), obesity (OR 1.3 95% CI 1.0-1.7) and dyslipidaemia (OR 1.2 95% CI 1.0-1.6). Our findings demonstrate a possible association between psoriasis and the metabolic syndrome. Further studies are needed to establish this observation.     

Mediterranean Diet and White Matter Hyperintensity Change over Time in Cognitively Intact Adults

Current evidence on the impact of Mediterranean diet (MeDi) on white matter hyperintensity (WMH) trajectory is scarce. This study aims to examine whether greater adherence to MeDi is associated with less accumulation of WMH. This population-based longitudinal study included 183 cognitively intact adults aged 20–80 years. The MeDi score was obtained from a self-reported food frequency questionnaire; WMH was assessed by 3T MRI. Multivariable linear regression was used to estimate the effect of MeDi on WMH change. Covariates included socio-demographic factors and brain markers. Moderation effects by age, gender, and race/ethnicity were examined, followed by stratification analyses. Among all participants, WMH increased from baseline to follow-up (mean difference [follow-up-baseline] [standard deviation] = 0.31 [0.48], p < 0.001). MeDi adherence was negatively associated with the increase in WMH (β = −0.014, 95% CI = −0.026–−0.001, p = 0.034), adjusting for all covariates. The association between MeDi and WMH change was moderated by age (young group = reference, p-interaction[middle-aged × MeDi] = 0.075, p-interaction[older × MeDi] = 0.037). The association between MeDi and WMH change was observed among the young group (β = −0.035, 95% CI = −0.058–−0.013, p = 0.003), but not among other age groups. Moderation effects by gender and race/ethnicity did not reach significance. Greater adherence to MeDi was associated with a lesser increase in WMH over time. Following a healthy diet, especially at younger age, may help to maintain a healthy brain.     

Pursuing longevity: delay vs elimination of degenerative diseases.

Using a new model which allows for projection of mortality change resulting from preventive health care measures, prospective changes in longevity for the resident United States population in 1978 were compared with projections of longevity gains occurring under a standard single cause-elimination model. Results indicate that equal or greater gains accrue from the prevention or delay of several major degenerative diseases, than from the complete elimination of some single major degenerative diseases. Observed declines in mortality from 1960 to 1978 have resulted in gains in longevity equivalent to the successful elimination of some major degenerative diseases.     

Simultaneous/multiple cause-delay (SIMCAD): an epidemiological approach to projecting mortality

Methods being used to project mortality are based on the hypothetical elimination of one or more diseases from the population or on extrapolation from observed mortality rates. This research presents an alternative projection method based on an epidemiological theory of aging and mortality change that is consistent with recent mortality transitions. The model is founded on the observation that recent mortality declines in the United States are attributable to improved life styles and advances in the prevention and treatment of degenerative diseases and that the risk of dying from such diseases is being redistributed (or delayed) from younger to older ages. A test using U.S. mortality and population data indicates that this alternative method is promising--particularly for projecting mortality rates from major chronic degenerative diseases among populations in middle and older ages.     

APOE genotype influences functional status among elderly without dementia

The presence of apolipoprotein-?4 (APOE-?4) significantly increases the risk of Alzheimer's disease (AD). The association between APOE-?4 status and functional abilities was explored further in a multicultural sample of community-dwelling, non-demented elders. The sample was limited to cognitively-intact, community-dwelling elders, who were free of stroke or other neurologic disability. In 218 elders who met research criteria, the presence of APO-?4 was associated with poorer functional status, apart from the effects of neuropsychological performance, gender, age, and education (OR = 2.5, 95% CI: 1.3, 4.9). In 158 subjects without an APOE-?4 allele, 50% reported no functional limitation; in the 60 subjects with an ?4 allele, only 28% reported no functional limitation (P < .01). The relationship was not explained by the distribution of co-morbidities. The association between poorer function and the presence of an APOE-?4 allele was evident in each ethnic group. In path analyses, the presence of an APOE-?4 allele was associated with decreased functional ability in non-demented elders not simply through an association with poorer cognitive status, but also independently. These results suggest that the APOE-?4 genotype is associated with functional deficit in people with normal neuropsychological profiles. © 1995 Wiley-Liss, Inc.