Neighbourhood social fragmentation and the mental health of children in poverty

Using data from 7,776 Millennium Cohort Study children in England, we examined the role of neighbourhood social fragmentation in trajectories of emotional/behavioural problems at ages three, five and seven, and in moderating the association of children׳s emotional/behavioural problems with neighbourhood poverty, family poverty and adverse family events. Allowing for key background characteristics, social fragmentation generally added little to explain child outcomes, but there were fewer conduct problems among children in poor neighbourhoods with less fragmentation. Surprisingly, in less fragmented neighbourhoods poor families tended to feel less safe and more distressed, which was associated with children׳s conduct problems.     

Women's attitudes towards receiving family planning services from community health workers in rural Western Kenya

BackgroundKenya ranks among the countries in Africa with high fertility rates. In order to reverse the trends in high fertility rates, there is need to increase uptake of family planning services particularly by use of community health workers (CHWs) in providing these services in rural areas.ObjectiveTo describe the perceptions of women towards family planning service provision by CHWs in four rural districts of Western Kenya. It is based on baseline survey data from a three-year, rural community-based family planning project funded by The David and Lucile Packard Foundation.MethodsA cross-sectional baseline survey was conducted in Western Kenya. The data presented is part of a broader the broader survey . A survey questionnaire was administered to 1,997 women (15–49 years) but only 963 cases were valid for our analyses.ResultsThe findings revealed that only a third of the respondents exhibited high approval for Family Planning services from CHWs. Only four out of the thirteen variables explored showed significance on attitudes towards family planning services from CHWs. These are age, level of education, knowledge about family planning benefits and districts.ConclusionWomen''s perception towards family planning services delivered by CHWs in Western region in Kenya is quite low. To improve the demand and supply for family planning services in this region, there is need to invest a substantial amount of effort into sensitization of women on the relevance of CHWs in providing family planning services.     

Fatty acid changes help to better understand regression of nonalcoholic fatty liver disease

AIM: To investigate whether liver steatosis reduction due to a six-month dietary intervention results in significant changes in the concentrations of fatty acids.METHODS: A group of 35 Caucasian individuals diagnosed with different levels of steatosis were prospectively enrolled in the present study.Analysis of the fatty acid profiles was performed according to changes in liver steatosis(liver steatosis reduction by one or two degrees) after a six-month dietary intervention.The diet helped reduce body mass in obese and overweight patients,and stabilize both glycemia and dyslipidemia.Fatty acids were extracted according to the Folch method and analyzed by gas chromatography.RESULTS: This study showed significant changes in fatty acid profiles in patients who had reduced liver steatosis by one as well as two degrees.A reduction in liver steatosis by one degree caused a significant increase in the level of the n-3 family: eicosapentaenoic acid(P < 0.055),docosapentaenoic acid-C 22:5(P < 0.05) and docosahexaenoic acid(P < 0.05).A reduction in liver steatosis by two degrees caused a significant decrease in serum palmitoleic acid-C 16:1(P < 0.05).CONCLUSION: Liver steatosis reduction is associated with changes in fatty acid profiles,and these changes may reflect an alteration in fatty acid synthesis and metabolism.These findings may help better understand regression of nonalcoholic fatty liver disease.     

Patterns of intervention utilization among school-aged children on the autism spectrum: Findings from a multi-site research consortium

When designing and interpreting results from clinical trials evaluating treatments for children on the autism spectrum, a complicating factor is that most children receive a range of concurrent treatments. Thus, it is important to better understand the types and hours of interventions that participants typically receive as part of standard of care, as well as to understand the child, family, and geographic factors that are associated with different patterns of service utilization. In this multi-site study, we interviewed 280 caregivers of 6-to-11-year-old school-aged children on the autism spectrum about the types and amounts of interventions their children received in the prior 6 weeks. Reported interventions were coded as “evidence-based practice” or “other interventions,” reflecting the level of empirical support. Results indicated that children received a variety of interventions with varying levels of empirical evidence and a wide range of hours (0–79.3 h/week). Children with higher autism symptom levels, living in particular states, and who identified as non-Hispanic received more evidence-based intervention hours. Higher parental education level related to more hours of other interventions. Children who were younger, had lower cognitive ability, and with higher autism symptom levels received a greater variety of interventions overall. Thus, based on our findings, it would seem prudent when designing clinical trials to take into consideration a variety of factors including autism symptom levels, age, cognitive ability, ethnicity, parent education and geographic location. Future research should continue to investigate the ethnic, racial, and socioeconomic influences on school-aged intervention services.     

Outcomes of familial abdominal aortic aneurysm repair in the Vascular Quality Initiative

Objective

Recent investigations have reported increased rates of aneurysm-related complications after endovascular aneurysm repair (EVAR) in familial abdominal aortic aneurysm (fAAA) patients. The purpose of this study was to evaluate the outcomes of open aortic repair (OAR) and EVAR in sporadic AAA (spAAA) and fAAA patients in the Society for Vascular Surgery Vascular Quality Initiative.

Assessing helpful and harmful family and friend involvement in adults’ type 2 diabetes self-management

Objective: Develop and evaluate a measure assessing helpful and harmful family/friends’ involvement in adults’ type 2 diabetes (T2D) self-management.Methods: Prior mixed-methods research, cognitive interviews, and expert input informed measure development. We administered the measure in two studies (N = 392 and N = 512) to evaluate its factor structure, internal consistency reliability, test-retest reliability, and construct, criterion and predictive validity.Results: Analyses supported a two-factor solution: helpful and harmful involvement with internal consistency reliability α = .86 and .72, respectively. Three-month test-retest reliability was rho = 0.64 for helpful and rho = 0.61 for harmful (both p < 0.001). Over 90% reported at least one instance of family/friend involvement in the past month. Associations with other measures of diabetes involvement were as anticipated (all p < .01). Helpful and harmful involvement were independently associated with diabetes self-efficacy, diet, blood glucose testing and medication adherence cross-sectionally [βs 0.13–0.39 helpful, ?0.12–?0.33 harmful; all p < .05]. Harmful involvement independently predicted worse HbA1c (β = 0.08), and worsening HbA1c over three months (β = 0.12, both p < 0.05).Conclusion: The Family and Friend Involvement in Adults’ Diabetes (FIAD) is a reliable and valid measure assessing family/friend involvement in adults’ T2D.Practice implications: FIAD use can inform interventions to improve social contexts in which adults manage diabetes.