Hope as a Moderator of Negative Life Events and Depressive Symptoms in a Diverse Sample

Depression is a significant public health problem for young adults of college age, and negative life events exacerbate risk. Not all individuals who experience negative life events, however, report depressive symptoms, perhaps owing to protective characteristics. We examined one such characteristic, trait hope, a goal‐oriented construct, as a potential moderator of the association between negative life events and depressive symptoms in an ethnically diverse sample of 386 college students. In support of our hypotheses, negative life events were significantly associated with greater levels of depressive symptoms, and higher levels of hope attenuated this relationship, such that those with greater hope reported fewer depressive symptoms related to potentially traumatic events. The moderating effect of hope did not differ across ethnic groups. Our findings have implications for managing the sequelae of negative life events, including depression. Cognitive–behavioural interventions tailored to help young adults identify and attain important life goals might help to overcome psychopathology associated with life stress. Copyright © 2012 John Wiley & Sons, Ltd.     

“All Colors and Hues”: An Autoethnography of a Multiethnic Family's Strategies for Bilingualism and Multiculturalism

This two‐year autoethnographic action research study explores the processes a multiethnic/multiracial family uses to maintain their children's heritage language of Spanish and the family's multiculturalism. Data sources (including interviews and participant observations in the home and the dual‐language school) specifically focus on the eldest child, Nelia, from her kindergarten and first‐grade years where she attended a public dual‐language program. The findings illuminate the integral link between the family's ideology toward valuing bilingualism and the necessity of school support.     

Meat consumption, heterocyclic amines and colorectal cancer risk: the Multiethnic Cohort Study

Greater consumption of red and processed meat has been associated with an increased risk of colorectal cancer in several recent meta-analyses. Heterocyclic amines (HCAs) have been hypothesized to underlie this association. In this prospective analysis conducted within the Multiethnic Cohort Study, we examined whether greater consumption of total, red or processed meat was associated with the risk of colorectal cancer among 165,717 participants who completed a detailed food frequency questionnaire at baseline. In addition, we examined whether greater estimated intake of HCAs was associated with the risk of colorectal cancer among 131,763 participants who completed a follow-up questionnaire that included a meat-cooking module. A total of 3,404 and 1,757 invasive colorectal cancers were identified from baseline to the end of follow-up and from the date of administration of the meat-cooking module to the end of follow-up, respectively. Proportional hazard models were used to estimate basic and multivariable-adjusted relative risks (RRs) and 95% confidence intervals for colorectal cancer associated with dietary exposures. In multivariable models, no association with the risk of colorectal cancer was detected for density-adjusted total meat (RR(Q5 vs. Q1) = 0.93 [0.83-1.05]), red meat (RR = 1.02 [0.91-1.16]) or processed meat intake (RR = 1.06 [0.94-1.19]) or for total (RR = 0.90 [0.76-1.05]) or specific HCA intake whether comparing quintiles of dietary exposure or using continuous variables. Although our results do not support a role for meat or for HCAs from meat in the etiology of colorectal cancer, we cannot rule out the possibility of a modest effect.     

Diet Quality and Risk of Lung Cancer in the Multiethnic Cohort Study

Diet quality, assessed by the Healthy Eating Index-2015 (HEI-2015), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED) score, the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII^®), was examined in relation to risk of lung cancer in the Multiethnic Cohort Study. The analysis included 179,318 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45–75 years, with 5350 incident lung cancer cases during an average follow-up of 17.5 ± 5.4 years. In multivariable Cox models comprehensively adjusted for cigarette smoking, the hazard ratios (95% confidence intervals) for the highest vs. lowest quality group based on quintiles were as follows: 0.85 (0.77–0.93) for HEI-2015; 0.84 (0.77–0.92) for AHEI-2010; 0.83 (0.76–0.91) for aMED; 0.83 (0.73–0.91) for DASH; and 0.90 (0.82–0.99) for DII. In histological cell type-specific analyses, the inverse association was stronger for squamous cell carcinoma than for adeno-, small cell, and large cell carcinomas for all indexes. There was no indication of differences in associations by sex, race/ethnicity, and smoking status. These findings support that high-quality diets are associated with lower risk of lung cancer, especially squamous cell carcinomas, in a multiethnic population.     

Longitudinal association of anthropometry with mammographic breast density in the Study of Women's Health Across the Nation

High percent mammographic breast density is strongly associated with increased breast cancer risk. Though body mass index (BMI) is positively associated with risk of postmenopausal breast cancer, BMI is negatively associated with percent breast density in cross‐sectional studies. Few longitudinal studies have evaluated associations between BMI and weight and mammographic breast density. We studied the longitudinal relationships between anthropometry and breast density in a prospective cohort of 834 pre‐ and perimenopausal women enrolled in an ancillary study to the Study of Women's Health Across the Nation (SWAN). Routine screening mammograms were collected and read for breast density. Random intercept regression models were used to evaluate whether annual BMI change was associated with changes over time in dense breast area and percent density. The study population was 7.4% African‐American, 48.8% Caucasian, 21.8% Chinese, and 21.9% Japanese. Mean follow‐up was 4.8 years. Mean annual weight change was +0.32 kg/year, mean change in dense area was ?0.77 cm²/year, and mean change in percent density was ‐1.14%/year. In fully adjusted models, annual change in BMI was not significantly associated with changes in dense breast area (?0.17 cm², 95% CI ?0.64, 0.29). Borderline significant negative associations were observed between annual BMI change and annual percent density change, with percent density decreasing 0.36% (95% CI ?0.74, 0.02) for a one unit increase in BMI over a year. This longitudinal study provides modest evidence that changes in BMI are not associated with changes in dense area, yet may be negatively associated with percent density. © 2008 Wiley‐Liss, Inc.     

Fat and meat intake and prostate cancer risk: the multiethnic cohort study

Dietary fat and meat as potential risk factors for prostate cancer have been the focus of many epidemiologic investigations, and findings from recent studies in particular have been inconsistent. Therefore, we examined the association between these exposures and prostate cancer risk in the Multiethnic Cohort Study. The analyses included 82,483 men in Hawaii and Los Angeles aged >or=45, who completed a detailed quantitative food frequency questionnaire in 1993-1996. During the follow-up period of 8 years, a total of 4,404 incident cases, including 1,278 nonlocalized or high-grade cancer cases, were identified. Cox proportional hazard models were used to estimate relative risks of prostate cancer after adjustment for time on study, ethnicity, family history of prostate cancer, education, body mass index, smoking status and energy intake. Intake of different types of fat (total, saturated, monounsaturated or polyunsaturated), n-6 fatty acid, cholesterol, various meats, and fats from meat showed no association with overall prostate cancer risk or with nonlocalized or high-grade prostate cancer. Furthermore, we found little evidence of any relation of fat and meat intake with prostate cancer risk within any of the 4 racial/ethnic groups (African Americans, Japanese Americans, Latinos and Whites). There was a suggestion of a protective effect of n-3 fatty acid intake that was limited to Latinos and Whites. However, overall, our findings from a large cohort study of ethnically diverse population give no indication that intake of fat and meat substantially affects prostate cancer risk.     

The Role of Social Networks and Support in Postpartum Women's Depression: A Multiethnic Urban Sample

Objectives: This study examined the relationship of social support, and of social networks, to symptoms of depression in a multiethnic sample of women having recently given birth. Methods: Women at community health centers in a Northeastern city were randomly sampled from groups stratified by race/ethnicity (African American, Hispanic, and White) and postpartum interval. Mother's score on the Center for Epidemiologic Studies of Depression Scale (CES-D) was the dependent variable. Main independent variables included the Medical Outcomes Study (MOS) Social Support Survey and a social network item. Univariate statistics assessed the relationship between CES-D score and each of the independent variables. Multivariate linear regression models included core sociodemographic variables alone, the core model with each of the social support and social network variables added separately, and all variables together. We evaluated interactions between race and social support, race and social networks, and social support and social networks. Results: The multivariate models with MOS Social Support and core variables indicated that each 10-point increase in the MOS Social Support Survey was related to a 2.1-unit lower score on the CES-D (95% CI −2.4, −1.7). The inclusion of the social network variable into the core model showed that having two or more friends or family members available was associated with a 13.6-point lower mean score on the CES-D (95% CI −17.5, −9.6), compared to women reporting none or only one available person. Conclusions: Both social support and social networks were statistically significant and independently related to depressive symptomatology.     

Risk of colorectal adenomas in a multiethnic Asian patient population: Race does not matter

Background:  Ethnic differences have been reported for colorectal polyps and large bowel cancer; although the supporting data is weak and insufficient to draw firm conclusions.
Aim:  We undertook this study to determine whether such racial disparity in colorectal adenomas exists in an ethnically mixed non-migrant population. The prevalence, histology and distribution of colonic polyps were documented as well as other known risk factors for colorectal malignancy.
Methods:  In this prospective cross-sectional study, 311 consecutive referred and self-referred multiracial patients attending for colonoscopy over a 41-month period in a private endoscopy center were recruited. The mean age of the study population was 51.8 ± 14 years (range 16–91). The male to female ratio was 1.1 and an ethnic breakdown as follows: 87 Malays, 115 Chinese and 109 Indians.
Results:  Sixty-three adenomas were recorded in 36 patients: six Malays, 19 Chinese and 11 Indians. Of these adenomas, 59 were polypoid, three flat and one depressed. The majority of adenomas 42/63 (67%) were distal to the splenic flexure as were all (10/10) the Duke's A carcinomas and 6/8 (75%) of the advanced cancers. Patients with adenoma(s) compared with those without (controls) were significantly older ( P =  0.005), more likely to have a family history of colorectal cancer ( P =  0.005), and showed a trend towards significance for ethnic group ( P =  0.09) on univariate analysis. Using logistic regression analysis, only family history ( P =  0.05) and age ≥ 50 years ( P =  0.011) were found to be significantly associated with adenomas.
Conclusion:  Risk factors for colonic adenoma(s) in our cohort of symptomatic multiethnic patients attending for colonoscopy do not seem to differ from those reported elsewhere and, in particular, race does not appear to be a factor.