The development of eating pathology in Chinese-Australian women: acculturation versus culture clash

Objective
Recent research suggests there has been an increase in the incidence of eating pathology among Asian women residing in the West. Two alternate explanations for the development of this eating pathology have been proposed; acculturation versus culture clash. The current study was designed to further examine the influence of acculturation versus culture clash on the development of eating pathology in Chinese-Australian women.

Method
Eighty-one Chinese-Australian women completed a questionnaire investigating their level of eating pathology, perceived sociocultural influences to lose weight, parental overprotection and care, self-perceptions of physical appearance, sociability and global self-worth, and the strength of their ethnic identity.

Results
It was found that, overall, low levels of satisfaction with physical appearance, high levels of parental overprotection, and high levels of perceived pressure from best female friends to lose weight predicted greater eating pathology in both acculturated and traditional women. However, acculturated women who perceived higher levels of pressure from their fathers and best male friends to lose weight and traditional women who experienced higher levels of parental care reported the greatest eating pathology.

Discussion
The findings suggest that there are both similarities and differences between the risk factors that correlate with eating pathology between acculturated and traditional women. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 35: 579-588, 2004.

The relationship between patient blood pathology values and patient falls in an acute-care setting : a retrospective analysis

Few studies have investigated the relationship between patient falls and patient blood pathology values, which can reveal objective information about the health and nutritional status of a patient. It could be that some abnormal values are associated with patients that fall. The objectives of the current study were to determine whether blood pathology values were different in patients who fell compared to patients who did not fall, and whether there was a difference in the type and number of currently documented risk factors for falls found for patients who fell compared to patients who did not fall. A retrospective audit of patient incident reports and medical records was conducted in an acute-care hospital for 220 patients who fell and who did not fall. Faller and non-faller patients were matched by casemix type and length of stay. Findings revealed a significant relationship between patients who fell and the variables of age, confusion status and alkaline phosphatase blood values.

Apoptosis may underlie the pathology of zinc-deficient skin

The trace element zinc is essential for the survival and function of all cells. Zinc deficiency, whether nutritional or genetic, is fatal if left untreated. The effects of zinc deficiency are particularly obvious in the skin, seen as an erythematous rash, scaly plaques, and ulcers. Electron microscopy reveals degenerative changes within keratinocytes. Despite the well-documented association between zinc deficiency and skin pathology, it is not clear which cellular processes are most sensitive to zinc deficiency and could account for the typical pathological features. We used the cultured HaCaT keratinocyte line to obtain insight into the cellular effects of zinc deficiency, as these cells show many characteristics of normal skin keratinocytes. Zinc deficiency was induced by growing cells in the presence of the zinc chelator, TPEN, or by growth in zinc-deficient medium. Growth of cells in zinc-deficient medium resulted in a 44% reduction of intracellular zinc levels and a 75% reduction in the activity of the zinc-dependent enzyme, 5'-nucleotidase, relative to the control cells. Over a period of 7 days of exposure to zinc-deficient conditions, no changes in cell viability and growth, or in the cytoskeletal and cell adhesion systems, were found in HaCaT cells. At 7 days, however, induction of apoptosis was indicated by the presence of DNA fragmentation and expression of active caspase-3 in cells. These results demonstrate that apoptosis is the earliest detectable cellular change induced by zinc deficiency in HaCaT keratinocytes. Our observations account for many of the features of zinc deficiency, including the presence of degenerate nuclei, chromatin aggregates and abnormal organization of keratin, that may represent the later stages of apoptosis. In summary, a major causal role for apoptosis in the pathology of zinc deficiency in the skin is proposed. This role is consistent with the previously unexplained diverse range of degenerative cellular changes seen at the ultrastructural level in zinc-deficient keratinocytes.

High reproducibility of patellar tendon vascularity assessed by colour doppler ultrasonography : a reliable measurement tool for quantifying tendon pathology

Background: This study examined whether patellar tendon vascularity could be quantified accurately in the clinical setting using colour Doppler ultrasonography.

Methods: A sonographer and two radiologists visually estimated tendon vascularity in millimetres in 74 tendons during ultrasound (US) examination and from hard copy films. These estimates were then compared to the length of vessels measured from the digital image in millimetres and the correlation between them was determined. A subset of 16 tendons was used to compare the estimates of vascularity by two examiners at US examination.

Results: The estimation of vascular length at US examination correlated highly with the measured vascular length (r = 0.92; 95% confidence interval (CI) 0.87 to 0.94), as did the length estimated from the films (r = 0.94; 95% CI 0.9 to 0.96). The correlation between examiners was 0.84 (95% CI 0.51 to 0.94) for the estimates made during US examination and 0.85 (95% CI 0.59 to 0.95) for the vessel lengths measured from the digital images.

Conclusions: These excellent correlations indicate that tendon vascularity can be reliably estimated using colour Doppler ultrasonography and tendon vascularity could therefore be used by clinicians to rate clinical change. This method of quantifying tendon vascularity could also be used in research to investigate the effects of tendon treatments on vascularity.

The development of eating pathology in Chinese-Australian women: acculturation versus culture clash

Recent research suggests there has been an increase in the incidence of eating pathology among Asian women residing in the West. Two alternate explanations for the development of this eating pathology have been proposed; acculturation versus culture clash. The present study was designed to further examine the influence of acculturation versus culture clash on the development of eating pathology in Chinese-Australian women. Eighty-one Chinese-Australian women completed a questionnaire investigating their level of eating pathology, perceived sociocultural influences to lose weight, parental overprotection and care, selfperceptions of physical appearance, sociability and global self worth, and the strength of their ethnic identity. It was found that overall, low levels of satisfaction with physical appearance, high levels of parental overprotection, and high levels of perceived pressure from best female friends to lose weight predicted greater eating pathology in both acculturated and traditional women. However, acculturated women who perceived higher levels of pressure from their fathers and best male friends to lose weight and traditional women who experienced higher levels of parental care, reported the greatest eating pathology. The findings suggest that there are both similarities and differences between the risk factors that correlate with the eating pathology among acculturated and traditional women.

Increased versican content is associated with tendinosis pathology in the patellar tendon of athletes with jumper

Expansion of the extracellular matrix is a prominent but poorly characterized feature of tendinosis. The present study aimed to characterize the extent and distribution of the large aggregating proteoglycan versican in patients with patellar tendinosis. We obtained tendon from tendinopathy patients undergoing debridement of the patellar tendon and from controls undergoing intramedullary tibial nailing. Versican content was investigated by Western blotting and immunohistochemistry. Microvessel thickness and density were determined using computer-assisted image analysis. Markers for smooth muscle actin, endothelial cells (CD31) and proliferating cells (Ki67) were examined immunohistochemically. Western blot analysis and immunohistochemical staining revealed elevated versican content in the proximal patellar tendon of tendinosis patients (P=0.042). Versican content was enriched in regions of fibrocartilage metaplasia and fibroblast proliferation, as well as in the perivascular matrix of proliferating microvessels and within the media and intima of arterioles. Microvessel density was higher in tendinosis tissue compared with control tissue. Versican deposition is a prominent feature of patellar tendinosis. Because this molecule is not only a component of normal fibrocartilagenous matrices but also implicated in a variety of soft tissue pathologies, future studies should further detail both pathological and adaptive roles of versican in tendons.

Pathology of chronic achilles-tendon injuries in athletes

Overuse tendon conditions have traditionally been considered to result from an inflammatory process and were treated as such. Microscopic examination of abnormal Achilles-tendon tissues, however, reveals a non-inflammatory degenerative process. The histopathology found in surgical specimens in patients with chronic overuse Achilles tendinopathy and those with Achilles-tendon rupture are reviewed. Seminal studies suggest that so-called tendinitis is a rare condition that might occur occasionally in the Achilles tendon in association with a primary tendinosis. These data have clinical implications and require a review of the traditional classification of pathologies seen in tendon conditions, The authors recommend that nomenclature be based on histopathological findings rather than traditional hypothesis.

Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy

Overuse tendinopathy is problematic to manage clinically. People of different ages with tendons under diverse loads present with varying degrees of pain, irritability, and capacity to function. Recovery is similarly variable; some tendons recover with simple interventions, some remain resistant to all treatments.

The pathology of tendinopathy has been described as degenerative or failed healing. Neither of these descriptions fully explains the heterogeneity of presentation. This review proposes, and provides evidence for, a continuum of pathology. This model of pathology allows rational placement of treatments along the continuum.

A new model of tendinopathy and thoughtful treatment implementation may improve outcomes for those with tendinopathy. This model is presented for evaluation by clinicians and researchers.

Multicellular spheroids in ovarian cancer metastases: Biology and pathology

Epithelial ovarian cancer (EOC) has a relatively high mortality rate (~55%). One of the presiding causes is that the current chemotherapeutic regimes are unable to achieve sustained remission, despite frequently producing a positive response at first treatment. One of the reasons that EOC is difficult to treat is that the mechanism of dissemination is unusual. EOC dissemination characteristically involves local invasion of pelvic and abdominal organs. Unlike many epithelial cancers, initial dissemination rarely requires the vasculature, although the vasculature is often implicated in the advanced stages of disease. Recently, it has become apparent that aggregates of malignant cells (spheroids) contained within malignant ascites represent a significant impediment to efficacious treatment of late stage EOC. In vivo, spheroids are present in the malignant ascites of EOC patients, while in vitro cultured spheroids are capable of tumorgenesis in vivo and display a reduced response to chemotherapeutic drugs when compared to monolayers. A major problem associated with the current generation of chemotherapy agents is that they do not address the anchorage and vascular-independent growth conditions associated with a 3-dimensional structure that has formed and/or grown in suspension. Thus, spheroid formation may represent a key component of platinum/taxanesensitive recurrence. If this is correct, a better understanding of spheroid biology may contribute to the identification of new treatment opportunities for the sustained treatment of metastatic EOC. This review article outlines the key biological features of spheroids, specifically discussing their role in EOC dissemination and chemo-response as well as providing insights into spheroid functionality.

On the relationship between child abuse and eating pathology

The thesis examined variables that could potentially mediate the relationship between child abuse and eating pathology. The relationship was found to be intricate and multi-faceted with important gender differences. The most novel finding was that drive for muscularity was significantly associated with child abuse in males and in females. The portfolio presents four adult case studies, each with different experiences of child abuse. It aims to examine if the core tenets of neurobiological theory of trauma can be useful to understand the lasting effects of child abuse on adult functioning.

Self-injury and eating pathology

It was found that Urgency and lack of Perseverance were significantly elevated in women with self-injury or eating pathology, and significantly higher again in women with both these syndromes. A longitudinal design found that self-injury tends to progress from milder, compulsive forms, to more severe, impulsive forms over time. The portfolio examines the frequent co-occurrence of substance use and psychiatric disorders (Dual Diagnosis). Four primary conceptualisations of how dual diagnoses develop and present are discussed. These models are then applied to inform four case studies.