Lower resting energy expenditure and fat oxidation in Native American and Hispanic infants born to mothers with diabetes

OBJECTIVE: To determine whether exposure to diabetes in utero affects resting energy expenditure (REE) and fuel oxidation in infants.

STUDY DESIGN: At 35 ± 5 days after birth, body composition and REE were measured in full-term offspring of Native American and Hispanic women with either well-controlled diabetes (13 girls, 11 boys) or normal healthy pregnancies (18 girls, 17 boys).

RESULTS: Control of dysglycemia during gestation in the women with diabetes mellitus met current clinical standards, shown by average glycated hemoglobin (5.9 ± 0.2%; 40.6 ± 2.3 mmol/mol). Infant body mass (offspring of women with diabetes: 4.78 ± 0.13, control offspring: 4.56 ± 0.08 kg) and body fatness (offspring of women with diabetes: 25.2 ± 0.6, control offspring: 24.2 ± 0.5 %) did not differ between groups. REE, adjusted for lean body mass, was 14% lower in offspring of women with diabetes (41.7 ± 2.3 kJ/h) than control offspring (48.6 ± 2.0, P = .025). Fat oxidation was 26% lower in offspring of women with diabetes (0.54 ± 0.05 g/h) than control offspring (0.76 ± 0.04, P < .01) but carbohydrate oxidation did not differ. Thus, fat oxidation accounted for a lower fraction of REE in the offspring of women with diabetes (49 ± 4%) than control offspring (60 ± 3%, P = .022). Mothers with diabetes were older and had higher prepregnancy body mass index than control mothers.

CONCLUSIONS: Well-controlled maternal diabetes did not significantly affect body mass or composition of offspring at 1-month old. However, infants with mothers with diabetes had reduced REE and fat oxidation, which could contribute to adiposity and future disease risk. Further studies are needed to assess the impact differences in age and higher prepregnancy body mass index.

Cord blood adipokines, neonatal anthropometrics and postnatal growth in offspring of Hispanic and Native American women with diabetes mellitus

BACKGROUND: Offspring of women with diabetes mellitus (DM) during pregnancy have a risk of developing metabolic disease in adulthood greater than that conferred by genetics alone. The mechanisms responsible are unknown, but likely involve fetal exposure to the in utero milieu, including glucose and circulating adipokines. The purpose of this study was to assess the impact of maternal DM on fetal adipokines and anthropometry in infants of Hispanic and Native American women.

METHODS: We conducted a prospective study of offspring of mothers with normoglycemia (Con-O; n = 79) or type 2 or gestational DM (DM-O; n = 45) pregnancies. Infant anthropometrics were measured at birth and 1-month of age. Cord leptin, high-molecular-weight adiponectin (HMWA), pigment epithelium-derived factor (PEDF) and C-peptide were measured by ELISA. Differences between groups were assessed using the Generalized Linear Model framework. Correlations were calculated as standardized regression coefficients and adjusted for significant covariates.

RESULTS: DM-O were heavier at birth than Con-O (3.7 ± 0.6 vs. 3.4 ± 0.4 kg, p = 0.024), but sum of skinfolds (SSF) were not different. At 1-month, there was no difference in weight, SSF or % body fat or postnatal growth between groups. Leptin was higher in DM-O (20.1 ± 14.9 vs. 9.5 ± 9.9 ng/ml in Con-O, p < 0.0001). Leptin was positively associated with birth weight (p = 0.0007) and SSF (p = 0.002) in Con-O and with maternal hemoglobin A1c in both groups (Con-O, p = 0.023; DM-O, p = 0.006). PEDF was positively associated with birth weight in all infants (p = 0.004). Leptin was positively associated with PEDF in both groups, with a stronger correlation in DM-O (p = 0.009). At 1-month, HMWA was positively associated with body weight (p = 0.004), SSF (p = 0.025) and % body fat (p = 0.004) across the cohort.

CONCLUSIONS: Maternal DM results in fetal hyperleptinemia independent of adiposity. HMWA appears to influence postnatal growth. Thus, in utero exposure to DM imparts hormonal differences on infants even without aberrant growth.

Revolution and the ritual year: religious conflict and innovation in Cristero Mexico

This article analyses Catholic responses to persecution of the Church by the Mexican state during Mexico's cristero rebellion (1926–9) and seeks to make a new contribution to the revolt's religious history. Faced with the Calles regime's anticlericalism, the article argues, Mexico's episcopate developed an alternative cultic model premised on a revitalised lay religion. The article then focuses on changes and continuities in lay – clerical relations, and on the new religious powers of the faithful, now empowered to celebrate ‘white’ masses and certain sacraments by themselves. The article concludes that persecution created new spaces for lay religious participation, showing the 1910–40 Revolution to be a period of religious, as well as social, upheaval.

“Hegemony Protected by the Armour of Coercion”: Dashiell Hammett’s Red Harvest and the State

This article argues that Dashiell Hammett's 1929 novel Red Harvest is best understood in the context of the consolidation and expansion of the US state following the First World War and the Russian Revolution. It also argues that Hammett's novel constitutes a highly significant articulation of theoretical debates about the nature of political authority and state power in the modern era and speaks about the transition of one state formation to another. Insofar as Red Harvest explores the way in which the state's coercive and ethical character are bound up together, this article argues that Hammett's novel draws upon an understanding of political authority and state power primarily derived from Gramsci, via Marx. Gramsci insists that control cannot be maintained through force alone (and his conception of hegemony, in turn, suggests a power bloc that can become fragmented and disunited in a war of position). In the same way, Red Harvest traces the transformation of the “economic-corporate” state into the expanded or “ethical” State but crucially any ethical dimension, as Gramsci notes, is always beholden to the needs of the capitalist economy. As such, the apparently arbitrary bloodshed in the novel is conceived as a relatively minor realignment in the ranks of the capitalist classes – certainly less serious than the miners' strike that prefigures the novel. What makes this realignment significant is that it calls attention to the state both as repressive and as a site of conflict and compromise. Here, the work performed by the Continental Op and by the crime novel in general – simultaneously buttressing and, to some extent, contesting the power of the state – needs to be understood as part of the process by which the state is consistently enacting hegemony (albeit protected by the armour of coercion). The article concludes by pointing out that while Gramsci is perhaps too willing to dwell upon the state's expanded reach, Red Harvest is more interested in examining possible “cracks and fissures” in the state formation, even if the critique it ultimately offers goes nowhere and yields nothing.

AA and the Redeployment of Temperance Literature

This essay is an examination that, primarily comparativist in its approach, links publication materials from the temperance and Prohibition periods with the Big Book to show how AA's narrative antidotes to the traumas of modernity (sited in alcohol abuse) were as much the product of premodernist and turn-of-the-century hysteria as they were an attempt to write a new chapter in America's relationship with alcohol based on contemporary medical and social research.

On the way to 'duende' (through Lorca's 'Elogio de Antonia Merce, 'la Argentina', 1930)

This article analyzes how Lorca develops the concept of ‘duende’, finding a crucial missing link in the Elogio de Antonia Mercé, ‘la Argentina’ (1930). ‘Duende’ crystallizes around 1929/1930 when the poet explicitly takes into account the art of the dancer in performance. Three aspects of performance are singled out and systematically traced through Lorca's evolving reflections on popular art and the struggle of the modern artist to create the new – from his first lecture on the cante jondo in 1922 to the Arquitectura del cante jondo (1930) and finally Juego y teoría del duende (1933). The conclusion is drawn that it is in the performance and reception of a text – whether it is heard or read – that the artist's agonistic stand between tradition and modernity, repetition and singularity, is played out, in an invitation to the listener or reader to celebrate his or her mortality.

Muriel Rukeyser, America, and the “Melville Revival”

Whilst Muriel Rukeyser's poetic affinity with Walt Whitman is generally acknowledged, the close relation of her work and poetic sensibility to the thought and writing of Herman Melville has somehow gone relatively unnoticed, and almost wholly unexamined. In 1918, Van Wyck Brooks called for the creation of a usable past that would energize America by recasting its cultural tradition. His plea addressed the need to rebuild a national heritage via the rediscovery of culturally “great” figures. By the late 1930s, many scholars and writers had answered the call, and the new discipline of American studies was beginning to take shape, aided by a reclamation of one of the country's greatest, most neglected, writers – Herman Melville. This was also the period in which Rukeyser “came of age”; a time when political and international conflicts and economic crises generated both the stark, documentary representation of present social realities and the drive to retrieve or reconstruct a more golden age that might mobilize a dislocated nation. The following article examines the importance of Melville to Rukeyser's work, and situates her within the “Melville revival” as an important figure in the movement throughout the first half of the twentieth century to reconstruct an American cultural character.

Service user perspectives on palliative care education for health and social care professionals supporting people with learning disabilities

Background and objectives
Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. Although professionals’ perceptions of their training needs in this area have been studied, the perceptions of people with learning disabilities and family carers are not known. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training.

Methods
A qualitative, exploratory design was used. A total of 17 people with learning disabilities were recruited to two focus groups which took place within an advocacy network. Additionally, three family carers of someone with a learning disability, requiring palliative care, and two family carers who had been bereaved recently were also interviewed.

Results
Combined data identified the perceived learning needs for healthcare professionals. Three subthemes emerged: ‘information and preparation’, ‘provision of care’ and ‘family-centred care’.

Conclusions
This study shows that people with learning disabilities can have conversations about death and dying, and their preferred end-of-life care, but require information that they can understand. They also need to have people around familiar to them and with them. Healthcare professionals require skills and knowledge to effectively provide palliative care for people with learning disabilities and should also work in partnership with their family carers who have expertise from their long-term caring role. These findings have implications for educators and clinicians.

The Ocho Poetas Mexicanos and the marginalisation of Catholic authors in post-revolutionary Mexico

The group known as the Ocho Poetas Mexicanos were marginalised in post-revolutionary literary circles and remain largely forgotten by literary history because they were dismissed as Catholic authors by a literary establishment which favoured nation-building literature at a time when Catholicism was excluded from official constructions of nationhood. This article draws attention to the significant contribution made by group members to contemporary cultural life and re-evaluates the work they published in the 1955 anthology which announced their arrival onto the literary scene. An analysis of this collection demonstrates that there was scant justification for labelling the group as Catholic poets and suggests that they are best understood with reference to the “universal” strand of Mexican literature and as heirs to groups such as the Contemporáneos. The treatment of the Ocho Poetas provides important evidence of the way in which Catholic authors were marginalised in mid-twentieth century Mexico, even if they did not express religious beliefs in their work, and draws attention to the non-literary criteria which can come into play when evaluating texts.