Linkage and association of candidate obesity genes in Mexican-Americans from Starr County, Texas

Obesity and related chronic diseases represent a tremendous public health burden among Mexican Americans, a young and rapidly-expanding population. This study investigated the impact of variation within eight candidate obesity genes, which include leptin (LEP), leptin receptor (LEPR), neuropeptide Y (NPY), NPYY1 receptor (NPYY1), glucagon-like peptide-1 (GLP-1), GLP-1 receptor (GLP1R), beta-3 adrenergic receptor (β3AR), and uncoupling protein (UCP1), on variation in human obesity status and/or quantitative traits related to obesity in Mexican Americans from Starr County, Texas. The Trp64Arg polymorphism within β3AR was typed in 820 random individuals and 240 pedigrees (N = 2,044). The Arg allele frequency was significantly greater in obese versus non-obese individuals (0.20 versus 0. 15, respectively). In addition, within the random sample, the Arg allele was associated with significantly greater body weight (p = 0.031) and body mass index (BMI, p = 0.008) than the Trp allele. In the family sample, the Trp64Arg locus was also linked to percent fat (p = 0.045) but not to body weight or BMI. No linkage between obesity, diabetes, hypertension, or gallbladder disease and the Trp64Arg mutation was observed in families using affected sib pair linkage analysis or the transmission disequilibrium test. Microsatellite markers proximate to the remaining seven genes were typed in 302 individuals from 59 families. Sib pair linkage analysis provided evidence for linkage between obesity and NPY within affected sibling pairs (p = 0.042; n = 170 pairs). NPY was also linked to weight (p = 0.020), abdominal circumference (p = 0.031), hip circumference (p = 0.012), DBP (p ≤ 0.005), and a composite measure of body mass/fat (p ≤ 0.048) in all sibling pairs (n = 545 pairs). Additionally, LEP was linked to waist/hip ratio (p ≤ 0.009), total cholesterol (p ≤ 0.030), and HDL cholesterol (p ≤ 0.026), and LEPR was linked to fasting blood glucose (p ≤ 0.018) and DBP (p ≤ 0.003). Subsequent to the linkage analyses, the NPY gene was sequenced and eight variant sites identified. Two variant sites (-880I/D and 69I/D) were typed in a random sample of 914 individuals. The 880I/D variant was significantly associated with waist/hip ratio (p = 0.035) in the entire sample (N = 914) and with BMI (p = 0. 031), abdominal circumference (p = 0.044), and waist/hip ratio (p = 0.041) in a non-obese subsample (BW < 30 kg/m2, n = 594). The 69I/D variant was a rare mutation observed in only one pedigree and was not associated with obesity or body size/mass within this pedigree. Results of this study indicate that variation at or near β3AR, LEP, LEPR, and NPY may exert effects which increase obesity susceptibility and influence obesity-related measures in this population. ^

The illness narratives of Hispanic American women with coronary heart disease (CHD): An ethnographic approach

Purpose. To provide a descriptive representation of the illness narratives described by Hispanic American women with CHD. ^ Design. Focused ethnographic design. ^ Setting. One outpatient general medicine clinic, one nurse-managed health promotion clinic, and informants' homes in a large metropolitan city located in southeast Texas. ^ Sample. Purposeful sampling from two different sites resulted in 17 interviews being conducted with 14 informants. ^ Method. Focused ethnographic techniques were employed in the designation of participants for the study, data collection, analysis and re-presentation. Audiotaped interviews and fieldwork were transcribed verbatim and analyzed through an iterative process of data reduction, data display, drawing conclusions and verification. ^ Findings. The developing conceptual framework that emerged from the data is labeled after the overarching experience described by informants, the experience of Embodied Exhaustion. Embodied Exhaustion, as described in this study, refers to an ongoing, dynamic, indeterminate experience of mind-body exhaustion resulting from a complex constellation of biologic, psychological and social distresses occurring over the life course. The experience consists of three categories: Taking Care of Others, Wearing Down and Hurting Hearts. Two stabilizing forces were identified: Collective Self and Believing in God. ^ Conclusions. The findings of this study emphasize the importance of framing all research, theory and practice targeting Hispanic women with CHD within a sociocentric paradigm. Nursing is challenged to provide care that extends beyond the physical body of the patient to include the social context of illness, especially the family. ^

An ethnographic study of home remedy use for African-American children

Background and significance. The use of herbs and other remedies by adult and elderly African-Americans has been documented. However, little is understood regarding the use of herbs for African-American children. The purpose of this study was to document and describe the historical and present day uses of herbal and other remedies, specifically for the health and illness of African-American children. This information will provide health care providers with a better understanding of their African-American patients. This information may also contribute to the emerging appreciation of indigenous uses of phytotherapeutics. ^ Methods. A focused ethnographic approach was used to describe the cultural context, including the beliefs, values, customs, and behaviors of a particular culture. The use of intensive fieldwork, including participant observation, audiotaped formal interviews, photographs, and specimen collection of plants helped to describe herb use in this population. Information on the growing, harvesting, preparation, and storage of these plant remedies, as well as the amount and dosage of these compounds was collected in a typology. Detailed information was gathered to discern how, when, and under what conditions these remedies were used and their expected results. Further data collection focused on the history of herbal use, and explanations for how and why informants thought the herbs work. ^ Setting and participants. The setting for this study was in East Texas and field work extended over the period of one year. Thirty African-Americans, age 38 to 98, were interviewed for the study. The African-American population in this area has been relatively stable, with roots dating back prior to the reconstruction period, which allowed excellent historical information. Informants were chosen by a nominated sampling technique starting with two key informants knowledgeable about the use of home remedies for children. ^ Findings. The findings of this study suggest that African-American children in East Texas have a long history of receiving herbs and home remedies for health promotion and illness. Data further suggests that there is a strong connection between spirituality and the health beliefs and practices of this community. This spiritual component underlies the accuracy of oral recall for remedies that have been used over many generations and the use of natural folk remedies. A typology of the herbal remedies was developed with folk and Latin name, herb place of origin, known scientific properties, and informant folk usage and dosage information. ^

Ethnic differences in adolescents' mental distress

Objectives. The aims of this cross-sectional study were to (1) examine differences among four ethnic groups of middle school students (Anglos, African Americans [AAs], Hispanics, and Asians) on (a) three indicators of mental distress (depression, somatic symptoms, suicidal ideation) (b) social stress (general social stress, process-oriented stress, discrimination) and resources (family relationships, coping, self-esteem) and (2) identify significant risk factors and resources for each ethnic group by examining the moderating effects of ethnicity. ^ Methods. Respondents included 316 students from three schools (144 Anglos, 66 AAs, 77 Hispanics, 29 Asians/Others) who completed self-administered questionnaires. Social stress and somatic symptoms were measured by using the SAFE-C and Somatic Symptom Scale, respectively. The DSD was used to assess depression and suicidal ideation. Resources were measured by using the FES, age-appropriate adaptations of two existing coping scales, and Rosenberg's Self-Esteem Scale. For specific aims, descriptive statistics, ANOVA, ANCOVA, and logistic regression analysis were used. ^ Findings. No statistically significant ethnic group or gender differences were observed in depression and somatic symptoms, but the odds of experiencing depression symptoms were about 9.7 times greater for Hispanic females than for the referent group, Anglo males. Hispanics were also 2.04 times more likely to have suicidal ideation than Anglos ( P < 0.05). AAs and Hispanics reported significantly higher levels of stress than Anglos (OR: 2.2–4.3, 0.00 ≤ P ≤ 0.03). These findings imply that adolescents in these ethnic groups may be exposed to considerable amounts of stress even if they do not exhibit significant symptoms of mental distress yet. Negative moderating effects for ethnicity were found by the significant interaction between ethnicity and social stress in somatic symptoms among AAs and Hispanics. This finding indicates that AA and Hispanic adolescents may require higher levels of social stress to exhibit the same amount of somatic symptoms as Anglo adolescents. Observed ethnic differences in social stress and interaction between social stress and ethnicity in relation to somatic symptoms demonstrated a need for subsequent longitudinal studies, and provided a rationale for incorporating social stress as a critical component not only in research but also in culturally sensitive prevention programs. ^

A hybrid method in combining treatment effects from matched and unmatched studies

In the biomedical studies, the general data structures have been the matched (paired) and unmatched designs. Recently, many researchers are interested in Meta-Analysis to obtain a better understanding from several clinical data of a medical treatment. The hybrid design, which is combined two data structures, may create the fundamental question for statistical methods and the challenges for statistical inferences. The applied methods are depending on the underlying distribution. If the outcomes are normally distributed, we would use the classic paired and two independent sample T-tests on the matched and unmatched cases. If not, we can apply Wilcoxon signed rank and rank sum test on each case. ^ To assess an overall treatment effect on a hybrid design, we can apply the inverse variance weight method used in Meta-Analysis. On the nonparametric case, we can use a test statistic which is combined on two Wilcoxon test statistics. However, these two test statistics are not in same scale. We propose the Hybrid Test Statistic based on the Hodges-Lehmann estimates of the treatment effects, which are medians in the same scale.^ To compare the proposed method, we use the classic meta-analysis T-test statistic on the combined the estimates of the treatment effects from two T-test statistics. Theoretically, the efficiency of two unbiased estimators of a parameter is the ratio of their variances. With the concept of Asymptotic Relative Efficiency (ARE) developed by Pitman, we show ARE of the hybrid test statistic relative to classic meta-analysis T-test statistic using the Hodges-Lemann estimators associated with two test statistics.^ From several simulation studies, we calculate the empirical type I error rate and power of the test statistics. The proposed statistic would provide effective tool to evaluate and understand the treatment effect in various public health studies as well as clinical trials.^

Risk factors for diabetic retinopathy in Mexican Americans in Starr County, Texas

The prevalence of diabetes in Mexican Americans is disproportionately higher than in non-Hispanic whites. The rate of diabetic retinopathy resulting from prolonged diabetes is also greater in Mexican Americans than in non-Hispanic whites. A longitudinal study was carried out on data collected from Mexican Americans in Starr County, Texas to assess the association between socioeconomic and acculturation factors with diabetic retinopathy prevalence, incidence, and progression in those free of diabetic retinopathy or who had only early non-proliferative diabetic retinopathy. A multivariable analysis was done. ^ The incidence rate was 12.78 cases per year and the progression rate was 8.55 cases per year. The baseline characteristics of the population revealed that more people with occupations synonymous with lower income jobs like trade workers and machine operators had early non-proliferative diabetic retinopathy. A multivariable analysis revealed that those with early non-proliferative diabetic retinopathy were more likely to have been born in Mexico as compared to those free of diabetic retinopathy. Surprisingly, a multivariable analysis also showed that those that progressed in diabetic retinopathy disease status were more likely to have been employed as compared to those that did not. ^ This analysis reveals that Mexican Americans are heterogeneous in socioeconomic and acculturation factors that may be used to deter the incidence and progression of diabetic retinopathy severity. These findings could be targeted to create culturally sensitive intervention programs that will improve the detection and treatment of diabetic retinopathy in the work arena in addition to programs that will impact those that do not work. Workplace preventative health screenings and dissemination of language-specific informational brochures is warranted to curb the rates of progression in those employed. ^ A limitation of this study is the narrow surrogates used for assessing socioeconomic and acculturation status. To fully evaluate these variables, a study using a questionnaire with a multitude of surrogates for socioeconomic and acculturation factors should be employed.^

Field test evaluation of rear lighting deceleration signals: I - analytical and experimental studies. Interim report.

National Highway Traffic Safety Administration, Washington, D.C.

Of cats and rats : studies of the neural basis of aggression /

Mode of access: Internet.

The chances of death, and other studies in evolution.

"Errata" slip tipped in at v. 1, p. [1]; Addenda slip tipped in at v. 2, p. [413]

Contributions to midwifery, and diseases of women and children : with a report on the progress of obstetrics, and uterine and infantile pathology in 1858 /

Mode of access: Internet.

Textbook of obstetrics and obstetric nursing

Mode of access: Internet.

Social and philosophical studies,

Mode of access: Internet.

Veterinary obstetrics and zootechnics /

"References" at end of each part.

Strategies to optimize the impact of nutritional surveys and epidemiological studies

The development of nutrition and health guidelines and policies requires reliable scientific information. Unfortunately, theoretical considerations and empirical evidence indicate that a large percentage of science-based claims rely on studies that fail to replicate. The session "Strategies to Optimize the Impact of Nutrition Surveys and Epidemiological Studies" focused on the elements of design, interpretation, and communication of nutritional surveys and epidemiological studies to enhance and encourage the production of reliable, objective evidence for use in developing dietary guidance for the public. The speakers called for more transparency of research, raw data, consistent data-staging techniques, and improved data analysis. New approaches to collecting data are urgently needed to increase the credibility and utility of findings from nutrition epidemiological studies. Such studies are critical for furthering our knowledge and understanding of the effects of diet on health.