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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2009.10.025 Byline: Virginia H. Rice (a)(b), Linda S. Weglicki (a), Thomas Templin (a), Hikmet Jamil (c), Adnan Hammad (d) Author Affiliation: (a) Wayne State University College of Nursing, United States (b) Karmanos Cancer Institute, United States (c) Wayne State University School of Medicine, United States (d) Arab Community Center for Economic and Social Services (ACCESS), United States

Abstract Objective Successful weight loss interventions for African-Americans adolescents are lacking. Cognitive-behavioral interventions seek to develop weight loss skills (e.g., counting calories, goal setting, managing one's environment). Little is known about how well adolescents implement such skills in their daily lives. Study aims were to (1) examine weight loss skills utilization at midpoint and end of a 6-month cognitive-behavioral/motivational interviewing weight loss sequential multiple assignment randomized trial (SMART), and (2) determine if greater skill utilization predicted weight loss at treatment end and 3 months post-treatment. Method One hundred and eighty six African-Americans adolescents with obesity and their caregiver were first randomly assigned to complete 3 months of cognitive-behavioral and motivational interviewing family-based weight loss treatment in their home or in the research office (Phase 1). Nonresponders (i.e., those who lost < 3% of initial weight, n = 161) were rerandomized to 3 months of continued skills training (n = 83) or contingency management (n = 78) for Phase 2; responders were allocated to 3 months of relapse prevention (n = 20). Adolescents' frequency of weight loss skills utilization was assessed via questionnaire at treatment midpoint and end. Results Higher treatment attendance was associated with better skill utilization. Higher skill utilization was associated with more weight loss at treatment end, whereas higher baseline confidence was associated with more weight loss at follow-up. Conclusions This study indicates the importance of attending weight loss intervention sessions to develop and strengthen weight loss skills in African-American adolescents with obesity, and strengthening confidence to use such skills for continued weight loss. [ABSTRACT FROM AUTHOR]

Abstract Purpose The purpose of this study was to determine the prevalence of respiratory and/or physical fitness health problems in adolescent (ages 18–21) water pipe (WP) smokers (with or without cigarette smoking), cigarette-only smokers, and nonsmokers. Methods A comparative four-group study design was used to recruit a non–probability sample of 153 WP smokers only, 103 cigarette smokers only, and 102 cigarette+WP smokers along with 296 nonsmokers. Our hypothesis was that youth who smoked WPs and/or cigarettes would report more respiratory problems and/or poorer physical fitness than those who did not smoke. Results The results showed that coughs were significantly associated with smoking in all three of the smoking groups (p <.05). Cigarette-only smokers reported the most adverse outcomes with more wheezing, difficulty breathing, and less ability to exercise without shortness of breath. A dose-response analysis showed similar patterns of adverse health effects for both WP and cigarette smokers. The combined use of both products was not appreciably worse than smoking one product alone. This could be due to cigarette+WP smokers' reporting using less of the respective products when only one product was smoked. Conclusions Even during the adolescent years, WP and/or cigarette smoking youth experienced reportable negative health effects. [ABSTRACT FROM AUTHOR]

Background The Respiratory Distress Observation Scale © (RDOS) is a means for assessing respiratory distress when a patient is unable to give a dyspnea self-report. Cut-point determination was needed to guide clinical application. Method A Receiver Operating Characteristic (ROC) curve analysis was conducted in a prospective, observation study with inpatients ranked by nurse practitioners (NP) into levels of respiratory distress. A research assistant simultaneously measured RDOS blinded to NP ranking. Results Participants were 84 adults: mean age of 72.6 (SD = 15.2) years, 53.6% male, 77.4% African-American. NP ranking was distributed: none (30%), mild (26%), moderate (31%), and severe (13%) distress. RDOS scores ranged 0–13 ( M = 4.8, SD = 3). NP ranking was significantly correlated with RDOS ( rho = .91, p < .01). ROC curve analyses yielded cut-points: none = 0–2, any = 3, mild-moderate = 4–6, and severe ≥7 ( p < .01). Conclusions Intensity cut-point enhances the clinical utility of the RDOS. [ABSTRACT FROM AUTHOR]

Purpose: Chronic exposure to racial discrimination by pregnant African American women may lead to allostatic overload; thereby, predisposing women to systemic inflammation. Thus, the goal of this study was to examine if experiences of racial discrimination are related to systemic inflammation in pregnant African Americans. Methods: A sample of 96 African American women from Chicago completed questionnaires and had blood drawn during the second trimester of pregnancy (19.7 ± 2.5 weeks). Results: Experiences of racial discrimination were associated with higher cytokine levels of interleukin (IL)-4 (B = 2.161,95% CI = 1.02-3.30, p b .001) and IL-6 (B = 1.859,95% CI = .61-3.11, p = .004) when controlling for covariates. Conclusion: These findings suggest that experiences of racial discrimination may cause physiological wear and tear on the body leading to alteration of immune functions. Nurses should inquire about women's experiences of racial discrimination and make referrals for community or church support groups for women who report racial discrimination. [ABSTRACT FROM AUTHOR]

Objective To determine if preoperative ICD Risk Score for Adverse Outcome (ICD-RSAO) would predict need for hospital 30-day readmission. Background Pre-analysis of National Cardiovascular Data Registry ICD database identified preoperative predictors of adverse outcomes associated with ICD implantation. Methods Logistic regression, descriptive statistics and Chi-square were used to examine the relationship between ICD-RSAO and 30-day readmission after ICD implantation. Results BUN >30, history of lung disease, NYHA Class IV and device implant during inpatient stay were predicative of 30-day readmission ( P = 0.001; 95% CI = 0.58–0.79). Patients with a combination of two or more of four variables were more likely to be readmitted (Hosmer–Lemeshow ( χ 2 = 3.44, P = 0.49), c-statistic = 0.71, and Nagelkerke R 2 = 0.15). Conclusion Patients who have elevated BUN's, NYHA Class IV, chronic lung disease and ICD implantation during a concomitant hospital admission are at increased risk for readmission and need early follow up. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: We evaluated the psychometric properties of a revised version of the Parental Monitoring of Diabetes Care questionnaire (PMDC-R) designed to evaluate parental supervision and monitoring of adolescent diabetes care behaviors. The revised measure was intended to capture a broad range of ways used by parents to gather information about youth adherence to diabetes care. Methods: Two hundred sixty-seven caregivers of 12–18-year-old adolescents with type 1 diabetes completed the PMDC-R. Measures of parental knowledge of youth illness management, illness management behavior, and metabolic control were also obtained. Results: The PMDC-R demonstrated good internal consistency (alpha coefficient = .91) and test–retest reliability (r = .79, p < .001). Supporting the instrument''s construct validity, a bifactor model with one primary factor and three secondary factors had an acceptable fit to the data (comparative fit index = .92, root mean square error of approximation = .06). Concurrent validity was also supported. In structural equation models, parental monitoring, as assessed by the PMDC-R, had a significant direct effect on parental knowledge of adolescent diabetes management and, through knowledge, an indirect effect on adolescent diabetes management and metabolic control. Conclusions: The PMDC-R displayed strong psychometric properties and represents an important next step in refining the measurement of parental monitoring for youth with chronic illnesses. [Copyright &y& Elsevier]

Purpose: MicroRNAs (miRNAs), a class of noncoding small RNAs that regulate gene expression, are involved in numerous physiologic processes in normal and malignant cells. Our in vivo study measured miRNA and gene expression changes in human blood cells in response to ionizing radiation, to develop miRNA signatures that can be used as biomarkers for radiation exposure. Methods and Materials: Blood from 8 radiotherapy patients in complete remission 1 or 2 was collected immediately before and 4 hours after total body irradiation with 1.25 Gy x-rays. Both miRNA and gene expression changes were measured by means of quantitative polymerase chain reaction and microarray hybridization, respectively. Hierarchic clustering, multidimensional scaling, class prediction, and gene ontology analysis were performed to investigate the potential of miRNAs to serve as radiation biomarkers and to elucidate their likely physiologic roles in the radiation response. Results: The expression levels of 45 miRNAs were statistically significantly upregulated 4 hours after irradiation with 1.25 Gy x-rays, 27 of them in every patient. Nonirradiated and irradiated samples form separate clusters in hierarchic clustering and multidimensional scaling. Out of 223 differentially expressed genes, 37 were both downregulated and predicted targets of the upregulated miRNAs. Paired and unpaired miRNA-based classifiers that we developed can predict the class membership of a sample with unknown irradiation status, with accuracies of 100% when all 45 upregulated miRNAs are included. Both miRNA control of and gene involvement in biologic processes such as hemopoiesis and the immune response are increased after irradiation, whereas metabolic processes are underrepresented among all differentially expressed genes and the genes controlled by miRNAs. Conclusions: Exposure to ionizing radiation leads to the upregulation of the expression of a considerable proportion of the human miRNAome of peripheral blood cells. These miRNA expression signatures can be used as biomarkers of radiation exposure. [Copyright &y& Elsevier]

Background: Water-pipe smoking is a rapidly growing form of tobacco use worldwide. Building on an earlier report of experimentation with cigarette and water-pipe smoking in a U.S. community sample of Arab-American youth aged 14–18 years, this article examines water-pipe smoking in more detail (e.g., smoking history, belief in harmfulness compared to cigarettes, family members in home who smoke water pipes) and compares the water-pipe–smoking behaviors of Arab-American youth with non–Arab-American youth in the same community. Methods: A convenience sample of 1872 Arab-American and non–Arab-American high school students from the Midwest completed a 24-item tobacco survey. Data were collected in 2004–2005 and analyzed in 2007–2008. Results: Arab-American youth reported lower percentages of ever cigarette smoking (20% vs 39%); current cigarette smoking (7% vs 22%); and regular cigarette smoking (3% vs 15%) than non–Arab-American youth. In contrast, Arab-American youth reported significantly higher percentages of ever water-pipe smoking (38% vs 21%) and current water-pipe smoking (17% vs 11%) than non–Arab-American youth. Seventy-seven percent perceived water-pipe smoking to be as harmful as or more harmful than cigarette smoking. Logistic regression showed that youth were 11.0 times more likely to be currently smoking cigarettes if they currently smoked water pipes. Youth were also 11.0 times more likely to be current water-pipe smokers if they currently smoked cigarettes. If one or more family members smoked water pipes in the home, youth were 6.3 times more likely to be current water-pipe smokers. The effects of ethnicity were reduced as a result of the explanatory value of family smoking. Conclusions: Further research is needed to determine the percentages, patterns, and health risks of water-pipe smoking and its relationship to cigarette smoking among all youth. Additionally, youth tobacco prevention/cessation programs need to focus attention on water-pipe smoking in order to further dispel the myth that water-pipe smoking is a safe alternative to cigarette smoking. [Copyright &y& Elsevier]

Abstract: Purpose: Monitoring of adolescents’ behavior and whereabouts has been repeatedly identified as an important predictor of adolescent behavioral outcomes. However, to date, measures of parental supervision and monitoring are lacking in the chronic illness literature. The present study describes development and initial evaluation of a measure of parental monitoring of the illness management of adolescents with diabetes: the Parental Monitoring of Diabetes Care scale (PMDC). Methods: Ninety-nine parents of 12–18-year-old children with type 1 diabetes completed the PMDC. Measures of illness management and metabolic control were also obtained. Results: The PMDC demonstrated good internal consistency (alpha coefficient = .81) and test–rest reliability (ICC = .80). Supporting the instrument’s construct validity, confirmatory factor analysis indicated that a five subdomain structure had an acceptable fit to the data, [χ2 (181.65)/df (126) = 1.44, Bollen-Stine χ2 = 165.03, p = .32, comparative fit index (CFI) = .91, and root-mean-square error of approximation = .07]. In structural equation models, parental monitoring as assessed by the PMDC had a significant direct effect on adolescent diabetes management, accounting for 38% of the variance. Parental monitoring also had a significant indirect effect on metabolic control. Conclusions: The PMDC represents an important first step in the development of measures of parental monitoring for use with adolescents with chronic medical conditions. [Copyright &y& Elsevier]

Abstract: In many vertebrate species, the superior olive in the auditory brainstem plays an essential role in sound source localization. Little is known, however, about the structural and functional changes in this nucleus during development when alterations in head size and shape as well as in inner ear projections are expected to affect the perception of binaural cues. Using stereological techniques, we investigated the changes in several cellular and spatial features of the bullfrog superior olive across metamorphosis, the time period during which the animal transforms from a totally aquatic larva to a semiterrestrial adult. The total number of cells shows a strongly linear increase from hatchling through late larval stages. The number of neurons decreases during metamorphic climax stages, and recovers to pre-metamorphic climax levels in the early post-metamorphic froglet stage. The number of glial cells increases during the early larval period, and remains relatively stable, with no systematic variation, from late larval to froglet stages. The volume of the superior olive increases rapidly in early larval stages, followed by a much-attenuated rate of growth between late larval and froglet stages. These morphological changes may provide a substrate for the functional restructuring of the bullfrog superior olive, shortly before the switch from aquatic to mostly atmospheric hearing. [Copyright &y& Elsevier]

Abstract: Pain is a common problem that affects the functional status and quality of life of people in all communities. This study explored the occurrence of pain and the pain self-treatment modalities used by 723 community residents. Mean worst pain scores were moderate to severe and interfered with all activities at a low-to-moderate level. Participants reported taking nonopioid analgesics (75%), opioid analgesics (15%), adjuvant analgesics (11.6%), and herbal products and supplements (29%); 68% used nonpharmacological modalities. Current regimens were reported to relieve only 45% of pain. Twenty-eight percent of participants reported that they had not informed their primary care practitioner of their self-treatment choices. Knowledge of self-treatment choices is imperative in planning treatment regimens for pain or other health problems to prevent potential interactions or side effects. [Copyright &y& Elsevier]

Persons who have injected drugs are highly susceptible to a life-long, debilitating condition of the legs called chronic venous insufficiency (CVI). CVI may affect a person''s ability to function. The purposes of this study were to examine (a) the functional relationship between CVI severity, pain, and behavior; and (b) the extent to which pain mediates the relationship between CVI severity and functional behavior for persons with a history of injection drug use. The 100 participants had a history of injection drug use and were recruited from a medical clinic and a methadone treatment clinic. Participants responded to a questionnaire that contained demographic, health history, drug history, pain and functioning components. Their legs were examined from the knees to the feet for clinical manifestations of CVI. Pain and functional behavior were monotonically related to severity of CVI. Path analysis showed leg pain as a mediator of the relationship between CVI and behavioral functioning controlling for the effects of other chronic diseases. Treatment center counselors need to be aware of leg changes that occur with injected drugs, realize these changes may affect many aspects of functioning and cause pain, and encourage clients to obtain medical assistance for treatment of their legs. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to shorten a human immunodeficiency virus (HIV) stigma scale to make it less burdensome for HIV-positive (HIV+) youth without compromising psychometric properties. The shortened questionnaire showed good internal consistency and validity, suggesting that a 10-item measure of stigma has promise for assessing this important construct in HIV+ youth. [Copyright &y& Elsevier]

Background Symptoms of depression have been related to lower gestational age and preterm birth (<37 completed weeks gestation). Leisure time physical activity may have protective effects on preterm birth; however, less has been published with regard to other domains of physical activity such as walking for a purpose (e.g., for transportation) or the pathways by which symptoms of depression impact gestational age at birth. Methods This was a secondary analysis of available data of African American women. Women were interviewed within 3 days after birth. We proposed a model in which walking for a purpose during pregnancy mediated the effects of symptoms of depression (measured by the 20-item Center for Epidemiologic Studies-Depression [CES-D] scale) on gestational age at birth in a sample of 1,382 African American women. Results Using structural equation modeling, we found that the direct effect of CES-D scores of 23 or greater, which have been correlated with major depression diagnosis, on gestational age at birth was -4.23 ( p < .001). These results indicate that symptoms of depression were associated with a decrease in gestational age at birth of 4.23 days. Walking for a purpose mediated the effect of CES-D scores of 23 or greater on gestational age at birth. Conclusions Compared with African American women without symptoms of depression, African American women who had symptoms of depression walked less for a purpose during their pregnancy and delivered infants with lower gestational age at birth. If not medically contraindicated, clinicians should incorporate walking as part of prenatal care recommendations and reassure women about safety of walking during pregnancy. [ABSTRACT FROM AUTHOR]

Background Although depressive symptoms during pregnancy have been related to negative maternal and child health outcomes such as preterm birth, low birth weight infants, postpartum depression, and maladaptive mother–infant interactions, studies on the impact of neighborhood environment on depressive symptoms in pregnant women are limited. Pregnant women residing in disadvantaged neighborhoods reported higher levels of depressive symptoms and lower levels of social support. No researchers have examined the relationship between neighborhood environment and avoidance coping in pregnant women. Guided by the Ecological model and Lazarus and Folkman's transactional model of stress and coping, we examined whether social support and avoidance coping mediated associations between the neighborhood environment and depressive symptoms in pregnant African-American women. Methods Pregnant African-American women ( n = 95) from a medical center in Chicago completed the instruments twice during pregnancy between 15 and 25 weeks and between 25 and 37 weeks. The self-administered instruments measured perceived neighborhood environment, social support, avoidance coping, and depressive symptoms using items from existing scales. Objective measures of the neighborhood environment were derived using geographic information systems. Findings Perceived neighborhood environment, social support, avoidance coping, and depressive symptoms were correlated significantly in the expected directions. Objective physical disorder and crime were negatively related to social support. Social support at time 1 (20 ± 2.6 weeks) mediated associations between the perceived neighborhood environment at time 1 and depressive symptoms at time 2 (29 ± 2.7 weeks). An increase in avoidance coping between times 1 and 2 also mediated the effects of perceived neighborhood environment at time 1 on depressive symptoms at time 2. Conclusion Pregnant African-American women's negative perceptions of their neighborhoods in the second trimester were related to higher levels of depressive symptoms in the third trimester. If these results are replicable in prospective studies with larger sample sizes, intervention strategies could be implemented at the individual level to support pregnant women in their ability to cope with adverse neighborhood conditions and ultimately improve their mental health. [ABSTRACT FROM AUTHOR]

Abstract: We present a methodology to statistically discriminate among univariate and multivariate indices to improve accuracy in differentiating schizophrenia patients from healthy controls. Electroencephalogram data from 71 subjects (37 controls/34 patients) were analyzed. Data included P300 event-related response amplitudes and latencies as well as amplitudes and sensory gating indices derived from the P50, N100, and P200 auditory-evoked responses resulting in 20 indices analyzed. Receiver operator characteristic (ROC) curve analyses identified significant univariate indices; these underwent principal component analysis (PCA). Logistic regression of PCA components created a multivariate composite used in the final ROC. Eleven univariate ROCs were significant with area under the curve (AUC) >0.50. PCA of these indices resulted in a three-factor solution accounting for 76.96% of the variance. The first factor was defined primarily by P200 and P300 amplitudes, the second by P50 ratio and difference scores, and the third by P300 latency. ROC analysis using the logistic regression composite resulted in an AUC of 0.793 (0.06), p<0.001 (CI=0.685–0.901). A composite score of 0.456 had a sensitivity of 0.829 (correctly identifying schizophrenia patients) and a specificity of 0.703 (correctly identifying healthy controls). Results demonstrated the usefulness of combined statistical techniques in creating a multivariate composite that improves diagnostic accuracy. [Copyright &y& Elsevier]

Abstract: We examined the mother–child adjustment and child behavior problems in Arab Muslim immigrant families residing in the U.S.A. The sample of 635 mother–child dyads was comprised of mothers who emigrated from 1989 or later and had at least one early adolescent child between the ages of 11 and 15 years old who was also willing to participate. Arabic speaking research assistants collected the data from the mothers and children using established measures of maternal and child stressors, coping, and social support; maternal distress; parent–child relationship; and child behavior problems. A structural equation model (SEM) was specified a priori with 17 predicted pathways. With a few exceptions, the final SEM model was highly consistent with the proposed model and had a good fit to the data. The model accounted for 67% of the variance in child behavior problems. Child stressors, mother–child relationship, and maternal stressors were the causal variables that contributed the most to child behavior problems. The model also accounted for 27% of the variance in mother–child relationship. Child active coping, child gender, mother''s education, and maternal distress were all predictive of the mother–child relationship. Mother–child relationship also mediated the effects of maternal distress and child active coping on child behavior problems. These findings indicate that immigrant mothers contribute greatly to adolescent adjustment, both as a source of risk and protection. These findings also suggest that intervening with immigrant mothers to reduce their stress and strengthening the parent–child relationship are two important areas for promoting adolescent adjustment. [Copyright &y& Elsevier]

An increasing proportion of newly diagnosed AIDS cases is being reported among African American urban women. Recent research regarding the psychosocial and behavioral impact of a mother''s HIV status on her uninfected children as well as a growing body of clinical evidence suggest that these children are extremely vulnerable and at risk for problems in psychosocial adjustment. The present paper reports the results of research designed to examine the pathways by which a mother''s HIV-positive status affects the psychosocial adjustment of her uninfected school-age child. The principal predictor variables of the model are family sociodemographic characteristics, social support available to mother and child, HIV-related symptom distress in the mother, coping strategies of both mother and child, emotional distress of the mother, and quality of the parent–child relationship. The dependent variable is the psychosocial adjustment of the child. Data were collected on 147 mother–child dyads using standardized questionnaires and personal interviews. Eighty-six percent of the mothers were African American and over 96% were on public assistance. Structural equation modeling was used to test the proposed model of mother–child coping and adjustment. After adding three paths, the model had a good fit to the data (comparative fit index=0.94; root mean square estimate of error=0.06). Five model constructs accounted for 36% of the variance in child adjustment. The constructs in order of importance were maternal HIV-associated stressors, maternal emotional distress, child social support, child coping, and quality of parent–child relationship. [Copyright &y& Elsevier]

Abstract: A quasi-experimental design was used to test a modified Project Towards No Tobacco (TNT) use program on cigarette smoking in 380 Arab American and 236 non-Arab American 9th graders in the Midwest. Tenth grade Non-Arab American students given the intervention as 9th graders were 23% less likely to experiment (Odds Ratio=1.31, 95% CI: 1.05, 1.64) or to have smoked cigarettes in the past 30 days (Odd Ratio=1.43 times, 95% CI: 1.03, 2.01) compared to Arab American youth. Arab American students reported greater experimentation with water pipe smoking than cigarettes (38% vs. 22%), and more current (16% vs. 6%) and regular (7% vs. 3%) use of water pipes than cigarettes, respectively. The intervention designed to focus on cigarette smoking had non-significant effects on water pipe smoking. These findings provide support for a school-based intervention revised to focus on prevention as well as cessation and to be culturally consistent. They also call for further research and intervention tailoring to address the problem of water pipe smoking in a growing Arab American adolescent population. [Copyright &y& Elsevier]

Living in a lower-quality neighborhood is associated with higher levels of depressive symptoms in the general population as well as among pregnant and postpartum women. However, little is known of the important pathways by which this association occurs. We proposed a model in which perceived stress and social support mediated the effects of neighborhood quality on depressive symptoms during pregnancy (measured by the 20-item Center for Epidemiologic Studies-Depression, CES-D, scale) in a sample of 1383 African American women from the Detroit metropolitan area interviewed during their delivery hospitalization. Using structural equation modeling (SEM), we built a latent variable of neighborhood quality using 4 measures (neighborhood disorder, neighborhood safety/danger, walking environment, overall rating). We then tested two SEM mediation models. We found that lower neighborhood quality was associated with higher prevalence of depressive symptoms during pregnancy (standardized total effect = .16, p = .011). We found that perceived stress partially mediated the neighborhood quality association with depressive symptoms. Although the association of social support with depressive symptoms was negligible, social support mediated associations of neighborhood quality with perceived stress [standardized path coefficient = .38 (.02), p = .009]. Our results point to the need for public health, health care, as well as non-health related interventions (e.g. crime prevention programs) to decrease overall exposure to stressors, as well as stress levels of women living in poor quality neighborhoods. Interventions that increase the levels of social support of women during pregnancy are also needed for their potential to decrease stress and ultimately improve mental health at this important time in the life course. [ABSTRACT FROM AUTHOR]

Abstract: Depression and inflammation are associated with poorer birth outcomes. African-American women have higher levels of inflammatory biomarkers, more depressive symptoms, and a disparate burden of poorer birth outcomes, but the association between depressive symptoms and inflammation within this higher-risk group is unknown. We examined this association among African-American women in the second trimester of pregnancy and additionally tested whether body mass index (BMI) mediates or moderates this relationship. We recruited 187 women from the obstetrics clinics of a large urban health system. Depression symptoms were measured with the Center for Epidemiological Studies Depression (CES-D) scale and inflammatory biomarkers (high-sensitivity C-reactive protein [hs-CRP], interleukin [IL]-6, IL-10, IL-1β, and tumor necrosis factor-α [TNF-α]) with enzyme immunoassays. Multivariate regression models were fitted to determine the association between CES-D score and each inflammatory biomarker. CES-D was not associated with hs-CRP or TNF-α. CES-D was directly associated with IL-1β (P =0.03). BMI moderated the relationship between CES-D and IL-6 (P <0.01) and IL-10 (P =0.04); in leaner women, depressive symptoms were associated with higher IL-6 and IL-10 levels, whereas in heavier women, depressive symptoms were associated with lower IL-10 levels. BMI did not mediate the relationship between CES-D and inflammation. We conclude that depressive symptoms are associated with increased inflammation among pregnant African-American women. Future studies are needed to examine if depression, mediated through inflammation, increases the risk of adverse pregnancy outcomes in African-American women. [Copyright &y& Elsevier]

The article examines whether multisystemic therapy (MST), a home-based psychotherapy, could reduce diabetes-related stress among adolescents with type 1 diabetes. Results show that MST reduces diabetes-related stress among adolescents with type 1 diabetes. These stress reductions are vital for the psychological well-being of a subset of youths with diabetes at risk for health complications.