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The purpose of this study was to investigate the relative contributions of previously identified Polycystic ovary syndrome (PCOS) manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Participants were 126 female endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of PCOS manifestations and psychological symptoms. Participants had significantly elevated scores on nine subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. After controlling for demographic factors, menstrual problems were the strongest predictor of psychological symptoms. Findings suggest features of excess body hair, obesity, and menstrual abnormalities carry unique risks for adverse psychologic symptoms, but menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.

Religious Commitment is a construct known to be predictive of various health-related factors of importance to researchers. However, data collection efficiency and instrument brevity in healthcare settings are priorities regardless of the construct being measured. Brief, valid instruments are particularly valuable in health research and will be vital for testing mechanisms by which health may be improved or maintained. This series of studies aims to demonstrate that Religious Commitment can be validly measured with a very brief instrument, the Religious Surrender & Attendance Scale-3 (RSAS-3), which combines a 2-item measure of Surrender, a specific type of religious coping, with a 1-item measure of Attendance at religious services. Three studies are reported, two utilizing undergraduate university students (Ns = 964 and 466) and one utilizing a clinical-based pregnant population (N = 320), all in southern Appalachia. The original 12-item Surrender Scale, a 2-item subset of Surrender items, and Attendance were found to be highly positively correlated with each other and with Intrinsic Religiosity, an additional measure of Religious Commitment employed to demonstrate concurrent validity. Religiosity variables were found to be strongly negatively correlated with Anxiety and stress, which were the health outcomes of interest. Hierarchical multiple regression analysis was used to confirm the similarity of Anxiety and stress prediction using the 12-item and 2-item Surrender measures and to confirm the superior stress prediction of the 3-item instrument RSAS-3. The RSAS-3 is recommended as a measure of Religious Commitment in future health research.

Methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (P. aeruginosa) infections are frequently associated with hospitalization and increased healthcare costs. Vitamin D deficiency may contribute to increased costs for patients with these infections and there is evidence that vitamin D may have an antimicrobial role. To evaluate the role of vitamin D deficiency in the costs incurred with these infections, we studied the relationship of serum 25(OH)D levels to healthcare costs in veterans in the southeastern United States. Patients with both infections were vitamin D deficient to a similar extent and so were combined for further analysis. Vitamin D deficient patients had higher costs and service utilization than those who were not vitamin D deficient. Those with vitamin D deficiency had higher inpatient costs compared to the non-deficient group, and this difference was across most categories except for the number of inpatient hospitalizations or total number of days as an inpatient. Vitamin D deficiency was not significantly related to outpatient cost or service utilization parameters. We conclude that vitamin D deficiency is intimately linked to adverse healthcare costs in veterans with MRSA and P. aeruginosa infections. Vitamin D status should be assayed in patients with these infections.

Objectives: The purpose of the present study was to examine background and modifiable pregnancy health behavior factors predicting infant birthweight in an economically and educationally disadvantaged sample with low medical risk. Methods: Participants were recruited from a family practice center in rural Appalachia. Participants: Over 220, predominantly Caucasian and lower SES women with low risk pregnancies were included in the sample. Data were collected through systematic chart review. Half of the women smoked during pregnancy and over 10% gave birth to low birth weight (LBW; < 2500 g) babies. Results: Compared with those who gave birth to normal weight newborns, women with LBW babies had more miscarriages, but did not differ significantly on other background factors. Women who delivered LBW babies gained less weight during pregnancy and were more likely to smoke than remaining women. After control for background factors, modifiable pregnancy health behavior factors (weight gain, prenatal care, smoking, alcohol and substance use) accounted for over 11% of birth weight variance, with nearly 7% attributable solely to smoking. Conclusions: Pregnancy smoking was the strongest behavioral predictor of LBW in this economically and educationally disadvantaged rural sample, suggesting that efforts to reduce LBW in similar populations should include targeting pregnancy smoking.

Children in the United States are exposed to considerable community violence that has been linked to child functioning. However, not all those exposed, experience negative outcomes. Recent research has focused on factors that "buffer" or protect children from negative consequences of violence exposure. The purpose of this investigation was to examine the potential buffering or moderating role of maternal acceptance in the relationship between community violence exposure and internalizing and externalizing problems. Subjects were 268 urban African American first graders. Community violence exposure was significantly related to symptoms of post-traumatic stress, but did not correlate with either internalizing or externalizing problems for all children, after control for demographics, maternal mental health, and general life stress. However, children's perceptions of maternal acceptance moderated the relationship between violence exposure and internalizing and externalizing problems which included being withdrawn, anxious-depressed, and demonstrating delinquent behavior. Children with the lowest levels of self-reported maternal acceptance were most impacted by community violence. In this sample of urban first graders, low levels of maternal acceptance placed children at greater risk for adverse outcomes associated with community violence exposure compared to moderate and high levels of maternal acceptance.