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This study investigates associations between religious involvement and identity and attitudes related to domestic violence using nationally representative cross‐sectional data from n = 1287 Australian adults in the 2018 Australian Survey of Social Attitudes (AuSSA). Linear regression models were used to analyse the association between religious involvement (frequency of service attendance and prayer) and identity (religious, spiritual or both) with attitudes related to domestic violence (patriarchal beliefs, failure to acknowledge domestic violence as an issue and trust in faith leaders' responses to domestic violence). Results showed that religious service attendance, frequency of prayer and spiritual/religious identity were associated with more patriarchal beliefs about gender roles. There was no evidence that religious involvement or identity was associated with failure to acknowledge domestic violence as a national issue. In contrast, frequent (but not infrequent) religious involvement and religious identity were associated with failure to acknowledge domestic violence in participants' own faith communities. Addressing patriarchal beliefs and acknowledgement of domestic violence within faith communities among those who regularly attend services, pray and identify as religious are key targets for action to address domestic violence and improve population health. [ABSTRACT FROM AUTHOR]

Aquaculture (freshwater and marine) has largely supplemented fisheries, but in theory could help reduce fishing pressure on wild stocks. Although not the sole factors, some potential benefits depend on aquaculture pressures on fished species, including collection of wild 'seed' material—earlier to later life stages—for rearing in captivity and the capacity of aquaculture to increase. Here we first classify 203 marine (saltwater and brackish) animal species as being produced by either open‐cycle capture‐based aquaculture (CBA) or closed‐cycle domesticated aquaculture (DA)—based on their likely reliance on wild seed—and assess the extent to which these forms of aquaculture could support seafood production and greater wild biomass. Using a data‐limited modelling approach, we find evidence that current aquaculture practices are not necessarily helping reduce fishing to sustainable levels for their wild counterparts—consistent with emerging scientific research. However, if some wild capture species (87 equivalent spp.) were instead produced through CBA, almost a million extra tonnes could theoretically be left in the wild, without reducing seafood production. Alternatively, if reliance on wild seed inputs is further reduced by shifting to DA production, then a little less than doubling of aquaculture of the overexploited species in our study could help fill the 'production gap' to support fishing at maximum sustainable levels. While other ecological (e.g. escapes), social and economic considerations (e.g. market substitution) are important, we focused on a critical biological linkage between wild fisheries and aquaculture that provides another aspect on how to improve management alignment of the sectors. [ABSTRACT FROM AUTHOR]

While racial/ethnic oral health inequities have been documented for many years in the United States, the potential role of racism has not been examined until recently. In fact, the common practice has been to attribute racial/ethnic disparities in oral health to low socioeconomic position and/or the lack of access to care. In contrast, racism is considered a fundamental cause of a broad range of adverse health outcomes for racial/ethnic minorities. Emerging evidence on oral health suggests that racism can affect access to oral health and clinical decision‐making by acting as a social determinant of health (SDoH). Specifically, SDoHs may affect access to quality dental care due to the lack of dental insurance, low dentist‐population ratio in racial/ethnic minority communities and the lack of diversity in the dental profession. We describe potential mechanisms through which racism can affect important SDoHs that are essential to oral health equity, outline recommendations to mitigate its existing negative effects and propose interventions to minimize pathogenic effects of racism on oral health outcomes in the population. [ABSTRACT FROM AUTHOR]

Aquaculture policy often promotes production of low‐trophic level species for sustainable industry growth. Yet, the application of the trophic level concept to aquaculture is complex, and its value for assessing sustainability is further complicated by continual reformulation of feeds. The majority of fed farmed fish and invertebrate species are produced using human‐made compound feeds that can differ markedly from the diet of the same species in the wild and continue to change in composition. Using data on aquaculture feeds, we show that technical advances have substantially decreased the mean effective trophic level of farmed species, such as salmon (mean TL = 3.48 to 2.42) and tilapia (2.32 to 2.06), from 1995 to 2015. As farmed species diverge in effective trophic level from their wild counterparts, they are coalescing at a similar effective trophic level due to standardisation of feeds. This pattern blurs the interpretation of trophic level in aquaculture because it can no longer be viewed as a trait of the farmed species, but rather is a dynamic feature of the production system. Guidance based on wild trophic position or historical resource use is therefore misleading. Effective aquaculture policy needs to avoid overly simplistic sustainability indicators such as trophic level. Instead, employing empirically derived metrics based on the specific farmed properties of species groups, management techniques and advances in feed formulation will be crucial for achieving truly sustainable options for farmed seafood. [ABSTRACT FROM AUTHOR]

Copyright of Conservation Biology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study investigated trajectories of individual and vicarious online racial discrimination (ORD) and their associations with psychological outcomes for African American and Latinx adolescents in 6th-12th grade (N = 522; Mgrade  = 9th) across three waves. Data were analyzed using growth mixture modeling to estimate trajectories for ORD and to determine the effects of each trajectory on Wave 3 depressive symptoms, anxiety, and self-esteem. Results showed four individual and three vicarious ORD trajectories, with the majority of participants starting out with low experiences and increasing over time. Older African American adolescents and people who spend more time online are at greatest risk for poor psychological functioning. [ABSTRACT FROM AUTHOR]

Global biodiversity losses continue despite tremendous growth in the volume of conservation science and many local successes. Research that can achieve conservation science's aims—arresting declines in biodiversity and preventing extinctions—is therefore of ever greater importance. Here, we ask whether conservation science, as currently performed, is progressing in such a way as to maximize its impact. We present a simple framework for how effective conservation research could progress, from identifying problems to diagnosing their proximate and ultimate causes, and from proposing, to designing, implementing, and testing responses. We then demonstrate that for three well‐known examples—South Asian vultures, whooping cranes, and bycatch of procellariform seabirds—published studies appear to follow this sequence, with considerable benefits. However, for a representative sample of the wider conservation literature, we find no evidence of such a progression. Instead, the vast majority of papers remain focused on describing the state of nature or on mechanisms directly causing changes, with very little research on designing or implementing conservation responses. This lack of research on the sorts of questions that might most help conservation science deliver its stated mission strongly suggests we will struggle to translate the huge increase in research activity into real‐world benefits. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the explanatory role of health behaviors, socioeconomic position (SEP), and psychosocial stressors on racial/ethnic obesity disparities in a multiethnic and multiracial sample of adults.Methods: Using data from the Chicago Community Adult Health Study (2001-2003), Oaxaca-Blinder decomposition analysis was conducted to quantify the extent to which health behaviors (fruit and vegetable consumption and physical activity), SEP, and cumulative stressors (e.g., perceived discrimination, financial strain) each explained differences in obesity prevalence in Black, US-born Hispanic, and non-US-born Hispanic compared with non-Hispanic White participants.Results: SEP and health behaviors did not explain obesity differences between racial/ethnic minorities and White individuals. Having high levels of stress in four or more domains explained 4.46% of the differences between Black and White individuals, whereas having high levels of stress in three domains significantly explained 14.13% of differences between US-born Hispanic and White. Together, the predictors explained less than 20% of differences between any racial/ethnic minority group and White individuals.Conclusions: Exposure to stressors may play a role in obesity disparities, particularly among Black and US-born Hispanic individuals. Other obesity-related risk factors need to be examined to understand the underlying mechanisms explaining obesity disparities. [ABSTRACT FROM AUTHOR]

Background: To provide an overview of the empirical research linking self-reports of racial discrimination to health status and health service utilization.Methods: A review of literature reviews and meta-analyses published from January 2013 to 2019 was conducted using PubMed, PsycINFO, Sociological Abstracts, and Web of Science. Articles were considered for inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework.Results: Twenty-nine studies met the criteria for review. Both domestic and international studies find that experiences of discrimination reported by adults are adversely related to mental health and indicators of physical health, including preclinical indicators of disease, health behaviors, utilization of care, and adherence to medical regimens. Emerging evidence also suggests that discrimination can affect the health of children and adolescents and that at least some of its adverse effects may be ameliorated by the presence of psychosocial resources.Conclusions: Increasing evidence indicates that racial discrimination is an emerging risk factor for disease and a contributor to racial disparities in health. Attention is needed to strengthen research gaps and to advance our understanding of the optimal interventions that can reduce the negative effects of discrimination. [ABSTRACT FROM AUTHOR]

What strategies help ethnic minority adolescents to cope with racism? The present study addressed this question by testing the role of ethnic identity, social support, and anger expression and suppression as moderators of the discrimination-adjustment link among 269 Mexican-origin adolescents (Mage  = 14.1 years), 12-17 years old from the Midwestern U.S. Results from multilevel moderation analyses indicated that ethnic identity, social support, and anger suppression, respectively, significantly attenuated the relations between discrimination and adjustment problems, whereas outward anger expression exacerbated these relations. Moderation effects differed according to the level of analysis. By identifying effective coping strategies in the discrimination-adjustment link at specific levels of analysis, the present findings can guide future intervention efforts for Latino youth. [ABSTRACT FROM AUTHOR]

As tropical cattle ranching continues to expand, successful conservation will require an improved understanding of the relative impacts of different livestock systems and landscape structure on biodiversity. Here, we provide the first empirical and multi-scale assessment of the relative effects of livestock intensification and landscape structure on biodiversity in the threatened tropical dry forests of Mesoamerica., We used a dataset of dung beetles (169,372 individuals from 33 species) collected from 20 1-km2 landscapes, ranging from zero-yielding forest sites to high-yield cattle ranches and maize farms, to investigate the relative effect of livestock intensification (net cattle production; macrocyclic lactone use; annual dung production) and landscape structure (landscape composition and configuration) at multiple spatial scales on different attributes of dung beetle communities using a multi-model averaging approach., Dung beetle species richness, biomass and composition were more strongly related to landscape structure than to livestock intensification., Forest cover was the best predictor of dung beetle assemblages, being positively related to species diversity and biomass across multiple spatial scales. The use of macrocyclic lactones was strong and negatively related to dung beetle communities at the local scale., Synthesis and applications: Maximising forest protection through a 'land sparing' strategy is likely to be the best strategy for reducing negative impacts of cattle farming on Neotropical dung beetle communities. However, increasing or maintaining yields while reducing agrochemical inputs will be important for conserving on-farm biodiversity and the ecosystem services that dung beetles provide in livestock-dominated landscapes. [ABSTRACT FROM AUTHOR]

Balancing the production of food, particularly meat, with preserving biodiversity and maintaining ecosystem services is a major societal challenge. Research into the contrasting strategies of land sparing and land sharing has suggested that land sparing-combining high-yield agriculture with the protection or restoration of natural habitats on nonfarmed land-will have lower environmental impacts than other strategies. Ecosystems with long histories of habitat disturbance, however, could be resilient to low-yield agriculture and thus fare better under land sharing. Using a wider suite of species (birds, dung beetles and trees) and a wider range of livestock-production systems than previous studies, we investigated the probable impacts of different land-use strategies on biodiversity and aboveground carbon stocks in the Yucatán Peninsula, Mexico-a region with a long history of habitat disturbance. By modelling the production of multiple products from interdependent land uses, we found that land sparing would allow larger estimated populations of most species and larger carbon stocks to persist than would land sharing or any intermediate strategy. This result held across all agricultural production targets despite the history of disturbance and despite species richness in low- and medium-yielding agriculture being not much lower than that in natural habitats. This highlights the importance, in evaluating the biodiversity impacts of land use, of measuring population densities of individual species, rather than simple species richness. The benefits of land sparing for both biodiversity and carbon storage suggest that safeguarding natural habitats for biodiversity protection and carbon storage alongside promoting areas of high-yield cattle production would be desirable. However, delivering such landscapes will probably require the explicit linkage of livestock yield increases with habitat protection or restoration, as well as a deeper understanding of the long-term sustainability of yields, and research into how other societal outcomes vary across land-use strategies. [ABSTRACT FROM AUTHOR]

The present paper explores the little studied area concerning the acquisition of recent biopharmaceutical initial public offering firms. We examine the nature of the relationship between the acquiring firm and the acquired initial public offering firm prior to the acquisition and from the perspective of the resource-based view. We find to some extent that firm specific-resources affect the prospect that the firm will be acquired. Furthermore, our findings show that firms with more of these types of resources are likely to be acquired by firms engaged in co-opetition rather than by firms engaged solely in collaboration, competition, or (to a limited extent) with no prior relationship. [ABSTRACT FROM AUTHOR]

In Australia 1% of individuals aged over 50 years have Parkinson disease ( PD). Guidance for commencing device-assisted therapies ( DAT) for PD in Australia was developed based on a review of European recommendations and their relevance to the local clinical setting. An online survey and teleconference discussions were held by a group of eight local movement disorder experts to develop consensus. Referral to a movement disorder specialist and consideration of DAT is appropriate when motor fluctuations cause disability or reduced quality of life, response to treatment is inconsistent or motor fluctuations and dyskinesias require frequent treatment adjustment without apparent benefit and levodopa is required four or more times daily. Three types of DAT are available in Australia for patients with PD: continuous subcutaneous apomorphine; continuous levodopa-carbidopa intestinal gel infusion; and deep brain stimulation. All improve consistency of motor response. The most important aspects when considering which DAT to use are the preferences of the patient and their carers, patient comorbidities, age, cognitive function and neuropsychiatric status. Patients and their families need to be provided with treatment options that are suitable to them, with adequate explanations regarding the recommendations and comparison of potential device-related complications. DAT are best managed, where possible, in a specialist centre with experience in all three types of therapy. Proactive and early management of symptoms during disease progression is essential to maintain optimally motor responses and quality of life in patients with PD. [ABSTRACT FROM AUTHOR]

Background Sleep benefit ( SB) in Parkinson's disease refers to improved motor symptoms upon waking despite an entire night without medications. Although it was first proposed 30 years ago, this phenomenon proved difficult to investigate, and its true prevalence and underlying mechanisms remain unclear. Objective This study aimed to identify and quantify SB through measurement of motor function using a validated smartphone application and to identify disease characteristics that predicted SB. Methods Ninety-two patients recruited from 2 Movement Disorder Services were clinically assessed at home using a validated smartphone application. Each patient was tested in the on-state, at the end of dose, and on waking (before medications) 3 times. Differences between the 3 states were used to determine the impact of sleep and levodopa on motor function. SB was considered to be a 'measurable improvement in parkinsonism from the end of dose.' Results The morning waking motor function of 20 patients (22%) improved compared with the end-of-dose function, with 9 patients demonstrating superior function compared with their on-state. No clinical features predicted SB. Although all participants subjectively reported motor fluctuations, only 35 patients (38%) demonstrated an objective improvement with levodopa. Patients who had SB more often demonstrated objective motor fluctuations compared with those who did not (65% vs. 31%; P = 0.008). Conclusions SB is a genuine motor phenomenon: 1 in 5 patients have a measurable improvement in motor function on waking. It remains questionable whether this improvement is a direct effect of sleep. Until its underlying mechanism is better understood, it is more appropriate to refer to this phenomenon as simply morning improvement or diurnal fluctuation of motor symptoms. [ABSTRACT FROM AUTHOR]

Objective Disparities in tobacco use persist despite successful policies reducing use within the United States. In particular, the prevalence of tobacco use in rural and certain minority communities is significantly higher compared to that of their counterparts. In this work, we examine the impact of rurality, mental health, and racial discrimination on tobacco use. Methods Data come from the 2003 California Health Interview Survey (n = 42,044). Modified Poisson regression models were adjusted for age, sex, race/ethnicity, birth origin, education, income, insurance, and marital status. Results Compared to urban residents, rural residents had a significantly higher risk for smoking after adjustment (RR = 1.10, 95% CI: 1.01-1.19). Those who reported having experienced racial discrimination also had a significantly greater risk for smoking compared to those who did not (RR = 1.17, 95% CI: 1.07-1.27). Additionally, those who reported higher stress had a significantly greater risk for smoking (RR = 1.61, 95% CI: 1.07-1.67). There was evidence of interaction between rurality and race/ethnicity, and rurality and gender ( P < .05). Conclusion Residing in rural areas was associated with an increased risk for smoking, above and beyond sociodemographics. There were no significant differences across rural-urban environments for the relationship between stress and tobacco use-an indication that the impact of stress and discrimination is not buffered or exacerbated by environmental characteristics potentially found in either location. Mechanisms that explain rural-urban tobacco use disparities need to be explored, and smoking cessation programs and policies should be tailored to target these factors within rural communities. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread use of the Progressive Supranuclear Palsy Rating Scale (PSPRS), it is not known what change in this scale is meaningful for patients.Methods: We analyzed data from a large clinical trial in PSP-Richardson's syndrome (AL-108-231) to calculate minimal clinically important worsening. This was defined as the difference in mean change of PSPRS in subjects rated "a little worse" and those rated "unchanged" on the Clinicians' Global Impression of Change Scale. A multivariate analysis using logistic regression assessed the relationship between clinical worsening, PSPRS, depression, and activities of daily living.Results: The minimal clinically important worsening on the PSPRS was 5.7 points, corresponding to the mean decline over 6 months in the trial. Changes in activities of daily living and PSPRS were significantly associated with clinical worsening.Conclusions: Clinically meaningful change is measurable on the PSPRS over 6 months. © 2016 International Parkinson and Movement Disorder Society. [ABSTRACT FROM AUTHOR]

Black women have a higher incidence of breast cancer before the age of 40 years, more severe disease at all ages, and an elevated mortality risk in comparison with white women. There is limited understanding of the contribution of social factors to these patterns. Elucidating the role of the social determinants of health in breast cancer disparities requires greater attention to how risk factors for breast cancer unfold over the lifecourse and to the complex ways in which socioeconomic status and racism shape exposure to psychosocial, physical, chemical, and other individual and community-level assaults that increase the risk of breast cancer. Research that takes seriously the social context in which black women live is also needed to maximize the opportunities to prevent breast cancer in this underserved group. Cancer 2016;122:2138-49. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

The clinical differentiation of progressive supranuclear palsy from Parkinson's disease can be challenging, due to overlapping clinical features and a lack of diagnostic markers. Abnormalities in cognitive function form part of the clinical spectrums of these diseases and distinctive cognitive profiles may be helpful in differentiating these diseases in the diagnostic period. A comprehensive neuropsychological test battery was administered to 12 patients with clinically diagnosed progressive supranuclear palsy and 12 patients with Parkinson's disease matched for age and disease duration. Effect size ( Cohen's d) was calculated for cognitive tests that were significantly different between groups. Patients with progressive supranuclear palsy performed significantly worse than those with Parkinson's disease on measures of processing speed, verbal fluency, planning, verbal abstract reasoning, verbal memory, and made more perseverative responses on a set shifting task. Measures of executive function, manual dexterity and processing speed were most diagnostically useful ( Cohen's d > 2.0) in differentiating between progressive supranuclear palsy and Parkinson's disease. These findings suggest that more severe and prominent 'frontal' cognitive deficits in patients with progressive parkinsonism would be helpful in predicting progressive supranuclear palsy rather than Parkinson's disease and these findings may contribute to the development of diagnostic criteria. [ABSTRACT FROM AUTHOR]

Debate over the Late Quaternary megafaunal extinctions has focussed on whether human colonisation or climatic changes were more important drivers of extinction, with few extinctions being unambiguously attributable to either. Most analyses have been geographically or taxonomically restricted and the few quantitative global analyses have been limited by coarse temporal resolution or overly simplified climate reconstructions or proxies. We present a global analysis of the causes of these extinctions which uses high-resolution climate reconstructions and explicitly investigates the sensitivity of our results to uncertainty in the palaeological record. Our results show that human colonisation was the dominant driver of megafaunal extinction across the world but that climatic factors were also important. We identify the geographic regions where future research is likely to have the most impact, with our models reliably predicting extinctions across most of the world, with the notable exception of mainland Asia where we fail to explain the apparently low rate of extinction found in in the fossil record. Our results are highly robust to uncertainties in the palaeological record, and our main conclusions are unlikely to change qualitatively following minor improvements or changes in the dates of extinctions and human colonisation. [ABSTRACT FROM AUTHOR]

Abstract: Levodopa‐carbidopa intestinal gel (LCIG) is an effective treatment for Parkinson disease. Initiating therapy involves an initial naso‐jejunal (NJ) titration phase. The NJ phase is prolonged with significant morbidity. The aim of this study is to assess the impact of proceeding without the NJ phase on resource utilisation and the outcomes of patients. Twenty‐five patients were started on LCIG using the patients existing levodopa equivalent dose (LED). We recorded change in LED, length of hospital stay, readmission rates and use of outpatient services and clinical outcomes within 6 months. The median length of stay was 4.5 days. Patients had four outpatient clinic reviews and 2.5 community nurse contacts within 6 months. There was no significant change in daily LED on discharge (P = 0.56). There were significant improvements in all Unified Parkinson Disease Rating Scale subscores (P < 0.05), the Freezing of Gait scale (P < 0.01) and Parkinson Disease Quality Of Life 39 score (P < 0.01). Initiating LCIG without the NJ phase resulted in short admissions, a minimal outpatient burden and no significant requirement for dose titration while producing good clinical outcomes. [ABSTRACT FROM AUTHOR]

Preclinical animal models implicate serotonin neurons in the pathophysiology of levodopa ( l-dopa)-induced dyskinesias in Parkinson's disease (PD), but effective treatment remains elusive. We examined the relationship between serotonin and l-dopa-induced dyskinesias in a pathologically confirmed cohort of PD patients. We obtained brain tissue from 44 PD cases and 17 age-matched controls and assessed monoamine levels and the serotonin and dopamine transporters in the striatum, and the extent of dopaminergic and serotonergic cell preservation in the substantia nigra (SN) and the dorsal raphe nuclei (DRN), respectively. As expected, PD patients demonstrated a severe loss of all dopaminergic markers, including dopamine ( P < 0.0001) and the dopamine transporter ( P < 0.0001) in the striatum, and dopaminergic neurons ( P < 0.001) in the SN, compared with controls. Marked serotonin loss was observed in the caudate (but not putamen) in PD patients compared with controls ( P < 0.001), but no difference was found in the levels of the serotonin transporter in the striatum or density of serotonergic neurons in the DRN between these groups, suggesting a functional but not structural change in the serotonergic system in PD. No difference was seen in levels of serotonergic and dopaminergic markers in the striatum between PD patients with and without dyskinesias, or between cases separated according to the clinical severity of their dyskinesias. The absence of a correlation between striatal serotonin markers and the incidence and severity of l-dopa-induced dyskinesias suggests that an intact and functioning serotonergic system is not a risk factor for developing dyskinesias in PD. © 2015 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND We used a latent class analysis ( LCA) to characterize coping styles of urban youth and examined if coping styles moderated the association between experiencing discrimination and bullying and depressive symptoms. METHODS The data come from the 2006 Boston Youth Survey, where students were asked to select 2 behaviors they do most often when they are upset, from a list of 15 options. A total of 927 (75%) students contributed to the LCA analytic sample (44% non-Hispanic Blacks, 29% Hispanics, and 58% girls). Relative and absolute fit indices determined the number of classes. An interaction term between types of discrimination and bullying experienced and coping style tested for moderation. RESULTS The LCA revealed that a 3-class solution had the best fit (Lo-Mendell-Rubin likelihood ratio test, 4-class vs 3-class, p-value .12). The largest coping style class was characterized by high endorsement of distractive coping strategies (59%), the second class was characterized by using supportive coping strategies (27%), and the third class was characterized by using avoidance coping strategies (12%). We found a significant interaction between discrimination and coping style for depressive symptoms. CONCLUSIONS The relationship between experiencing discrimination and depression varied based on coping style and the type of discrimination and bullying experienced. [ABSTRACT FROM AUTHOR]

We examined the relationship between neighborhood environment (e.g., objective neighborhood socioeconomic status [SES] and subjective neighborhood perceptions) and waist-hip ratio (WHR) or central obesity using logistic regression and content analysis of respondents' narratives on housing unfair treatment in the YES Health pilot study. Multivariate results showed significant relationships between low SES White, low SES Black, and middle SES Black versus middle SES White neighborhoods and total-sample and women's obesity, in almost all neighborhood perception models. Significant relationships included: disliking neighborhood and total-sample obesity; neighborhood informal monitoring/surveillance and total-sample and women's obesity; social participation and total-sample and women's obesity; and perceptions of families and total-sample and women's obesity. Qualitative results partially corroborate our quantitative results that low SES neighborhood adults were more likely to experience neighborhood disorders and safety issues. Our findings highlight examining objective and subjective neighborhood environments related to central obesity, suggesting specific health targets for neighborhood intervention programs. [ABSTRACT FROM AUTHOR]

Although Black-White differences in depression are well documented, vigilant coping style as an explanation for the observed inequalities in depression is less understood. Using data from 718 adults in the Exploring Health Disparities in Integrated Communities (EHDIC) Study, we estimated logistic regression models to examine the cross-sectional relationship between race, vigilant coping style, and depression. After controlling for demographic variables, White adults were more likely to report depression than Black adults. Moreover, when accounting for coping style, the Black-White difference in depression widened. This association persisted even with the addition of the covariates. While high rates of depression among Whites compared with Blacks are well documented, the degree of the differences appears to be greater than previously reported once vigilance is accounted for. This finding suggests that if it were not for the high prevalence of vigilant coping in Blacks, the well-documented Black advantage regarding depression compared to Whites would likely be even greater. [ABSTRACT FROM AUTHOR]

Conventional magnetic resonance imaging (cMRI) is often used to aid the diagnosis of progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), but its ability to predict the histopathological diagnosis has not been systematically studied. cMRI from 48 neuropathologically confirmed cases, including PSP (n = 22), MSA (n = 13), Parkinson's disease (PD) (n = 7), and corticobasal degeneration (n = 6), and controls (n = 9) were assessed blinded to clinical details and systematically rated for reported abnormalities. Clinical diagnosis and macroscopic postmortem findings were retrospectively assessed. Radiological assessment of MRI was correct in 16 of 22 (72.7%) PSP cases and 10 of 13 (76.9%) MSA cases with substantial interrater agreement (Cohen's kappa 0.708; P < .001); no PSP case was misclassified as MSA or vice versa. MRI was less sensitive but more specific than clinical diagnosis in PSP and both more sensitive and specific than clinical diagnosis in MSA. The 'hummingbird' and 'morning glory' signs were highly specific for PSP, and 'the middle cerebellar peduncle sign' and 'hot cross bun' for MSA, but sensitivity was lower (up to 68.4%) and characteristic findings may not be present even at autopsy. cMRI, clinical diagnosis, and macroscopic examination at postmortem have similar sensitivity and specificity in predicting a neuropathological diagnosis. We have validated specific radiological signs in pathologically confirmed PSP and MSA. However, the low sensitivity of these and macroscopic findings at autopsy suggest a need for imaging techniques sensitive to microstructural abnormalities without regional atrophy. © 2012 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Characteristic tau isoform composition of the insoluble fibrillar tau inclusions define tauopathies, including Alzheimer's disease ( AD), progressive supranuclear palsy ( PSP) and frontotemporal dementia with parkinsonism linked to chromosome 17/frontotemporal lobar degeneration-tau ( FTDP-17/ FTLD-tau). Exon 10 splicing mutations in the tau gene, MAPT, in familial FTDP-17 cause elevation of tau isoforms with four microtubule-binding repeat domains (4R-tau) compared to those with three repeats (3R-tau). On the basis of two well-characterised monoclonal antibodies against 3R- and 4R-tau, we developed novel, sensitive immuno- PCR assays for measuring the trace amounts of these isoforms in CSF. This was with the aim of assessing if CSF tau isoform changes reflect the pathological changes in tau isoform homeostasis in the degenerative brain and if these would be relevant for differential clinical diagnosis. Initial analysis of clinical CSF samples of PSP ( n = 46), corticobasal syndrome ( CBS; n = 22), AD ( n = 11), Parkinson's disease with dementia ( PDD; n = 16) and 35 controls revealed selective decreases of immunoreactive 4R-tau in CSF of PSP and AD patients compared with controls, and lower 4R-tau levels in AD compared with PDD. These decreases could be related to the disease-specific conformational masking of the RD4-binding epitope because of abnormal folding and/or aggregation of the 4R-tau isoforms in tauopathies or increased sequestration of the 4R-tau isoforms in brain tau pathology. [ABSTRACT FROM AUTHOR]

A number of cognitive abnormalities have been identified as putative diagnostic markers in neurodegenerative parkinsonism based on statistically significant differences between diseases. The effect sizes of these differences frequently have not been reported, making practical interpretation of the results difficult. The objective of this study was to assess the potential contribution of cognitive testing to the diagnosis of parkinsonian disorders by quantifying effect size of previously identified significant differentiating cognitive features. A Medline search identified 1038 articles. Nineteen studies directly comparing at least 2 of Parkinson's disease, progressive supranuclear palsy, multiple system atrophy, and corticobasal syndrome/degeneration were selected. Cohen's d and positive likelihood ratio were calculated as appropriate for cognitive tests showing statistically significant differences between diseases. Clinically useful differences were considered present when Cohen's d > 1 or the positive likelihood ratio > 2 and were considered high when Cohen's d > 1.94 or the positive likelihood ratio > 10. Only 16 of 141 cognitive tests were found to be highly useful. Cognitive testing was only moderately helpful in separating Parkinson's disease and multiple system atrophy. Inferior performance on phonemic ( d = 1.56-2.13) and semantic ( d = 1.43-2.13) verbal fluency, the Trail-Making Test ( d = 1.63-1.95) and the Wisconsin Card Sorting Test ( d = 1.63-2.22) were moderately to very useful in separating progressive supranuclear palsy from Parkinson's disease and multiple system atrophy. Cognitive testing could not differentiate corticobasal syndrome from other parkinsonian disorders, although sequential orobuccal apraxia was very useful ( d = 2.01-2.23). Few of the cognitive tests separating parkinsonian disorders identified from previous studies have sufficient effect size to be practically useful. Even these features must be interpreted in conjunction with other clinical characteristics to be helpful diagnostically. © 2012 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Objective To illustrate the complex patterns that emerge when race/ethnicity, socioeconomic status ( SES), and gender are considered simultaneously in health care disparities research and to outline the needed research to understand them by using disparities in lung cancer risks, treatment, and outcomes as an example. Principal Findings SES, gender, and race/ethnicity are social categories that are robust predictors of variations in health and health services utilization. These are usually considered separately, but intersectionality theory indicates that the impact of each depends on the others. Each reflects historically and culturally contingent variations in social, economic, and political status. Distinct patterns of risk and resilience emerge at the intersections of multiple social categories and shape the experience of health, health care access, utilization, quality, and outcomes where these categories intersect. Intersectional approaches call for greater attention to understand social processes at multiple levels of society and require the collection of relevant data and utilization of appropriate analytic approaches to understand how multiple risk factors and resources combine to affect the distribution of disease and its management. Conclusions Understanding how race/ethnicity, gender, and SES are interactive, interdependent, and social identities can provide new knowledge to enhance our efforts to effectively address health disparities. [ABSTRACT FROM AUTHOR]

Objective To develop a conceptual framework for investigating the role of racial/ethnic residential segregation on health care disparities. Data Sources and Settings Review of the MEDLINE and the Web of Science databases for articles published from 1998 to 2011. Study Design The extant research was evaluated to describe mechanisms that shape health care access, utilization, and quality of preventive, diagnostic, therapeutic, and end-of-life services across the life course. Principal Findings The framework describes the influence of racial/ethnic segregation operating through neighborhood-, health care system-, provider-, and individual-level factors. Conceptual and methodological issues arising from limitations of the research and complex relationships between various levels were identified. Conclusions Increasing evidence indicates that racial/ethnic residential segregation is a key factor driving place-based health care inequalities. Closer attention to address research gaps has implications for advancing and strengthening the literature to better inform effective interventions and policy-based solutions. [ABSTRACT FROM AUTHOR]

A 56-year-old man presented with gait disturbance, personality change, and behavioral disturbances. He subsequently developed falls, postural instability, and axial rigidity. The cognitive problems progressed and he developed aphasia and later eye movement abnormalities. He died after 9 years of disease. Experts discuss the syndromal diagnosis and predict the underlying pathology. The pathological diagnosis is given and clinical learning points are considered. © 2011 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The basal ganglia are involved in the preferential selection and suppression of competing responses. Parkinson's disease and Huntington's disease are 2 prototypical basal ganglia disorders that feature impaired inhibitory control, a function of poor conflict resolution. Previous saccadic studies showed that individuals with Parkinson's disease experience difficulty suppressing unwanted ocular motor responses, whereas evidence for a similar difficulty in Huntington's disease is more equivocal. Relative to saccades, few research studies have examined inhibitory control processes in the context of an ongoing smooth pursuit task. In this study, we examined the ability of 16 patients with Parkinson's disease and 12 patients with Huntington's disease to suppress automatic responses to irrelevant distracters that transiently appeared during the tracking of a moving visual stimulus. Compared with an equivalent number of age-matched controls, patients with Parkinson's disease generated proportionately more saccades to distracter stimuli. This was particularly evident for distracters appearing far away from the target. Conversely, whereas individuals with early-stage Huntington's disease and healthy controls made a comparable number of errors toward distracter stimuli, those in a more advanced clinical stage demonstrated significantly poorer inhibitory control. The current findings in parkinsonian patients replicate those previously reported in the saccadic and manual response literature, demonstrating difficulty inhibiting a competing motor response. However, in Huntington's disease we demonstrate for the first time that inhibitory control declines in more advanced-disease stages. This suggests that ocular motility may provide a sensitive marker of clinical disease progression in Huntington's disease. © 2011 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Previous studies suggested that olfaction is normal in progressive supranuclear palsy (PSP). We applied the University of Pennsylvania Smell Identification Test (UPSIT) to 36 patients with PSP who scored more than 18 on the Mini Mental State Examination (MMSE), 140 patients with nondemented Parkinson's disease (PD) and 126 controls. Mean UPSIT scores in PSP were lower than in controls ( P < 0.001) but higher than in PD ( P < 0.001) after adjusting for age, gender, and smoking history. For patients with PSP, UPSIT scores correlated with MMSE ( r = 0.44, P = 0.006) but not disease duration ( P = 0.6), motor subscale of the Unified Parkinson's Disease Rating Scale ( P = 0.2), or Frontal Assessment Battery ( P = 0.5). The brains of six of the patients with PSP were examined postmortem and all revealed neurofibrillary tangles and tau accumulation in the rhinencephalon, although only three had hyposmia. Further prospective studies including patients with early PSP and PSP-P with postmortem confirmation might help clarify if smell tests could be useful when the differential diagnosis lies between PD and PSP. © 2010 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Progressive supranuclear palsy-parkinsonism (PSP-P) is a primary tauopathy characterised by neurofibrillary degeneration, which is frequently mistaken for Parkinson's disease (PD), multiple system atrophy (MSA), and vascular parkinsonism (VP) at presentation. The aim of this study was to identify particular clinical features (green flags) that may be helpful in differentiating PSP-P from these other disorders. We identified 37 patients with PSP-P from 726 patients archived at the Queen Square Brain Bank. Using a retrospective case notes review the clinical features were compared between the PSP-P group and Lewy body associated parkinsonism (PD, n = 444 and dementia with Lewy bodies (DLB), n = 46), MSA (n = 90), and VP (n = 19), using the χ2-test for proportions for a two-by-two contingency table. The sensitivity, specificity, and positive predictive values (PPV) and negative predictive values (NPV) were calculated for individual clinical features. A specificity of >0.85 or a PPV of >0.85 were considered reliable discriminators. No clinical features were predictive of PSP-P, but late drug induced dyskinesias (specificity 0.92, PPV 0.99), late autonomic dysfunction (specificity 0.94, PPV 0.99) and any visual hallucinations (specificity 0.94, PPV 0.99) were better in distinguishing PD and PSP-P than predicted using operational diagnostic criteria for PD. PSP-P shares many clinical features with PD and DLB, MSA and VP, but visual hallucinations, drug induced dyskinesias and autonomic dysfunction are very uncommon and may be helpful exclusion criteria. © 2010 Movement Disorder Society [ABSTRACT FROM AUTHOR]

This paper provides an overview of racial variations in health and shows that differences in socioeconomic status (SES) across racial groups are a major contributor to racial disparities in health. However, race reflects multiple dimensions of social inequality and individual and household indicators of SES capture relevant but limited aspects of this phenomenon. Research is needed that will comprehensively characterize the critical pathogenic features of social environments and identify how they combine with each other to affect health over the life course. Migration history and status are also important predictors of health and research is needed that will enhance understanding of the complex ways in which race, SES, and immigrant status combine to affect health. Fully capturing the role of race in health also requires rigorous examination of the conditions under which medical care and genetic factors can contribute to racial and SES differences in health. The paper identifies research priorities in all of these areas. [ABSTRACT FROM AUTHOR]

Smell identification tests (SITs) have been suggested as useful in the differential diagnosis of Parkinson's disease (PD). We have applied the 40 item University of Pennsylvania SIT (UPSIT-40) and/or the 16 item SIT from Sniffin Sticks (SS-16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD ("PD probability"). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) "PD probability" were: sensitivity 85.0% (78.8-89.7%), specificity 84.6% (77.3-89.9%) for the UPSIT-40; sensitivity 90.4% (83.5-94.7%), specificity 85.5% (76.2-91.7%) for the SS-16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123-I]-FP-CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTSCAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging. [ABSTRACT FROM AUTHOR]

Background: Questions have existed as to whether residential segregation is a mediator of racial/ethnic disparities in breast cancer care and breast cancer mortality, or has a differential effect by race/ethnicity.Methods: Data from the Surveillance, Epidemiology, and End Results-Medicare database on white, black, and Hispanic women aged 66 to 85 years with breast cancer were examined for the receipt of adequate breast cancer care.Results: Blacks were less likely than whites to receive adequate breast cancer care (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.71-0.86). Individuals, both black and white, who lived in areas with greater black segregation were less likely to receive adequate breast cancer care (OR, 0.73; 95% CI, 0.64-0.82). Black segregation was a mediator of the black/white disparity in breast cancer care, explaining 8.9% of the difference. After adjustment, adequate care for Hispanics did not significantly differ from whites, but individuals, both Hispanic and white, who lived in areas with greater Hispanic segregation were less likely to receive adequate breast cancer care (OR, 0.73; 95% CI, 0.61-0.89). Although Blacks experienced greater breast cancer mortality than whites, black segregation did not substantially mediate the black-white disparity in survival, and was not significantly associated with mortality (hazards ratio, 1.03; 95% CI, 0.87-1.21). Breast cancer mortality did not differ between Hispanics and whites.Conclusions: Among seniors, segregation mediates some of the black-white disparity in breast cancer care, but not mortality. Individuals who live in more segregated areas are less likely to receive adequate breast cancer care. [ABSTRACT FROM AUTHOR]

Nonmotor symptoms (NMS) are increasingly recognized as a significant cause of morbidity in later stages of Parkinson's disease (PD). Prodromal NMS are also a well recognized component of the clinical picture in some patients but the prevalence of NMS as presenting complaints, and their impact on clinical management, in pathologically-proven cases of PD is unknown. The presenting complaints of 433 cases of pathologically-proven PD archived at the Queen Square Brain Bank for Neurological Diseases were identified from the clinical case notes. 91/433 (21%) of patients with PD presented with NMS of which the most frequent were pain (15%), urinary dysfunction (3.9%), anxiety, or depression (2.5%). Presenting with NMS is associated with a delayed diagnosis of PD (Mann-Whitney U, P = 0.001). These patients were more likely to be misdiagnosed initially and were more likely to have been referred to orthopedeic surgeons or rheumatologists than neurologists (nonmotor group 5.5% vs. motor group 44.2%, χ2 P < 0.0001). NMS are commonly seen as presenting complaints in pathologically confirmed PD, and initial misdiagnosis may be associated with potentially inappropriate medical interventions. Presenting with NMS does not affect the motor response to medication, but is associated with shorter disease duration (χ2 P = 0.016). © 2007 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The clinical syndrome of pure akinesia has most often been associated with progressive supranuclear palsy (PSP) and is characterized by difficulty initiating gait and "freezing" during walking, writing and speaking. Similar syndromes have been described under the rubrics of primary progressive freezing gait and primary gait ignition failure. We investigated the specificity of the clinical syndrome of pure akinesia with gait freezing (PAGF) for PSP-tau pathology. Among 749 patients archived at the QSBB, only 7 fulfilled proposed diagnostic criteria of: gradual onset of freezing of gait or speech; absent limb rigidity and tremor; no sustained response to levodopa; and no dementia or ophthalmoplegia in the first 5 years of disease. In these cases detailed pathological examination was performed. PSP was the pathological diagnosis in six patients, and Parkinson's disease (PD) in the seventh. As defined, this syndrome had a positive predictive value of 86% for PSP-tau pathology. In the cases with PSP there were no additional features of coexistent vascular or PD and the median PSP-tau score was 3, reflecting relative mild tau load. The clinical syndrome of PAGF appears to have a high specificity for PSP-tau pathology. This relatively uncommon presentation of PSP-tau pathology has less severe tau accumulation than in the more common, "classic" PSP clinical phenotype: Richardson's disease. [ABSTRACT FROM AUTHOR]

Using nationally representative data from South Africa, we examine lifetime prevalence of traumas and multiple traumas (number of events). Employing multiple regression analysis, the authors study the sociodemographic risk of trauma, and the association between trauma and distress. Results indicate most South Africans experience at least one traumatic event during their lives, with the majority reporting multiple. Consistent variation in risk is evident for gender and marital status, but not other sociodemographics. Trauma is positively related to high distress, and findings also support a cumulative effect of trauma exposure. Individuals with the most traumas (6+) appear at 5 times greater risk of high distress. This study highlights the importance of considering traumatic events in the context of other traumas in South Africa. [ABSTRACT FROM AUTHOR]

Kufor Rakeb disease is an autosomal recessive disorder characterized by subacute, juvenile-onset, levodopa-responsive parkinsonism, pyramidal signs, dementia, and a supranuclear gaze palsy. It was originally described more than a decade ago, and linkage analysis identified a locus on chromosome 1p36 that was previously assigned PARK9. We have further characterized the clinical picture and specifically re-assessed the response to levodopa in the original family, in the northern highlands of Jordan. In the 4 surviving patients, there has been a narrowing of the therapeutic window for levodopa with the emergence of peak-dose dyskinesias with increased spasticity and cognitive decline. Several new features were identified, including facial-faucial-finger mini-myoclonus, visual hallucinations, and oculogyric dystonic spasms. © 2005 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The objectives of the National Survey of American Life (NSAL) are to investigate the nature, severity) and impairment of mental disorders among national samples of the black and non-Hispanic white (n = 1,006) populations in the US. Special emphasis in the study is given to the nature of race and ethnicity within the black population by selecting and interviewing national samples of African-American (N = 3,570), and Afro-Caribbean (N = 1,623) immigrant and second and older generation populations. National multi-stage probability methods were used in generating the samples and race/ethnic matching of interviewers and respondents were used in the largely face-to-face interview, which lasted on average 2 hours and 20 minutes. The Diagnostic and Statistical Manual (DSM) LV World Mental Health Composite Interview (WHO-CIDI) was used to assess a wide range of serious mental disorders, potential risk and resilience factors, and help seeking and service use patterns. This paper provides an overview of the design of the NSAL, sample selection procedures, recruitment and training of the national interviewing team, and some of the special problems faced in interviewing ethnically and racially diverse national samples. Unique features of sample design, including special screening and listing procedures, interviewer training and supervision, and response rate outcomes are described. [ABSTRACT FROM AUTHOR]