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Background: Tobacco smoke, an endocrine and metabolic disruptor, is associated with increased abdominal adiposity in active smokers (ASs). However, the role of secondhand smoke (SHS) exposure in central adiposity is unclear. Abdominal adiposity, measured as sagittal abdominal diameter (SAD), is associated with increased risk of cardiometabolic disease and mortality. We assessed the role of SHS exposure in explaining patterns of SAD and evaluated this relationship for differences by age. Methods: Cross-sectional data from the National Health and Nutrition Examination Survey 2011–2012 were utilized for 6188 individuals aged 12–80 years. Using serum cotinine and self-reported smoking information, smoking status was categorized as nonsmoker (NS

ObjectiveTo identify specific cultural and behavioural factors that might be influenced to increase colostrum feeding in a rural village in Northern Ethiopia to improve infant health.DesignBackground interviews were conducted with six community health workers and two traditional birth attendants. A semi-structured tape-recorded interview was conducted with twenty mothers, most with children under the age of 5 years. Variables were: parental age and education; mother's ethnicity; number of live births and children's age; breast-feeding from birth through to weaning; availability and use of formula; and descriptions of colostrum v. other stages of breast milk. Participant interviews were conducted in Amharic and translated into English.SettingKossoye, a rural Amhara village with high prevalence rates of stunting: inappropriate neonatal feeding is thought to be a factor.SubjectsWomen (20–60 years of age) reporting at least one live birth (range: 1–8, mean: ∼4).ResultsColostrum (inger) and breast milk (yetut wotet) were seen as different substances. Colostrum was said to cause abdominal problems, but discarding a portion was sufficient to mitigate this effect. Almost all (nineteen of twenty) women breast-fed and twelve (63 %) reported ritual prelacteal feeding. A majority (fifteen of nineteen, 79 %) reported discarding colostrum and breast-feeding within 24 h of birth. Prelacteal feeding emerged as an additional factor to be targeted through educational intervention.ConclusionsTo maximize neonatal health and growth, we recommend culturally tailored education delivered by community health advocates and traditional health practitioners that promotes immediate colostrum feeding and discourages prelacteal feeding.

Objective: We tested sex, race, and age differences in the patterning of visceral adipose tissue (VAT) and subcutaneous adipose tissue. Research Methods and Procedures: Contiguous 1-cm-thick magnetic resonance (MR) images of the abdomen were collected from 820 African-American and white adults. Repeated-measures ANOVA was used to examine the effects of image location, sex, race, and age (≥50 vs.

Objective. To evaluate the effects of habitual physical activity (PA) on the metabolic syndrome (MS) in young adult men and women. Research methods and procedures. Cross-sectional PA data were utilized from 249 women and 237 men, aged 18–40 years in the Fels Longitudinal Study. MS components—abdominal circumference (AC), triglycerides (TG), HDL, blood pressure (BP), and fasting glucose (FG)—were dichotomized according to the National Cholesterol Education Program's Adult Treatment Panel III revised criteria. Leisure, sport, work, and total PA scores were calculated using the Baecke Questionnaire of Habitual Physical Activity. Multiple logistic regression modeling assessed the effects of PA, age, smoking, and BMI on MS status. Results. 26.9% of men and 19.3% of women had MS. For men, MS risk was reduced with increases in both total PA [OR = 0.65 (95% CI: 0.47, 0.90)] and sport PA [OR = 0.40 (95% CI: 0.23, 0.70)]. AC, TG, and HDL values also improved with total and sport PA. Among women, the risk for MS was marginally reduced by total PA [OR = 0.72 (95% CI: 0.50, 1.02)] and HDL levels were increased by both total PA [OR = 0.79 (95% CI: 0.63, 0.98)] and sport PA [OR = 0.54 (95% CI: 0.35, 0.84)]. Discussion. Increased total and sport PA reduces risk for the MS in young men, though not as clearly in young women. Am. J. Hum. Biol. 19:544–550, 2007. © 2007 Wiley-Liss, Inc.

Introduction. Given the considerable time and research cost of analyzing biomedical images to quantify adipose tissue volumes, automated image analysis methods are highly desirable. Hippo Fat™ is a new software program designed to automatically quantify adipose tissue areas from magnetic resonance (MR) images without user inputs. Hippo Fat™ has yet to be independently validated against commonly-used image analysis software programs. Objective. Our aim was to compare estimates of VAT (visceral adipose tissue) and SAT (subcutaneous adipose tissue) using the new Hippo Fat™ software against those from a widely-used, validated, computer-assisted manual method (slice-O-matic version 4.2, Tomovision, Montreal, CA) to assess its potential utility for large-scale studies. Methods. A Siemens Magnetom Vision 1.5-Tesla whole body scanner and a T1-weighted fast spin echo pulse sequence were used to collect multiple, contiguous axial images of the abdomen from a sample of 40 healthy adults (20 men) aged 18-77 years of age, with mean BMI of 29 kg/m2 (range=19−43 kg/m2). Results. Hippo Fat™ provided estimates of VAT and SAT that were highly correlated with estimates using slice-O-matic™ (R2>0.9). Average VAT was 9.4% lower and average SAT was 3.7% higher using Hippo Fat™ compared to slice-O-matic™; the overestimation of SAT tended to be greater among individuals with greater adiposity. Individual-level differences for VAT were also substantial; Hippo Fat™ gave estimates of VAT ranging from 1184 cm3 less to 566 cm3 more than estimates for the same person using slice-O-matic™. Conclusion. Hippo Fat™ provides a rapid method of quantifying total VAT, although the method does not provide estimates that are interchangeable with slice-O-matic™ at either the group (mean) or individual level.

John Paul Jones, the "Father of the American Navy," is known for the battletime assertion that he had "not yet begun to fight." His central role in a triumph of scientific forensic identification more than a century after his death is less known. John Paul Jones died in 1792 and was buried in Paris, France. The location of his grave was lost over time and a search for his corpse began in 1899. Remains matching his physical characteristics and circumstance of burial were discovered in 1905 and returned to the United States for a hero's burial. Some questioned the identification at the time and the major source of identifying information has since been shown to contain false information. The published forensic literature fails to address existing critiques of the identification. We provide a substantive analysis and conclude that the available evidence supports the identification of the unknown remains as those of John Paul Jones.

Glucocorticoids induce insulin resistance in humans, whereas thiazolidinediones enhance insulin sensitivity. Although the effects of glucocorticoids and thiazolidinediones have been assessed in isolation, interaction between these drugs, which both act as ligands for nuclear receptors, has been less well studied. Therefore, we examined the metabolic effects of dexamethasone and troglitazone, alone and in combination, for the first time in humans. A total of 10 healthy individuals with normal glucose tolerance (age 40 ± 11 years, BMI 31 ± 6.1 kg/m2) were sequentially studied at baseline, after 4 days of dexamethasone (4 mg/day), after 4–6 weeks on troglitazone alone (400 mg/day), and again after 4 days of dexamethasone added to troglitazone. Key metabolic variables included glucose tolerance assessed by blood glucose and insulin responses to an oral glucose tolerance test (OGTT), insulin sensitivity evaluated via hyperinsulinemic-euglycemic clamp, free fatty acids (FFAs) and FFA suppressibility by insulin during the clamp study, and fasting serum leptin. Dexamethasone drastically impaired glucose tolerance, with fasting and 2-h OGTT insulin values increasing by 2.3-fold (P < 0.001) and 4.4-fold (P < 0.001) over baseline values, respectively. The glucocorticoid also induced a profound state of insulin resistance, with a 34% reduction in maximal glucose disposal rates (GDRs; P < 0.001). Troglitazone alone increased GDRs by 20% over baseline (P = 0.007) and completely prevented the deleterious effects of dexamethasone on glucose tolerance and insulin sensitivity, as illustrated by a return of OGTT glucose and insulin values and maximal GDR to near-baseline levels. Insulin-mediated FFA suppressibility (FFA decline at 30 min during clamp/FFA at time 0) was also markedly reduced by dexamethasone (P = 0.002). Troglitazone had no effect per se, but it was able to normalize FFA suppressibility in subjects coadministered dexamethasone. Futhermore, the magnitudes of response of FFA suppressibility and GDR to dexamethasone were proportionate. The same was true for the reversal of dexamethasone-induced insulin resistance by troglitazone, but not in response to troglitazone alone. Leptin levels were increased 2.2-fold above baseline by dexamethasone. Again, troglitazone had no effect per se but blocked the dexamethasone-induced increase in leptin. Subjects experienced a 1.7-kg weight gain while taking troglitazone but no other untoward effects. We conclude that in healthy humans, thiazolidinediones antagonize the action of dexamethasone with respect to multiple metabolic effects. Specifically, troglitazone reverses both glucocorticoid-induced insulin resistance and impairment of glucose tolerance, prevents dexamethasone from impairing the antilipolytic action of insulin, and blocks the increase in leptin levels induced by dexamethasone. Even though changes in FFA suppressibility were correlated with dexamethasone-induced insulin resistance and its reversal by troglitazone, a cause-and-effect relationship cannot be established. However, the data suggest that glucocorticoids and thiazolidinediones exert fundamentally antagonistic effects on human metabolism in both adipose and muscle tissues. By preventing or reversing insulin resistance, troglitazone may prove to be a valuable therapeutic agent in the difficult clinical task of controlling diabetes in patients receiving glucocorticoids.

This study is the first translation and validation of the WHOQOL-BREF for general use in Somali refugee populations. A community sample of 303 Somali refugees living in the USA responded to the WHOQOL-BREF following translation, adaptation, and validation guidelines established by the World Health Organization. Psychometric properties of the quality of life instrument were assessed including tests of the four-domain factor structure using multiple regression and principal component analysis. Principal component analysis demonstrated an acceptable fit between PCA components and original WHOQOL-BREF domains. Four components had eigenvalues greater than one and explained 63.4 % of the observed variance. Most scale items loaded like the original WHOQOL-BREF domains, with the notable difference among four items of physical health that loaded more strongly under the environment domain. Construct validity of the scale was confirmed by higher intercorrelations of each WHOQOL-BREF item with its intended domain (all r 2 > 0.50) than with other domains. Multiple regression analyses of the domain scores on overall quality of life (Q1) and health satisfaction (Q2) explained half of the observed variance in each measure. Item correlations showed good internal consistency (0.65 ≥ Cronbach’s alpha ≤ 0.82). Validation of this first Somali version of the WHOQOL-BREF provides further evidence that this instrument can be a valid measure for cross-cultural comparative studies of quality of life. Policies that address health disparities can be more broadly evaluated if quality of life is systematically measured in the community. This is particularly important for evaluating policy impact and implications for refugee populations.

Background Chewing khat leaves is often accompanied by tobacco use. We assessed aspects of tobacco use and explored factors associated with tobacco use patterns (frequency of use per week) among khat chewers who used tobacco only when chewing khat (“simultaneous tobacco and khat users”, STKU). Methods A sample of 204 male khat chewers was recruited during random visits to khat outlets. Data collected included socio-demographic items, tobacco use and khat chewing behaviours. Both psychological and physical dependence on khat were assessed using the Severity of Psychological Dependence on Khat (SDS-Khat) Scale, the Diagnostic Statistical Manual IV (DSM-IV) and adapted items from the Fagerström Test for Nicotine Dependence (chewing even when ill, and difficulty in abstaining from khat chewing for an entire week). Descriptive statistics and non-parametric analyses were conducted. Results Of the 204 khat chewers, 35% were khat chewers only, 20% were STKU, and the remainder were daily cigarette smokers. The mean age of STKU was 38.12 (±14.05) years. Fifty seven percent of STKU smoked tobacco and chewed khat for two days per week and 43% smoked and chewed more frequently (three to six days: 33%, daily: 10%). Three quarters (74%) were former daily tobacco users. Khat chewing initiated tobacco smoking among 45% of STKU and 71% reported attempts to quit tobacco smoking during khat chew. Among STKU, smoking tobacco for more than two days per week was significantly associated (p

Introduction: In Ethiopia, an estimated 676 maternal deaths occur for every 100,000 live births. The major causes of mortality and morbidity are direct obstetric causes; they mainly occur from the third trimester of pregnancy to the first week following delivery. This study elucidates the type, magnitude and associated factors of postpartum morbidity conditions among pregnant women who gave birth at the health institutions and is essential to understand the health care need for obstetric emergencies, postpartum conditions and to prepare health organizations to better monitoring and evaluation of safe motherhood programs. Objective: To assess birth outcome and prevalence of postpartum morbidity among women attending antenatal care and gave birth at health institutions in Gondar town. Methods: We have conducted a four-month follow up study among 203 randomly selected pregnant women from five health institutions in Gondar town. Data were collected between March 1, 2010 and June 30, 2010 through interviews and physical examinations at four follow up visits: antenatal care, labor and delivery, 12th and 42nd postpartum days. We have used Epi Info 2002 for data entry and Statistical Package for the Social Sciences (SPSS) for data analysis. Results: A total of 203 (89.04%) pregnant women completed the four follow up visits and were included in the analysis. Postpartum morbidity conditions were found among 48 (23.6%) mothers, of whom 12 (5.9%) mothers had suffered two or more morbidity conditions. Overall, morbidity from postpartum hemorrhage had the highest prevalence 30 (14.8%) followed by sepsis and anemia. Intra-partum deviations were the main contributing factor to the postpartum morbidity conditions (AOR=4.148, P=0.027). There were 5(2.5%) still births and 38(18.7%) low birth weights. Conclusion and recommendation: The occurrence of postpartum morbidity, low birth and still birth among pregnant women attending and giving birth at health institution in Gondar town was significant health concern. Intrapartum abonormalities were the main predictive factor triggering maternal morbidity conditions. The time from birth to the first 6 hrs of purperum was the peak time to postpartom hemorrhage. Therefore, interventions such as universal use of the partograpgh, active third stage management and encouraging all delivering women to stay in the health institution during the first 24 hours of delivery could play a key role in reducing postpartum morbidity

Objective: ADHD is a common comorbid condition with substance use disorder. This study seeks to examine the discrepancy in the prevalence rate between those previously diagnosed with ADHD and those diagnosed while in treatment. It is hypothesized that clients with ADHD would have earlier unsuccessful terminations from treatment than non-ADHD clients and that the ADHD Self-Report Scale (ASRS Version 1.1) would be a reliable predictor. Method: Participants ( N = 87) are admitted to a publicly funded 28-day residential treatment program. All participants are screened with the ASRS and participate in a clinical assessment evaluation. Results: A significant difference is found between the clinical record rate of 3.44% and the 43.68% rate found during treatment. The ASRS significantly predicts ADHD. Conclusions: The use of the ASRS is recommended and should be incorporated into standard intake assessment protocols. Careful diagnostic interviews are urged to determine if clients in residential treatment have ADHD.

Epidemiological studies may require noninvasive methods for off-site DNA collection. We compared the DNA yield and quality obtained using a whole-saliva collection device (Oragene DNA collection kit) to those from three established noninvasive methods (cytobrush, foam swab, and oral rinse). Each method was tested on 17 adult volunteers from our center, using a random crossover collection design and analyzed using repeated-measures statistics. DNA yield and quality were assessed via gel electrophoresis, spectophotometry, and polymerase chain reaction (PCR) amplification rate. The whole-saliva method provided a significantly greater DNA yield (mean +/- SD = 154.9 +/- 103.05 microg, median = 181.88) than the other methods (oral rinse = 54.74 +/- 41.72 microg, 36.56; swab = 11.44 +/- 7.39 microg, 10.72; cytobrush = 12.66 +/- 6.19, 13.22 microg) (all pairwise P < 0.05). Oral-rinse and whole-saliva samples provided the best DNA quality, whereas cytobrush and swab samples provided poorer quality DNA, as shown by lower OD(260)/OD(280) and OD(260)/OD(230) ratios. We conclude that both a 10-ml oral-rinse sample and 2-ml whole-saliva sample provide sufficient DNA quantity and better quality DNA for genetic epidemiological studies than do the commonly used buccal swab and brush techniques.

Although lipid profiles tend to worsen with age, it is not fully known if such age-related changes are influenced primarily by body composition and lifestyle or by other aspects of aging. We investigated the extent to which the fat and fat-free components of body mass index (BMI) and lifestyle factors influence patterns of change in lipids independent of age. Serial data were analyzed using sex-specific longitudinal models. These models use serial data from individuals to assume a general pattern of change over time, while allowing baseline age and the rate of change to vary among individuals. Serial data were obtained from 940 examinations of 269 healthy white participants (126 men, 143 women), aged 40–60 years, in the Fels Longitudinal Study. Measurements included age, the fat (FMI) and fat-free mass (FFMI) components of BMI, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), triglycerides (TG), total cholesterol (TC), fasting glucose and insulin, physical activity, alcohol use and smoking, and women's menopausal status and estrogen use. In both sexes, increased FMI was significantly associated with increased LDL-C, TG and TC, and decreased HDL-C. Increased FFMI was significantly related to decreased HDL-C and increased TG. Independent age effects remained significant only for LDL-C and TC in men and TC in women. Increased insulin was significantly related to increased TG in women. Moderate alcohol consumption was associated with higher HDL-C in men. Physical activity lowered male LDL-C and TC levels, and increased female HDL-C levels. Menopause was associated with increases in LDL-C. Premenopausal women not using estrogen had significantly lower HDL-C, TG, and TC than postmenopausal women taking estrogen. (1) Age is an important independent predictor for LDL-C and TC in men, and TC in women, but it is not as influential as body composition and lifestyle on HDL-C and TG in men and women, and LDL-C in women. (2) Increasing FMI is the major contributor to elevated TC, LDL-C and TG levels, and decreased HDL-C levels in men and women. (3) FFMI significantly influences HDL and TG levels in both sexes. (4) Maintaining a lower BMI via a reduced fat component may be more beneficial in lowering CVD risks than other factors.