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The HIV/AIDS pandemic in sub-Saharan Africa has brought renewed attention to the role of grandmothers as caregivers of children. Using 2004 Lesotho Demographic and Health Survey data, the authors examine the relationship between coresidence with a grandmother and child schooling in Lesotho, a country with one of the highest rates of HIV infection. Results confirm the critical role grandmothers play in the event of maternal death. Maternal orphans who live with a grandmother are just as likely to be in school as children living with a mother. The protective effect of living with a grandmother is also important for children whose mothers are alive but not affiliated with their households. The results of the analysis underscore the importance of attending to the simultaneous presence of mothers and grandmothers, as well as the circumstances associated with mother absence, when assessing the relationship between grandmother coresidence and child outcomes. [ABSTRACT FROM AUTHOR]

This article investigates the importance of household context to subjective well-being among the oldest old (aged 80 years and older) in China. Using data from the Chinese Longitudinal Healthy Longevity Survey, the authors find that living arrangements have strong implications for elderly emotional health. First, living alone is associated with lower subjective well-being. Second, coresidence with immediate family (spouse or children) is associated with positive subjective well-being. Third, compared to living with a son, the traditionally dominant type of living arrangement, coresidence with a daughter appears positively linked to the emotional health of the oldest old. Results highlight the importance of family and cultural context to subjective well-being of the oldest old. They also suggest that the gendered nature of caregiving merits further attention in China and other patrilineal societies. [ABSTRACT FROM AUTHOR]

Antifreeze proteins (AFPs) are natural biomolecules found in cold-adapted organisms that lower the freezing point of water, allowing survival in icy conditions. These proteins have the potential to improve cryopreservation techniques by enhancing the quality of genetic material postthaw. Deschampsia antarctica , a freezing-tolerant plant, possesses AFPs and is a promising candidate for cryopreservation applications. In this study, we investigated the cryoprotective properties of AFPs from D. antarctica extracts on Atlantic salmon spermatozoa. Apoplastic extracts were used to determine ice recrystallization inhibition (IRI), thermal hysteresis (TH) activities and ice crystal morphology. Spermatozoa were cryopreserved using a standard cryoprotectant medium (C+) and three alternative media supplemented with apoplastic extracts. Flow cytometry was employed to measure plasma membrane integrity (PMI) and mitochondrial membrane potential (MMP) postthaw. Results showed that a low concentration of AFPs (0.05 mg/mL) provided significant IRI activity. Apoplastic extracts from D. antarctica demonstrated a cryoprotective effect on salmon spermatozoa, with PMI comparable to the standard medium. Moreover, samples treated with apoplastic extracts exhibited a higher percentage of cells with high MMP. These findings represent the first and preliminary report that suggests that AFPs derived from apoplastic extracts of D. antarctica have the potential to serve as cryoprotectants and could allow the development of novel freezing media.

The chorion fulfills important functions in fish embryos, including protecting the embryo during development. The characterization of the protein profile of this envelope could be used as a bioindicator in the evaluation of the quality of embryonic development. The object of this work was to validate a standardized protocol for protein extraction from chorion of Salmo salar embryos at 280 accumulated thermal units (ATU) by comparing and combining existing methods. The protocol consists of consecutive washing of the chorion samples followed by protein extraction with the solution that was named SDS solution (Tris-HCl 100 mM (pH 8), Urea 8 M, 1% SDS, β-mercaptoethanol 300 mM and EGTA 10 Mm, and 1% protease inhibitor cocktail) and mechanical methods. Protein extraction is enhanced by a working temperature of 75 °C and use of a disperser. The protein concentration was quantified by Bradford Assay. After extraction, the samples were diluted (dilution factor 10) before reading against the calibration curve. After gel electrophoresis with a load of 3 µg of protein, staining showed more than 4 bands, with molecular weights between 25 kDa and 180 kDa.•The protein profile of fish chorion was between 25 kDa and 180 kDa.•Solution containing 1% SDS allows a higher extraction of proteins from the chorion of Atlantic salmon embryos with 280 ATU.•Chorion protein identification is a valuable tool in determining gamete and embryo quality in fish., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier B.V.)

Objectives: The prevalence of dementia varies geographically in the United States. However, the extent to which this variation reflects contemporary place-based experiences versus embodied exposures from earlier in the life course remains unclear, and little is known regarding the intersection of place and subpopulation. This study, therefore, evaluates whether and how risk for assessed dementia varies by place of residence and birth, overall and by race/ethnicity and education., Methods: We pool data from the 2000 to 2016 waves of the Health and Retirement Study, a nationally representative panel survey of older U.S. adults (n = 96,848 observations). We estimate the standardized prevalence of dementia by Census division of residence and birth. We then fit logistic regression models of dementia on region of residence and birth, adjusting for sociodemographic characteristics, and examine interactions between region and subpopulation., Results: The standardized prevalence of dementia ranges from 7.1% to 13.6% by division of residence and from 6.6% to 14.7% by division of birth, with rates highest throughout the South and lowest in the Northeast and Midwest. In models accounting for region of residence, region of birth, and sociodemographic covariates, Southern birth remains significantly associated with dementia. Adverse relationships between Southern residence or birth and dementia are generally largest for Black and less-educated older adults. As a result, sociodemographic disparities in predicted probabilities of dementia are largest for those residing or born in the South., Discussion: The sociospatial patterning of dementia suggests its development is a lifelong process involving cumulated and heterogeneous lived experiences embedded in place., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Indigenous people in the United States experience disadvantage in multiple domains of health. Yet, their maternal health receives limited research attention. With a focus on empirical research findings, we conduct a scoping review to address two questions: 1) what does the literature tell us about the patterns and prevalence of maternal mortality and morbidity of American Indian and Alaska Native (AI/AN) people? and 2) how do existing studies explain these patterns? A search of CINAHL, Embase and Medline yielded 4757 English-language articles, with 66 eligible for close review. Of these, few focused specifically on AI/AN people's maternal health. AI/AN people experience higher levels of maternal mortality and morbidity than non-Hispanic White people, with estimates that vary substantially across samples and geography. Explanations for the maternal health of AI/AN people focused on individual factors such as poverty, cultural beliefs, and access to healthcare (e.g. lack of insurance). Studies rarely addressed the varied historical and structural contexts of AI/AN tribal nations, such as harms associated with colonization and economic marginalization. Research for and by Indigenous communities and nations is needed to redress the effective erasure of AI/AN people's maternal health experiences and to advance solutions that will promote their health and well-being., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Women's health, and what we know about it, are influenced by social factors. From the exclusion of women's bodies in medical research, to the silence and stigma of menstruation and menopause, to the racism reflected in maternal mortality, the relevance of social factors is paramount. After a brief history of research on women's health, we review selected patterns, trends, and inequalities in US women's health. These patterns reveal US women's poor and declining longevity relative to those in other high-income countries, gaps in knowledge about painful and debilitating conditions that affect millions of women, and deep inequalities that underscore the need to redress political and structural features of US society that enhance health for some and diminish it for others. We close by describing the challenges and opportunities for future research, and the promise of a social determinants of health approach for advancing a multilevel, intersectional, and biosocial understanding of women's health.

Globally, high rates of unintended pregnancy occur despite widespread distribution of modern contraceptive methods, reflecting the complexity of individual contraceptive use. The concept of unmet need provides a framework for addressing the gap between women's desire to prevent pregnancy and the ability of health services to meet women's contraceptive needs. Through in-depth interviews in Khayelitsha, South Africa, we examine 14 young women's experiences with contraception, interrogating how and why reproductive intentions and outcomes often differ markedly. Three main themes were identified and explored. First, unintended pregnancies were common in our sample, despite high knowledge about contraceptive options and availability of multiple methods. Second, women's contraceptive preferences are strongly shaped by concerns with side effects and other embodied experiences, leading to pivotal moments of method-switching or cessation of contraceptive use. Third, using contraception provides participants with the potential for purposeful and self-directed action. These enactments of agency though, occur within intimate and familial relationships, where gendered expectations of the participants' choices ultimately shape both method preference and use. These findings demonstrate the need for an understanding of women's lives and narratives as the basis for understanding complex health behaviours such as contraceptive use.

Objectives: High blood pressure (BP) or hypertension, a major risk factor for death and disease, is pervasive among older adults. While reducing BP to targeted levels can prevent adverse outcomes, rates of successful BP control remain suboptimal, and it is unclear whether older adults recognize its proven benefits. The current study sheds light on older adults' beliefs about the consequences of hypertension and benefits of BP control by examining how their self-reports of hypertension diagnosis and BP control, as well as measured BP, contribute to subjective life expectancy (SLE), their perceived probability of surviving to a target age., Methods: In a representative sample of U.S. adults aged 50-89 from the 2006-2014 Health and Retirement Study (n = 18,979 respondents), we analyze SLE using generalized linear regression., Results: Diagnosed hypertension is associated with lower SLE, regardless of measured BP. Among diagnosed hypertensives, those who self-report controlled BP expect to live longer than those who do not. Finally, about 1 in 10 older adults have high measured BP but have never been diagnosed with hypertension, and most diagnosed hypertensives with uncontrolled measured BP self-report their BP as controlled., Discussion: Older adults appear to recognize the harmful effects of hypertension and the benefits of BP control, but often lack knowledge of their own hypertension and BP control statuses. Health communications should continue to stress the value of BP control, although improvements may require increased hypertension awareness and BP monitoring., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Abstract: Leitch, BA, Wilson, PB, Ufholz, KE, Roemmich, JN, Orysiak, J, Walch, TJ, Short, SE, and Fitzgerald, JS. Vitamin D awareness and intake in collegiate athletes. J Strength Cond Res 35(10): 2742-2748, 2021-Poor vitamin D status is a risk factor for negative health and performance outcomes in athletes, but little is known about how athletes' awareness and beliefs about vitamin D affect their consumption of vitamin D. This observational study investigated awareness of vitamin D for health and performance among collegiate athletes and evaluated the association of vitamin D awareness with its dietary intake. Fifty-two female and 29 male Division I collegiate athletes completed an online vitamin D awareness and dietary intake questionnaire between November 1, 2015, and January 30, 2016. Median intake of vitamin D was 330 International Units (IU), which is below the recommended daily allowance (RDA) of 600 IU, but was greater in male athletes (693 IU) than female athletes (263 IU, p < 0.01). The RDA for vitamin D was met by 62% of men and 30% of women. Athletes responded that vitamin D "probably" or "definitely" will play a role in their health (88.9%) and athletic performance (71.6%). However, only 23.4 and 28.4% of athletes reported concern for their vitamin D levels or believed that they were at risk for deficiency, respectively. Results showed small-to-moderate, positive correlations (r = 0.28-0.495, p < 0.05) between aspects of vitamin D awareness and vitamin D intake, particularly with supplemental forms of vitamin D. Given the lack of awareness concerning risk of vitamin D deficiency, and the links between aspects of vitamin D awareness and vitamin D intake, nutritional education programs designed to increase vitamin D awareness in athletes may be an effective strategy to reduce deficiency., (Copyright © 2019 National Strength and Conditioning Association.)

Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest.

This study examined the role of women's political leadership at the community level in China, a context that has experienced recent political and socioeconomic change and has a distinctive rural-urban divide. Drawing on longitudinal data from the China Family Panel Studies (N range = 40,918-52,406 person-year observations), we found that female community directors outnumbered male directors in urban China but were much less common in rural areas. Female community directors had higher levels of human capital regardless of rural or urban location. Residents living in female-directed communities reported better mental health but not physical health or life satisfaction compared to those living in male-directed communities, and this association was most robust among rural women. For rural women, the mental health benefit of living in female-directed communities was partially explained by reduced personal experience of gender discrimination, suggesting that female leadership fosters ideational change toward women that lowers discriminatory behaviors among constituents.

Parenting is emotionally demanding and highly gendered. We use data from the American Time Use Survey to examine mothers' and fathers' momentary affect during childcare activities. We observe a gender imbalance in the emotional rewards of childcare: fathers report more happiness, less stress, and less tiredness than mothers. We introduce the "care context"-defined as the type of childcare activity, when and where it takes place, who is present, and how much care is involved-as an explanation for these gender differences in parents' affect. The analysis reveals that most dimensions of the care context vary between mothers and fathers. We also find that the care context fully accounts for differences in mothers' and fathers' happiness, partially explains differences in stress, and does little to explain differences in tiredness. Thus, the gender imbalance in the emotional rewards of childcare is partially due to parents' highly gendered engagement with their children.

The objective of this study is to measure the preliminary efficacy of a pilot intervention, grounded in behavioural economics, increasing adherence of dual protection (simultaneous use of effective modern contraception and a barrier method, such as a condom) to protect against HIV, other sexually transmitted infections, and unintended pregnancy. Between 2015 and 2016, 100 women aged 18-40 years, seeking post-abortion care in Cape Town, South Africa were recruited to Empower Nudge, a randomised controlled trial to test a lottery incentive intervention designed to increase dual protection. At baseline, the mean age of participants was 27 years; 82% of them were from South Africa; 58% self-identified as Black African; average education completed was 11.7 years. At three months, assignment to the lottery intervention was associated with higher odds of returning for study visits (OR: 6.0; 95%CI: 2.45 to 14.7, p < 0.01), higher condom use (OR: 4.5; 95%CI: 1.43 to 14.1; p < 0.05), and higher use of dual protection (OR: 3.16; 95%CI: 1.01 to 9.9; p < 0.05). Only 60% of the study population returned after three months and only 38% returned after six months. Women who receive post-abortion care represent a neglected population with an urgent need for HIV and pregnancy prevention. Dual protection is a critically important strategy for this population. Lottery-based behavioural economics strategies may offer possible ways to increase dual protection use in this population. Further research with larger samples, longer exposure time, and more sites is needed to establish fully powered efficacy of lottery incentives for dual protection; using objective verification for monitoring.

Objectives: The primary aim of this study was to examine relationships between digit ratio (2D:4D) and game-related statistics in professional and semi-professional male basketball players. The secondary aim was to quantify differences in mean 2D:4Ds between starting and reserve players., Methods: Using a cross-sectional design, 93 male basketball players from the professional Australian National Basketball League and the semi-professional South Australian Premier League were measured in-season for height, mass, and 2D:4D, with game-related statistics collected end-season. Linear relationships between right and left 2D:4Ds and game-related statistics were quantified using nonparametric partial correlations, and differences in mean 2D:4Ds between starting and reserve players were quantified using analysis of covariance (ANCOVA). All partial correlations and ANCOVAs were adjusted for playing experience, body size, and competitive standard., Results: 2D:4D was a weak to moderate negative correlate of points scored and assists-to-turnovers ratio, indicating that males with lower 2D:4Ds were generally better offensively as they recorded more points and assists relative to turnovers. The difference in mean 2D:4D between starting and reserve players was negligible., Conclusions: 2D:4D was favorably correlated with open-skill sports performance, as evidenced by the better offensive statistics of male basketball players with lower 2D:4Ds. These results probably reflect the organizational benefits of prenatal testosterone and indicate that 2D:4D may be a useful complement to traditional physical, physiological, skill, and behavioral predictors of basketball success., (© 2018 Wiley Periodicals, Inc.)

Sex/gender differences in health are a function of social and biological factors, and their interplay over the life course. Despite a large body of research documenting sex/gender as a determinant of health behavior and outcomes, far less scholarship examines how these differences are reflected in physiologic function-an important mediator through which social experiences "get under the skin"-in young adulthood. Using nationally representative, longitudinal data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examine the relationship between gender and biological function (inflammation and immunosuppression) in young adulthood. Second, we examine the contribution of social and economic circumstances in childhood and early adulthood to gender differences in health. The findings reveal strong gender differences in physiologic function, which are robust to the inclusion of many indicators of the social environment, in both inflammation and immune function.

Objective: Digit ratio (2D:4D) is a negative correlate of sports performance, although this relationship may be weak in open-skill sports such as basketball. The primary aim was to quantify relationships between 2D:4D and game-related statistics in semi-professional female basketball players. The secondary aim was to quantify the differences in mean 2D:4Ds between players based on their position in the starting lineup., Methods: Using a cross-sectional design, 64 female basketball players who competed in the South Australian Premier League were measured in-season for height, mass, and 2D:4D, with game-related statistics collected end-season. Partial correlations (adjusted for age and body mass index) were used to quantify relationships between right and left 2D:4Ds and game-related statistics. Unpaired t-tests were used to quantify differences in mean 2D:4Ds between starting and reserve players., Results: 2D:4D was a substantial negative correlate of blocks, rebounds, and field-goal percentage; meaning, females with lower 2D:4Ds were generally better defensively as they recorded more blocks and rebounds, and were more efficient scorers, irrespective of their age and body size. Mean 2D:4D differed by position in the starting lineup, as females with lower 2D:4Ds were more likely to be in the starting lineup., Conclusions: This study found evidence that 2D:4D was a correlate of performance in an open-skill sport. Female players with lower digit ratios tended to perform better in several aspects of basketball, especially defensively, and were more likely to be starters, suggesting they are the best players on the team in their positions. These results probably reflect the organizational benefits of prenatal testosterone., (© 2017 Wiley Periodicals, Inc.)

The theory of social diagnosis recognizes two principles: 1) extra-medical social structures frame diagnosis; and 2) myriad social actors, in addition to clinicians, contribute to diagnostic labels and processes. The relationship between social diagnosis and (de)medicalization remains undertheorized, however, because social diagnosis does not account for how social actors can also resist the pathologization of symptoms and conditions-sometimes at the same time as they clamor for medical recognition-thereby shaping societal definitions of disease in different, but no less important, ways. In this article, we expand the social diagnosis framework by adding a third principle, specifically that 3) social actors engage with social structures to both contribute to, and resist, the framing of a condition as pathological (i.e. medicalization and demedicalization). This revised social diagnosis framework allows for the systematic investigation of multi-directional, dynamic processes, formalizing the link between diagnosis and (de)medicalization. It also responds to long-standing calls for more contextualized research in (de)medicalization studies by offering a framework that explicitly accounts for the social contexts in which (de)medicalizing processes operate. To showcase the utility of this revised framework, we use it to guide our analyses of a highly negotiated diagnosis: intersex., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

In this paper, we investigate the possibility that genetic variation contributes to self-perceived weight status among adolescents and young adults in the U.S. Using samples of identical and fraternal twins across four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) study, we calculate heritability estimates for objective body mass index (BMI) that are in line with previous estimates. We also show that perceived weight status is heritable (h(2) ∼ 0.47) and most importantly that this trait continues to be heritable above and beyond objective BMI (h(2) ∼ 0.25). We then demonstrate significant sex differences in the heritability of weight identity across the four waves of the study, where h(2)women = 0.39, 0.35, 0.40, and 0.50 for each wave, respectively, and h(2)men = 0.10, 0.10, 0.23, and 0.03. These results call for a deeper consideration of both identity and gender in genetics research., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Millions of children in Sub-Saharan Africa live with adults, often parents, who are HIV-infected or ill due to AIDS. These children experience social, emotional, and health vulnerabilities that overlap with, but are not necessarily the same as, those of orphans or other vulnerable children. Despite their distinctive vulnerabilities, research aimed at understanding the situation of these children has been limited until very recently. This review summarizes the state of knowledge based on a systematic search of PubMed and Web of Science that identified 47 empirical research articles that examined either the population prevalence of children living with HIV-infected or AIDS-sick adults, or the consequences of adult HIV infection or AIDS illness for child well-being. This review confirms that this population of children is substantial in size, and that the vulnerabilities they experience are multi-faceted, spanning physical and emotional health and schooling. Mechanisms were examined empirically in only a small number of studies, but encompass poverty, transmission of opportunistic infections, care for unwell adults, adult distress, AIDS stigma, lack of social support, maternal breastfeeding issues, and vertical HIV transmission. Some evidence is provided that infants, adolescents, children with infected or ill mothers, and children living with severely ill adults are particularly vulnerable. Future research would benefit from more attention to causal inference and further characterization of processes and circumstances related to vulnerability and resilience. It would also benefit from further study of variation in observed associations between adult HIV/AIDS and child well-being based on characteristics such as age, sex, kinship, severity of illness, TB co-infection, disclosure, and serostatus awareness. Almost one-quarter of the studies reviewed did not investigate variation based on any of these factors. More nuanced understanding of the short- and long-term effects of adult HIV on children's needs and circumstances will be important to ongoing discussions about equity in policies and interventions.

Background: In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children's health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children's health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children., Methods: Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households., Results: The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent., Conclusion: Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct vulnerabilities of these children.

Health behaviors shape health and well-being in individuals and populations. Drawing on recent research, we review applications of the widely applied "social determinants" approach to health behaviors. This approach shifts the lens from individual attribution and responsibility to societal organization and the myriad institutions, structures, inequalities, and ideologies undergirding health behaviors. Recent scholarship integrates a social determinants perspective with biosocial approaches to health behavior dynamics. Empirical advances model feedback among social, psychological and biological factors. Health behaviors are increasingly recognized as multidimensional and embedded in health lifestyles, varying over the life course and across place and reflecting dialectic between structure and agency that necessitates situating individuals in context. Advances in measuring and modeling health behaviors promise to enhance representations of this complexity.

Intermittent hypobaric hypoxia (IH) is linked with oxidative stress, impairing cardiac function. However, early IH also activate cardio-protective mechanisms. Omega 3 fatty acids (Ω3) induce cardioprotection by reducing infarct size and reinforcing antioxidant defenses. The aim of this work was to determine the combined effects of IH and Ω3 on cardiac function; oxidative balance and inflammatory state. Twenty-eight rats were randomly divided into four groups: normobaric normoxia (N); N + Ω3 (0.3 g·kg-1·day-1); IH; and IH + Ω3. IH was induced by 4 intercalate periods of hypoxia (4 days)-normoxia (4 days) in a hypobaric chamber during 32 days. At the end of the exposure, hearts were mounted in a Langendorff system and subjected to 30 min of ischemia followed by 120 min of reperfusion. In addition, we determined HIF-1α and ATP levels, as well as oxidative stress by malondialdehyde and nitrotyrosine quantification. Further, the expression of the antioxidant enzymes superoxide dismutase, catalase, and glutathione peroxidase was determined. NF-kappaB and myeloperoxidase levels were assessed in the hearts. Relative to N hearts, IH improved left ventricular function (Left ventricular developed pressure: N; 21.8 ± 3.4 vs. IH; 42.8 ± 7.1 mmHg; p < 0.05); reduced oxidative stress (Malondialdehyde: N; 14.4 ± 1.8 vs. IH; 7.3 ± 2.1 μmol/mg prot.; p < 0.05); and increased antioxidant enzymes expression. Supplementation with Ω3 induces similar responses as IH group. Our findings suggest that both, IH and Ω3 in an independent manner, induce functional improvement by antioxidant and anti-inflammatory mechanisms, establishing cardio-protection.

Background: Intermittent hypobaric hypoxia (IHH) induces changes in the redox status and structure in rat testis. These effects may be present in people at high altitudes, such as athletes and miners. Polyunsaturated fatty acids (PUFA) can be effective in counteracting these oxidative modifications due to their antioxidants properties. The aim of the work was to test whether PUFA supplementation attenuates oxidative damage in testis by reinforcing the antioxidant defense system. The animals were divided into four groups (7 rats per group): normobaric normoxia (~750 tor; pO2 156 mmHg; Nx); Nx + PUFA, supplemented with PUFA (DHA: EPA = 3:1; 0.3 g kg(-1) of body weight per day); hypoxic hypoxia (~428 tor; pO2 90 mmHg; Hx) and, Hx + PUFA. The hypoxic groups were exposed in 4 cycles to 96 h of HH followed by 96 h of normobaric normoxia for 32 days. Total antioxidant capacity (FRAP) and lipid peroxidation (malondialdehyde, MDA) in plasma and reduced (GSH)/oxidized glutathione (GSSG) ratio, tissue lipid peroxidation (TBARS) and antioxidant enzymes activity were assessed at the end of the study in testis. Also, SIRTUIN 1 and HIF-1 protein expression in testis were determined., Results: IHH increased lipid peroxidation in plasma and HIF-1 protein levels in testis. In addition, IHH reduced FRAP levels in plasma, antioxidant enzymes activities and SIRTUIN 1 protein levels in testis. PUFA supplementation attenuated these effects, inducing the increases in FRAP, in the antioxidant enzymes activity and HIF-1 levels., Conclusions: These results suggest that the IHH model induces a prooxidant status in plasma and testis. The molecular protective effect of PUFA may involve the induction of an antioxidant mechanism.

Context: An estimated 10% of U.S. women of reproductive age report a current disability; however, the relationship between disability, motherhood attitudes and fertility intentions among these women is largely unknown., Methods: Data from the 2006-2010 National Survey of Family Growth were used to examine attitudes toward motherhood and fertility intentions among 10,782 U.S. women aged 15-44. A series of regression models assessed, separately for mothers and childless women, associations between disability status and women's attitudes and intentions., Results: Women with and without disabilities held similar attitudes toward motherhood. Among women without children, women with and without disabilities were equally likely to want a child and equally likely to intend to have one. However, childless women with disabilities who wanted and intended to have a child were more likely to report uncertainty about those intentions than were childless women without disabilities (odds ratio, 1.7). Mothers with disabilities were more likely to want another child (1.5), but less likely to intend to have a child (0.5), than were mothers without disabilities., Conclusions: Deepening understanding of the reproductive health desires, needs and challenges of women with disabilities is essential if the highest quality reproductive health services are to be provided for all., (Copyright © 2014 by the Guttmacher Institute.)

Research on neighborhoods and health increasingly acknowledges the need to conceptualize, measure, and model spatial features of social and physical environments. When ignoring underlying spatial dynamics, we run the risk of biased statistical inference and misleading results. In this article, we propose an integrated multilevel spatial approach for Poisson models of discrete responses. In an empirical example of child mortality in 1880 Newark, New Jersey, we compare this multilevel spatial approach with the more typical aspatial multilevel approach. Results indicate that spatially defined egocentric neighborhoods, or distance-based measures, outperform administrative areal units, such as census units. In addition, although results do not vary by specific definitions of egocentric neighborhoods, they are sensitive to geographic scale and modeling strategy. Overall, our findings confirm that adopting a spatial multilevel approach enhances our ability to disentangle the effect of space from that of place, pointing to the need for more careful spatial thinking in population research on neighborhoods and health.

Gender and HIV risk have been widely examined in southern Africa, generally with a focus on dynamics within sexual relationships. Yet the social construction of women's lives reflects their broader engagement with a gendered social system, which influences both individual-level risks and social and economic vulnerabilities to HIV/AIDS. Using qualitative data from Lesotho, we examine women's lived experiences of gender, family and HIV/AIDS through three domains: (1) marriage; (2) kinship and social motherhood, and (3) multigenerational dynamics. These data illustrate how women caregivers negotiate their roles as wives, mothers, and household heads, serving as the linchpins of a gendered family system that both affects, and is affected by, the HIV/AIDS epidemic. HIV/AIDS interventions are unlikely to succeed without attention to the larger context of women's lives, namely their kinship, caregiving, and family responsibilities, as it is the family and kinship system in which gender, economic vulnerability and HIV risk are embedded.

Neuronal nicotinic acetylcholine receptor (nAChR) genes (CHRNA5/CHRNA3/CHRNB4) have been reproducibly associated with nicotine dependence, smoking behaviors, and lung cancer risk. Of the few reports that have focused on early smoking behaviors, association results have been mixed. This meta-analysis examines early smoking phenotypes and SNPs in the gene cluster to determine: (1) whether the most robust association signal in this region (rs16969968) for other smoking behaviors is also associated with early behaviors, and/or (2) if additional statistically independent signals are important in early smoking. We focused on two phenotypes: age of tobacco initiation (AOI) and age of first regular tobacco use (AOS). This study included 56,034 subjects (41 groups) spanning nine countries and evaluated five SNPs including rs1948, rs16969968, rs578776, rs588765, and rs684513. Each dataset was analyzed using a centrally generated script. Meta-analyses were conducted from summary statistics. AOS yielded significant associations with SNPs rs578776 (beta = 0.02, P = 0.004), rs1948 (beta = 0.023, P = 0.018), and rs684513 (beta = 0.032, P = 0.017), indicating protective effects. There were no significant associations for the AOI phenotype. Importantly, rs16969968, the most replicated signal in this region for nicotine dependence, cigarettes per day, and cotinine levels, was not associated with AOI (P = 0.59) or AOS (P = 0.92). These results provide important insight into the complexity of smoking behavior phenotypes, and suggest that association signals in the CHRNA5/A3/B4 gene cluster affecting early smoking behaviors may be different from those affecting the mature nicotine dependence phenotype., (© 2013 WILEY PERIODICALS, INC.)

This article addresses 2 questions. First, to what extent are sex and gender incorporated into research on genetics and health? Second, how might social science understandings of sex and gender, and gender differences in health, become more integrated into scholarship in this area? We review articles on genetics and health published in selected peer-reviewed journals. Although sex is included frequently as a control or stratifying variable, few articles articulate a conceptual frame or methodological justification for conducting research in this way, and most are not motivated by sex or gender differences in health. Gender differences in health are persistent, unexplained, and shaped by multilevel social factors. Future scholarship on genetics and health needs to incorporate more systematic attention to sex and gender, gender as an environment, and the intertwining of social and biological variation over the life course. Such integration will advance understandings of gender differences in health, and may yield insight regarding the processes and circumstances that make genomic variation relevant for health and well-being.

Background: Mixed findings have been reported on the association between Western fast-food restaurants and body weight status. Results vary across study contexts and are sensitive to the samples, measures and methods used. Most studies have failed to examine the temporally dynamic associations between community exposure to fast-food restaurants and weight changes., Methods: Bayesian hierarchical regressions are used to model changes in body mass index, waist-to-height ratio (WHtR) and waist-to-hip ratio (WHpR) as a function of changes in Western fast-food restaurants in 216 communities for more than 9000 Chinese adults followed up multiple times between 2000 and 2009., Results: Number of Western fast-food restaurants is positively associated with subsequent increases in WHtR and WHpR among rural population. More fast-food restaurants are positively associated with a future increase in WHpR for urban women. Increased availability of fast food between two waves is related to increased WHtR for urban men over the same period. A past increase in number of fast-food restaurants is associated with subsequent increases in WHtR and WHpR for rural population., Conclusions: The associations between community exposure to Western fast food and weight changes are temporally dynamic rather than static. Improved measures of exposure to community environment are needed to achieve more precise estimates and better understanding of these relationships. In light of the findings in this study and China's rapid economic growth, further investigation and increased public health monitoring is warranted since Western fast food is likely to be more accessible and affordable in the near future.

Context: Recent studies have shown an association between cigarettes per day (CPD) and a nonsynonymous single-nucleotide polymorphism in CHRNA5, rs16969968., Objective: To determine whether the association between rs16969968 and smoking is modified by age at onset of regular smoking., Data Sources: Primary data., Study Selection: Available genetic studies containing measures of CPD and the genotype of rs16969968 or its proxy., Data Extraction: Uniform statistical analysis scripts were run locally. Starting with 94,050 ever-smokers from 43 studies, we extracted the heavy smokers (CPD >20) and light smokers (CPD ≤10) with age-at-onset information, reducing the sample size to 33,348. Each study was stratified into early-onset smokers (age at onset ≤16 years) and late-onset smokers (age at onset >16 years), and a logistic regression of heavy vs light smoking with the rs16969968 genotype was computed for each stratum. Meta-analysis was performed within each age-at-onset stratum., Data Synthesis: Individuals with 1 risk allele at rs16969968 who were early-onset smokers were significantly more likely to be heavy smokers in adulthood (odds ratio [OR] = 1.45; 95% CI, 1.36-1.55; n = 13,843) than were carriers of the risk allele who were late-onset smokers (OR = 1.27; 95% CI, 1.21-1.33, n = 19,505) (P = .01)., Conclusion: These results highlight an increased genetic vulnerability to smoking in early-onset smokers.

In Southern Africa, high adult HIV prevalence has fueled concern about the welfare of children losing parents to the epidemic. A growing body of evidence indicates that parental, particularly maternal, death is negatively associated with child outcomes. However, a better understanding of the mechanisms is needed. In addition, the way orphan disadvantage and the mechanisms giving rise to it are understood on the ground is essential for the successful translation of research into policies and programs. This study employs data from 89 in-depth interviews with caregivers and key informants in Lesotho, a setting where approximately one-quarter of adults is infected with HIV, to elaborate understandings of orphan disadvantage. Our analysis focuses on two questions: (i) Do local actors perceive orphans to be disadvantaged compared to non-orphans, and if so, in what ways; and (ii) How do they explain orphans' differential disadvantage?Analyses suggest that orphans were widely perceived to be disadvantaged; respondents described this disadvantage in material as well as affective domains. Thematic analyses reveal five broad categories of explanation: poverty, love and kin connection, caregiver character, perceptions of orphans, and community norms related to orphan care. These results underscore the need for research and policy to address (i) multiple types of disadvantage, including deficits in kindness and attention; and (ii) the social embeddedness of disadvantage, recognizing that poverty, kinship, and community interact with individual attributes to shape caregiving relationships and child experiences. The findings suggest limited success for programs and policies that do not address the emotional needs of children, or that focus on child or caregiver support to the exclusion of community outreach.

We examined the distribution of health insurance in China during 1997-2006, a period when government interventions were implemented to improve access to health care. We analyzed data from a survey that follows households in nine provinces that are home to more than 40 percent of China's population. The analysis shows that the percentage of individuals with insurance increased from 24 percent in 1997 to 28 percent in 2004 and then rose dramatically, to 49 percent in 2006. Rural and urban levels of insurance coverage became more similar, reflecting a dramatic upswing in coverage in rural areas that is likely to have benefited millions of rural Chinese. At the same time, the analysis suggests that health insurance reimbursement rates to consumers for inpatient care might have declined in rural villages. Because reimbursement and other insurance characteristics affect health care use, future efforts to reduce rural-urban disparities should address the quality of health insurance and the level of reimbursement in addition to coverage rates.

Context: Sexually experienced women are at risk of cervical cancer, one of the most common female reproductive cancers. Nearly 20% of U.S. women aged 18-64 have a disability, and disability is associated with health care access; however, the relationship between disability and Pap smear receipt remains underexplored., Methods: Data on 20,907 women aged 21-64 from the 2000 and 2005 National Health Interview Surveys were used to investigate the relationship between disability and cervical cancer screening. Logistic regression analyses were conducted to assess the association between disability and both women's receipt of a Pap smear and their receipt of a doctor's recommendation for a Pap smear in the past year., Results: Having a disability was negatively associated with Pap smear receipt (odds ratio, 0.6). Compared with women with no disabilities, those with mobility limitations and those with other types of limitations had reduced odds of having received a Pap smear (0.5-0.7). Disability was positively associated with having received a recommendation for a Pap smear (1.2); however, among women who had received a recommendation, those with disabilities had reduced odds of having received a Pap smear (0.5). Among women who had not received a Pap smear, 31% of those with disabilities and 13% of others cited cost or lack of insurance as the primary reason., Conclusions: The negative relationship between Pap smear receipt and multiple types of disability suggests barriers beyond the human-made physical features of the environment. Efforts to reduce inequalities in reproductive health care access should consider the needs of women with disabilities., (Copyright © 2010 by the Guttmacher Institute.)

Recently, genetic association findings for nicotine dependence, smoking behavior, and smoking-related diseases converged to implicate the chromosome 15q25.1 region, which includes the CHRNA5-CHRNA3-CHRNB4 cholinergic nicotinic receptor subunit genes. In particular, association with the nonsynonymous CHRNA5 SNP rs16969968 and correlates has been replicated in several independent studies. Extensive genotyping of this region has suggested additional statistically distinct signals for nicotine dependence, tagged by rs578776 and rs588765. One goal of the Consortium for the Genetic Analysis of Smoking Phenotypes (CGASP) is to elucidate the associations among these markers and dichotomous smoking quantity (heavy versus light smoking), lung cancer, and chronic obstructive pulmonary disease (COPD). We performed a meta-analysis across 34 datasets of European-ancestry subjects, including 38,617 smokers who were assessed for cigarettes-per-day, 7,700 lung cancer cases and 5,914 lung-cancer-free controls (all smokers), and 2,614 COPD cases and 3,568 COPD-free controls (all smokers). We demonstrate statistically independent associations of rs16969968 and rs588765 with smoking (mutually adjusted p-values<10(-35) and <10(-8) respectively). Because the risk alleles at these loci are negatively correlated, their association with smoking is stronger in the joint model than when each SNP is analyzed alone. Rs578776 also demonstrates association with smoking after adjustment for rs16969968 (p<10(-6)). In models adjusting for cigarettes-per-day, we confirm the association between rs16969968 and lung cancer (p<10(-20)) and observe a nominally significant association with COPD (p = 0.01); the other loci are not significantly associated with either lung cancer or COPD after adjusting for rs16969968. This study provides strong evidence that multiple statistically distinct loci in this region affect smoking behavior. This study is also the first report of association between rs588765 (and correlates) and smoking that achieves genome-wide significance; these SNPs have previously been associated with mRNA levels of CHRNA5 in brain and lung tissue., Competing Interests: NLS is the spouse of S.F. Saccone, who is listed as an inventor on a patent, “Markers of Addiction”, covering the use of certain SNPs in diagnosing, prognosing, and treating addiction. LJB, JCW and JPR are listed as inventors on a patent, “Markers of Addiction,” covering the use of certain SNPs in diagnosing, prognosing, and treating addiction. LJB has served as a consultant to Pfizer in 2008. XK is a full time employee of GlaxoSmithKline. SP was a full time employee of GlaxoSmithKline. Current affiliation is with Hoffman-La Roche. JK has served as a consultant to Pfizer in 2008. MDL has served as a consultant to NIH, deCODE genetics, University of Pennsylvania, Reckitt Benckiser Pharmaceuticals, Pennsylvania Department of Health, and Informational Managements Consulting. Dr. Li also serves as a scientific advisor to ADial Pharmaceuticals. TJP receives compensation from the University of Mississippi Medical Center; part of his salary has been supported by grants from NIDA, NCI, the University of Mississippi Health Care Cancer Institute, the Mississippi State Department of Health, Pfizer Inc., and GlaxoSmithKline.

The HIV/AIDS pandemic in sub-Saharan Africa has brought renewed attention to the role of grandmothers as caregivers of children. Using 2004 DHS data, we examine the relationship between co-residence with a grandmother and child schooling in Lesotho, a country with one of the highest rates of HIV infection. Results confirm the critical role grandmothers play in the event of maternal death. Maternal orphans who live with a grandmother are just as likely to be in school as children living with a mother. The protective effect of living with a grandmother is also important for children whose mothers are alive but not affiliated with their households. The results of the analysis underscore the importance of attending to the simultaneous presence of mothers and grandmothers, as well as the circumstances associated with mother absence, when assessing the relationship between grandmother co-residence and child outcomes.

Imagery is a cognitive process during which people use their minds to create (or recreate) experiences that are similar to real-life situations. This study examined how college athletes used imagery during weight training. Subjects were 295 Division I (n = 163) and Division II (n = 132) college student athletes (men: n = 138, women: n = 157) who participated in a weight training program as a requirement of their sport. They completed a slightly modified version of the "Weight Lifting Imagery Questionnaire." Results showed that appearance imagery (i.e., images related to the attainment of a fit-looking body) was used and considered the most effective followed by technique imagery (i.e., images related to performing the skill and techniques correctly with good form) and energy imagery (i.e., images related to getting "psyched up" or feeling energized). Other variables that effected imagery use were gender, age, time of season, and levels of motivation. In addition, gender, previous imagery training, and level of motivation had an effect on the perceptions of imagery effectiveness. Confidence in the ability to image was associated with both imagery use and effectiveness, and imagery use and effectiveness were associated with confidence in the weight room. The findings support previous research in exercise imagery that appearance imagery is most used followed by technique and energy imagery and extend them in such a way that strength coaches have practical advice on how to use imagery in a positive way with their athletes. Suggestions about how strength coaches can use imagery with their clients are provided.

Research on changes in women's parenting has focused primarily on their increased likelihood of combining parenthood with paid employment, exploring the pressures that result from this "second shift" or "double burden." This article complements this approach by focusing instead on the likely reduction in the help that mothers of small children have received as declines both in fertility and the coresidence of nonnuclear adults have reduced the number of other women in the household. Using national census data for the period 1880 to 2000, we show a substantial decline in the presence and availability of other females in the household, as fewer are coresident and more of those who are coresident are employed or in school. Although all mothers experience this decline, it is most acute for mothers working for pay in nonagricultural activities.

The factors that influence whether an athlete chooses to engage in imagery are largely unknown. One reason may be the amount of confidence athletes have in their ability to image. The aim of this study was to examine the relationships among efficacy in using imagery, imagery use and imagery ability. Consistent with Bandura's (1986, 1997) theory, it was hypothesized that there would be a positive correlation between efficacy in using imagery and imagery use, and that efficacy in using imagery would mediate the relationship between imagery ability and imagery use. Participants were 74 female athletes from various sports. The instruments we used were the Movement Imagery Questionnaire-Revised (Hall & Martin, 1997) for imagery ability, the Sport Imagery Questionnaire (Hall, Mack, Paivio, & Hausenblas, 1998) for imagery use, and a modified version of the latter questionnaire for efficacy in using imagery. Correlations showed that the more athletes were confident in their ability to use a certain image, the more they used it. Efficacy in using imagery was found to mediate only the relationship between imagery ability and cognitive imagery use.

This study compared coaches' assessments of their own coaching efficacy with their athletes' perceptions of the coaches' efficacy. Coaching efficacy was measured with the Coaching Efficacy Scale. Participants were 9 football coaches and 76 football players from the same team. Analysis indicated coaches were confident in their coaching abilities (range 6.5 to 9.0 on a 9-point scale). For 7 of the 9 coaches the coaches' ratings of themselves were higher than the athletes' ratings. For the other 2 coaches, athletes' ratings of coaches' efficacy were higher than the coaches' ratings of themselves. All coaches' ratings fell within the 95% confidence interval based on the athletes' ratings of the coaches' efficacy. Results are discussed in terms of the interplay between athletes and coaches efficacy beliefs and its influence on behavior.

Completing the State Sport Confidence Inventory requires participants to compare themselves with the most confident athlete they know. Inconsistency is inherent in participants' choices that may result in unsystematic variance across such responses. This study tested the modifiability of the inventory by removing the "comparison" component from the instructions and from each of the 13 questions. Using data from 31 female figure skaters (M age=16.1 yr., SD=1.0), the original and modified versions were compared. Adequate reliabilities were found for both measures (both rs=.94), but a paired sample t test indicated significant differences between mean scores on the two versions. The total score and all of the item scores were higher for the modified version than the original, and coefficients of determination showed variance shared by the modified and original items ranged only from 9 to 59% per item. These results suggest that the modified version was not an adequate representation of the original inventory.

To assess whether the Group Environment Questionnaire is applicable to athletes in co-acting sports such as track and field, the factor structure of the Group Environment Questionnaire among a heterogeneous sample of 199 co-acting team sport athletes was investigated. A confirmatory factor analysis did not support the hypothesized four-factor model. A subsequent exploratory factor analysis yielded two independent factors that had no interpretable pattern of the four Group Environment Questionnaire factors within them. While this finding requires replication and confirmation, the four-factor model of the Group Environment Questionnaire does not appear to be as valid for co-acting sports as for interacting sports.

Sterilization is the most prevalent method of contraception in China. Approximately half of all women of reproductive age report that they or their husbands are sterilized. Using data from the China Health and Nutrition Survey we describe patterns of sterilization in eight Chinese provinces. With a discrete-time event history model we investigate the link between characteristics of local birth planning policy and the risk of sterilization. After controlling for parity, the risk of sterilization is highest in communities where birth planning policy is least strong as measured by exceptions to the one-child policy. These results suggest that couples with more flexibility in family building may have less control over contraceptive method use. Other factors affecting the risk of sterilization are a woman's age, parity, and whether or not she has a son. Our results emphasize the importance of taking into account multiple dimensions of reproductive behaviour when assessing one-child policy changes.

Of all the reforms and policies set in motion in the early 1980s in China, the one-child policy has been called the most far-reaching in its implications for China's population and economic development. Almost two decades later, little is known about what the policy looks like across local neighborhoods and villages. To sketch a more general picture of the one-child policy, this article presents panel data from three waves of the China Health and Nutrition Survey (1989, 1991, and 1993) collected in 167 communities in eight provinces. Local policy, including policy strength and policy incentives and disincentives, is detailed separately for urban and rural areas. These data confirm that no single one-child policy exists; policy varied considerably from place to place and within individual communities during the 1989-93 period.