Greater Affluence Research Articles

Magnitudes of overweight and obesity among adult and associated factors in jigjiga town, Somali region, Ethiopia

Overweight and obesity are major worldwide health concerns, with serious consequences for mortality and morbidity. Overweight and obesity rates are frighteningly high in Sub-Saharan Africa, particularly Nigeria and Ethiopia, due to a variety of causes such as urbanization, greater affluence, and bad food habits. The purpose of this study was to determine the prevalence of overweight and obesity among people in Jigjiga Town, Somali Region, Eastern Ethiopia, as well as to investigate related factors in order to inform treatments and policy. A cross-sectional survey was done among persons aged 20 to 64 working in the government, non-governmental, and commercial sectors. Socio-demographic information, food habits, physical activity, and anthropometric measures were all recorded. The overall prevalence of overweight and obesity was shown to be 42.4 %, with significant correlations identified with profession and TV viewing habits. Employed people were less likely to be overweight or obese than those in commerce/trade, and those who watched TV for 2–3 h had a reduced risk than those who watched less than 2 h. The study found that khat chewing is significantly associated with an increased risk of overweight and obesity, with chewers being 1.56 times more likely to be overweight or obese compared to non-chewers. Additionally, there is an inverse relationship between snacking frequency and overweight/obesity risk; participants who snacked once a day were 2.5 times more likely to be overweight or obese than those who snacked three or more times a day. These findings highlight that khat chewing and snacking patterns are important modifiable risk factors for overweight and obesity in the studied population. These findings highlight the need of focused treatments targeting food choices, physical activity, and sedentary behavior in combating overweight and obesity in Eastern Ethiopia. Collaboration among academics, policymakers, healthcare professionals, and community stakeholders is critical for developing successful methods for promoting healthy lifestyles and lowering the region's overweight and obesity burden.

P-444 The use of socioeconomic deprivation as an explanation of variation in IVF success rates between clinics

Abstract Study question Can differences in the live birth rate (LBR) between clinics with similar standard operating procedures (SOPs) be explained by variations in socioeconomic deprivation? Summary answer Socioeconomic deprivation does not appear to explain differences in LBR between clinics with similar SOPs in this cohort What is known already IVF success rates vary markedly between clinics. Numerous factors determine whether an IVF cycle is likely to be successful. It has been suggested that more socioeconomically deprived women are significantly less likely to achieve a live birth per cycle than less deprived women. In the UK, there is considerable variation in the levels of socioeconomic deprivation between different cities. Study design, size, duration We undertook a multi-center, retrospective review of prospectively collected data. We included all women undergoing their first IVF/ICSI cycle between January 2016 and December 2020 in eight different clinics belonging to the same IVF group. Clinics were located across England: three were situated in ‘very deprived’ cities, two in ‘predominantly affluent’ cities and the remaining cities were ‘neither very deprived nor very affluent’ i.e. their distribution was not skewed. Participants/materials, setting, methods We included all women undergoing their first IVF/ICSI cycle involving transfer of a single, fresh embryo. SOPs for medical and laboratory aspects of treatment were similar across all eight clinics. Socioeconomic deprivation was assessed using the Index of Multiple Deprivation (IMD) determined by the residential postcode of each woman undergoing treatment. Patients were categorized into quintiles according to IMD score. Live birth rates across IMD quintiles were calculated. Statistical analysis was performed using SPSS 22. Main results and the role of chance In total, across the 8 clinics, 17171 women underwent an IVF/ICSI cycle. The LBR ranged from 17.9 - 35.7% (p < 0.001) with both upper and lower extremes in clinics in cities classified as ‘neither very deprived nor very affluent’. The overall LBR ranged from 23.7-26.0% across the IMD quintiles. This difference was neither linear nor statistically significant. Similar trends were noted whether the treatment was NHS (n = 4992) or self-funded (n = 12179). The proportion of women in each IMD quintile varied significantly (p < 0.001) across the different clinics: in the most deprived quintile this ranged from 3.2 - 22.8% and in the least deprived quintile this ranged from 19.1 - 30.8%. The LBR in each IMD quintile also varied significantly (p < 0.001) across the different clinics. The LBR in the most deprived quintile ranged from 7.1 - 46.1% and in the least deprived quintile ranged from 19.4 - 22.9%. Limitations, reasons for caution Our results require caution as the distribution of deprivation amongst women undergoing IVF was not representative of the cities in which clinics were located with a skew towards greater affluence seen. Further unknown variables appear responsible for the significant variation in LBRs between clinics rather than IMD categorization alone. Wider implications of the findings The distribution of deprivation amongst women undergoing IVF was not representative of the cities in which clinics were located. Whilst not unexpected due to the cost of IVF, ethical questions regarding access to fertility care are highlighted and efforts to promote inclusion should be prioritized. Trial registration number Not applicable

Communication between cancer patients, caregivers and oncologists about out-of-pocket spending

Abstract Background Concern about the cost and affordability of cancer drugs is widespread and well known. Even in countries with universal healthcare systems or health insurance for all, additional patient out-of-pocket (OOP) expenses are prevalent. Studies showed that honest communication between oncologists and patients is an important component in alleviating financial burden of cancer care. The study explores patient-caregiver-oncologist communication regarding the affordability of OOP medication and the extent to which this communication is related to families’ financial burden after their loved ones’ death. Methods A cross-sectional survey is conducted in Israel among 491 primary caregivers of deceased cancer patients, Jewish and Arab, in three oncology centers. Results About 43% caregivers said that they and/or the patients had paid OOP for medications during the last half-year of the patient's life. Most (73%) oncologists who suggested an OOP medication hardly asked or did not ask about financial ability and took little or no interest in ability to afford it, 43% hardly explained or did not explain the advantages of an OOP medication, and 52% hardly explained or did not explain any treatment alternatives. A linear regression analysis reveals that older age and female gender are related to less communication about an OOP medication and that better education, greater affluence, and having private health insurance are related to more communication. About 56% of caregivers say that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. A regression analysis revealed that physicians’ interest in their financial ability and in the explanation they gave decreased their burden. Conclusions Discussing and explaining the meaning of OOP payment alleviates the financial burden that families experience. It is crucial to develop and invest in improving oncologists’ education and skills to communicate costs more openly. Key messages

Leveling the playing field

Vision care remains one of the greatest unmet health needs. Hispanic and Black patients have fewer outpatient ophthalmologic visits than their non-Hispanic White counterparts, as do the uninsured compared to the insured, those with less income and education compared to those with greater affluence and more education, and those living in the Midwestern, southern, or western United States. Many factors affect how we can address issues such as race, ethnicity, income, insurance coverage, etc.

Changes in environmental worldviews among Chinese urban residents during economic growth and accelerating polluting in the 2000s

During the first decade of the 2000s, China experienced tremendous growth in the economy and environmental degradation. This study examines whether there has been a subsequent increase in pro-environmental worldviews among urban Chinese people over that period since theories predict that both greater affluence and exposure to pollution can promote such views. We find that from 2003 to 2010, Chinese urban citizens’ pro-environmental worldviews measured by the New Environmental/Ecological Paradigm (NEP) did not increase as would be predicted by multiple theories, indicating that environmental concern is more complex and multi-faceted. Instead, we find some evidence for a diffusion process of environmental concern from more educated people to the rest of the population. We also argue that the impact of different facets of socioeconomic status on environmental concern matter as we find that education increases pro-environmental worldviews more than income.

Out-of-Pocket Spending for Cancer Medication, Financial Burden, and Cost Communication with Oncologists in the Last Six Months of Life in Israel.

Honest communication between oncologists and patients is important in alleviating the financial burden of cancer care. This study explored patient–relative–oncologist communication regarding the affordability of out-of-pocket (OOP) medication and the extent to which this communication addresses itself to the families’ financial burden. A cross-sectional survey was conducted among primary caregivers of deceased cancer patients. About 43% of relatives said that they and/or the patients had paid out of pocket for medications during the last six months of the patient’s life. Most (73%) oncologists suggested an OOP medication without asking about financial ability, 43% hardly explained the advantages of an OOP medication, and 52% hardly explained any treatment alternatives. Older age and female gender were related to less communication about an OOP medication, and better education, greater affluence, and having private health insurance were related to more communication. About 56% of relatives said that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. Physicians’ interest in financial ability and giving explanation lightened the burden. Given the difficulty of explaining the complex interactions of cost and clinical outcomes, oncologists need to be better educated in skills that would enable them to communicate costs more openly and should consider the cost of a treatment when prescribing it.

Risky Alcohol Drinking Pattern and Its Association with Educational Attainment and Wealth Index among Adult Men Population in Ethiopia: Further Analysis of 2016 Ethiopian Demographic Health Survey.

Risky alcohol drinking is one of the major public health problems and an important health risk factor for premature death and disability worldwide. Identifying the determinants of risky alcohol drinking patterns is crucial for developing and improving intervention on drinking behavior. In Ethiopia, the role of educational attainment and affluence in reducing risky alcohol drinking patterns among men remains unclear. Therefore, this study aimed to assess the association of educational status and affluence with risky alcohol drinking patterns using national representative data in Ethiopia. Secondary data analysis was conducted on 12,688 adult men using data from the 2016 Ethiopia Demographic Health Survey (EDHS). The dependent variable was a risky alcohol drinking pattern which is defined as the consumption of alcohol every day in the last 12 months before the interview. Multivariable logistic regression was employed to assess the association between educational attainment, Ethiopian standard wealth index, and risky alcohol drinking pattern, after adjusting for the potential confounders. The overall magnitude of risky alcohol drinking patterns among men in Ethiopia was 4.5% (95% CI: 3.4–5.9). Of the total men who had ever taken alcohol, 9.7% of men drink almost every day in the last 12 months. The odds of having a risky alcohol drinking pattern were lower among men who completed secondary education (AOR = 0.56 (0.329–0.961)) and men who completed higher education levels (AOR = 0.35 (0.164–0.765)) as compared to men who did not attend any formal education. Adult men in the top two wealth quintiles were twice more likely to have risky alcohol drinking patterns than those in the lowest wealth quintile (AOR = 2.13 (1.254–3.605)). This study showed that from the total adult male population, nearly 5% of Ethiopian men had risky drinking patterns. Individuals with low educational status and greater affluence engaged in high-risk alcohol consumption behavior.

Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents

Young people choose energy-dense, nutrient-poor diets, yet understanding of potential determinants is limited. Associations between food choices, mental wellbeing, health-related quality of life (HRQoL) and family affluence were explored to identify targets for intervention to promote dietary health and wellbeing in young people. Adolescents were recruited via post-primary schools in the UK and surveyed at two time-points when aged 13–14 years and 15–16 years. The questionnaire enquired about mental wellbeing using the Short Warwick-Edinburgh Mental Wellbeing Scale, HRQoL using the KIDSCREEN-10, socio-economic status using the Family Affluence Scale and food choice by Food Frequency Questionnaire (FFQ). With missing and anomalous cases excluded, the sample comprised 1208 cases. Factor analysis on the FFQ indicated five food choice factors: ‘Junk Food’; ‘Meat’; ‘Healthy Protein’; ‘Fruit/Vegetables’; ‘Bread/Dairy’. Multivariate regression analysis indicated that frequent consumption of Junk Food was associated with being male and lower mental wellbeing. Frequent Meat intake was associated with being male and with lower HRQoL. Frequent choice of Bread/Dairy foods was more common among males and associated with higher wellbeing and greater affluence. Those who consumed Fruit/Vegetables frequently were more likely to be female, have higher HRQoL, higher mental wellbeing, and greater family affluence. These direct associations endured between time points. The dietary factors were not mutually exclusive. Those who frequently chose Junk Food were less likely to choose Fruit/Vegetables. Frequent choice of Meat was associated with more frequent choice of Junk Food and Healthy Protein. Intervention to improve dietary and psychological health in young people should target males, those in less affluent households, seek to reduce consumption of ‘junk’ food, and increase fruit and vegetable intake.

Neighborhood Socioeconomic Status, Long-Term Exposure to Particulate Matter, and Risk of Cardiovascular Disease and Mortality in the Nurses’ Health Study

Background: Although associations between particulate matter <2.5 microns (PM2.5) and cardiovascular disease (CVD) and mortality are well-established, less is known regarding the joint impact of PM2.5 and neighborhood socioeconomic status (nSES). Our objective was to investigate this interaction in a nationwide cohort of U.S. women. Methods: We used time-varying Cox proportional hazards models, conditioned on age and calendar time, to assess main and interaction effects of PM2.5 and nSES on risk of CVD (stroke, myocardial infarction) and mortality among 100,257 women in the Nurses’ Health Study between 1986 and 2008. Incident CVD (n=6,445) and mortality (n=10,186) cases were ascertained from medical or death record reviews. We created Census tract-level nSES scores by summing z-scores (where increasing scores were associated with affluence) of selected nSES metrics (e.g., race, education, income, home value, nativity, unemployment), and calculated time-varying 24-month average PM2.5 exposure using residential address history. Models were adjusted for time-varying demographic, lifestyle (e.g., diet, physical activity, smoking), and individual-level SES factors. Results: In multivariable adjusted models, increases in nSES (Hazard Ratio [HR]CVD: 0.98, 95% Confidence Interval [CI]: 0.97, 0.99; HRmortality: 0.99, 95% CI: 0.99, 1.00, per 1 unit increase) and PM2.5 (HRCVD: 1.03, 95% CI: 0.95, 1.12; HRmortality: 1.04, 95% CI: 0.97, 1.11, per 10 µg/m3 increase) were associated with incident CVD and mortality rates, although the associations with PM2.5 did not reach statistical significance. The interaction between PM2.5 and nSES was statistically significant for CVD risk (p<0.001) and mortality (p<0.013); associations with mortality were strongest among the least affluent neighborhoods, while associations with CVD were weakest in areas of least and greatest affluence. Conclusions: Our results suggest that PM2.5 and nSES exposures are associated with small changes in rates of mortality and CVD incidence. These exposures interact in a complex fashion, even within a relatively demographically homogeneous cohort of women.

Multimodal Metaphor Analysis of Print Advertisements Based on the Conceptual Blending Theory: Exploring the Hidden Ideology---Sign-Consumption

In today’s industrial society with great affluence in material goods, consumption in our mind no longer aims at objective function, but at the sign-value connoted in the objects. Advertisement is the main carrier of sign-consumption ideology with rich multimodal metaphorical resources. This study follows the analytical mode of Critical Discourse Analysis (CDA), by analyzing multimodal metaphor in print magazine advertisement from the perspective of Conceptual Blending Theory (CBT) to explore the hidden sign-consumption ideology. The main findings of the research are: 1) metaphors in selected ads are all novel metaphors, in which the target domain is always presented by the advertised products while source domain is always presented in form of image; 2) counterpart correspondences mapped between two input spaces are the imposed selling points and sign-value, which take the main marketing functions; 3) relegating and weakening the objective function but advocating sign-value of goods is essentially because of people’s desire for differentiation in homogenized industrial society, which would allow the market more space to conduct secondary exploitation to people instead of labor exploitation. This interdisciplinary study not only adds new content to linguistics but also provides new perspective to consumption issue of sociology and economics. Besides, it provides a rational warning for people to reflect their consumption behavior.In today’s industrial society with great affluence in material goods, consumption in our mind no longer aims at objective function, but at the sign-value connoted in the objects. Advertisement is the main carrier of sign-consumption ideology with rich multimodal metaphorical resources. This study follows the analytical mode of Critical Discourse Analysis (CDA), by analyzing multimodal metaphor in print magazine advertisement from the perspective of Conceptual Blending Theory (CBT) to explore the hidden sign-consumption ideology. The main findings of the research are: 1) metaphors in selected ads are all novel metaphors, in which the target domain is always presented by the advertised products while source domain is always presented in form of image; 2) counterpart correspondences mapped between two input spaces are the imposed selling points and sign-value, which take the main marketing functions; 3) relegating and weakening the objective function but advocating sign-value of goods is essentially because of people’s desire for differentiation in homogenized industrial society, which would allow the market more space to conduct secondary exploitation to people instead of labor exploitation. This interdisciplinary study not only adds new content to linguistics but also provides new perspective to consumption issue of sociology and economics. Besides, it provides a rational warning for people to reflect their consumption behavior.

The Glamorous World: How Instagram Use is related to Affluence Estimates, Materialism, and Self-esteem

Based on cultivation theory, this study examined whether Instagram use is positively related to: 1) greater affluence estimates (i.e., estimates regarding the prevalence of affluence); 2) greater materialistic values, and ultimately; 3) lower self-esteem. Based on an online survey of 530 adults in Korea, this study found that Instagram use was positively related to affluence estimates and materialistic values. In addition, the results showed that Instagram use was indirectly related to lower self-esteem mediated by greater materialistic beliefs. Theoretical and practical implications of these findings are discussed.

Lonely schools: the relationship between geographic isolation and academic attainment

BackgroundSchool improvement initiatives in England have focused on urban areas, which have traditionally been home to larger numbers of poor and underperforming pupils. Previous research has found that rural regions of the country have had higher overall educational attainment due to their greater affluence. However, that broad picture could be hiding under-serviced and under-performing pupils from disadvantaged backgrounds.PurposeThe study’s aim was to identify whether all pupils and all disadvantaged pupils attending geographically isolated secondary schools have different academic attainment rates compared with their peers at less isolated schools.MethodsThe isolation of a school is calculated based on the average travel time by car to its five nearest state-funded mainstream secondary schools. This was then included as an independent variable, along with variables for school demographics, prior pupil attainment and neighbourhood deprivation.ResultsDisadvantaged pupils attending more isolated schools had lower attainment rates (as measured by the percentage of students achieving grades of C or higher in English, mathematics and at least three other subjects at General Certificate of Secondary Education [GCSE] level) than pupils in less isolated schools, when controlling for school demographics and prior attainment. There was no relationship found between whole-school GCSE attainment and geographic isolation.ConclusionWhen framing the challenges of providing equitable opportunities in education, broader contexts beyond pupil characteristics, such as geographic isolation, should be taken into consideration.

Techniques Applied in Characterising Non-starch Polysaccharides in Underutilised Crops in Sub-Saharan Africa

The use of some crops in Sub-Saharan Africa is currently limited to local culinary uses despite promising characteristics of their non-starch polysaccharide. There is very little information on the properties of their non-starch polysaccharide which would stimulate expansion in their applications. Non-starch polysaccharides represent a group of heterogeneous compounds which differ considerably in chemical composition and physical properties both within and between plant sources. They show various physiological effects in the small and large intestine and therefore have important health implications for humans. The physiochemical and biological properties of these compounds correspond to dietary fibre. Their application/introduction in food may lead to diminished risk of serious diet-related diseases which are major problems in Western countries and are emerging in developing countries with a greater affluence. Insoluble NSPs (cellulose and hemicellulose) are effective laxatives whereas soluble NSPs (especially mixed-link β-glucans) lower plasma cholesterol levels and help to normalise blood glucose and insulin levels, making these kinds of polysaccharides a part of dietary plans to treat cardiovascular diseases and type 2 diabetes. In this review, techniques applied in characterising non-starch polysaccharides in five underutilised crops in sub-Saharan Africa were discussed.

Regional Characteristics of Impact Factors for Energy-Related CO2 Emissions in China, 1997–2010: Evidence from Tests for Threshold Effects Based on the STIRPAT Model

This paper analyses the forces driving energy-related CO2 emissions based on a threshold STIRPAT dynamic model, using Chinese state-level panel data during the period of 1997 to 2010. In addition to investigating the impact of affluence on CO2 emissions, this paper studies channels through which affluence could impact on CO2 emissions across development levels and explores the possibility of reducing CO2 emissions through greater affluence by analysing panels including all regions, high-income regions and low-income regions. A threshold STIRPAT dynamic model further estimates thresholds for the major determinants of CO2 emissions: in the long run, affluence is the most important determinant followed by urban population. Variability of affluence impact on CO2 emissions in high-income regions is explained mostly by trade openness degree, while low-income regions with a higher industrial level are associated with lower CO2 emissions. Different measures should be adopted for CO2 reductions in different regions according to local conditions.

Childhood obesity in low- and middle-income countries

Overweight and obesity in childhood is an increasing problem for the less affluent countries of the world. The prevalence of overweight/obesity varies, not only between countries but across countries, depending on the environments in which children live. Changes in physical activity and diet are having adverse effects on children’s nutrition. Greater affluence and urbanisation with more technology such as television in homes are associated with overweight. Affluence also brings the ability to purchase commercial, prepared ‘fast-food’ items, leading too often to disadvantageous effects on children’s diets. The solutions to this rising tide of overweight/obesity seem to lie with broad-based programmes initiated at central government level or at more local community level but which are designed to reach across and throughout societies to enable families and communities to modify the unhealthy lifestyle which too often accompanies increasing affluence and development.

Experimental Advances in Effect of Waviness on Properties of Fibre Reinforced Composite Materials

Categories, fabrication techniques, characterization techniques, and effect of waviness on properties of fibre reinforced composite materials and structures are reviewed. Waviness exerts a great affluence on properties of composite materials and structures, which leads to a significant degradation or reduction of mechanical performances, such as static compressive/tensile strength, compressive fatigue life, and so on. Various factors related to waviness nested into the composite materials and structures, including wave geometry, thickness position of the wavy layer, percentages of layers with waviness, are considered and stated in detail. Failure mode of laminate containing waviness and the reasons for their failure initiation are analytically stated. At last, some prospects about this study are presented.

American Sport and the Sports Heroes of the Roaring Twenties

The aim of the article is to show the role of sport in American society against the background of a very important—for many reasons—period of great social transformation in the United States, one which visibly gathered pace in the 1920s. The author presents different aspects of popular culture, which was in full bloom on account of the following factors: the joy after World War I, a sense of optimism, the development of the economy and industry, the growth of big cities, and the greater affluence of the citizens. The analysis of that unusual decade corroborates the role of sport and its great power of influence on society. In an age when technology and mass production had robbed experiences and objects of their uniqueness, sports provided some of the unpredictability and drama that people craved when looking for romance and adventure. The reasons for the popularity of sport in the USA are presented, as well as the major sports diciplines and heroes of American sport who, in a time when mass production seemed to be making individuals less significant, met with a favorable response — people clung to the heroic personalities of sports figures. The analysis of the beginnings of professionalism in sport, the beginnings of organized support, and sports broadcasting, leaves no doubt as to the significance of the period. As the article demonstrates, it was a time of rapid and profound transformation in the realm of sport. Every serious examination of phenomena in contemporary American sport—and this is also true in the case of other countries—without a knowledge of the specificity of sport in the 1920s, would be far from perfect.

The association between neighborhood socioeconomic status and ovarian cancer tumor characteristics

Higher pathologic grade, suboptimal debulking surgery, and late-stage are markers of more aggressive and advanced ovarian cancer. Neighborhood socioeconomic status (SES) has been associated with more aggressive and advanced tumors for other cancer sites, and this may also be true for ovarian cancer. We examined the association between neighborhood SES and ovarian cancer tumor characteristics using data on 581 women diagnosed with epithelial ovarian cancer in Cook County, Illinois. Two complementary measures (concentrated disadvantage and concentrated affluence) were used to estimate neighborhood SES. Prevalence differences and 95 % confidence intervals were estimated in logistic regression models adjusted for age and race. Greater disadvantage was associated with higher grade tumors (p = 0.03) and suboptimal debulking (p = 0.05) and marginally associated with later tumor stage (p = 0.20). Greater affluence was inversely associated with stage at diagnosis (p = 0.004) and suboptimal debulking (p = 0.03) and (marginally) with tumor grade (p = 0.21). Our findings suggest that lower SES, estimated by neighborhood SES, is associated with ovarian cancer tumor characteristics indicative of more advanced and aggressive disease.

Neighborhood characteristics and differential risk for depressive and anxiety disorders across racial/ethnic groups in the United States.

The prevalence of psychiatric disorders varies depending on the person's neighborhood context, their racial/ethnic group, and the specific diagnoses being examined. Less is known about specific neighborhood features that represent differential risk for depressive and anxiety disorders (DAD) across racial/ethnic groups in the United States. This study examines whether neighborhood etiologic factors are associated with DAD, above and beyond individual-level characteristics, and whether these associations are moderated by race/ethnicity. We utilized nationally representative data (N = 13,837) from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file). Separate weighted multilevel logistic regression models were fitted for any past-year depressive and/or anxiety disorder, any depressive disorder only, and any anxiety disorder only. After adjusting for individual-level characteristics, African Americans living in a neighborhood with greater affluence and Afro-Caribbeans residing in more residentially unstable neighborhoods were at increased risk for any past-year depressive disorder as compared to their non-Latino white counterparts. Further, Latinos residing in neighborhoods with greater levels of Latino/immigrant concentration were at increased risk of any past-year anxiety disorder. Lastly, Asians living in neighborhoods with higher levels of economic disadvantage were at decreased risk of any past-year depressive and/or anxiety disorders compared to non-Latino whites, independent of individual-level factors. Differences across subethnic groups are also evident. Results suggest neighborhood characteristics operate differently on risk for DAD across racial/ethnic groups. Our findings have important implications for designing and targeting interventions to address DAD risk among racial/ethnic minorities.

Dietary Roles of Non-Starch Polysachharides in Human Nutrition: A Review

Nonstarch polysaccharides (NSPs) occur naturally in many foods. The physiochemical and biological properties of these compounds correspond to dietary fiber. Nonstarch polysaccharides show various physiological effects in the small and large intestine and therefore have important health implications for humans. The remarkable properties of dietary NSPs are water dispersibility, viscosity effect, bulk, and fermentibility into short chain fatty acids (SCFAs). These features may lead to diminished risk of serious diet related diseases which are major problems in Western countries and are emerging in developing countries with greater affluence. These conditions include coronary heart disease, colo-rectal cancer, inflammatory bowel disease, breast cancer, tumor formation, mineral related abnormalities, and disordered laxation. Insoluble NSPs (cellulose and hemicellulose) are effective laxatives whereas soluble NSPs (especially mixed-link β-glucans) lower plasma cholesterol levels and help to normalize blood glucose and insulin levels, making these kinds of polysaccharides a part of dietary plans to treat cardiovascular diseases and Type 2 diabetes. Moreover, a major proportion of dietary NSPs escapes the small intestine nearly intact, and is fermented into SCFAs by commensal microflora present in the colon and cecum and promotes normal laxation. Short chain fatty acids have a number of health promoting effects and are particularly effective in promoting large bowel function. Certain NSPs through their fermented products may promote the growth of specific beneficial colonic bacteria which offer a prebiotic effect. Various modes of action of NSPs as therapeutic agent have been proposed in the present review. In addition, NSPs based films and coatings for packaging and wrapping are of commercial interest because they are compatible with several types of food products. However, much of the physiological and nutritional impact of NSPs and the mechanism involved is not fully understood and even the recommendation on the dose of different dietary NSPs intake among different age groups needs to be studied.