Number Of Poor Health Outcomes Research Articles

Do precipitation anomalies influence short-term mobility in sub-saharan Africa? An observational study from 23 countries

BackgroundPrecipitation anomalies are associated with a number of poor health outcomes. One potential consequence of precipitation extremes is human geographic mobility. We evaluated the associations between precipitation anomalies (droughts and heavy rains) and short-term mobility in 23 sub-Saharan African countries by linking satellite data on precipitation to cross-sectional representative surveys.MethodsUsing data from 23 Demographic and Health Surveys from 2011 to 2017, we estimated the associations between deviations in long-term rainfall trends and short-term mobility among 294,539 women and 136,415 men over 15 years of age. We fit multivariable logistic regression models to assess potential non-linear relationships between rainfall deviations and short-term mobility, adjusting for survey month and socio-demographic covariates, and stratified by participant gender. Furthermore, we assessed whether these associations differed by marital status.ResultsRainfall deviations were associated with short-term mobility among women, but not men. The relationship between rainfall deviations and mobility among women was U-shaped, such that women had increased marginal probabilities of mobility in instances of both lower and heavier precipitation. Differences between married and unmarried women were also revealed: among married women, we found positive associations between both rainfall deviation extremes (drought and heavy rains) and mobility; however, among unmarried women, there was only a positive association for heavy rains.ConclusionPrecipitation anomalies were associated with short-term mobility among women, which may be in turn associated with poor health outcomes. More research with longitudinal data is needed to elaborate the associations between weather shocks, mobility, and downstream health impacts.

Cultural differences in caring for people with dementia: a pilot study of concern about losing face and loneliness in Chinese American and European American caregivers

ABSTRACT Objectives Heavy demands upon dementia caregivers can lead to a number of poor health outcomes including declines in physical, mental, and brain health. Although dementia affects people from all backgrounds, research in the US has largely focused on European American caregivers. This has made providing culturally-competent care more difficult. This study begins to address this issue by empirically examining how culturally-shaped beliefs can influence loneliness in family caregivers of people with dementia. Methods We conducted a preliminary questionnaire study with Chinese American and European American family caregivers of people with dementia (N = 72). Results Chinese American caregivers were more concerned than European American caregivers about losing face, which in turn, was associated with greater loneliness. This pattern remained when accounting for caregiver gender, age, and relationship to the person with dementia. Conclusions These preliminary findings highlight the role that cultural beliefs can play in adverse caregiver outcomes, and suggest that addressing concerns about losing face may be an important way for healthcare providers to help reduce loneliness among Chinese American caregivers. Clinical Implications Understanding how cultural beliefs influence caregiver outcomes is critical as healthcare professionals work to provide culturally-competent care and design culturally-sensitive interventions.

Drought and child vaccination coverage in 22 countries in sub-Saharan Africa: A retrospective analysis of national survey data from 2011 to 2019.

BackgroundExtreme weather events, including droughts, are expected to increase in parts of sub-Saharan Africa and are associated with a number of poor health outcomes; however, to the best of our knowledge, the link between drought and childhood vaccination remains unknown. The objective of this study was to evaluate the relationship between drought and vaccination coverage.Methods and findingsWe investigated the association between drought and vaccination coverage using a retrospective analysis of Demographic and Health Surveys data in 22 sub-Saharan African countries among 137,379 children (50.4% male) born from 2011 to 2019. Drought was defined as an established binary variable of annual rainfall less than or equal to the 15th percentile relative to the 29 previous years, using data from Climate Hazards Group InfraRed Precipitation with Station (CHIRPS) data. We evaluated the association between drought at the date of birth and receipt of bacillus Calmette–Guérin (BCG), diphtheria–pertussis–tetanus (DPT), and polio vaccinations, and the association between drought at 12 months of age and receipt of measles vaccination. We specified logistic regression models with survey fixed effects and standard errors clustered at the enumeration area level, adjusting for child-, mother-, and household-level covariates and estimated marginal risk differences (RDs). The prevalence of drought at date of birth in the sample was 11.8%. Vaccination rates for each vaccination ranged from 70.6% (for 3 doses of the polio vaccine) to 86.0% (for BCG vaccination); however, only 57.6% of children 12 months and older received all recommended doses of BCG, DPT, polio, and measles vaccinations. In adjusted models, drought at date of birth was negatively associated with BCG vaccination (marginal RD = −1.5; 95% CI −2.2, −0.9), DPT vaccination (marginal RD = −1.4; 95% CI −2.2, −0.5), and polio vaccination (marginal RD = −1.3; 95% CI −2.3, −0.3). Drought at 12 months was negatively associated with measles vaccination (marginal RD = −1.9; 95% CI −2.8, −0.9). We found a dose–response relationship between drought and DPT and polio vaccinations, with the strongest associations closest to the timing of drought. Limitations include some heterogeneity in findings across countries.ConclusionsIn this study, we observed that drought was associated with lower odds of completion of childhood BCG, DPT, and polio vaccinations. These findings indicate that drought may hinder vaccination coverage, one of the most important interventions to prevent infections among children. This work adds to a growing body of literature suggesting that health programs should consider impacts of severe weather in their programming.

Increased Cardiometabolic and Mortality Risk Following Childhood Maltreatment in the United Kingdom.

BackgroundChildhood maltreatment remains a significant public health issue associated with a number of poor health outcomes. This study explores the association between childhood maltreatment and the subsequent development of cardiometabolic disease and all‐cause mortality.Methods and ResultsUsing a UK primary care database between January 1, 1995 and December 31, 2018, we conducted a population‐based open retrospective cohort study. We matched 80 657 adult patients with a historic recording of childhood maltreatment or maltreatment‐related concerns (exposed group) to 161 314 unexposed patients. Outcomes of interest were the development of cardiovascular disease, hypertension, type 2 diabetes mellitus, and risk of all‐cause mortality. During the study period there were 243 new diagnoses of cardiovascular disease (incidence rate 8.3 per 10 000 person‐years) in the exposed group compared with 254 in the unexposed group (incidence rate 4.6 per 10 000 person‐years). Following adjustment for key covariates, this translated to an adjusted incidence rate ratio of 1.71 (95% CI 1.42–2.06). Additionally, the exposed group had an increased risk of hypertension (adjusted incidence rate ratio 1.42; 95% CI, 1.26–1.59), type 2 diabetes mellitus (adjusted incidence rate ratio 2.13; 95% CI, 1.86–2.45) and all‐cause mortality (adjusted incidence rate ratio 1.75; 95% CI, 1.52–2.02) during the study period compared with the unexposed group.ConclusionsConsidering the high prevalence of exposure to childhood maltreatment, we have demonstrated the substantial associated burden of preventable cardiometabolic disease. There is a clear need to ensure that public health approaches are implemented to prevent the adverse consequences following exposure to childhood maltreatment.

Racial Residential Segregation, Perceived Neighborhood Conditions, and Self‐Rated Health: The Case of Houston, Texas

Previous research has linked racial residential segregation to a number of poor health outcomes. Yet, the mechanisms that could account for this association remain poorly understood and have seldom been empirically tested in the literature. In an analysis of the Houston area, we test one potential mechanism—perceived neighborhood conditions, as measured by two indices for neighborhood disorder and environmental quality. Using individual‐level health data from a survey of Houston residents and neighborhood‐level sociodemographic data from the U.S. Census, we estimate a series of multilevel models. We find that black and Latino segregation are linked to the perceived neighborhood disorder index, but no such relationship for the environmental quality index. Moreover, we find that both indices are related to poor self‐rated health in that residents who evaluate their neighborhood conditions negatively are more likely to evaluate their health as poor. We also find a direct effect of black and Latino segregation on poor self‐rated health, and that perceived neighborhood disorder partially mediates this relationship. We do not find a mediation effect for environmental quality. The results suggest that in order to improve the health of these communities, both residential segregation and neighborhood conditions need to be addressed.

LIFE COURSE ORIGINS OF FRAILTY IN LATER LIFE

Frailty, generally characterized as a clinical state of increased vulnerability resulting from age-related decline in reserve and function across multiple physiologic systems, has been gaining attention in recent years due to its high correlates with a number of poor health outcomes including falls, hospitalization, and mortality. Similar to other adult health outcomes, research on the etiology of frailty has begun to move from proximal risk factors only to those more distal in time. This research uses data from the Health and Retirement study (2004-2016) to examine whether childhood exposures predict developing frailty in later life. A series of ordinal logistic regression models were estimated to test whether six domains of childhood exposures (socioeconomic status, infectious disease, chronic disease, impairments, risky adolescent behavior, and risky parental behavior) were associated with frailty, composed of five components: unintentional weight loss, weakness, slowness, exhaustion, and low energy expenditure (Fried et al., 2001). After adjusting for demographic factors, experiencing multiple SES misfortunes or risky adolescent behaviors in childhood are associated with higher odds of frailty in later life (OR= 1.24 and 2.37, respectively), while experiencing any infectious diseases is associated with lower odds of frailty (OR= 0.67 and 0.72). After further adjusting for adult characteristics, experiencing 2 or more chronic diseases in childhood is associated with a 1.35 higher odds of incident frailty over an 8-year period. These results reveal some of the early exposures that may raise frailty risk in later life but also the mid-life factors that mediate those risks.

Examining the relationships between parent experiences and youth self-reports of slapping/spanking: a population-based cross-sectional study

BackgroundSlapping/spanking is related to a number of poor health outcomes. Understanding what factors are related to the increased or decreased use of spanking/slapping is necessary to inform prevention. This study used a population-based sample to determine the prevalence of slapping/spanking reported by youth; the relationship between sociodemographic factors and slapping/spanking; and the extent to which parental exposures to victimization and maltreatment in childhood and current parental mental health, substance use and family circumstances, are associated with youth reports of slapping/spanking.MethodsData were from the 2014 Ontario Child Health Study, a provincially representative sample of households with children and youth aged 4–17 years. Self-reported lifetime slapping/spanking prevalence was determined using a sub-sample of youth aged 14–17 years (n = 1883). Parents/primary caregivers (i.e., person most knowledgeable (PMK) of the youth) self-reported their own childhood experiences including bullying victimization, slapping/spanking and child maltreatment, and current mental health, substance use and family circumstances including mental health functioning and emotional well-being, alcohol use, smoking, marital conflict and family functioning. Analyses were conducted in 2018.ResultsLiving in urban compared to rural residence and family poverty were associated with decreased odds of slapping/spanking. PMK childhood experiences of physical and verbal bullying victimization, spanking, sexual abuse, emotional abuse, and exposure to physical intimate partner violence were associated with increased odds of youth reported slapping/spanking (adjusted odds ratio [AOR] ranged from 1.33–1.77). PMK experiences of physical abuse and exposure to emotional/verbal intimate partner violence in childhood was associated with decreased odds of youth reported slapping/spanking (AOR = 0.72 and 0.88, respectively). PMK’s higher levels of marital conflict, languishing to moderate mental health functioning and emotional well-being, and moderate or greater alcohol use were associated with increased odds of youth reported slapping/spanking (AOR ranged from 1.36–1.61).ConclusionsIt may be important to consider parent/primary caregiver’s childhood experiences with victimization and maltreatment along with their current parental mental health, substance use and family circumstances when developing and testing strategies to prevent slapping/spanking.

Intimate Partner Violence Among Transgender Youth: Associations with Intrapersonal and Structural Factors.

Intimate partner violence (IPV) is a serious public health problem, linked with a number of poor health outcomes. Some research demonstrates that transgender and gender nonconforming (TGNC) youth may experience IPV at similar rates to heterosexual cisgender women; however, there is a dearth of data examining the experiences of IPV among this population. The exclusion of TGNC youth in IPV research and public health interventions is problematic because it contributes to a traditional gender-based heterosexual model of IPV that ignores the specific needs of TGNC populations. Given the pervasiveness of transphobic stigma in the United States and the complexities of the lives of TGNC youth, it is important to understand how both structural and individual factors are associated with IPV among TGNC youth. Using data from a cross-sectional survey of 131 TGNC youth from 14 different cities in the United States representing various regions of the country, this study explores the associations between a range of structural and intrapersonal factors and experiences of IPV victimization among TGNC youth. Separate logistic regression models were fit to examine the relationships between structural and intrapersonal factors and IPV. Structural results found that TGNC youth experiencing extreme victimization, a history of incarceration, and participation in sex work were much more likely to report IPV. The only intrapersonal variable that was associated with IPV was depressive symptomatology; however, this relationship was strong, with participants being nearly eight times more likely to report IPV if they experienced symptoms of depression. Gaining a better understanding of the complexity of both structural and intrapersonal factors among TGNC youth will greatly inform the development of IPV prevention and services for TGNC youth experiencing this type of violence.

Health Outcomes in Individuals with Problem and Pathological Gambling: An Analysis of the 2014 North Carolina Behavioral Risk Factor Survey System (BRFSS).

Problem and pathological gambling refers to subclinical and clinical levels of maladaptive gambling, respectively, and is associated with specific sociodemographic characteristics as well as a number of poor health outcomes. We examined such demographic, physical health, mental health, and health-related behaviors in a sample of 7045 low-risk gamblers and 244 problem/pathological gamblers. Participants completed the 2014 North Carolina Behavioral Risk Factor Surveillance System telephone survey. Using the National Opinion Research Center's Diagnostic Screen for Gambling Disorders-CLiP, participants were categorized as either "problem/pathological gamblers" or "low-risk gamblers." Problem/pathological gamblers were younger, more likely to be male, of ethnic minority status, unmarried, and of lower education than low-risk gamblers. No physical health variables differentiated the groups but problem/pathological gamblers reported experiencing significantly more adverse childhood experiences and engaging in significantly more tobacco and alcohol use compared to low-risk gamblers. Moreover, gender moderated relationships between gambling group and several of the alcohol use variables such that male problem/pathological gamblers exhibited greater alcohol use behavior than male low-risk gamblers but no such relationship was present in females. Overall, this study expands the current knowledgebase on disordered gambling and highlights the need to assess disordered gambling in public health samples. Clinical implications are discussed.

Body image perception of African immigrants in Europe.

Nutritional disorders are now spreading worldwide both in developed and developing countries. Body image ideals and dissatisfaction have been linked to a number of poor health outcomes, including nutritional disorders. While previous studies have offered insight into weight status and body image perception of immigrants in North America, very few studies have analysed these aspects in migrants from Africa to Europe. Our review examines the effects of the migration process on beauty ideals and body dissatisfaction in African immigrants in Europe compared to residents in their own countries. The PubMed, PsycINFO and Google Scholar databases were searched for studies published from January 2000 till November 2015. Of the 730 titles identified, 26 met the inclusion criteria and were included in the present review. Among African residents, the body preferences depend on the country of residence and their socio-cultural status. Ethnic groups living in great isolation or with low incomes still have an ancestral idea of beauty, preferring a shapely body. However ethnic groups living in urban areas are moving toward Westernization of beauty ideals, preferring underweight or normal weight bodies. This review highlights that both residents and migrants are at high risk of nutritional disorders due to the adoption of Western beauty ideals. The results suggest that body dissatisfaction and BMI are increasing from Southern Africa to Europe according to a geographical gradient (described for females by Spearman’s coefficient and linear regression, respectively). We emphasize the need for monitoring of the weight and psychological status of immigrants and the development of specific preventive strategies in European countries.

Body image and appearance perceptions from immigrant adolescents in Canada: An interpretive description

Body dissatisfaction has been linked to a number of poor health outcomes, including eating disorders. However, very few studies have investigated body dissatisfaction among immigrant adolescents. Using inductive qualitative inquiry, this study recruited a purposeful sample of immigrant adolescents (N=18, 78% female) with an eating disorder (n=8) and without an eating disorder (n=10). All adolescents were between 16 and 19 years of age (M=16.80, SD=0.89) and were recruited from three municipalities in Ontario. Each adolescent participated in a face-to-face, qualitative interview. Content analysis revealed descriptions of body image that were similar across the sample. The main themes emerging from this work include (a) the “moderately slim” and “moderately muscular” ideal, (b) the “slim and curvy paradox,” (c) “ideal” privilege, (d) having an “expected” appearance, and (e) wishful comparisons. Findings have implications for reducing appearance-related dissatisfaction among immigrant adolescents in Canada.

Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing

An increasing number of grandparents in rural USA are serving as primary caregivers for their grandchildren because of parental incarceration, addiction, joblessness, or illness. Low-income, African American women from the South are overrepresented in this growing population. There is a paucity of research exploring the challenges faced by rural grandparent caregivers, and past studies have not explicitly addressed the potential consequences of rural grandparent caregiving for health. The purpose of this qualitative study was to explore grandparent caregiving among rural, low-income, African American grandmothers in a community in the American South, and to identify challenges to health that arose in that context. McLeroy's social ecological model (SEM) was used to examine these challenges at multiple levels of influence. This qualitative interview-based study was conducted in a high-poverty community in rural Georgia. In-depth interviews were conducted with African American grandparent caregivers and key informants from local community-based organizations. A key informant assisted in identifying initial interview participants, and then snowball sampling was used to recruit additional participants. Interview questions were grouped under five domains (intrapersonal, interpersonal, community, organizational, and policy), according to the levels of the SEM. Iterative content analysis of interview transcripts was utilized. Transcripts were coded to identify text segments related to each domain of the SEM, which were grouped together for analysis by domain. Reflexive memo-writing aided in development of themes, and data quality was assessed using Lincoln and Guba's trustworthiness criteria. Rural African American grandparent caregivers faced a range of challenges to health. Direct physical challenges included chronic pain that interfered with sleep and daily functioning, mobility issues exacerbated by child care, and the pressure of managing their own medical conditions as well as their grandchildren's. Financial scarcity added to their vulnerability to poor health outcomes, especially when caregivers would forego purchase of medications or visits to the doctor because of expenses related to their grandchildren. In addition, lack of child care made health appointments and hospitalizations logistically difficult. Emotional strain was common as grandparent caregivers struggled to protect their grandchildren in communities where rates of drug use, HIV, and incarceration were high. Caregivers worried about their mortality and the related consequences for their grandchildren. Chronic stress, which is linked to a number of poor health outcomes, was self-reported by most rural grandparent caregivers. In this study, the challenges of rural grandparent caregiving among African American women posed multiple threats to health and wellbeing. Further research is needed, in different rural contexts and with different caregiver populations, to more thoroughly examine the health risks of grandparent caregiving. In addition, the development of multi-faceted interventions and programs will be critical to meeting the needs of rural grandparent caregivers. A few models for such programs exist, although resource shortfalls have often limited their impact.

Consuming calories and creating cavities: beverages NZ children associate with sport

Sugar-sweetened beverages (SSBs) are widely available, discounted and promoted, and despite recommendations to the contrary, frequently consumed by children. They provide few nutritional benefits, and their consumption is implicated in a number of poor health outcomes. This study examined the nature of the beverages that sport-playing New Zealand (NZ) children associate with sport. It assessed how well the beverages aligned with nutrition guidelines and relevant regulations, and their likely impacts on health. Eighty-two children (38 girls and 44 boys) aged 10–12 years were purposively selected from netball, rugby and football clubs in low and high socioeconomic neighbourhoods, in Wellington, New Zealand (NZ). Children photographed beverages they associated with sport. The beverages were then purchased and analysed in accordance with NZ nutrition guidelines, and relevant content and labelling regulations, by: package and serving size; energy, sugar, sodium and caffeine content; pH; and advisory statements. The beverages the children associated with sport overwhelmingly had characteristics which do not support children in adhering to NZ nutrition guidelines. Implementing public health mechanisms, such as healthy food and beverage policies, widely promoting water as the beverage of choice in sport, and implementing healthy eating and drinking campaigns in sports clubs, would assist children who play organised sport to select beverages that are in keeping with children's nutrition guidelines. As part of a comprehensive public health approach they would also reduce the substantial, unnecessary and potentially harmful contribution sugar-sweetened beverages make to their diet.

Income inequality and Neisseria gonorrhoeae notifications in females: a country-level analysis

Background Patterns of population susceptibility to sexually transmissible infections may be influenced by various social determinants of health, however these receive relatively little attention. Income inequality is one such determinant that has been linked to a number of poor health outcomes. The objective of this analysis was to determine whether there is an association between income inequality and Neisseria gonorrhoeae notification rates when measured at the country level. Gini coefficients, gonorrhoea notification rates among women, per capita gross domestic product and approximate size of female population were obtained for 11 countries of the OECD. Linear regression was used to measure the association between income inequality and gonorrhoea notification rates, using generalised estimation equations (GEE) to control for the non-independence of repeat measures from particular countries. A total of 36 observations from 11 countries were included. Gini coefficients ranged from 0.21 to 0.38 and gonorrhoea notifications from 0.7 to 153 per 100000 females. Significant associations were found between country-level income inequality and gonorrhoea notification rates among women (b=17.79 (95% CI: 10.64, 24.94, P<0.01). Significant associations were found, highlighting the importance of acknowledging and accounting for social determinants of sexual health and suggesting that further research in this arena may be fruitful.

"Sisters in motion Memphis:" a faith-based community effort to lose weight and improve the health of African American women.

“Sisters In Motion Memphis:” A Faith-Based Community Effort to Lose Weight and Improve the Health of African American Women Linda Sessoms (bio) and Perry W. Payne Jr. , MD/JD/MPP (bio) In September of 2006, a group of African American women who attended the Mississippi Boulevard Christian Church in Memphis, Tennessee (http://www.theblvd.org/) had a desire to accomplish an ambitious physical activity and endurance goal. Their goal was to run the St. Jude Memphis Marathon (full or half), an uncommon goal in a city recently ranked as the most obese city in the United States by the Gallup Well Being Index.1 This idea of running a race together was the beginning of a long journey that would turn a group of six church members into a force of over 150 church members known as “Sisters in Motion Memphis” (http://sistersinmotionmemphis.org/) founded and led by the lead author of this article, Linda Sessoms. The Setting Memphis, the city of Blues, is known internationally for great music and good food. Among public health researchers, it is also known for great health disparities that are rooted in social determinants of health. For example, over 24% of the residents of the city live below the federal poverty line (compared with 13% nationally).2 Prominent among these disparities is obesity, which can lead to number of poor health outcomes and ultimately premature death. While obesity disparities are clearly multifactorial in nature, one University of Memphis expert points to a “local culture built around Southern hospitality”2 in Memphis that supports the use of food as a way of expressing love and caring for people. Perhaps nowhere is this more common than in churches, which are well known for their food gatherings for a variety of events—often multiple events in one month. In the midst of this uphill cultural battle, Sisters In Motion Memphis arose to encourage change and a new way of expressing love that keeps church members and their families living longer, healthier lives while negotiating the cultural notions of large amounts of food as a sign of love at church and family gatherings. The initiative benefited from the support of church leadership. Unlike some churches in Memphis [End Page 1599] Click for larger view View full resolution St. Jude Fire Cracker 5K in 2009—A Sisters in Motion Memphis official race, where a large number of members participate annually. and other Southern cities, Mississippi Boulevard Christian Church was engaged in a perpetual state of self-improvement led by former minister, Dr. Frank Anthony Thomas (known as Pastor Frank). The leadership of the church encouraged the creation of Sisters In Motion and other initiatives focused on improving the lives and well-being of church members. Hence, the effort was one which was faith-based, community-based, and community-supported from the beginning. Such leadership helped one of the authors, Sessoms, develop this to market it to church members without the opposition to cultural change that may have been faced in other church environments. Perhaps the challenges that Memphis faced and continues to face require such innovative thinking and strategic leadership from the pews and the pulpits. The Mission and Workout Plan The mission statement of Sisters in Motion is, “To encourage adult African American women of all ages to become physically active through regular exercise in a supportive and non-threatening environment.” To that end, the organization encourages its members to “stay active” and “in motion” through walking and/or running regularly and consistently. The members meet one morning per week (Saturday) to run and/or walk a prepared route with mileage ranging anywhere from two miles to twenty miles or more. Members are further encouraged to run and walk individually two to three other days during the week. [End Page 1600] The Members of Sisters in Motion Currently, Sisters in Motion has 190 members. Their ages range from range from 29–65, with the average age being 48. The education level of the members has never been a topic for discussion or requirement for membership. However, one of the authors (Sessoms) estimates that approximately 75%–80% are college educated. Members are asked to dedicate at least two...

FP01-3 The Plight of Migrants and Refugees: from the Perspective of a Burmese Psychiatrist

Body dissatisfaction has been linked to a number of poor health outcomes, including eating disorders. However, very few studies have investigated body dissatisfaction among immigrant adolescents. Using inductive qualitative inquiry, this study recruited a purposeful sample of immigrant adolescents (N = 18, 78% female) with an eating disorder (n = 8) and without an eating disorder (n = 10). All adolescents were between 16 and 19 years of age (M = 16.80, SD = 0.89) and were recruited from three municipalities in Ontario. Each adolescent participated in a face-to-face, qualitative interview. Content analysis revealed descriptions of body image that were similar across the sample. The main themes emerging from this work include (a) the “moderately slim” and “moderately muscular” ideal, (b) the “slim and curvy paradox,” (c) “ideal” privilege, (d) having an “expected” appearance, and (e) wishful comparisons. Findings have implications for reducing appearance-related dissatisfaction among immigrant adolescents in Canada.

Moderating Effects of Moderate-Intensity Physical Activity in the Relationship Between Depressive Symptoms and Interleukin-6 in Primary Care Patients

To determine whether the relationship between interleukin (IL)-6 and depressive symptoms is moderated by participation in moderate-intensity physical activity in a sample of primary care patients. Elevated inflammation has been associated with a number of poor health outcomes. Depressive symptoms may be related to higher levels of the inflammatory marker IL-6; however, previous findings are inconsistent, possibly due to unidentified moderating factors. A total of 107 participants, aged ≥ 40 years, were recruited in Rochester, New York, in 2006 to 2007. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale-Revised, participation in moderate-intensity physical activity was measured using a modified version of the Community Health Activities Model Program for Seniors Activity Questionnaire for Older Adults, and serum IL-6 concentrations were determined using standard enzyme-linked immunosorbent assay protocols and high-sensitivity, anti-cytokine antibody pairs. A hierarchical multiple regression analysis was conducted. The correlation between IL-6 and depressive symptoms was nonsignificant (r = .086, p = .40). The association between IL-6 and depressive symptoms was moderated by participation in moderate-intensity physical activity (p = .02). Among those who did not engage in moderate-intensity physical activity, higher levels of depressive symptoms were significantly associated with higher levels of IL-6 (r = .28, p = .05), whereas this association was not significant among those who did participate in moderate-intensity physical activity (r = -.13, p = .38). Participation in moderate-intensity physical activity may buffer the risk of higher inflammation often associated with higher levels of depressive symptoms.

Serum 25-Hydroxyvitamin D and Depressive Symptoms in Older Women and Men

Hypovitaminosis D is common in older adults. Vitamin D deficiency in this population has been linked to a large number of poor health outcomes. Several investigators have hypothesized that hypovitaminosis D may contribute to depression in older adults. The few small studies that examined the association between vitamin D and depression in the elderly had conflicting results. This prospective population-based study was designed to investigate the longitudinal relationship between vitamin D and depressive symptoms over a 6-year follow-up period in a representative group of older adults. The participants were enrolled in the InCHIANTI (Invecchiare in Chianti, aging in the Chianti area) Study. The study sample was comprised of 954 participants (531 women and 423 men) aged 65 years or older. The primary study outcome measure was 25-hydroxyvitamin D (serum 25[OH]D). Vitamin D insufficiency was defined as a 25(OH)D level of less than 50 nmol/L. The Center for Epidemiological Studies-Depression Scale (CES-D) was used to assess depressive symptoms at baseline and at 3- and 6-year follow-up. A CES-D score of 16 or higher was considered a clinically relevant depressed mood. The data were stratified by gender. Multivariable analysis was used to adjust for relevant biomarkers and covariates related to sociodemographics, somatic health, and functional status. Compared to women with 25(OH)D levels more than 50 nmol/L, those with levels below this threshold had average adjusted increases in CES-D scores at the 3- and 6-year follow-up of 2.1 (P = 0.02) and 2.2 (P = 0.04), respectively. Lower baseline serum levels of 25(OH)D in women were also associated with a significant higher risk of developing depressed mood during the follow-up; the hazard ratio was 2.0, with a 95% confidence interval of 1.2-3.2 (P = 0.005). Compared to men with 25(OH)D levels above the cutoff of 50 nmol/L, men with lower levels at 3- and 6-year follow-up had increases in CES-D scores of 1.9 (P = 0.01) and 1.1 (P = 0.20), respectively. Lower baseline serum 25(OH)D levels among men were associated with an insignificant increase in risk for depression compared with those with higher levels (hazard ratio, 1.6; 95% confidence interval, 0.9-2.8; P = 0.1). These findings provide evidence of a prospective independent association between hypovitaminosis D and new depression over time. The association is stronger in women than in men. The investigators believe that prevention of vitamin D deficiency may become a future strategy to substantially lower the risk of depression in the elderly patients.