Sleeping site preferences in Sapajus cay Illiger 1815 (Primates: Cebidae) in a disturbed fragment of the Upper Paraná Atlantic Forest, Rancho Laguna Blanca, Eastern Paraguay.

Wild primates can spend up to half of their lives sleeping, during which time they are subjected to many of the same selective pressures that they face when awake. Choosing an appropriate sleeping site can thus have important fitness consequences. We examined the sleeping site preferences of wild hooded capuchins (Sapajus cay) in a small degraded fragment of the Upper Paraná Atlantic Forest at Rancho Laguna Blanca (RLB) in eastern Paraguay. Sleeping trees and sites were identified during 5 months of field observations and their physical characteristics were compared to those of non-sleeping trees and sites. Capuchins preferred larger emergent trees with more main and forked branches, no lianas and denser undergrowth directly below. These were found in sites of more mature forest with fewer small trees, less liana coverage and denser undergrowth but more fruiting trees. The species composition of the sleeping sites differed from that of the non-sleeping sites and was dominated by Albizia niopoides (Mimosaceae) as well as Peltophorum dubium (Fabaceae) and Anadenanthera colubrina (Fabaceae). The capuchins were found to sleep most often in these three tree species: 69.23% in Albizia niopoides (Mimosaceae), 11.54% in Peltophorum dubium (Fabaceae) and 11.54% in Anadenanthera colubrina (Fabaceae). We found evidence for the predator avoidance, thermoregulatory, social contact and feeding site proximity hypotheses. We found no support for parasite avoidance, given the reuse of sites, although the small size of the forest fragment may have restricted this. Their preference for older-growth forest suggests that selective logging impacts hooded capuchins. However, their persistence in a disturbed fragment shows they are highly adaptable, providing support for the value of conservation and reforestation of even small fragments of the Paraguayan Upper Paraná Atlantic Forest.

Usefulness of Cardiac Rehabilitation After Spontaneous Coronary Artery Dissection.

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction; however, the role of cardiac rehabilitation (CR) for patients with SCAD has not been well defined. To further understand CR in patients with SCAD, we studied a large cohort of patients with confirmed SCAD enrolled in the Mayo Clinic SCAD Registry from January 2010 to December 2014 (n = 354). Demographics, clinical characteristics, mental health status, and details about CR participation and experience were collected through medical record review and questionnaires. Participants at time of SCAD were 46 ± 10 years old; 96% were women. Most (76%) attended ≥1 CR sessions, averaging 18 ± 12 sessions. Most reported CR-related physical and emotional benefits (82% and 75%, respectively). Of the CR nonparticipants, 57 of 85 reported not participating because CR was not recommended by their health care provider. Other reasons included inadequate transportation (10 of 85), no insurance coverage (7 of 85), cost (2 of 85), no energy (2 of 85), being too ill (2 of 85), and miscellaneous comments (5 of 85). In conclusion, 3 of 4 of patients with SCAD participated in CR, most of whom reported benefit. Lack of recommendation for CR by a health care provider was the primary reason patients did not participate.

Association of Breastfeeding and the Federal Poverty Level: National Survey of Family Growth, 2011-2013.

Breastfeeding is strongly endorsed in the Healthy People 2020 goals; however, there remain many disparities in breastfeeding prevalence. The purpose of this study was to examine the association between breastfeeding and the Federal Poverty Level in the United States. Data from 5,397 women in the National Survey of Family Growth 2011-2013 survey were included in this study. The data were analyzed for descriptive features and logistic regressions of the Federal Poverty Level on breastfeeding. There were 64.1% of women who reported breastfeeding. Over one-third (35.2%) of women reported having a household income of 0-99% of the Federal Poverty Level. There were 15.2% of women who reported an income of 400% and above the Federal Poverty Level. With statistical adjustment for maternal age, race/ethnicity, education, marital status, parity, preterm birth, birth weight, insurance, and dwelling, the Federal Poverty Level was not significantly associated with breastfeeding. In this recent survey of mothers, Federal Poverty Level was not shown to be a significant factor in breastfeeding.

Improvement in Functioning and Psychological Distress in Adolescents With Postural Orthostatic Tachycardia Syndrome Following Interdisciplinary Treatment.

Significant functional impairment and psychological distress have been observed in adolescent patients with postural orthostatic tachycardia syndrome (POTS). Interdisciplinary rehabilitation programs have been shown to be beneficial in the treatment of chronic pain in adults and adolescents. Only preliminary data have examined interdisciplinary rehabilitation efforts in patients with POTS. This study evaluated the impact of an interdisciplinary rehabilitation program on the functional impairment and psychological distress in 33 adolescents diagnosed with POTS. Patients included in the study were adolescents ages 11 to 18 diagnosed with POTS. Measures completed at admission and discharge from the program included the Functional Disability Index, Center for Epidemiological Studies-Depression-Child scale, and the Pain Catastrophizing Scale for Children. After participation in the 3-week program, adolescents with POTS demonstrated a significant increase in overall functional ability and significant reductions in depression and catastrophizing.

Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia.

Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.

Prevalence and predictors of depression and anxiety among survivors of myocardial infarction due to spontaneous coronary artery dissection.

PURPOSE: Depression and anxiety after myocardial infarction (MI) are common and associated with increased morbidity and mortality. The epidemiology and pathophysiology of MI due to spontaneous coronary artery dissection (SCAD) differs substantially from atherosclerotic MI, and rates of mental health comorbidities after SCAD are unknown. We aimed to determine the prevalence and predictors of depression/anxiety in SCAD survivors. METHODS: In this cross-sectional study, 158 SCAD survivors (97% women; mean age, 45.5 ± 9.3 years) were screened for depression/anxiety via surveys, including the Patient Health Questionnaire Depression Scale (PHQ-9) and Generalized Anxiety Disorder 7-Item Scale (GAD-7), a mean 3.7 ± 4.7 years after SCAD. Comorbidities and environmental, socioeconomic, and clinical cardiovascular characteristics were obtained from the surveys. RESULTS: Since their initial SCAD MI, 51 (33%) patients had received treatment with medications or counseling for depression and 57 (37%) for anxiety. When surveyed, 46 (31.7%) were taking antidepressant or anxiolytic medications. Overall, mean PHQ-9 (4.1) and GAD-7 (4.7) scores suggested borderline mild depression/anxiety (normal range: 0-4). Younger age was associated with higher PHQ-9 (P = .04) and GAD-7 (P = .02) scores. The 19 (12%) patients with peripartum SCAD had higher mean PHQ-9 (6.7 vs 3.7; P < .0005) and GAD-7 (8.1 vs 4.3; P = .003) scores. Patients treated with percutaneous coronary intervention had lower PHQ-9 (1.5; P = .02) and GAD-7 (2.4; P = .004) scores. CONCLUSIONS: Symptoms of depression/anxiety are common in patients with MI due to SCAD, particularly younger women and those with peripartum SCAD. The PHQ-9 and GAD-7 assessments may detect depression/anxiety in SCAD survivors who do not self-report these disorders, suggesting a role for routine screening in these patients.

Minors' attitudes toward peers with asthma: a developmental study.

OBJECTIVE: Peers can play a critical role in asthma management, with attitudes toward friends with asthma hindering or supporting self-management. We explored minors' attitudes toward peers with asthma, testing if attitudes varied by grade, sex, asthma knowledge, and asthma status. METHODS: Three hundred and eighty-one students in grades 5-11 (51% female; 51% White, non-Hispanic; 12% with asthma) read five vignettes about peers with asthma, and rated the characters on 10 adjective pairs (e.g., afraid/brave and sad/happy). Three vignettes portrayed an aspect of uncontrolled asthma (asthma-related school absence, asthma-related limited physical activity, and asthma-related school nurse visit). One vignette depicted controlled asthma; one described taking medication publically. We computed a total attitude score for each vignette and a mean attitude score across the three uncontrolled vignettes. Linear regression analyses tested the effect of each predictor (grade, sex, asthma knowledge, and asthma status) on attitudes, as well as the interaction of asthma status with the remaining three predictors. RESULTS: Grade was the most robust predictor. Participants in higher grades tended to have more favorable attitudes toward peers with asthma, except for the controlled asthma vignette where participants in lower grades had more favorable attitudes. There were significant interactions between grade and asthma status for the stop-running-and-taking-medication-publically vignettes: among those with asthma, participants in higher grades had more favorable attitudes. Sex interacted with asthma status for the overall uncontrolled, absence, and stop-running vignettes; among those with asthma, girls had more favorable attitudes. CONCLUSION: With increased grade, minors have better attitudes toward peers with asthma. Living with asthma may normalize asthma. Clinicians can use grade-specific findings to counsel patients.

Associations between spousal or significant other solicitous responses and opioid dose in patients with chronic pain.

OBJECTIVE: The primary aim of this study was to determine the effects of spouse or significant other solicitous responses on morphine equivalent dose among adults with chronic pain. DESIGN: Retrospective design. SETTING: Multidisciplinary pain rehabilitation center. PATIENTS: The cohort included 466 consecutively admitted patients who had a spouse or significant other and were using daily opioids. Intervention. Three-week outpatient pain rehabilitation program. OUTCOME MEASURES: Solicitous subscale of the Multidimensional Pain Inventory and morphine equivalent dose upon admission. RESULTS: The mean solicitous subscale score and morphine equivalent dose were 49.8 (standard deviation [SD] = 8.7) and 118mg/day (SD =149), respectively. Univariate linear regression analysis showed that greater subscale scores were associated with greater doses of opioids (P = 0.007). In a multivariate model adjusted for age, sex, ethnicity, years of education, employment status, pain duration, depression, and pain severity, the association retained significance (P = 0.007). CONCLUSIONS: These findings suggest solicitous responses from a spouse or significant other may have an important influence on opioid dose among adults with chronic pain.