"Scribble Scrabble": Migration, Young Parenting Latinas, and Digital Storytelling as Narrative Shock.

The nexus of migration and family offers a conjuncture to enrich understanding of teen pregnancy and parenting. This article draws findings from a project centered on participant-produced new media to reveal how young mothers negotiate reproductive health disparities. We focus on young mothers' experiences of migration and movement, captured in local vernacular through participants' digital story depictions and follow-up interviews. We argue that disparities link up with the single story of teen mothering, involve public shaming, continue hand-in-hand with institutional humiliation, and are exacerbated through migration and movement. To disrupt the normative notions that shadow young mothers, we take seriously the young women's narratives. We theorize how the richness of stories and storytelling may serve as a potent intervention-a narrative shock-for articulating meanings and cultivating dignity for young mothers and their families, especially those who do not fit the sedentary and age biases of parenting ideals.

Bodies as evidence: Mapping new terrain for teen pregnancy and parenting.

Predominant approaches to teen pregnancy focus on decreasing numbers of teen mothers, babies born to them, and state dollars spent to support their families. This overshadows the structural violence interwoven into daily existence for these young parents. This paper argues for the increased use of participatory visual methods to compliment traditional research methods in shifting notions of what counts as evidence in response to teen pregnancy and parenting. We present the methods and results from a body mapping workshop as part of 'Hear Our Stories: Diasporic Youth for Sexual Rights and Justice', a project that examines structural barriers faced by young parenting Latinas and seeks to develop relevant messaging and programming to support and engage youth. Body mapping, as an engaging, innovative participatory visual methodology, involves young parenting women and other marginalised populations in drawing out a deeper understanding of sexual health inequities. Our findings highlight the ways body mapping elicits bodies as evidence to understand young motherhood and wellbeing.

Social support seeking and early adolescent depression and anxiety symptoms: The moderating role of rumination.

This study examined how social support seeking and rumination interacted to predict depression and anxiety symptoms six months later in early adolescents (N = 118; 11 - 14 yrs at baseline). We expected social support seeking would be more helpful for adolescents engaging in low rather than high levels of rumination. Adolescents self-reported on all measures at baseline, and on depression and anxiety symptoms six months later. Social support seeking predicted fewer symptoms of depression and anxiety at low rumination levels, but lost its adaptive effects as rumination increased. For depression symptoms, social support seeking led to more symptoms at high rumination levels. Results were stronger for emotion-focused than problem-focused support seeking, and for depression compared to anxiety symptoms. These findings suggest that cognitive risk factors like rumination may explain some inconsistencies in previous social support literature, and highlight the importance of a nuanced approach to studying social support seeking.

Botanical Integrity: Part 2: Traditional and Modern Analytical Approaches.

The concept of botanical integrity (BI), introduced previously in HerbalGram issue 106, involves the determination of identity, homogeneity, bioactivity, and safety of plant-derived materials designated for human consumption.1 It goes beyond previously established quality control principles. The inaugural article in this series described the three major domains of expertise that are required to assess BI (as noted in Figure 1): botanical examination (botany), phytochemical analysis (chemistry), and biological efficacy and safety assessments (bioactivity, which encompasses the fields of pharmacology and toxicology).

Bridging graduate education in public health and the liberal arts.

The University of Massachusetts Amherst is part of Five-Colleges Inc, a consortium that includes the university and four liberal arts colleges. Consortium faculty from the School of Public Health and Health Sciences at the university and from the colleges are working to bridge liberal arts with public health graduate education. We outline four key themes guiding this effort and exemplary curricular tools for innovative community-based and multidisciplinary academic and research programs. The structure of the consortium has created a novel trajectory for student learning and engagement, with important ramifications for pedagogy and professional practice in public health. We show how graduate public health education and liberal arts can, and must, work in tandem to transform public health practice in the 21st century.

Botanical Integrity: The Importance of the Integration of Chemical, Biological, and Botanical Analyses, and the Role of DNA Barcoding.

Raw materials, ingredients, and products derived from plants are commonly referred to as herbs or botanicals in both the biomedical literature and the natural products health industry. This overarching term includes the breadth of crude herbs, plant parts, and the ingredients made from them, and also covers finished products such as botanical dietary supplements. Botanical dietary supplements are intended to supplement the human diet and are composed primarily of powdered plant parts, their extracts, or other preparations derived from crude herbal material; some formulations include other ingredients such as vitamins, minerals, and amino acids. Botanical dietary supplements are highly complex mixtures reflecting the diverse chemical constituents that comprise the source plant's raw material. Botanical analysis is an intricate analytical challenge requiring specialized skills and instrumentation that is different from those required for quality control of chemically simpler pharmaceuticals, or for the safety assessment of many conventional food or other products that are generally regarded as safe (GRAS).

Pharmacokinetics of prenylated hop phenols in women following oral administration of a standardized extract of hops.

SCOPE: Women seeking alternatives to hormone-replacement therapy for menopausal symptoms often try botanical dietary supplements containing extracts of hops (Humulus lupulus L.). Hops contain 8-prenylnaringenin (8-PN), a potent phytoestrogen, the related flavanones 6-prenylnaringenin and isoxanthohumol (IX), and the prenylated chalcone xanthohumol (XN). METHODS AND RESULTS: After chemically and biologically standardizing an extract of spent hops to these marker compounds, an escalating dose study was carried out in menopausal women to evaluate safety and pharmacokinetics. 8-PN, 6-prenylnaringenin, IX, and XN, sex hormones, and prothrombin time were determined in blood samples and/or 24 h urine samples. There was no effect on sex hormones or blood clotting. The maximum serum concentrations of the prenylated phenols were dose-dependent and were reached from 2 to 7 h, indicating slow absorption. The marker compounds formed glucuronides that were found in serum and urine. Secondary peaks at 5 h in the serum concentration-time curves indicated enterohepatic recirculation. The serum concentration-time curves indicated demethylation of IX to form 8-PN and cyclization of XN to IX. Slow absorption and enterohepatic recirculation contributed to half-lives exceeding 20 h. CONCLUSION: This human study indicated long half-lives of the estrogenic and proestrogenic prenylated phenols in hops but no acute toxicity.

Biological and chemical standardization of a hop (Humulus lupulus) botanical dietary supplement.

Concerned about the safety of conventional estrogen replacement therapy, women are using botanical dietary supplements as alternatives for the management of menopausal symptoms such as hot flashes. Before botanical dietary supplements can be evaluated clinically for safety and efficacy, botanically authenticated and standardized forms are required. To address the demand for a standardized, estrogenic botanical dietary supplement, an extract of hops (Humulus lupulus L.) was developed. Although valued in the brewing of beer, hop extracts are used as anxiolytics and hypnotics and have well-established estrogenic constituents. Starting with a hop cultivar used in the brewing industry, spent hops (the residue remaining after extraction of bitter acids) were formulated into a botanical dietary supplement that was then chemically and biologically standardized. Biological standardization utilized the estrogen-dependent induction of alkaline phosphatase in the Ishikawa cell line. Chemical standardization was based on the prenylated phenols in hops that included estrogenic 8-prenylnaringenin, its isomer 6-prenylnaringenin, and pro-estrogenic isoxanthohumol and its isomeric chalcone xanthohumol, all of which were measured using high-performance liquid chromatography-tandem mass spectrometry. The product of this process was a reproducible botanical extract suitable for subsequent investigations of safety and efficacy.

Parent predictors of adolescents' explanatory style.

The current study tested the prospective relations (six month lag) between three aspects of the parent-child relationship at Time 1 (T1) and adolescents' explanatory styles at Time 2 (T2): caregiving behaviors, parents' explanatory style for their own negative events, and parents' explanatory style for their children's negative events. The sample included 129 adolescents aged 11 to 14 years at baseline and their parents. Adolescents reported on their own explanatory style and their parents' caregiving behaviors; parents self-reported on their caregiving behaviors and their explanatory style for their own and their children's events. Regression analyses identified maternal acceptance as a significant predictor of T2 adolescents' explanatory style. Marginal effects emerged for fathers' psychological control and fathers' explanatory style for their children's events. Findings suggest that the ways parents - especially mothers - interact with their children may play a role in adolescents' cognitive vulnerability to depression.

"They just happened": the curious case of the unplanned baby, Italian low fertility, and the "end" of rationality.

Even in a country with super-low fertility rates, at least one-quarter of all babies are unplanned. The finding puzzles policymakers. This article uses Italy's "curious case" as a jumping-off point to expose assumptions about rationality. It offers a model to dismantle the "conceit" of rationality, drawing on Max Weber's classic critique and Emily Martin's contemporary appraisal. It asks: (1) How do assumptions about rationality related to sexuality and reproduction manifest? (2) How do qualitative data challenge rationalist assumptions? and (3) How are cultural logics expressed and what do they reveal about the "problem" of low fertility? Methodologically, the article offers an innovative approach, juxtaposing ethnographic data derived from the author's fieldwork with startling findings from Italian researchers' multicity project. The analysis exposes the rationality trope as a technique of governance in a context in which policymakers yearn for social cohesion and population politics intensify around birthing, immigration, and aging.

Health literacy in adult education: a natural partnership for health equity.

Incorporating health literacy in adult education instruction is a promising approach to increasing the health equity of people who face racial/ethnic health disparities. Six adult education centers throughout a small Northeast state received 1-year Health Literacy Project grants from a local foundation to increase their capacity to teach health literacy through Study Circles. The evaluation of the project assessed changes in adult learners' skills needed to navigate health systems, manage chronic diseases, and engage in preventive behavior; learners' self-efficacy; and how the education centers increased their capacity to teach health literacy skills to adult learners of color. Quantitative and qualitative data indicated that students' knowledge about health issues and self-efficacy increased significantly as a result of the health literacy instruction. All six centers improved their capacity to teach health literacy. By the end of the Health Literacy Project, almost three quarters of classes included health literacy instruction. Almost half of the Study Circle teachers continued to attend professional development activities for health literacy and share their knowledge with other teachers. Each center also developed partnerships with health care providers and created an infrastructure to continue to teach health literacy. Implications of the identified strengths and challenges on future efforts to increase health literacy and equity are considered.

Understanding cultural and linguistic barriers to health literacy.

Nurses today are providing care, education, and case management to an increasingly diverse patient population that is challenged with a triad of cultural, linguistic, and health literacy barriers. For these patients, culture and language set the context for the acquisition and application of health literacy skills. Yet the nursing literature offers minimal help in integrating cultural and linguistic considerations into nursing efforts to address patient health literacy. Nurses are in an ideal position to facilitate the interconnections between patient culture, language, and health literacy in order to improve health outcomes for culturally diverse patients. In this article the authors begin by describing key terms that serve as background for the ensuing discussion explaining how culture and language need to be considered in any interaction designed to address health literacy for culturally diverse patients. The authors then discuss the interrelationships between health literacy, culture, and language. Next relevant cultural constructs are introduced as additional background. This is followed by a description of how literacy skills are affected by culture and language, a note about culturally diverse, native-born patients, and a presentation of case examples illustrating how culture and language barriers are seen in patients' healthcare experiences. The authors conclude by offering recommendations for promoting health literacy in the presence of cultural and language barriers and noting the need for nursing interventions that fully integrate health literacy, culture, and language.

The Equity and Quality (EQual) Health-Care Project: A Connecticut Health Foundation initiative with Qualidigm.

In response to the growing incidence and prevalence of diabetes, quality and disparity of care concerns, and the increasing diversity of the US and Connecticut's populations, the Connecticut Health Foundation funded Qualidigm to implement the Equity and Quality (EQual) Health-Care Project. Now in its second full year, the EQualHealth-CareProject is helping eight primary-care practices in Connecticut improve the equity and quality of diabetes care through technology, education, and quality improvement.

Brain activation during autobiographical relationship episode narratives: a core conflictual relationship theme approach.

The authors combined the core conflictual relationship theme (CCRT) method and functional magnetic resonance imaging (fMRI) to identify brain regions involved in recall of autobiographical relationship episodes, a key process in psychotherapy. Relationship narratives were obtained from healthy subjects and scored for CCRT relationship themes and emotion. Autobiographical personal and nonautobiographical control narratives were presented in a block-design fMRI experiment. Personal versus control narratives showed activations in anterior cingulate, precuneus, inferior and middle frontal gyri, and inferior parietal lobule. These are regions involved in autobiographical memory, theory of mind, self-referential processing, and emotion. In an exploratory analysis, higher CCRT scores correlated with increased brain activation in the left hippocampus, parahippocampal gyrus, and middle occipital gyrus. This suggests that brain systems subserving memory processes are more active when recalling relationship episodes with greater CCRT content.

Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of black cohosh and red clover compared with placebo for the relief of menopausal vasomotor symptoms. METHODS: This study was a randomized, four-arm, double-blind clinical trial of standardized black cohosh, red clover, placebo, and 0.625 mg conjugated equine estrogens plus 2.5 mg medroxyprogesterone acetate (CEE/MPA; n = 89). Primary outcome measures were reduction in vasomotor symptoms (hot flashes and night sweats) by black cohosh and red clover compared with placebo; secondary outcomes included safety evaluation, reduction of somatic symptoms, relief of sexual dysfunction, and overall improvement in quality of life. RESULTS: Reductions in number of vasomotor symptoms after a 12-month intervention were as follows: black cohosh (34%), red clover (57%), placebo (63%), and CEE/MPA (94%), with only CEE/MPA differing significantly from placebo. Black cohosh and red clover did not significantly reduce the frequency of vasomotor symptoms as compared with placebo. Secondary measures indicated that both botanicals were safe as administered. In general, there were no improvements in other menopausal symptoms. CONCLUSIONS: Compared with placebo, black cohosh and red clover did not reduce the number of vasomotor symptoms. Safety monitoring indicated that chemically and biologically standardized extracts of black cohosh and red clover were safe during daily administration for 12 months.

Group interpersonal psychotherapy for low-income women with posttraumatic stress disorder.

The aim of this study was to assess the efficacy of group interpersonal psychotherapy (IPT) for low-income women with chronic posttraumatic stress disorder (PTSD) subsequent to interpersonal trauma. Non-treatment-seeking predominantly minority women were recruited in family planning and gynecology clinics. Individuals with interpersonal trauma histories (e.g., assault, abuse, and molestation) who met criteria for current PTSD (N=48) were randomly assigned to treatment or a wait list. Assessments were conducted at baseline, treatment termination, and 4-month follow-up; data analysis used a mixed-effects regression approach with an intent-to-treat sample. The results showed that IPT was significantly more effective than the wait list in reducing PTSD and depression symptom severity. IPT participants also had significantly lower scores than waitlist individuals on four interpersonal functioning subscales: Interpersonal Sensitivity, Need for Social Approval, Lack of Sociability, and Interpersonal Ambivalence.

Avoidant coping and PTSD symptoms related to domestic violence exposure: a longitudinal study.

The impact of avoidant coping on level of PTSD symptoms over 1 year was examined among 262 women exposed to intimate partner violence (IPV) within the past month. Covariates included childhood sexual abuse (CSA), IPV severity, perceived and formal social support, and revictimization. Using longitudinal hierarchical multiple regression, avoidant coping was found associated with PTSD symptoms at 1-year follow-up, controlling for initial symptoms and covariates. Revictimization also had long-term consequences beyond Time 1 symptoms. Reducing avoidant coping and increasing survivors' safety may assist in breaking a cycle of problematic coping and psychological distress.