Rosiglitazone transiently disturbs calcium homeostasis in monocytic cells.

The PPARgamma agonist Rosiglitazone exerts anti-hyperglycaemic effects by regulating the long-term expression of genes involved in metabolism, differentiation and inflammation. In the present study, Rosiglitazone treatment rapidly inhibited (5-30 min) the ER Ca(2+) ATPase SERCA2b in monocytic cells (IC(50)=1.88 microM; p<0.05), thereby disrupting short-term Ca(2+) homeostasis (resting [Ca(2+)](cyto)=121.2+/-2.9% basal within 1h; p<0.05). However, extended Rosiglitazone treatment (72 h) induced dose-dependent SERCA2b up-regulation, and restored calcium homeostasis, in monocytic cells (SERCA2b mRNA: 138.7+/-5.7% basal (1 microM)/215.0+/-30.9% basal (10 microM); resting [Ca(2+)](cyto)=97.3+/-8.3% basal (10 microM)). As unfavourable cardiovascular outcomes, possibly related to disrupted cellular Ca(2+) homeostasis, have been linked to Rosiglitazone, this effect may be of clinical interest. In contrast, in PPRE-luciferase reporter-gene assays, Rosiglitazone induced non-dose-dependent PPARgamma-dependent effects (1 microM: 152.5+/-4.9% basal; 10 microM: 136.1+/-5.1% basal (p<0.05 for 1 microM vs. 10 microM)). Thus, we conclude that Rosiglitazone can exert PPARgamma-independent non-genomic effects, such as the SERCA2b inhibition seen here, but that long-term Rosiglitazone treatment did not perturb resting [Ca](cyto) in this study.

Assessment of the ecological potential of mine-water treatment wetlands using a baseline survey of macroinvertebrate communities.

A baseline survey of macroinvertebrate populations in two mine-water treatment wetlands, one treating a net acidic spoil heap discharge and one a net alkaline ferruginous pumped mine water, was undertaken to assess the potential of these systems to provide habitats for faunal communities. Both wetlands were found to be impoverished in comparison to natural wetlands but did sustain a macroinvertebrate community that could support higher organisms. Wetland size and water quality in terms of pH, conductivity and metal concentrations were found to be important factors in determining the quality of the populations supported. Direct toxicity to organisms was unlikely to be the main cause of lower diversity, but the smothering of organisms via the precipitation of iron hydroxides particularly in the early parts of the treatment systems affected macroinvertebrate communities. The presence of areas of open water within the planted systems was found to be important for providing habitats for macroinvertebrates and this should be both a future design and maintenance consideration for environmental managers.

Centile reference charts for total energy expenditure in infants from 1 to 12 months.

BACKGROUND: A knowledge of energy expenditure in infancy is required for the estimation of recommended daily amounts of food energy, for designing artificial infant feeds, and as a reference standard for studies of energy metabolism in disease states. OBJECTIVES: The objectives of this study were to construct centile reference charts for total energy expenditure (TEE) in infants across the first year of life. METHODS: Repeated measures of TEE using the doubly labeled water technique were made in 162 infants at 1.5, 3, 6, 9 and 12 months. In total, 322 TEE measurements were obtained. The LMS method with maximum penalized likelihood was used to construct the centile reference charts. Centiles were constructed for TEE expressed as MJ/day and also expressed relative to body weight (BW) and fat-free mass (FFM). RESULTS: TEE increased with age and was 1.40,1.86, 2.64, 3.07 and 3.65 MJ/day at 1.5, 3, 6, 9 and 12 months, respectively. The standard deviations were 0.43, 0.47, 0.52,0.66 and 0.88, respectively. TEE in MJ/kg increased from 0.29 to 0.36 and in MJ/day/kg FFM from 0.36 to 0.48. CONCLUSIONS: We have presented centile reference charts for TEE expressed as MJ/day and expressed relative to BW and FFM in infants across the first year of life. There was a wide variation or biological scatter in TEE values seen at all ages. We suggest that these centile charts may be used to assess and possibly quantify abnormal energy metabolism in disease states in infants.

Formal and informal care for people with dementia: factors associated with service receipt.

Details of service receipt by 132 people diagnosed with dementia and their carers were collected in South London (boroughs of Lewisham, Camberwell, Southwark and Croydon), a geographical area served by several health and social care providers. The data collected included the Caregiver Activity Survey, which details the informal care given. This paper reports the formal and informal services received by the people with dementia at entry to the study. The amount of time spent on specific caring tasks by all informal carers of people with dementia averaged seven hours per week, but was significantly higher for co-resident carers, even when controlling for the level of dependency of the person cared-for. The odds ratios of receipt of formal services are given, according to where people were living: in the community or residential care, with co-resident carers or alone.

Diet composition and body composition in preschool children.

BACKGROUND: In studies of adult humans and in animal models, dietary intakes of the macronutrients, particularly fat, are related to body composition; however, data on children are more scarce. OBJECTIVE: We sought to determine whether diet composition is related to percentage body fat in children aged 1.5-4.5 y. DESIGN: In 77 preschool children, a 4-d weighed-food record was used to determine intakes of total energy and energy from each macronutrient. An oxygen-18 dilution method was used to calculate percentage body fat. Habitual physical activity level was determined by calculating the ratio of total energy expenditure (from stable isotope analyses) to predicted basal metabolic rate. Dietary intake and body-composition data were analyzed to evaluate whether diet composition was related to body fat. Further analyses incorporating physical activity level were performed. RESULTS: Percentage body fat was not significantly correlated with dietary intake variables (total energy or percentage of energy from fat, carbohydrate, or protein) and did not differ significantly among 3 increasing levels of each dietary intake variable by analysis of variance. In multiple regression analysis, physical activity level was related to body fat whereas diet composition was not. CONCLUSIONS: We found no relations between dietary intakes of total energy, fat, carbohydrate, or protein and percentage body fat in children. The relation between fat intake and body fat may develop over time and may not be evident in preschool children. Energy expenditure, in particular physical activity level, may have a greater influence on body composition in early childhood.

[Induced abortion as a cause of maternal mortality in Latin America]. / El aborto inducido como causa de mortalidad materna en America Latina.

PIP: Due to the restrictive abortion legislation which operates in almost all Latin American countries, knowledge about the incidence of induced abortions, their associated complications and related mortality is unreliable and approximate. There is little doubt, however, that the incidence of induced abortion in Latin America is among the highest in the world. The number of deaths due to complications from unsafe abortions is severely underestimated throughout the region. Based on Royston's method called the "maternal mortality route", the authors estimate that the actual number of abortion-related deaths in Latin America is between 5000 and 10,000 per year. Thus, compared to the estimated 4-6 million annual induced abortions, the abortion-related mortality rate would range from 83 to 250 deaths per 100,000 abortions. It is clear from the calculations presented that induced abortion in Latin America is a serious public health problem associated with deaths and health complications which could largely be avoided through the provision of accessible and appropriate family planning methods and the availability of high-quality abortion services. (author's)^ieng

Pregnant again? Psychosocial predictors of short-interval repeat pregnancy among adolescent mothers in Mexico City.

Which adolescent mothers are most likely to become pregnant soon after their first delivery? This study identifies and explores selected background, pregnancy, and postpartum predictors of short-interval repeat pregnancy among urban Mexican adolescents who were single when they conceived their first pregnancy. Of 137 adolescents followed until their second postpartum year, 26 had short-interval repeat pregnancies. These pregnancies were most likely to occur if the teenager was married or in consensual union by 5 months postpartum, was not using an IUD, and had a mother who had been an adolescent mother. Being married or in consensual union postpartum was, in turn, predicted by positive reactions of the adolescent and her partner during the first pregnancy. Nonuse of IUD was more likely if the adolescent had left school prior to pregnancy, did not receive support from her partner during the first pregnancy, and had not obtained an IUD before hospital discharge after first delivery. Adolescents whose mothers had been teen mothers came from more disadvantaged families.

Sex, contraception, and pregnancy among adolescent in Mexico City.

This article presents the development and results of a study that analyzed the psychosocial determinants of abstaining from sexual intercourse, practicing contraception, and avoiding pregnancy. It was carried out with a representative household and a clinic sample of 12-19-year-old females of lower-middle and lower socioeconomic levels in Mexico City. Among the implications of the results for program design are: (1) the need for clarifying erroneous beliefs and providing detailed, practical knowledge concerning sexuality, pregnancy, use of and access to contraceptives; (2) a broad definition of sex education that emphasizes family communication, values clarification, provision of alternative role options for women other than motherhood, and both the goals and the skills needed to achieve them--for example, independent decision-making. Attention to male attitudes and communication skills as well as ways of improving communication and support networks among peers was also found to be essential.

[The role of induced abortion in changing fertility in Latin America]. / El papel del aborto inducido en la transición de la fecundidad de América Latina.

The data and estimates presented suggest that the incidence of induced abortion in Latin America is high. In individual countries the average total abortion rate, ie lifetime induced abortions, seems to be between one and two per woman of fertile age, if not higher. The incidence of induced abortion in Latin America appears to be among the highest in the world, comparable to several East Asian and East European countries. Apparently the practice of induced abortion was already quite extensive in urban Latin America in the 1960s at a time when the use of contraception was low. As of the 1980s, induced abortion accounts for about one quarter of deliberate fertility control, and contraception for the remaining three quarters. The high incidence of induced abortion is due to an imbalance between the strong motivation for smaller families and the imperfect availability and utilization of contraception. The motivation for smaller families is widespread and contraceptive prevalence has been increasing steadily since the 1960s, yet many barriers exist to its universal and effective application. Contraceptives are not always available when needed; frequently access is difficult, particularly for young, single, and poor women and men; knowledge about reproductive functions and contraceptives is deficient and erroneous among large proportions of women; and at times the use of contraception is at odds with deeply in grained cultural and social patterns, as well as with personal sentiments. For these and other reasons, contraceptive failure is not uncommon. Consequently, the incidence of unwanted pregnancy is high and many women/couples resort to induced abortion.

[Abortion in Latin America. Induced abortion and its causes]. / El aborto en America Latina. El aborto inducido y sus causas.

PIP: Although abortion legislation is restrictive in Latin America, the limited available data confirm the region¿s high volume of abortion. The average number of abortions per woman in Latin America is around 1.5, according to estimates of various authors. Abortion contributes an estimated one-fourth of deliberate fertility control in the region. Abortion rates depend on the degree of motivation for limiting births and the availability and use of contraception. The motivation for smaller families preceded widespread introduction of modern contraception into Latin America. Fertility began to decline before 1960 in a few countries and declined more rapidly thereafter, due principally to induced abortion. The decline continued as contraceptive usage increased rapidly and substantially in the 1970s and 1980s. Abortion rates remained high, basically because the desire for smaller families was widely diffused, while barriers of different kinds hampered access to modern contraception. Inadequate contraceptive supplies, restricted choice of methods, lack of access for women who are poor or single or adolescent, misguided fears about health effects, and poor understanding of the operation of health services may all constitute obstacles to contraceptive use. Contraceptive failure is not infrequent and is another factor in the persistence of abortion. Even within the framework of restrictive legislation, steps could be taken to reduce the problem of abortion: improving the supply and availability of contraceptives, improving the quality of services, promoting sex education, and improving the status of women.^ieng

[Psychosocial antecedents of adolescent pregnancy].

PIP: The present article is a review of the literature concerning adolescent pregnancy and its relation to psychosocial variables. A summary of the major findings is presented for each of the following headings: the adolescent's family of origin; peer group; boyfriend or husband; the adolescents' personal characteristics; and knowledge, attitudes and practices concerning sexual relations, use of contraceptives and pregnancy. Considering that the specific socio-cultural characteristics of Mexico most likely modify some of the patterns described in other countries, the relevance of these findings to Mexico should be carefully studied and analyzed in order to provide objective, culturally relevant bases for preventive and educational programs. (Author's).^ieng

[Breast feeding: impact of early mother-child post-partum contact]. / La lactancia: impacto del encuentro temprano madre-hijo

PIP: The objective of this study is to evaluate the impact of early contact between mother and her newborn (during the 1st hour after birth) and the establishment and duration of breastfeeding, within the context of a rooming-in service which provides continuous 24 hour contact during postpartum hospitalization. 60 healthy pares were studied, 30 of which were provided with early contact and rooming-in, while the other 30 experienced regular rooming-in. Milk production was measured during the 1st 3 days postpartum. The early contact group had significantly greater milk production on the 1st day than the group with only rooming-in. However, by the 2nd and 3rd days, this difference was no longer present. These results suggest that the continued contact and demand feeding which rooming-in provides compensates for the initial advantage of the mothers early contact group. With respect to duration of lactation, 50% of the mothers were still breastfeeding at 6 months regardless of the group to which they belonged. It is concluded that the early contact has a positive effect on the establishment of milk production in the 1st day. However, it had no additional impact on the duration of breastfeeding given the continued contact of the rooming-in experience. Mothers for this study all lived in the Federal District in Mexico and delivered full-term, healthybabies. They had no significant differences in age, parity, socioeconomic status, education, or prenatal care/instruction. (author's modified)^ieng