Dietary Influence on Calcitropic Hormones and Adiposity in Caucasian and African American Postmenopausal Women Assessed by Structural Equation Modeling (SEM).

OBJECTIVES: To examine differences in hydroxycholecalciferol (25(OH)D) and parathyroid hormone (PTH) concentrations between Caucasian and African American (AA) postmenopausal women, as well as the effects of dietary calcium, protein and vitamin D intakes on 25(OH)D, PTH, and body adiposity using structural equation modeling (SEM). DESIGN: Population-based prospective cohort study. SETTING: Academic research using the baseline data from two longitudinal studies. Participants Included n=113 Caucasian and n=40 African American, postmenopausal women who completed the baseline data collection and met inclusion criteria (dietary calcium intake <900 mg/day and being generally healthy) between 2006 and 2010. MAIN OUTCOME: Dietary intake of calcium and vitamin D, assessed by dietary records, were examined in relation to calcitropic hormones concentrations and adiposity markers. Independent t-tests, confirmatory factor analysis, SEM and multi-group analyses were conducted to examine the aforementioned relationships as well as group differences among hormones, dietary intake, anthropometrics, age and other factors. RESULTS: Dietary calcium and protein intakes were significantly lower in AA women. Years since menopause were significantly higher in AA compared to Caucasian women. PTH and 25(OH)D levels were significantly lower in AA compared to Caucasian women. Dietary calcium and protein intakes did not influence body adiposity in either group of women. Dietary vitamin D had minimal indirect (via 25(OH)D levels) influence on adiposity. CONCLUSION: The study confirmed the positive relationship of 25(OH)D with adiposity markers and both AA and Caucasian women. The study provides a unique example of the use of SEM in nutrition research within a clinical context. This model should be further tested in other populations.

The incidence of tuberculosis in patients treated with certolizumab pegol across indications: impact of baseline skin test results, more stringent screening criteria and geographic region.

OBJECTIVES: We report the incidence of tuberculosis (TB) across certolizumab pegol (CZP) clinical trials in rheumatoid arthritis (RA), psoriasis, psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), before and after the introduction of stricter TB screening. METHODS: TB incidence rates (IRs) were assessed and stratified according to screening guidelines used at the time of CZP trials. Before 2007 (original trials), purified protein derivative (PPD) tuberculin skin test positivity varied according to local standards (induration ≥5 up to ≥20 mm). Since 2007, all CZP trial protocols have been amended, including trials spanning (intermediate) and initiated after 2007 (current), mandating that any patient with PPD≥5 mm receives treatment for latent TB infection (LTBI). All cases of suspected TB or PPD≥5 mm, in pooled data from 5402 CZP patients across all CZP trials up to 2012, underwent blinded central review by independent experts. RESULTS: 44 TB cases were confirmed in pooled CZP RA trials (IR 0.47/100PY, patient-years) with no cases in Japanese RA trials (J-RAPID, HIKARI). Single TB cases were confirmed in psoriasis and axSpA trials (RAPID-axSpA), and no cases in the PsA trial (RAPID-PsA). IR of TB was 0.51/100PY across original or intermediate RA trials and 0.18/100PY in current trials. The majority of TB cases in RA occurred in Eastern (IR 1.02/100PY) and Central Europe (IR 0.58/100PY). Of 242/370 PPD≥5 mm patients who received 9 months isoniazid (INH) treatment for latent TB infection (LTBI), none developed TB, versus 7.8% of 128 untreated PPD≥5 mm patients. CONCLUSIONS: Implementation of more stringent LTBI screening, plus treatment for LTBI, reduced the IR of TB, even when INH was administered after starting CZP therapy.

Examining change in social support and fruit and vegetable consumption in African American adults.

OBJECTIVE: To examine (a) inter-individual variation in African Americans' fruit and vegetable social support, behavior, and consumption trajectories by estimating latent growth curves (LGCs) and (b) the associations between these trajectories over time. DESIGN: As part of a larger intervention study, data were collected from mid-life and older African Americans yearly for three years. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender. SETTING: Six churches in North Florida. PARTICIPANTS: Two hundred and thirty one (73% women; median age range of 57-63) older African Americans. MEASUREMENTS: A structured questionnaire elicited personal data as well as information on dietary social support, eating-related behaviors, and fruit and vegetable dietary intake. RESULTS: Age was positively associated with initial social support but negatively associated with the rate of change in social support. More important, the rate of change in dietary social support predicted eating-related behavior trajectories, which influenced the rate of change in fruit and vegetable consumption over time after controlling for the intervention. CONCLUSION: These findings illustrate the mediating role of eating-related behaviors and the inter-locking nature of social support, behavior and consumption trajectories. This research has implications for future research as well as community interventions and programs.

Life dissatisfaction and eating behaviors among older African Americans: the protective role of social support.

OBJECTIVES: To examine (a) the influences of life dissatisfaction and dietary social support on eating behaviors (a high-fat diet and fruit/vegetable consumption) of older African Americans and (b) the moderating role of perceived dietary social support on the association between their life dissatisfaction and unhealthy eating behaviors. DESIGN: Baseline data from a larger intervention study of mid-life and older African Americans. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender. SETTING: Six churches in North Florida. PARTICIPANTS: One hundred and seventy-eight (132 females and 46 males with a median age of 60) older African Americans. MEASUREMENTS: A structured questionnaire elicited personal data as well as information on eating behaviors, life dissatisfaction, and perceived dietary social support. RESULTS: Older African Americans with more cumulative life adversity, as reflected by high life dissatisfaction, had significantly poorer eating behaviors including the consumption of a high-fat diet and low intake of fruits and vegetables. Older African Americans' dietary choices were also associated with their perceived social support. More importantly, perceived social support acted as a buffer to mitigate the influence of life dissatisfaction on older African Americans' eating behaviors. CONCLUSION: Life dissatisfaction places older African Americans at risk for unhealthy eating behaviors. However, high levels of dietary social support can protect older African Americans from the influence of life dissatisfaction on unhealthy eating behaviors. There are practical implications of this research for health interventions and programming.

Cyber security risk assessment for SCADA and DCS networks.

The growing dependence of critical infrastructures and industrial automation on interconnected physical and cyber-based control systems has resulted in a growing and previously unforeseen cyber security threat to supervisory control and data acquisition (SCADA) and distributed control systems (DCSs). It is critical that engineers and managers understand these issues and know how to locate the information they need. This paper provides a broad overview of cyber security and risk assessment for SCADA and DCS, introduces the main industry organizations and government groups working in this area, and gives a comprehensive review of the literature to date. Major concepts related to the risk assessment methods are introduced with references cited for more detail. Included are risk assessment methods such as HHM, IIM, and RFRM which have been applied successfully to SCADA systems with many interdependencies and have highlighted the need for quantifiable metrics. Presented in broad terms is probability risk analysis (PRA) which includes methods such as FTA, ETA, and FEMA. The paper concludes with a general discussion of two recent methods (one based on compromise graphs and one on augmented vulnerability trees) that quantitatively determine the probability of an attack, the impact of the attack, and the reduction in risk associated with a particular countermeasure.

Audit of colorectal cancer surgery by non-specialist surgeons.

BACKGROUND: Some authorities recommend that colorectal cancer should be treated in specialist units but evidence that non-specialist units demonstrate comparatively poor results may be lacking. METHODS: Between 1987 and 1991, 267 patients were operated on by four general surgeons, none of whom was a specialist in colorectal surgery. Procedure-related complications, postoperative mortality and disease-related survival rates were analysed. RESULTS: There were four cases of intraperitoneal sepsis (1 per cent) and five of 189 patients (3 per cent) had clinical anastomotic dehiscence; there was no case of wound dehiscence. The postoperative mortality rate after elective and emergency surgery was 2 and 13 per cent respectively. The 5-year disease-related survival rate for curative and palliative surgery was 67 and 9 per cent respectively. There were no significant differences between the surgeons. CONCLUSION: Disease-related variables such as early-stage disease and fewer patients presenting as emergencies may have a greater favourable influence on ultimate survival than surgeon-related variables.

Senior centers and minority elders: a critical review.

This paper examines the literature on senior center participation and factors related to participation for minority elders. The extent of involvement of minority elders in senior centers is unclear due to lack of data for certain groups and methodological problems in some studies. Traditional and emerging factors that might affect minority elderly's senior center participation are identified and discussed. Suggestions are provided for expanding the knowledge base in this area.

Recrudescence of Entopolypoides macaci Mayer, 1933 (Babesiidae) infection secondary to stress in long-tailed macaques (Macaca fascicularis).

Parasites were found in red blood cells of two long-tailed macaques (Macaca fascicularis) imported from Indonesia and housed in the Washington Regional Primate Research Center breeding colony for 7 years or longer. Both macaques developed parasitemias secondary to stress (type D retrovirus in one case and severe trauma in the other). Entopolypoides macaci (Babesiidae) was diagnosed on the basis of morphology from peripheral blood smears stained with Wright's stain. Antibodies against Babesia sp. were detected by immunofluorescence assay (IFA) from one infected macaque, which showed antibody cross-reactions (high titer) to B. bigemina, B. bovis, B. canis, and (low titers) to Plasmodium falciparum. Five feral long-tailed macaques that had been imported recently from the same country had no detectable antibodies. This is the first report of IFA as an aid to diagnose E. macaci in nonhuman primates.

Senior center utilization by black elderly adults: social, attitudinal and knowledge correlates.

This study examined factors that affect utilization of senior centers by three groups of black elderly adults: attenders (n = 46) and nonattenders (n = 33) of a neighborhood senior center in one community and nonattenders (n = 27) in a comparable community without a neighborhood senior center. Variables investigated included social contact (with family and with friends), attitudes (disengagement potential, acceptability to others, commitment to become involved in senior centers) and knowledge (perception of senior centers). Results of the multivariate analysis of variance showed that sex, age, marital status, health, and transportation did not have a significant effect on the six variables studied. The three groups differed in commitment to become involved in senior centers, perception of senior centers, contact with family, and contact with friends. Similarities between the attenders and nonattenders in the comparable community suggest that the latter group are potential senior center participants.

Learning needs and efforts of the black elderly.

The purpose of this study was to investigate the self-perceived educational needs and activities of adults age sixty-five and older from varying backgrounds, with attention given to comparing black elderly (N = 51) with white elderly (N = 59) respondents. Sex, SES, and educational level differences also were investigated. Interviews were conducted using Tough's learning project procedure, Hiemstra's instrumental and expressive education instrument, and a general educational needs checklist developed by the investigator. Findings revealed significant race, sex, SES, and educational level differences in general educational needs. Significant race, SES and educational level differences were found in both learning projects and instrumental and expressive education. The number of significant race differences suggests that the cultural orientation of older blacks may have an affect on their interest and participation in educational endeavors.