Early life adversity is associated with elevated levels of circulating leptin, irisin, and decreased levels of adiponectin in midlife adults.

CONTEXT: Early-life adversity, defined as physical, emotional, or sexual abuse and neglect before 18 years of age, is associated with metabolic syndrome, obesity, and type 2 diabetes mellitus in adult life. However, the underlying mechanism is not fully understood, and whether adipomyokines are associated with early-life adversity independent of other factors such as body mass index, psychosocial risks, and health behaviors is not known. OBJECTIVES: The objective of the study was to evaluate the association between early-life adversity and circulating the levels of the adipomyokines such as leptin, adiponectin, and irisin and the inflammatory marker, C-reactive protein (CRP). DESIGN/SUBJECTS/SETTING: This study was a cross-sectional study of 95 adults at a university-based research center. We collected venous blood from participants and analyzed serum for leptin, adiponectin, irisin, and CRP. RESULTS: Circulating leptin, irisin, and CRP levels were significantly higher in the highest adversity tertile group compared with low and middle tertile groups (P < .001 for leptin, P = .01 for irisin, and P = .02 for CRP). Adiponectin levels were lower in the highest tertile group compared with the low and middle tertile groups (P = .03). After adjusting for demographic variables, physical activity, diet, current mental health, and body mass index, the associations between early-life adversity leptin, irisin, and did not change. However, adiponectin and CRP levels were no longer significantly related to early life adversity. CONCLUSION: Early-life adversity is directly associated with elevated circulating leptin and irisin, and indirectly associated with elevated CRP and decreased adiponectin. These findings suggest that these adipomyokines may play a role in the pathogenesis of metabolic abnormality in a population with significant early life adversity.

Training pediatric residents and pediatricians about adolescent mental health problems: a proof-of-concept pilot for a proposed national curriculum.

OBJECTIVE: This article presents a DVD-based educational program intended to help pediatric residents and practicing pediatricians recognize and respond to adolescent depression in busy primary care settings. METHODS: Representatives from pediatrics and adolescent medicine, child and adolescent psychiatry and psychology, and experts in the creation of educational mental health programs met to design a multimedia approach to improving the mental health diagnostic skills among pediatric residents. The authors chose depression as the initial topic because of its relatively high prevalence among children and adolescents, and evidence suggesting that pediatricians may have difficulty diagnosing this disorder in the primary care setting. The authors created a 30-minute DVD program featuring depressed adolescents and experts in child psychiatry and adolescent medicine. After viewing the DVD, residents in the training program, as well as practicing pediatricians, completed a standardized survey to assess the usefulness and attractiveness of this approach to pediatric education. RESULTS: The survey results support the potential value of this type of material and the feasibility of similar programs in addressing an array of mental health concerns in pediatric residencies. Participants found the program useful and indicated interest in receiving more educational programs in this format. CONCLUSION: The authors suggest that the relative ease with which initiatives such as this media-based approach can be implemented make this educational technique appropriate and feasible on a large scale for programs throughout the nation and for a variety of mental health concerns.

Women seeking health information: distinguishing the web user.

Given the advantages of using the Web for health information-seeking and a survey result that women are more likely to use the Web as a channel to locate health information, the authors explored the health information-seeking process and behavior of women who use the Web to seek such information. Although based on previously collected data, this article represents an extension of the earlier analysis with its focus on women who, at least to some extent, seek health care information via The Web (herein, Web user), a topic not thoroughly addressed in the earlier study. A comparison of female Web users and non-Web users who seek health information revealed that Web users sought health information at a higher rate than non-Web users. Web users were more likely to communicate with medical professionals about the health information found and claimed that their decisions about health treatments were influenced by the health information. In most cases, Web users expressed a higher awareness of resources, regardless of format. Web users did not report that finding health information, from any channel, however, was noticeably easier.

Comparing hand washing to hand sanitizers in reducing elementary school students' absenteeism.

PURPOSE: To compare the efficacy of an alcohol-based hand sanitizer to standard hand washing in reducing illness and subsequent absenteeism in school-age children. METHOD: A randomized cross-over design was used with 18 classrooms of 2nd and 3rd grade students (n = 383) from 4 elementary schools. Half of the classes from each school used an anti-microbial gel hand sanitizer while the other half used soap and water for regular hand hygiene for 2 months, then, the students switched cleaning methods for the following 2 months. RESULTS: No significant differences in absenteeism rates were demonstrated. A follow-up focus group comprised of teachers and school nurses indicated that hand sanitizers were preferred over soap and water. CONCLUSION: Hand sanitizers are an appropriate alternative to hand washing for hand cleansing and may offer additional benefits in the school setting.

Factors correlated with violent video game use by adolescent boys and girls.

PURPOSE: To compare the video and computer game play patterns of young adolescent boys and girls, including factors correlated with playing violent games. METHODS: Data collected in November/December, 2004 from children in grades 7 and 8 at two demographically diverse schools in Pennsylvania and South Carolina, using a detailed written self-reported survey. RESULTS: Of 1254 participants (53% female, 47% male), only 80 reported playing no electronic games in the previous 6 months. Of 1126 children who listed frequently played game titles, almost half (48.8%) played at least one violent (mature-rated) game regularly (67.9% of boys and 29.2% of girls). One third of boys and 10.7% of girls play games nearly every day; only 1 in 20 plays often or always with a parent. Playing M-rated games is positively correlated (p < .001) with being male, frequent game play, playing with strangers over the Internet, having a game system and computer in one's bedroom, and using games to manage anger. CONCLUSIONS: Most young adolescent boys and many girls routinely play M-rated games. Implications for identifying atypical and potentially harmful patterns of electronic game use are discussed, as well as the need for greater media literacy among parents.