Childhood Socioeconomic Status and Depressive Symptom Trajectories in the Transition to Adulthood in the United States and Canada

Purpose: We examined whether young people in the U.S. and Canada exhibit similar depressive symptom trajectories in the transition to adulthood and compared the effect of childhood socioeconomic status on trajectory membership. Methods: We used the American National Longitudinal Survey of Youth 1979 Child/Young Adult (n = 6,315) and the Canadian National Longitudinal Survey of Children and Youth (n = 3,666). Depressive symptoms were measured using five items from the Center for Epidemiological Studies on Depression scale. Latent trajectories of depressive symptoms from ages 16–25 years were identified using growth mixture models. We estimated the effect of childhood family income, parental education, and parental unemployment on trajectory membership using multivariable Poisson regression models with robust variances. Results: We identified four similar trajectories in the two countries: (1) low stable; (2) mid-peak; (3) increasing; and (4) decreasing. Relatively more Americans were in the low-stable trajectory group than Canadians (77.6% vs. 64.9%), and fewer Americans were in the decreasing group (7.1% vs. 19.1%). In the U.S., childhood family income in the bottom two quartiles was related to higher rates of increasing trajectory membership compared with income in the top quartile (incidence rate ratios: 1.59–1.79, p <.05), but not in Canada. In the U.S., parental education at a high school level was associated with higher rates of decreasing trajectory membership compared with higher education (incidence rate ratio = 1.45, confidence interval: 1.10–1.91; p =.01), but not in Canada. Conclusions: Depressive symptoms may take a similar course in the transition to adulthood within these two countries. Country differences may modify the degree to which childhood socioeconomic status determines trajectory membership

Artikulationen des Affektiven und die Formierung transkultureller Emotionsrepertoires im Vietnamesischen Berlin

Aus anthropologisch-psychiatrischer Perspektive thematisiert unser Beitrag die Formierung transkultureller Emotionsrepertoires in den Lebensentwürfen vietnamesischer Migrant_innen der ersten Generation in Berlin. Konkret gilt unser empirisches Interesse den affektiven Anstrengungen von Migration, die sich im Leben von vietnamesischen Patient_innen abzeichnen, die psychiatrisch- psychotherapeutische Hilfe in Anspruch nehmen, sowie von deren Angehörigen. Zum einen möchten wir der Frage nachgehen, wann genau affektive Krisenerfahrungen zu Belastungen werden, die auf Basis bisheriger Emotionsrepertoires nicht länger zu bewältigen sind und zu einer Inanspruchnahme psychiatrisch-psychotherapeutischer Hilfe führen. Zum anderen möchten wir Antworten auf die Frage geben, inwiefern diese Inanspruchnahme zu einer Herausbildung neuer und dezidiert transkultureller Emotionsrepertoires beiträgt, die Beheimatungsprozesse begünstigen können, welche in neue und multiple Zugehörigkeiten und/oder Nichtzugehörigkeiten münden (Pfaff-Czarnecka 2012, Scheer 2014, Lähdesmäki et al. 2016, Röttger-Rössler 2016). Die Relevanz der letzteren Frage spiegelt sich in der zunehmenden Akzeptanz vietnamesisch- sprachiger und transkulturell sensibler psychiatrischer Versorgungsan-gebote im Rahmen der Eröffnung zweier Spezialambulanzen in Berlin wider (Ta et al. 2015,Hahn et al. 2016). Diese Versorgungsangebote sind eingebettet in ein aktives Netzwerk, welches die Förderung der seelischen Gesundheit von vietnamesischen Migrant_innen in Deutschland dient und dabei Träger sozialer Hilfen miteinander in Beziehung setzt und auch transnationale psychiatrische Perspektiven miteinbezieht (Ta et al. 2016b). Aus unseren ethnographischen Begegnungen, Beobachtungen und Gesprächen geht hervor, dass das erwähnte Setting in den Spezialambulanzen für unsere Gesprächspartner_innen einen einzigartigen Artikulationsraum darstellt, in dem in bislang ungewohnter Weise und jenseits von Stigmatisierungsängsten über affektive Erfahrungen, Anstrengungen und Belastungen gesprochen werden kann. Wer sich in Vietnam in psychiatrische Behandlung begebe oder in eine psychiatrische Klinik „eingewiesen“ werde, habe es laut unserer Gesprächspartner_innen nicht nur in Bezug auf die Qualität der Versorgung schlechter als in Deutschland: Der-/diejenige werde schnell als điên bezeichnet und müsse mit Diskriminierung und Stigmatisierung in Form eines Gesichtsverlusts rechnen, der sich auch auf das familiäre Umfeld ausweite. Das Wort điên bedeute „verrückt sein“, umgangssprachlich steht es für den medizinischen Ausdruck „an einer psychischen Krankheit leiden“ (bị bệnh tâm thần). Jedoch birgt es durchweg negative Konnotationen in sich, da Menschen, die als điên bezeichnet werden, nicht länger ernst genom-men und aus ihrem sozialen Umfeld ausgegrenzt würden. Affektive Belastungen werden aus diesem Grund häufig verdeckt, um einerseits nicht gegen die Gebote der Wahrung sozialer Harmonie zu verstoßen und andererseits, um eine individuelle und familiäre Stigmatisierung zu vermeiden (Lauber & Rössler 2007, Machleidt 2013). Selbstverständlich gibt es auch in Vietnam vielfältige Bewältigungsstrategien. In Migrationserfahrungen fußende affektive Belastungen beinhalten unserer Meinung nach aber andere Herausforderungen, welche die vertrauten Strategien in dem veränderten sozialen, politischen und wirtschaftlichen Kontext oftmals an ihre Grenzen stoßen lassen. Im Folgenden erläutern wir zunächst, inwiefern wir Affekte von Emotionen im Kontext von Migration konzeptuell unterscheiden und was unter einem transkulturellen Emotionsrepertoire zu verstehen ist. Des Weiteren wird die psychiatrische Ambulanz als ein besonderer Artikulationsraum des Affektiven vorgestellt, sowie auch als Forschungsraum unseres interdisziplinären Projektes. Sodann gewähren wir Einblicke in die Lebensentwürfe von zwei Gesprächspartnern, die beide der ersten Generation vietnamesischer Migrant_innen angehören. Um auch eine transgenerationale Sicht auf Affekte und Emotionen in der Migration zu ermöglichen, beschließen wir unseren empirischen Teil mit einer Beschreibung der Ansichten einer Gesprächspartnerin der zweiten Generation, deren Mutter in psychiatrisch- psychotherapeutischer Be-handlung ist. Unser Beitrag endet mit einer Diskussion, in der wir gängigen Vorstellungen widersprechen, die die Inanspruchnahme psychiatrisch-psychotherapeutischer Hilfe als ein Zeichen von Hilflosigkeit werten und insbesondere Patient_innen mit migrationsbezogenem Hintergrund Handlungsmacht und Kompetenz absprechen (Pratt Ewing 2005, Kirmayer 2007)

Does social capital flatten the social gradient in early childhood development? An ecological study of two provinces in Canada

Social capital is thought to buffer the negative effects of low income on health and thereby flatten the social gradient. Child development research on social capital has suggested that social networks of adults and children in a neighborhood may play a protective role in children's outcomes. Yet little is known about how this relationship applies to diverse developmental outcomes in early childhood. This study examines whether the presence of role model adults and the willingness of neighbors to help keep children safe moderates the relationship between neighborhood income and five developmental outcomes for children in kindergarten: (1) physical health and well-being, (2) social competence, (3) emotional maturity, (4) language and cognitive development, and (5) communication and general knowledge. We linked neighborhood-level data on child development from two Canadian provinces, British Columbia (BC, n = 100) and Ontario (n = 482), to neighborhood-level data on social capital from the Ontario Kindergarten Parent Survey, and the BC Social Capital Study; and income data from the 2006 Canadian Census. Multiple regression analyses were conducted to examine the main and interaction effects of social capital and income in relation to child development outcomes. In Ontario, higher levels of social capital were associated with better child outcomes on all five developmental domains. Similar trends were observed in BC. Higher levels of social capital flattened the income gradient in language and cognitive development in both provinces, and social competence in Ontario. Implications for research and practice are discussed

High-resolution Imaging of Myeloperoxidase Activity Sensors in Human Cerebrovascular Disease

Progress in clinical development of magnetic resonance imaging (MRI) substrate-sensors of enzymatic activity has been slow partly due to the lack of human efficacy data. We report here a strategy that may serve as a shortcut from bench to bedside. We tested ultra high-resolution 7T MRI (microMRI) of human surgical histology sections in a 3-year IRB approved, HIPAA compliant study of surgically clipped brain aneurysms. microMRI was used for assessing the efficacy of MRI substrate-sensors that detect myeloperoxidase activity in inflammation. The efficacy of Gd-5HT-DOTAGA, a novel myeloperoxidase (MPO) imaging agent synthesized by using a highly stable gadolinium (III) chelate was tested both in tissue-like phantoms and in human samples. After treating histology sections with paramagnetic MPO substrate-sensors we observed relaxation time shortening and MPO activity-dependent MR signal enhancement. An increase of normalized MR signal generated by ultra-short echo time MR sequences was corroborated by MPO activity visualization by using a fluorescent MPO substrate. The results of microMRI of MPO activity associated with aneurysmal pathology and immunohistochemistry demonstrated active involvement of neutrophils and neutrophil NETs as a result of pro-inflammatory signalling in the vascular wall and in the perivascular space of brain aneurysms

Mental Health Determinants Among a Psychiatric Outpatient Sample of Vietnamese Migrants in Germany

Background: Mental health risk-factors for Asian migrants have been studied almost exclusively in the US, Canada, and Australia but not in European countries. Therefore, we aimed to identify sociodemographic, clinical, and migration-surrounding factors associated with experienced mental distress among Vietnamese migrants in Germany. Method: 305 Vietnamese migrants utilizing Germany's first Vietnamese psychiatric outpatient clinic filled out at admission the Brief-Symptom-Inventory 18 (BSI-18) as well as a questionnaire on 22 potential mental health determinants. Using a multiple linear regression model, we identified those sociodemographic, clinical, and migration-surrounding factors that were significantly related to the Global Severity Index (GSI) of the BSI-18. Results: The factors unemployment (B = -6.32, p = 0.014), financial problems (B = -10.71, p < 0.001), no or only little religious involvement (B = -3.23, p = 0.002), no psychiatric precontact (B = -7.35, p = 0.004), previous migration experiences (B = 8.76, p = 0.002), and perceived discrimination (B = 6.58, p = 0.011) were found to significantly increase the level of mental distress according to the BSI-GSI. Conclusion: Based on these results, we were able to construct a mental health risk-profile for Vietnamese migrants in Germany, which aims to detect candidates for psychiatric problems earlier and supply them with customized prevention and therapy options

The Shape of the Socioeconomic Gradient: Testing to Functional Form of the Relationship between Socioeconomic Status and Early Child Development

Introduction The literature provides abundant evidence of socioeconomic gradients in health outcomes. However, it is unclear, and particularly understudied in early child development research, whether these observed gradients are linear, whether they diminish as socioeconomic status (SES) increases, and if they ultimately reverse in slope at the highest SES values. Objectives and Approach We linked neighbourhood-level Census and Tax Filer data with Early Development Instrument (EDI) data across Canada. The EDI is a kindergarten teacher-completed measure of five domains of early child development. We used this linked database to statistically compare and choose the most appropriate functional form of the relationship between each of the EDI domains (dependent variables), and the Canadian Neighbourhoods and Early Child Development (CanNECD) study's SES index (predictor) in regression models. Model comparison approaches included: visual checks of lines fitted using Generalized Additive Models, Akaike and Bayesian Information Criterions, Ramsay’s RESET, J and Cox tests. Results The results indicate the optimal functional form of the gradient varies across domains of the EDI. The best model for the Physical Health and Well-Being domain was quadratic, suggesting there may be some reversal in slope at higher values of SES. The best models for the Social Competence and Language and Cognitive Development domains were logarithmic, indicating diminishing returns to SES but with no slope reversal. The best model for the Emotional Maturity domain was linear, suggesting the gradient was consistent across all values of SES. The best fit for the Communication Skills and General Knowledge domain was a cubic ‘S’ curve, suggesting the curve is positive and concave for lower levels of SES but curves upwards beyond a certain SES threshold. Conclusion/Implications The results demonstrate the importance of examining functional forms when modeling socioeconomic gradients. Assuming linear relationships between SES and health outcomes (early child development, in this case) may distort and bias the true nature of the relationships, thus leading to misinterpretations, especially at the highest and lowest values of SES

Состояние провоспалительного цитокинового звена у больных с нестабильной стенокарадией и сахарным диабетом 2-го типа в зависимости от функционального класса хронической сердечной недостаточности

Проанализировано состояние провоспалительного звена цитокинов у больных с нестабильной стенокардией (НС) и сопутствующим сахарным диабетом (СД) 2−го типа в зависимости от функционального класса хронической сердечной недостаточности (ХСН). Нарастание проявлений сердечной декомпенсации у больных с НС и СД 2−го типа ассоциируется с высокой активностью провоспалительного цитокинового звена, представленного фактором некроза опухолей−α и интерлейкином−6. Повышение функционального класса ХСН характеризуется увеличением инсулинорезистентности у больных с НС и СД 2−го типа.Проаналізовано стан прозапальної ланки цитокінів у хворих із нестабільною стенокардією (НС) та супутнім цукровим діабетом (ЦД) 2−го типу залежно від функціонального класу хронічної серцевої недостатності (ХСН). Наростання проявів серцевої декомпенсації у хворих із НС та СД 2−го типу асоціюється з високою активністю прозапальної цитокінової ланки, представленої фактором некрозу пухлин−α та інтерлейкіном−6. Підвищення функціонального класу ХСН характеризується зростанням інсулінорезистентності у хворих із НС та ЦД 2−го типу.The state of pro−inflammatory cytokines in patients with unstable angina (UA) and associated type 2 diabetes mellitus (DM) was analyzed depending on the functional class of chronic heart failure (CHF). The increase in manifestations of cardiac decompensation in patients with UA and type 2 DM is associated with high activity of pro−inflammatory cytokine level represented by tumor necrosis factor−β and interleukin−6. Increase of functional class of CHF is characterized by increased insulin resistance in patients with UA and type 2 DM

Engineering antibody heavy chain CDR3 to create a phage display Fab library rich in antibodies that bind charged carbohydrates.

peer reviewedA number of small charged carbohydrate moieties have been associated with inflammation and cancer. However, the development of therapeutic Abs targeting these moieties has been hampered by their low immunogenicity and their structural relationship to self-Ag. We report the design of an Ab repertoire enriched in Abs binding to small charged carbohydrates and the construction of a human Fab phagemid library, "FAB-CCHO." This library combines L chain Ig sequences from human donors and H chain synthetic diversity constructed in key Ag contact sites in CDRs 1, 2, and 3 of the human framework V(H)3-23. The H chain CDR3 has been engineered to enrich the library in Abs that bind charged carbohydrates by the introduction of basic residues at specific amino acid locations. These residues were selected on the basis of anti-carbohydrate Ab sequence alignment. The success of this design is demonstrated by the isolation of phage Abs against charged carbohydrate therapeutic target Ags such as sulfated sialyl-Lewis X glycan and heparan sulfate

Migration-related emotional distress among Vietnamese psychiatric patients in Germany: An interdisciplinary, mixed methods study

Culture and socialization influence how individuals perceive and express emotional distress. Research therefore, must consider the context to capture individual experiences. However, the majority of studies on factors associated with emotional distress among migrants use quantitative approaches, limiting an in-depth understanding. This study investigates emic themes of emotional distress among Vietnamese migrants by integrating anthropological and psychiatric approaches. The mixed methods study first quantified differences in reported themes of distress between Vietnamese (n = 104) and German (n = 104) patients, who utilized two psychiatric outpatient clinics in Berlin, Germany. Based on these differences, ethnographic interviews were conducted with 20 Vietnamese patients. In the quantitative part, differences in frequency of reported distress between Vietnamese and German patients indicate cultural and migration-related issues among Vietnamese migrants, such as the upbringing of children in a transcultural context. In the qualitative part, interviews with Vietnamese patients elicited contextualizing information and additional themes of distress. Besides commonly expressed socioeconomic themes, such as work and finances, we identified affectively charged themes concerning roles toward partnership and children. A central emic theme is expressed as “moments of speechlessness,” which go beyond a lack of language proficiency and challenge patients in different spheres of life. Migration entails complex affective dynamics, determined by a specific migratory and post-migratory context. Within this context, norms and values determine which themes of distress patients articulate openly. Therefore, an interdisciplinary, mixed-methods approach can yield a contextualized understanding of emotional distress and the complex nature of migration

Colon cancer risk and different HRT formulations: a case-control study

<p>Abstract</p> <p>Background</p> <p>Most studies have found no increased risk of colon cancer associated with hormone replacement therapy (HRT), or even a decreased risk. But information about the effects of different HRT preparations is lacking.</p> <p>Methods</p> <p>A case-control study was performed within Germany in collaboration with regional cancer registries and tumor centers. Up to 5 controls were matched to each case of colon cancer. Conditional logistic regression analysis was applied to estimate crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Stratified analyses were performed to get an impression of the risk associated with different estrogens and progestins.</p> <p>Results</p> <p>A total of 354 cases of colon cancer were compared with 1422 matched controls. The adjusted overall risk estimate for colon cancer (ColC) associated with ever-use of HRT was 0.97 (0.71 – 1.32). No clinically relevant trends for ColC risk were observed with increasing duration of HRT use, or increasing time since first or last HRT use in aggregate.</p> <p>Whereas the overall risk estimates were stable, the numbers in many of the sub-analyses of HRT preparation groups (estrogens and progestins) were too small for conclusions. Nevertheless, if the ColC risk estimates are taken at face value, most seemed to be reduced compared with never-use of HRT, but did not vary much across HRT formulation subgroups. In particular, no substantial difference in ColC risk was observed between HRT-containing conjugated equine estrogens (CEE) or medroxyprogesterone acetate (MPA) and other formulations more common in Europe.</p> <p>Conclusion</p> <p>Ever-use of HRT was not associated with an increased risk of colon cancer. In contrary, most risk estimates pointed non-significantly toward a lower ColC risk in HRT ever user. They did not vary markedly among different HRT formulations (estrogens, progestins). However, the small numbers and the overlapping nature of the subgroups suggest cautious interpretation.</p