Urge urinary incontinence and the brain factor

Aims To evaluate cognitive processing in elderly women with urge incontinence as compared to continent cohorts by measuring performance on neuropsychological tests of working memory, attention and inhibition. To measure speed of information processing, intensity of bladder filling sensation, and urine volume at a first desire (FDV) and strong desire to void (SDV), and level of attentional demands. Methods Test measures included Operation and Reading Span, Wisconsin Card‐Sorting, Stroop Color Reading, Map Planning, and Maze Speed tests. A Likert scale measured bladder filling sensation intensity at FDV and SDV. An Attentional Demands Survey measured perceived attentional demands. Results Women with urge incontinence had a mean severity index of 4.71 ± 2.7 with 84% demonstrating urge incontinence and 16% with mixed urge/stress incontinence. They experienced a FDV and a SDV to void at a lower bladder filling intensity with significantly smaller volumes of urine in the bladder compared to controls. Incontinent women also perceived significantly higher attentional demands but were not significantly different than controls on tests of executive function. Conclusions While observations from neuroimaging provide evidence of differences between women with urge incontinence and controls in regional brain activity, efforts need to be made to decipher how these differences in metabolic activity relate to the fluid operations that create thoughts, decisions, and behavior. Neurourol. Urodynam. 32: 441–448, 2013. © 2012 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98783/1/22357_ftp.pd

Bhabha in the clinic

Before professional diagnosis, the determination of whether one is ‘ill’ or ‘well’ rests within the patient. These moments, when sufferers (re)cognize their own bodily and phenomenological experience as abnormal or different, are critical to the positioning of healer and patient. So too are moments when diagnosed patients, struggling with a treatment regime, compromise and adjust to embrace, if only partially, disparate ideas of health. In this article, I apply Homi Bhabha’s framework of hybridity and difference to think about the perception of illness, self-diagnosis, and power in healing relationships. I consider how sufferers enact hybrid positions between their bodily perceptions and their professional diagnoses. To illustrate the utility of Bhabha’s colonial critique for health care, I examine narratives by patients with diabetes-related vision loss about: (1) first realizations that something was wrong, what Bhabha might call the ‘intervention of difference’; (2) expressed differences between self-knowledge and biomedical knowledge, corresponding to Bhabha’s ‘partial embrace’ of the colonial ideal; and (3) the self-colonizing epistemological work that compliant patients do as they re-orient their pre-diagnostic self to a post-diagnostic habitus of self-monitoring, timed medications, and other treatments. I conclude with a discussion of how Bhabha’s colonial hybridity supports a more productively contentious medical anthropology that envisions and pursues decolonized health care

Epidemiological placism in public health emergencies: Ebola in two Dallas neighborhoods

Super-diverse cities face distinctive challenges during infectious disease outbreaks. For refugee and immigrant groups from epidemic source locations, identities of place blend with epidemiological logics in convoluted ways during these crises. This research investigated the relationships of place and stigma during the Dallas Ebola crisis. Ethnographic results illustrate how Africanness, more than neighborhood stigma, informed Dallas residents’ experience of stigma. The problems of place-based stigma, the imprecision of epidemiological placism, and the cohesion of stigma to semiotically powerful levels of place – rather than to realistic risk categories – are discussed. Taking its authority from epidemiology, placism is an important source of potential stigma with critical implications for the success of public health messaging

Family and Family-Like Relations for Transnational Migrants: Ideals of Care Informed by Kin, Non-Family, and Religion

Studies of transnational family formation and care relationships suggest that, while family forms and care values are idealized, they are also negotiated, enacted, and fluid constructs. Strategies of resilience and mechanisms of flexible care achieved by transnational families are fine-tuned under multiple influences. Among these influences are well-known sources such as social networks, as well as less well-understood sources such as religious teachings. We report findings of a 4-month, ethnographic study among Latinx immigrants to the U.S. whose (n = 14) narratives of family “care” reflect their ideals and simultaneously work to linguistically produce role continuity. Thematic results address three key strategies for achieving this continuity: (1) valuations of flexibility; (2) family-like care by non-family and church members; and (3) commitments to and reliance on new networks, particularly through church relations. We conclude by suggesting how family-like care, such as that from church relations, informs the flexible relational obligations, resources, resiliencies, and values of transnational migrants

Characteristics of Internalizing Social-Emotional Behaviors of Southwestern Native American Children

The knowledge base targeting internalizing symptomatology in Native American children is surprisingly limited. As yet, it is not clear if the process and symptoms of internalizing disorders are the same across cultures. The need for further investigation is heightened by the fact that, compared to the majority population, Native Americans are believed to be at greater risk for psychological problems because of impoverished conditions, high unemployment, and high numbers of traumatic events on the reservations. Additionally, the losses of traditional culture and language are considered risk factors for greater psychopathology. The negative ramifications of internalizing disorders (e.g., depression and anxiety) include academic failure, lowered social skills and self-esteem, and greater risk for substance abuse and suicide. Furthermore, evidence suggests that all children with mental disorders are at high risk for severe psychopathology when left unidentified or untreated. It seems clear that additional research is needed to better understand internalizing symptoms among members of this cultural group. To help meet this need, the present study focused on internalizing disorders among Native American children from the southwest, utilizing a portion of extant data from the Flower of Two Soils Project. This project was one of very few methodologically sound studies that have been successful in obtaining multisource. multimethod data on social, emotional, and behavioral functioning of Native American children. Data were collected using a modified version of the Child Behavior Checklist (CBCL), Youth Self-Report (YSR), and Teacher\u27s Report Form (TRF) assessment instruments for parents, teachers, and children. Findings with respect to elementary school-aged children found relatively high rates of depression, anxiety, somatization symptoms and, potentially, disorders. These findings are a cause for concern among parents, teachers, and all agencies responsible for children\u27s mental health. Across all three informant groups a consistent pattern of negative correlations was observed between internalizing symptoms and child competencies. This finding is consistent with previous findings for the general population. However,. competitiveness and academic achievement were positively correlated with internalizing symptoms, perhaps indicating that an emphasis on competitiveness and individual achievement is stressful for children from a collectivistic Native American culture. This was a descriptive study providing broad exploratory information, but there remains a need for more focused research identifying multivariate relationships among relevant variables. These findings should be cautiously interpreted and with due consideration for the specific cultural and historical context of children and families. Recommendations are included for research and practice

The traditional food of migrants: Meat, water, and other challenges for dietary advice. An ethnography in Guanajuato, Mexico

The term “traditional diet” is used variously in public health and nutrition literature to refer to a substantial variety of foodways. Yet it is difficult to draw generalities about dietary tradition for specific ethnic groups. Given the strong association between migration and dietary change, it is particularly important that dietary advice for migrants be both accurate and specific. In this article, I examine the cultural construct of “traditional foods” through mixed method research on diet and foodways among rural farmers in Guanajuato, MX and migrants from this community to other Mexican and U.S. destinations. Findings reveal first, that quantitatively salient terms may contain important variation, and second, that some “traditional” dietary items –like “refresco,” “carne,” and “agua” – may be used in nutritionally contradictory ways between clinicians and Mexican immigrant patients. Specifically, the term “traditional food” in nutritional advice for Mexican migrants may be intended to promote consumption of fresh produce or less meat; but it may also invoke other foods (e.g., meats or corn), inspire more regular consumption of formerly rare foods (e.g., meats, flavored waters), or set up financially impossible goals (e.g., leaner meats than can be afforded). Salience studies with ethnographic follow up in target populations can promote the most useful and accurate terms for dietary advice

The Relationship Between Serum 25-Hydroxyvitamin D, Vitamin D and Calcium Intake, and Adiposity in Infants

Purpose: National prevalence of childhood overweight and obesity has plateaued in recent years, but rates remain high, with approximately 10% among children“high weight.” The relationship between adiposity and serum 25-hydroxyvitamin D [25(OH)D] status has been well-explored in older individuals, with inconsistent results. Furthermore, previous studies have suggested a relationship between adequate consumption of calcium and vitamin D and healthy weight status in older children and adults. However, in the infant population, there are few studies detailing the interaction between body composition and serum 25(OH)D or intake of calcium and vitamin D. Our study aims were to assess the association between serum 25(OH)D and body composition and to examine the association between adiposity and dietary intake of calcium and vitamin D in a sample of infants and toddlers. Methods: Our population included healthy male and female infants and toddlers from Pittsburgh, PA who participated in the “Practices Affecting Vitamin D Status in Pittsburgh Infants and Toddlers” study. Parents completed a Vitamin D and Sunlight Exposure Questionnaire, which assessed dietary intake of foods high in calcium and vitamin D as well as daily sunlight exposure (≥2 hours vs. \u3e2 hours). Anthropometric measures and bloodwork for serum 25(OH)D were obtained during at the time of the study visit. Weight-for-length (WFL) percentile status was determined using WHO growth standards (low weight97.7 %ile) and WFL z-scores were calculated. ANOVA was used to compare mean serum 25(OH)D and calcium and vitamin D intake by WFL status. Chi square analysis was used to evaluate the relationship between serum 25(OH) D status (deficient =/mL, insufficient = 12-20 ng/mL, sufficient \u3e20 ng/mL), calcium intake status (sufficient = \u3e700 mg), vitamin D intake status (sufficient = \u3e400 IU) and WFL percentile status. Pearson’s correlation coefficient was used to assess the strength and significance of associations between serum 25(OH)D, calcium and vitamin D intake and WFL z-score. The analysis was repeated after subdivision by race and sun exposure. Results: 125 infants and toddlers (9 to 24 months of age, 68% African American) participated in the study. Approximately 11% of the population had a high weight. Mean vitamin D intake (~600 IU/d) and median calcium intake (~1550 mg/d) exceeded recommendations. Prevalence of high weight was higher among children with adequate intake compared to those who consumed less than the recommendations (calcium: 41% vs. 36%, respectively; vitamin D: 45% vs. 29%, respectively). However, this difference was not statistically significant. Mean serum 25(OH)D level (37 ng/mL) was sufficient. When compared across WFL status, neither mean serum 25(OH)D nor mean intake of calcium and vitamin D varied significantly. No significant correlation was found between WFL and serum 25(OH)D for the cohort or any of the subgroups examined. Conclusions: Rates of infant overweight and obesity in our sample are similar in comparison with the national average. Our results do not support a relationship between calcium and vitamin D intake on weight status or an association between serum vitamin D and body composition in children of this age. Future studies are needed to re-examine these relationships in a larger group of children of more evenly distributed weight status

Expanding Effective 21st Century Access to Historical and Academic Materials: Examples, Strategies and Implications

Given the capabilities for digitization that have emerged in recent years along with mobile access to the internet, new library and business partnerships are now not only possible but also compelling in various ways. HTML5 web apps now make available library collections that historically have been closed or difficult to access. A partnership involving The British Library, Microsoft and BiblioLabs realizes some of these new potentials