Fatty acid amide hydrolase binding is inversely correlated with amygdalar functional connectivity: a combined positron emission tomography and magnetic resonance imaging study in healthy individuals.

Background: Upregulation of the endocannabinoid enzyme fatty acid amide hydrolase (FAAH) has been linked to abnormal activity in frontoamygdalar circuits, a hallmark of posttraumatic stress disorder. We tested the hypothesis that FAAH levels in the amygdala were negatively correlated with functional connectivity between the amygdala and prefrontal cortex, subserving stress and affect control. Methods: Thirty-one healthy participants completed positron emission tomography (PET) imaging with the FAAH probe [C-11]CURB, and resting-state functional MRI scans. Participants were genotyped for the FAAH polymorphism rs324420, and trait neuroticism was assessed. We calculated amygdala functional connectivity using predetermined regions of interest (including the subgenual ventromedial prefrontal cortex [sgvmPFC] and the dorsal anterior cingulate cortex [dACC]) and a seed-to-voxel approach. We conducted correlation analyses on functional connectivity, with amygdala [C-11]CURB binding as a variable of interest. Results: The strength of amygdala functional connectivity with the sgvmPFC and dACC was negatively correlated with [C-11]CURB binding in the amygdala (sgvmPFC: r = -0.38, q = 0.04; dACC: r = -0.44; q = 0.03). Findings were partly replicated using the seed-to-voxel approach, which showed a cluster in the ventromedial prefrontal cortex, including voxels in the dACC but not the sgvmPFC (cluster-level, family-wise error rate corrected p < 0.05). Limitations: We did not replicate earlier findings of a relationship between an FAAH polymorphism (rs324420) and amygdala functional connectivity. Conclusion: Our data provide preliminary evidence that lower levels of FAAH in the amygdala relate to increased frontoamygdalar functional coupling. Our findings were consistent with the role of FAAH in regulating brain circuits that underlie fear and emotion processing in humans.

Optimizing adherence to advice from antimicrobial stewardship audit and feedback rounds.

We examined adherence to antimicrobial stewardship prospective audit and feedback rounds in a rehabilitation service compared with the remainder of the acute hospital, and explored the reasons for this. Between October 2014 and December 2015, we retrospectively assessed the rate of non-adherence to advice from antimicrobial stewardship prospective audit and feedback rounds between the rehabilitation service and the acute hospital, along with the source of the patient referral. Compared with the rehabilitation service, acute hospital medical staff were almost twice as likely to not adhere to advice provided on antimicrobial stewardship prospective audit and feedback rounds (13.8% vs. 7.6%, p < 0.0001, relative risk 1.8 [95% confidence interval 1.3, 2.5]). In the rehabilitation service, referrals were more likely to come from medical staff (61.9% vs. 16.3%, p < 0.0001). These findings may be explained by regular, direct engagement of the antimicrobial stewardship team with the rehabilitation service clinical team, a model potentially applicable to other settings.

Phytochemical profile of commercially available food plant powders: their potential role in healthier food reformulations.

Reformulation of existing processed food or formulation of new foods using natural products (plant-based) will inherently confer to new products with less calories, fat, salt, phosphates and other synthetic components, and higher amounts of fibre, antioxidants, vitamins and other beneficial components. Plant ingredients, such as food plant powders, are currently being used in food manufacturing, predominantly for flavouring and colouring purposes. To expand their use as a food ingredient, freeze-dried powders representing major vegetable groups were characterised by targeted LC-MS/MS analysis of their phytochemicals. All the plant powders were found to be rich in flavonoids, phenolic acids and derivatives; total content in these compounds varied from around 130 mg kg(-1) (green pea) to around 930 mg kg(-1) (spinach). The food plant powders' phytochemical content represents valuable information for the food industry in the development of healthier novel foods and for the reformulation of existing food products in relation to antioxidants, food preservatives and alternatives to nitrite use.

Combinatorial treatment of acute spinal cord injury with ghrelin, ibuprofen, C16, and ketogenic diet does not result in improved histologic or functional outcome.

Because of the complex, multifaceted nature of spinal cord injury (SCI), it is widely believed that a combination of approaches will be superior to individual treatments. Therefore, we employed a rat model of cervical SCI to evaluate the combination of four noninvasive treatments that individually have been reported to be effective for acute SCI during clinically relevant therapeutic time windows. These treatments included ghrelin, ibuprofen, C16, and ketogenic diet (KD). These were selected not only because of their previously reported efficacy in SCI models but also for their potentially different mechanisms of action. The administration of ghrelin, ibuprofen, C16, and KD several hours to days postinjury was based on previous observations by others that each treatment had profound effects on the pathophysiology and functional outcome following SCI. Here we showed that, with the exception of a modest improvement in performance on the Montoya staircase test at 8-10 weeks postinjury, the combinatorial treatment with ghrelin, ibuprofen, C16, and KD did not result in any significant improvements in the rearing test, grooming test, or horizontal ladder. Histologic analysis of the spinal cords did not reveal any significant differences in tissue sparing between treatment and control groups. Although single approaches of ghrelin, ibuprofen, C16, and KD have been reported to be beneficial after SCI, our results show that the combination of the four interventions did not confer significant functional or histological improvements in a cervical model of SCI. Possible interactions among the treatments may have negated their beneficial effects, emphasizing the challenges that have to be addressed when considering combinatorial drug therapies for SCI.

Bound phytophenols from ready-to-eat cereals: comparison with other plant-based foods.

Whole-grain diets are linked to reduced risk of several chronic diseases (heart disease, cancer, diabetes, metabolic syndrome) and all-cause mortality. There is increasing evidence that these benefits are associated with the gut microbiota and that release of fibre-related phenolic metabolites in the gut is a contributing factor. Additional sources of these metabolites include fruits and vegetables, but the evidence for their protective effects is less well established. With respect to the availability of bound phytophenols, ready-to-eat cereals are compared with soft fruits (considered rich in antioxidants) and other commonly consumed fruits and vegetables. The results demonstrated that when compared with an equivalent serving of fruits or vegetables, a recommended portion of whole-grain cereals deliver substantially higher amounts of bound phytophenols, which are available for metabolism in the colon. The increased amount of these phenolic metabolites may, in part, explain the evidence for the protective effects of whole-grain cereals.

Provider perceptions of pharmacy-initiated tuberculosis referral services in Cambodia, 2005-2010.

SETTING: Since 2005, private pharmacies linked to the National Tuberculosis Programme (NTP) and the Municipal Health Department in Phnom Penh have referred tuberculosis (TB) symptomatic patients to public sector TB clinics. OBJECTIVE: To investigate the attitudes and practices of pharmacy-initiated referral service providers in Phnom Penh from 2005 to 2010. METHODS: In a qualitative study, participants were purposively selected from the register of pharmacy owners providing referral services. Discussions were conducted in Khmer by trained facilitators. Participants discussed topics relating to their experiences and participation in the referral programme. RESULTS: In January 2011, 54 pharmacy owners participated in six focus group discussions held in Phnom Penh. Interpreted data showed consistency of message across all topics. The emergent themes-altruism, pragmatism and professionalism-underpinned owner commitment to programme goals. Issues associated with patient counselling, fear of infection and quality of care in public sector clinics were of concern to participants. Owners believed ongoing professional support, improved public sector patient care and media campaigns would strengthen their role. CONCLUSION: Pharmacy outlets provide further options for NTPs engaging with private sector providers. Recognising private provider needs and aspirations may be an essential component of public/private mix programmes to meet public health goals.

Sibling, peer, neighbor, and schoolmate correlations as indicators of the importance of context for adolescent development.

We use nationally representative data to calculate correlations in achievement and delinquency between genetically differentiated siblings within a family, between peers as defined by adolescents' "best friend" nominations, between schoolmates living in the same neighborhood, and between grademates within a school. We find the largest correlations between siblings, especially identical twins. Grademate and neighbor correlations are small. Peer-based correlations are considerably larger than grademate and neighbor correlations but not larger than most sibling correlations. The data suggest that family-based factors are several times more powerful than neighborhood and school contexts in affecting adolescents' achievement and behavior.

Work-based antipoverty programs for parents can enhance the school performance and social behavior of children.

We assess the impact of the New Hope Project, an antipoverty program tested in a random assignment experimental design, on family functioning and developmental outcomes for preschool- and school-aged children (N = 913). New Hope offered wage supplements sufficient to raise family income above the poverty threshold and subsidies for child care and health insurance to adults who worked full-time. New Hope had strong positive effects on boys' academic achievement, classroom behavior skills, positive social behavior, and problem behaviors, as reported by teachers, and on boys' own expectations for advanced education and occupational aspirations. There were not corresponding program effects for girls. The child outcomes may have resulted from a combination of the following: Children in New Hope families spent more time in formal child care programs and other structured activities away from home than did children in control families. New Hope parents were employed more, had more material resources, reported more social support, and expressed less stress and more optimism about achieving their goals than did parents in the control sample. The results suggest that an anti-poverty program that provides support for combining work and family responsibilities can have beneficial effects on the development of school-age children.

Family poverty, welfare reform, and child development.

Our review of research suggests that family poverty has selective effects on child development. Most important for policy are indications that deep or persistent poverty early in childhood affects adversely the ability and achievement of children. Although the 1996 welfare reforms have spurred many welfare-to-work transitions, their time limits and, especially, sanctions are likely to deepen poverty among some families. We suggest ways policies might be aimed at preventing either economic deprivation itself or its effects.

Rat metallothionein-2 contains N(alpha)-acetylated and unacetylated isoforms.

Mammalian metallothioneins (MT), are characteristically N(alpha)-acetylated and the presence of an unblocked N-terminus has not previously been reported. On-line capillary electrophoresis-electrospray mass spectrometry of hepatic MT-2 from rats injected with zinc revealed two isoforms differing by a mass equivalent to that of a single acetyl group. The lower mass component constituted > 20% of total MT-2 protein and both MT-2 isoforms were separated by reversed-phase high-performance liquid chromatography. The identity of each fraction was confirmed by matrix-assisted laser desorption ionisation mass spectrometry, and amino acid analysis and N-terminal sequencing revealed that the lower mass isoform was unblocked at the N-terminus and had an amino acid composition and sequence which is characteristic of rat MT-2. Thus the complementary techniques of mass spectrometry and N-terminal sequencing demonstrated conclusively that purified MT-2 from zinc-treated rats contains an unacetylated isoform. We propose that the cotranslational acetylation of rat MT-2 may under some circumstances be inefficient compared to that in other nonrodent species, where we have detected only trace levels of unacetylated MT isoforms.

Gender and the socioeconomic gradient in mortality.

Despite considerable evidence documenting a strong and persistent relationship between socioeconomic position and mortality, recent research suggests that this association may be weaker among women. In our examination of gender differences in the socioeconomic gradient in mortality, we argue that this inconsistency arises from the failure to consider the ways in which gender is a fundamental constituent of socioeconomic position. The data used are from the Panel Study of Income Dynamics. Respondents, including all household heads and their partners, aged 29 years and older in 1972 (N = 5,665; 56% female), were followed until 1991, death, or attrition. Discrete time event history analysis was used to examine the predictors of death between 1972 and 1991. Of the key socioeconomic predictors, years of education was measured at baseline, while earned income was a time-varying covariate. We find no gender differences in the effect of respondents' own socioeconomic positions on their mortality risk. However, increasing spousal income raises men's odds of dying, while the opposite is true for women. Our results raise questions about the prevailing view that the socioeconomic gradient in mortality is weaker among women. Moreover, gender differences in the effects of spousal earnings on mortality risk suggest that their labor market rewards have fundamentally different meanings for women and men.

Kienbock's disease: treatment by implantation of vascular pedicle and bone grafting.

Eleven patients with stage II and IIIA Kienbock's disease treated with vascular pedicle implantation and bone grafting were reviewed to determine the long term efficacy of the procedure. Eight wrists had a negative ulnar variance and three wrists had a neutral ulnar variance. The procedure involved implanting the second dorsal metacarpal artery and its venae commitantes into a hole made in the lunate through a dorsal approach. Cancellous bone graft from the dorsal aspect of the distal radius was loosely packed in the hole to secure the pedicle. Follow-up was from 37 to 140 months with an average of six years. Nine patients had significant long term pain relief, improved function, and required no additional procedures. In two patients, continued pain necessitated proximal row carpectomy at two and 4.5 years postoperatively. Ten of the eleven patients had no worsening of their radiographic staging, but in no patient was the architecture of the lunate restored. There were no complications. The results are promising enough to recommend consideration of this procedure in the early stages of Kienbock's disease in patients with a neutral or negative ulnar variance.

Macro-to-micro links in the relation between income inequality and mortality.

A growing literature points to links between income inequality and mortality. Any examination of the link should distinguish, both theoretically and empirically, between shifts in inequality that result from changes in the bottom and top of the income distribution. When state-level data from the U.S. censuses of 1980 and 1990 were used to measure differences in mortality, the results indicated that inequality measures reflecting depth of poverty show stronger correlations with mortality than do inequality measures reflecting heights of affluence. In addition, longitudinal data from the Panel Study of Income Dynamics were used to related state-level inequality measures to individual-level data on mortality. This comparison revealed significant associations between degree of income inequality in state of residence and individual risk of death only for nonelderly individuals with middle-class incomes in 1990.

Income dynamics and adult mortality in the United States, 1972 through 1989.

OBJECTIVES: The aim of this study was to examine relationships between income and mortality, focusing on the predictive utility of single-year and multiyear measures of income, the shape of the income gradient in mortality, trends in this gradient over time, the impact of income change on mortality, and the joint effects of income and age, race, and sex on mortality risk. METHODS: Data were taken from the Panel Study of Income Dynamics for the years 1968 through 1989. Fourteen 10-year panels were constructed in which predictors were measured over the first 5 years and vital status over the subsequent 5 years. The panels were pooled and logistic regression was used in the analysis. RESULTS: Income level was a strong predictor of mortality, especially for persons under the age of 65 years. Persistent low income was particularly consequential for mortality. Income instability was also important among middle-income individuals. Single-year and multiyear income measures had comparable predictive power. All effects persisted after adjustment for education and initial health status. CONCLUSIONS: The issues of low income and income instability should be addressed in population health policy.

The effects of poverty on children.

Although hundreds of studies have documented the association between family poverty and children's health, achievement, and behavior, few measure the effects of the timing, depth, and duration of poverty on children, and many fail to adjust for other family characteristics (for example, female headship, mother's age, and schooling) that may account for much of the observed correlation between poverty and child outcomes. This article focuses on a recent set of studies that explore the relationship between poverty and child outcomes in depth. By and large, this research supports the conclusion that family income has selective but, in some instances, quite substantial effects on child and adolescent well-being. Family income appears to be more strongly related to children's ability and achievement than to their emotional outcomes. Children who live in extreme poverty or who live below the poverty line for multiple years appear, all other things being equal, to suffer the worst outcomes. The timing of poverty also seems to be important for certain child outcomes. Children who experience poverty during their preschool and early school years have lower rates of school completion than children and adolescents who experience poverty only in later years. Although more research is needed on the significance of the timing of poverty on child outcomes, findings to date suggest that interventions during early childhood may be most important in reducing poverty's impact on children.

Economic mobility of young workers in the 1970s and 1980s.

This paper uses longitudinal data to estimate cohort changes in the earnings trajectories of young adult males. Levels of earnings are uniformly lower for male workers turning 21 between 1980 and 1991 than in 1970-1979, although rates of earnings growth are roughly comparable. Among males turning 21 before 1980, six in 10 (60%) of all men and seven in 10 (71%) college-educated men attained earnings levels by age 30 that were at least twice the poverty level. Corresponding fractions for workers turning 21 between 1980 and 1991 were considerably lower (42% and 56%). Recent cohorts from all demographic subgroups appeared to have more difficulty than older cohorts in attaining middle-class earnings.

Ethnic differences in children's intelligence test scores: role of economic deprivation, home environment, and maternal characteristics.

We examine differences in intelligence test scores of black and white 5-year-olds. The Infant Health and Development Program data set includes 483 low birthweight premature children who were assessed with the Wechsler Preschool and Primary Scale of Intelligence. These children had been followed from birth, with data on neighborhood and family poverty, family structure, family resources, maternal characteristics, and home environment collected over the first 5 years of life. Black children's IQ scores were 1 SD lower than those of white children. Adjustments for ethnic differences in poverty reduced the ethnic differential by 52%. Adjustments for maternal education and whether the head of household was female did not reduce the ethnic difference further. However, differences in home environment reduced the ethnic differential by an additional 28%. Adjustments for economic and social differences in the lives of black and white children all but eliminate differences in the IQ scores between these two groups.

Income dynamics and health.

The focus of this article is the economic dimension of socioeconomic status as it relates to health. In contrast to the assumptions of many life cycle models, the author finds household income to be quite volatile for many families, even during periods of macroeconomic growth. Income inequality has increased dramatically in the last 20 years. Studies relating various measures of health (e.g., low birth weight; cognitive development, stunting, wasting in early childhood; mortality in later adult years) to longitudinal measures of family income often find quite powerful effects of income, even after controlling for correlated aspects of socioeconomic status and baseline health status. The author discusses strategies for modeling income effects.