Food insecurity is associated with poor sleep outcomes among US adults.

BACKGROUND: Although food insecure (FI) adults are at risk of chronic conditions, little research attention is given to their health behaviors, such as sleep. OBJECTIVE: We examined the associations between adult food security status and sleep duration, sleep latency, and sleep complaints reported to a health care professional. METHODS: Our population-based sample included 5637 men and 5264 women (≥22 y) who participated in the NHANES 2005-2010. Food security status was assessed with USDA's 10-item adult Food Security Survey Module. Self-reported information about sleep duration, sleep latency, and sleep complaints to a health care professional were used as sleep outcomes. Multiple linear, stratified by sex, and logistic regression models were used to estimate the association between food security status and the 3 sleep outcomes. RESULTS: Very low food secure (FS) women reported significantly shorter sleep duration than fully FS women (difference: -30 ± 5.2 min; P < 0.01); however, no relation to sleep duration was observed among men. Among men, participants who were marginally FS (4 ± 1.1 min), low FS (4 ± 1.7 min), and very low FS (5 ± 1.8 min) reported significantly longer sleep latency than fully FS men (P < 0.05), but no association with sleep latency was observed among women. The divergent patterns in sleep duration and latency were likely because of our reference groups reporting undesirable sleep outcomes; fully FS men reported inadequate sleep and fully FS women reported long sleep latency. Among both men and women, marginally FS (OR: 1.64; 95% CI: 1.24, 2.16), low FS (OR: 1.63; 95% CI: 1.16, 2.30), and very low FS (OR: 1.99; 95% CI: 1.36, 2.92) participants were more likely to report sleep complaints than their fully FS counterparts (P < 0.05). CONCLUSIONS: Poor sleep quantity and quality may predispose FI adults to adverse health outcomes.

Pathways to vocational services: factors affecting entry by veterans enrolled in Veterans Health Administration mental health services.

The current study provides naturalistic data documenting the pathways-to-care to vocational services for 155 veterans who were receiving some form of mental health care from the Veterans Health Administration and had a vocational need but were not currently enrolled in vocational services. Of the participants, 94.2% had recognized their vocational need, 80.6% reported that they or someone else had sought help to alleviate the need, and 77.4% had previously received some form of vocational services. The median length of the participants' vocational need was more than 4.2 years. Delays associated with recognition, help-seeking, and treatment entry all contributed to the overall delay in entering appropriate care. Filtering factors associated with quicker recognition, seeking help, and receiving services included diagnosis, level of disability, type of vocational need, and support from primary providers, family, and friends. The results provide information for designing interventions to improve service entry by adults with mental health problems and vocational needs.

Are we there yet? The four-year impact of a VA fellowship program on the recovery orientation of rehabilitation programs.

OBJECTIVE: This study represents the first program evaluation of the impact of a Psychosocial Rehabilitation (PSR) fellowship program within the Veterans Health Administration (VHA). Specifically, it examines the recovery orientation of five mental health rehabilitation programs at the Edith Nourse Rogers Memorial VA Medical Center (ENRM VAMC) in Bedford, MA by comparing program stakeholder rating of the "recovery orientation" between the initial data and the four-year follow-up during which the PSR fellowship was in operation. The goal of this fellowship program is to increase the VHA's fidelity to recovery-oriented best practice recommendations. METHOD: Participants were mental health consumers and staff members within five key psychiatric rehabilitation programs at the ENRM VAMC. Perception of programs' recovery orientation was measured at the start of the fellowship (Time 1) and after the fellowship was in place for four years (Time 2). RESULTS: Results demonstrate that across the entire sample of stakeholders, perceptions of recovery orientation significantly improved from Time 1 to Time 2. Results also reveal a significant overall increase in program recovery orientation over time in three out of the five rehabilitation programs, with years of fellow involvement in particular programs significantly and positively correlating with increases in ratings of program recovery-orientation gains. DISCUSSION: Implications for using fellowships as agents of program change, and specifically, recovery-oriented change, are discussed.

Increased hypothalamic signal transducer and activator of transcription 3 phosphorylation after hindbrain leptin injection.

Reduction of food intake and body weight by leptin is attributed largely to its action in the hypothalamus. However, the signaling splice variant of the leptin receptor, LRb, also is expressed in the hindbrain, and leptin injections into the fourth cerebral ventricle or dorsal vagal complex are associated with reductions of feeding and body weight comparable to those induced by forebrain leptin administration. Although these observations suggest direct hindbrain action of leptin on feeding and body weight, the possibility that hindbrain leptin administration also activates the Janus kinase/signal transducer and activator of transcription 3 (STAT3) signaling in the hypothalamus has not been investigated. Confirming earlier work, we found that leptin produced comparable reductions of feeding and body weight when injected into the lateral ventricle or the fourth ventricle. We also found that lateral and fourth ventricle leptin injections produced comparable increases of STAT3 phosphorylation in both the hindbrain and the hypothalamus. Moreover, injection of 50 ng of leptin directly into the nucleus of the solitary tract also increased STAT3 phosphorylation in the hypothalamic arcuate and ventromedial nuclei. Increased hypothalamic STAT3 phosphorylation was not due to elevation of blood leptin concentrations and the pattern of STAT3 phosphorylation did not overlap distribution of the retrograde tracer, fluorogold, injected via the same cannula. Our observations indicate that even small leptin doses administered to the hindbrain can trigger leptin-related signaling in the forebrain, and raise the possibility that STAT3 phosphorylation in the hypothalamus may contribute to behavioral and metabolic changes observed after hindbrain leptin injections.

Diet quality is low among female food pantry clients in Eastern Alabama.

OBJECTIVE: Examine diet quality, food security, and obesity among female food pantry clients. DESIGN: Cross-sectional study. SETTING: A food pantry in Lee County, Alabama. PARTICIPANTS: Fifty-five female food pantry clients between 19 and 50 years of age. MAIN OUTCOME MEASURE(S): Diet quality using United States (US) Department of Agriculture Healthy Eating Index (HEI-2005), adult obesity (Body Mass Index [BMI] > or = 30 kg/m(2)), household food security (US Department of Agriculture Module). ANALYSIS: Analysis of variance and multivariate models. RESULTS: Diet quality of the women was generally poor, with a mean HEI of a 43 on a 100 point scale. Having low education level (less than a high school degree) and being a smoker were related to lower overall diet quality. Sixty-seven percent of the clients were obese while 65% percent were food insecure. CONCLUSIONS AND IMPLICATIONS: Food pantry clients are characterized by high levels of food insecurity, obesity and poor diet quality. Smoking was associated with food insecurity and low diet quality. Increased outreach efforts to improve nutrition education and to help food pantry clients stop smoking could be beneficial.

The conjugate addition-Peterson olefination reaction for the preparation of cross-conjugated cyclopentenone, PPAR-gamma ligands.

5-Alkylidenecyclopent-2-enones 15a-q may be prepared via a conjugate addition-Peterson olefination sequence, best achieved in one-pot, using exo-2-trimethylsilyl-3a,4,7,7a-tetrahydro-4,7-methanoinden-1-one 12, followed by a retro-Diels-Alder reaction. The geometry of the exocyclic alkene may be controlled according to the use of organometallic species in the conjugate addition step; organocuprate reagents are found to selectively lead to the formation of E-exocyclic alkene adducts, whereas Grignard reagents favour the formation of Z-alkenyl isomers. The use of enantiomerically enriched 12, accessed from an asymmetric Pauson-Khand reaction, affords the corresponding enantioenriched 5-alkylidenecyclopent-2-enones and this approach is exemplified by the short, stereoselective total syntheses of two cyclopentenone phytoprostanes 51 and 13,14-dehydrophytoprostane J1 65. The ability of this family of synthetic compounds to activate the peroxisome proliferator activated receptor-gamma is reported.

Food insecurity is not associated with lower energy intakes.

We examined the association between food insecurity and total daily energy intakes in American men and women. We estimated the number of daily snacks and meals consumed by individuals in different food security categories. Also, we calculated the energy contribution, energy density, and food group sources of those snacks and meals. Using the 1999-2002 National Health and Nutrition Examination Survey (NHANES), we examined the Food Security Survey Module (FSSM) and dietary information from the 24-h recall. Differences in energy intakes between groups were not significant. Women who were food insecure without hunger (FIWOH) and food insecure with hunger (FIWH) had significantly fewer meals than food secure (FS) women. The energy contribution of each meal and the total energy contributed from snacking were both significantly greater for FIWOH women than for FS women. The number of meals was significantly lower whereas the daily number of snacking occasions and the total energy from snacking were significantly increased for FIWOH men relative to FS men. FIWOH men consumed snack foods that had significantly lower energy density than those consumed by FS men. Among men and women, the major sources of meal energy were the grain group, the meat, poultry, and fish group, and the sugar, sweets, and beverages group whereas the major source of snacking energy was the sugar, sweets, and beverages group. Total energy intakes were not different for FI individuals; however, their meal and snack behaviors were different. Focusing solely on total energy intake would miss important consequences of food insecurity.

The role of meaning in grapheme-colour synaesthesia.

When the synaesthete, J, is shown black graphemes, in addition to perceiving the black digits or letters she also experiences highly specific colours that overlay the graphemes (e.g., 5 is pink, S is green). We used ambiguous graphemes in a Stroop-type task to show that the exact same forms (e.g., 5) can elicit different synaesthetic colours depending on whether they are interpreted as digits or letters. J was shown strings of black digits (e.g., 3 4 5 6 7) or words (e.g., M U S I C for 1 sec. All but one of the graphemes then disappeared and the remaining grapheme changed to a colour that J had to name as quickly as possible. The key trials involved coloured graphemes that were ambiguous (e.g., the 5 in the strings above could be interpreted either as a digit or as a letter). On congruent trials, the colour of the ambiguous target grapheme was the same as J's photism for the digit or letter interpretations of the grapheme. On incongruent trials, the colours of the ambiguous target graphemes were different than the colours of J's photisms for the digit or letter interpretations of the graphemes. On digit-context incongruent trials, the ambiguous graphemes were presented in J's colour for the letter-interpretations of the graphemes, whereas on letter-context incongruent trials, the ambiguous graphemes were presented in J's colours for the digit-interpretations of the graphemes. Thus the same ambiguous grapheme (e.g., a pink 5) served as a congruent stimulus in one context and an incongruent stimulus in another context. J's response times showed that ambiguous graphemes elicited different photisms depending on whether they were interpreted as digits or letters. This finding suggests that it is not the form but the meaning of graphemes (whether they are interpreted as digits or letters) that determines the colours of synaesthetic photisms.

International education and reflection: transition of Swedish and American nursing students to authenticity.

Reflection, a process grounded in distancing from the self to enhance self-awareness, can be used as a pedagogic activity to promote students' transition to a greater authenticity and professionalism and, therefore, improve patient care and nursing practice. In this international educational project (implemented in 2001) using interactive videoconferencing technology (IVC), Swedish and U.S. nursing students and faculty incorporated reflective journaling, drama in education, photolanguage, and off-air meeting discussions to enhance personal and professional development. Highlights from the literature, a description of the project, and student and faculty appraisals are presented.