Trichoderma guizhouense NJAU4742 augments morphophysiological responses, nutrient availability and photosynthetic efficacy of ornamental Ilex verticillata.

Winterberry holly (Ilex verticillata [L.] A. Gray), a deciduous shrub producing glossy bright red berries, is a valuable ornamental and medicinal plant with good market prospects. However, the growth and development of I. verticillata are significantly affected by various stresses, and environmentally hazardous agrochemicals are often used to mitigate them. Trichoderma spp., ubiquitous soil-borne eco-friendly plant growth-promoting fungi, are potent biostimulants and biofertilizers and viable alternatives to agrochemicals for healthy and sustainable agriculture. In this study, the temporal efficacy of different dosages of the filamentous fungus Trichoderma guizhouense NJAU4742 in promoting morphophysiological responses of I. verticillata and the physicochemical properties and enzymatic activities of the substrate were investigated. Different concentrations of the strain T. guizhouense NJAU4742 spore suspension (C [0%], T1 [5%, v/m], T2 [10%, v/m] and T3 [15%, v/m]) were injected in the substrate contained in a pot in which 1-year-old I. verticillata was planted for temporal treatment (15, 45 and 75 days) under open-air conditions. The beneficial effects of T2 and/or T3 treatment for a long duration (75 days) were evident on the different root, aerial and photosynthetic traits; total contents of nitrogen (N), phosphorus (P) and potassium (K) in different tissues and the physicochemical properties of the substrate and its enzymatic activities (urease and invertase). Overall, the study revealed the potency of strain T. guizhouense NJAU4742 as a sustainable solution to improve the growth and development and ornamental value of I. verticillata.

Non-surgical Restoration of L3/L4 Disc Herniation.

We report the case of a 52-year-old Asian man presenting with severe lower back pain and bilateral radiculopathy due to acute L3/L4 disc extrusion, causing severe spinal canal stenosis and bilateral L4 nerve root compression. Following a ten-week conservative management plan consisting of high-velocity, low-amplitude spinal manipulation, adjunctive therapies, and home exercise, the patient experienced significant pain relief, functional improvement, and near resolution of deficits. A six-month follow-up MRI revealed the resolution of the L3/L4 disc extrusion, and the patient remained asymptomatic at nine months. This case highlights the potential for spontaneous resorption of a lumbar disc herniation and symptomatic improvement with conservative management, including chiropractic treatment. A favorable natural course of a disc herniation should be considered when deciding between early surgical intervention and conservative management, warranting further prospective studies to evaluate the effectiveness of chiropractic treatment and the role of spontaneous regression in symptomatic lumbar disc herniation.

North American Yoga Practitioners' Lived Experiences of Mind-Body Connection: A Phenomenological Study.

The practice of yoga was born in India thousands of years ago and brought to North America gradually beginning in the 20th century. The traditional practice of yoga is spiritual in nature with an intention of purifying the mind and body, leading to an alleviation of suffering through connection with the Divine (i.e., liberation). Yoga has gained widespread popularity in North America, but whether North American yoga practice includes an intention on the purification of the mind-body, in contemporary practice often described as a mind-body connection, has yet to be explored. This research study investigated North American yoga practitioners' experiences of mind-body connection in their practices. Six yoga practitioners residing in North America were interviewed for this study. Interviews were audiorecorded and transcribed. Phenomenological analysis was conducted to produce the essence data, and thematic analysis was conducted to produce the contextual data. Phenomenological themes regarding the co-researchers' experiences of mind-body connection in their yoga practices were identified and grouped into four textural essences: (1) the experience of breath, (2) local or internal experiences, (3) an increased sense of awareness and mindfulness, and (4) transcendental and spiritual qualities. Four structural conditions that allow practitioners to experience mind-body connection during yoga practice were identified: (1) breath, (2) physical asana, (3) practitioner intentionality, and (4) environmental conditions. Findings of the current study suggest a capacity for North American yoga practitioners to experience mind-body connection that is essential to traditional yoga practice.

Inhibition of angiotensin II-induced hypertrophy and cardiac dysfunction by North American ginseng (Panax quinquefolius).

We determined whether North American ginseng (Panax quinquefolius L.) mitigates the effect of angiotensin II on hypertrophy and heart failure. Angiotensin II (0.3 mg/kg) was administered to rats for 2 or 4 weeks in the presence or absence of ginseng pretreatment. The effect of ginseng (10 µg/mL) on angiotensin II (100 nM) - induced hypertrophy was also determined in neonatal rat ventricular myocytes. We also determined effects of ginseng on fatty acid and glucose oxidation by measuring gene and protein expression levels of key factors. Angiotensin II treatment for 2 and 4 weeks induced cardiac hypertrophy as evidenced by increased heart weights, as well as the upregulation of the hypertrophy-related fetal gene expression levels, with all effects being abolished by ginseng. Ginseng also reduced abnormalities in left ventricular function as well as the angiotensin II-induced increased blood pressure. In myocytes, ginseng abolished the hypertrophic response to angiotensin II as assessed by surface area and gene expression of molecular markers of hypertrophy. Ginseng modulated angiotensin II-induced abnormalities in gene expression and protein levels of CD36, CPT1M, Glut4, and PDK4 in vivo and in vitro. In conclusion, ginseng suppresses angiotensin II-induced cardiac hypertrophy and dysfunction which is related to normalization of fatty acid and glucose oxidation.

Alcohol extract of North American ginseng (Panax quinquefolius) reduces fatty liver, dyslipidemia, and other complications of metabolic syndrome in a mouse model.

We investigated whether North American ginseng (Panax quinquefolius) could reduce development of the metabolic syndrome phenotype in a mouse model (ETKO) of the disease. Young ETKO mice have no disease but similar to humans start to develop the fatty liver, hypertriglyceridemia, obesity, and insulin resistance at 25-30 weeks of age, and the disease continues to progress with ageing. ETKO mice were orally given an ethanol extract of ginseng roots at 4 and 32 weeks of age. Treatments with ginseng eliminated the ETKO fatty liver, reduced hepatic and intestinal lipoprotein secretion, and reduced the level of circulating lipids. Improvements by ginseng treatments were manifested as a reduction in the expression of genes involved in the regulation of fatty acid and triglyceride (fat) synthesis and secretion by the lipoproteins on one hand, and the stimulation of fatty acid oxidation and triglyceride degradation by lipolysis on the other hand. These processes altogether improved glucose, fatty acid, and triglyceride metabolism, reduced liver fat load, and reversed the progression of metabolic syndrome. These data confirm that treatments with North American ginseng could alleviate metabolic syndrome through the maintenance of a better balance between glucose and fatty acid metabolism, lipoprotein secretion, and energy homeostasis in disease-prone states.

Development and Use of Health-Related Technologies in Indigenous Communities: Critical Review.

BACKGROUND: Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so. OBJECTIVE: The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples. METHODS: Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically. RESULTS: Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent. CONCLUSIONS: A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes.

NMR characterization of novel pyranoanthocyanins derived from the pulp of Panax quinquefolius L. (North American ginseng).

Three major pigments (one natural and two derived) were determined to be present in the berry pulp of Panax quinquefolius L. (North American ginseng). The first was a simple anthocyanin (pelargonidin 3-O-lathyroside) along with two novel pyranoanthocyanins, structurally similar to those recently discovered in Staghorn sumac. The three anthocyanins were structurally characterized using NMR (1 H, gCOSY, gHSQC, gHMBC, TOCSY, ROESY, and 13 C DEPTq135) and High Resolution MS. All three anthocyanins had the disaccharide lathyrose (2-O-(ß-D-xylopyranosyl)-ß-D-galactopyranoside) attached at the 3-O position. In the tradition of naming novel anthocyanin aglycones based on botanical origin, the new pyranoanthocyanin aglycones have been given the common names Panaxidin A (pelaragonidin-4-vinylcatechol) and Panaxidin B (pelargonidin-4-vinylphenol). Copyright © 2015 Her Majesty the Queen in Right of Canada Magnetic Resonance in Chemistry © 2015 John Wiley & Sons, Ltd.

North American ginseng inhibits myocardial NOX2-ERK1/2 signaling and tumor necrosis factor-α expression in endotoxemia.

Sepsis is a systemic inflammatory response to infection with a high mortality but has no specific treatment despite decades of research. North American (NA) ginseng (Panax quinquefolius) is a popular natural health product with anti-oxidant and anti-inflammatory properties. The aim of the present study was to investigate the effects of NA ginseng on pro-inflammatory cytokine expression and cardiac function in endotoxemia, a model of sepsis. Mice were challenged with lipopolysaccharide (LPS) to induce endotoxemia. Myocardial expression of tumor necrosis factor-alpha (TNF-α), a major pro-inflammatory cytokine that causes cardiac dysfunction, was upregulated in mice with endotoxemia, which was accompanied by increases in NOX2 expression, superoxide generation and ERK1/2 phosphorylation. Notably, pretreatment with NA ginseng aqueous extract (50mg/kg/day, oral gavage) for 5days significantly inhibited NOX2 expression, superoxide generation, ERK1/2 phosphorylation and TNF-α expression in the heart during endotoxemia. Importantly, cardiac function and survival in endotoxemic mice were significantly improved. Additionally, pretreatment with ginseng extract inhibited superoxide generation, ERK1/2 phosphorylation and TNF-α expression induced by LPS in cultured cardiomyocytes. We conclude that NA ginseng inhibits myocardial NOX2-ERK1/2-TNF-α signaling pathway and improves cardiac function in endotoxemia, suggesting that NA ginseng may have the potential in the prevention of clinical sepsis.

Screening North American plant extracts in vitro against Trypanosoma brucei for discovery of new antitrypanosomal drug leads.

BACKGROUND: Human African Trypanosomiasis (HAT) is a protozoan parasitic disease caused by Trypanosoma brucei. The disease is endemic in regions of sub-Saharan Africa, covering 36 countries and more than 60 million people at the risk. Only few drugs are available for the treatment of HAT. Current drugs suffer from severe toxicities and require intramuscular or intravenous administrations. The situation is further aggravated due to the emergence of drug resistance. There is an urgent need of new drugs that are effective orally against both stages of HAT. Natural products offer an unmatched source for bioactive molecules with new chemotypes. METHODS: The extracts prepared from 522 plants collected from various parts of the North America were screened in vitro against blood stage trypamastigote forms of T. brucei. Active extracts were further screened at concentrations ranging from 10 to 0.4 µg/mL. Active extracts were also investigated for toxicity in Differentiated THP1 cells at 10 µg/mL concentration. The results were computed for dose-response analysis and determination of IC50/IC90 values. RESULTS: A significant number (150) of extracts showed >90 % inhibition of growth of trypomastigote blood forms of T. brucei in primary screening at 20 µg/mL concentration. The active extracts were further investigated for dose-response inhibition of T. brucei growth. The antitrypansomal activity of 125 plant extracts was confirmed with IC50 < 10 µg/mL. None of these active extracts showed toxicity against differentiated THP1 cells. Eight plants extracts namely, Alnus rubra, Hoita macrostachya, Sabal minor, Syzygium aqueum, Hamamelis virginiana, Coccoloba pubescens, Rhus integrifolia and Nuphar luteum were identified as highly potent antitrypanosomal extracts with IC50 values <1 µg/mL. CONCLUSIONS: Limited phytochemical and pharmacological reports are available for the lead plant extracts with potent antitrypanosomal activity. Follow up evaluation of these plant extracts is likely to yield new antitrypanosomal drug-leads or alternate medicines for treatment of HAT.

The complete chloroplast genome of North American ginseng, Panax quinquefolius.

We report complete nucleotide sequence of the Panax quinquefolius chloroplast genome using next-generation sequencing technology. The genome size is 156 359 bp, including two inverted repeats (IRs) of 52 153 bp, separated by the large single-copy (LSC 86 184 bp) and small single-copy (SSC 18 081 bp) regions. This cp genome encodes 114 unigenes (80 protein-coding genes, four rRNA genes, and 30 tRNA genes), in which 18 are duplicated in the IR regions. Overall GC content of the genome is 38.08%. A phylogenomic analysis of the 10 complete chloroplast genomes from Araliaceae using Daucus carota from Apiaceae as outgroup showed that P. quinquefolius is closely related to the other two members of the genus Panax, P. ginseng and P. notoginseng.

Analysis Grid for Environments Linked to Obesity (ANGELO) framework to develop community-driven health programmes in an Indigenous community in Canada.

Indigenous First Nations people in Canada have high chronic disease morbidity resulting in part from enduring social inequities and colonialism. Obesity prevention strategies developed by and for First Nations people are crucial to improving the health status of this group. The research objective was to develop community-relevant strategies to address childhood obesity in a First Nations community. Strategies were derived from an action-based workshop based on the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. Thirteen community members with wide-ranging community representation took part in the workshop. They combined personal knowledge and experience with community-specific and national research to dissect the broad array of environmental factors that influenced childhood obesity in their community. They then developed community-specific action plans focusing on healthy eating and physical activity for children and their families. Actions included increasing awareness of children's health issues among the local population and community leadership, promoting nutrition and physical activity at school, and improving recreation opportunities. Strengthening children's connection to their culture was considered paramount to improving their well-being; thus, workshop participants developed programmes that included elders as teachers and reinforced families' acquaintance with First Nations foods and activities. The research demonstrated that the ANGELO framework is a participatory way to develop community-driven health programmes. It also demonstrated that First Nations people involved in the creation of solutions to health issues in their communities may focus on decolonising approaches such as strengthening their connection to indigenous culture and traditions. External funds were not available to implement programmes and there was no formal follow-up to determine if community members implemented programmes. Future research needs to examine the extent to which community members can implement programmes on their own and whether community action plans, when implemented, lead to short- and long-term benefits in health outcomes.

American Indians' Family Health Concern on a Northern Plains Reservation: "Diabetes Runs Rampant Here".

OBJECTIVES: The objective was to identify significant family health concerns from the perspective of adult tribal members residing in a reservation setting on the Northern Plains of the United States. Findings were used to cocreate culturally appropriate strategies to address the most significant family health concern. DESIGN AND SAMPLE: A focused ethnography within a participatory framework was employed. An advisory council, comprised of seven tribal members, guided the research team. A purposive sampling technique with a snowball process was used. Twenty-one adult tribal members volunteered to participate. MEASURES: Face-to-face, audio-recorded, semi-structured interviews were conducted and transcribed verbatim. Other data sources included field notes of approximately 100 hours of field work, windshield surveys, and a focus group. Data were analyzed using Spradley's guidelines. RESULTS: The significant family health concern was "diabetes runs rampant here" with inter-related cognitive, emotional, and behavioral responses. These responses were compounded by accumulated emotional trauma from witnessing premature deaths and severe comorbidities associated with diabetes. Contextual factors shaping "diabetes runs rampant here" were identified. CONCLUSION: Holistic approaches are urgently needed in diabetes prevention and management programs. Implications for public health nurses are discussed and recommendations are provided for future research.

Chemical analysis of Panax quinquefolius (North American ginseng): A review.

Panax quinquefolius (PQ) is one of the best-selling natural health products due to its proposed beneficial anti-aging, anti-cancer, anti-stress, anti-fatigue, and anxiolytic effects. In recent years, the quality of PQ has received considerable attention. Sensitive and accurate methods for qualitative and quantitative analyses of chemical constituents are necessary for the comprehensive quality control to ensure the safety and efficacy of PQ. This article reviews recent progress in the chemical analysis of PQ and its preparations. Numerous analytical techniques, including spectroscopy, thin-layer chromatography (TLC), gas chromatography (GC), high-performance liquid chromatography (HPLC), liquid chromatography/mass spectrometry (LC/MS), high-speed centrifugal partition chromatography (HSCPC), high-performance counter-current chromatography (HPCCC), nuclear magnetic resonance spectroscopy (NMR), and immunoassay, are described. Among these techniques, HPLC coupled with mass spectrometry (MS) is the most promising method for quality control. The challenges encountered in the chemical analysis of PQ are also briefly discussed, and the remaining questions regarding the quality control of PQ that require further investigation are highlighted.

Partnering with Indigenous student co-researchers: improving research processes and outcomes.

OBJECTIVE: To examine the contribution of student co-researchers to a community-based participatory Photovoice investigation of Indigenous children's food-related lived experience. We examine co-researchers' contributions to the research process, their role in knowledge co-generation and dissemination, and factors that fostered research partnership with the teenage co-researchers. METHODS: High school students attending a First Nation community school in Canada were trained as research partners. They contributed to aspects of research design, conducted interviews with grades 3 and 4 Photovoice participants, and participated in data analysis and the development of a culturally relevant photobook. The study was initiated by the community's research committee. It is informed by critical consciousness theory and the positive youth development framework. RESULTS: Student co-researchers incorporated culturally appropriate strategies as they interviewed participants. Co-researchers adopted conversational approaches, built rapport by articulating personal and cultural connections, and engaged in mentoring and health promotion as they interviewed participants. They made critical contributions to dissemination by developing photobook content that promoted the importance of traditional foods and the vital role of family and community in healthy eating practices. Relationships and "dialogic" space were important to building partnership with and promoting capacity development among youth co-researchers. CONCLUSIONS: Partnership between university researchers and Indigenous student co-researchers holds great promise for health promotion in communities. Co-researchers developed research and leadership skills, gained understanding of health challenges facing their community, and initiated health and cultural promotion through the project's Photobook. This investigation supports the powerful potential of student co-researchers to meaningfully contribute to research processes and to build knowledge that is relevant and credible both within and outside of their communities. Findings have implications for youth, communities and researchers.

Antioxidant and immunoregulatory activity of alkali-extractable polysaccharides from North American ginseng.

The alkali-extractable polysaccharide (AEP) was isolated from the root of North American ginseng. Two fractions, AEP-1 and AEP-2, were further purified by gel filtration column chromatography. Gas chromatography analysis identified that AEP-1 was composed of Glc, Gal and GalA. And AEP-2 mainly contained Ara, Man, Gal, Glc and GalA. Antioxidant assays indicated that AEP and AEP-2 exhibited significant antioxidant activities in a dose-dependent manner. AEP-2 also exhibited macrophage-activating activity by increasing NO, TNF-α and IL-6 production. The results suggest that AEP-2 could be used as potential antioxidants and immunomodulators.

Antiproliferation activity of Devil's club (Oplopanax horridus) and anticancer agents on human pancreatic cancer multicellular spheroids.

Devil's club (DC, Oplopanax horridus) is an important medicinal herb of the Pacific Northwest which has significant antiproliferation activity against a variety of human tumor cell lines in vitro. This study compared the antiproliferation activity of DC extract alone, and in combination with chemotherapeutic agents gemcitabine (GEM), cisplatin (CDDP), and paclitaxel (PTX) on human pancreatic cancer PANC-1 3D spheroids and 2D monolayer cells. 3D tumor spheroids were prepared with a rotary cell culture system. PANC-1 3D spheroids were significantly more resistant to killing by DC extract, GEM and PTX compared to 2D cells, with IC50 levels closer to that observed in vivo. DC extract significantly enhanced the antiproliferation activity of CDDP and GEM at some concentrations. The bioactive compound identified as a polyacetylene showed strong antiproliferation activity against PANC-1 2D cells and 3D spheroids with IC50 at 0.73±0.04 and 3.15±0.16µM, respectively. 3D spheroids and 2D cells differentially expressed a number of apoptosis related genes. Cell cycle analysis showed that the proportion of cells in S phase was increased and in G2/M phase reduced in 3D spheroids compared to 2D cells. DC extract can potentially be used to enhance the activity of chemotherapeutic agents against pancreatic cancer cells. Use of 3D spheroid model for screening of natural products can potentially increase the efficiency in discovering in vivo bioactive compounds.

Diagnosis and management of Clostridium difficile infection.

Clostridium difficile infection (CDI) is increasing in frequency and severity in and out of the hospital, with a high probability of recurrence after treatment. The recent literature on CDI was reviewed using PubMed to include recent publications dealing with diagnosis and therapy. Real-time polymerase chain reaction is a sensitive and useful diagnostic test for CDI but there are growing concerns of false-positive test results if the rate of CDI is low in the patient population providing samples and/or if the population being studied commonly includes people with C difficile colonization. Recommended therapy of CDI includes oral metronidazole for milder cases of CDI and oral vancomycin or fidaxomicin for more severe cases, each given for 10 days. Colectomy is being performed more frequently in patients with fulminant CDI. For treatment of first recurrences the drug used in the first bout can be used again and for second recurrences longer courses of vancomycin often are given in a tapered dose or intermittently to allow gut flora reconstitution, or other treatments including fidaxomicin may be used. Bacteriotherapy with fecal transplantation is playing an increasing role in therapy of recurrent cases. Metagenomic studies of patients with CDI during successful therapy are needed to determine how best to protect the flora from assaults from antibacterial drugs and to develop optimal therapeutic approaches. Immunotherapy and immunoprophylaxis offer opportunities to prevent CDI, to speed up recovery from CDI, and to eliminate recurrent infection. Humanized monoclonal antitoxin antibodies and active immunization with vaccines against C difficile or its toxins are both in development and appear to be of potential value.

Vitamin D deficiency in a Manitoba community.

OBJECTIVE: Using a cross-sectional survey, to investigate the vitamin D status of a random sample of 80 mother-child pairs (child age 3-24 months) in a Manitoba community with a high incidence of rickets. METHOD: A questionnaire on feeding habits, gestational history, maternal diet and vitamin supplements was administered to mothers in their homes with the assistance of a local interpreter. Venous blood was collected from both mother and child for serum 25-hydroxyvitamin D levels. RESULTS: Of 91% babies initially breastfed, 36% received no formula or milk after weaning and 40% received no vitamin supplements. 24% of mothers took no vitamin supplements during pregnancy and lactation. Knowledge about rickets was poor. In 43% of children and 76% of mothers, serum 25-hydroxyvitamin D levels were below normal range. CONCLUSIONS: Vitamin D levels are low in this population due to lack of fortified dairy products and vitamin D supplements. A public health program should include counseling on rickets and vitamin D supplementation for all infants and pregnant or lactating women.

PIP: In the isolated Island Lake area of northern Manitoba, which has a high incidence of rickets, interviews were conducted with 80 mothers, each with a child at least 2 years old, living in St. Theresa Point and Garden Hill in their homes during June-July 1987 to determine their knowledge and attitudes towards rickets. Nurses obtained blood samples from the women and their young children so the researchers could determine the vitamin D status of both. The mother-child pairs were native Canadians from the Ojibway linguistic group that speaks its own dialect of Ojibway-Cree. Mothers initially breast fed 91% of the children. After weaning, 1/3 of infants received neither infant formula nor milk. No vitamin supplements were given to 40%. Many of the children who did receive vitamin supplements did not receive them regularly. 70% of the mothers did not drink any milk. 24% were milk-intolerant. 24% took no vitamin supplements during pregnancy and lactation. Mothers who did take supplements did not do so regularly. 17% claimed that their skin was sensitive to sunlight. 84% of mothers in one community had never heard of rickets. Most did not know its cause. Neither mothers nor the children were exposed to the sunlight in the summer. When outside, almost all small infants were completely covered to protect them from the elements. The mean 25-hydroxy-vitamin D level was 26.2 nmol/l for the children and 19.8 nmol/l for the mothers. 43% of children and 76% of mothers had a 25-hydroxy-vitamin D level below the normal range. These high levels of vitamin D insufficiency were even more troublesome given that the blood was taken in late June and July when vitamin D levels would be likely to be at their highest. The dearth of vitamin D fortified dairy products and vitamin supplements greatly contributed to the low level of vitamin D status in this area. The findings show a need for public health officials to include education on rickets and vitamin D supplementation for all infants and pregnant or lactating women.

Cultural beliefs and teenage pregnancy.

The influence of cultural variables on teenage pregnancy is not clearly understood. In-depth interviews with 20 Native American Indian, 17 black and 18 white teenage women indicated intercultural differences in beliefs about: (1) prevention of pregnancy, (2) significance of becoming a mother at an early age and (3) kinds of support systems available to them within their social network. The implications of these differences for nursing care include recognition and acceptance of intercultural differences and support of a decision-making model of pregnancy prevention for teenagers that incorporates diverse belief systems.

PIP: The rate of teenage pregnancy continues to rise despite increased access to contraception and sex education programs for teenagers. 35% of sexually active female teenagers become pregnant before age 19; 59% of those pregnant teenagers continue their pregnancies through delivery. Approximately 90% of adolescent mothers in the US keep their babies. Adolescent pregnancy is a multifaceted problem with grave consequences involving a higher incidence of physical risks to mother and infant and the potential for longterm detrimental psychological and sociological effects on infant and parents. Based on the assumption that beliefs have a powerful influence on behavior, data were gathered from urban pregnant teenagers regarding their beliefs related to pregnancy and its prevention. In depth interviews were conducted with 20 Native American Indian women (1/2 from an upper Midwestern city and 1/2 from a city in the Pacific Northwest). 18 white and 17 black women from the same Pacific Northwest city were also interviewed. Certain patterns emerged that indicated intercultural differences in the group. The areas of difference included beliefs about prevention of pregnancy and contraception, significance of being a mother at an early age, and kinds of support systems available within their social network. These beliefs were influential in their becoming pregnant as well as during their pregnancy. All of the young women were knowledgeable about contraceptives and their availability. Beliefs about them and when they should be used, and how they worked varied among the 3 cultural groups. American Indian women did not believe contraception should be used until after the 1st baby was born. The black teenager believed that contraception was appropriate, but birth control pills and IUDs were unacceptable because they altered the menstrual cycle and thus would cause illness. Beliefs of the white women stemmed from their religious backgrounds. The American Indian women believed that within their culture, high value was placed on early pregnancy and becoming pregnant validated one's feminine role. Black women did not perceive negative sanctions within their culture if they did not meet the ideal norm of education followed by employment and marriage and children. Becoming a mother at a young age, although not highly desirable, had a fairly high level of acceptance. The white women believed that pregnancy at a young age was undesirable. When the background of the client and the practitioner differ, practitioners must be aware of folk beliefs to allow open communication. When these beliefs are assessed and incorporated into a care plan, a more effective program for pregnancy prevention will result.

Evaluation of lactational performance of Navajo women.

The effect of suboptimal maternal nutrition on lactational performance of 23 Navajo women was studied in terms of milk volume, milk composition, and infant growth. The mean milk volume produced by 10 Navajo women was 634 +/- 113 mg/24 h after approximately 1 month of lactation. The content of protein, lactose, and lipid were within normal limits. Retinol and carotene content were 32.9 +/- 15.7 and 19.7 +/- 6.3 microgram/dl, respectively. Milk folacin averaged 56.4 +/- 23.9 mg/ml. The mean contents of zinc, iron, and copper were 2.8 +/- 1.1, 0.8 +/- 0.6, and 0.3 +/- 0.2 mg/l, respectively. Despite evidence of suboptimal nutriture among these Navajo women, lactational performance was adequate in terms of infant growth, milk volume, and milk composition with the exception of vitamin A which was lower than normal.

PIP: The effect of suboptimal maternal nutrition on lactation performance of 23 Navajo women, age range 16 to 23 years, was investigated in terms of milk volume, milk composition, and infant growth. All of the women were in full lactation on the day of assessment, which varied from day 19 to 62 of lactation. 10 mothers agreed to the 24-hour test weighing session. Milk samples (n = 23) were expressed manually or extracted with a manual pump between 12:00 and 4:00 p.m. Maternal and infant health since hospital discharge were reviewed by a questionnaire. The mean milk volume produced by 10 Navajo women was 634 + or - 113 ml/24 hours after approximately 1 month of lactation. The content of protein, lactose, and lipid were all within normal limits. Retinol and carotene content were 32.9 + or - 15.7 and 19.7 + or - 6.3mc/dl, respectively. Milk folacin averaged 56.4 + or - 23.9 ng/ml. The mean contents of zinc, iron, and copper were 2.8 + or - 1.1, 0.8 + or - 0.6, and 0.3 + or - 0.2 mg/1, respectively. The mean rate of infant growth was 35.9 g/day. The rate of weight gain between birth and 1 month of age corresponded to the 75th percentile of the Iowa growth standards for females and to the 90th percentile for males. There were a few episodes of fever, diarrhea, and colds. The 1st month of life presented no grave problems for the infants. In sum, despite evidence of suboptimal nutriture among this group of Navajo women, lactational performance was adequate in terms of infant growth, milk volume, and milk composition with the exception of viatmin A which was lower than normal.