Heart health for South Asians: improved cardiovascular risk factors with a culturally tailored health education program.

BACKGROUND/AIM: The Kaiser Permanente (KP) Northern California Heart Health for South Asians (HHSA) Program is a two-hour educational class that provides culturally relevant lifestyle and dietary recommendations to South Asian (SA) patients, in an effort to reduce their known disproportionate burden of cardiovascular (CV) disease. We evaluated the impact of the HHSA Program on CV risk factors and major adverse CV events (MACE). METHODS: A retrospective cohort study identified 1517 participants of SA descent, ≥ 18 years old from 2006 to 2019. We evaluated the change in risk factors with program attendance (median follow up of 6.9 years) for systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), LDL, HDL, BMI, and HbA1c. We also performed a propensity matched analysis to evaluate differences in MACE including stroke, myocardial infarction (MI), coronary revascularization, and all-cause mortality. RESULTS: There were significant improvements in DBP, TG, LDL-c, HDL-c, BMI, and HbA1c at one year follow up and sustained improvements in DBP (-1.01mmHg, p = 0.01), TG (-13.74 mg/dL, p = 0.0001), LDL-c (-8.43 mg/dL, p = < 0.0001), and HDL-c (3.16 mg/dL, p = < 0.0001) levels at the end of follow up. In the propensity matched analysis, there was a significant reduction in revascularization (OR 0.33, 95% CI 0.14-0.78, p = 0.011) and mortality (OR 0.41, 95% CI 0.22-0.79, p = 0.008), and a trend towards reduction in stroke. CONCLUSIONS: Our study demonstrates the efficacy of a culturally tailored SA health education program in improving CV risk factors and reducing MACE. The program highlights the importance and value of providing culturally tailored health education in primary CV disease prevention.

Habituation of hissing by Madagascar hissing cockroaches (Gromphadorhina portentosa): evidence of discrimination between humans?

Anecdotal reports suggest that insects can be "tamed" with frequent human contact. In the present experiment, repeated handling of Madagascar hissing cockroaches by the same person resulted in habituation of the hissing response in ten of 12 subjects. These subjects were then handled by a novel person in order to determine whether habituation might be specific to a particular human. Four of ten "habituated" subjects immediately began to hiss in the presence of the novel handler, but again ceased hissing when contact with the familiar person was reestablished. Our results suggest that in some cases "taming" may be person-specific, rather than a generalized response to humans. These preliminary findings are the first evidence of discrimination between humans by an insect species, although comparable results are well documented in mammals and birds.

Prediction and preparation: Pavlovian implications of research animals discriminating among humans.

A growing body of evidence suggests that animals of various species can discriminate among the humans with whom they have regular contact. This discriminative ability has considerable implications for research. Because animal life is hedonistic, there is a strong incentive for animal subjects to predict the events that bring them pleasure and pain. Many research settings attempt to deliver hedonic stimuli under strictly regulated conditions without formal warning. Nevertheless, the possibility remains that the presence of a particular human may signal delivery of an important event, thus allowing the animal to prepare for its occurrence. In Pavlovian terms, humans become walking conditioned stimuli, eliciting measurable conditioned responses from animal subjects. These preparatory responses may take behavioral, physiological, and/or motivational forms and modulate the effects of the variables under study. The discussion addresses practical implications of knowing that discrimination among humans by animal subjects may affect one's research agenda.