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ABSTRACTObjectivesThe goal of this study was to develop and evaluate an intervention aimed at increasing cognitive empathy, improving mental health, and reducing inflammation in dementia caregivers, and to examine the relevant neural and psychological mechanisms.MethodsTwenty dementia caregivers completed an intervention that involved taking 3–5 daily photographs of their person living with dementia (PLWD) over a period of 10 days and captioning those photos with descriptive text capturing the inner voice of the PLWD. Both before and after the intervention, participants completed questionnaires, provided a blood sample for measures of inflammation, and completed a neuroimaging session to measure their neural response to viewing photographs of their PLWD and others.Results87% of enrolled caregivers completed the intervention. Caregivers experienced pre- to post-intervention increases in cognitive empathy (i.e. Perspective-Taking) and decreases in both burden and anxiety. These changes were paralleled by an increased neural response to photographs of their PLWD within brain regions implicated in cognitive empathy.ConclusionThese findings warrant a larger replication study that includes a control condition and follows participants to establish the duration of the intervention effects.Clinical ImplicationsCognitive empathy interventions may improve caregiver mental health and are worthy of further investigation.

ABSTRACTEpigenetic clocks quantify regular changes in DNA methylation that occur with age, or in relation to biomarkers of ageing, and are strong predictors of morbidity and mortality. Here, we assess whether measures of fetal nutrition and growth that predict adult chronic disease also predict accelerated biological ageing in young adulthood using a suite of commonly used epigenetic clocks. Data come from the Cebu Longitudinal Health and Nutrition Survey (CLHNS), a long-running cohort followed since birth in metropolitan Cebu, Philippines. Past work has shown that birth weight (BW) and the mother’s arm fat during pregnancy (a measure of pregnancy energy status) relate inversely to health outcomes in the CLHNS but primarily in males. Genome-wide DNA methylation was assessed in whole blood using the Infinium EPIC array. Participants included males (n=895) and females (n=803) measured in 2005 (20.8–22.5 years). Clocks included the Hannum and Horvath clocks trained on chronological age, the DNAmPhenoAge and DNAmGrimAge clocks trained on clinical biomarkers, the Dunedin pace of ageing (DunedinPACE) clock trained on longitudinal changes in ageing biomarkers, and the DNAmTL clock trained on leukocyte telomere length. In males, lower BW predicted advanced biological ageing using the Hannum, DNAmPhenoAge, DunedinPoAm, and DNAmTL clocks. In contrast, BW did not predict any clock in female participants. Participants’ mothers’ pregnancy arm fat only predicted DNAmTL in males. These findings suggest that epigenetic clocks are a useful tool for gauging long-term outcomes predicted by fetal growth, and add to existing evidence in the CLHNS for sex differences in these relationships.

Background: Inflammation may be an important mediator of the association between nutrition and cardiovascular diseases, but most studies have been conducted in Western populations with high rates of overweight and obesity and low levels of infectious disease. Objectives: This study sought to investigate the predictors of C-reactive protein (CRP) in young adults living in the Philippines and to examine patterns of association with adiposity compared with young adults in the United States. Design: Maximum likelihood logistic regression models were used to predict elevated high-sensitivity CRP (>3 mg/L) in relation to anthropometric measures of adiposity, symptoms of infectious disease, and proxy measures of pathogen exposure in men and women from the Philippines (n = 1648; age: 20-22 y). Comparative data were drawn from a nationally representative sample in the United States (National Health and Nutrition Examination Survey; n = 616; age: 19-24 y). Results: Median concentrations of CRP were substantially lower in the Philippines (0.2 mg/L) than in the United States (0.9 mg/L), and the likelihood of elevated CRP was lower in the Philippines than in the United States at the same level of waist circumference or skinfold thickness. In the Philippines, infectious symptoms and pathogen exposure predicted elevated CRP, independent of adiposity. Conclusions: Adiposity and infectious exposures are associated with elevated CRP in the Philippines; other populations undergoing comparable lifestyle and dietary changes associated with increasing rates of overweight and obesity are likely experiencing similar double burdens of inflammatory stimuli. Low concentrations of CRP in this Philippine sample raise the question of whether CRP cutoffs based on European or European-American reference populations are appropriate for predicting disease risk in populations undergoing the nutrition transition.

AbstractEarly nutritional and growth experiences can impact development, metabolic function, and reproductive outcomes in adulthood, influencing health trajectories in the next generation. The insulin-like growth factor (IGF) axis regulates growth, metabolism, and energetic investment, but whether it plays a role in the pathway linking maternal experience with offspring prenatal development is unclear. To test this, we investigated patterns of maternal developmental weight gain (a proxy of early nutrition), young adult energy stores, age, and parity as predictors of biomarkers of the pregnancy IGF axis (n= 36) using data from the Cebu Longitudinal Health and Nutrition Survey in Metro Cebu, Philippines. We analyzed maternal conditional weight measures at 2, 8, and 22 years of age and leptin at age 22 (a marker of body fat/energy stores) in relation to free IGF-1 and IGFBP-3 in mid/late pregnancy (mean age = 27). Maternal IGF axis measures were also assessed as predictors of offspring fetal growth. Maternal age, parity, and age 22 leptin were associated with pregnancy free IGF-1, offspring birth weight, and offspring skinfold thickness. We find that free IGF-1 levels in pregnancy are more closely related to nutritional status in early adulthood than to preadult developmental nutrition and demonstrate significant effects of young adult leptin on offspring fetal fat mass deposition. We suggest that the previously documented finding that maternal developmental nutrition predicts offspring birth size likely operates through pathways other than the maternal IGF axis, which reflects more recent energy status.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2010.08.002 Byline: Ann E.B. Borders (a)(b), William A. Grobman (a)(b), Laura B. Amsden (b), Thomas W. McDade (c), Lisa K. Sharp (d), Jane L. Holl (b)(e) Keywords: biomarker; C-reactive protein; Epstein-Barr virus; stress Abstract: The purpose of this study was to determine whether there is an association between self-reported and biologic measures of stress in low-income, reproductive-age women. Author Affiliation: (a) Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Northwestern University, Chicago, IL (b) Institute for Healthcare Studies, Northwestern University, Chicago, IL (c) Department of Anthropology, Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, College of Medicine, University of Illinois at Chicago, Chicago, IL (d) Section of Health Promotion Research, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL (e) Children's Memorial Hospital, Chicago, IL Article History: Received 11 March 2010; Revised 12 June 2010; Accepted 9 August 2010 Article Note: (footnote) Supported by National Institutes of Health/National Institute of Child Health and Human Development Grant no. 1 K12 HD050121-02; the National Institute of Child Health and Human Development (R01HD39148); the John D. and Catherine T. MacArthur Foundation; the Joyce Foundation; and a Women's Reproductive Health Research Program a National Research Service Award postdoctoral fellowship at the Institute for Healthcare Studies under an institutional award (5 T32 HS000078-08) from the Agency for Healthcare Research and Quality (A.E.B.B.)., Cite this article as: Borders AEB, Grobman WA, Amsden LB, et al. The relationship between self-report and biomarkers of stress in low-income reproductive-age women. Am J Obstet Gynecol 2010;203:577.e1-8.

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Background: Recently, researchers have considered the fetal and infant origins of several adult cardiovascular and metabolic diseases, but the implications of early events for immune function and infectious disease are unclear. Objective: We investigated the association between prenatal undernutrition and immunocompetence in adolescence and hypothesized that intrauterine growth retardation is associated with a lower likelihood of mounting an adequate antibody response later in life. Design: A subsample of one hundred three 14-15-y-olds was recruited from an ongoing longitudinal study in which data collection began while participants were in utero. A typhoid vaccine was given, and anti-typhoid antibodies were measured 2 wk and 3 mo later as a functional marker of immunocompetence. The likelihood of mounting an adequate antibody response was compared for adolescents who were small for gestational age or appropriate for gestational age at birth while controlling for a range of postnatal exposures. Results: The predicted probability of mounting a positive antibody response for adolescents who were prenatally and currently undernourished was 0.32, compared with probabilities of 0.49-0.70 for adequately nourished adolescents (P = 0.023). Diarrhea in the first year of life (P = 0.009) and fast weight gain during the first 6 mo (P = 0.003) were also associated with a higher probability of response. Conclusions: These findings extend the concept of fetal and early infant programming of adult diseases to the immune system and suggest that early environments may have long-term implications for immunocompetence and infectious disease risk, particularly in developing countries. KEY WORDS Prenatal exposure, immune system, growth and development, infantile diarrhea, vaccine, nutrition, adolescents

While research now consistently links consumer financial debt with adverse emotional health outcomes, specific forms of debt and their impact on measures of physical health are underexplored. This gap in knowledge is significant because different forms of loans and debt may have different experiential qualities. In this paper, we focus on a type of unsecured debt - short-term/payday loan borrowing – that has risen dramatically in recent decades in the United States and is characterized by predatory, discriminatory, and poorly regulated lending practices. Using data from a study of debt and health among adults in Boston, MA (n=286), we test whether short-term borrowing is associated with a range of emotional and physical health indicators. We find that short-term loans are associated with higher body mass index, waist circumference, C-reactive protein levels, and self-reported symptoms of physical health, sexual health, and anxiety, after controlling for several socio-demographic covariates. We discuss these findings within the contexts of regulatory shortcomings, psychosocial stress, and racial and economic credit disparities. We suggest that within the broader context of financial debt and health, short-term loans should be considered a specific risk to population health.

Racial discrimination is an important predictor of racial inequities in mental and physical health. Scholars have made progress conceptualizing and measuring structural forms of racism, yet, little work has focused on measuring structural racism in social contexts, which are especially relevant for studying the life course consequences of racism for health. Using the National Longitudinal Study of Adolescent to Adult Health, we take a biosocial, life course approach and develop two life stage-specific indices measuring manifestations of structural racism in school contexts in adolescence, a sensitive period of development. The first is a school contextual disadvantage index (CDI), which captures differences in resources and opportunities across schools that have been partly determined by socio-historic structural racism that has sorted Black students into more disadvantaged schools. The second is a school structural racism index (SRI), which measures differences in resources and opportunities between Black and white students within schools. Then, we relate these indices to adolescent depressive symptoms. We find that among both Black and white students of both genders, higher CDI levels are associated with more depressive symptoms. However, Black students are twice as likely to be in schools with a CDI above the median compared to white students. We also find that, controlling for the CDI, the SRI is positively associated with depressive symptoms among Black boys and girls only. Finally, the CDI and the SRI interact to produce a pattern where the likelihood of depressive symptoms increases as the SRI increases, but only among Black boys and girls in low-disadvantage schools. These findings underscore the importance of measuring structural racism in social contexts in multifaceted ways to study life course health inequities.

No one surpasses the U.S. bishops when it comes to working for quality education for all, and especially the most vulnerable and poor. The history of Catholic schools in this [...]

The aim of this study was to examine whether health-related self-protection (e.g., using positive reappraisals or avoiding self-blame) prevents lonely older adults from exhibiting increases in diurnal cortisol secretion and higher levels of C-reactive protein (CRP).

Anthropologists, conservation biologists, and psychologists have generally found a long-term (secular) decline of ethnobotanical knowledge among indigenous people. To estimate such knowledge loss, researchers have typically relied on a single cross-sectional data set to (a) measure knowledge among people of different ages, (b) compare measures between ages, and (c) infer a loss of knowledge if the old knew more than the young. We improve on the approach by simultaneously controlling for cohort effects and age effects—the first refers to the effect of the birth period and the second refers to the effect of the life cycle (or aging). Failure to simultaneously control for both effects may produce the misleading impression that the old know more than the young, and the conclusion that the difference reflects a secular loss of knowledge when in fact it may reflect different positions in the life cycle. We use data collected during 2005 from a native Amazonian society of foragers-farmers in Bolivia (Tsimane') to estimate secular changes in knowledge. Participants included 269 women and 287 men (age ≥20) born 1920-1985. We equate knowledge with theoretical knowledge of useful plants and use cultural consensus to measure knowledge. Multiple regressions were used with knowledge as an outcome and age, birth decade, schooling, and sex as explanatory variables. We find no significant secular change in knowledge in the main analysis, but results were sensitive to (a) the definition and domain of ethnobotanical knowledge and (b) the sample. In the sensitivity analysis we find evidence of a secular increase in knowledge, consistent with the view that knowledge is dynamic and changes.

Researchers often need to know the parental school attainment of adult subjects. When researchers cannot ask parents about their school attainment, they must ask adult offspring about the school attainment of their parents. We assess the accuracy of answers provided by adults about the school attainment of their parents with data from a native Amazonian society in Bolivia (Tsimane'). Offspring overestimate the school attainment of their parents. They also report inaccurately other human capital attributes of their parents (e.g., writing skills, fluency speaking Spanish, practical indigenous knowledge of medicinal plants). Results mesh with findings from the United States about the lack of reliability of adults' self-reports about parental school attainment and with prior research among the Tsimane' suggesting significant misreporting of other outcomes (e.g., age, income, parental height).

We review 34 quantitative studies that have measured individual-level variations in ethnobotanical knowledge, analyzing how those studies have conceptualized and operationalized ethnobotanical knowledge. We found that this type of research is recent but growing, and is concentrated in indigenous peoples of developing countries. We also found that studies differ on how they conceptualize and measure individual ethnobotanical knowledge. As it is the case in other interdisciplinary research, the lack of conceptual consistency and comparable data limit the inferences that can be drawn from empirical analyses of ethnobotanical knowledge. Future research should 1) validate the consistency of measures of individual ethnobotanical knowledge; 2) analyze the reliability of data generated by the different methods developed so far; and 3) address the relationship between the various dimensions of ethnobotanical knowledge. Studies of individual ethnobotanical knowledge have the potential to contribute to a systematic understanding of humanity's most widespread and ancient form of knowledge.

Leptin is important in a wide range of physiological processes, but logistical constraints associated with venipuncture blood collection have limited research on leptin in diverse, community‐based settings. The aim of this short report is to present and validate an enzyme immunoassay method for quantifying leptin in samples of capillary whole blood collected from a simple finger prick and dried on filter paper. The method was evaluated through analysis of precision, reliability, stability, and comparisons with matched plasma and blood spot samples. We report acceptable levels of assay precision and reliability, and good agreement between results obtained from matched plasma and blood spot samples (r = 0.976, P< 0.001). Leptin concentrations begin to deteriorate after only 3 days at room temperature. Thus, care should be taken to refrigerate or freeze samples promptly. The relative ease of blood spot sample collection may facilitate research on leptin in a wider range of cultural and ecological settings. Am. J. Hum. Biol. 18:857–860, 2006. © 2006 Wiley‐Liss, Inc.

C-reactive protein (CRP) is emerging as an important predictor of cardiovascular disease (CVD), and chronic inflammation may be a mechanism through which stress affects disease risk. We investigated the contribution of behavioral and psychosocial factors to variation in CRP concentrations in a population-based sample of middle-aged and older adults.

There is compelling evidence to suggest that early environments are important determinants of immune function over the life course. While current research focuses on proximate mechanisms and clinical implications, an adaptationist perspective may contribute a theoretical basis for explaining, rather than merely describing, the long‐term impact of early environments. Life history theory in particular, with its emphasis on the life cycle and investment in maintenance effort—of which immune function is a central component—provides a predictive framework for identifying prenatal and early postnatal factors that are likely to shape immunity. Key life history issues at these stages include avoiding death from infectious disease, investing in immune defenses that are appropriate for the local disease ecology, and optimizing competing demands for investment in immune function and growth. A series of hypotheses derived from these issues are proposed and evaluated with data from ongoing research in the Philippines and Bolivia. Ecologically‐informed research on immunity is in its earliest stages, and life history theory has the potential to make important contributions to our understanding of the development and function of this critical physiological system. Am. J. Hum. Biol. 17:81–94, 2005. © 2004 Wiley‐Liss, Inc.

The purpose of this study was to examine the context of iron deficiency and feeding patterns of iron-rich foods among northern Kenyan school-aged children. A nutrition survey was conducted among 300 subjects in two Rendille communities, Korr and Karare. The objectives were to determine the prevalence of iron deficiency as it relates to parasitic infection, dietary intake, and sociodemographic factors, as well as cultural food proscriptions influencing child feeding. Sociodemographic and qualitative data on food beliefs and child-feeding practices were obtained from the primary caretaker of each subject. From pediatric subjects, 24-hour dietary recall data were obtained with the help of the primary caretaker, and capillary blood from a fingerstick was used to detect iron deficiency based on measures of hemoglobin, the zinc protoporphyrin-to-heme ratio, C-reactive protein, and transferrin receptor. With an overall prevalence of 31.2%, iron deficiency was found to be associated with dietary iron intakes constrained by diverse economic, cultural, and environmental factors among Rendille children. In Karare, where children's iron intake approached recommended levels, iron deficiency was found to be attributable to low bioavailability of iron (only 4.3% of total iron intake), rather than low dietary intake per se. By contrast, in Korr the average daily iron intake was estimated at only 65% of recommended allowances, indicating that iron deficiency was the outcome not merely of low bioavailability, but rather of overall inadequate iron intake. Sociodemographic analysis showed a significant interaction between sex and economic status, revealing that girls in economically sufficient households were 2.4 times as likely to have iron deficiency as boys. This difference in risk parallels culturally defined gender-based proscriptions for child feeding: girls are believed to benefit from “soft foods,” including rice, maize porridge, and tea, whereas boys benefit from “hard foods,” including meat, blood, and beans. Consequently, in households economically able to purchase iron-rich foods, these foods are being preferentially fed to boys. Economic development may result in improved iron status for boys, but it will be unlikely to benefit girls in the absence of a dietary modification intervention. A modification of culturally acceptable “soft foods” to include iron-rich foods may provide a sustainable approach to controlling and preventing iron deficiency in this population.

In Samoa, the presence of a matai title in the family has historically been a valued source of social status. However, as the process of Westernization continues, new sources of social status are emerging. This study explores the degree to which new and old markers of social status agree—or disagree —and the consequences they have for the experience of stress in 329 Samoan adolescents. The study integrates cultural and biological methods and data, and measures an aspect of immune function (antibodies against the Epstein‐Barr virus) as a biomarker of psychosocial stress. Results indicate that status "incongruent" adolescents experience significantly more stress (indicated by reduced immune function), and that emerging markers of social status are becoming inextricably linked to "traditional" markers in such a way that discordance between them is a significant source of stress. This study proposes new conceptual models for future studies of culture change and suggests that biomarkers may represent ethnographic tools that can provide insight into hidden cultural dynamics and the experience of stress, [status inconsistency, Westernization, psychoneuroimmunology, adolescence, South Pacific]

Abstract: Lactation constitutes a major focus for research in international health because of its dramatic impact on child survival; evolutionary biology has investigated lactation as an important aspect of parenting strategy, with implications for understanding parent-offspring conflict. These perspectives are brought together in an attempt to develop integrated models for an issue of key international health concern: the duration of exclusive breast-feeding and the timing of weaning. This analysis highlights the relevance of evolutionary theory for practical problems in public health, and it suggests the utility of public health outcomes for addressing evolutionary questions.

This study was designed to pursue three objectives: 1) investigate the impact of culture change on children and adolescents in Western Samoa; 2) introduce a cross‐cultural perspective to studies of psychosocial stress and immune function; and 3) evaluate the utility of minimally invasive methods for assessing immune function. Seven hundred sixty individuals between the ages of 4 and 20 years were recruited from three distinct geographic regions within Western Samoa that differ in degree of westernization. Finger prick samples of whole blood were collected from each individual and analyzed for antibodies against the Epstein‐Barr virus (EBV; an indirect marker of cell‐mediated immune function) and C‐reactive protein (a nonspecific marker of current infection). After controlling for age, sex, and current infection, EBV antibody levels were significantly elevated in urban Apia and rural Upolu, indicating lower levels of cell‐mediated immune function. The results suggest a higher degree of psychosocial stress in these regions, possibly due to exposure to westernizing influences. Am. J. Hum. Biol. 12:792–802, 2000. © 2000 Wiley‐Liss, Inc.

Evolutionary principles inform central design features of human immune defenses and provide key insights into this complicated host defense system. This article explores the selection pressures and adaptive responses that have elaborated the immune system over the course of evolution and discusses their implications for understanding contemporary immune development and function. Special attention is given to the challenges posed by diverse, rapidly evolving pathogens and the mammalian response to these challenges. The process of lymphocyte diversity generation and subsequent clonal selection is quintessentially Darwinian: pathogens provide selection pressure that drives differential replication of host immune cell lines, resulting in changes in genetic frequencies within an individual's population of lymphocytes. The immune system also incorporates nongenetic transgenerational processes in the transfer of antibodies from mother to offspring through the placenta and breast milk. The consequences of these observations for human development, health, and the ecology of immune function are considered throughout the life cycle. Specifically, evolutionary processes provide insight into autoimmunity, thymic function, lymphocyte development, infectious disease risk, and lactation. While much work in evolutionary medicine focuses on the discordance between evolved biology and rapidly changing cultural environments, with respect to the immune system, evolutionary processes may be most revealing when applied within individuals. Am. J. Hum. Biol. 11:705–717, 1999. © 1999 Wiley‐Liss, Inc.

Benign prostatic hyperplasia (BPH) is clinically diagnosed in approximately three-fourths of American men, a prevalence two to three times higher than that currently reported in Scotland and Japan. Prostatectomy is the most common operation performed on American men over 65. A critical medical anthropological analysis reveals that American urologists rely on prostatectomy to maintain their practices, and the growth of urology as a specialty is significantly related to the 50% increase in the rate of surgery since 1965. Marketing campaigns and studies funded by pharmaceutical companies promote the perception of urinary difficulties as problematic, encourage men to medicalize their symptoms, and create demand for drug therapy and urologist treatment. The social construction of BPH as a progressive age-related disorder and the profit orientation of American medicine account for the elevated prevalence of BPH.

Elevated circulating levels of total immunoglobulin E (IgE) are associated with both allergic disease and repeated macro‐parasitic infections. Population‐based research on IgE has been limited by the logistical constraints associated with obtaining and processing venipuncture blood samples. In this short report, we present an enzyme immunoassay protocol for quantifying circulating total IgE levels in capillary whole blood, collected from a finger prick and dried on filter paper. The assay demonstrated acceptable levels of accuracy, precision, and reliability. IgE remained stable at room temperature for only 2–4 days and degraded rapidly at higher temperatures suggesting that samples should be refrigerated or frozen within 1–2 days of collection. It is hoped that the relative ease of blood spot collection will expand opportunities for population‐based research on IgE.Am. J. Hum. Biol. 19:440–442, 2007. © 2007 Wiley‐Liss, Inc.

The poem "The New World" by Thomas M. McDade is presented. First Line: Stained glass; Last Line: Stained glass.

Presents the poem "Badmouthing Big Bill," by Thomas Michael McDade. First Line: When Robinson had me patching; Last Line: coat with tails.

The article presents the poem "Richard Hugo, April 6th, 1978," by Thomas Michael McDade. First Line: The reading was in the Oak Room; Last Line: like an errant bomb.

Presents the poem "Cold Cuts," by Thomas Michael McDade.

Presents the poem "Money, Confederate and Funny," by Thomas Michael McDade.