Relationship between poverty and health among adolescents

Although the effect of low socioeconomic status on the health of adolescents has been documented, the mechanism by which this occurs is not well understood. Furthermore, improving adolescent health through public health policy typically requires the presence of one or more modifiable risk factors which can be targeted for intervention. In spite of the well-documented negative associations between poverty and health, few modifiable risk factors have been identified. This study used the Evans-Stoddart Model of Health and Well-Being as a framework to examine data on 1,759 adolescents, aged 12 to 19, collected as part of the 1994 National Population Health Survey. Results not only confirm the relationship between income and health, but suggest how the pathway operates through the social environment, lifestyle differences, access to health care, and a reduced sense of self-esteem and self-mastery. Bivariate and multivariate analyses found positive associations between physical activity levels and self-esteem and mastery. We interpret these findings as preliminary evidence that it might be possible to buffer the impact of poverty on health through policies which increase physical activity levels among those living in poverty. Such policies could also include a secondary goal of increasing the activity levels among inactive adolescents who are not living in poverty, as they will derive benefits from this increase, both psychologically and physiologically.     

Perceptions of another person's heavy drinking as a function of one's relationship to the drinker a pilot study

Of 301 participants in a telephone survey, 201 could identify a problem drinker within their social networks. In 67 cases the drinker was a partner, in 45 another family member, in 61 a friend, and in 28 a work colleague. Another person's heavy drinking was reported as most disrupting to one's life when that person was a partner or other family member or if one was living in the same residence as the drinker. The exception to this was that reported disruption to respondents' work life was greatest when the drinker was a work colleague. While there appear to be problems for friends and work colleagues, partners and other family members appear to report the most disruption so providing services to family members seems appropriate.     

On the relation between maternal state of mind and sensitivity in the prediction of infant attachment security

Attachment theorists assume that maternal mental representations influence responsivity, which influences infant attachment security. However, primary studies do not support this mediation model. The authors tested mediation using 2 mother-infant samples and found no evidence of mediation. Therefore, the authors explored sensitivity as a moderator, studying the (a) interaction of mental representation and sensitivity as it predicts infant attachment security and (b) level of sensitivity in mothers whose infants' attachment security is either concordant or discordant with their own. The interactional analyses were not significant. But the match-mismatch data showed that when mother-infant attachment strategies were discordant, maternal sensitivity was more consistent with infant than maternal attachment strategy. These findings are congruent with an interpretation of sensitivity as a moderator that can block transmission of attachment strategy.     

Validity and reliability of the audit and CAGE-AID in Northern Plains American Indians

According to the Indian Health Service, substance abuse and Type 2 diabetes are serious problems among Native Americans. To assess substance use in a medical setting, valid screening tests are needed so the Alcohol Use Disorders Identification Test (AUDIT), a simple brief screen for excessive drinking, and the CAGE-adapted to Include Drugs (CAGE-AID) for identifying primary care patients with alcohol and drug disorders were given 50 Northern Plains American Indians with diabetes. Both are short, easy to administer, have good sensitivity and specificity, and can be easily incorporated into a medical history protocol or intake procedure. Reliability coefficients were above .90 and appeared to have sufficient concurrent and divergent validity indicated by moderate correlations with the General Well-being Schedule (rs=-.39 and -.36), the Family-Adaptation, Partnership, Growth, Affection, & Resolve (r =-.47 and -.36), and the Beck Depression Inventory-IT (r = .36 and .29).     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Test-retest reliability of the Holyoake Codependency Index with Australian students

The Holyoake Codependency Index is a 13-item self-report measure of three aspects of codependency: External Focus, Self-sacrifice, and a sense of being overwhelmed by another person's problematic behavior (termed Reactivity). Previous studies have supported internal validity and the internal consistency and construct validity of the subscales. The present scores for 59 students indicate full scale test-retest reliability of .88 and for subscales (.76 to .82) over a 3-wk. interval.     

Clinical Implications for Supporting Caregivers at the End-of-Life: Findings and from a Qualitative Study

Despite families providing considerable care at end of life, there are substantial gaps in the provision of supportive care. A qualitative interview study was conducted with 17 caregivers of people supported by an adult hospice to explore the support needs of families. Family members readily identified the ways in which the diagnosis of a life-limiting illness impacted on them and the family as a whole, not just the patient. Implications for practice demonstrate the need to intervene at a family and relational level prior to bereavement, in order to mitigate complicated grief for the surviving family members. Such an approach offers a fruitful prospective alternative to supporting caregivers post-bereavement.     

An index of prenatal steroid exposure predicts adult face perception skills

Face perception skills are fundamental to social cognition, yet they vary markedly across individuals. This diversity has stimulated controversy over the relative contributions of genetic factors, prenatal environment, and postnatal experience to face perception. Recent twin studies have found that face perception is heritable, highlighting the potential for substantial prenatal determination of these skills. In contrast, previous work on potential influences of the prenatal hormonal environment on social cognition have found no association between 2D:4D, a marker for prenatal androgen exposure, and processing of facial emotional expressions, apparently precluding a major role for prenatal hormones in governing face perception. We propose that substantial predictive relationships between 2D:4D and face perception may have been masked in previous work because the task employed required both face perception and processing of others?? emotions, the latter component being greatly influenced by circulating hormones in adults. To assess prenatal hormone influences on face perception without requiring emotion processing, we related 2D:4D to the face inversion effect (FIE), a measure of the recruitment of specialist face processes to visual perception. The magnitude of the resulting predictive relationship (r = .52) compared surprisingly well with that found between identical twins?? face perception (rs = .27?C.61), suggesting that mechanisms of 2D:4D may account for a substantial proportion of perinatal influences on face processing. Furthermore, we employed 2D:4D as a common scale to map individual differences in the FIE onto prenatal testosterone:estrogen ratios, assayed by Lutchmaya, Baron-Cohen, Raggatt, Knickmeyer, and Manning (Early Human Development 77:23?C28, 2004). The substantial overlap between the two data sets further implicates prenatal steroids in adult face perception skills.