The role of nutrition in the pathophysiology and management of sickle cell disease among children: A review of literature

ABSTRACT

Sickle cell disease (SCD) is one of the common inherited blood disorders in humans and has been associated with decreased dietary intake which results in poor nutritional status and impaired growth. Nutrition is one of the most important but often forgotten aspect of care of patients with chronic disorders and there have been emerging concern in literature on increased nutritional needs of SCD patients. This paper sought to review the available literature on the roles of individual nutrients in the pathophysiology and management of SCD among children. Children with SCD have been shown to exhibit suboptimal status with respect to both macronutrients and micronutrients. Thus, nutrition could play an important role in the management of SCD. However, there is paucity of evidence coming from trials with large sample sizes to support the suggestion that supplementation with various nutrients that have been considered in this review will be helpful.     

Interpretation of the variability of levels of regional background aerosols in the Western Mediterranean

Results on interpretation of the variability of regional background PM levels in the Western Mediterranean basin (WMB) are presented. Mean PM levels recorded at Montseny, MSY (North-Eastern Spain) in the 2002-2007 period reached 17, 13 and 11 µg/m³ of PM₁₀, PM_2.5 and PM₁, respectively.The daily evolution of PM levels is regulated by the breeze circulation (mountain and sea breezes). PM levels are lower at the rural sites at night owing to the nocturnal drainage flows and to the lowering of the mixing layer height below the MSY high. These nocturnal low levels allowed us to estimate the continental background PM levels. At midday, the atmospheric pollutants accumulated in the pre-coastal depression are transported upwards by the breeze, increasing PM levels.Maximum PM₁₀ levels were recorded in summer, and February-March and November, and minimum values in the rest of the year coinciding with the highest frequency of Atlantic advection. PM peak episodes attributed to Saharan dust outbreaks were recorded in summer and February-March. In addition, anticyclonic situations (February-March and November) may impact in elevated rural areas by increasing hourly levels of PM₁ up to 75 µg/m³. This scenario induces the stagnation of pollutants in the pre-coastal depression. Solar radiation activates mountain winds, transporting polluted air masses from the valleys to elevated areas resulting in an increase of fine PM levels in areas outside the boundary layer.A significant decrease in PM annual means (40% and 34% for the entire monitoring period, 7 µgPM₁₀/m³ and 5 µgPM_2.5/m³) was recorded at MSY between 2002 and 2007. There appears to be no single cause behind these trends. This could partially be ascribed to the varying frequency and intensity of Saharan dust episodes, but also to large-scale meteorological processes or cycles, and/or to local or meso-scale processes such as nearby anthropogenic emission sources.     

Attributional style as a risk marker of genetic effects for adolescent depressive symptoms.

Genetic effects on adolescent depression have been consistently reported, but little is known about mediating pathways from the distal genotype to resultant behavioral symptoms. Identifying intermediate risk markers may provide clues on these pathways. In the present study, longitudinal twin and sibling data were used to address 3 issues pertaining to attributional style as a putative marker of genetic risk for adolescent depression: state independence by assessing predictive effects between attributional style and depressive symptoms, heritability of attributional style at different time points, and genetic links between attributional style and depressive symptoms characterizing concurrent and longitudinal associations. The authors further examined whether these predictive and genetic links varied across levels of stress, age, and gender. Negative attributions preceded, co-occurred with, and followed symptoms. The predictive association between earlier negative attributions and later depressive symptoms did not differ by stress, age, or gender. Attributional style was moderately heritable at both time points. Genetic links with concurrent and prospective depressive symptoms were larger in individuals reporting higher levels of stress, who were older and female. Implications for attributional style as a marker reflecting genetic risks are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived group devaluation, depression, and HIV-risk behavior among Asian gay men.

[Correction Notice: An erratum for this article was reported in Vol 27(3) of Health Psychology (see record 2008-08834-013). In the aforementioned article, the second sentence of the Results portion of the abstract should read: Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI; but was associated with lower levels of nonprimary partner UAI among those most attracted to non-Whites.] Objective: This study examined depressive mood and HIV-risk behavior in relation to perceived group devaluation and group identity. Design: Cross-sectional survey of 192 Asian gay men. Main Outcome Measures: Depressive mood assessed using the Centers for Epidemiological Studies Depression Scale (CES-D) and self-reported receptive or insertive unprotected anal intercourse (UAI) in the past 3 months. Results: Group devaluation was positively associated with depressive mood. Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI, among those most attracted to non-Whites. Among participants reporting higher levels of group devaluation, those with more positive personal evaluations of the Asian gay community had lower levels of total UAI compared to those with more negative personal evaluations of the Asian gay community. Conclusions: Results suggest that group devaluation is associated with higher levels of depressive mood among Asian gay men. Asian gay men most attracted to non-Whites or hold more positive evaluations of their group may be buffered from the influence of high perceived group devaluation on UAI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Perceived group devaluation, depression, and HIV-risk behavior among Asian gay men": Correction to Chae and Yoshikawa (2008).

Reports an error in "Perceived group devaluation, depression, and HIV-risk behavior among Asian gay men" by David H. Chae and Hirokazu Yoshikawa (Health Psychology, 2008[Mar], Vol 27[2], 140-148). In the aforementioned article, the second sentence of the Results portion of the abstract should read: Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI; but was associated with lower levels of nonprimary partner UAI among those most attracted to non-Whites. (The following abstract of the original article appeared in record 2008-03424-002.) Objective: This study examined depressive mood and HIV-risk behavior in relation to perceived group devaluation and group identity. Design: Cross-sectional survey of 192 Asian gay men. Main Outcome Measures: Depressive mood assessed using the Centers for Epidemiological Studies Depression Scale (CES-D) and self-reported receptive or insertive unprotected anal intercourse (UAI) in the past 3 months. Results: Group devaluation was positively associated with depressive mood. Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI, among those most attracted to non-Whites. Among participants reporting higher levels of group devaluation, those with more positive personal evaluations of the Asian gay community had lower levels of total UAI compared to those with more negative personal evaluations of the Asian gay community. Conclusions: Results suggest that group devaluation is associated with higher levels of depressive mood among Asian gay men. Asian gay men most attracted to non-Whites or hold more positive evaluations of their group may be buffered from the influence of high perceived group devaluation on UAI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interparental conflict, negative parenting, and children's adjustment: Bridging links between parents' depression and children's psychological distress.

Pathways linking parental depressive symptoms, adult relationship insecurity, interparental conflict, negative parenting, and children's psychological adjustment (internalizing symptoms and externalizing problems) were assessed using a 3-wave longitudinal research design. Two-parent families (N = 352) with 11- to 13-year-old children (179 boys, 173 girls) participated in the study. Maternal and paternal depressive symptoms were associated with insecurity in adult close relationships assessed 12 months later, which was concurrently related to heightened levels of interparental conflict. Controlling for children's initial symptom levels, interparental conflict was related to child appraisals of father and mother rejection assessed an additional 12 months later, which were related to children's internalizing symptoms and externalizing problems, respectively. Results are discussed with regard to the implications for understanding the complex interplay between adult depressive symptoms, attributions in close adult relationships, interparental conflict, negative parenting, and children's psychological adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of emotional well-being in mothers of adolescents and adults with autism.

Raising an adolescent or adult child with a developmental disability confers exceptional caregiving challenges on parents. We examined trajectories of 2 indicators of emotional well-being (depressive symptoms and anxiety) in a sample of primarily Caucasian mothers (N = 379; M age = 51.22 years at Time 1) of adolescent and adult children with an autism spectrum disorder (ASD; M age = 21.91 years at Time 1, 73.2% male). We also investigated within-person associations of child context time-varying covariates (autism symptoms, behavior problems, residential status) and maternal context time-varying covariates (social support network size and stressful family events) with the trajectories of emotional well-being. Data were collected on 5 occasions across a 10-year period. Average patterns of stable (depressive symptoms) and improved (anxiety) emotional well-being were evident, and well-being trajectories were sensitive to fluctuations in both child and maternal context variables. On occasions when behavior problems were higher, depressive symptoms and anxiety were higher. On occasions after which the grown child moved out of the family home, anxiety was lower. Anxiety was higher on occasions when social support networks were smaller and when more stressful life events were experienced. These results have implications for midlife and aging families of children with an ASD and those who provide services to these families. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of paternal and maternal depressive symptoms on child internalizing symptoms and asthma disease activity: Mediation by interparental negativity and parenting.

This study tested a hypothesized model of the relationships among parental depressive symptoms, family process (interparental negativity and negative parenting behavior), child internalizing symptoms, and asthma disease activity. A total of 106 children with asthma, aged 7 to 17, participated with their fathers and mothers. Parental depressive symptoms were assessed by self-report. Interparental and parenting behaviors were observed and rated during family discussion tasks. Child internalizing symptoms were assessed by self-report and by clinician interview and rating. Asthma disease activity was assessed according to National Heart, Lung and Blood Institute guidelines. Results of structural equation modeling generally supported interparental negativity and negative parenting behavior as mediators linking parental depressive symptoms and child emotional and physical dysfunction. However, paternal and maternal depressive symptoms play their role through different pathways of negative family process. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Relations between spouses' depressive symptoms and marital conflict: A longitudinal investigation of the role of conflict resolution styles.

This study investigated longitudinal relations between spouses' depressive symptoms and styles of conflict resolution displayed by husbands and wives in marital conflict, including angry, depressive, and constructive patterns of expression. Behavioral observations were made from a community sample of 276 couples during marital conflict resolution tasks once a year for 3 years. Couples were observed engaging in a major and minor conflict resolution task. Constructive, angry, and depressive conflict resolution styles were derived from the behavioral observation coding. Couples self-reported on depressive symptoms and marital dissatisfaction. Path analyses provided support for an extension of the marital discord model of depression (Beach, Sandeen, & O'Leary, 1990). Specifically, angry, depressive, and constructive styles of conflict each mediated the link between marital dissatisfaction and depressive symptoms. Significant cross-spouse effects were found. Implications for the treatment of depressed and/or relationally discordant couples are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Gender differences in the development and adult outcome of co-occurring depression and delinquency in adolescence.

Using a dual trajectory modeling approach, we examined co-occurring trajectories of depression and delinquency from age 11 to age 18 and their relation to adult outcome six years later in a community sample of 1423 (674 boys) adolescents. We also examined the effects of childhood externalizing, internalizing, and social problems on trajectory membership for depression and delinquency. The results showed that although more girls than boys were likely to follow high-level, co-occurring trajectories on depression and delinquency, the adult outcome of adolescents following high-level trajectories on both domains was poorer for boys than for girls. However, the combination of decreasing depression symptoms and increasing delinquency symptoms across adolescence was related with poorer adult outcomes for girls compared to boys. Finally, whereas boys' high-level co-occurring trajectory of depression and delinquency was predicted by childhood aggression, girls' equivalent trajectory was predicted by childhood depression and delinquency. The findings support the “gender paradox” effect (Loeber & Keenan, 1994) stating that in disorders with an unequal gender ratio, members of the gender with the lower prevalence rate tend to be more seriously affected in terms of comorbidity and poor outcome. (PsycINFO Database Record (c) 2011 APA, all rights reserved)