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Biomedical subjects

L A Palinkas

Publications and source records attributed to L A Palinkas.

At least 19 recordsLinked to original sources
PubMed2004

A prospective study of Type 2 diabetes and depressive symptoms in the elderly: the Rancho Bernardo Study.

AIMS: The association between Type 2 diabetes and depressive symptoms was examined prospectively to assess possible causal relationships between the two diseases. METHODS: A cohort of 971 men and women aged 50 and older from the adult population of Rancho Bernardo, California had an oral glucose tolerance test and completed the Beck Depression Inventory (BDI) at two clinic visits, 1984-87 and 1992-96. RESULTS: Depressive symptoms at baseline were associated with higher follow-up levels of non-fasting plasma glucose (P = 0.001) and an increased risk of developing Type 2 diabetes [odds ratio (OR) = 2.50; 95% confidence interval (CI) = 1.29-4.87], independent of sex, age, exercise and body mass index. Conversely, baseline non-fasting plasma glucose was not significantly associated with follow-up depressive symptoms and Type 2 diabetes at baseline was not significantly associated with the onset of BDI scores > or = 11 by the second visit (OR = 0.73; 95% CI = 0.41-1.30). CONCLUSIONS: Depressed mood is more likely to be a risk factor for Type 2 diabetes in older adults than the reverse.

Age Distribution↗
PubMed2001

Circannual pattern of hypothalamic-pituitary-thyroid (HPT) function and mood during extended antarctic residence.

The seasonal variation in thyroid function and mood was examined in 10 men and two women who spent the 1997 or 1998 austral winter at McMurdo Station, Antarctica. Serum samples of TSH, free T3 and free T4 were collected each month over a 10-month period (October-August), along with responses to the Profile of Mood States (POMS) and the Center for Epidemiologic Studies - Depression (CES-D) Scale. Both TSH and mood (a summary score created from the POMS depression, anger, fatigue and confusion subscales) exhibited a circannual pattern with peaks during the months of November and July and a trough during the months of March and April. High levels of tension-anxiety and confusion were preceded by declines in free T3 and T4. However, increases in tension-anxiety and total mood disturbance also preceded a decline in free T3 levels, suggesting a feedback of mood on T3 levels. Levels of free T4 were independently associated with preceding increases in anger scores. These results support the hypothesis that the symptoms characteristic of the winter-over syndrome is a state of relative CNS hypothyroidism. This model of seasonal variation in thyroid function and mood also has implications for an understanding of potential mechanisms underlying the association between latitude and SAD or S-SAD.

Adult↗
PubMed2001

Impairment in cognitive and exercise performance during prolonged antarctic residence: effect of thyroxine supplementation in the polar triiodothyronine syndrome.

Humans who work in Antarctica display deficits in cognition, disturbances in mood, increased energy requirements, a decline of thyroid hormone products, and an increase of serum TSH. We compared measurements in 12 subjects, before deployment (baseline), with 11 monthly studies during Antarctic residence (AR). After 4 months of AR (period 1), half of the subjects (T(4) group) received L-thyroxine [64 nmol.day(-)(1) (0.05 mg.day(-)(1))]; and the other half, a placebo (placebo group) for the next 7 months of AR (period 2). During period 1, there was a 12.3 +/- 5.1% (P < 0.03) decline on the matching-to-sample (M-t-S) cognitive task and an increase in depressive symptoms, compared with baseline. During the intervention in period 2, M-t-S scores for the T(4)-treated group returned to baseline values; whereas the placebo group, in contrast, showed a reduced M-t-S score (11.2 +/- 1.3%; P < 0.0003) and serum free T(4) (5.9 +/- 2.4%; P < 0.02), compared with baseline. The change in M-t-S score was correlated with the change in free T(4) (P < 0.0003) during both periods, and increases in serum TSH preceded worsening scores in depression, tension, anger, lack of vigor, and total mood disturbance (P < 0.001) during period 2. Additionally, the submaximal work rate for a fixed O(2) use decreased 22.5 +/- 4.9% in period 1 and remained below baseline in period 2 (25.2 +/- 2.3%; P < 0.005) for both groups. After 4 months of AR, the L-thyroxine supplement was associated with improved cognition, which seems related to circulating T(4). Submaximal exercise performance decrements, observed during AR, were not changed with this L-thyroxine dose.

Adult↗
PubMed2001

Mental and cognitive performance in the cold.

Vigilance, attention, memory, and motivation are essential to adapting to the physiological changes that occur with prolonged exposure to the cold and to avoiding both the environmental hazards associated with cold and the health-related consequences of these hazards. This paper summarizes the effects of cold temperatures on cognitive performance and mood. Although the effects of hypothermic-induced cold temperatures on cognitive performance and mood have been well documented, evidence of nonhypothermic effects has been inconsistent. There is evidence of a dose-response relation involving decrements in cognitive performance with respect to decline in core body temperature and complexity of tasks performed. However, it is unclear whether these effects are due to distraction or increased arousal. Likewise, further research is required to test the efficacy of existing and proposed pharmacologic and nutritional countermeasures.

Adaptation, Physiological↗
PubMed2001

Psychosocial issues in long-term space flight: overview.

Anecdotal evidence of the individual and interpersonal problems that occurred during the Shuttle-Mir Space Program (SMSP) and other long-duration Russian/Soviet missions, and studies of personnel in other isolated and confined extreme (ICE) environments suggest that psychosocial elements of behavior and performance are likely to have a significant impact on the outcome of long-duration missions in space. This impact may range from individual decrements in performance, health and well being, to catastrophic mission failure. This paper reviews our current understanding of the psychosocial issues related to long duration space missions according to three different domains of behavior: the individual domain, the interpersonal domain and the organizational domain. Individual issues include: personality characteristics that predict successful performance, stress due to isolation and confinement and its effect on emotions and cognitive performance, adaptive and maladaptive coping styles and strategies, and requirements for the psychological support of astronauts and their families during the mission. Interpersonal issues include: impact of crew diversity and leadership styles on small group dynamics, adaptive and maladaptive features of ground-crew interactions, and processes of crew cohesion, tension and conflict. Organizational issues include: the influence of organizational culture and mission duration on individual and group performance, and managerial requirements for long duration missions. Improved screening and selection of astronaut candidates, leadership, coping and interpersonal skills training of personnel, and organizational change are key elements in the prevention of performance decrements on long-duration missions.

Adaptation, Psychological↗
PubMed2000

Sociocultural change and health status among the Seri Indians of Sonora, Mexico.

The influence of changes in sociocultural status on obesity, arterial blood pressure, and depression was examined in a cohort of 81 Seri Indians living in two communities in Sonora, Mexico. Residents of the less acculturated and modernized community, Desemboque, exhibited significantly higher waist circumference and prevalence of obesity than did residents of the more acculturated and modernized community of Punta Chueca. The prevalence of obesity was also significantly associated with low levels of acculturation and modernization, while the prevalence of clinically significant depressive symptoms was associated with low levels of modernization and household income. Lifestyle incongruity was a significant independent risk factor for body mass index and depressive symptom scores but not for arterial blood pressure. The results support the notion of a curvilinear relationship between health status and sociocultural change in which health status initially declines with increasing lifestyle incongruity but eventually improves with increasing acculturation, modernization, and income.

Adolescent↗
PubMed2000

Relationship of climate, ethnicity and socioeconomic status to Kawasaki disease in San Diego County, 1994 through 1998.

BACKGROUND: Kawasaki disease (KD) is the most common cause of acquired heart disease in children in the United States. By monitoring trends in patient numbers and demographics during a 5-year period, we were able to explore the relationship between climate, ethnicity, socioeconomic status and susceptibility to KD. METHODS: We conducted active surveillance for all patients hospitalized with KD in San Diego County from 1994 through 1998. Data on seasonal variation in monthly rainfall and temperature were obtained from the US Meteorological Service. Patient sex, age, date of admission and self-reported ethnicity were identified from patient medical records. Socioeconomic status was assessed on the basis of insurance status among patients hospitalized at a single institution. RESULTS: During the 5-year period there were 169 cases of KD in San Diego County. The overall annual incidence of KD in children < 5 years of age ranged from 8.0 to 15.4/100 000. KD incidence was inversely associated with average monthly temperature (r = -0.47, P < 0.001) and positively associated with average monthly precipitation (r = -0.52, P < 0.001). Asian/Pacific Islanders < 5 years of age were 2.7 times as likely and Hispanics were one-third as likely to be hospitalized for KD than children from all other ethnic groups combined. Children with private or military insurance in all ethnic groups were more likely to have a diagnosis of KD than children with government assistance or no insurance. After controlling for insurance status, only Asian/Pacific Islanders remained at increased risk (rate ratio, 2.14) for KD relative to all other ethnic groups combined. CONCLUSION: KD is a common childhood vasculitis of unknown etiology. The skewed ethnic distribution and seasonality are consistent with the hypothesis that KD is an infectious disease that is influenced by environmental and genetic factors.

California↗
PubMed2000

Stages of change in mood and behavior during a winter in Antarctica.

Seasonal variation in mood and behavior was examined in 87 American men and women who spent the 1991 austral winter at three different research stations in Antarctica. The South Pole station (90 degrees S) crew reported a significant decline in tension/anxiety, depression, anger, confusion, and fatigue from March to August, followed by a significant increase in tension/anxiety and fatigue and a significant decline in vigor from August to October. The McMurdo station (78 degrees 51' S) crew also reported a significant decline in tension/anxiety from March to July and a significant increase in tension/anxiety from July to August. In contrast, the Palmer station (64 degrees 46' S) crew experienced no significant changes in any mood subscale from May to October. The nonlinear pattern of change in mood suggests that adaptation to prolonged isolation and confinement in an extreme environment occurs in two or three stages.

Adaptation, Psychological↗
PubMed2000

Sleep and mood during a winter in Antarctica.

Seasonal variations in sleep characteristics and their association with changes in mood were examined in 91 American men and women who spent the 1991 austral winter at three different research stations in Antarctica. Measures of total hours of sleep over a 24-hr period, duration of longest (i.e., "nighttime") sleep event, number of sleep events, time of sleep onset, and quality of sleep remained unchanged over the course of the austral winter (March through October). However, exposure to total darkness based on station latitude was significantly associated with total hours of sleep, duration of longest sleep event, time of sleep onset, and quality of sleep. Reported vigor the previous month was a significant independent predictor of changes in all five sleep measures; previous month's measures of all six POMS subscales were significant independent predictors of sleep quality. Sleep characteristics were significant independent predictors of vigor and confusion the following month; total sleep, longest sleep event, sleep onset and sleep quality were significant independent predictors of tension-anxiety and depression. Changes in mood during the austral winter are preceded by changes in sleep characteristics, but prolonged exposure to the photo-periodicity characteristic of the high latitudes appears to be associated with improved sleep. In turn, mood changes appear to affect certain sleep characteristics, especially sleep quality.

Adult↗
PubMed2000

Predictors of behavior and performance in extreme environments: the Antarctic space analogue program.

BACKGROUND: To determine which, if any, characteristics should be incorporated into a select-in approach to screening personnel for long-duration spaceflight, we examined the influence of crewmember social/ demographic characteristics, personality traits, interpersonal needs, and characteristics of station physical environments on performance measures in 657 American men who spent an austral winter in Antarctica between 1963 and 1974. METHODS: During screening, subjects completed a Personal History Questionnaire which obtained information on social and demographic characteristics, the Deep Freeze Opinion Survey which assessed 5 different personality traits, and the Fundamental Interpersonal Relations Orientation-Behavior (FIRO-B) Scale which measured 6 dimensions of interpersonal needs. Station environment included measures of crew size and severity of physical environment. Performance was assessed on the basis of combined peer-supervisor evaluations of overall performance, peer nominations of fellow crew-members who made ideal winter-over candidates, and self-reported depressive symptoms. RESULTS: Social/demographic characteristics, personality traits, interpersonal needs, and characteristics of station environments collectively accounted for 9-17% of the variance in performance measures. The following characteristics were significant independent predictors of more than one performance measure: military service, low levels of neuroticism, extraversion and conscientiousness, and a low desire for affection from others. CONCLUSIONS: These results represent an important first step in the development of select-in criteria for personnel on long-duration missions in space and other extreme environments. These criteria must take into consideration the characteristics of the environment and the limitations they place on meeting needs for interpersonal relations and task performance, as well as the characteristics of the individuals and groups who live and work in these environments.

Adult↗
PubMed2000

Behavior and performance on long-duration spaceflights: evidence from analogue environments.

BACKGROUND: Analyses of data collected in Antarctica since 1963 were conducted to identify features of behavior and performance likely to occur during long-duration missions in space. METHODS: The influence of mission duration and station latitude on POMS mood scores was examined in 450 American men and women who wintered-over in Antarctica between 1991 and 1998. The influence of crewmember social characteristics, personality traits, interpersonal needs, and station environments on measures of behavior and performance at the end of the austral winter was examined in 657 American men who wintered-over between 1963 and 1974. Both data sets were used to examine the influence of crew social structure on individual performance. RESULTS: Seasonal variations in mood appear to be associated with the altered diurnal cycle and psychological segmentation of the mission. Concurrent measures of personality, interpersonal needs, and coping styles are better predictors of depressed mood and peer-supervisor performance evaluations than baseline measures because of the unique features of the station social and physical environments and the absence of resources typically used to cope with stress elsewhere. Individuals in crews with a clique structure report significantly more depression, anxiety, anger, fatigue and confusion than individuals in crews with a core-periphery structure. Depressed mood is inversely associated with severity of station physical environment, supporting the existence of a positive or "salutogenic" effect for individuals seeking challenging experiences in extreme environments. CONCLUSION: Behavior and performance on long-duration spaceflights is likely to be seasonal or cyclical, situational, social, and salutogenic.

Adaptation, Psychological↗
PubMed2000

The use of complementary and alternative medicine by primary care patients. A SURF*NET study.

BACKGROUND: Despite the increased use and acceptance of complementary and alternative medicine (CAM) practices and practitioners by patients and health care providers, there is relatively little information available concerning the reasons for use or its effect on patient health status and well-being. METHODS: We conducted a survey of 542 patients attending 16 family practice clinics that belong to a community-based research network in San Diego, California, to determine patients' reasons for using CAM therapies in conjunction with a visit to a family physician and the impact of these therapies on their health and well-being. RESULTS: Approximately 21% of the patients reported using one or more forms of CAM therapy in conjunction with the most important health problem underlying their visit to the physician. The most common forms of therapy were visiting chiropractors (34.5%) of CAM users), herbal remedies and supplements (26.7%), and massage therapy (17.2%). Recommendations from friends or coworkers, a desire to avoid the side effects of conventional treatments, or failure of conventional treatments to cure a problem were the most frequently cited reasons for using these therapies. Use of practitioner-based therapies was significantly and independently associated with poor perceived health status, poor emotional functioning, and a musculoskeletal disorder, usually low back pain. Use of self-care-based therapies was associated with high education and poor perceived general health compared with a year ago. Use of traditional folk remedies was associated with Hispanic ethnicity. CONCLUSIONS: Sociodemographic characteristics and clinical conditions that predict use of CAM therapies by primary care patients in conjunction with a current health problem vary with the type of therapy used.

Adult↗
PubMed1999

Immigration reform and the health of Latino immigrants in California.

This paper examines Latino immigrant health within the context of the current debate over immigration reform and the resulting cultural construction of public health in California. A review of epidemiologic and ethnographic data indicates that the subordinate socioeconomic status of Latino immigrants plays a major role in both disease etiology and access to health services. However, this status does not explain why certain patterns of health services utilization and disease morbidity and mortality persist although political and economic circumstances have changed. These patterns include the reluctance to utilize certain health services despite access to health insurance and the presence of an epidemiologic paradox in which Latinos have health status indicators comparable to or better than that of other ethnic groups despite high poverty, low education, and lack of access to care. An "economy of culture" model is used to explain these inconsistencies in the political economy model of Latino immigrant health.

Journal Article↗
PubMed1998

Longitudinal studies of behavior and performance during a winter at the South Pole.

BACKGROUND: Evidence of a specific pattern of performance decrement in isolated and confined (ICE) environments has not been consistently demonstrated in previous research. HYPOTHESIS: Decrements in performance in ICE environments: a) occur in a linear, dose-response manner; b) occur in stages; or c) do not occur at all. METHODS: There were 83 members of the United States Antarctic Program who spent an austral winter at the Amundsen-Scott South Pole Station (90 degrees S) between 1991 and 1994 and completed the Profile of Moods States (POMS) once a month for an 8-mo period from March through October. RESULTS: Over the entire 8-mo period, there was a decline in depression (p = 0.007) and vigor (p < 0.0001), and an increase in fatigue (p = 0.059) and tension-anxiety (p = 0.075). Of these four measures, only vigor exhibits a linear pattern. Mean scores for tension-anxiety and fatigue were lower during the first half of the winter than the second half (p = 0.074 and 0.077, respectively). In comparisons between each quarter and the remaining three quarters, averaged mean tension-anxiety scores and fatigue scores were lower during the second quarter (p = 0.009 and 0.03, respectively), and higher during the fourth quarter (p = 0.025 and 0.035, respectively) than during the previous three quarters combined. CONCLUSIONS: The duration of optimal performance in isolated and extreme environments and the explanation for changes in performance during long duration assignments in such environments both depend on what behavioral measure is used to assess performance.

Acclimatization↗
PubMed1997

People in high latitudes: the "Big Five" personality characteristics of the circumpolar sojourner.

The personality of the polar sojourner has been of interest to psychologists for a number of years. Using the NEO Five Factor Inventory, this study examined the general personality factors of the polar worker compared to a normative population, and how these factors differ according to the worker's occupational classification and the polar region in which he or she is working. It was found that polar workers scored higher than a normative group on all factors except Neuroticism. Comparisons across occupational groups showed that scientists were lower than military personnel on Extraversion and lower than technical/support staff on Agreeableness and Conscientiousness. The analysis by polar region indicated that Antarctic workers were higher than Arctic personnel on Extraversion, Agreeableness, and Conscientiousness. A group of Italian Antarctic personnel, completing a translated form of the NEO-FFI, scored lower than the rest of the polar groups on all factors. These findings are discussed in light of various features of the polar environment and Gunderson's 3-predictor model of polar adaptability.

Adaptation, Psychological↗
PubMed1996

Depressive symptoms in overweight and obese older adults: a test of the "jolly fat" hypothesis.

The association between body weight and depressive symptoms in older adults was examined in a population-based study of 2,245 noninstitutionalized men and women aged 50 to 89 years living in Rancho Bernardo, California, U.S.A. The prevalence of Beck Depression Inventory scores > or = 13 was inversely associated with body weight in men, but not in women. Overweight and obese 50- to 69-yr-old women were more depressed than women with a body mass index below 25 kg/m2, but the difference was only marginally significant (p = 0.09). When age, health status and medication use were controlled, the odds of being depressed were 0.34 (p = 0.004) in overweight men and 0.28 (p = 0.09) in obese men, compared to men with a body mass index below 25 kg/m2. In this cohort, depression in men was inversely associated with body weight, supporting the "Jolly Fat" hypothesis. The likelihood that more stigma is attached to excessive weight in women than men may account for the lack of an inverse association between weight and depression in women.

Adult↗