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Our results suggest that dietary fiber is protective against high CRP, which supports current recommendations for a diet high in fiber.

Objective-Systemic inflammation may play an important role in the development of atherosclerosis, type 2 diabetes, and some cancers. Few studies have comprehensively assessed the direct relationships between dietary fiber and inflammatory cytokines, especially in minority populations. Using baseline data from 1,958 postmenopausal women enrolled in the Women's Heath Initiative Observational Study, we examined cross-sectional associations between dietary fiber intake and markers of systemic inflammation (including serum C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α receptor 2 (TNF-α-R2)), as well as differences in these associations by ethnicity.Method-Multiple linear regression models were used to assess the relationship between fiber intake and makers of systemic inflammation.Results-After adjustment for covariates, intake of dietary fiber were inversely associated with both IL-6 (P values for trend were 0.01 for total fiber, 0.004 for soluble fiber, and 0.001 for insoluble fiber) and TNF-α-R2 (P values for trend were 0.002 for total, 0.02 for soluble, and <0.001 for insoluble fiber). Although the sample sizes were small in minority Americans, results were generally Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-These findings lend support to the hypothesis that a high-fiber diet is associated with lower plasma levels of IL-6 and TNF-α-R2. Contrary to previous reports, however, there was no association between fiber and hs-CRP among postmenopausal women. Future studies on the influence of diet on inflammation should include IL-6 and TNF-α-R2 and enroll participants from ethnic minorities. NIH Public Access

The decision to move a family member with dementia to a nursing home is a difficult experience for caregivers. Complex psychosocial factors are involved and knowledge of predictive factors alone is insufficient. Using grounded theory, this study explores the decision-making process with regards to institutionalization, from the perspective of family caregivers. Fourteen people who moved a relative to long-term care in the preceding 6 months were interviewed. Data analysis using comparative analysis and line-by-line dimensional analysis was used to develop a theoretical model of the decision-making process. Three factors within the model were central to the process: (a) caregivers' perceptions of their ability to provide care, (b) caregivers' evaluations of their relatives' ability to make care decisions, and (c) the evolving influence of contextual factors and interactions with healthcare professionals. The contribution of these findings to new conceptualizations of institutionalization is discussed.

No abstract

Making end-of-life care decisions in the context of dementia is complex. As people with advanced dementia are incapable of deciding about their own care, family caregivers often become involved with health care providers in the decision-making process to ensure the best care for their loved one. Using a grounded theory approach, the experience of family caregivers in making such end-of-life care decisions was explored. Twenty-four caregivers were interviewed. The results show that caregivers evoke five dimensions when considering these decisions. One dimension, the relationship with health care providers, emerged as vital to their experience. Four elements of this relationship are presented in this article: quality of the relationship, frequency of contact, congruence of their values and beliefs with those of health care providers, and the level of trust. In an era that promotes partnership with families in long-term-care settings, care standards are needed in order to guarantee family participation in achieving quality dementia care.

Objective-To compare the effects of a low-glycemic index (GI) diet to the American Diabetes Association (ADA) diet on glycosylated hemoglobin (HbA1c) among individuals with type 2 diabetes.Subjects/Methods-Forty individuals with poorly controlled type 2 diabetes were randomized to either a low-GI or an ADA diet. The intervention, consisting of eight educational sessions (monthly for the first six months and then at months 8 and 10), focused on either a low-GI or an ADA diet. Data on demographic, diet, physical activity, psychosocial factors, and diabetes medication use were assessed at baseline, and 6-and 12-months. Generalized linear mixed models were used to compare the two groups on HbA1c, diabetic medication use, blood lipids, weight, diet, and physical activity.Results-Participants (53% female; mean age= 53.5 years) were predominantly white with mean body mass index of 35.8 kg/m 2 . While both interventions achieved similar reductions in mean HbA1c at 6 months and at 12 months, the low-GI diet group was less likely to add or increase dosage of diabetic medications (odd ratio=0.26, p=0.01). Improvements in HDL cholesterol, triglycerides, and weight loss were similar among groups.Conclusions-Compared to the ADA diet, the low-GI diet achieved equivalent control of HbA1c using less diabetic medication. Despite its limited size, this trial suggests that low-GI diet is a viable alternative to ADA diet. Findings should be evaluated in a larger randomized controlled trial.

Recent events in the workplace, government, and college campuses in the US have brought the issues of sexual harassment and assault to the forefront of media and public discussion. Industrial and organizational (I-O) psychologists are uniquely suited to help address these issues by aiding in intervention development. Specifically, I-O psychologists can provide key insight regarding the context, design, development, and evaluation of sexual harassment and assault training efforts. Although some empirical evidence suggests that trainings are effective in the short term, there is little evidence to suggest long-term attitudinal or behavioral change outside of the training environment. Much of the research in this area, however, has focused solely on the training intervention, excluding the pre- and post-training environment. Thus, the present effort focuses on designing trainings that promote transfer, as well as improving measurement of desired outcomes, to provide a framework for improving sexual harassment and assault training. This framework addresses how individual differences, needs analysis, training design, evaluation, and post-training support contribute to lasting change while addressing the unique challenges associated with sexual harassment and assault. Last, this framework provides guidance for improving research in this area as well as practical suggestions for improving training programs.