OBJECTIVE-Objective indices of socioeconomic status (SES) predict diverse sources of morbidity and mortality, as well as numerous biological and behavioral risk factors for disease. Here we examine whether subjective SES may be similarly associated with measured risk factors, including the metabolic syndrome and its components of elevated blood pressure, high fasting glucose, dyslipidemia, and central adiposity. METHODS-Observationswere based on a community sample of 981 adults (30-54 years of age; 52% female; 84% white, 16% African American). Subjective SES was measured using the nationally referenced (U.S.) MacArthur Scale of Subjective Social Status, and objective SES indexed by composite of years of education and family income.RESULTS-Likelihood of meeting criteria for presence of the metabolic syndrome varied inversely with subjective SES (Odds Ratio [OR] =0.75; 95% CI: 0.64, 0.88, for a 1 SD increase in subjective SES, adjusted for age, sex, and race), and this association persisted on further adjustment for objective SES (OR = 0.82; 95% CI: 0.68, 0.99). Subjective SES was also associated inversely with blood pressure, waist circumference, and serum triglycerides, and positively with HDL cholesterol. Level of physical activity and smoking status were predicted by subjective SES as well, but adjusting for these health behaviors did not appreciably reduce associations of subjective SES with metabolic syndrome and syndrome components.CONCLUSIONS-These findings support speculation that perceived social standing is associated with prominent cardiovascular risk factors and may prove a useful adjunct to conventional socioeconomic indicators in epidemiological research.

Pediatric obesityRecent estimates show that nearly 32% of children in the United States are overweight, which is dramatically higher than the prevalence reported in the 1980s (ref. 1). Childhood obesity is associated with psychological, neurologic, pulmonary, gastrointestinal, circulatory, and endocrine conditions (2,3). Most pediatric obesity interventions are marked by modest changes in weight or adiposity and substantial relapse (4). More comprehensive assessments documenting specific behavior change are needed, eliminating methodology compromised by self-report and retrospective recall (5). Moreover, given exclusion criteria in many pediatric obesity trials, children with mood disorders (depression) and medical comorbidities (sleep problems) do not receive the interventions. Domains such as mood and sleep may be essential dimensions of assessment as mediators or moderators of weight-loss treatment. Therefore, we sought not only to examine the feasibility of adding methodologically sound technology to an empirically validated weightmanagement intervention, but also to examine interregulatory processes across behaviors (i.e., eating, physical activity (PA), mood, and sleep) in an objective manner.Ecological Momentary Assessment (EMA) is an innovative form of data collection that provides objective data on patterns of behaviors within a participant's natural environment. EMA helps to circumvent sources of bias inherent in other retrospective self-report measures (6). In adults, multiple applications of EMA methodology have provided insight into food intake and maintenance of weight-related disorders (7), and initial research has demonstrated its utility in pediatric samples with psychopathology (8). Thus, EMA methodology may assist weight-loss efforts by clarifying the antecedents of participants' eating behavior (6), by improving accuracy of selfmonitoring (9) and by specifying the temporal relationships of the target behaviors (10). The aims of this pilot study were to (i) examine the feasibility of utilizing EMA in overweight children participating in an empirically validated cognitivebehavioral weight-management intervention, and (ii) examine the relationship between EMA and weight (primary) and behavioral outcomes (secondarily; mood and sleep). To our knowledge, no studies have examined the utility of complementary EMA methodologies (phone calls and actigraphy) to measure interregulatory health processes in obese adolescents participating in a weight-loss trial. In this brief report, we discuss pilot data primarily regarding aim 1 (EMA utilization). MethodsThis study was conducted alongside the Weight Management Center at Children's Hospital of Pittsburgh and approved by the University's Institutional Review Board. Informed assent and consent were obtained from 20 English-speaking participants (11-19 years old, 80% white, 15% African American, mean BMI = 39). Exclusion criteria consisted This study examined the feasibility of using Ecological Momentary Assessment (EMA) to examine important domains relevant...

Growing evidence suggests that socioeconomic attributes of both childhood and adulthood confer risk for cardiovascular morbidity and mortality. In this study, we examine the association of both parental and individual educational attainment with C-reactive protein (CRP), an inflammatory mediator relevant to cardiovascular pathophysiology, in a midlife community sample. Subjects were 811 men and women (394 men/417 women; 87 % European-American/13 % African American), 30–54 years of age. Plasma concentrations of CRP were determined from blood samples obtained at a single session following an overnight fast. Regression analyses adjusting for age and race showed both parental education and individual education to be associated inversely with CRP in women, but not men. The relationship of parental education with CRP in women persisted on multivariable adjustment for both lifestyle risk factors (smoking, alcohol consumption, sleep, exercise, body mass index) and individual SES. Independent of reported personal educational attainment, mid-life adult women whose parents achieved fewer years of educational attainment exhibit higher levels of circulating CRP than women with higher parental education. This association may help explain the increased risk of atherosclerotic cardiovascular morbidity and mortality conferred by low childhood socioeconomic status.

This article describes the performance of active duty U.S. Marines on the Physical Fitness Test (PFT) and Combat Fitness Test (CFT) during calendar years 2000 through 2012. Our study sample included PFT composite scores (n = 543,185), PFT and CFT composite scores (n = 160,936), and PFT and CFT event scores (n = 135,926 and n = 201,953, respectively). In general, all Marines performed very well on each fitness test, with overall annual improvements. Interestingly, the majority of female Marines passed the minimum male standard on the CFT. Further studies will evaluate the relationship of fitness test performance and injury.

The aim of this study is to examine existing research on social cognitive factors that may, in part, mediate the relationship between socioeconomic status (SES) and coronary heart disease (CHD). We focus on how social status is ‘carried’ in the mental systems of individuals, and how these systems differentially affect CHD risk and associated behaviors. To this end, literatures documenting the association of various social cognitive factors (e.g., social comparison, perceived discrimination, and self-efficacy) with cardiovascular disease are reviewed as are literatures regarding the relationship of these factors to SES. Possible mechanisms through which social cognitions may affect health are addressed. In addition, directions for future research are discussed, and a model identifying the possible associations between social cognitive factors, SES, and coronary disease is provided.

Background Sugammadex is a novel neuromuscular blockade reversal agent approved by the Food and Drug Administration in 2015, but little literature exists for patients less than 2 years of age. Aims The aims of this study were to: describe a cohort of patients 2 years old and younger who received sugammadex; describe any adverse effects of sugammadex in this age group; compare time from end of surgery to out of operating room for sugammadex versus neostigmine; compare time between last dose of neuromuscular blocking drug and reversal; and use train‐of‐four data to assess reversal. Methods Chart review of the medical record and the anesthesia information system captured all patients in this age cohort who received sugammadex or neostigmine over a two‐year period. Adverse medication events were pulled from a mandatory quality improvement field in the electronic anesthesia record. T‐tests were used for analyses. Results No adverse effects were reported with 331 doses of sugammadex. The average time in minutes between end of surgery and out of operating room was similar for neostigmine (19.6) versus sugammadex (19.4) (mean difference 0.2, 95% CI −1.5‐1.8, P = 0.85). The average time in minutes between last dose of neuromuscular blocking drug and reversal agent was longer for neostigmine (103) than for sugammadex (84) (mean difference 19, 95% CI 13‐26, P < 0.001). Conclusions Sugammadex administration in this young population did not result in any adverse effects. It appears to be equally effective as neostigmine in patients under 2 years of age.

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