Obesity and Physical and Emotional Well‐Being: Associations between Body Mass Index,Chronic Illness,and the Physical and Mental Components of the SF‐36 Questionnaire

Objective: To clarify the associations between obesity and health‐related quality of life by exploring the associations between physical and emotional well‐being in relation to obesity and the presence of other chronic illness. Research Methods and Procedures: The study data were collected as part of a postal‐survey within the old Oxford Regional Health Authority of England in 1997. Completed questionnaires were returned by 8889 of 13,800 randomly selected adults aged 18 to 64 years. The main outcome measures were body mass index in five categories (underweight, normal weight, overweight, moderately obese, morbidly obese); chronic illness status (any vs. none and number of such illnesses 0, 1 to 2, 3+); and mean SF‐36 questionnaire score in two summary component measures reflecting physical and emotional well‐being. Results: Of the subjects, 31% were overweight and an additional 11% were obese. Body mass index was significantly associated with health status, but the pattern varied according to whether the measure reflected physical or emotional well‐being. Physical, but not emotional, well‐being deteriorated markedly with increasing degree of overweight and was limited in subjects who were obese but had no other chronic condition; subjects with chronic illnesses other than obesity were compromised in both dimensions. In terms of the number of chronic illnesses reported, the additional presence of obesity was associated with a significant deterioration in physical but not emotional well‐being. Discussion: Overweight and obesity are associated with poor levels of subjective health status, particularly in terms of physical well‐being. The limitations in emotional well‐being that are reported here and in other studies may be a result of confounding by the presence of accompanying chronic illness.     

The pursuit of euthymia

Psychiatrists often consider the positive characteristics displayed by a patient in their clinical judgment, yet current assessment and treatment strategies are shifted on the side of psychological dysfunction. Euthymia is a transdiagnostic construct referring to the presence of positive affects and psychological well‐being, i.e., balance and integration of psychic forces (flexibility), a unifying outlook on life which guides actions and feelings for shaping future accordingly (consistency), and resistance to stress (resilience and tolerance to anxiety or frustration). There is increasing evidence that the evaluation of euthymia and its components has major clinical implications. Specific instruments (clinical interviews and questionnaires) may be included in a clinimetric assessment strategy encompassing macro‐analysis and staging. The pursuit of euthymia cannot be conceived as a therapeutic intervention for specific mental disorders, but as a transdiagnostic strategy to be incorporated in an individualized therapeutic plan. A number of psychotherapeutic techniques aiming to enhance positive affects and psychological well‐being (such as well‐being therapy, mindfulness‐based cognitive therapy, and acceptance and commitment therapy) have been developed and validated in randomized controlled clinical trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continuing growth and development, the belief that life is purposeful and meaningful, satisfaction with one's relations with others, the capacity to manage effectively one's life, and a sense of self‐determination.     

Oral health-related well-being of the long-term hospitalised elderly

Objective: To investigate oral health‐related well‐being of the long‐term hospitalised elderly as reported by their primary nurses in relation to subject's oral health assessed either by primary nurses or by a clinical dental examination. Background data: Little is known about oral health‐related well‐being of the medically compromised, long‐term hospitalised elderly, most of whom are unable to express their feelings and opinions. Materials and methods: A cross‐sectional study using a questionnaire for primary nurses about oral health and oral health‐related well‐being regarding functional, pain/discomfort‐related, and psychosocial limitations of the subjects (n = 255) and assessment of oral health by clinical examination. The total number of limitations and the number of limitations in each category was calculated. Results: Most (77%) of our subjects were unable to eat normal food. Functional limitations dominated followed by psychosocial and pain/discomfort‐related limitations. Overall assessment by each subject's primary nurse ranked oral health of as good for 9% of subjects, as moderate for 44%, and as poor for 47%. Clinical examination‐based assessment ranked oral health as good for 19%, as moderate for 33%, and as poor for 48% of our subjects, with good oral health being ranked as good for more men than women (26% vs. 16%; p = 0.045). Fewer limitations were recorded for those with better oral health assessed both by primary nurse and by clinical examination. Conclusion: More efforts are called for to maintain the oral health of the long‐term hospitalised elderly so as to improve their well‐being.     

A revised stratigraphic framework for Olduvai Gorge Bed I based on tuff geochemistry

Olduvai Gorge, Tanzania has rich records of Plio-Pleistocene fauna and flora, hominin fossils, and stone artifacts preserved between well-dated tephra layers (tuffs). Accurate correlation between sites in the two million year section is complicated by faulting, erosion, change in physical appearance of the tuffs, and quality of preservation. Traditional tuff geochemical techniques using glass cannot be applied because of poor glass preservation, and previous physical mapping has led to miscorrelations in Bed I. A new approach, using a combination of glass and mineral compositions (feldspar, augite, hornblende, and oxides) produced successful geochemical fingerprints for all ten major Bed I (∼2.03-1.79 Ma) tuffs. These fingerprints make available a reliable means for correlating specific tuffs between the well-dated "Junction" sites, such as FLK and HWK, and less well-dated sites at the basin margins. The new correlations provide a high-resolution stratigraphic framework for Bed I and correct previous miscorrelations in the west of the basin. Olduvai Hominin 65, from western Olduvai, was recovered from a level between Tuff IC and the Ng’eju Tuff, and therefore dates to 1.79-1.84 Ma.     

Occurrence of Bondar's Nesting Whitefly,Paraleyrodes bondari (Hemiptera: Aleyrodidae), on cassava in Uganda

Cassava is a valued calorific source to millions of Africans who eat it daily and a vital staple for their food security. One of the key constraints to this crop is whiteflies which are both a vector of viral diseases and a direct pest. Although the African cassava whitefly is known to cause physical damage on cassava with considerable tuberous yield loss, a recent whitefly outbreak caused unusually severe damage, which prompted the current reported investigation. Molecular identification of whitefly adults sampled from the affected cassava field revealed the presence of a new whitefly species, Paraleyrodes bondari. This communication is the first report of the occurrence of P. bondari on cassava in Uganda.     

Mental illness and well‐being: an affect regulation perspective

Mental health crucially depends upon affective states such as emotions, stress responses, impulses and moods. These states shape how we think, feel and behave. Often, they support adaptive functioning. At other times, however, they can become detrimental to mental health via maladaptive affect generation processes and/or maladaptive affect regulation processes. Here, we present an integrative framework for considering the role of affect generation and regulation in mental illness and well‐being. Our model views affect generation as an iterative cycle of attending to, appraising and responding to situations. It views affect regulation as an iterative series of decisions aimed at altering affect generation. Affect regulation decisions include identifying what, if anything, should be changed about affect, selecting where to intervene in the affect generation cycle, choosing how to implement this intervention, and monitoring the regulation attempt to decide whether to maintain, switch or stop it. Difficulties with these decisions, often arising from biased inputs to them, can contribute to manifestations of mental illness such as clinical symptoms, syndromes and disorders. The model has a number of implications for clinical assessment and treatment. Specifically, it offers a common set of concepts for characterizing different affective states; it highlights interactions between affect generation and affect regulation; it identifies assessment and treatment targets among the component processes of affect regulation; and it is applicable to prevention and treatment of mental illness as well as to promotion and restoration of psychological well‐being.     

Lessons learned in developing community mental health care in Africa

This paper summarizes the findings for the African Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. We present an overview of mental health policies, plans and programmes in the African region; a summary of relevant research and studies; a critical appraisal of community mental health service components; a discussion of the key challenges, obstacles and lessons learned, and some recommendations for the development of community mental health services in the African region.     

Intensive Farming, Agro-Diversity, and Food Security Under Conditions of Extreme Population Pressure in Western Kenya

This paper examines the impact of very high population densities and agricultural intensification on farm diversity and food security. Geertz and other researchers have suggested that intensification is likely to lead to crop specialization and a loss of diversity. Others, especially for Africa, have argued that intensification maintains or even increases agro-diversity. The case of Hamisi, in western Kenya, one of the most densely populated areas in all of rural Africa, supports the latter scenario. Farmers engage in a wide variety of sophisticated practices that maintain exceptionally high levels of agro-diversity. Their farming system includes complex patterns of intercropping, polyvariety, an emphasis on multi-purpose crops, and the close integration of crops and livestock. Despite this agro-diversity, we find that the intense population pressure in Hamisi has resulted in such small landholdings that diet quality and food security are seriously jeopardized. Despite the diversity of their farms, most families are highly dependent on market purchases and they consume very limited quantities of nutritionally dense foods, especially protein.     

The Effect of Wildlife Conservation on Local Perceptions of Risk and Behavioral Response

In this study, we examine the effect of Tarangire National Park (TNP) on local perceptions of risk and how these perceptions may influence behavioral responses. Data were collected during 2004–2005 through household surveys and participatory risk mapping (PRM) in eight villages east of TNP. By identifying and rank-ordering respondents’ perceived risks, PRM enhances understanding of the nature and variation of risks faced within a population by distinguishing between the incidence and severity of subjective risk perceptions. Results indicate that proximity to the park has a strong effect on the type and severity of perceived risks. Within villages close to the park, however, behavioral response to perceived risks varies considerably. This study contributes to an appreciation of how behavioral response to environmental and socioeconomic factors is mediated by human perception.