Exploring how structural and cognitive social capital influence preventive health behavior

Purpose

People living on poverty-level incomes in developing nations face unique health challenges as compared to those in developed nations. New insights emerge from a bottom of the pyramid context (India) where culture-based health notions, preventive orientation and health resources differ from developed western health orientations and resources. The purpose of this paper is to explore how structural and cognitive social capital indirectly influence preventive health behavior (PHB) through perceived health value.

Design/methodology/approach

The participants for this study include rural people from Tamil Nadu, a state of India who are classified as those living below poverty level based on a per capita/per day consumption expenditure of Rupees 22.50 (an equivalent of US$0.40 a per capita/per day) (Planning Commission, Government of India, 2012). The study included a total number of 635 participants (312 males and 323 females). Relatively a high response rate (79 percent) was achieved through personal contacts and telephone solicitation, cash incentive and multiple follow-ups. Participants completed a questionnaire assessing structural and cognitive social capital, preventative health behavior, perceived health value, and health locus of control (HLC).

Findings

The results show that perceived health value mediates the relationship between cognitive social capital and PHB. Specifically, cognitive social capital influences BoP people’s assessment of benefits of engaging in PHB, that, in turn, influences PHB. In addition, the findings showed that HLC moderates the effect of social capital on PHB. Social capital positively related to enhanced PHB only among those who believe that health outcomes are controllable.

Originality/value

The authors findings indicate that cognitive social capital has enormous potential in promoting health intervention and the health of poor communities, a sentiment shared by prior researchers (Glenane-Antoniadis et al., 2003; Fisher et al., 2004; Martin et al., 2004; Weitzman and Kawachi, 2000). Overall, from a theoretical, empirical and methodological perspective, the current study offers a unique contribution to the social capital and PHB literature. First, drawing from the HBM and HLC, the findings provide a more nuanced explanation of how distinct aspects of social capital predict PHB. Specifically, the relationship between social capital and PHB is qualified by the extent one perceives personal control over her health. In addition, the cognitive component of social capital influences PHB through perceptions of health value.

Limits of Applicability of the Voronoi Tessellation Determined by Centers of Cell Nuclei to Epithelium Morphology

It is well accepted that cells in the tissue can be regarded as tiles tessellating space. A number of approaches were developed to find an appropriate mathematical description of such cell tiling. A particularly useful approach is the so called Voronoi tessellation, built from centers of mass of the cell nuclei (CMVT), which is commonly used for estimating the morphology of cells in epithelial tissues. However, a study providing a statistically sound analysis of this method's accuracy is not available in the literature. We addressed this issue here by comparing a number of morphological measures of the cells, including area, perimeter, and elongation obtained from such a tessellation with identical measures extracted from direct imaging acquired by staining the cell membranes. After analyzing the shapes of 15,000 MDCK II epithelial cells under several conditions, we find that CMVT reasonably well reproduces many of the morphological properties of the tissue with an error that is between 10 and 15%. Moreover, cross-correlations between different morphological measures are reproduced qualitatively correctly by this method. However, all of the properties including the cell perimeters, number of neighbors, and anisotropy measures often suffer from systematic or size dependent errors. These discrepancies originate from the polygonal nature of the tessellation which sets the limits of the applicability of CMVT.

Novel growth regime of MDCK II model tissues on soft substrates

It is well established that MDCK II cells grow in circular colonies that densify until contact inhibition takes place. Here, we show that this behavior is only typical for colonies developing on hard substrates and report a new growth phase of MDCK II cells on soft gels. At the onset, the new phase is characterized by small, three-dimensional droplets of cells attached to the substrate. When the contact area between the agglomerate and the substrate becomes sufficiently large, a very dense monolayer nucleates in the center of the colony. This monolayer, surrounded by a belt of three-dimensionally packed cells, has a well-defined structure, independent of time and cluster size, as well as a density that is twice the steady-state density found on hard substrates. To release stress in such dense packing, extrusions of viable cells take place several days after seeding. The extruded cells create second-generation clusters, as evidenced by an archipelago of aggregates found in a vicinity of mother colonies, which points to a mechanically regulated migratory behavior.

Effect of probenecid on kinetics of enrofloxacin in lactating goats after subcutaneous administration

A comparative pharmacokinetic study of enrofloxacin (5 mg/kg, sc) was conducted in probenecid-pretreated (70 mg/kg, orally 1.5 h prior to enrofloxacin administration) lactating goats to assess the effect of probenecid on the kinetics of enrofloxacin. Concentration of enrofloxacin in plasma, milk and urine was estimated by microbiological assay using Escherichia coli (ATCC 25922). Minimum detection level of enrofloxacin was 0.01 microg/ml. The plasma log concentration versus time curve showed monophasic pattern and followed one compartment open model. Plasma drug concentration was significantly higher during 1-2 h in probenecid-pretreated group. Significantly higher drug concentration in milk was noted at most of the time points, while significantly lower urine drug concentration (0.083-1 h and 5-12 h) were obtained in probenecid-pretreated group. The kinetic parameters (A, B and 3) were significantly higher, while t(1/2)beta, MRT and Vd(area) were significantly lower in probenecid-pretreated group. Probenecid pretreatment decreased the urinary excretion of enrofloxacin, whereas enhanced excretion in milk which could be useful in cases of affections of udder in goats.

Effect of fever on pharmacokinetics and dosage regimen of intramuscularly administered amikacin in goats

A comparative pharmacokinetic study of amikacin (10 mg/kg intramuscular) by microbiological assay method in normal and experimentally induced febrile goats revealed that the plasma drug concentrations were significantly higher in febrile condition at most of the time intervals. Various pharmacokinetic parameters like t(1/2), AUC, AUMC, MRT and Vd(area) were significantly higher whereas total body clearance (Cl(B)) was significantly lower in febrile goats as compared to normal goats. Absorption half-life (t(1/2) ka) value differed non-significantly. For maintaining mean therapeutic level of 2 mg/ml, a priming dose (D*) of 14.73+/-2.28 mg/kg, followed by maintenance dose (D(o)) of 13.95+/-2.28 mg/kg at shorter dosage interval (t) of 8 hr may be useful in case of normal goats whereas lower doses (D* of 13.58+/-1.61 mg/kg followed by D(o) of 12.65+/-1.60 mg/kg) at longer tau of 12 hr may be advised in case of febrile goats.

Immunity in children with exposure to environmental lead: I. Effects on cell numbers and cell-mediated immunity

Studies conducted in animal systems have shown that lead is an immunosuppressive agent at levels far below those causing overt toxicity. Children less than six years of age are the population at highest risk for exposure to environmental lead; however little data were available to assess effects on the developing immune system in this age group. Reported here is the completed Phase I study on 193 children, ages 9 months to 6 years, with blood lead levels from 1 to 50 (μg dL(-1), recruited from the urban population of Springfield-Greene County, Missouri, through their participation in the WIC (Women, Infants, and Children) and Lead Poisoning Prevention Programs. This portion of the study dealt with enumeration of cells involved with the immune response andin vitro mitogenic stimulation of lymphocytes. The percent lymphocytes, monocytes, granulocytes, T cells (total), B cells, CD4+T's and CD8+T's and CD4+/CD8+ ratios were determined and the data were analysed. No consistent significant differences were seen among the various risk categories currently identified by the CDC. Though two age groups showed some possible effect of lead, none of the various cellular parameters within these age groups showed significant correlation with blood lead. The lymphocyte response toin vitro mitogenic stimulus was studied on 42 children (including 17 in risk classifications IIA and higher) using the mitogens phytohemagglutinin (PHA), Concanavalin A (Con A), and Pokeweed mitogen (PWM). No consistent statistically significant differences were seen among the various risk categories; the effects of lead, if present, are most likely subtle and obscured by the interindividual and time-dependent variation inherent in this type of study.

Internationalization of multi hospital systems

Much like the manufacturing multinationals of yore, professional service establishments are now going abroad in large numbers. Two factors drive their expansion overseas--the increasing restrictions on their operations domestically, and the inviting opportunities in some of the global markets. A survey of multi hospital corporations both with and without experience in foreign markets was conducted regarding the expansion of their operations overseas. Examined were factors central to the decision-making process including: the various types of foreign health care systems; the entry strategies in penetrating foreign markets (fully owned, joint ventures, etc.); favorable factors and barriers considered in choosing foreign markets; the ability to transfer standardized systems from operations in the U.S.; and the profits from such operations. Respondents provided information regarding the above factors that are critical in determining an overseas expansion strategy.

Pharmacokinetics and distribution of ampicillin in plasma, milk and uterine fluid of female buffaloes

A pharmacokinetic study of ampicillin (6 mg/kg intravenous) revealed that the peak concentrations of 17.81 +/- 1.25, 5.64 +/- 2.24 and 1.09 +/- 0.10 micrograms/ml of the drug were attained at 15 min, 30 min and 2 h in plasma, milk and uterine fluid respectively. A therapeutic concentration of greater than or equal to 0.1 microgram/ml was maintained from 15 min-8 h, 15 min-6 h and 30 min-6 h in plasma, milk and uterine fluid. Hence, the drug may be used effectively in mammary gland and uterine infections apart from its use in other systemic infections.

Disposition kinetics and distribution of demeclocycline in various biological fluids in female goats

A pharmacokinetic study of demeclocycline was carried out following intravenous administration at 5 mg/kg body weight in lactating goats. Demeclocycline appeared within 5 min in plasma, interstitial fluid (isf) and urine, while it appeared at 1 h in milk. Peak concentrations of 21.70 +/- 4.06, 2.67 +/- 0.23, 5.65 +/- 0.45 and 82.23 +/- 10.06 micrograms/ml were attained at 5 min and at 6, 8 and 8 h in plasma, isf, milk and urine respectively. A potentially therapeutic concentration of greater than or equal to 0.5 micrograms/ml was maintained from 5 min-36 h, 30 min-30 h, 1-36 h and 5 min-48 h in plasma, isf, milk and urine respectively. The drug was detectable in all the above biological fluids for at least 48 h. A low distribution half life (t1/2 alpha) of 0.44 +/- 0.04 h and a high elimination half life (t1/2 beta) of 19.24 +/- 1.22 h denote rapid distribution but very slow elimination of the drug in goats. A high tissue plasma concentration ratio [K12:(K21-beta)] of 5.12 +/- 0.97 during the elimination phase and a Vdarea of 1.59 +/- 0.18 L/kg indicate uniform distribution of demeclocycline in the tissues and body fluids of goats. The dosage regimen for maintaining minimum plasma concentration (Cp infinity min = MIC) of 0.5, 1.0 and 1.5 micrograms/ml at selected dosage intervals of 12 and 24 h was also calculated.

Pharmacokinetic data on doxycycline and its distribution in different biological fluids in female goats

A pharmacokinetic study of doxycycline after intravenous administration at 5 mg/kg body weight in goats revealed that a concentration of greater than or equal to 0.5 microgram/ml was maintained for 5 min-2 h, 4-12 h, 2-12 h and 5 min-greater than 48 h in plasma, interstitial fluid, milk and urine respectively. The low t1/2 alpha of 0.73 +/- 0.11 h and high t1/2 beta of 16.63 +/- 1.58 h show that the drug is rapidly distributed but slowly eliminated from the body. The tissue:plasma concentration of 4.86 +/- 1.06 during the elimination phase [K12/(K21-beta)] indicates a high expected tissue concentration, which is supported by similarly increased drug concentration in interstitial fluid and milk. The high Vdarea of 9.78 +/- 0.86 L/kg observed denotes that, apart from its wide distribution, the drug may be stored in fat depots as it is known to be highly lipophilic. As the drug maintained a therapeutic concentration for a shorter time in plasma, and the calculated dose rate for maintaining a minimal plasma concentration of 0.5-1.5 micrograms/ml is relatively high, it may not be of much use in treating septicaemia in this species. Since the observed tissue:plasma concentration was higher and a therapeutic concentration was maintained in interstitial fluid and milk for longer, the drug can be used for other systemic infections at a lower dose rate than that required for treating septicaemia. As the drug maintained a very high concentration in urine, it may be of particular value in treating urinary tract infections caused by sensitive micro-organisms.

Pharmacokinetics and distribution of sulphadimidine in plasma, milk and uterine fluid of female buffaloes

The pharmacokinetics of sulphadimidine after a single dose (200 mg/kg i.v.) was studied in five healthy lactating buffaloes. The study revealed that the drug attained its peak concentration of 314.0 +/- 13.0, 242.4 +/- 3.0 and 100.2 +/- 2.5 micrograms/ml at 15 min, 30 min and 12 h in plasma, milk and uterine fluid, respectively. The pharmacokinetic parameters calculated by a 2-compartment open model gave values for t1/2 alpha, t1/2 beta and vdarea of 2.10 +/- 0.36 h, 12.36 +/- 0.57 h and 1.23 +/- 0.07 L/Kg, respectively. A high vdarea as well as a value of 0.74 +/- 0.08 for K12:K21-beta (tissue approximately equal to Plasma) indicates better penetration of the drug into the different body fluids and tissues, which is further supported by a high concentration obtained in milk and uterine fluid. The therapeutic concentration (greater than or equal to 50 micrograms/ml) was maintained for around 24 h in plasma and milk and 12 h in uterine fluid. The results suggest that, apart from its use in systemic infections, the drug can be effectively used by the i.v. route in uterine and mammary gland infections. The dosages for maintaining concentration of 50 micrograms/ml, 100 micrograms/ml and 150 micrograms/ml at convenient dosage intervals of 12 and 24 h were also determined.

Effect of some beta-adrenoceptor blockers and of (+) propranolol on adrenaline-induced pulmonary edema in mice

(+) Propranolol is considered to prevent adrenaline-induced pulmonary edema (A.P.E.) due to the beta-adrenoceptor blockade. However, local anaesthetics also are known to prevent pulmonary edema. To assess the role of beta-adrenergic blockade in A.P.E., the effect of a beta 1-blocker possessing local anaesthetic action (+/- Metaprolol) and a beta 1-blocker possessing no local anaesthetic action (+/- practolol) was studied along with propranolol derivatives. The study revealed that (+), (-), (+/-) propranolol and (+/-) metaprolol completely prevented A.P.E. whereas (+/-) practolol did not. This shows that local anaesthetic action but not the-beta adrenergic blockade may be responsible for prevention of A.P.E.

Pulmonary surfactants in pulmonary oedema induced by head injury in mice

A study has been carried out to examine the role of pulmonary surfactants in pulmonary oedema induced by head injury. Pulmonary oedema was induced by head injury in mice by the method of Mackay (5). There was no change in surface tension as well as total phospholipid concentration of the lung between control and test groups suggesting that there was no involvement of lung surfactant sytem in pulmonary oedema induced by head injury. Since the animals in the test group died within a few minutes, possibly there may not have been sufficient time for alteration of lung surfactant system.

Pharmacokinetics of streptomycin with particular reference to its distribution in plasma, milk and uterine fluid of she-buffaloes

The study elucidated the pharmacokinetics of streptomycin in healthy lactating she-buffaloes after a single intramuscular (IM) injection (10 mg/kg). The drug attained its peak concentrations of 24.39 +/- 2.67, 0.45 +/- 0.05 and 5.06 +/- 0.18 micrograms/ml at 1, 4 and 1 hour in plasma, milk and uterine fluid respectively. Calculations based on the assumption of a 2-compartment model gave a plasma t1/2 (beta) of 4.01 +/- 0.44 h and an apparent volume of distribution [Vd(area)] of 0.47 +/- 0.06 1/kg. The drug was detectable in the plasma, milk and uterine fluid for 30, 8 and 12 hours, respectively. A therapeutic concentration of the drug was maintained for 6 to 7 hours in the plasma and for around 1 hour only in the uterine fluid. However, a therapeutic level could not be achieved in milk at any time. The results suggest that the drug can be used clinically by the IM route against streptomycin susceptible systemic infections but not those in the uterus and mammary gland.