OBJECTIVETo investigate the associations of markers of insulin resistance with cardiovascular disease risk factors and inflammation in young, normal-weight, Hispanic women.RESEARCH DESIGN AND METHODSSeventy-one normal-weight (BMI <25 kg/m2) Hispanic women (age, 20–39 years) participated in a fasting blood draw for glucose, insulin, lipids, and inflammatory markers; a glucose tolerance test; anthropometric and blood pressure measurements; body composition by dual-energy x-ray absorptiometry; and measurements of cardiorespiratory fitness via Vo2max and daily physical activity by accelerometer.RESULTSSix percent of participants had impaired fasting glucose, 14% had impaired glucose tolerance, and 48% had at least one cardiovascular disease risk factor. Homeostasis model assessment of insulin resistance (HOMA-IR) and fasting insulin were positively correlated with glucose, triglycerides, systolic blood pressure, and diastolic blood pressure, and were negatively correlated with adiponectin (P < 0.05). The 2-h insulin was positively correlated with diastolic blood pressure, triglycerides, and high-sensitivity C-reactive protein. HOMA-IR and fasting insulin remained significantly and positively related to glucose, triglycerides, and blood pressure after adjustment for body composition. The relationships between markers of insulin resistance and adiponectin and high-sensitivity C-reactive protein were attenuated after adjustment for body composition.CONCLUSIONSSurrogate markers of insulin resistance were associated with cardiovascular disease risk factors and inflammation in young, normal-weight, Hispanic women. Our findings suggest that HOMA-IR, fasting, and 2-h insulin may be important clinical markers for identifying young, normal-weight, Hispanic women who may be at risk for development of type 2 diabetes and cardiovascular disease. Our findings show the importance of early screening for prevention of type 2 diabetes and cardiovascular disease in this population.

BackgroundBody weight has been increasing in the general population and is an established risk factor for hypertension, diabetes, and all-cause and cardiovascular mortality. Patients undergoing peritoneal dialysis (PD) gain weight, mainly during the first months of treatment. The aim of this study was to assess the relationship between body composition and metabolic and inflammatory status in patients undergoing PD.MethodsThis was a prospective, non-interventional study of prevalent patients receiving PD. Body composition was studied every 3 months using bioelectrical impedance (BCM®). We performed linear regression for each patient, including all BCM® measurements, to calculate annual changes in body composition. Thirty-one patients in our PD unit met the inclusion criteria.ResultsMedian follow-up was 26 (range 17–27) months. Mean increase in weight was 1.8 ± 2.8 kg/year. However, BCM® analysis revealed a mean increase in fat mass of 3.0 ± 3.2 kg/year with a loss of lean mass of 2.3 ± 4.1 kg/year during follow-up. The increase in fat mass was associated with the conicity index, suggesting that increases in fat mass are based mainly on abdominal adipose tissue. Changes in fat mass were directly associated with inflammation parameters such as C-reactive protein (r = 0.382, P = 0.045) and inversely associated with high-density lipoprotein cholesterol (r=−0.50, P = 0.008).ConclusionsFollow-up of weight and body mass index can underestimate the fat mass increase and miss lean mass loss. The increase in fat mass is associated with proinflammatory state and alteration in lipid profile.

The Problem The lack of theoretical frameworks representing voices and leadership experiences of women of color, compounded by multiple ways intersectionality changes the experience, continues to be under-represented in Human Resources Development (HRD) literature. Furthermore, given the field of HRD is fundamental to developing the whole person, lack of attention to voices and leadership experiences of women of color is problematic. Here, women of color represent Black, African American, and Indigenous women leaders. The Solution Applied critical leadership is introduced as a theoretical framework to expand and enhance HRD research, theory, and practice in the development of women of color as leaders. A conceptual development model, the Feminist Indigenous Mixteco Migrant Epistemology (FIMME) is introduced as a sociocultural view of leadership, defining multiple ways women of color harness the power of intersecting racial, ethnic, gendered, linguistic, socio-economic, and migrant leadership practices. The Stakeholders Human Resources Development scholars, students, and policymakers benefit from novel ways to think about women of color in leadership through culturally grounded concepts, bringing light to nuanced understandings. Exemplars for women’s leadership for culturally and linguistically diverse and Indigenous societies are provided as solutions to socio-political complexity.

No abstract

This review article describes the development of the use of ultrasound guidance for neuraxial blocks in obstetric anesthesia. Current evidence of the clinical utility and application, basic lumbar spine sonoanatomy and practical clinical approach of the ultrasound-guided technique for neuraxial blocks are presented and discussed. Suggested curriculum is intended to prepare anesthesiology residents for application of ultrasound guidance in epidural analgesia and obstetric anesthesia. Keywords:Ultrasound for epidural analgesia, Ultrasound guidance for obstetric analgesia and anesthesia, Ultrasound for neuraxial blocks, Teaching of ultrasound imaging and technical skills in anesthesiology, Role of ultrasound in regional anesthesia.