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BackgroundType 1 diabetes (T1D) afflicts approximately 154,000 people under 20 years of age. Three-quarters of adolescents are not achieving glycosylated hemoglobin (HbA1c) targets, which leads to negative health outcomes. Mobile health (mHealth), the use of technology in health, has been used successfully to improve health in many chronic conditions, including diabetes. ObjectiveThe purpose of this study was to use patient-centered research methods to inform and improve the design and functionality of our T1D app, MyT1DHero, and to provide insight for others who are designing a health app for adolescents and parents. MethodsThis study included data from focus groups with participants recruited from the Juvenile Diabetes Research Foundation (JDRF) southeast Michigan’s family network. All data collected during the sessions were audio-recorded, transcribed, and coded. ResultsFour key themes were identified: (1) diabetes is unpredictable, (2) negative and frustrated communication, (3) motivations to use an app, and (4) feedback specific to our app. ConclusionsA patient-centered approach was used to assist in the development of an app for adolescents with T1D. Participants were satisfied with overall app design; customization, interactivity, and tangible rewards were identified as being necessary for continued use. Participants believed the app would help improve the communication between parents and adolescents. Many apps developed in the health context have not used a patient-centered design method or have seen vast improvements in health. This paper offers suggestions to others seeking to develop apps for adolescents and their parents.

Objectives: To determine whether first-year college students cluster in networks based on subjective perceptions of loneliness. Participants: 492 first-year Notre Dame students completed surveys across two semesters and provided communication data used to reconstruct their social networks. Methods: Subjective perceptions of loneliness are measured using the Social and Emotional Loneliness Scale for Adults (SELSA). Correlations between an individual's loneliness and the average loneliness of their alters are compared to associations in random networks created using a rewiring algorithm to determine statistical significance. Results: During their first semester, students are more likely than chance to form ties with other students with similar levels of family and romantic loneliness. In their second semester, students cluster on romantic loneliness but not on family or social loneliness. Conclusions: Students are more likely than chance to form ties with people with similar self-perceived levels of loneliness, but only for certain types of loneliness and during certain periods.

From Time to Time Italo Calvino's If on a winter's night a traveler opens with these words: 'You are about to begin reading Italo Calvino's new novel, If on a [...]

A long-standing concern in the study of culture is understanding how culture is distributed, often discussed in terms of cultural "coherence." Cultural diversity, defined as the degree to which people share beliefs or meanings, is one dimension of cultural coherence that has been associated with many social outcomes. This article contributes to this area of research by considering how to measure cultural diversity in text and introducing a simple approach that uses word counts and sets of diversity indices (called "diversity profiles"). Text is useful for social-psychological analysis because as an artifact of individual thought, it provides a way to measure how beliefs and meanings are distributed and made salient across groups. The measurement approach outlined here contrasts to many contemporary computational approaches to measuring culture in text, which employ a relational logic of meaning based on word co-occurrences. While these more sophisticated approaches are well suited to measuring diversity in many instances, I show that there are some cases for which simpler measures based on word counts are ideal. After discussing the measurement of cultural diversity using word counts, I present a computational analysis of interview transcripts of American religious parents discussing the ages at which it is appropriate for children to participate in different practices often considered inappropriate for young children. The analysis points to the homogenizing influence of institutions on discussions of age appropriateness. I conclude by discussing implications for cultural analysis more generally. [ABSTRACT FROM AUTHOR]

Exposure to potentially morally injurious events (PMIEs) is a pervasive threat for military service members and may be associated with symptoms of anxiety, depression, and suicidal ideation. However, coping mechanisms, such as mindfulness, may ameliorate symptoms and improve recovery. Two studies were conducted to test dispositional mindfulness as a moderator of the links between PMIEs, as assessed using the Moral Injury Events Scale (i.e., total score and Self‐Transgression, Other‐Transgression, and Betrayal subscale scores), and symptoms of anxiety, depression, and suicidal ideation among different samples of active‐duty soldiers in garrison. In Sample 1 (N = 310), mindfulness buffered the links between PMIE exposure and symptoms of both anxiety, ∆R2 =.02, and depression, ∆R2 =.03. In Sample 2 (N = 669), mindfulness moderated the link between the MIES Betrayal subscale and anxiety symptoms, ∆R2 =.01. The results suggest that dispositional mindfulness may be a protective factor against some of the negative impacts of PMIE exposure. Further implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Past research has demonstrated that adolescents with Type 1 diabetes (T1D) typically have a decline in health outcomes as they begin to assume more self-management activities. Mobile app interventions have been suggested as one possible way to improve this behavior. Purpose: The primary aim of this study was to address declines in health outcomes by pilot testing the satisfaction, use and feasibility of an app-based family communication intervention aimed to assist in adolescent self-management of T1D. Methods: Thirty-three adolescent–parent pairs were enrolled in and completed the 12-week pilot study. Participants were randomized 2:1 to intervention (app use) or control group. Pre/post quantitative and qualitative data were collected, including HbA1c and surveys. Paired-sample t -tests and ANOVA statistics were conducted. Results: The parents and adolescents reported high satisfaction with the app, and that it was easy to use. Results showed HbA1c stability in the intervention group and significant worsening in the control group. There were also significant improvements in adherence to diabetes management and quality of life for the parents in the intervention group. The adolescents did not show any improvement in quality-of-life measures. Conclusion: This study suggests that the app intervention is acceptable, shows promise for improving health outcomes for adolescents with T1D, and may improve family communication. The public health implications of this work are that app interventions have a potential role in positively influencing chronic disease outcomes. Additional research with a more extensive and diverse sample is needed to determine generalizability. [ABSTRACT FROM AUTHOR]

To describe the diagnosis and successful treatment of systemic francisellosis in a dog. An 11‐year‐old female spayed Labrador retriever presented for progressive lethargy, hyporexia, and cough. The dog was febrile with a neutrophilia, nonregenerative anemia, thrombocytopenia, and had increased activity in serum of liver‐derived enzymes. Francisella philomiragia was isolated from aerobic blood culture. The dog was treated for 6 weeks with enrofloxacin orally. Repeated aerobic blood cultures after 2 and 6 weeks of antibiotic therapy were negative. The dog was clinically normal 7 months after diagnosis with no evidence of relapse. [ABSTRACT FROM AUTHOR]

Objective: Acute agitation in pediatrics is commonly encountered in hospital settings, can contribute to significant physical and psychological distress, and management is highly varied in practice. As such, the development of a standardized pharmacologic guideline is paramount. We aimed to develop a novel clinical pathway (CP) for management of acute agitation for all hospitalized pediatric patients in Canada. Methods: Healthcare professionals in Canada with expertise in treating and managing pediatric agitation formed a working group and developed a CP through conducting a literature review, engaging key partners, and obtaining interdisciplinary consensus (iterative real-time discussions with content experts). Once developed, the preliminary CP was presented to additional internal and external partners via multiple grand rounds and a webinar; feedback from participants guided final CP revisions. Results: The working group created a pediatric inpatient CP to guide pharmacologic management of agitation and serve as an easy-to-use clinical and educational resource with three complementary sections including: 1) a treatment algorithm, 2) a quick reference medication chart, and 3) two supporting documents, which provide a general overview of non-pharmacologic strategies prior to CP implementation and an illustrative scenario to accompany the medication chart to ensure effective utilization. Conclusions: This is the first CP to standardize pharmacological treatment and management of acute agitation in children in inpatient settings in Canada. Although further research is warranted to assess implementation and support process improvement, the CP can be adapted by individual institutions to assist in prompt pharmacological management of pediatric agitation to potentially improve outcomes for patients, families, and healthcare professionals. [ABSTRACT FROM AUTHOR]

Cinacalcet is an oral calcimimetic that has potential to non‐invasively treat primary hyperparathyroidism in dogs (Canis lupis familiaris). There is minimal data assessing its efficacy in dogs. This study aimed to determine whether a single dose of cinacalcet decreases serum ionized calcium (iCa), total calcium (tCa), and parathyroid hormone (PTH) concentrations. Twelve dogs received a median dose of 0.49 mg/kg (range 0.30–0.69 mg/kg) cinacalcet per os. Venous blood samples were collected at time 0 (before cinacalcet administration), 3, 8, and 24 h following cinacalcet administration. PTH, iCa, and tCa concentrations were measured at each time point and compared to 0 hour concentrations. A significant (50%) decrease in serum PTH occurred at 3 h with a median PTH of 4.6 pmol/L (range 2.7–10.8) at baseline and 1.65 pmol/L (range 0.5–14.7) at 3 h; p =.005. A significant, but not clinically relevant, decrease in serum iCa from a median baseline of 1.340 mmol/L (range 1.32–1.41) to a 3 h median of 1.325 mmol/L (range 1.26–1.39), p =.043, was also observed. tCa concentrations were not different. This study showed that a single dose of cinacalcet leads to transient decreases in iCa and PTH concentrations in healthy dogs. [ABSTRACT FROM AUTHOR]

Background: Youth violence is a significant problem affecting community health. Community-academic partnerships can advance youth nonviolence education by synergizing the strengths of collaborators while working toward a common goal. We describe a collaboration between an urban public middle school, community nonprofit, and university-based graduate school of nursing in implementing and evaluating the Healthy Power program, a school-based youth nonviolence program for middle-school boys. Methods: A participatory program evaluation approach was used to plan and implement evaluation of the "Healthy Power" program with a cohort of 8 students. Collaborative planning allowed for the selection of measures that reflected program objectives and were of value to community partners while also scientifically sound. A mixed-methods approach included a focus group and a pretest-posttest with quantitative items and open-ended questions. Results: While the quantitative pre-posttest did not show any significant change, the open-ended questions and focus group suggested that students had advanced their understanding and application of conflict resolution skills. Conclusions: The findings support the usefulness of community-academic partnerships for peace/conflict resolution education and program evaluation. Such programs may benefit from mixed methods of evaluation.