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Describes the curriculum of Brown University, a curriculum that honors the Emersonian ideal of individual self-realization while it addresses the challenges of cultural difference. Points out that interdisciplinary exploration and undergraduate research are the key components of Brown's distinctive curriculum. (SLD)

Objective: To assess the psychometric properties of the Chinese version of the Gout Impact Scale (GIS), a gout-specific HRQoL measure.Methods: This was a single-center, cross-sectional, observational survey of patients with gout recruited from the Taipei Medical University Hospital from November 2017 to April 2018. The respondents were recruited by convenience sampling. The reliability of the Chinese GIS was tested by Cronbach's α coefficient and adjusted using the Spearman-Brown prophecy formula. Content validity was assessed and confirmed by rheumatologists and pharmacists before the administration of the survey. Convergent validity was tested by Spearman correlation analysis to examine the association of the EQ-5D-5L with GIS total and subscale scores. Construct validity of the Chinese GIS was assessed by hypothesis testing.Results: A total of 311 patients were included in the analysis. The majority of these respondents were male (93.2%) with no comorbidities (69.5%) and they had a mean age of 52.9 (±14.2) years. The internal consistency of the Chinese GIS subscales was acceptable to excellent (Cronbach's α = 0.73-0.98) after adjusting to a 10 item scale with the Spearman-Brown prophecy formula. The GIS total and subscale scores were significantly associated with lower EQ-5D-5L scores ([-0.14] - [-0.27], p < .05). In addition, the GIS total and all subscale scores had a significant positive correlation with gout attack severity (rs = 0.13-0.57, p < .05) and gout attack pain (rs = 0.17-0.54, p < .01). Moreover, respondents' most recent sUA concentration was associated with both the GIS gout concern overall subscale (rs = 0.13, p < .05) and the unmet gout treatment need subscale (rs = 0.18, p < .01).Conclusions: The present study demonstrates that the Chinese version of the GIS shows good internal consistency and association with gout-related characteristics. Future studies may consider using this gout-specific instrument to assess the HRQoL of gout patients in Taiwan. [ABSTRACT FROM AUTHOR]

Background: About 50% of obsessive-compulsive disorder patients still suffer significant symptoms even after the recommended first-line therapy. This demonstrates the necessity to investigate strategies to improve alleviation of symptoms.Objective: The main objective of this study was to investigate the efficacy of a 5-hydroxytryptophan 3 receptor antagonist, tropisetron, as an adjuvant therapy to selective serotonin reuptake inhibitors, in ameliorating obsessive-compulsive disorder symptoms.Methods: Men and women between the ages of 18-60 years diagnosed with obsessive-compulsive disorder, based on DSM5, who had a Yale-Brown obsessive compulsive scale score of more than 21 were recruited in a double-blinded, parallel-group, placebo-controlled, clinical trial of 10 weeks to receive either tropisetron (5 mg twice daily) and fluvoxamine (100 mg daily initially followed by 200 mg daily after week 4) or placebo and fluvoxamine. The primary outcome of interest in this study was the Yale-Brown obsessive compulsive scale total score decrease from baseline.Results: One hundred and eight participants were equally randomized into two groups; 48 participants in each group finished the trial. The Yale-Brown obsessive compulsive total score significantly dropped in both groups while the tropisetron group participants experienced a significantly higher decrease in their scores (Greenhouse-Geisser F(1.53-65.87)=3.516, p-value=0.04). No major adverse effect was observed in any of the groups.Conclusion: This trial showed a significant efficacy for tropisetron over placebo in treatment of obsessive-compulsive disorder symptoms when added to fluvoxamine. [ABSTRACT FROM AUTHOR]

Key ideas from a workshop convened by the National Academies of Sciences, Engineering, and Medicine to discuss developments in IVG (National Academies of Sciences, Engineering, and Medicine 2023) chaired by Dr Eli Y. Adashi (former Dean of Medicine and Biological Sciences at Brown University). The authors are solely responsible for the content of this paper, which does not necessarily represent the views of the National Academies of Sciences, Engineering, and Medicine. [ABSTRACT FROM AUTHOR]

Incarcerated women, in comparison to nonincarcerated women, are at high risk for sexually transmitted infections (STIs) and many have experienced interpersonal violence. The psychological construct of emotional dysregulation—which includes heightened intensity of emotions, poor understanding of emotions, negative reactivity to emotion state, inability to control behaviors when experiencing emotional distress, and maladaptive emotion management responses—is a possible pathway to explain the link between interpersonal violence exposure and STI risk. The present study examined maladaptive emotion management responses for emotional dysregulation (i.e., avoidance and numbing, and dissociation) occurring in the context of risky sexual behavior. We collected qualitative data from 4 focus groups with a sample of n = 21 incarcerated women (aged 18+ years) from urban facilities in New England. Qualitative data were analyzed using a thematic analysis approach. Findings indicated that incarcerated women reported engaging in a variety of maladaptive responses for emotion management during sexual encounters. These maladaptive responses for emotion management appear to increase sexual risk behaviors and alter women’s ability to implement STI protective behaviors, such as sexual negotiation and condom use. Preventive interventions to reduce sexual risk behaviors should incorporate strategies to promote emotional regulation among incarcerated women with histories of interpersonal violence. [ABSTRACT FROM AUTHOR]

Introduction: Lung screening is an opportunity for smoking cessation and relapse prevention, but smoking behaviors may differ across screening results. Changes in smoking were evaluated among 18 840 current and former smokers aged 55-74 scheduled to receive three annual lung screenings.Methods: Participants were randomized to low-dose computed tomography or single-view chest radiography in the American College of Radiology/National Lung Screening Trial. Outcome measures included point and sustained (6-month) abstinence and motivation to quit among smokers; and relapse among smokers who quit during follow-up, recent quitters (quit < 6 months), and long-term former smokers (quit ≥ 6 months).Results: During five years of follow-up, annual point prevalence quit rates ranged from 11.6%-13.4%; 48% of current smokers reported a quit attempt and 7% of long-term former smokers relapsed. Any false positive screening result was associated with subsequent increased point (multivariable hazard ratio HR = 1.23, 95% CI = 1.13, 1.35) and sustained (HR = 1.28, 95% CI = 1.15, 1.43) abstinence among smokers. Recent quitters with ≥1 false positive screen were less likely to relapse (HR = 0.72, 95% CI = 0.54, 0.96). Screening result was not associated with relapse among long-term former smokers or among baseline smokers who quit during follow-up.Conclusions: A false positive screen was associated with increased smoking cessation and less relapse among recent quitters. Consistently negative screens were not associated with greater relapse among long-term former smokers. Given the Affordable Care Act requires most health plans to cover smoking cessation and lung screening, the impact and cost-effectiveness of lung screening could be further enhanced with the addition of smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between manganese intake and the risk of type 2 diabetes in postmenopausal women and determine whether this association is mediated by circulating markers of inflammation.Research Design and Methods: We included 84,285 postmenopausal women without a history of diabetes from the national Women's Health Initiative Observational Study (WHI-OS). Replication analysis was then conducted among 62,338 women who participated in the WHI-Clinical Trial (WHI-CT). Additionally, data from a case-control study of 3,749 women nested in the WHI-OS with information on biomarkers of inflammation and endothelial dysfunction were examined using mediation analysis to determine the relative contributions of these known biomarkers by which manganese affects type 2 diabetes risk.Results: Compared with the lowest quintile of energy-adjusted dietary manganese, WHI-OS participants in the highest quintile had a 30% lower risk of type 2 diabetes (hazard ratio [HR] 0.70 [95% CI 0.65, 0.76]). A consistent association was also confirmed in the WHI-CT (HR 0.79 [95% CI 0.73, 0.85]). In the nested case-control study, higher energy-adjusted dietary manganese was associated with lower circulating levels of inflammatory biomarkers that significantly mediated the association between dietary manganese and type 2 diabetes risk. Specifically, 19% and 12% of type 2 diabetes risk due to manganese were mediated through interleukin 6 and hs-CRP, respectively.Conclusions: Higher intake of manganese was directly associated with a lower type 2 diabetes risk independent of known risk factors. This association may be partially mediated by inflammatory biomarkers. [ABSTRACT FROM AUTHOR]

Background: The FDA recently acquired regulatory authority over tobacco products, leading to renewed interest in whether reducing the nicotine content of cigarettes would reduce tobacco dependence in the United States. Given the association between depressive symptoms and cigarette smoking, it is important to consider whether smokers with elevated depressive symptoms experience unique benefits or negative consequences of nicotine reduction.Methods: In this secondary analysis of a randomized clinical trial that examined the effects of cigarettes varying in nicotine content over a 6-week period in non-treatment-seeking smokers, we used linear regression to examine whether baseline depressive symptom severity (scores on the Center for Epidemiologic Studies Depression Scale [CES-D]) moderated the effects of reduced-nicotine content (RNC) cigarettes, relative to normal-nicotine content (NNC) cigarettes, on smoking rates, depressive symptom severity, and related subjective and physiological measures.Results: Of the 717 participants included in this analysis, 109 (15.2%) had CES-D scores ≥ 16, indicative of possible clinical depression. Relative to NNC cigarettes, RNC cigarettes reduced smoking rates, nicotine dependence, and cigarette craving, and these effects were not significantly moderated by baseline CES-D score. A significant interaction between baseline CES-D score and cigarette condition on week 6 CES-D score was observed (p < .05); among those with CES-D scores ≥ 16 at baseline, those assigned to RNC cigarettes had lower week 6 CES-D scores than those assigned to NNC cigarettes. Among those in the lowest nicotine content conditions, biochemically confirmed compliance with the RNC cigarettes was associated with an increase in CES-D score for those with baseline CES-D scores < 16 and no change in CES-D score for those with baseline CES-D scores ≥ 16.Conclusions: These findings provide initial evidence that a reduced-nicotine standard for cigarettes may reduce smoking, without worsening depressive symptoms, among smokers with elevated depressive symptoms.Implications: This secondary analysis of a recent clinical trial examined whether depressive symptom severity moderated the effects of reduced-nicotine cigarettes on smoking and depressive symptoms. Results indicate that, regardless of baseline depressive symptoms, participants randomized to reduced-nicotine cigarettes had lower smoking rates, nicotine intake, nicotine dependence, and craving at week 6 post-randomization than those assigned to normal-nicotine cigarettes. In participants with higher baseline depressive symptoms, those assigned to reduced-nicotine cigarettes had lower week 6 depressive symptoms than those assigned to normal-nicotine cigarettes. These results suggest that a nicotine reduction policy could have beneficial effects for smokers, regardless of depressive symptom severity. [ABSTRACT FROM AUTHOR]

Studies suggest that actively fighting back against an attacker is effective in decreasing the severity and completion of a sexual assault, yet little is known about the factors that contribute to women's confidence in fighting back. Accordingly, the present study examines correlates of college women's self-efficacy in resisting unwanted sexual advances (N = 650). Results suggest that fewer psychological barriers to resistance, greater sexual communication, increased use of dating self-protective behaviors, and greater sexual assertiveness were associated with increased sexual resistance self-efficacy. Findings underscore the importance of developing sexual assault prevention programs that increase women's confidence in fighting back. [ABSTRACT FROM AUTHOR]

Background Patients treated with mechanical thrombectomy (MT) for acute ischemic strokes from large vessel occlusion (LVO) have better outcomes with effective reperfusion. However, it is unknown which technique leads to better technical and clinical success. We aimed to determine which technique yields the most effective first pass reperfusion during MT. Methods In a prospective, multicenter global registry we enrolled patients treated with operator preferred MT technique at 71 hospitals from January 2019 to January 2022. Three techniques were assessed: SR Classic with stent retriever (SR) and balloon guide catheter (BGC); SR Combination which employed SR with contact aspiration with or without BGC; and direct aspiration (DA) with or without BGC. The primary outcome was achieving an expanded Thrombolysis In Cerebral Infarction (eTICI) score of 2c or 3 on the first pass, with the primary technique as adjudicated by core lab. The primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0--2. Results A total of 1492 patients were enrolled. Patients treated with SR Classic or SR Combination were more likely to achieve first pass eTICI 2c or 3 reperfusion (P=0.01). There was no significant difference in mRS 0--2 (P=0.46) or safety endpoints. Conclusions The use of SR Classic or SR Combination was more likely to achieve first pass eTICI 2c or 3 reperfusion. There were no significant differences in clinical outcomes and safety endpoints. [ABSTRACT FROM AUTHOR]

The study of firearm violence in Mexico has primarily focused on homicides and trafficking. Less attention has been given to understanding how firearms affect other crimes and facilitate criminal activity beyond drug markets. By analyzing two questions, this study explores the role of firearms in extortions perpetrated in Mexico from 2012 to 2021. Questions are: What is the likelihood of reporting extortions to the police if offenders exhibited firearms? What is the likelihood of compliance with demands when offenders are armed with firearms? We obtained data from Mexico's National Crime Victimization Surveys and analyzed 2,619 extortions reported from 2012 to 2021. To explore our research questions, we ran two binary logistic regressions. Our dependent variables were dichotomous (reported to police = 1, complied with demands = 1). The independent variables were weapon types (extortions involving firearms as the reference group). We controlled for victim demographics as well as crime characteristics. Our results indicate that 40% of these extortions (n = 1,058) were perpetrated with a firearm. Fifty-two percent of extortions were perpetrated by unarmed offenders (n = 1,348) and 8% (n = 213) were perpetrated with other weapons (no firearms). Models suggest that, when compared to extortions perpetrated by unarmed offenders or those exhibiting other weapons (no firearms), victims of extortions involving firearms are less likely to report these crimes to police, mainly because of fear of reprisal. Similarly, victims are more likely to comply with demands if offenders exhibit firearms. Findings highlight the role of firearms in criminal enterprises and support the need for a comprehensive policy agenda to address firearm violence in Mexico. [ABSTRACT FROM AUTHOR]

The purpose of this logistic regression study was to identify predictors of teacher-reported sustained use of data-based instruction (DBI) during the COVID-19 pandemic and assess the extent to which the identified predictors explained teachers' sustained use after completing programmatic support for intensive early writing instruction. We surveyed 58 teachers who participated in a professional development efficacy trial regarding their sustained use of DBI in writing. The model indicated a higher predicted probability of sustaining DBI for teachers who received the full treatment (tools, learning modules, and coaching for 20 weeks of intervention during their year of participation in the efficacy trial) compared to teachers in the control group who only received tools and learning modules at the end of their participation year. In addition, teachers who taught in-person were more likely to sustain compared to those who taught in remote or hybrid models, controlling for other variables. Furthermore, as the number of facilitators that teachers reported increased, teachers were more likely to sustain their use of DBI components, controlling for other variables. Further research could shed light on the relative impact of different types of facilitators and different levels of support. [ABSTRACT FROM AUTHOR]

Introduction: Medications for addiction treatment (MAT) are the evidence-based standard of care for treatment of opioid use disorder (OUD), but stigma continues to surround their use. We conducted an exploratory study to characterize perceptions of different types of MAT among people who use drugs. Methods: We conducted this qualitative study in adults with a history of non-medical opioid use who presented to an emergency department for complications of OUD. A semi-structured interview that explored knowledge, perceptions, and attitudes toward MAT was administered, and applied thematic analysis conducted. Results: We enrolled 20 adults. All participants had prior experience with MAT. Among participants indicating a preferred treatment modality, buprenorphine was the commonly favored agent. Previous experience with prolonged withdrawal symptoms upon MAT discontinuation and the perception of "trading one drug for another" were common reasons for reluctance to engage in agonist or partial-agonist therapy. While some participants preferred treatment with naltrexone, others were unwilling to initiate antagonist therapy due to fear of precipitated withdrawal. Most participants strongly considered the aversive nature of MAT discontinuation as a barrier to initiating treatment. Participants overall viewed MAT positively, but many had strong preferences for a particular agent. Conclusion: The anticipation of withdrawal symptoms during initiation and cessation of treatment affected willingness to engage in a specific therapy. Future educational materials for people who use drugs may focus on comparisons of respective benefits and drawbacks of agonists, partial agonists, and antagonists. Emergency clinicians must be prepared to answer questions about MAT discontinuation to effectively engage patients with OUD. [ABSTRACT FROM AUTHOR]

This article presents updates on the activities of universities and colleges in the U.S. in relation to labor management. The Labor Relations Council of the University of Pennsylvania has prepared essays on different aspects of wage determination. Several studies have been conducted by the Department of Economics of Brown University including an analysis of workmen's compensation. A study of membership relations and attitudes of trade union members in upstate New York has been completed by faculty at the University of Buffalo. The Iowa Bureau of Labor and Management is experimenting with new techniques for estimating available labor supply in rural areas.

The article reports an increase in marijuana use by teenagers as National Survey on Drug Use and Health survey data released by Substance Abuse and Mental Health Services Administration (SAMHSA).

The article offers medical industry news briefs from the U.S. as of October 2014. The American Psychological Association has released a report which reveals that frequent marijuana use significantly adversely affects the brains of teenagers and young adults. The American Academy of Pediatrics (AAP) revealed that children with attention-deficit hyperactivity disorder (ADHD) are more likely than their peers to develop a substance use disorder (SUD).

The article presents research indicating the association of dating violence among adolescents with illicit drug use, depression and alcohol.

The article presents research indicating the significance of school-based programs associated to social influence model in preventing juvenile substance use through refusal skill, normative perception and attitude modification in Europe.

The article focuses on a study which examines the risk of serious adverse events among adolescent girls after receiving quadrivalent human papillomavirus vaccine.

The article offers information on the impact of genetic and environmental factors on young children's reading development.

The authors measured the impact of educational efforts on the number of college students who received meningococcal vaccine. First-year Brown University students from the classes of 2004 (n = 1,562) and 2005 (n = 1,518) received educational vaccine materials before they arrived on campus, whereas students from the class of 2003 (n = 1,441) did not. Students in the class of 2003, 13% (n = 184) of whom had received vaccine before their arrival on campus, served as the baseline. These educational efforts by the college health services before students arrived on campus increased the number of students immunized before campus arrival to 46% (n = 724) for the class of 2004, and 60% (n = 913) for the class of 2005. Education about the benefits of meningococcal vaccine before students' arrival on campus increased both the number of immunized students and the overall immunization rate among students. [ABSTRACT FROM AUTHOR]

Objective: To explore the perspectives of stakeholders on consenting and reconsenting children and adolescents living with HIV (CALWH) to participate in research involving biological sampling and biobanking. Stakeholders included CALWH, their caregivers, subject matter experts (SMEs) such as Institutional Review Board (IRB) members, Community Advisory Board (CAB) members, Healthcare Providers, researchers, and community leaders. Study design: This qualitative study was conducted at the Academic Model Providing Access to Healthcare (AMPATH) in Kenya. Semi-structured interviews were conducted with CALWH, their caregivers, and SMEs. Audio recordings were transcribed, thematically analyzed, and emerging themes derived. Results: In total, 99 participants were interviewed, of which the majority (52%) were female; 50% of CALWH were female with a median age of 17.5 years (range 11-24); 70% of caregivers and 44% of SMEs were female. All SMEs, CALWH, and caregivers emphasized that recontacting and reconsenting were their strong preferences for the use of biospecimens and also an essential procedure to address legal and ethical considerations and confidentiality. All CALWH wanted consent to detail how they will be informed about research findings and emphasized making their results available to them. Caregivers highlighted the importance of trust in the use of the stored samples to be maintained as per the consents. Conclusion: Our findings revealed that CALWH and their caregivers want researchers to go beyond the typical information provided about biospecimen storage and use. They desire to be recontacted and reconsented as well as maintain ongoing communication with the research team about the research findings. Plain Language Summary: Bioethics of reconsenting biospecimen samples of adolescents and children living with HIV from the perspective of stakeholders The study explores the bioethics surrounding re-consent for children and adolescents living with HIV from a stakeholder perspective. Stakeholders include children and adolescents living with HIV (CALWH), their caregivers, Institutional Review Board (IRB) members, Community Advisory Board (CAB) members, healthcare providers, researchers, and community leaders. Results found that repeat contacting and reconsenting is an essential procedure to ensure legal and ethical considerations and confidentiality are upheld. The findings suggest researchers should provide comprehensive information on the purpose of biospecimen storage to participants. [ABSTRACT FROM AUTHOR]

Social reactions to disclosure of sexual victimization play an important role in the process of recovery. The purpose of this qualitative study was to explore the impact of online disclosure of sexual victimization. The sample for this qualitative study (n = 17) focused on participants who shared their experiences with disclosing about their sexual victimization online and the reactions received in these spaces. Using applied thematic analysis, the research team identified three major themes from the data, each with respective subthemes, including helpful, harmful, and mixed reactions to online disclosure. Findings highlighted the nuances of disclosing online and the diverse reactions that were received. Participants provided in-depth descriptions of not only how the disclosure experience and resulting reactions could be helpful or harmful but also nuanced, mixed, and simultaneously harmful and helpful. This data is a crucial reminder that survivors' stories are unique and that survivors experience many varying motivations for choosing if, when, where, to whom, or for whom they may disclose. The findings may help inform clinical recommendations for mental health practitioners working with survivors of sexual victimization and holding therapeutic space to process these decisions of disclosure. Future researchers should also consider further studying online interactions, especially within and between survivors, including when and how survivors choose to connect or disconnect. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and measures taken to decrease the spread impacted youth in foster care and foster parents in a myriad of ways. One critical yet unexplored area is how educational changes during the first 2 years of the pandemic impacted this specific group of youth in foster care and foster parents. This exploratory study used three methods: (1) A scoping review of the prior research on pandemics/climate events and school closures and the research from early 2020; (2) individual interviews and focus groups with foster parents and teachers; and (3) an online survey of 88 foster parents. We endeavored to include findings at each stage of the process. Research from prior epidemics and school closures and predictive models predicted learning losses which were verified by the findings in the survey and interviews. Foster parents reported that the youth in foster care had great difficulty concentrating with on-line delivery and the absence or greatly limited access to mental health services compounded the challenges. Even as children returned to classrooms, the behavior of children, youth resulted in suspensions and expulsions likely increasing learning losses. The discussion identifies some approaches to addressing COVID-19 learning gaps and the mental health needs of this vulnerable group of children and youth. [ABSTRACT FROM AUTHOR]

Purpose: School-based telefacilitators are critical yet underresearched members of telepractice programs. They are the face of the telepractice program and are often telepractice champions in their communities. However, we have little research explaining the typical profile of telefacilitators, making it more difficult to identify personnel characteristics that contribute to the implementation of sustainable telepractice programs. The purpose of this study was to describe the typical profile and preparation of school-based telefacilitators for physical, occupational, and speech therapy in the United States. Method: A cross-sectional survey gathered 21 telefacilitator responses about their primary job title, preparation, confidence, and basic demographics. Survey recruitment followed an adaptive sampling method with three phases: stratified random sampling, purposive sampling, and targeted convenience sampling. Results were analyzed using frequency counts and descriptive statistics where appropriate. Results: Most respondents held the primary job title of paraprofessional, but a diverse range of titles were reported, including superintendents and directors of special education. Half of the respondents received various methods of formal training for the role, whereas the other half were self-taught. Overall levels of confidence in job performance were high, yet self-taught telefacilitators felt that lack of training negatively impacted their performance. Most respondents had a bachelor's degree or higher. Conclusions: There is a high degree of variability in the profile and preparation of telefacilitators. Inconsistency in terminology and lack of agreed-upon job responsibilities are significant barriers to studying the role of telefacilitators and the ability to plan telepractice staffing needs adequately. Clinical implications and opportunities for future investigation are highlighted. [ABSTRACT FROM AUTHOR]

The article focuses on a study regarding the relationship between the caffeine use of teenagers and self-reported violent behaviors and conduct disorders which found an additive power of caffeine in 50.2% of girls aged 15-16 enrolled at the Icelandic national education system in February 2012.

The article focuses on a study regarding Parents-CARE, a youth suicide prevention program for parents which shows the important role of families in preventing youth suicide.

With concern over parental involvement in students' academic lives on the rise, research is needed to provide guidance for advisors and parents. In this article, student-parent interactions about academic and career decisions are examined. Data come from the Brown University Office of Institutional Research and semi-structured interviews with students at Brown University. In the interviews, students reported that they rely on their parents for general support and as a source of advice about academic and career decisions. These findings are consistent with institutional data and prior research. Analysis of the findings draws on attachment theory and on Baxter Magolda's self-authorship model of adult development. Implications for advising practice as well as suggestions for fostering constructive parent involvement are addressed. [ABSTRACT FROM AUTHOR]

Affective response to exercise may mediate the effects of self-paced exercise on exercise adherence. Fiftynine low-active (exercise <60 min/week), overweight (body mass index: 25.0-39.9) adults (ages 18-65) were randomly assigned to self-paced (but not to exceed 76% maximum heart rate) or prescribed moderate intensity exercise (64-76% maximum heart rate) in the context of otherwise identical 6-month print-based exercise promotion programs. Frequency and duration of exercise sessions and affective responses (good/bad) to exercise were assessed via ecological momentary assessment throughout the 6-month program. A regression-based mediation model was used to estimate (a) effects of experimental condition on affective response to exercise (path a = 0.20, SE = 0.28, f2 = 0.02); (b) effects of affective response on duration/latency of the next exercise session (path b = 0.47, SE = 0.25, f2 = 0.04); and (c) indirect effects of experimental condition on exercise outcomes via affective response (path ab = 0.11, SE = 0.06, f2 = 0.10). Results provide modest preliminary support for a mediational pathway linking self-paced exercise, affective response, and exercise adherence. [ABSTRACT FROM AUTHOR]

The article offers research-based updates. A study has examined the parental perceptions of a school-aged child's body mass index for overweight category. A study has examined the relationship between psychosocial development in children and electronic game playing. A Study has investigated the effects of exposure to antipsychotic drugs to weight gain and diabetes.

Objective Little is known about the hospital outcomes of moderately preterm (MPT; 29 0/7–33 6/7 weeks gestational age) infants born to insulin-dependent diabetic mothers (IDDMs). We evaluated characteristics and outcomes of MPT infants born to IDDMs compared with those without IDDM (non-IDDM). Study Design Cohort study of infants from 18 centers included in the MPT infant database from 2012 to 2013. We compared characteristics and outcomes of infants born to IDDMs and non-IDDMs. Results Of 7,036 infants, 527 (7.5%) were born to IDDMs. Infants of IDDMs were larger at birth, more often received continuous positive pressure ventilation in the delivery room, and had higher risk of patent ductus arteriosus (adjusted relative risk or aRR: 1.49, 95% confidence interval [CI]: 1.20–1.85) and continued hospitalization at 40 weeks postmenstrual age (aRR: 1.55, 95% CI: 1.18–2.05). Conclusion MPT infants of IDDM received more respiratory support and prolonged hospitalizations, providing further evidence of the important neonatal health consequences of maternal diabetes. Key Points Little data are available on moderate preterm infants of IDDMs. MPT infants of IDDMs need more respiratory support. Longer neonatal intensive care unit stays among MPT infants of IDDMs. [ABSTRACT FROM AUTHOR]

Introduction: A cigarette purchase task (CPT) is a behavioral economic measure of the reinforcing value of smoking in monetary terms (ie, cigarette demand). This study investigated whether cigarette demand predicted response to contingent monetary rewards for abstinence among individuals with substance use disorders. It also sought to replicate evidence for greater price sensitivity at whole-dollar pack price transitions (ie, left-digit effects).Methods: Participants (N = 338) were individuals in residential substance use disorder treatment who participated in a randomized controlled trial that compared contingent vouchers to noncontingent vouchers for smoking abstinence. Baseline demand indices were used to predict number of abstinent days during the 14-day voucher period (after the reduction lead-in) and at 1 and 3 months afterward.Results: Demand indices correlated with measures of smoking and nicotine dependence. As measured by elasticity, intensity and O max, higher demand significantly predicted fewer abstinent exhaled carbon monoxide readings during voucher period for individuals in the noncontingent vouchers condition. Breakpoint exhibited a trend-level association with abstinent exhaled carbon monoxide readings. Demand indices did not predict abstinence in the contingent vouchers group, and did not predict abstinence at 1- and 3-month follow-ups. Left-digit price transitions were associated with significantly greater reductions in consumption.Conclusions: The association of cigarette demand with smoking behavior only in the group for whom abstinence was not incentivized indicates that CPT assesses the value of smoking more than the value of money per se and that vouchers counteract the effects of the intrinsic reinforcing value of cigarettes. Results provide initial short-term evidence of predictive validity for the CPT indices.Implications: This study provides the first evidence of the validity of the CPT for predicting early response to brief advice for smoking cessation plus nicotine replacement in smokers with substance dependence. However, demand for cigarettes did not predict voucher-based treatment response, indicating that incentives serve as a powerful motivator not to smoke that acts in opposition to the intrinsic reinforcing value of cigarettes and that the indices reflect the value of smoking more than the value of money per se. [ABSTRACT FROM AUTHOR]

Objective: To examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions.Data Sources: Secondary data analysis of 2016-2017 national VA administrative data linked with Medicare claims.Study Design: Observational study examining sociodemographic, medical, and healthcare utilization characteristics associated with receipt of A&A among Veterans receiving pension.Principal Findings: In 2017, 9.7% of Veterans with pension newly received the A&A benefit. The probability of receiving A&A among black and Hispanic pensioners was 4.6 percentage points lower than for white pensioners (95%CI = -0.051, -0.042). Married Veterans receiving pension had a 4.4-percentage point higher probability of receiving A&A (95%CI = 0.039, 0.048). Most indicators of need for assistance (eg, home health utilization, dementia, stroke) were associated with significantly higher probabilities of receiving A&A, with notable exceptions: pensioners with a diagnosis of Post-Traumatic Stress Disorder (marginal effect = -0.029 95%CI = -0.037, -0.021) or enrolled in Medicaid (marginal effect = -0.053, 95%CI = -0.057, -0.050) had lower probabilities of receiving A&A. Unadjusted and adjusted rates of receiving A&A among Veterans receiving pension varied by VA medical center.Conclusions: This study identified potential inequities in receipt of the A&A enhanced pension among a sample of Veterans receiving pension. Increased Veteran outreach, provider education, and VA office coordination can potentially reduce inequities in access to this benefit. [ABSTRACT FROM AUTHOR]

We consider the problem of designing a confirmatory randomized trial for comparing two treatments versus a common control in two disjoint subpopulations. The subpopulations could be defined in terms of a biomarker or disease severity measured at baseline. The goal is to determine which treatments benefit which subpopulations. We develop a new class of adaptive enrichment designs tailored to solving this problem. Adaptive enrichment designs involve a preplanned rule for modifying enrollment based on accruing data in an ongoing trial. At the interim analysis after each stage, for each subpopulation, the preplanned rule may decide to stop enrollment or to stop randomizing participants to one or more study arms. The motivation for this adaptive feature is that interim data may indicate that a subpopulation, such as those with lower disease severity at baseline, is unlikely to benefit from a particular treatment while uncertainty remains for the other treatment and/or subpopulation. We optimize these adaptive designs to have the minimum expected sample size under power and Type I error constraints. We compare the performance of the optimized adaptive design versus an optimized nonadaptive (single stage) design. Our approach is demonstrated in simulation studies that mimic features of a completed trial of a medical device for treating heart failure. The optimized adaptive design has $25\%$ smaller expected sample size compared to the optimized nonadaptive design; however, the cost is that the optimized adaptive design has $8\%$ greater maximum sample size. Open-source software that implements the trial design optimization is provided, allowing users to investigate the tradeoffs in using the proposed adaptive versus standard designs. [ABSTRACT FROM AUTHOR]

Objective: Greater depressive symptoms and low positive affect (PA) are associated with poor smoking cessation outcomes. Smoking cessation approaches that incorporate a focus on PA may benefit smokers trying to quit. The purpose of this study was to conduct a pilot randomized clinical trial to compare standard smoking cessation treatment (ST) with smoking cessation treatment that targets positive affect, termed positive psychotherapy for smoking cessation (PPT-S).Method: Smokers who were seeking smoking cessation treatment were assigned by urn randomization to receive, along with 8 weeks of nicotine replacement therapy, either ST (n = 31) or PPT-S (n = 35). Seven-day point prevalence smoking abstinence was biochemically confirmed at 8, 16, and 26 weeks.Results: Compared to ST, a greater percentage of participants in PPT-S were abstinent at 8 weeks, 16 weeks, and 26 weeks, but these differences were nonsignificant. In a more statistically powerful longitudinal model, participants in PPT-S had a significantly higher odds of abstinence (adjusted odds ratio [AOR] = 2.75; 95% CI = 1.02, 7.42; p = .046) across follow-ups compared to those in ST. The positive effect of PPT-S was stronger for those higher in PA (OR = 6.69, 95% CI = 1.16, 38.47, p = .03). Greater use of PPT-S strategies during the initial 8 weeks of quitting was associated with a less steep decline in smoking abstinence rates over time (OR = 2.64, 95% CI = 1.06, 6.56, p =.04).Conclusion: This trial suggests substantial promise for incorporating PPT into smoking cessation treatment. [ABSTRACT FROM AUTHOR]

The Missouri Mothers and Their Children Study (MO-MATCH) was specifically designed to critically investigate prenatal environmental influences on child attention problems and associated learning and cognitive deficits. The project began as a pilot study in 2004 and was formally launched in 2008. Participants in the study were initially identified via the Department of Vital Statistics birth record (BR) database. Interview and lab-based data were obtained from: (1) mothers of Missouri-born children (born 1998–2005), who smoked during one pregnancy but not during another pregnancy; (2) biological fathers when available; and (3) the children (i.e., full sibling pairs discordant for exposure to maternal smoking during pregnancy (SDP). This within-mother, between-pregnancy contrast provides the best possible methodological control for many stable maternal and familial confounding factors (e.g., heritable and socio-demographic characteristics of the mother that predict increased probability of SDP). It also controls for differences between mothers who do and do not smoke during pregnancy, and their partners, that might otherwise artifactually create, or alternatively mask, associations between SDP and child outcomes. Such a design will therefore provide opportunities to determine less biased effect sizes while also allowing us to investigate (on a preliminary basis) the possible contribution of paternal or other second-hand smoke exposure during the pre, peri, and postnatal periods to offspring outcome. This protocol has developed a cohort that can be followed longitudinally through periods typically associated with increased externalizing symptoms and substance used initiation. [ABSTRACT FROM PUBLISHER]

Introduction: Blacks in the United States experience greater persistent pain than non-Hispanic Whites across a range of medical conditions, but to our knowledge no longitudinal studies have examined the risk factors or incidence of persistent pain among Blacks experiencing common traumatic stress exposures such as after a motor vehicle collision (MVC). We evaluated the incidence and predictors of moderate to severe axial musculoskeletal pain (MSAP) and widespread pain six weeks after a MVC in a large cohort of Black adults presenting to the emergency department (ED) for care. Methods: This prospective, multi-center, cohort study enrolled Black adults who presented to one of 13 EDs across the US within 24 hours of a MVC and were discharged home after their evaluation. Data were collected at the ED visit via patient interview and self-report surveys at six weeks after the ED visit via internet-based, self-report survey, or telephone interview. We assessed MSAP pain at ED visit and persistence at six weeks. Multivariable models examined factors associated with MSAP persistence at six weeks post-MVC. Results: Among 787 participants, less than 1% reported no pain in the ED after their MVC, while 79.8 (95% confidence interval [CI], 77.1 -- 82.2) reported MSAP and 28.3 (95% CI, 25.5 -- 31.3) had widespread pain. At six weeks, 67% (95% CI, 64, 70%) had MSAP and 31% (95% CI, 28, 34%) had widespread pain. ED characteristics predicting MSAP at six weeks post-MVC (area under the curve = 0.74; 95% CI, 0.72, 0.74) were older age, peritraumatic dissociation, moderate to severe pain in the ED, feeling uncertain about recovery, and symptoms of depression. Conclusion: These data indicate that Blacks presenting to the ED for evaluation after MVCs are at high risk for persistent and widespread musculoskeletal pain. Preventive interventions are needed to improve outcomes for this high-risk group. [ABSTRACT FROM AUTHOR]

Introduction: Boarding of patients in the emergency department (ED) is associated with decreased ED efficiency. The provider-in-triage (PIT) model has been shown to improve ED throughput, but it is unclear how these improvements are affected by boarding. We sought to assess the effects of boarding on ED throughput and whether implementation of a PIT model mitigated those effects. Methods: We performed a multi-site retrospective review of 955 days of ED operations data at a tertiary care academic ED (AED) and a high-volume community ED (CED) before and after implementation of PIT. Key outcome variables were door to provider time (D2P), total length of stay of discharged patients (LOSD), and boarding time (admit request to ED departure [A2D]). Results: Implementation of PIT was associated with a decrease in median D2P by 22 minutes or 43% at the AED (p < 0.01), and 18 minutes (31%) at the CED (p < 0.01). LOSD also decreased by 19 minutes (5.9%) at the AED and 8 minutes (3.3%) at the CED (p<0.01). After adjusting for variations in daily census, the effect of boarding (A2D) on D2P and LOSD was unchanged, despite the implementation of PIT. At the AED, 7.7 minutes of boarding increased median D2P by one additional minute (p < 0.01), and every four minutes of boarding increased median LOSD by one minute (p < 0.01). At the CED, 7.1 minutes of boarding added one additional minute to D2P (p < 0.01), and 4.8 minutes of boarding added one minute to median LOSD (p < 0.01). Conclusion: In this retrospective, observational multicenter study, ED operational efficiency was improved with the implementation of a PIT model but worsened with boarding. The PIT model was unable to mitigate any of the effects of boarding. This suggests that PIT is associated with increased efficiency of ED intake and throughput, but boarding continues to have the same effect on ED efficiency regardless of upstream efficiency measures that may be designed to minimize its impact. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Prevalence and risk factors for elevated glycated haemoglobin (HbA1c) and blood pressure (BP) are poorly understood among Pacific children. We examined associations of HbA1c and BP in 6–9 year‐olds with body mass index (BMI) at ages 2, 5, and BMI velocity between 2–9 years in Samoa. Methods: HbA1c (capillary blood) and BP were measured in n = 410 Samoan children who were part of an ongoing cohort study. Multilevel models predicted BMI trajectory characteristics. Generalized linear regressions assessed associations of childhood characteristics and BMI trajectories with HbA1c and BP treated as both continuous and categorical outcomes. Primary caregiver‐reported childhood characteristics were used as covariates. Results: Overall, 12.90% (n = 53) of children had high HbA1c (≥5.7%) and 33.17% (n = 136) had elevated BP. BMI at 5‐years and BMI velocity were positively associated with high HbA1c prevalence in males. A 1 kg/m2 per year higher velocity was associated with a 1.71 (95% CI: 1.07, 2.75) times higher prevalence of high HbA1c. In females, higher BMI at 5‐years and greater BMI velocity were associated with higher BP at 6–9 years (95% CI: 1.12, 1.40, and 1.42, 2.74, respectively). Conclusion: Monitoring childhood BMI trajectories may inform cardiometabolic disease screening and prevention efforts in this at‐risk population. [ABSTRACT FROM AUTHOR]

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Aiming to disrupt the way fashion studies is developed – often from a Eurocentric approach and within rigid disciplinary, methodological and social boundaries – this Special Issue invites different scholars to present their own way of studying and exploring fashion, but also to make their familiar methods strange, re-assessing what fashion means and what it means to do fashion research in the first place. Promoting an interdisciplinary dialogue, the articles in this Special Issue show how fashion studies would benefit from 'bending' existing methodological boundaries and blending cross-disciplinary methodologies, conceptual orientations, objects, ideas, forms, subjects and questions in their epistemological approach. We hope that the curation, organization and general assemblage of the texts give rise to the intellectual alchemy of unpredictable encounters: conversations, clashes and contradictions. From article to article, readers will encounter different ways of doing research on and through fashion and be inspired to imagine more divergent epistemologies of fashion. [ABSTRACT FROM AUTHOR]

In the United States, there is an urgent need to provide HIV prevention services to African American men who have sex with men and women (MSMW) but who do not identify as gay or homosexual. Engaging these men in HIV prevention has historically been challenging. This study used qualitative methodology to explore the beliefs and experiences from community-based service providers ( n == 21) and from African American MSMW ( n == 21) regarding the provision of HIV prevention education and counseling to these men. Data analysis revealed that (a) African American MSMW who do not identify as gay can challenge service providers' assumptions about sexual behavior and sexual identity; (b) service providers' attitudes toward these men can be affected by ambivalent or negative beliefs that pervade the general community; (c) African American MSMW need safe and nonjudgmental spaces that offer HIV risk reduction, but they also might experience anxiety about disclosing same-sex behaviors to counselors. Findings highlighted the complexities related to culture, masculinity, and sexuality as determinants of HIV risk in African American MSMW, and findings also revealed tensions between these factors that may affect the quality of HIV prevention services. Service providers may need additional training to provide appropriate and non-judgmental HIV prevention counseling and education. [ABSTRACT FROM AUTHOR]

Background: Simian virus-40 (SV40) is a DNA tumour virus that was introduced into the human population with contaminated poliovirus vaccine, and its role in mesothelioma is widely debated. PCR based testing has been called into question, as false positives can be because of cross-reactivity with related viruses, or to laboratory contamination. The Institute of Medicine has recommended the development of more sensitive and specific tests to resolve this controversy.Methods: We have characterized highly sensitive RT-PCR based assays that are specific for SV40-encoded microRNAs (miRNAs), as an alternative to current testing methods.Results: Using this sensitive and specific detection method, we were unable to identify SV40 miRNA expression in human malignant pleural mesothelioma (MM) samples.Conclusion: Our work indicates that SV40 miRNAs are not likely to contribute to mesothelioma tumourogenesis, but highlights the value of this approach when compared with the relatively unspecific current testing methods. [ABSTRACT FROM AUTHOR]

The article discusses a research study on nickel nanoparticles. It references a study published in "Toxicological Sciences" journals where Brown University researchers exposed to nanoscale particles of nickel oxide and metallic nickel, the human lung cells and found that smaller nickel particles are setting off hypoxia inducible factor (HIF) -1 alpha pathways. Findings indicated that nanoparticles of metallic nickel have potentials to cause cancer and are more harmful than microscale particles.

Objective: To study the efficacy and safety of galantamine hydrobromide ER for the enhancement of cognition in non-demented Parkinson's patients (PD). Methods: Sixty-nine non-demented PD participants were randomised in a double-blind, placebo-controlled study of galantamine or placebo. Galantamine was administered over 16 weeks (8 mg/day for 4 weeks, a therapeutic dose of 16 mg/day for 6 weeks and a maximum dose of 24 mg/day for 6 weeks). Outcome measures were neuropsychological (attention, verbal fluency, executive, memory, visuospatial), behavioural (Frontal Systems Behavior Scale, Neuropsychiatric Inventory-Questionnaire, PDQ-39) and motor (Unified Parkinson's Disease Rating Scale motor scale). Results: 26 individuals on active medication and 28 individuals on placebo were included in the outcome analyses. No significant differences were found between the active and placebo groups on cognitive, behavioural or motor outcome measures. Most common adverse events were gastrointestinal and self-reported worsening of PD symptoms. Conclusions: Contrary to our hypotheses, galantamine treatment did not improve attention/executive, memory or visuospatial performance in non-demented PD patients. Further, there was a high, statistically significant drop-out rate in the treatment group due to gastrointestinal side effects and self-reported worsening of PD symptoms. Treatment with galantamine did not enhance self- perception of mental sharpness or quality of life. No negative behavioural change such as hallucinations or apathy was found with treatment. [ABSTRACT FROM AUTHOR]

Background: The loss of E-cadherin (ECAD) protein expression has been linked to aggressive head and neck squamous cell carcinoma (HNSCC). Promoter hypermethylation of the cadherin 1, type 1 (CDH1) gene (encoding ECAD) is 1 mechanism by which this protein can be inactivated, although this epigenetic alteration of the gene has not been linked conclusively to poorer patient outcome and, in fact, may be associated with better patient prognosis.Methods: The authors investigated the prevalence of CDH1 promoter hypermethylation in a population-based case series of 340 primary HNSCC tumors using methylation-specific polymerase chain reaction. They also studied the association between CDH1 hypermethylation and patient demographic characteristics using multivariate analysis and examined the impact of CDH1 hypermethylation on patient survival using both univariate and multivariate methods.Results: Hypermethylation of CDH1 was significantly more prevalent (P < .03) among individuals with a low smoking history independent of whether they were seropositive for human papillomavirus type 16 (HPV-16). Patients who had tumors with CDH1 hypermethylation had significantly better overall survival compared with patients who had tumors without hypermethylation (P < .02; log-rank test). This effect was independent of HPV-16 status and demonstrated a significant hazard ratio of 0.5 (95% confidence interval, 0.3-0.9) in a model that controlled for HPV-16 serology, age, sex, and tumor stage.Conclusions: The current results suggested that hypermethylation of CDH1 occurs more commonly in patients with HNSCC who are low smokers, suggesting that an additional factor may be driving this epigenetic alteration. Clinically, CDH1 hypermethylation may hold powerful prognostic potential in addition to that observed with HPV serology, and the authors concluded that it should be pursued in additional studies. [ABSTRACT FROM AUTHOR]

Purpose: Skilled nursing facility (SNF) care has historically been influenced by systemic issues that could impact speech-language pathology (SLP) service provision. However, there has been little study specifically on factors associated with SLP service provision in SNFs. Large administrative data sets are rarely analyzed in SLP research but can be used to understand real-world SLP services. This study investigated associations between patient and facility characteristics and SLP services. Method: Mixed-effects logistic regression models were used to evaluate factors associated with SLP service provision in 2018 Medicare administrative data representing 833,653 beneficiaries. Results: Beneficiaries had higher odds of receiving SLP services when they had neurologic diagnosis (odds ratio [OR] = 3.32), had SLP-related functional impairments (ORs = 1.19-3.41), and received other rehabilitative services (ORs = 3.11- 3.78). Beneficiaries had lower odds of receiving SLP services when they received care from SNFs located in hospitals versus freestanding (OR = 0.45), with need for interpreter services (OR = 0.76) and with thresholding (OR = 0.68), a financially motivated practice. Direction of association varied across racial and ethnic groups and measures of location. Odds of being provided SLP services decreased with increasing communication impairment severity. Conclusions: The results suggest that clinicians are identifying patients with diagnoses most likely to warrant SLP services. However, association disparities and weakening association of service provision with increasing impairment severity have concerning clinical implications. Health services research methods can be used to further explore SLP practices in SNFs to support equitable service provision. [ABSTRACT FROM AUTHOR]

In response to the diverse health challenges faced by today's youth and their extensive time spent in schools, we conducted a school health awareness campaign aimed at prioritizing well-being and academic performance. This analytical longitudinal study, spanning 27 schools in Lebanon, aimed to assess the impact of the awareness campaign on the health knowledge and practices of 5-, 8-, and 11-year-old students throughout pre- and post-intervention testing focused on general health and healthy habits, employing 11, 14, and 15 questions tailored to 5, 8, and 11 year olds, respectively. The questions covered various aspects, including sleep, personal and dental hygiene, nutrition, physical activity, addiction, security measures, and bullying. Out of the 7100 students who participated, 16.11% (1144 students) were evaluated before and after the campaign. The results indicated a significant increase in health awareness post-intervention across all age groups. For instance, in 5-year-olds, limited awareness decreased from 91.6% to 36.38%, while adequate awareness rose from 8.03% to 62.3%. Improvement varied across health knowledge topics, with security-related questions showing the highest enhancement. Factors such as governorate, normal-weight status, and close supervision influenced improvement. However, no significant correlations were found with school type, size, gender, age, nationality, parental factors, or comorbidities. The study concludes that the school health awareness campaign successfully heightened children's health awareness, advocating for the integration of regular health promotions into the standard educational curriculum. [ABSTRACT FROM AUTHOR]