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Objectives This study systematically evaluates age and race differences in mental health symptoms as they unfold microlongitudinally during the coronavirus disease 2019 (COVID-19) pandemic with a focus on within-person reactivity to forecasting and experiencing COVID-19 stress. Method A daily diary approach was used to examine predictors of daily anxiety and depressive symptoms among 526 adults (White [54%] and Black American [46%]) aged 21–79. A total of 3,605 online diaries were collected for 21 consecutive days between October and November, 2020. In addition to mental health symptoms, participants reported forecasted (next 24 h) stress as well as experienced (past 24 h) stress related to COVID-19. Results Patterns of reactivity to forecasted and experienced COVID-19 stress depended on age and race. White older adults displayed greater reactivity to COVID-19-related stress than White younger adults, but the effects of COVID-19-related stress were consistently detrimental for the daily anxiety of Black Americans, regardless of age. For Black Americans, age was less negatively associated with depressive symptoms than for White Americans. Increases in experienced COVID-19 stress were also more strongly associated with increases in depressive symptoms for Black Americans relative to White participants. Discussion This study moves beyond cross-sectional, descriptive work within the context of the COVID-19 pandemic and emphasizes the dynamic nature of within-person reactivity patterns that differ by age and race. Although White older adults experienced an increase in daily anxiety when forecasting COVID-19 stress, the co-occurring pandemic of systemic racism may be more powerful than age-related vulnerabilities for Black adults. [ABSTRACT FROM AUTHOR]

Objectives Older adults are at higher risk for death and infirmity from COVID-19 than younger and middle-aged adults. The current study examines COVID-19-specific anxiety and proactive coping as potential risk and resilience factors that may be differentially important for younger and older adults in understanding stress experienced due to the COVID-19 pandemic. Methods Five hundred and fifteen adults aged 20–79 years in the United States reported on their anxiety about developing COVID-19, proactive coping, and stress related to COVID-19 in an online survey. Results Although there were no age differences in stress levels, anxiety about developing COVID-19 was associated with more COVID-19 stress for older adults relative to younger adults, but proactive coping was associated with less COVID-19 stress for older adults relative to younger adults. Discussion Our results suggest that anxiety might function as a risk factor, whereas proactive coping may function as a resilience factor for older adults' COVID-19 stress. We encourage future context-dependent investigations into mental health among older adults during this pandemic and beyond. [ABSTRACT FROM AUTHOR]

Background. Beginning in 2010, the US Department of Health and Human Services (HHS) funded more than 40 evaluations of adolescent pregnancy prevention interventions. The government's emphasis on rigor and transparency, along with a requirement that grantees collect standardized behavioral outcomes, ensured that findings could be meaningfully compared across evaluations. Objectives. We used random and mixed-effects meta-analysis to analyze the findings generated by these evaluations to learn whether program elements, program implementation features, and participant demographics were associated with effects on adolescent sexual risk behavior. Search Methods. We screened all 43 independent evaluation reports, some of which included multiple studies, funded by HHS and completed before October 1, 2016. HHS released, and our team considered, all such studies regardless of favorability or statistical significance. Selection Criteria. Of these studies, we included those that used a randomized or high-quality quasi-experimental research design. We excluded studies that did not use statistical matching or provide pretest equivalence data on a measure of sexual behavior or a close proxy. We also excluded studies that compared 2 pregnancy prevention interventions without a control group. A total of 44 studies from 39 reports, comprising 51 150 youths, met the inclusion criteria. Data Collection and Analysis. Two researchers extracted data from each study by using standard systematic reviewing and meta-analysis procedures. In addition, study authors provided individual participant data for a subset of 34 studies. We used mixed-effects meta-regressions with aggregate data to examine whether program or participant characteristics were associated with program effects on adolescent sexual risk behaviors and consequences. To examine whether individual-level participant characteristics such as age, gender, and race/ethnicity were associated with program effects, we used a 1-stage meta-regression approach combining participant-level data (48 635 youths) with aggregate data from the 10 studies for which participant-level data were not available. Main Results. Across all 44 studies, we found small but statistically insignificant mean effects favoring the programs and little variability around those means. Only 2 program characteristics showed statistically reliable relationships with program effects. First, gender-specific (girl-only) programs yielded a statistically significant average effect size (P <.05). Second, programs with individualized service delivery were more effective than programs delivering services to youths in small groups (P <.05). We found no other statistically significant associations between program effects and program or participant characteristics, or evaluation methods. Nor was there a statistically significant difference in the mean effect sizes for programs with previous evidence of effectiveness and previously untested programs. Conclusions. Although several individual studies reported positive impacts, the average effects were small and there was minimal variation in effect sizes across studies on all of the outcomes assessed. Thus, we were unable to confidently identify which individual program characteristics were associated with effects. However, these studies examined relatively short-term effects and it is an open question whether some programs, perhaps with distinctive characteristics, will show longer-term effects as more of the adolescent participants become sexually active. Public Health Implications. The success of a small number of individualized interventions designed specifically for girls in changing behavioral outcomes suggests the need to reexamine the assumptions that underlie coed group approaches. However, given the almost total absence of similar programs targeting male adolescents, it is likely to be some time before evidence to support or reject such an approach for boys is available. [ABSTRACT FROM AUTHOR]

Standard audiometric evaluations are not sensitive enough to identify hidden hearing loss (HHL) and/or cochlear synaptopathy (CS). Patients with either of these conditions frequently present with difficulty understanding speech in noise or other complaints such as tinnitus. The purpose of this systematic review is to identify articles in peer-reviewed journals that assessed the sensitivity of audiologic measures for detecting HHL and/or CS, and which showed potential for use in a clinical test battery for these disorders. A reference librarian submitted specific boolean terminology to MEDLINE, Embase, and Web of Science. The authors used a consensus approach with specially designed score sheets for the selection of titles, abstracts, and then articles for inclusion in the systematic review and for quality assessment. Fifteen articles were included in the systematic review. Seven articles involved humans; seven involved animals, and one study used both humans and animals. Results showed that pure-tone audiometry to 20 kHz, otoacoustic emissions, electrocochleography, auditory brainstem response (ABR), electrophysiological tests, speech recognition in noise with and without temporal distortion, interviews, and self-report measures have been used to assess HHL and/or CS. For HHL, ultrahigh-frequency audiometry may help identify persons with sensory hair cell loss that does not show up on standard audiograms. Promising nonbehavioral measures for CS included ABR wave I amplitude, the summating potential-to-action potential ratio, and speech recognition in noise with and without temporal distortion. Self-report questionnaires also may help identify auditory dysfunction in persons with normal hearing. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to relevance of high perceived social standing (PSS) for better heath prospects of Ugandan adults with HIV undergoing antiretroviral therapy. Topics discussed include health advantages possessed by individuals with high socio-economic status (SES) as compared to p;people with low SES, inverse correlation between PSS and mental and physiological health and less PSS score of HIV-infected adults getting treatment in tertiary health care center.

Background: A large volume of literature has shown negative associations between stunting and child development; however, there is limited evidence for associations with milder forms of linear growth faltering and determinants of malnutrition in developing countries.Objective: The objective of this study was to assess the association between anthropometric growth indicators across their distribution and determinants of malnutrition with development of Tanzanian children.Methods: We used the Bayley Scales of Infant Development III to assess a cohort of 1036 Tanzanian children between 18 and 36 mo of age who were previously enrolled in a neonatal vitamin A trial. Linear regression models were used to assess standardized mean differences in child development for anthropometry z scores, along with pregnancy, delivery, and early childhood factors.Results: Height-for-age z score (HAZ) was linearly associated with cognitive, communication, and motor development z scores across the observed range in this population (all P values for linear relation < 0.05). Each unit increase in HAZ was associated with +0.09 (95% CI: 0.05, 0.13), +0.10 (95% CI: 0.07, 0.14), and +0.13 (95% CI: 0.09, 0.16) higher cognitive, communication, and motor development z scores, respectively. The relation of weight-for-height z score (WHZ) was nonlinear with only wasted children (WHZ <-2) experiencing deficits (P values for nonlinear relation < 0.05). Wasted children had -0.63 (95% CI: -0.97, -0.29), -0.32 (95% CI: -0.64, 0.01), and -0.54 (95% CI: -0.86, -0.23) z score deficits in cognitive, communication, and motor development z scores, respectively, relative to nonwasted children. Maternal stature and flush toilet use were associated with higher cognitive and motor z scores, whereas being born small for gestational age (SGA) was associated with a -0.16 (95% CI: -0.30, -0.01) z score deficit in cognition.Conclusions: Mild to severe chronic malnutrition was associated with increasing developmental deficits in Tanzanian children, whereas only wasted children exhibited developmental delays during acute malnutrition. Interventions to reduce SGA, improve sanitation, and increase maternal stature may have positive effects on child development. This trial was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12610000636055. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Cessation of exclusive breastfeeding (EBF) with early introduction of complementary food provides additional calories for catch-up growth but may also increase the risk of adverse outcomes. The objective of this study was to assess effects of exclusive breastfeeding for less than 6 months compared with 6 months in preterm and low birth weight infants. METHODS: Data sources include Medline, Scopus, Web of Science, CINAHL, and Index Medicus through June 30, 2021. Study selection includes randomized trials and observational studies. Primary outcomes were mortality, morbidity, growth, and neurodevelopment. Data were extracted and pooled using random-effects models. The Cochrane Risk of Bias 2 tool was used to assess the risk of bias of included studies. RESULTS: A total of 2 studies of 307 preterm or low birth weight infants were included. None of the study results could be pooled. Both studies compared EBF for 4 months to 6 months. Growth was similar between the 4-month and 6-month EBF groups for the following outcomes: weight-for-age z-score at corrected age 12 months (mean [standard deviation], 4-month group: -1.7 [1.1], 6-month group: -1.8 [1.2], 1 study, 188 participants, low certainty evidence), absolute weight gain (gram) from 16 to 26 weeks of age (4-month group: 1004 [366], 6-month group: 1017 [350], 1 study, 119 participants, very low certainty evidence), and linear growth gain (cm) from 16 to 26 weeks of age (4-month group: 4.3 [0.9], 6-month group: 4.5 [1.2], 1 study, 119 participants, very low certainty evidence). There were no apparent differences in reported morbidity symptoms. No difference in the timing to achieve motor development milestones between the 2 groups was found (1 study; 119 participants, very low certainty evidence). A limited number of studies prevented data pooling. CONCLUSIONS: The evidence is very uncertain about the effect of exclusive breastfeeding for less than 6 months for preterm and low birth weight infants. Further studies are warranted to better answer this question. [ABSTRACT FROM AUTHOR]