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Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are associated with a high incidence of cardiovascular disease. Coronary atherosclerosis, particularly total plaque and noncalcified plaque on coronary computed tomography angiography (CCTA) has been correlated with cardiovascular events. We compared baseline coronary plaque burden and progression by serial CCTA in SLE and RA patients.We prospectively evaluated 44 patients who underwent serial CCTA examinations to quantify coronary plaque progression, 22 SLE patients, and 22 age- and sex-matched RA patients. Semiautomated plaque software was used for quantitative plaque assessment. Linear regression examined the effect of SLE diagnosis (versus RA) on annualized change in natural log-transformed total normalized atheroma volume (ln-TAV norm ) for low-attenuation, fibrofatty, fibrous, total noncalcified, densely calcified, and total plaque.No quantitative differences for any plaque types were observed at baseline between SLE and RA patients ( P = 0.330-0.990). After adjustment for baseline plaque and cardiovascular risk factors, the increase in ln-TAV norm was higher in SLE than RA patients for fibrous [Exp-β: 0.202 (0.398), P = 0.0003], total noncalcified [Exp-β: 0.179 (0.393), P = 0.0001], and total plaque volume [Exp-β: 0.154 (0.501), P = 0.0007], but not for low-attenuation, fibrofatty, or densely calcified plaque ( P = 0.103-0.489). Patients with SLE had 80% more fibrous, 82% more noncalcified, and 85% more total plaque increase than those with RA.Coronary plaque volume was similar in RA and SLE at baseline. Progression was greater in SLE, which may explain the greater cardiovascular risk in this disease. Further research to evaluate screening and management strategies for cardiovascular disease in these high-risk patients is warranted.

This study examined the effect of moderate intensity stair stepping exercise on the glycemic response, and antioxidant capacity (TAC) during an oral glucose tolerance test (OGTT).Thirty participants (women = 12) completed 4 OGTTs during rest or stair walking bouts of 1, 3, and 10 min in a randomized order. Blood was collected at baseline and 30 min during the OGTTs and analyzed for glucose, insulin, TAC, and lactate. Glucose concentrations were decreased following the 10 min (-22.69 (-34.66 to -10.72) mg/dL, p 0.002) and 3 min (-15.37 (-25.05 to -5.69) mg/dL, p 0.004) bouts but not the 1 min bout (-6.18 (-19.54 to 7.18) mg/dL, p = 0.352). Insulin concentrations were decreased following the 10 min (-6.11 (-8.86 to -3.36 μIU/dL), p 0.001) and 3 min (-2.589 (-4.54 to -0.63) μIU/dL, p 0.012) bouts but not the 1 min bout (-0.37 (-1.87 to 1.13) μIU/dL, p = 0.616). Insulin sensitivity index values showed a significant increase in the 10-min trial (1.81 (0.03-3.58), p 0.048), but not during the 3 min (0.65 (-0.66 to 1.96) p = 0.317) or 1 min trial (0.13 (-1.58 to 1.84) p = 0.878). There was no omnibus effect for trial in TAC (p = 0.132, ηThis study provides evidence bouts as short as 3 min decrease postprandial blood glucose and insulin levels but longer bouts are needed to affect insulin sensitivity.

We present an ocean-basin-scale dataset that includes tail fluke photographic identification (photo-ID) and encounter data for the majority of living individual humpback whales (Megaptera novaeangliae) in the North Pacific Ocean. The dataset was built through a broad collaboration combining 39 separate curated photo-ID catalogs supplemented with community science data. All available images were compared using a recently developed machine learning artificial intelligence image recognition algorithm able to rapidly and accurately detect matches between individuals. For the study period of 2001 to 2021, a total of 27,956 unique individuals were documented in 157,379 encounters, with each individual encountered, on average, in 5.6 sampling periods (i.e., breeding and feeding seasons), and with an annual average of 87.1% of whales encountered in more than one season. The combined dataset and image recognition tool represents a living and accessible resource for collaborative, basin-wide studies of a keystone marine mammal in a time of rapid ecological change.

Aim There has been a global movement towards transformation of youth mental health services, but limited information on the core principles and characteristics of these new services is available. Jigsaw is one such service, established in Ireland in 2006, with the intent of creating change in Ireland's system of mental healthcare for 12-25 year olds. The aim of this paper is to describe the evolution of Jigsaw services, which are now firmly embedded in the Irish system of care for young people, and recognized internationally as an established service network. Methods This paper describes provides an up-to-date description of the Jigsaw service model, key areas of evolution that have shaped this model, and identifies future directions in service development. Results Key attributes of the Jigsaw service model including therapeutic service, scope of practice, youth mental health promotion, youth participation, and monitoring/evaluation are described in this paper. Information on key enablers (funding and governance/quality) and service providers is also included. Conclusions Information on the core principles and characteristics of youth mental health services is important. This paper addresses a gap in the literature by describing the Jigsaw service model, which continues to evolve so that it is responsive to the needs of young people.

Despite long established comparatively poor health outcomes there has been limited research into the healthcare access of Irish migrants in the UK. This study examines the relationship between demography, self-reported health (SRH) and social support and healthcare access and the influence of gender on these associations. Data was collected as part of a community-based action research project with Irish migrants in London (n = 790). Hierarchical logistic regression was used to predict self-reported access to a GP (compared with no reported access). The effect of gender was measured via interactions entered in the second step of the model. Older participants and males were less likely to report GP access. SRH was a significant predictor. Gender moderated the relationship between SRH, social support, employment and GP access. Findings highlight the help-seeking vulnerability of male and older Irish migrants and the potential of social support in promoting healthcare access for males.

While studies have demonstrated a link between neighborhood social cohesion (NSC) and mental health, this relationship has been inadequately explained for migrant communities. This study explores the effect of NSC on the self-reported depression (SRD) of Irish migrants in the United Kingdom. Considering differing migration experiences and health outcomes across age groups of Irish migrants to the United Kingdom, we explore how this relationship was moderated by age. Logistic regression models showed that NSC promoted mental health in universal contexts. As risks increased, only perceived neighborhood safety promoted mental health. Age had a significant effect on the relationship between NSC and depression. NSC may be associated with reduced SRD for younger but not older Irish migrants. Our findings support interventions, which promote NSC in low-risk contexts and safety in higher-risk settings for Irish migrants. This study reiterates the mental health vulnerability of older Irish migrants.

Postprandial blood glucose (PBG) is an independent predictor of disease and mortality risk. To date, the shortest, single, moderate-intensity exercise intervention to reduce PBG is a 1 min bout of stair stepping during an oral glucose tolerance test. Whether this effect translates to real meal consumption is unknown.Subjects (N = 30) participated in a randomized controlled crossover trial performing 0 min (seated control), 1 min, 3 min or 10 min of stair climbing and descending bouts (SCD) at a self-selected pace after consumption of a mixed meal on four separate visits. Compared to control, all SCD reduced PBG at least one timepoint: at 30-min the 3 min (-10.8 (-18.7 to -2.8) mg/dL, p = 0.010) and 10 min (-36.3 (-46.4 to -26.3) mg/dL), p .001), and at 45-min the 1 min (-7.3 (-13.9 to -0.7) mg/dL, p = 0.030, 3 min (-8.7 (-13.9 to -3.6) mg/dL, p = 0.002 and 10 min SCD (-12.2 (-18.2 to -6.1)mg/dL, p 0.000) reduced PBG. The area under the curve (AUC) for PBG was lower following the 3 min (-4.4% (-7.5 to -1.4%), p = 0.006) and 10 min (-8.9% (-12.4 to -5.3%), p 0.001), while the incremental AUC (iAUC) was reduced only following the 10 min (-38.0% (-63.7 to -12.3%), p = 0.005) SCD. All SCD were rated by subjects as very light to light intensity.Single, subjectively "light" intensity stair climbing and descending bouts as short as 1 min in duration attenuate the postprandial glucose response in normal weight individuals following consumption of a mixed meal. More pronounced effects require longer bouts in a dose-dependent manner.

Climate change may increase the occurrence and severity of forest fires, leading to worsening wildfire seasons. More frequent burn events would have various effects due to increased haze and smoke, including a greater incidence of impacts on human health and reduced or impaired visibility. In areas such as the Lower Fraser Valley of British Columbia, which prides itself on panoramic mountain and city views, individuals may be willing to pay to address deteriorating visibility conditions arising from wildfires or other sources. However, studies consistently show that any attempt to ask individuals how much they are willing to pay to improve local visibility will be confounded with the benefits of improving local health conditions. We used a discrete choice experiment to estimate the value of potential improvements in local visibility in the Lower Fraser Valley, but we included the consideration of health effects and found that these two attributes were indeed linked. As human preferences are rarely homogeneous, we also considered heterogeneity in respondents’ preferences for increases in the number of improved-visibility days versus healthy days. Finally, we applied our results to estimate the value of damages from visibility disruptions related to wildfire smoke from 2002 to 2018 in the Lower Fraser Valley.

Using over 350,000 U.S. patent citations, we test whether knowledge transfers in the energy sector are sensitive to distance, and whether that sensitivity has changed over time. Controlling for self-citation by inventor, assignee and examiner, multivariate regression analysis shows that physical distance is becoming less important for spillovers with time, but differs by energy subsector.

Background: The purpose of this study was to measure sweat rate during exercise in the heat after directly inhibiting carbonic anhydrase (CA) in eccrine sweat glands via transdermal iontophoresis of acetazolamide. It was hypothesized that if CA was important for sweat production, local administration of acetazolamide, without the confounding systemic effects of dehydration typically associated with past studies, would have a significant effect on sweat rate during exercise. Methods: Ten healthy subjects volunteered to exercise in the heat following acetazolamide or distilled water iontophoresis on the forearm. Results: The distilled water iontophoresis site had a mean sweat rate during exercise in the heat of 0.59±0.31 μL/cm2/min, while the acetazolamide iontophoresis site had a mean sweat rate of 0.63±0.36 μL/cm2/min (p>0.05). Conclusions: The most important finding of the current study was that iontophoresis of acetazolamide did not significantly decrease sweat rate during exercise in the heat. Such results suggest that in past studies it was systemic dehydration, and not CA inhibition at the level of the sweat gland, that caused the reported decreased sweat rate.

Despite research demonstrating the health promoting effects of social support, few studies have examined the moderating effect of functional social support on everyday unfair treatment for migrant communities. This study investigates whether functional social support moderates the association between unfair treatment and poor self-rated health for Irish migrants to the UK. Analysis of a purposive sample of Irish migrants in London was conducted ( n = 790). Interaction was analyzed via hierarchical logistic regression. Irish migrants who perceived unfair treatment were over three times more likely to report fair/poor health (odds ratio = 3.47, 95% confidence interval = 2.0–6.02). Higher levels of support in times of crisis were associated with reduced poor health. Higher levels of instrumental or practical support from neighbors moderated against the negative effect of unfair treatment on self-rated health (odds ratio = 0.29, 95% confidence interval = 0.08–0.96) and had a protective stabilizing effect. Instrumental support may have a protective-enhancing effect for female migrants. Results support other studies which indicate that instrumental support is most influential in the context of adversity. Interventions that promote neighborhood social capital may build resilience to unfair treatment for migrant communities in large cities.

Vitamin D is widely known to regulate bone health, but there is increasing evidence that it may also ameliorate colitis through inflammation, cell proliferation and apoptosis, and the microbiota. The purpose of this review is to systematically examine the mechanisms by which vitamin D reduces colitis. PubMed and Web of Science were searched for articles published between 2008 and 2019 using key words such as “vitamin D,” “colitis,” “inflammatory bowel disease,” “inflammation,” “apoptosis,” “cell proliferation,” and “gut bacteria”. Retrieved articles were further narrowed and it was determined whether their title and abstracts contained terminology pertaining to vitamin D in relation to colitis in human clinical trials, animal studies, and cell culture/biopsy studies, as well as selecting the best match sorting option in relation to the research question. In total, 30 studies met the established criteria. Studies consistently reported results showing that vitamin D supplementation can downregulate inflammatory pathways of COX-2, TNF-α, NF-κB, and MAPK, modify cell kinetics, and alter gut microbiome, all of which contribute to an improved state of colitis. Although vitamin D and vitamin D analogs have demonstrated positive effects against colitis, more randomized, controlled human clinical trials are needed to determine the value of vitamin D as a therapeutic agent in the treatment of colitis.

BACKGROUND Previous reports indicate that postprandial glucose (PPG) responses to exercise may depend on cardiorespiratory fitness (CRF), such that less fit individuals have greater reductions in PPG with exercise. Our aim was to investigate moderating effects of CRF on PPG response following exercise of progressively shorter durations and sedentary rest. METHODS Thirty-four participants (14 female) completed a 75-g oral glucose tolerance test (OGTT) at seated rest. On three subsequent visits, participants completed additional OGTT with either 1, 3, or 10 minutes of stair-climbing. Fingerstick blood glucose measurements were taken every 15 minutes for 1 hour. CRF was determined using a treadmill ramp test. RESULTS There was a main effect of condition F(3, 93)=13.07, P

This article describes a community-based participatory action research (CBPAR) project that examined the postmigration living difficulties (PMLD), help-seeking and community resilience of recent Irish migrants to London (n = 176). The majority of respondents were young adults, in managerial or professional occupations and in good or very good health. Mixed methods indicate inadequate planning for relocation and poor social support as the main difficulties in the initial stages of migration. Community factors promoting resilience included employment opportunities, local and transnational supports, and cultural familiarity and acceptance. Community participation in the action orientated phase of this CBPAR is discussed.

Despite growing understanding of resilience as a process associated with both individual capacities and physical and relational resources located in social ecologies, most instruments designed to measure resilience overemphasize individual characteristics without adequately addressing the contextual resources that support resilience processes. Additionally, most resilience studies have focused on children and youth, without significant attention to social ecological factors that promote post-risk adaptation for adults and how this is measured. Consequently, a key issue in the continued study of adult resilience is measurement instrument development. This article details adaptation of the Child and Youth Resilience Measure for use with an adult population. The article draws on data from a mixed methods study exploring the resilience processes of Irish survivors of clerical institutional abuse. The sample included 105 adult survivors (aged 50–99) who completed the RRC-ARM and the Warwick–Edinburgh Mental Well-being Scale (WEMWBS) during the first phase of the study. Exploratory factor analysis, Cronbach Alpha and MANOVA were conducted on the data. EFA identified five factors; social/community inclusion, family attachment and supports, spirituality, national and cultural identity, and personal competencies. The RRC-ARM shows good internal reliability and convergent validity with the WEMWBS, with significant differences on scale scores for men and women, as well as place of residence. This exploratory adaptation supports the potential of the RRC-ARM as a measure of social ecological resilience resources for adult populations and may have particular applications with vulnerable communities. Further validation is required in other contexts and specifically with larger samples.

Objectives Examine effect of single hand heating with and without negative pressure on fasting blood glucose (FBG) and postprandial blood glucose (PBG). Design Double-blind randomized controlled trial with crossover design. Subjects FBG experiment: 17 healthy subjects (4 males). PBG experiment: 13 healthy subjects (1 males). Interventions Devices included one providing heat only, one heat and negative pressure, and one acting as a sham. For the FBG experiment the devices were used for 30 min. For the PBG experiment the devices were used for one hour during an oral glucose tolerance test (OGTT). Outcome Measures Blood glucose measurements were used to determine change in FBG, peak PBG, area under the curve (AUC), and incremental AUC (iAUC). Results Temperature: Change in tympanic temperature was ≤ 0.15 °C for all trials. FBG: There was no effect on FBG. PBG: Compared to the sham device the heat plus vacuum and heat only device lowered peak blood glucose by 16(31)mg/dL, p = 0.092 and 18(28)mg/dL, p = 0.039, respectively. AUC and iAUC: Compared to the sham device, the heat plus vacuum device and heat only device lowered the AUC by 5.1(15.0)%, p = 0.234 and 7.9(11.1)%, p = 0.024 respectively and iAUC by 17.2(43.4)%, p = 0.178 and 20.5(34.5)%, p = 0.054, respectively. Conclusions Heating a single hand lowers postprandial blood glucose in healthy subjects.

ObjectivesMental health is regarded as more than the absence of mental health difficulties, with clinical and research focus moving towards measurement of well-being. The Mental Health Continuum-Short Form (MHC-SF) was developed to assess overall and emotional, social and psychological well-being. Little is known about the use of the MHC-SF with young people engaging with mental health services. The current pilot study sought to examine the performance of the MHC-SF in an Irish primary care youth mental health service for 12–25 year olds.MethodsA sample of 229 young people (female n=143; male n=85, unknown n=1) aged 12–24 years (M=15.87, SD=2.51) who completed the MHC-SF prior to commencing their first intervention session in Jigsaw participated in this study. The psychometric properties of the MHC-SF were investigated using confirmatory factor analysis (CFA) and Cronbach’s alpha for internal consistency.ResultsCFA supported the three-factor structure of the MHC-SF for emotional, social, and psychological well-being, and very good internal consistency was observed.ConclusionFindings provide evidence for the psychometric properties of the MHC-SF in a primary care youth mental health setting, and suggest that the MHC-SF’s three-factor structure is valid for use in this context. Limitations and recommendations for future research are discussed.

There are estimated to be 1,333,700 aboriginal people in Canada, as of 1997. Health and social indicators illustrate a significant gap between aboriginal people and the general Canadian population. Health Canada provides funding to communities in order that they may hire Community Health Representatives (CHRs). The CHR is to collect water samples, and then ship them to laboratories for microbiological analysis. In the majority of communities, CHRs are extremely overburdened with numerous responsibilities. In order to ensure the safety of drinking water in aboriginal communities, Health Canada, in partnership with the Split Lake Cree First Nation aboriginal community, developed a bacteriological water quality monitoring training program. First Nation communities have various challenges to overcome in regard to ensuring a safe water supply for residents. Even communities with good water treatment systems in place experience problems. For example, a poorly trained operator may add too much chlorine to the system, resulting in an unacceptable taste.

Despite an increasing volume of research on Irish migrants to the UK, limited scientific data exists on the main effects of social support on the health of this community. A sample of Irish migrants in London was purposefully recruited (n = 790). Linear regression was used to predict social support. Logistic regression examined the independent association between functional social support and self-rated health (SRH) controlling for low risk covariates. Older age, economic factors and better SRH precited stronger social support. Irish migrants who reported being able to rely on at least three people in times of crisis and those who perceived stronger emotional support were more likely to report good SRH when adjusted for demography and socio-economic factors. As risks increased only perceived support in times of crisis predicted SRH. Interventions which build reliable and trusted social networks may have a direct effect on migrant health.

Objectives The objective of this study was to assess sex differences in PPG responses to short stair stepping bouts, and to describe their intensity and metabolic cost. Design Crossover trial. Methods 34 participants (age: 25.9 ± 5.5 y; women = 14) underwent 4 oral glucose tolerance tests (OGTT) during rest or with stair-stepping bouts at self-selected, moderate pace for 1, 3, and 10 min. Blood was collected every 15 min during the OGTTs and assessed for glucose. Participants also underwent maximal aerobic capacity assessment. Expired gases were collected during capacity testing, and each stair-stepping bout. Results Normalized to body weight there was no significant interaction for sex with stair-stepping trials (p = 0.445, ηp2 = 0.03), or time (p = 0.069, ηp2 = 0.09), or trial by time (p = 0.264, ηp2 = 0.04). Women had higher mean glucose values than men (15(CI = 3, 27)%, p = 0.015). iAUC also showed no interaction of sex*trial (p = 0.059, ηp2 = 0.09). Women had higher iAUC values (meanΔ = −29(−48, −11)%, p = 0.003). There was a main effect for trial with 10min showing the largest reduction from control for women (e.g. AUC −10(−6, −13)%, p Conclusions Both sexes had similar responses to short bouts of exercise, which they perceived as less intense than indicated by objective assessment. Stair stepping reduces postprandial glucose response with similar effectiveness for both sexes. ClinicalTrials.gov Identifier: NCT03400774.

Understanding how survivors of complex trauma navigate towards resources can inform the design of interventions and health promotion strategies. However, there are little data on the resilience and help-seeking experiences of this group or others who have experienced institutional abuse in childhood. This empirical study sets out to illustrate the help-seeking experiences of Irish emigrant survivors of institutional childhood abuse (ICA). Twenty-two survivors of ICA were purposefully recruited from community organisations in the UK and data were collected via semi-structured interviews. As a result of negative initial help-seeking experiences in Ireland, most participants engaged in long periods of self-management and disclosed information about their childhood as part of a redress scheme in later life. Outside of this scheme, turning points, such as illness or family problems, and the needs of children were influential in seeking help. Peer support networks played an important role as a trusted signposting pathway towards formal interventions. Participants identified interpersonal barriers to formal help-seeking as helping professionals’ failure to share control, insensitivity to identity loss and literacy issues, and the lack of explicit boundaries. The paper concludes with a discussion about the implications for research and future practice. ‘This empirical study sets out to illustrate the help-seeking experiences of Irish emigrant survivors of institutional childhood abuse’ Key Practitioner Messages Turning points, such as illness and bereavement, and the desire to provide for children, influence the help-seeking of survivors of ICA. Irish emigrant survivors of ICA cite failure to share control, insensitivity to identity loss, literacy issues and the lack of explicit boundaries as barriers to help-seeking. General awareness of ICA can help practitioners in low-threshold services prevent against culturally insensitive practice. Peer support networks can provide uniquely trusted signposting towards formal interventions.

To assess neurodevelopmental outcomes among participants with biliary atresia with their native liver at ages 12 months (group 1) and 24 months (group 2), and to evaluate variables predictive of neurodevelopmental impairment.Participants enrolled in a prospective, longitudinal, multicenter study underwent neurodevelopmental testing with either the Bayley Scales of Infant Development, 2nd edition, or Bayley Scales of Infant and Toddler Development, 3rd edition. Scores (normative mean = 100 ± 15) were categorized as ≥100, 85-99, and85 for χThere were 148 children who completed 217 Bayley Scales of Infant and Toddler Development, 3rd edition, examinations (group 1, n = 132; group 2, n = 85). Neurodevelopmental score distributions significantly shifted downward compared with test norms at 1 and 2 years of age. Multivariate analysis identified ascites (OR, 3.17; P = .01) and low length z-scores at time of testing (OR, 0.70; P .04) as risk factors for physical/motor impairment; low weight z-score (OR, 0.57; P = .001) and ascites (OR, 2.89; P = .01) for mental/cognitive/language impairment at 1 year of age. An unsuccessful hepatoportoenterostomy was predictive of both physical/motor (OR, 4.88; P .02) and mental/cognitive/language impairment (OR, 4.76; P = .02) at 2 years of age.Participants with biliary atresia surviving with native livers after hepatoportoenterostomy are at increased risk for neurodevelopmental delays at 12 and 24 months of age. Those with unsuccessful hepatoportoenterostomy are4 times more likely to have neurodevelopmental impairment compared with those with successful hepatoportoenterostomy. Growth delays and/or complications indicating advanced liver disease should alert clinicians to the risk for neurodevelopmental delays, and expedite appropriate interventions.Clinicaltrials.gov: NCT00061828 and NCT00294684.

High speed foil bearings are currently used in increasingly demanding, high performance applications. The application under consideration is a 120 krpm natural gas turboexpander-compressor, which requires 38 mm (1.5 in.) foil journal bearings with high stiffness and load capacity to help enhance rotordynamic stability. This paper describes the development of the foil bearing for this application and includes measured stiffness and damping coefficients recorded on a high-speed dynamic bearing test rig. The dynamic test data were taken for several different foil bearing configurations with varying spring-element foil thicknesses, number of spring-element foils, and bearing shim thickness. All three parameters have a direct impact on bearing clearance. The influence of these different parameters on measured stiffness and damping coefficients and thermal performance of the bearings are presented and discussed.