Does Participating in a Variety of Activities at a Variety of Locations or With Different People Predict Physical Activity Behavior Among Adolescents? The Mediating Role of Perceived Variety

We examine whether adolescents' participating in a variety of physical activities, locations, and/or with a variety of people relates to physical activity 16 months later and whether perceptions of variety mediate these relationships. Adolescents (N = 369) completed measures indicating various physical activities they participated in, where they primarily participated, and with whom they primarily participated, at three time points over a year (averaged for baseline measures). Perceptions of variety was measured 8 months later. Physical activity was measured 16 months after baseline. Mediation analyses tested perceptions of variety as a mediator of variety support and physical activity. Results indicated that variety of activities and variety of locations were indirectly associated with physical activity through perceptions of variety. Participating in a breadth of physical activities in a variety of locations during adolescence is positively associated with perceptions of variety, which relates to physical activity 16 months later.

Race, Ethnicity, and Other Cultural Background Factors in Trials of Internet-Based Cognitive Behavioral Therapy for Depression: Systematic Review

BACKGROUND

There is a growing interest in developing scalable interventions, including internet-based cognitive behavioral therapy (iCBT), to meet the increasing demand for mental health services. Given the growth in diversity worldwide, it is essential that the clinical trials of iCBT for depression include diverse samples or, at least, report information on the race, ethnicity, or other background indicators of their samples. Unfortunately, the field lacks data on how well diversity is currently reported and represented in the iCBT literature.

OBJECTIVE

Thus, the main objective of this systematic review was to examine the overall reporting of racial and ethnic identities in published clinical trials of iCBT for depression. We also aimed to review the representation of specific racial and ethnic minoritized groups and the inclusion of alternative background indicators such as migration status or country of residence.

METHODS

Studies were included if they were randomized controlled trials in which iCBT was compared to a waiting list, care-as-usual, active control, or another iCBT. The included papers also had to have a focus on acute treatment (eg, 4 weeks to 6 months) of depression, be delivered via the internet on a website or a smartphone app and use guided or unguided self-help. Studies were initially identified from the METAPSY database (n=59) and then extended to include papers up to 2022, with papers retrieved from Embase, PubMed, PsycINFO, and Cochrane (n=3). Risk of bias assessment suggested that reported studies had at least some risk of bias due to use of self-report outcome measures.

RESULTS

A total of 62 iCBT randomized controlled trials representing 17,210 participants are summarized in this study. Out of those 62 papers, only 17 (27%) of the trials reported race, and only 12 (19%) reported ethnicity. Reporting outside of the United States was very poor, with the United States accounting for 15 (88%) out of 17 of studies that reported race and 9 (75%) out of 12 for ethnicity. Out of 3,623 participants whose race was reported in the systematic review, the racial category reported the most was White (n=2716, 74.9%), followed by Asian (n=209, 5.8%) and Black (n=274, 7.6%). Furthermore, only 25 (54%) out of the 46 papers conducted outside of the United States reported other background demographics.

CONCLUSIONS

It is important to note that the underreporting observed in this study does not necessarily indicate an underrepresentation in the actual study population. However, these findings highlight the poor reporting of race and ethnicity in iCBT trials for depression found in the literature. This lack of diversity reporting may have significant implications for the scalability of these interventions.

Prevalence of Diverse Genders and Sexualities in Australia and Associations With Five Forms of Child Maltreatment and Multi-type Maltreatment

This study presents the most comprehensive national prevalence estimates of diverse gender and sexuality identities in Australians, and the associations with five separate types of child maltreatment and their overlap (multi-type maltreatment). Using Australian Child Maltreatment Study (ACMS) data (N = 8503), 9.5% of participants identified with a diverse sexuality and .9% with a diverse gender. Diverse identities were more prevalent in the youth cohort, with 17.7% of 16-24 years olds identifying with a diverse sexuality and 2.3% with a diverse gender. Gender and sexuality diversity also intersect - for example, with women (aged 16-24 and 25-44) more likely than men to identify as bisexual. The prevalence of physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence was very high for those with diverse sexuality and/or gender identities. Maltreatment was most prevalent for participants in the youth cohort with diverse gender identities (90.5% experiencing some form of child maltreatment; 77% multi-type maltreatment) or diverse sexualities (85.3% reporting any child maltreatment; 64.3% multi-type maltreatment). The strong association found between child maltreatment and diverse sexuality and gender identities is critical for understanding the social and mental health vulnerabilities of these groups, and informing services needed to support them.

Impact of Telemedicine Modality on Quality Metrics in Diverse Settings: Implementation Science-Informed Retrospective Cohort Study

BACKGROUND

Video-based telemedicine (vs audio only) is less frequently used in diverse, low socioeconomic status settings. Few prior studies have evaluated the impact of telemedicine modality (ie, video vs audio-only visits) on clinical quality metrics.

OBJECTIVE

The aim of this study was to assess telemedicine uptake and impact of visit modality (in-person vs video and phone visits) on primary care quality metrics in diverse, low socioeconomic status settings through an implementation science lens.

METHODS

Informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, we evaluated telemedicine uptake, assessed targeted primary care quality metrics by visit modality, and described provider-level qualitative feedback on barriers and facilitators to telemedicine implementation.

RESULTS

We found marginally better quality metrics (ie, blood pressure and depression screening) for in-person care versus video and phone visits; de-adoption of telemedicine was marked within 2 years in our population.

CONCLUSIONS

Following the widespread implementation of telemedicine during the COVID-19 pandemic, the impact of visit modality on quality outcomes, provider and patient preferences, as well as technological barriers in historically marginalized settings should be considered.

territories: A scoping review1

Objective: Tele-neuropsychology (teleNP) has the potential to deliver assessment to people who face limited access to culturally and linguistically appropriate services, health disparities, and negative social determinants of health (SDOH). We reviewed to what extent teleNP has been examined in racially and ethnically diverse samples within the U.S. and U.S. territories and describe validity, feasibility, barriers, and facilitators. Method: A scoping review was conducted to examine factors relevant to teleNP with racially/ethnically diverse samples, using Google Scholar and PubMed®. Key words referenced "tele-neuropsychology," racial/ethnic populations within the U.S. and territories, and relevant constructs (e.g. "validity," "feasibility"). Studies included in the final analysis were empirical, addressed teleNP, and included racially/ethnically diverse individuals within the U.S. The search resulted in 10,312 articles total, with 9,670 following removal of duplicates. We excluded 9,600 following abstract review, and an additional 54 articles following full-text review. Thus, 16 studies were included in the final analysis. Results: Results showed the greatest number of studies supporting feasibility and utility of teleNP with older LatinX/Hispanic adults. Limited reliability and validity data suggested that, for the most part, teleNP and face-to-face neuropsychological evaluations were broadly equivalent, and no studies contraindicated use of teleNP in culturally diverse populations. Conclusions: This review provides preliminary support, particularly in terms of teleNP feasibility, with culturally diverse individuals. Current research is hampered by low inclusion of culturally diverse individuals and limited studies, and while support is nascent, these findings should be balanced with promotion of healthcare equity/access.

Skin of Color Representation Trends in JAAD Case Reports 2015-2021: Content Analysis

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Fixing Flexner: Disrupting and Rebuilding Academic Medicine for Women of Color to Lead

In an effort to address the lack of compositional diversity seen in academic leadership, our generation has an opportunity to rebuild academic medicine in a way that welcomes, values, and supports the development and success of women of color.

Toward More Inclusive Networks and Initiatives in Innovation Ecosystems: Protocol for a Systematic Review

Background

Expanding the cooperation and enlarging the participation of more diverse stakeholders within innovation ecosystems will increase their efficiency and capacity to contribute at local, regional, and national levels.

Objective

This paper presents the protocol for a systematic review that will identify “opening-up” strategies of innovation ecosystems for increasing the participation of more diverse innovation stakeholders, particularly from low-innovation countries, during the ecosystem formation period.

Methods

An algorithmic search in 4 databases (Web of Science, Cochrane Library, Scopus, and Social Science Research Network) will be applied based on the PerSPecTIF (perspective, setting, phenomenon of interest/problem, environment, optional comparison, time/timing, and findings) methodology, the Cochrane guidelines for qualitative evidence synthesis, and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Selection criteria for eligibility include peer-reviewed articles published after December 31, 1999, and containing original data. No restrictions will be placed on the article language and study region, design, or methodology. Methodological strengths and limitations will be assessed using the Critical Appraisal Skills Programme tool. The thematic synthesis method will be adopted, and the GRADE-CERQual tool will be used to assess confidence.

Results

A preliminary search in Web of Science revealed 2758 records. This work is part of the ANGIE project, which was funded by the European Union’s Horizon 2020 research and innovation program (grant 952152) in January 2021. We anticipate that the results of this systematic review will be published in spring 2022.

Conclusions

We anticipate that the outcomes of this systematic review will outline the best practices used by initiatives and networks, as well as their impacts on creating larger and more inclusive ecosystems.

Trial Registration

OSF Registries osf.io/hc62k 10.17605/OSF.IO/HC62K

International Registered Report Identifier (IRRID)

PRR1-10.2196/34071

The effects of experimentally manipulated social status and subjective social status on physical activity among Hispanic adolescents: An RCT

BACKGROUND

Low objective socioeconomic status (SES) and subjective social status (SSS), one's perceived social rank, are associated with obesity. This association may be due, in part, to social status-related differences in energy expenditure. Experimental studies are needed to assess the extent to which SES and SSS relate to energy expenditure.

OBJECTIVE

Assess the effects of experimentally manipulated social status and SSS on moderate-to-vigorous physical activity (MVPA) and sedentary behaviour.

METHODS

One hundred thirty-three Hispanic adolescents aged 15-21 were randomized to a high or low social status position, facilitated through a rigged game of Monopoly™. SSS was assessed with MacArthur Scales. Post-manipulation 24-h MVPA and sedentary behaviour were assessed via accelerometry. Analyses were conducted with general linear regression models.

RESULTS

Experimentally manipulated social status did not significantly affect the total time spent in MVPA or sedentary behaviour; however, identifying as low SSS was significantly associated with less MVPA (p = 0.0060; 18.76 min less).

CONCLUSIONS

Tewnty-four-hour MVPA and sedentary behaviour are not affected by an acute experimental manipulation of social status. However, low SSS, independent of SES, was associated with clinically significant differences in MVPA. SSS may be a better predictor of MVPA than SES among Hispanic adolescents, potentially influencing obesity, and other health-related outcomes.

Evaluation of mHealth Apps for Diverse, Low-Income Patient Populations: Framework Development and Application Study

Background

The use of mobile technology or smartphones has grown exponentially in the United States, allowing more individuals than ever internet access. This access has been especially critical to households earning less than US $30,000, the majority of whom indicate that smartphones are their main source of internet access. The increasing ubiquity of smartphones and virtual care promises to offset some of the health disparities that cut through the United States. However, disparities cannot be addressed if the medical information offered though smartphones is not accessible or reliable.

Objective

This study seeks to create a framework to review the strengths and weaknesses of mobile Health (mHealth) apps for diverse, low-income populations.

Methods

Focusing on smoking cessation, diabetes management, and medication adherence as models of disease management, we describe the process for selecting, evaluating, and obtaining patient feedback on mHealth apps.

Results

The top 2 scoring apps in each category were QuitNow! and Smoke Free-Quit Smoking Now for smoking cessation, Glucosio and MyNetDiary for diabetes management, and Medisafe and MyMeds for medication adherence.

Conclusions

We believe that this framework will prove useful for future mHealth app development, and clinicians and patient advisory groups in connecting culturally, educationally, and socioeconomically appropriate mHealth apps with low-income, diverse communities and thus work to bridge health disparities.

Diverse vaccine platforms safeguarding against SARS-CoV-2 and its variants

INTRODUCTION

Appearances of SARS-CoV-2 variants have created havoc and additional challenges for the ongoing vaccination drive against pandemic COVID-19. Interestingly, several vaccine platforms are showing great potential to produce successful vaccines against SARS-CoV-2 and its variants. Billions of COVID-19 vaccine doses have been administered worldwide. Mix-and-Match COVID-19 vaccines involving the mixing of the same platform vaccines and also two different vaccine platforms may provide greater protection against SARS-CoV-2 and its variants. COVID-19 vaccines have become one of the most important tools to mitigate the ongoing pandemic COVID-19.

AREAS COVERED

We describe SARS-Cov-2 variants, their impact on the population, COVID-19 vaccines, diverse vaccine platforms, doses of vaccines, the efficacy of vaccines against SARS-CoV-2 and its variants, mitigation of the COVID-19 transmission- alternatives to vaccines.

EXPERT OPINION

Diverse vaccine platforms may safeguard against ongoing, deadly SARS-CoV-2 and its infectious variants. The efficacies of COVID-19 vaccines are significantly high after the administration of the second dose. Further, it protects individuals including vulnerable patients with co-morbidities from SARS-CoV-2 and its variants. The hospitalizations and deaths of the individuals may be prevented by COVID-19 vaccines.

Varied diets: implications for lamb performance, rumen characteristics, total antioxidant status, and welfare

Intensive pastoral systems have moved away from diverse and varied diets towards overly simple monotonous diets. Feed choice through time is an obsolete way of providing forage to animals, as intensive management schemes generally allocate a single herbage or a dyad mixed sward. Monotonous feeding regimes impose nutritional repetition, which may impair animal performance and welfare. The objective of this experiment was to determine the impact of a diverse diet [DIV; free choice from perennial ryegrass (Lolium perenne L.), plantain (Plantago lanceolata L.), alfalfa (Medicago sativa L.), and chicory (Cichorium intybus L.) at all times], a varied diet [VAR; choice from ryegrass and plantain in the AM (0700-1600 h), and chicory and alfalfa in PM (1600-0700 h)], and a single forage diet of alfalfa [SFA; alfalfa at all times], on DMI, performance, and welfare of lambs. Six-month-old Coopworth ram lambs (n = 21) were offered their respective fresh-forage treatment (n = 7) diet indoors for 20 d. The DIV lambs consumed 1.64 ± 0.03 kg DM/d (mean ± SEm), which was 6% more (P < 0.05; 1.54 ± 0.03 kg DM/d) than the SFA and were not different (P > 0.05; 1.59 ± 0.03 kg DM/d) to the VAR lambs. Average daily gain (ADG) of DIV (296 g/d) and VAR (378 g/d) was 30% and 67% greater (P < 0.05) than that in the SFA lambs (227 g/d), respectively. The VAR lambs had 28% greater (P < 0.05) ADG than the DIV lambs. Differences among treatments were detected (P < 0.05) for the proportion of the day spent conducting the following behaviors: eating, ruminating, idling, lying, and standing. In addition, the number of bouts of stereotypic behaviors recorded from the SFA lambs (13.2 ± 2.2) was 150% greater (P < 0.05) than the DIV (5.1 ± 1.0) and VAR (5.5 ± 1.0) lambs. Our results suggest that the varied diet offered can improve animal performance and welfare compared to a monotonous SFA diet. Feeding management to provide a varied diet can improve performance relative to giving lambs free choice from taxonomically diverse forage options. Moreover, performance is affected by more than the primary chemical composition of the diet consumed, but how the diet is presented through time and the herbage species and quantities of each that are consumed to reach that chemical composition.

Predictors of Treatment Access and Initiation Among Diverse, Low-Income Victims of Violence Offered a Trauma-Focused Evidence-Based Psychotherapy

Many victims of violence may benefit from trauma-focused evidence-based psychotherapies (EBPs), but fail to utilize treatment. The current study investigated factors associated with treatment access and treatment initiation in a low-income, racially and ethnically diverse, urban population of victims of violence who were screened for EBPs. The sample consisted of 941 adults, mean age = 35.87 (SD = 12.8), who were screened for mental health treatment and offered an EBP. Overall, 55.7% of individuals accessed treatment by attending an in-person screening appointment and intake, and 79.0% of the individuals who accessed treatment then initiated treatment by attending the first EBP session. Analysis revealed higher age (odds ratio [OR] = 1.05, 95% confidence interval (CI) = [1.04, 1.09]) and lower expression of posttraumatic stress disorder (PTSD) symptoms predicted higher rates of accessing treatment (OR = 0.20, 95% CI = [0.05, 0.82]). Higher global severity of distress (OR = 3.22, 95% CI = [1.14, 9.10]), poor quality of life in the area of psychological health (OR = 0.90, 95% CI = [0.81, 1.00]), and better quality of life in the area of physical health significantly predicted initiation of treatment (OR = 1.11, 95% CI = [0.998, 1.24]). Findings suggest that low-income, ethnically and racially diverse victims of violence may effectively utilize trauma-focused EBPs offered in a community setting.

Multiple clades of SARS-CoV-2 were introduced to Thailand during the first quarter of 2020

In early January 2020, Thailand became the first country where a coronavirus disease 2019 (COVID‐19) patient was identified outside China. In this study, 23 whole genomes of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) from patients who were hospitalized from January to March 2020 were analyzed, along with their travel histories. Six lineages were identified including A, A.6, B, B.1, B.1.8, and B.58, among which lineage A.6 was dominant. Seven patients were from China who traveled to Thailand in January and early February. Five of them were infected with the B lineage virus, and the other two cases were infected with different lineages including A and A.6. These findings present clear evidence of the early introduction of diverse SARS‐CoV‐2 clades in Thailand.

A Review of the Current Status of Gestational Diabetes Mellitus in Australia-The Clinical Impact of Changing Population Demographics and Diagnostic Criteria on Prevalence

The current status of gestational diabetes mellitus in Australia reveals an almost quadrupling prevalence over the last decade. A narrative review of the current Australian literature reveals unique challenges faced by Australian maternity clinicians when addressing this substantial disease burden in our diverse population. Rising rates of maternal overweight and obesity, increasing maternal age and the diversity of ethnicity are key epidemiological impactors, overlaid by the 2015 changes in screening and diagnostic parameters. Our vast land mass and the remote location of many at risk women requires innovative and novel ideas for pathways to diagnose and effectively manage women with gestational diabetes mellitus. By modifying and modernizing models of care for women with gestational diabetes mellitus, we have the ability to address accessibility, resource management and our acute response to global events such as the COVID 19 pandemic. With continuing research, education and robust discourse, Australia is well placed to meet current and future challenges in the management of gestational diabetes mellitus.

Promoting Equity, Social Justice, and Saving Lives with Life Jacket and Clothing Policies

Worldwide, diverse racial/ethnic groups have disproportionately higher drowning rates. Learning to swim and wearing life jackets decrease drowning risk. We evaluated aquatic facilities’ policies regarding use of life jackets, clothing, and diapers through a lens of social justice, equity, and inclusion to ensure they met the needs of the diverse high-risk groups they serve and changing aquatic activities and programs. Public recreational pools, beach and waterpark facilities in the US and international organizations were surveyed regarding their policies on life jacket use, clothing, and diapers between 2015 and 2016. A total of 562 facilities responded, mostly pools. Almost all facilities allowed wearing life jackets in the shallow end but less so in the deep end, and wearing of T-shirts, shorts, and clothes for modesty reasons. Policies varied most on wearing non-swim clothes. Almost universal requirement of diapers applied to infants only. Respondents’ reported themes included cost, access, safety, hygiene and equipment maintenance. Reviewed policies generally reflected facilities’ responsiveness to diverse populations’ specific needs. However, policy variations around wearing clothing and swim diapers could be costly, confusing, and impede participation in aquatic activities by vulnerable populations, specifically young children and racial and ethnic minorities. Standardization of these policies could assist aquatic facilities and their users. A best-practices-based policy is outlined.

Enrollment of Diverse Populations in the INGENIOUS Pharmacogenetics Clinical Trial

Recruitment of diverse populations and subjects living in Medically Underserved Areas and Populations (MUA/P's) into clinical trials is a considerable challenge. Likewise, representation of African-Americans in pharmacogenetic trials is often inadequate, but critical for identifying genetic variation within and between populations. To identify enrollment patterns and variables that predict enrollment in a diverse underserved population, we analyzed data from the INGENIOUS (Indiana GENomics Implementation and Opportunity for the UnderServed), pharmacogenomics implementation clinical trial conducted at a community hospital for underserved subjects (Safety net hospital), and a statewide healthcare system (Academic hospital). We used a logistic regression model to identify patient variables that predicted successful enrollment after subjects were contacted and evaluated the reasons that clinical trial eligible subjects refused enrollment. In both healthcare systems, African-Americans were less likely to refuse the study than non-Hispanic Whites (Safety net, OR = 0.68, and p < 0.002; Academic hospital, OR = 0.64, and p < 0.001). At the Safety net hospital, other minorities were more likely to refuse the study than non-Hispanic Whites (OR = 1.58, p < 0.04). The odds of refusing the study once contacted increased with patient age (Safety net hospital, OR = 1.02, p < 0.001, Academic hospital, OR = 1.02, and p < 0.001). At the Academic hospital, females were less likely to refuse the study than males (OR = 0.81, p = 0.01) and those not living in MUA/P's were less likely to refuse the study than those living in MUA/P's (OR = 0.81, p = 0.007). The most frequent barriers to enrollment included not being interested, being too busy, transportation, and illness. A lack of trust was reported less frequently. In conclusion, African-Americans can be readily recruited to pharmacogenetic clinical trials once contact has been successfully initiated. However, health care initiatives and increased recruitment efforts of subjects living in MUA/Ps are needed. Enrollment could be further enhanced by improving research awareness and knowledge of clinical trials, reducing time needed for participation, and compensating for travel.

Dementia caregiver intervention development and adaptation in the Vietnamese American community: A qualitative study

Objectives:

The purpose of this study was to obtain input and feedback on a proposed intervention to reduce stress and enhance the health of Vietnamese dementia caregivers.

Methods:

Sixteen semi-structured, in-depth interviews and two focus groups were conducted with a total of 21 key stakeholders (i.e., family caregivers, professionals, and community leaders).

Results:

Several themes emerged from the data, and these themes fell into two major domains: the first domain was recruitment and engagement into the intervention: (1) importance of faith-based institutions, (2) inclusion of multiple family members in the intervention, (3) community empowerment/ownership, and (4) importance of credibility and trust. The second domain included themes on intervention content: (1) education about Alzheimer’s disease and dementias and (2) tailoring the intervention to caregivers’ needs.

Conclusions:

Findings indicate that the proposed intervention could be very beneficial to caregivers, but slight modifications needed to be made.

Impact of a Formal Lactation Curriculum for Residents on Breastfeeding Rates Among Low-Income Women

Obstetrics-gynecology residents have inadequate training in lactation management and are typically unable to address basic breastfeeding needs. A retrospective study was performed to evaluate the impact of a formal lactation curriculum for obstetrics-gynecology residents on breastfeeding. Demographic information, medical history, and breastfeeding rates were derived from medical records and hospital lactation logs. Breastfeeding outcomes of women with term, singleton infants were analyzed before and after curriculum implementation. The study included 717 women, 337 prior to intervention and 380 after intervention. Women who delivered after curriculum implementation were more likely to breastfeed exclusively at 6 weeks postpartum (odds ratio [OR]: 2.01; 95% confidence interval [CI]: 1.28-3.15). A targeted breastfeeding curriculum was associated with increased exclusive breastfeeding rates at 6 weeks postpartum in a diverse, low-income population.

Structural Barriers to Pre-exposure Prophylaxis Use Among Young Sexual Minority Men: The P18 Cohort Study

BACKGROUND

Despite decreasing rates of HIV among many populations, HIV-related health disparities among gay, bisexual and other men who have sex with men persist, with disproportional percentages of new HIV diagnoses among racial and ethnic minority men. Despite increasing awareness of HIV pre-exposure prophylaxis (PrEP), PrEP use remains low. In addition to exploring individual-level factors for this slow uptake, structural drivers of PrEP use must also be identified in order to maximize the effectiveness of biomedical HIV prevention strategies.

METHOD

Using cross-sectional data from an ongoing cohort study of young sexual minority men (N=492), we examine the extent to which structural-level barriers, including access to health care, medication logistics, counseling support, and stigma are related to PrEP use.

RESULTS

While almost all participants indicated awareness of PrEP, only 14% had ever used PrEP. PrEP use was associated with lower concerns about health care access, particularly paying for PrEP. Those with greater concerns talking with their provider about their sexual behaviors were less likely to use PrEP.

CONCLUSION

Paying for PrEP and talking to one's provider about sexual behaviors are concerns for young sexual minority men. In particular, stigma from healthcare providers poses a significant barrier to PrEP use in this population. Providers need not only to increase their own awareness of and advocacy for PrEP as an effective risk-management strategy for HIV prevention, but also must work to create open and non-judgmental spaces in which patients can discuss sexual behaviors without the fear of stigma.

Pathways to age-friendly communities in diverse urban neighborhoods: Do social capital and social cohesion matter?

Using a social capital and social cohesion lens, we reposition the concept of civic engagement among older adults to examine pathways for building age-friendly communities. We analyzed data drawn from a Community-Based Participatory Research study in the Southern U.S. that explored lived experiences of older adults, age 55 and above, who participated in individual interviews (n = 15) and six focus group discussions (n = 45) to examine their perceptions of social identity, social connectedness, and civic engagement geared toward an age-friendly city. Findings indicated that several older adults had access to social networks and socially invested resources, thereby having opportunities for civic engagement and building age-friendly neighborhoods. However, social, cultural, linguistic, and structural barriers were more evident among certain diverse ethnic populations. Marginalized low-income minorities and immigrants, such as Hispanic participants, felt the lack of social cohesion among the larger society limited their ability to give back, thus decreasing their civic engagement activities. In contrast, Caucasian and African-American older adults were able to contribute to the political process through more civic participation activities. We provide implications for examining the role of social capital and social engagement to bolster civic engagement among older adults in building age-friendly communities.

Predictors of Non-Alcoholic Liver Disease in Ethnically Diverse Overweight Children and Adolescents

OBJECTIVES

To study the relationship between Non-Alcoholic Fatty Liver Disease (NAFLD) and sleep, Physical Activity (PA), and screen-time habits/behaviors among a multiethnic sample of overweight children/adolescents.

METHODS

A retrospective medical chart review (6/2013-7/2014) identified 209 patients (7-21 years old) who were overweight/obese (BMI > 85th% for age/sex). A follow-up telephone survey was completed among 130 of these patients' parents to obtain information on sleep, screen-time, PA habits, and socio-demographics. NAFLD was defined as ALT and/or AST levels above the age/sexadjusted cutoff value in the absence of medications or associated medical conditions. Logistic regression models were fitted to identify predictors of NAFLD by adjusting age, sex, heritage, and income.

RESULTS

Over a third (34%) of the sample (N=130, 55% males, 74% Hispanic) had NAFLD. Compared to non-Hispanics, Central American heritage subjects were over three times as likely to have NAFLD compared to non-Hispanics (OR=3.90, 95% CI, 1.23-12.37) after adjusting for socioeconomics and lifestyle habits. Subjects with low PA levels were at increased risk for NAFLD (aOR=4.52, 95% CI, 1.21-16.82) compared to their more active counterparts. Lower income families were over twice as likely to have NAFLD as higher income families (OR = 2.57, 0.95-6.96).

CONCLUSIONS

Families residing from a Central American heritage are at significant risk for NAFLD versus their ethnic group counterparts. Identifying specific groups and risks for pediatric-onset NAFLD can inform and improve clinical practice and public health initiatives, especially as patient populations become more ethnically diverse across the nation.

Bats host diverse parvoviruses as possible origin of mammalian dependoparvoviruses and source for bat-swine interspecies transmission

Compared to the enormous species diversity of bats, relatively few parvoviruses have been reported. We detected diverse and potentially novel parvoviruses from bats in Hong Kong and mainland China. Parvoviruses belonging to Amdoparvovirus, Bocaparvovirus and Dependoparvovirus were detected in alimentary, liver and spleen samples from 16 different chiropteran species of five families by PCR. Phylogenetic analysis of partial helicase sequences showed that they potentially belonged to 25 bocaparvovirus, three dependoparvovirus and one amdoparvovirus species. Nearly complete genome sequencing confirmed the existence of at least four novel bat bocaparvovirus species (Rp-BtBoV1 and Rp-BtBoV2 from Rhinolophus pusillus, Rs-BtBoV2 from Rhinolophus sinicus and Rol-BtBoV1 from Rousettus leschenaultii) and two novel bat dependoparvovirus species (Rp-BtAAV1 from Rhinolophus pusillus and Rs-BtAAV1 from Rhinolophus sinicus). Rs-BtBoV2 was closely related to Ungulate bocaparvovirus 5 with 93, 72.1 and 78.7 % amino acid identities in the NS1, NP1 and VP1/VP2 genes, respectively. The detection of bat bocaparvoviruses, including Rs-BtBoV2, closely related to porcine bocaparvoviruses, suggests recent interspecies transmission of bocaparvoviruses between bats and swine. Moreover, Rp-BtAAV1 and Rs-BtAAV1 were most closely related to human AAV1 with 48.7 and 57.5 % amino acid identities in the rep gene. The phylogenetic relationship between BtAAVs and other mammalian AAVs suggests bats as the ancestral origin of mammalian AAVs. Furthermore, parvoviruses of the same species were detected from multiple bat species or families, supporting the ability of bat parvoviruses to cross species barriers. The results extend our knowledge on the diversity of bat parvoviruses and the role of bats in parvovirus evolution and emergence in humans and animals.

Pika Gut May Select for Rare but Diverse Environmental Bacteria

The composition of the mammalian gut bacterial communities can be influenced by the introduction of environmental bacteria in their respective habitats. However, there are no extensive studies examining the interactions between environmental bacteriome and gut bacteriome in wild mammals. Here, we explored the relationship between the gut bacterial communities of pika (Ochotona spp.) and the related environmental bacteria across host species and altitudinal sites using 16S rRNA gene sequencing. Plateau pikas (O. curzoniae) and Daurian pikas (O. daurica) were sampled at five different sites, and plant and soil samples were collected at each site as well. Our data indicated that Plateau pikas and Daurian pikas had distinct bacterial communities. The pika, plant and soil bacterial communities were also distinct. Very little overlap occurred in the pika core bacteria and the most abundant environmental bacteria. The shared OTUs between pikas and environments were present in the environment at relatively low abundance, whereas they were affiliated with diverse bacterial taxa. These results suggested that the pika gut may mainly select for low-abundance but diverse environmental bacteria in a host species-specific manner.

Effects of Variety Support on Exercise-Related Well-Being

BACKGROUND

The purpose of this study was to experimentally examine the extent to which variety support in a resistance exercise program influences exercise-related well-being among inactive adults.

METHODS

A sample of 121 inactive university students were randomly assigned and participated in either a high or low variety support 6-week exercise program. Measures of exercise-related perceived variety, positive affect, negative affect, and subjective vitality were completed at baseline, after 3 weeks, and after 6 weeks (i.e. post-test).

RESULTS

Through use of structural equation modelling, the results showed that for those who completed measures at post-test (i.e. n = 55), and for all participants who received variety support (i.e. a modified intention-to-treat analysis; N = 121), exercise-related variety support indirectly explained higher levels of exercise-related positive affect, and subjective vitality, and lower levels of negative affect, through the mediating role of perceived variety.

CONCLUSIONS

The provision of variety support in a resistance exercise program influences exercise-related well-being through perceptions of variety. Results are discussed in relation to the potential utility of providing variety support to promote exercise-related well-being in people who are physically inactive.

Prevalence and overlap of childhood and adult physical, sexual, and emotional abuse: a descriptive analysis of results from the Boston Area Community Health (BACH) survey

Abuse is associated with a wide variety of health problems, yet comprehensive population-based data are scant. Existing literature focuses on a single type of abuse, population, or lifestage. Using a racially/ethnically diverse community-based sample, we document the prevalence of physical, emotional, and sexual abuse by lifestage and gender, assess variation in abuse by sociodemographics; establish overlap of abuses; and examine childhood abuse relationships with abuse in adulthood. Prevalence of abuse ranges from 15% to 27%; women report more adulthood emotional abuse and lifetime sexual abuse than men; reports of abuse can vary by race/ethnicity and poverty status, particularly in women; there is overlap between types of abuse; and a history of childhood abuse is associated with a greater risk of abuse as an adult.

"Knowing is better": preferences of diverse older adults for discussing prognosis

BACKGROUND

Prognosis is critical in individualizing care for older adults with late life disability. Evidence suggests that preferences for prognostic information may be culturally determined. Yet little is known about the preferences of diverse elders for discussing prognosis.

OBJECTIVE

To determine the preferences for discussing prognosis of a diverse sample of older adults with late-life disability.

DESIGN & PARTICIPANTS

We interviewed 60 older adults with mean age 78 and mean 2.5 Activities of Daily Living dependencies. Participants were recruited from San Francisco's On Lok program, the first Program of All-inclusive Care for the Elderly (PACE). Participants were interviewed in English, Spanish, and Cantonese, and responded to scenarios in which their doctors estimated they had 5 years and 1 year left to live. Open-ended questions explored the reasons for their responses. Results were analyzed qualitatively using grounded theory.

KEY RESULTS

Sixty-five percent of participants wanted to discuss the prognosis if their doctor estimated they had <5 years to live and 75% if the estimate was <1 year. Three themes were prominent among patients who wanted to discuss prognosis: to prepare, to make the most of the life they had left, and to make medical or health-related decisions. Those who preferred not to discuss prognosis described emotional difficulty, the uncertainty of prognosis, or that it would not be useful. Nearly all participants said that doctors should not make assumptions based on race or ethnicity, though differences between ethnic groups emerged.

CONCLUSIONS

Most patients in this diverse sample of disabled elders were interested in discussing prognosis, while a substantial minority was not. Among those participants who preferred to discuss prognosis, many said that prognostic information would be important as they made difficult medical and personal decisions in late-life. Clinicians should inquire about preferences for discussing prognosis before sharing prognostic estimates.

Who needs liquor stores when parents will do? The importance of social sources of alcohol among young urban teens

OBJECTIVES

Examine sources of alcohol over time in a large, ethnically diverse adolescent population from a poor, urban environment.

METHODS

Surveys were administered at four time points (6th-8th grades) assessing demographic characteristics, past year alcohol use and sources of alcohol to youth in Chicago, Illinois 2002-2005. Growth curve analysis was used to examine alcohol access trends among all alcohol using youth and consistent alcohol users. Interactions by race and gender were tested.

RESULTS

Social sources of alcohol were the most prevalent source over time. Parents were the primary source of alcohol, but their prominence significantly decreased over time. Taking alcohol from home, and getting alcohol from other adults, individuals under age 21, and commercial sources significantly increased as sources of alcohol over time. Males were significantly more likely than females to get alcohol from commercial sources and friends' parents.

CONCLUSIONS

Greater attention for reducing social access to alcohol, particularly among parents, is needed for alcohol prevention efforts prior to and during middle school.

Primitive nervous systems: action of aminergic drugs and blocking agents on activity in the ventral nerve cord of the flatworm Notoplana acticola

Electrically evoked activity in the submuscular ventral longitudinal nerve cords of Notoplana acticola is depressed by GABA and glycine in the presence of high magnesium concentrations. This inhibition occurs with 0.001--0.01 millimolar concentrations of these putative aminergic neurotransmitters and is reversible when washed out. The action of GABA and glycine was reversed nonspecifically by picrotoxin, bicuculline, and strychnine. PTZ (Pentylenetetrazole) was shown to mimic the effects that these blocking agents had on evoked activity when they were tested alone. The release of inhibition by these blocking agents is similar to that of decerebration. Three possible mechanisms responsible for synaptic activity in high Mg2+ concentrations are discussed and the possibility that the effector site of interaction may be the chloride ionophore is explored.