Disengagement coping and sleep problems among trauma-exposed adolescents

BACKGROUND

The formation of healthy sleep patterns is a critical component of positive adolescent development. Dysregulated sleep habits can put youth at risk for the development of a multitude of inimical outcomes, particularly among those who are exposed to a traumatic event.

DESIGN AND METHODS

The present study investigated the links between voluntary disengagement coping (e.g., avoidance, denial, wishful thinking) and sleep outcomes among 86 trauma-exposed and non-exposed adolescents between the ages of 12-17 (Mage = 15.44, SD = 1.51; 41.9% female).

RESULTS

The relationship between voluntary disengagement coping and sleep outcomes was significant only among trauma-exposed adolescents, such that greater use of voluntary disengagement strategies was associated with greater sleep disturbances and greater daytime dysfunction.

CONCLUSIONS

Targeting disengagement coping may be an important strategy to improve sleep health among trauma-exposed adolescents. Continued efforts in improving the efficacy of trauma-exposed adolescent intervention strategies are needed.

Examining the Factor Structure and Correlates of Motives to Drink Before Attending a Virtual Social Event During COVID-19 Among University Students

Background: Many university students pregame or drink before a social event. Pregaming carries some risk due to its link to heavy drinking. During the COVID-19 pandemic, there was limited access to many drinking venues (e.g., bars/clubs). Moreover, universities shifted to a virtual format and imposed restrictions on in-person gatherings resulting in the reliance on virtual platforms for class instruction, meetings, and social events. The pandemic facilitated changes in students' drinking behaviors, stress levels, and how they maintained social contact with others. Thus, it is conceivable that during an academic pandemic year, students may have engaged in the act of drinking before attending a virtual social event. Objectives: In the present study, we examined the factor structures/item loadings of the Pregaming Motives Measure-Virtual (PGMM-V) among students (N = 283; Mage = 21.38; women = 69.3%; White = 45.4%, Hispanic = 40.8%) from seven universities who completed an online questionnaire (Spring/Summer-2021). Items from the original Pregaming Motives Measure (Bachrach et al., 2012) were modified to reflect motives to drink before attending a virtual social event. Results: We found evidence for a 2-factor structure model of the PGMM-V which includes social/enhancement and social ease/stress. Bivariate correlations indicated that social/enhancement and social ease/stress were (a) positively associated with frequency of drinking and alcohol consumption prior to attending virtual social events, and (b) general drinking motives (social/enhancement/coping) that align with these motives. Conclusions: The PGMM-V is a promising instrument that could be used in future research designed to understand students' pregaming behaviors for virtual social events as the use of such platforms are increasingly relied upon for social engagement.

Business as usual? Drinking games participation before and during an academic pandemic (COVID-19) year among university students

Objective: A drinking game (DG) is a risky social drinking activity that is prevalent among university students and promotes rapid alcohol consumption. We examined university students' DG behaviors before and during the COVID-19 pandemic. Method: Students (N = 368; Mage=21.12; women = 72.6%; Hispanic = 44.7%) from seven universities completed an online survey in 2021 (spring/summer). Results: 57% played DGs in-person before the pandemic and continued to play during the pandemic. These students were less worried about their health/symptoms if they were to contract COVID-19, had lower confidence in wearing a mask properly/socially distancing while under the influence of alcohol, consumed more alcohol during the pandemic, and endorsed higher enhancement drinking motives than students who played DGs before but stopped playing during the pandemic (30%). Conclusions: College health practitioners could pay close attention to students who endorse high enhancement motives as they are susceptible to risky DG play.

The experiences of people with liver disease of palliative and end-of-life care in the United Kingdom-A systematic literature review and metasynthesis

BACKGROUND

Liver disease is a growing health concern and a major cause of death. It causes multiple symptoms, including financial, psychological and social issues. To address these challenges, palliative care can support people alongside active treatment, and towards the end of life, but little is known about the care experiences of individuals with liver disease in the United Kingdom. This review aimed to explore the palliative and end-of-life care experiences of people with liver disease in the United Kingdom.

METHOD

A systematic review was conducted using a five-stage process and following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. Searches were across Web of Science, Scopus, EBSCO and grey literature until 10 May 2023. The review was registered through International Prospective Register of Systematic Reviews (PROSPERO). NVivo 12.5 was used to facilitate data analysis (systematic review registration: PROSPERO CRD42022382649).

RESULTS

Of 6035 papers (excluding duplicates) found from searches, five met the inclusion criteria of primary research related to adults with liver disease receiving palliative and/or end-of-life care in the United Kingdom, published in English. Reflexive thematic analysis of the data was conducted. The themes identified were the experiences of people with liver disease of relating to healthcare professionals, using services, receiving support, and experiences of information and communication. These were connected by an overarching concept of disempowerment versus empowerment, with the notion of person-centred care as an important feature.

CONCLUSION

This review has found variations in the care experiences of people with advanced liver disease towards the end of life and an overall lack of access to specialist palliative care services. Where services are designed to be person-centred, experiences are more empowering. Further research is needed but with recognition that it is often unclear when care for people with liver disease is palliative or end-of-life.

PATIENT AND PUBLIC CONTRIBUTION

An online public involvement workshop was held on 18 April 2023 through Voice (2023). This included four people with liver disease and four carers to discuss the review findings and to design a qualitative research study to further explore the topic.

Wildlife health surveillance: gaps, needs and opportunities

Disease emergence represents a global threat to public health, economy and biological conservation. Most emerging zoonotic diseases have an animal origin, most commonly from wildlife. To prevent their spread and to support the implementation of control measures, disease surveillance and reporting systems are needed, and due to globalisation, these activities should be carried out at the global level. To define the main gaps affecting the performance of wildlife health surveillance and reporting systems globally, the authors analysed data from a questionnaire sent to National Focal Points of the World Organisation for Animal Health that inquired on structure and limits of wildlife surveillance and reporting systems in their territories. Responses from 103 Members, covering all areas of the globe, revealed that 54.4% have a wildlife disease surveillance programme and 66% have implemented a strategy to manage disease spread. The lack of dedicated budget affected the possibility of outbreak investigations, sample collection and diagnostic testing. Although most Members maintain records relating to wildlife mortality or morbidity events in centralised databases, data analysis and disease risk assessment are reported as priority needs. The authors' evaluation of surveillance capacity found an overall low level, with marked variability among Members that was not restricted to a specific geographical area. Increased wildlife disease surveillance globally would help in understanding and managing risks to animal and public health. Moreover, consideration of the influence of socio-economic, cultural and biodiversity aspects could improve disease surveillance under a One Health approach.

The Indirect Effects of Recalled Trauma Severity on Pain Ratings among People with Fibromyalgia: a Moderated Mediation Model

Fibromyalgia syndrome (FM) is a chronic musculoskeletal condition that is accompanied by hypersensitivity to pain. Researchers have examined factors that affect pain ratings among people with FM, such as trauma, depressive symptoms, and coping; however, collectively, the interrelationships among this set of variables, and their relationships to pain, have not been examined. To better understand these relationships, a moderated-mediation model was used to examine how recalled trauma severity, depressive symptoms, relative emotion-focused coping relate to pain ratings. There were 501 participants who were primarily female, White, and ranged in age from 20 to 84 years. All participants had a physician's diagnosis of FM. The results indicated a significant moderated-mediation. Depressive symptoms significantly mediated the relationship between recalled trauma severity and pain ratings, such that greater trauma severity related to more depressive symptoms which in turn were associated with more pain. The mediation chain was moderated by relative emotion-focused coping (i.e., the proportion of emotion-focused coping compared to problem-focused coping), such that when relative emotion-focused coping was used at higher levels, the relationship between recalled trauma severity and depressive symptoms significantly weakened, reducing the indirect association between recalled trauma severity and pain ratings. The findings from the present study indicate that a treatment approach that includes a trauma-focused therapy such as exposure therapy or Emotional Awareness and Expression Therapy should be tested to determine whether these treatments can reduce the impact of past traumas, improve depressive symptoms, decrease pain ratings, and promote more adaptive coping among people with FM.

Needs assessment and planning for a clinic-community-based implementation program for hypertension control among blacks in New York City: a protocol paper

BACKGROUND

Hypertension (HTN) control among Blacks in the USA has become a major public health challenge. Barriers to HTN control exist at multiple levels including patient, physician, and the health system. Patients also encounter significant community-level barriers, such as poor linkage to social services that impact health (unstable housing, food access, transportation). We describe a multi-component needs assessment to inform the development, implementation, and evaluation of a program to improve HTN management within a large healthcare system in New York City (NYC).

METHODS

Guided by the Community-Based Participatory Research (CBPR) and Consolidated Framework for Implementation Research (CFIR) frameworks, data will be collected from four main sources: (1) quantitative surveys with health systems leadership, providers, and staff and with community-based organizations (CBOs) and faith-based organizations (FBOs); (2) qualitative interviews and focus groups with health systems leadership, providers, and staff and with CBOs and FBOs; (3) NYC Community Health Survey (CHS); and (4) New York University (NYU) Health system Epic Electronic Health Record (EHR) system. The data sources will allow for triangulation and synthesis of findings.

DISCUSSION

Findings from this comprehensive needs assessment will inform the development of a clinic-community-based practice facilitation program utilizing three multi-level evidence-based interventions (nurse case management, remote blood pressure (BP) monitoring, and social determinants of health (SDoH) support) integrated as a community-clinic linkage model for improved HTN control in Black patients. Integration of stakeholders' priorities, perspectives, and practices into the development of the program will improve adoption, sustainability, and the potential for scale-up.

TRIAL REGISTRATION

NCT05208450; registered on January 26, 2022.

How well do polygenic risk scores identify men at high risk for prostate cancer? Systematic review and meta-analysis

OBJECTIVES

Genome-wide association studies have revealed over 200 genetic susceptibility loci for prostate cancer (PCa). By combining them, polygenic risk scores (PRS) can be generated to predict risk of PCa. We summarize the published evidence and conduct meta-analyses of PRS as a predictor of PCa risk in Caucasian men.

PATIENTS AND METHODS

Data were extracted from 59 studies, with 16 studies including 17 separate analyses used in the main meta-analysis with a total of 20,786 cases and 69,106 controls identified through a systematic search of ten databases. Random effects meta-analysis was used to obtain pooled estimates of area under the receiver-operating characteristic curve (AUC). Meta-regression was used to assess the impact of number of single-nucleotide polymorphisms (SNPs) incorporated in PRS on AUC. Heterogeneity is expressed as I² scores. Publication bias was evaluated using funnel plots and Egger tests.

RESULTS

The ability of PRS to identify men with PCa was modest (pooled AUC 0.63, 95% CI 0.62-0.64) with moderate consistency (I² 64%). Combining PRS with clinical variables increased the pooled AUC to 0.74 (0.68-0.81). Meta-regression showed only negligible increase in AUC for adding incremental SNPs. Despite moderate heterogeneity, publication bias was not evident.

CONCLUSION

Typically, PRS accuracy is comparable to PSA or family history with a pooled AUC value 0.63 indicating mediocre performance for PRS alone.

Background shielding by dense samples in low-level gamma spectrometry

In low activity gamma spectrometric measurements of large, dense samples, the bulk sample material shields the HPGe crystal from external background sources. If not accounted for in studies that utilise background-subtraction methods, this effect may result in systematic errors in the sample activity and detection limit estimation. We introduce a Monte Carlo based method to minimise the impact of this effect on sample gamma spectra. It is validated using simulated detector backgrounds and applied to a measurement of low-activity [Formula: see text] . One main prerequisite for the correct application of this method is to know in advance the nuclides which contribute to the detector background spectrum and their spatial distribution. With a thorough understanding of the detector backgrounds, the method improves the accuracy of sensitive low-background measurements of low-activity samples. Even without knowing the background sources and their distribution, conservative results may still be presented that account for the potential systematic errors introduced by this background shielding effect.

M.I.C.A.H. Project HEAL: Sustainability of a Faith-Based Community Health Advisor Training Program in Urban Underserved Communities in the USA

Faith-based organizations (FBOs) can play an important role in improving health outcomes. Lay community health advisors (CHAs) are integral to these efforts. This paper assesses the sustainability of a CHA training program for congregants in African-American and Latino FBOs and subsequent implementation of educational workshops. The program is unique in that a health care chaplain in an academic medical center was central to the program's development and implementation. Forty-eight CHAs in 11 FBOs were trained to teach workshops on cardiovascular health, mental health, diabetes, and smoking cessation. Two thousand four hundred and forty-four participants attended 70 workshops. This program has the potential to be a model to educate individuals and to address health inequities in underserved communities. Health care chaplains in other medical centers may use this as a model for enhancing community engagement and education.

Interpersonal trauma and its relation to childhood psychopathic traits: what does ADHD and ODD add to the equation?

BACKGROUND

Childhood trauma has demonstrated associations with callous-unemotional traits (e.g., reflecting lack of remorse and guilt, unconcern about own performance). Less is known about associations between trauma and multiple domains of child psychopathic traits. There has also been limited focus on the role of co-occurring disorders to psychopathy traits among children, namely, attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and how they interact with childhood trauma.

METHODS

We examined to what degree childhood interpersonal trauma can predict parent-rated psychopathic traits in a large population based Swedish twin sample (N = 5057), using a stringent definition of interpersonal trauma occurring before age 10. Two hundred and fifty-one participants met the interpersonal trauma criteria for analysis. The study explored the additional impact of traits of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).

RESULTS

Linear regressions demonstrated statistically significant but clinically negligible effects of interpersonal trauma on total and subscale scores of parent-rated psychopathic traits. When exploring interaction effects of ADHD and ODD into the model, the effect increased. There were interaction effects between ODD and trauma in relation to psychopathic traits, suggesting a moderating role of ODD. Having been exposed to trauma before age 10 was significantly associated with higher parent rated psychopathy traits as measured by The Child Problematic Traits Inventory-Short Version (CPTI-SV), however the explained variance was small (0.3-0.9%).

CONCLUSIONS

The results challenge the notion of association between interpersonal trauma and youth psychopathic traits. They also highlight the need to gain an improved understanding of overlap between psychopathic traits, ADHD and ODD for clinical screening purposes and the underlying developmental mechanisms.

Prognostic significance and immune correlates of CD73 expression in renal cell carcinoma

Background

CD73–adenosine signaling in the tumor microenvironment is immunosuppressive and may be associated with aggressive renal cell carcinoma (RCC). We investigated the prognostic significance of CD73 protein expression in RCC leveraging nephrectomy samples. We also performed a complementary analysis using The Cancer Genome Atlas (TCGA) dataset to evaluate the correlation of CD73 (ecto-5′-nucleotidase (NT5E), CD39 (ectonucleoside triphosphate diphosphohydrolase 1 (ENTPD1)) and A2 adenosine receptor (A2AR; ADORA2A) transcript levels with markers of angiogenesis and antitumor immune response.

Methods

Patients with RCC with available archived nephrectomy samples were eligible for inclusion. Tumor CD73 protein expression was assessed by immunohistochemistry and quantified using a combined score (CS: % positive cells×intensity). Samples were categorized as CD73_negative (CS=0), CD73_low or CD73_high (< and ≥median CS, respectively). Multivariable Cox regression analysis compared disease-free survival (DFS) and overall survival (OS) between CD73 expression groups. In the TCGA dataset, samples were categorized as low, intermediate and high NT5E, ENTPD1 and ADORA2A gene expression groups. Gene expression signatures for infiltrating immune cells, angiogenesis, myeloid inflammation, and effector T-cell response were compared between NT5E, ENTPD1 and ADORA2A expression groups.

Results

Among the 138 patients eligible for inclusion, ‘any’ CD73 expression was observed in 30% of primary tumor samples. High CD73 expression was more frequent in patients with M1 RCC (29% vs 12% M0), grade 4 tumors (27% vs 13% grade 3 vs 15% grades 1 and 2), advanced T-stage (≥T3: 22% vs T2: 19% vs T1: 12%) and tumors with sarcomatoid histology (50% vs 12%). In the M0 cohort (n=107), patients with CD73_high tumor expression had significantly worse 5-year DFS (42%) and 10-year OS (22%) compared with those in the CD73_negative group (DFS: 75%, adjusted HR: 2.7, 95% CI 1.3 to 5.9, p=0.01; OS: 64%, adjusted HR: 2.6, 95% CI 1.2 to 5.8, p=0.02) independent of tumor stage and grade. In the TCGA analysis, high NT5E expression was associated with significantly worse 5-year OS (p=0.008). NT5E and ENTPD1 expression correlated with higher regulatory T cell (Treg) signature, while ADORA2A expression was associated with increased Treg and angiogenesis signatures.

Conclusions

High CD73 expression portends significantly worse survival outcomes independent of stage and grade. Our findings provide compelling support for targeting the immunosuppressive and proangiogenic CD73–adenosine pathway in RCC.

Disaster medicine and pandemic response: A novel curriculum to improve understanding of complex care delivery during the COVID-19 pandemic

BACKGROUND

Despite a 2009 recommendation from the AMA that disaster medicine and public health response training should be implemented in medical schools, anywhere from 31% to 47% of medical education programs lack a formalized disaster medicine curriculum. A need for disaster medicine response training for University of Alabama medical students in an appropriately socially distanced format was identified during the COVID-19 pandemic.

METHODS

Our emergency medicine faculty in collaboration with the Federal Emergency Management Agency Center for Disaster Preparedness (FEMA CDP) created and implemented a novel virtual disaster medicine and pandemic response course for third-year medical students at the University of Alabama at Birmingham (UAB). The course was administered via a teleconferencing platform (Zoom, Zoom Video Communications, Inc.) in spring 2020 to more than 130 medical students.

RESULTS

Using pre- and postcourse surveys, we assessed a change in student confidence levels for their ability to explain topics covered in the course and their understanding of a chosen disaster. The students reported an average increase of 2.183 on a 5-point scale, with a score of 5 representing "completely confident" and a score of 1 representing "not at all confident." This course established the feasibility of a virtual instructor-led training (VILT) format for disaster medicine education and provided a template for the delivery of over 300 courses to more than 4,000 first responders and medical professionals through the FEMA CDP.

CONCLUSIONS

Through collaboration with the FEMA CDP, our UAB faculty were able to successfully deliver a novel virtual disaster-preparedness and response course. The course resulted in subjective improvement of students' content understanding while also establishing the feasibility and effectiveness of a VILT format that could be readily applied to future courses in undergraduate medical education and beyond.

Systemic acidemia impairs cardiac function in critically Ill patients

BACKGROUND

Acidemia, is associated with reduced cardiac function in animals, but no studies showing an effect of acidemia on cardiac function in humans are reported. In the present study, we examined the effect of acidemia on cardiac function assessed with transpulmonary thermodilution technique with integrated pulse contour analysis (Pulse Contour Cardiac Output, PiCCO™) in a large cohort of critically ill patients.

METHODS

This was a prospective multicenter observational cross-sectional study of 297 patients from 6 intensive care units in London, England selected from all patients admitted consecutively between May 2018 and March 2019. Measurements of lowest plasma pH and concurrent assessment of cardiac function were obtained.

FINDINGS

There was a significant difference between two pH categories (pH ≤ 7.28 vs. pH > 7.28) for the following variables of cardiac function: SVI (difference in means 32.7; 95% CI: 21 to 45 mL/m2; p < 0.001); GEF (18; 95% CI: 11 to 26%; p < 0.001), dPmax (-331; 95% CI: -510 to -153 mmHg/s; p = 0.001), CFI (0.7; 95% CI: 0.2 to 1.3 1/min; p = 0.01) and CPI (0.09; 95% CI: 0.03 to 0.15 W/m2; p < 0.001). However, there was no significant difference in CI (0.13; 95% CI: -0.20 to 0.47 L/min/m2; p = 0.12) between the pH categories. Also, a significant relationship was found between the quantitative pH and the following variables: SVI (132; 95% CI: 77 to 188 mL/m2; p < 0.001), GEF (74.7; 95% CI: 37.1 to 112.4%; p < 0.001), dPmax (-1587; 95% CI: -2361 to -815 mmHg/s; p < 0.001), CFI (3.5; 95% CI: 0.9 to 6.1 /min; p = 0.009), CPI (0.62; 95% CI: 0.36 to 0.88 W/m2; p < 0.001) and CI (regression coefficient 1.96; 95% CI:0.45 to 3.47 L/min/m2; p = 0.01).

INTERPRETATION

Acidemia is associated with impaired cardiac function in seriously ill patients hospitalized in the intensive care unit supporting the potential value of early diagnosis and improvement of arterial pH in these patients.

FUNDING

The study was partially supported by unrestricted funds from the UCLA School of Medicine.

The Use of Precision Nutrition Among African Americans With Chronic Disease

Objectives

To characterize the effects of precision nutrition on dietary behavior change, weight, and waist circumference. To examine perceptions of receiving a personalized nutrition plan.

Methods

Food as Medicine Phase II is a pilot study that measured the effectiveness of incorporating precision nutrition to improve chronic disease management in a cohort of 24 low income African Americans with either pre-diabetes, type 2 diabetes mellitus, hypertension, elevated blood cholesterol levels, obesity or a combination of these disorders. Anthropometric measures and a food questionnaire were collected pre/post study. DNA samples were obtained from each participant and analyzed at Howard University on SNPs related to nutrient metabolism. Results from the DNA tests were incorporated in a detailed personal nutrition plan developed for each participant. Plans were presented and discussed during an initial individual face-to-face counseling session. Due to COVID 19, a second counseling session was conducted via Zoom. For three months after the 2nd counseling session, participants received weekly text messages reinforcing the information received.

Results

Participants reported significant improvements in their intake of most recommended foods. Reductions in weight, waist circumference, and in the reported intake of non-recommended foods and beverages were not significant. Most participants either strongly agreed (14) or agreed (4) that the personalized nutrition plan provided useful information. The coronavirus pandemic was mentioned by 20% of participants as a barrier to following their personalized nutrition plan recommendations.

Conclusions

The results suggest that a personalized approach in providing dietary recommendations utilizing precision nutrition has the potential to increase self-efficacy and improve dietary intake among low income African Americans with chronic disease. It also demonstrated that it is feasible to recruit and retain individuals of African ancestry to participate in an investigation that assesses and discloses gene-associated disease risk.

Funding Sources

Ardmore Institute of Health

Evaluation of the 30km/h speed limit trial in the City of Yarra, Melbourne, Australia

OBJECTIVE

Safe vehicle speeds were identified as a key element in a safe system approach to road safety. The City of Yarra in Melbourne, Australia has a 40 km/h default speed limit across their municipality, but wished to reduce the speed limit in local residential streets to 30 km/h. The Monash University Accident Research Center provided Council with a design for a demonstration trial and agreed to evaluate its safety benefits over 12 months. The trial was expected to show significant reductions in speed and increased community support.

METHOD

A before and after design was employed with a control (untreated) area to evaluate the safety outcomes of the trial. Speed limits were reduced to 30 km/h in the trial area for 12 months but kept at kept at the current 40 km/h (25 mph) limit in the control region. Vehicle speeds were measured at around 100 selected sites in the trial and control areas, and resident surveys were undertaken in both regions before and after the trial.

RESULTS

The findings showed a small but modest reduction of 1.1% in average speed in the trial region but a surprising 2.7% in the control region. On further examination, significant reductions were observed in the percent of vehicles exceeding 40 km/h (25 mph) and 50 km/h (31 mph) in both the treated and control regions, but not at 30 km/h (19 mph). A regression analysis further showed a significant treatment effect of 11% at 40 km/h and 25% at 50 km/h when adjusting for differences between treated and controls. Among other findings, the survey results found increased support for the lower speed limit of 17% with little adverse consequences.

CONCLUSION

The findings give support for the likely safety benefits of the 30 km/h trial with increased support from the residents. Speed reductions in the control region suggested a carry-over of the effects of the trial but also added support by local residents for reduced speed limits in the region. Potential injury savings were estimated at a 4% reduction in the risk of a pedestrian injury from the observed treatment effect in the trial region.

TEMPO® EC for the Enumeration of Escherichia coli in Foods: Collaborative Study

The automated method for enumeration of Escherichia coli, TEMPO&lt;sup/&gt; EC, in foods uses a dehydrated culture medium and enumeration card containing 48 wells across three different dilutions for the automatic determination of the most probable number (MPN). The alternative method was compared in a multilaboratory collaborative study to AOAC Official MethodSM 966.24. Six food types were artificially contaminated with E. coli: raw ground beef, bagged lettuce, cooked chicken, pasteurized crabmeat, frozen green beans, and pasteurized whole milk. All foods were analyzed for E. coli counts by 11 collaborating laboratories throughout the United States. Test portions from the six food types each contaminated at four different contamination levels were evaluated. The study demonstrated that the TEMPO EC method is a reliable, automated assay for the enumeration of E. coli in foods.

The Implications of Food Insecurity at a HBCU (P04-086-19)

Objectives

The objectives of the study were: 1) to determine whether there is food insecurity among matriculating students attending a Historically Black College/University (HBCU), 2) to investigate the associations between food security status and the demographic characteristics (gender, classification, housing status) of students, 3) to examine the relationship of food security status to the consumption of fruits and vegetables (FV), 4) to investigate the association of student food security status with overweight/obesity, and 5) to assess fast food consumption among food insecure students.

Methods

Five hundred Seventy undergrad and graduate students were recruited to participate in an online survey. The survey was voluntary and anonymous. Data were collected via a 20-item survey using Qualtrics, an online software program that allows its users to create and distribute survey instruments. The main survey questions were derived the Six-item United States Department of Agriculture-Adult Food Security Survey Module (USDA-AFSSM). The survey also included questions which measured: height and weight, daily fruit and vegetable consumption, fast food purchases and potential food pantry utilization. The remaining questions in the survey determined demographic characteristics which included gender, class, meal plan, and housing status.

Results

Data indicated 77.7% (405) of the sample had experienced some level of food insecurity over the last 12 months, whereas 116 (22.2%) were determined to be food secure. The prevalence of the four categories of food security status is shown in Figure 1.

Food insecure students were significantly more likely to purchase fast foods two or more times a week and had significantly lower mean fruit and vegetable intakes than food secure students.

Sophomores were least likely to be food secure (11.1%), while graduate/professional students were most likely to be food secure (37.6%). Students living on campus were found to be more likely to be food insecure.

Conclusions

The present study provides evidence of significant food insecurity. More fast food and decreased fruit and vegetable consumption was found among the food insecure vs food secure. Food security on college campuses bears further investigation.

Funding Sources

Howard University.

Supporting Tables, Images and/or Graphs

Barriers to Participation in Genomic Health Research by African Americans and Other Minority Populations : A Systematic Review (P04-116-19)

Objectives

The paucity of data for African-Americans (AAs) participating in health-related research (e.g., genomic research in nutrition) is often attributed to difficulty in recruitment and retention. The reasons for such unwillingness to participate remains unclear and could account for health disparities. Studies demonstrate that AAs may be more difficult to recruit and retain in genomic studies due to psychosocial impacts, cultural beliefs and other issues. Historically, these factors have shown to both affect participation and adversely influence health disparities, which may lead to premature death, reduced quality of life, missed economic opportunities, and inequalities. The purpose of this study was to conduct a systematic review to answer the following question: What are the barriers to acceptance of genomic health research among AAs and other minority populations?

Methods

This systematic review investigates acceptance barriers in AAs participating in health-related research involving DNA. A total of 37 articles met inclusion criteria for this review. Acceptance to participate in health-related research involving DNA were examined from articles published in PubMed and Scopus between 2008–2018. Results were based on feedback collected by trained research assistants and phlebotomists during interviews conducted in groups, face-to-face, via telephone, and responses collected from survey questionnaires.

Results

AA participation in health-related research is influenced by various pervasive factors including, but not limited to, perceived and/or actual experiences of mistrust and deceptiveness with investigators, misuse of genomic data, unethical research practices, healthcare system distrust, privacy concerns, socioeconomic influences, cultural beliefs and other influences associated with psychosocial factors.

Conclusions

Results of this review are consistent with literature which shows diminishing participation of AAs in health-related research is attributable to a range of factors leading to growing concerns about health disparities. It is important to address these factors among diverse populations, and AAs in particular, who have not largely been represented in health-related research to promote better health outcomes and understand how to prevent and treat diseases.

Funding Sources

Howard University.

Laboratory exposure to Coccidioides: lessons learnt in a non-endemic country

Coccidioides is a primary pathogenic fungus, which infects humans through highly infectious arthroconidia, causing substantial morbidity including life-threatening disseminated infections. Due to the low infectious dose, laboratory personnel might become infected during diagnostic procedures. Accordingly, coccidioidomycosis is reported as the most frequent laboratory-acquired systemic mycosis worldwide. This risk is aggravated in non-endemic countries, where the diagnosis may not be suspected. We report on an inadvertent exposure of 44 persons to Coccidioides posadasii in a clinical microbiology laboratory in Chile, the measures of containment after rapid diagnosis with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the lessons learnt in a non-endemic setting.

Cancer Screening and Diagnostic Tests in Global Contexts: Case Study and Concept Analysis

Objective:

Although the purposes and outcomes of screening and diagnostic tests are different, they are often confused. Therefore, it is important to delineate the clinical concept of cancer screening tests to be clear in our communication not only among healthcare professionals but also with client populations. The aim of this study is to both describe and analyze the concept of cancer screening and explain their practical meaning in global contexts.

Methods:

Comparative case studies of cervical and liver cancer screening tests were used as the basis for developing an understanding of a specific concept (phenomenon) of cancer screening and for delineating the relationships between factors that cause screening to occur.

Results:

A cancer screening is defined as an action taken by both the patient and health-care provider to detect a possible pre-cancerous condition among healthy and asymptomatic individuals who are at sufficient risk of a specific disorder to warrant further investigation or treatment. The case study-based concept analysis has been shown to be useful for improving our understanding of the multi-dimensional nature of the concept in global contexts.

Conclusions:

New paradigms maximizing participation in cancer screening to detect diseases before symptoms are manifested rather than focusing on diagnosis and treatment of symptomatic infectious diseases need to be developed and implemented.

Search for Boosted Dark Matter Interacting with Electrons in Super-Kamiokande

A search for boosted dark matter using 161.9 kt yr of Super-Kamiokande IV data is presented. We search for an excess of elastically scattered electrons above the atmospheric neutrino background, with a visible energy between 100 MeV and 1 TeV, pointing back to the Galactic center or the Sun. No such excess is observed. Limits on boosted dark matter event rates in multiple angular cones around the Galactic center and Sun are calculated. Limits are also calculated for a baseline model of boosted dark matter produced from cold dark matter annihilation or decay. This is the first experimental search for boosted dark matter from the Galactic center or the Sun interacting in a terrestrial detector.

Socially Shared Cognition, Affect, and Behavior: A Review and Integration

In this article, we review 4 classes of models of socially shared cognition and behavior: supraindividual models, information-processing models, communication models, and social interaction models. Our review draws on research and theory in social psychology, sociology, and organization behavior. We conclude that these innovative perspectives on socially shared behavior represent a new approach to the study of groups and are distinct from traditional models of the group mind and crowd behavior. The key processes implicated in these models focus on the potency of immediate interaction, reciprocal influence processes between individuals and groups, goal-directed behavior, negotiated processing of information and ideas, and the maintenance and enhancement of social identity. This approach to socially shared understanding is not antagonistic toward the analysis of individual-level processes but rather maintains that individual-level processes are necessary but not sufficient to build a social psychology of shared understanding.

Two Generations of Mothers and Daughters: Role Position and Interdependence

Using both partners as informants and three interdependence measures (contact, aid, and attachment) as criterion variables, we address the assumption that women's orientation to and dependence on other generations differ because of unique roles. In 135 pairs of student women and their mothers and 119 pairs of middle-aged women and their mothers, we ask how a woman's role position interacts with her partner's role position in regard to interdependence. Both dyadic and individual role combinations are examined. In younger pairs, we examine the combination of daughter's marital status and both mother's launching and work statuses; in older pairs, we examine the combination of mother's marital status and both daughter's launching and marital statuses. Regression analyses demonstrate that, except for younger pairs where married daughters and their mothers are less interdependent than single daughters and their mothers, interdependence is remarkably unrelated to role positions, singly or in combination. Results suggest normative pressures toward new conjugal bonds and stability in women's family roles.