Financial wellness is multidimensional, incorporating all aspects of a person’s financial situation, including their awareness of their financial situation, goal setting to maintain or improve their ...current financial situation, and the capability to put these goals into action. This review explores key aspects of college student financial wellness and financial behavior including use of credit cards and student loans, financial literacy, financial stress, and financial self-efficacy. This review also incorporates new information from the multi-institutional Study on Collegiate Financial Wellness, which adds depth to understanding of college student financial wellness in unique ways. Colleges and universities can and should contribute to the ongoing development of the financial capability of the college student population. To effectively plan and implement financial wellness initiatives on campus, understanding the needs of students on our campuses and how finances influence the day-to-day lives of students is critical.
Abstract
Purpose
Neonatal macrosomia is a known complication of maternal obesity and gestational diabetes, and it is a risk factor for obesity and diabetes in offspring. Amino acids and ...acylcarnitines are biomarkers for obesity in children and adults. These analytes, which are also routinely obtained on the newborn screen, have not been well-characterized in macrosomic newborns. The impact of macrosomia on rates of false-positive results in the newborn screen has also not been well-studied. We test the hypothesis that macrosomia is an interfering factor for amino acids and/or acylcarnitines on the newborn screen.
Methods
Newborn screening analytes determined by tandem mass spectroscopy were obtained from the Colorado Department of Public Health and Environment archives (2016–2018). This included metabolite concentrations obtained at 24–72 hours of life from newborns with birth weight 2500 to 3999 g (nonmacrosomic, n = 131 896) versus 4000 to 8000 g (macrosomic, n = 7806). Mother/infant phenotypic data were limited to information provided on the newborn screening dried blood spot card. Data were analyzed using Student t-test and chi-squared analysis.
Results
Macrosomic newborns had elevations in C2, C3, dicarboxylic, and long-chain acylcarnitines (specifically C16 and C18 species). C3 and C18:1 were 2 to 3 times more likely to be above predetermined state cutoffs in macrosomic versus nonmacrosomic newborns (both male and female).
Main conclusions
Macrosomia is an interfering factor for the analytes C3 and C18:1, leading to higher risk of false-positive results for methylmalonic/propionic acidemia and carnitine palmitoyl transferase type 2 deficiency, respectively. Analyte patterns found in macrosomic neonates correspond with similar analyte patterns in obese children and adults.
Advancements in congenital heart surgery have heightened the importance of durable biomaterials for adult survivors. Dystrophic calcification poses a significant risk to the long-term viability of ...prosthetic biomaterials in these procedures. Herein, we describe the natural history of calcification in the most frequently used vascular conduits, expanded polytetrafluoroethylene grafts. Through a retrospective clinical study and an ovine model, we compare the degree of calcification between tissue-engineered vascular grafts and polytetrafluoroethylene grafts. Results indicate superior durability in tissue-engineered vascular grafts, displaying reduced late-term calcification in both clinical studies (p < 0.001) and animal models (p < 0.0001). Further assessments of graft compliance reveal that tissue-engineered vascular grafts maintain greater compliance (p < 0.0001) and distensibility (p < 0.001) than polytetrafluoroethylene grafts. These properties improve graft hemodynamic performance, as validated through computational fluid dynamics simulations. We demonstrate the promise of tissue engineered vascular grafts, remaining compliant and distensible while resisting long-term calcification, to enhance the long-term success of congenital heart surgeries.
Methionine synthase deficiency (cblG complementation group) is a rare inborn error of metabolism affecting the homocysteine re‐methylation pathway. It leads to a biochemical phenotype of ...hyperhomocysteinemia and hypomethioninemia. The clinical presentation of cblG is variable, ranging from seizures, encephalopathy, macrocytic anemia, hypotonia, and feeding difficulties in the neonatal period to onset of psychiatric symptoms or acute neurologic changes in adolescence or adulthood. Given the variable and nonspecific symptoms seen in cblG, the diagnosis of affected patients is often delayed. Medical management of cblG includes the use of hydroxocobalamin, betaine, folinic acid, and in some cases methionine supplementation. Treatment has been shown to lead to improvement in the biochemical profile of affected patients, with lowering of total homocysteine levels and increasing methionine levels. However, the published literature contains differing conclusions on whether treatment is effective in changing the natural history of the disease. Herein, we present five patients with cblG who have shown substantial clinical benefit from treatment with objective improvement in their neurologic outcomes. We demonstrate more favorable outcomes in our patients who were treated early in life, especially those who were treated before neurologic symptoms manifested. Given improved outcomes from treatment of presymptomatic patients, cblG warrants inclusion in newborn screening.
Post-cardiothoracic surgery (CTS) complications (e.g. myocardial injury, renal dysfunction, atrial fibrillation) may occur as a result of enhanced systemic inflammation, perhaps provoked by an ...oxidative stress response. N-acetylcysteine (NAC) is a free radical scavenger antioxidant agent that may attenuate this physiologic response and reduce post-CTS complications. Thus, a meta-analysis was performed to help characterize the potential beneficial effects of perioperative NAC administration in patients undergoing CTS. A systematic literature search in MEDLINE, EMBASE and the Cochrane Library was conducted through April 2008. A search strategy using medical subject headings and text keywords was performed. Results are reported as odds ratios or weighted mean differences with accompanying 95% confidence intervals (CIs). Studies were pooled using a fixed-effect model. The primary outcomes included atrial fibrillation (AF), myocardial infarction (MI), stroke, acute kidney injury (AKI), need for renal replacement therapy (RRT), mortality and total hospital length-of-stay (LOS). Upon meta-analysis of 13 trials (n = 1338 subjects), the use of NAC appeared to statistically significantly lower the odds of developing post-CTS AF by 36% (95%CI 2–58%) (n = 6 studies). This corresponded to an 8% (1–15%) pooled risk difference and a number-needed-to-treat of 13. NAC did not appear to significantly alter any of the other meta-analysis endpoints. The exclusion of the study utilizing only oral NAC therapy and the study with lower internal validity did not affect the overall conclusions of our meta-analysis. Currently, the most compelling data for using NAC in CTS patients is in post-CTS AF prevention. However, additional, larger randomized controlled trials evaluating this and other postoperative complication endpoints are needed.
Background.
Cardiotoxicity can be a complication of anthracycline‐ or trastuzumab‐based therapy for breast cancer patients. Screening echocardiograms (ECHOs) and radionuclide ventriculograms (RVGs) ...are often performed before administration of these agents to evaluate cardiac function. Limited evidence for the clinical utility of these screening tests is available.
Methods.
Early‐stage breast cancer patients diagnosed from 2006 to 2011 (n = 1,067) with baseline ECHOs/RVGs were identified in a single institution prospective registry. Medical record review was performed to obtain pre‐ and post‐ECHO/RVG treatment plans, baseline ECHO/RVG results, cardiac risk factors, and cardiac events. Patients with cardiac history were excluded. ECHO/RVG abnormalities were defined as ejection fraction (EF) <55%, valvular disease, left ventricular hypertrophy, and diastolic dysfunction. Cardiac events were defined as heart failure, myocardial infarction, arrhythmia, valvular disease, or angina during or after chemotherapy.
Results.
Among 600 eligible patients, abnormal ECHO/RVG results were observed in 13 (2.2%, 1.2%–3.7%), including 9 with baseline EF <55%. There were no detected changes in treatment plans, although more frequent cardiac monitoring was recommended for 2 patients. There were no significant differences in age, race, menopausal status, smoking history, alcohol use, body mass index, or medical comorbidities between patients with abnormal and normal results. In follow‐up (mean, 4.0 years; range, 0–8.3), 15 patients developed cardiac events (none of whom had had abnormal baseline ECHOs/RVGs).
Conclusion.
Baseline ECHO/RVG in patients without prior cardiac history rarely yields an abnormality that prompts change in planned anthracycline‐ and/or trastuzumab‐based treatment. Moreover, few cardiac events developed in this screened population in follow‐up.
Implications for Practice:
Baseline cardiac function screening with echocardiograms or radionuclide ventriculograms is frequently performed before administration of anthracycline‐ or trastuzumab‐based chemotherapy in breast cancer patients due to the relatively low cost and risk to patients and the concern for potential cardiotoxicity. However, at a population level, these tests can take up time and can add up to significant costs for both patients and the health care system. This study finds that in patients with no history of cardiac disease, baseline cardiac function screening rarely identifies abnormalities that change treatment plans. Moreover, few cardiac events develop in an average of 4 years of follow‐up, including none in patients with abnormal baseline cardiac function screening results. This suggests that baseline cardiac function screening may have limited utility in chemotherapy planning in young breast cancer patients with no history of cardiac disease.
摘要
背景. 心脏毒性是以蒽环类或曲妥珠单抗为基础的乳腺癌治疗方案的潜在并发症。超声心动图 (ECHO) 筛查和放射性核素心室造影 (RVG) 检查常用于在给予上述治疗前评价心功能。但这些筛查检验在临床中用途的证据仍然很有限。
方法. 从一家单中心的前瞻性登记系统里识别出2006∼2011年期间诊断为早期乳腺癌且有基线ECHO/RVG结果的患者 (n=1 067)。回顾病史以获取ECHO/RVG前后的治疗方案、基线ECHO/RVG结果、心脏危险因素和心脏事件。排除有心脏病史的患者。ECHO/RVG异常定义为射血分数 (EF) < 55%、瓣膜病变、左心室肥厚和舒张功能障碍。心脏事件定义为心力衰竭、心肌梗死、心律不齐、瓣膜病变, 或者化疗期间或化疗后心绞痛。
结果. 600例符合标准的患者中, 13例ECHO/RVG结果异常 (2.2%, 1.2%∼3.7%), 其中9例基线EF < 55%。无一例患者的治疗计划发生改变, 但2例患者被建议增加心脏监测的频率。正常结果和异常结果患者的年龄、人种、绝经状态、吸烟史、酒精摄入、体重指数和合并症情况均无差异。15例患者在随访期间 (平均4.0年, 范围: 0∼8.3) 发生心脏事件 (其中无一例基线ECHO/RVG结果异常)。
结论. 在无心脏病史的患者中, 基线ECHO/RVG很少得到导致以蒽环类和 (或) 曲妥珠单抗为基础的治疗计划改变的异常结果。此外, 这一筛查人群在随访期间较少发生心脏事件。The Oncologist 2016;21:666–670
对临床实践的提示: 乳腺癌患者在开始以蒽环类或曲妥珠单抗为基础的化疗前, 常常采用超声心电图或放射性核素心室造影进行基线心功能筛查, 因为这些检查费用相对较低, 另一方面也是考虑到治疗的潜在心脏毒性。但是在人群水平上, 这些检查可能耗费时间并且显著增加患者和医疗系统的支付成本。本研究发现在无心脏病史的患者中, 心功能筛查很少发现可导致治疗计划改变的异常结果。此外, 在平均 4 年的随访期间, 很少发生心脏事件, 且无一例基线心功能筛查结果异常的患者发生心脏事件。这提示在无心脏病史的年轻乳腺癌患者的化疗计划中, 基线心功能筛查用途有限。
Screening echocardiograms (ECHOs) and radionuclide ventriculograms (RVGs) are often used to evaluate cardiac function before anthracycline‐ or trastuzumab‐based therapy for breast cancer patients. A study of 600 eligible patients with early‐stage breast cancer found that baseline ECHO/RVG in patients without prior cardiac history rarely yields an abnormality that prompts change in planned anthracycline and/or trastuzumab‐based treatment.
College students are one of the most at-risk population groups for food poisoning, due to risky food safety behaviors. Using the Likert Scale, undergraduate students were asked to participate in a ...Food Safety Survey which was completed by 499 students ages 18-25. Data was analyzed using SPSS and AMOS statistical software. Four conceptual definitions regarding food safety were defined as: general food safety, bacterial food safety, produce food safety, and politics associated with food safety. Knowledge seems to be an important factor in shaping students attitudes regarding general and bacterial safety. Ethnicity plays a role in how people view the politics of food safety, and the safety of organic foods.
Objective
Weight suppression (WS), the difference between highest past non‐pregnancy weight and current weight, predicts negative outcomes in eating disorders, but the impact of WS and related weight ...constructs are understudied in nonclinical, midlife populations. We examined WS (current weight < highest weight) and weight elevation (WE), the opposite of WS (current weight > lowest weight) and their associations with eating psychopathology in women aged 50+.
Method
Participants were a community‐based sample (N = 1,776, Mage = 59) who completed demographic and eating psychopathology questions via online survey. WS, WE, and WS × WE were tested as predictors of outcome variables; BMI and medical conditions that affect weight were controlled for.
Results
Individuals that were higher on WS and WE were most likely to engage in current weight loss attempts, dieting in the past 5 years, and extreme lifetime restriction. Individuals with higher WS were more likely to experience binge eating, greater frequency of weight checking, overvaluation of shape and weight, and lifetime fasting. Individuals with higher WE were more likely to report negative life impacts of eating and dieting. Higher WS and WE each predicted higher levels of skipping meals over the lifetime.
Discussion
This novel study investigated WS in midlife women and introduced a new conceptualization of weight change (WE) that may be more relevant for aging populations given that women tend to gain weight with age. The findings implicate the utility of investigating both WS and WE as factors associated with eating psychopathology in midlife women.
Mental illness in adolescence is associated with high-risk sexual behaviors including multiple sex partners, infrequent or inconsistent condom use, and nonuse of contraception. Inpatient psychiatric ...care represents a promising setting to provide sexual health education. This pilot study investigates the feasibility and acceptability of online sexual health education in this group by assessing usability and impact on short-term psychosocial outcomes. We administered online modules on healthy relationships, pregnancy prevention, condom use, and sexually transmitted infection (STI) prevention to youth. We evaluated outcomes using a single group, pre/post-intervention design. One quality improvement session assessed staff acceptability of the programming. Participants included 51 inpatients (mean age = 15.3; 61% female; 57% Hispanic or Latino; 55% heterosexual). Overall, the program was feasible to administer and highly acceptable to youth (84-89% liked the modules, 98-100% found them easy to use, 96-100% found them credible, 91-98% said information would lead to healthier dating relationships, and 78-87% would refer to a friend). Youth who completed modules demonstrated improvement in several outcomes: attitudes and norms towards violence (
p
< 0.001), intention to use a method of birth control other than condoms if having sex in the next 3 months (
p
< 0.001), condom knowledge (
p
< 0.001), condom use self-efficacy (
p
< 0.001), condom beliefs (
p
= 0.04), HIV/STI knowledge (
p
< 0.001), and perceived susceptibility to STI (
p
< 0.01). The quality improvement session revealed high acceptability by nursing staff on the unit. This intervention could be useful and efficacious in an inpatient setting and larger studies are warranted to understand its full impact.
Highlights
Computer-based sexual health modules were acceptable to inpatient adolescents and feasible to implement.
Inpatient adolescents improved on knowledge and psychosocial outcomes following online sexual health education.
Psychiatric units may be viable settings to implement important sexual health education for youth.
Research suggests that individuals with high liking for sweets are at increased risk for binge eating, which has been minimally investigated in individuals with binge-eating disorder (BED). Forty-one ...adults (85% female, 83% white) with binge eating concerns completed a sweet taste test and measures of eating disorder behaviors and food cravings. A subset of participants with BED completed an oral glucose tolerance test (OGTT; N=21) and a 24-hour dietary recall (N=26). Regression models were used to compare highest sweet preferers (HSP N=18) to other sweet preferers (OSP N=23) and were used to assess associations between sweet taste preference and outcome variables. Effect sizes (ηp2) for differences between HSP and OSP ranged from small (≤0.01) to large (≥0.24); group differences were statistically nonsignificant except for 24-hour caloric intake (ηp2=0.16, p=0.04), protein intake (ηp2=0.16, p=0.04), and insulin sensitivity index (ηp2=0.24, p=0.04), which were higher in HSP, and postprandial insulin, which was smaller in HSP (ηp2=0.27, p=0.03). Continuous analyses replicated postprandial insulin response. Compared with OSP, HSP reported numerically higher binge-eating frequency (ηp2=0.04), over-eating frequency (ηp2=0.06), and carbohydrate intake (ηp2=0.14), and they exhibited numerically smaller postprandial glucose AUC (ηp2=0.16). Sweet taste preference may have implications for glucose regulation, binge-eating frequency, and nutrient intake in BED.
•Sweet taste preference may be quite prevalent in individuals with BED.•Highest Sweet Preferers have more binge-eating episodes than Other Sweet Preferers.•Highest Sweet Preferers have smaller postprandial glucose and higher insulin sensitivity.•Highest Sweet Preference may be a meaningful sub-phenotype of those with BED.
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