Objectives: The neighborhood environment may be an important determinant of racial/ethnic disparities in cognitive function. To understand how neighborhoods are linked to cognition across ...racial/ethnic groups, this scoping review organizes research investigating relationships between multiple neighborhood domains and cognitive function in diverse samples of US midlife and older adults. Methods: PubMed/MEDLINE, Web of Science, and CAHL were used to extract quantitative disparities-focused studies (n = 17) that included US adults ages 50+, racial/ethnic minoritized populations, cognitive dependent variable(s), and neighborhood-level independent variable(s) published from January 2010 to October 2021. Results: Studies demonstrate variation within and between racial/ethnic groups in how neighborhood factors are associated with cognition. Economically and socially advantaged neighborhoods were associated with better cognition. Findings were mixed for built and neighborhood composition measures. Discussion: More research with greater racial/ethnic representation is needed to disentangle which aspects of the neighborhood are most salient for specific cognitive function domains across diverse populations.
Distorting science, putting water at risk Sullivan, S. Mažeika Patricio; Rains, Mark C.; Rodewald, Amanda D. ...
Science (American Association for the Advancement of Science),
08/2020, Letnik:
369, Številka:
6505
Journal Article
Recenzirano
A recent rule is inconsistent with science and will compromise the integrity of U.S. waters.
The Navigable Waters Protection Rule (NWPR) (
1
), which was published in April by the U.S. Environmental ...Protection Agency (EPA) and the Department of the Army (“the Agencies”), has redefined “waters of the U.S.” (WOTUS) to restrict federal protection of vulnerable waters (
2
). With its emphasis on “continuous surface connections” and “permanence,” the NWPR removes or reduces protection for U.S. waters, including millions of miles of streams and acres of wetlands, many of which comprise headwaters that are critical for sustaining water quality and healthy watersheds (
3
) (see the figure). Although the Agencies claim to have “looked to scientific principles to inform” the NWPR, science has been largely ignored and oversimplified. These new exclusions are based on selective parsing of statutory language and earlier case law, rather than on previously established, science-based interpretations of the U.S. Federal Water Pollution Control Act, commonly known as the Clean Water Act (CWA) (
4
). The EPA's own Science Advisory Board (SAB) found sufficient evidence to conclude that “…the proposed Rule lacks a scientific justification, while potentially introducing new risks to human and environmental health” (
5
). Responding to this unprecedented distortion of science and rollback in water protections, which went into effect nationwide on 22 June, will require coordinated efforts among scientists, lawmakers, and resource managers.
Infectious disease forecasting aims to predict characteristics of both seasonal epidemics and future pandemics. Accurate and timely infectious disease forecasts could aid public health responses by ...informing key preparation and mitigation efforts.
For forecasts to be fully integrated into public health decision-making, federal, state, and local officials must understand how forecasts were made, how to interpret forecasts, and how well the forecasts have performed in the past. Since the 2013-14 influenza season, the Influenza Division at the Centers for Disease Control and Prevention (CDC) has hosted collaborative challenges to forecast the timing, intensity, and short-term trajectory of influenza-like illness in the United States. Additional efforts to advance forecasting science have included influenza initiatives focused on state-level and hospitalization forecasts, as well as other infectious diseases. Using CDC influenza forecasting challenges as an example, this paper provides an overview of infectious disease forecasting; applications of forecasting to public health; and current work to develop best practices for forecast methodology, applications, and communication.
These efforts, along with other infectious disease forecasting initiatives, can foster the continued advancement of forecasting science.
Unfavorable neighborhood conditions are linked to health disparities. Yet, a dearth of literature examines how neighborhood characteristics contribute to cognitive health in diverse samples of older ...adults. The present study uses an intersectional approach to examine how race/ethnicity, gender, and education moderate the association between neighborhood perceptions and cognitive functioning in later life. We used data from adults ≥65 years old (
= 8023) in the 2010-2016 waves of the nationally representative Health and Retirement Study (HRS). We conducted race/ethnicity-stratified linear regression models where cognitive functioning, measured using the 35-point Telephone Interview Cognitive Screen (TICS), was regressed on three neighborhood characteristics-cleanliness, safety, and social cohesion. We examine whether there is heterogeneity within race/ethnicity by testing if and how the relationship between neighborhood characteristics and cognitive functioning differs by gender and education. Among White adults, worse neighborhood characteristics were associated with lower cognitive functioning among those with less education. However, for Black adults, poor perceived quality of one's neighborhood was associated with worse cognitive functioning among those with more years of education compared to those with fewer years of education. Among Mexicans, perceived neighborhood uncleanliness was associated with lower cognitive functioning among those with less education, but higher cognitive functioning for those with higher levels of education. Thus, this study contributes to the literature on racial/ethnic disparities in cognitive aging disparities by examining neighborhood contextual factors as determinants of cognitive functioning. In particular, we find that higher education in the context of less favorable neighborhood environments does not confer the same benefits to cognitive functioning among all older adults.
Background. Bordetella pertussis causes severe respiratory illness among infants and adolescents. High proportions of breakthrough infection have been observed. To understand the effect of ...vaccination in the era of acellular pertussis vaccines (DTaP and Tdap), we assessed if vaccination status is associated with disease severity and duration. Methods. The Multnomah County Health Department conducts enhanced pertussis surveillance for 1.7 million residents in the Portland, Oregon, metropolitan area. Surveillance activities include ascertaining demographics, clinical presentation, cough duration, vaccination history, and other health outcomes. Utilizing Advisory Committee on Immunization Practices (ACIP) routine vaccination recommendations, we analyzed a cohort of persons aged 6 weeks to 18 years with confirmed pertussis to assess illness severity and duration by vaccination status. Analysis was conducted using both logistic regression (disease severity) and survival analysis (cough duration). Results. During 2010–2012, 98.7% (n = 624) of patients with confirmed pertussis in our cohort had vaccination, treatment, demographic, and outcome information. Among these patients, 45% (n = 286) were ACIP up to date with vaccinations. Ever-vaccinated cases were significantly less likely to be hospitalized or develop severe illness (adjusted odds ratio aOR, 0.2; 95% confidence interval CI, .1–.8 and aOR, 0.4; 95% CI, .2–.9, respectively). ACIP up-to-date patients stopped coughing significantly more rapidly than unvaccinated patients (adjusted hazard ratio, 1.7; 95% CI, 1.3–2.2). Conclusions. Patients with pertussis vaccination had decreased morbidity characterized by less severe illness and significantly reduced illness duration. Therefore, vaccination is recommended among at–risk individuals, and research into the nature of the residual vaccine immunity is warranted.
BACKGROUND:Little is known about the relationship of airway microbiota with bronchiolitis in infants. We aimed to identify nasal airway microbiota profiles and to determine their association with the ...likelihood of bronchiolitis in infants.
METHODS:A case-control study was conducted. As a part of a multicenter prospective study, we collected nasal airway samples from 40 infants hospitalized with bronchiolitis. We concurrently enrolled 110 age-matched healthy controls. By applying 16S ribosomal RNA gene sequencing and an unbiased clustering approach to these 150 nasal samples, we identified microbiota profiles and determined the association of microbiota profiles with likelihood of bronchiolitis.
RESULTS:Overall, the median age was 3 months and 56% were male. Unbiased clustering of airway microbiota identified 4 distinct profilesMoraxella-dominant profile (37%), Corynebacterium/Dolosigranulum-dominant profile (27%), Staphylococcus-dominant profile (15%) and mixed profile (20%). Proportion of bronchiolitis was lowest in infants with Moraxella-dominant profile (14%) and highest in those with Staphylococcus-dominant profile (57%), corresponding to an odds ratio of 7.80 (95% confidence interval, 2.64–24.9; P < 0.001). In the multivariable model, the association between Staphylococcus-dominant profile and greater likelihood of bronchiolitis persisted (odds ratio for comparison with Moraxella-dominant profile, 5.16; 95% confidence interval, 1.26–22.9; P = 0.03). By contrast, Corynebacterium/Dolosigranulum-dominant profile group had low proportion of infants with bronchiolitis (17%); the likelihood of bronchiolitis in this group did not significantly differ from those with Moraxella-dominant profile in both unadjusted and adjusted analyses.
CONCLUSIONS:In this case-control study, we identified 4 distinct nasal airway microbiota profiles in infants. Moraxella-dominant and Corynebacterium/Dolosigranulum-dominant profiles were associated with low likelihood of bronchiolitis, while Staphylococcus-dominant profile was associated with high likelihood of bronchiolitis.
Little is known about the association of gut microbiota, a potentially modifiable factor, with bronchiolitis in infants. We aimed to determine the association of fecal microbiota with bronchiolitis ...in infants.
We conducted a case-control study. As a part of multicenter prospective study, we collected stool samples from 40 infants hospitalized with bronchiolitis. We concurrently enrolled 115 age-matched healthy controls. By applying 16S rRNA gene sequencing and an unbiased clustering approach to these 155 fecal samples, we identified microbiota profiles and determined the association of microbiota profiles with likelihood of bronchiolitis.
Overall, the median age was 3 months, 55% were male, and 54% were non-Hispanic white. Unbiased clustering of fecal microbiota identified 4 distinct profiles: Escherichia-dominant profile (30%), Bifidobacterium-dominant profile (21%), Enterobacter/Veillonella-dominant profile (22%), and Bacteroides-dominant profile (28%). The proportion of bronchiolitis was lowest in infants with the Enterobacter/Veillonella-dominant profile (15%) and highest in the Bacteroides-dominant profile (44%), corresponding to an odds ratio of 4.59 (95% confidence interval, 1.58-15.5; P = .008). In the multivariable model, the significant association between the Bacteroides-dominant profile and a greater likelihood of bronchiolitis persisted (odds ratio for comparison with the Enterobacter/Veillonella-dominant profile, 4.24; 95% confidence interval, 1.56-12.0; P = .005). In contrast, the likelihood of bronchiolitis in infants with the Escherichia-dominant or Bifidobacterium-dominant profile was not significantly different compared with those with the Enterobacter/Veillonella-dominant profile.
In this case-control study, we identified 4 distinct fecal microbiota profiles in infants. The Bacteroides-dominant profile was associated with a higher likelihood of bronchiolitis.
Abstract Background Ligation of the significantly injured infrarenal inferior vena cava (IVC) is an accepted practice in the setting of damage control surgery. This is a report of inpatient ...management, outcomes, and long-term follow-up in 25 patients after IVC ligation. Methods The records of patients with injuries to the IVC treated in an urban level I trauma center from 1995 to 2008 were reviewed. Demographics, injury severity, and outcome data were recorded. In addition, outpatient records were reviewed and telephone interviews were conducted to assess for the presence and severity of long-term sequelae. Results One hundred patients had IVC injuries, and 25 (25%) underwent ligation. Location of injury was infrarenal in 54 patients, suprarenal in 21, retrohepatic in 15, and suprahepatic in 10. Twenty-two of 54 (41%) injuries to the infrarenal IVC and 3 of 21 (14%) injuries to the suprarenal IVC were ligated. Patients who underwent ligation had a significantly higher Injury Severity Score (ISS) (22 vs 15, P < .001), a higher transfusion requirement (26 U vs 12 U, P < .001), a longer hospital length of stay (78 days vs 26 days, P = .02), a longer intensive care unit length of stay (24 days vs 9 days, P < .001), and a higher mortality (59% vs 21%, P < .001). Ten of 13 early survivors of infrarenal IVC ligation received early below knee fasciotomy. Three other patients with normal compartment pressures were treated expectantly without development of a compartment syndrome. The 1 survivor of suprarenal ligation had below knee fasciotomies and had normal renal function by 1 month post injury, despite an initial creatinine elevation from .7 mg/dL to 3.2 mg/dL. Ten (40%) patients with IVC ligation survived to hospital discharge (9 infrarenal, 1 suprarenal), and long-term follow-up data are available in 8 patients (7 infrarenal, 1 suprarenal). At an average of 42 months (11–117 months), no patient has significant lower extremity edema or dysfunction. Conclusions (1) Ligation of the infrarenal IVC is an acceptable damage control technique, although it remains associated with a high mortality. Ligation of the suprarenal IVC may be done, if necessary, although few survivors of this technique exist. (2) Early fasciotomy is generally required, but occasional patients may be treated expectantly, based on measurements of compartment pressures. (3) Long-term sequelae in survivors of IVC ligation for trauma are rare.
Hypereosinophilic syndromes (HESs) are a heterogeneous group of disorders characterized by peripheral eosinophilia and eosinophil-related end organ damage. Whereas most patients respond to ...glucocorticoid (GC) therapy, high doses are often necessary, and side effects are common. Dexpramipexole (KNS-760704), an orally bioavailable synthetic aminobenzothiazole, showed an excellent safety profile and was coincidentally noted to significantly decrease absolute eosinophil counts (AECs) in a phase 3 trial for amyotrophic lateral sclerosis. This proof-of-concept study was designed to evaluate dexpramipexole (150 mg orally twice daily) as a GC-sparing agent in HESs. Dual primary end points were (1) the proportion of subjects with ≥50% decrease in the minimum effective GC dose (MED) to maintain AEC <1000/μL and control clinical symptoms, and (2) the MED after 12 weeks of dexpramipexole (MEDD) as a percentage of the MED at week 0. Out of 10 subjects, 40% (95% confidence interval CI, 12%, 74%) achieved a ≥50% reduction in MED, and the MEDD/MED ratio was significantly <100% (median, 66%; 95% CI, 6%, 98%; P = .03). All adverse events were self-limited, and none led to drug discontinuation. Affected tissue biopsy samples in 2 subjects showed normalization of pathology and depletion of eosinophils on dexpramipexole. Bone marrow biopsy samples after 12 weeks of dexpramipexole showed selective absence of mature eosinophils in responders. Dexpramipexole appears promising as a GC-sparing agent without apparent toxicity in a subset of subjects with GC-responsive HESs. Although the exact mechanism of action is unknown, preliminary data suggest that dexpramipexole may affect eosinophil maturation in the bone marrow. This study was registered at www.clinicaltrials.gov as #NCT02101138.
•GC-sparing treatment alternatives are a critical need for patients with HESs.•The orally bioactive drug dexpramipexole demonstrated clinical efficacy with an excellent safety profile in a subset of patients with HESs.
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Impaired emotional processes are related to posttraumatic stress disorder (PTSD) and are implicated in intimate partner violence (IPV) perpetration. To address the interpersonal context of PTSD, ...emotion, and IPV, we examined interactions among one's own and one's partner's emotional expressivity and PTSD symptom severity in association with IPV perpetration. Heterosexual couples (N = 56) in which at least one partner met screening criteria for PTSD engaged in two video‐recorded discussions about negative and positive aspects of their relationships. Videos were coded for observed emotional expressiveness during moments participants reported experiencing significant emotions. Actor‐partner interdependence models revealed few main effects of emotional expressivity, except that women's expressivity of positive emotions was positively associated with men's IPV perpetration, r2adj = .14. Emotional expressivity played a larger role among couples managing PTSD symptoms; that is, the association between one's own PTSD symptom severity and more IPV perpetration was stronger among men who expressed more negative emotions, r2adj = .19, and women who expressed fewer negative emotions, r2adj = .21. Several partner effects suggested the importance of understanding the dyadic nature of these constructs. For example, men's PTSD symptom severity was differentially associated with each partners’ IPV perpetration based on women's expressivity of positive emotion, r2adj = .22–.27. Understanding of emotional expressivity in the link between PTSD and IPV must include consideration of gender differences in how these constructs operate interpersonally. Strategies to promote moderate and safe communication of positive and negative emotions may prevent IPV escalation, particularly among couples managing PTSD symptoms.
Resumen
Spanish s by the Asociación Chilena de Estrés Traumático (ACET)
Expresividad emocional observada, síntomas de trastorno de estrés postraumático y perpetración de violencia de parejas entre parejas de la comunidad
TEPT, EXPRESIVIDAD Y IPV
Los procesos emocionales deteriorados están relacionados con el trastorno de estrés postraumático (TEPT) y están implicados en la perpetración de la violencia de pareja (IPV en sus siglas en inglés). Para abordar el contexto interpersonal del TEPT, emoción e IPV, examinamos las interacciones entre la propia expresividad emocional y la de pareja y la gravedad de los síntomas de TEPT en asociación con la perpetración de IPV. Parejas heterosexuales (N = 56) en las cuales al menos una pareja cumplió con los criterios de detección para TEPT participaron en dos discusiones grabadas en video sobre aspectos negativos y positivos de sus relaciones. Los videos fueron codificados para la expresividad emocional observada durante los momentos que los participantes informaron experimentar emociones significativas. Los modelos de interdependencia actor‐pareja revelaron pocos efectos principales de la expresividad emocional, excepto que la expresividad de las emociones positivas de las mujeres se asoció positivamente con la perpetración de IPV de los hombres, r2 adj = .14. La expresividad emocional desempeñó un papel más importante entre las parejas que manejan los síntomas del TEPT; esto es, la asociación entre la propia severidad de los síntomas de TEPT y más perpetración de IPV fue más fuerte entre los hombres que expresaron más emociones negativas, r2 adj = .19 y las mujeres que expresaron menos emociones negativas, r2 adj = .21. Varios efectos de pareja sugirieron la importancia de comprender la naturaleza diádica de estos constructos. Por ejemplo, la severidad del síntoma de TEPT de los hombres se asoció diferencialmente con la perpetración de IPV de cada pareja en base a la expresividad de las mujeres de la emoción positiva, r2 adj = .22‐.27. La comprensión de la expresividad emocional en el vínculo entre el TEPT y el IPV debe incluir la consideración de las diferencias de género en la forma en que estos constructos operan interpersonalmente. Las estrategias para promover la comunicación moderada y segura de las emociones positivas y negativas pueden prevenir la escalada de IPV, particularmente entre las parejas que manejan los síntomas del TEPT.
抽象
Traditional and Simplified Chinese s by AsianSTSS
Observed Emotional Expressivity, Posttraumatic Stress Disorder Symptoms, and Intimate Partner Violence Perpetration Among Community Couples
Traditional Chinese
標題: 情侶中可觀察的情緒表現度、創傷後壓力症狀與親密伴侶暴力
撮要: 情緒處理受損跟創傷後壓力症(PTSD)有關, 亦可見於親密伴侶暴力(IPV)個案。為了檢視PTSD、情緒和 IPV在人際關係裡的關連, 本研究探索個人與伴侶的情緒表現度與PTSD症狀嚴重度跟IPV的關連。樣本為異性戀情侶(N = 56), 每對伴侶中至少有一位符合PTSD篩查準則。他們參與2次錄影討論節段, 談論關係裡的負面和正面範疇。我們觀察錄影片段並加入代碼, 記錄參與者經歷顯著情緒時的情緒表現。行動者─伴侶互倚模型(Actor‐partner interdependence models)反映, 女性表現正向情緒跟男性使出IPV有正向關連(r2adj = .14)。除此以外, 情緒表現度只有少量主要效應。情緒表現度的效應在面對PTSD的情侶間較大:表現較多負面情緒的男性(r2adj = .19)和表現較少負面情緒的女性(r2adj = .21), 自身的PTSD症狀嚴重度跟較常有IPV的關連較強。數個情侶效應反映, 我們需要理解這些構念帶雙向本質。例如, 基於女性的正向情緒表現, 男性的PTSD症狀嚴重度跟每對伴侶的IPV的關連帶有差別(r2adj = .22–.27)。嘗試了解情緒表現度在PTSD 與IPV之間的關係時, 我們需考慮到這些構念在人際關係的運作帶有性別差異。具策略地教導情侶如何適當和安全地溝通, 表達正向和負向情緒, 特別是對面對PTSD的情侶來說, 可能有助防止IPV加劇。
Simplified Chinese
标题: 情侣中可观察的情绪表现度、创伤后压力症状与亲密伴侣暴力
撮要: 情绪处理受损跟创伤后压力症(PTSD)有关, 亦可见于亲密伴侣暴力(IPV)个案。为了检视PTSD、情绪和 IPV在人际关系里的关连, 本研究探索个人与伴侣的情绪表现度与PTSD症状严重度跟IPV的关连。样本为异性恋情侣(N = 56), 每对伴侣中至少有一位符合PTSD筛查准则。他们参与2次录像讨论节段, 谈论关系里的负面和正面范畴。我们观察录像片段并加入代码, 记录参与者经历显著情绪时的情绪表现。行动者─伴侣互倚模型(Actor‐partner interdependence models)反映, 女性表现正向情绪跟男性使出IPV有正向关连(r2adj = .14)。除此以外, 情绪表现度只有少量主要效应。情绪表现度的效应在面对PTSD的情侣间较大:表现较多负面情绪的男性(r2adj = .19)和表现较少负面情绪的女性(r2adj = .21), 自身的PTSD症状严重度跟较常有IPV的关连较强。数个情侣效应反映, 我们需要理解这些构念带双向本质。例如, 基于女性的正向情绪表现, 男性的PTSD症状严重度跟每对伴侣的IPV的关连带有差别(r2adj = .22–.27)。尝试了解情绪表现度在PTSD 与IPV之间的关系时, 我们需考虑到这些构念在人际关系的运作带有性别差异。具策略地教导情侣如何适当和安全地沟通, 表达正向和负向情绪, 特别是对面对PTSD的情侣来说, 可能有助防止IPV加剧。
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