Child Sexual Abuse Victimization Amongst Detained Adolescents and Incarcerated Young Adults: Findings from an Australian Population-Based Birth Cohort Study.

To guide prevention and intervention efforts, the prevalence and impact of child sexual abuse (CSA) victimization among detained and incarcerated populations requires further examination, particularly with consideration of multi-type maltreatment experiences and sex-based variations. This longitudinal population-based study explores these relationships in an Australian birth cohort comprising all individuals born in Queensland in 1983 and 1984 (n = 82,409; 48.68% female). Data include all notified and substantiated harm(s) from child protection services (0 to 17 years), and sentences to youth detention and/or adult incarceration between ages 10 and 30. Findings indicate greater prevalence of CSA amongst detained/incarcerated individuals compared to the general population but emphasize the impact of cooccurring maltreatment (particularly neglect) on the likelihood of custodial outcomes. Important sex-based differences were noted in the intersection of CSA victimization and detention/incarceration. Findings reinforce the need for trauma-informed practices when working with custodial populations, particularly females, and highlight opportunities for prevention of detention/incarceration in at-risk populations, in line with a broader public health approach to child protection.

Utilizing Synergism between the Transverse Abdominal and Pelvic Floor Muscles at Different Postures in Nulliparous Women: A Randomized Case-Control Study.

INTRODUCTION: The aim of the study was to determine the effects of the pelvic floor muscle (PFM) training (PFM-T) in combination with transverse abdominal (TRA) muscle activation (cPFM-T) in female urinary incontinence. METHODS: We enrolled nulliparous women in supine (SUG) (n = 22), sitting (SIG) (n = 19), and control (COG) (n = 14) groups. We conducted an 8-week cPFM-T programme. We examined the effect of training on the parameters with the Kruskal-Wallis test, the pairwise comparisons with the Mann-Whitney U test, and the Wilcoxon rank test with the Bonferroni correction. RESULTS: Before training, 15 participants reported occasional urinary leakage. After cPFM-T, 7 participants reported that urinary leakage had disappeared. Maximal isometric contraction of the PFMs until fatigue improved significantly in the SUG (p < 0.001) and SIG (p = 0.015) groups but not significantly in the COG group (p = 0.499). Holding time increased in the SUG (p = 0.972) and the SIG (p = 0.717) groups and decreased in the COG group (p = 0.132). The dynamic endurance of the PFM improved significantly in the SUG group (p < 0.001) but not in the SIG (p = 0.798) and the COG (p = 0.153) groups. The number of maximal fast contractions within 1 min increased in both the SUG (p < 0.001) and SIG (p = 0.813) groups and decreased in the COG group (p = 0.257). Relaxation improved significantly in the SIG group (p = 0.011). TRA mucle thickness increased in both training groups. CONCLUSION: Slow-twitch fibres of the PFM can be trained effectively with PFM-T in both the body positions.

Primary school reopenings and parental work.

In this paper, we exploit the geographical pattern of primary school reopenings during the COVID-19 pandemic in Canada to estimate the impact of school reopenings on parental employment and work hours. We use a triple-difference approach, in which we first compare parents of primary-school children in regions where schools reopened to similar parents in regions where schools remained closed and add parents of older, secondary-school children as an additional control group. We estimate the impact of school reopenings separately for mothers and fathers, and for single parents and parents living in dual-parent households. We find a positive impact of school reopenings on employment and on actual hours worked. The effects tend to be stronger for single mothers, but are also present for mothers and fathers in dual-parent households in the spring of 2020. Overall, single mothers experienced an 18 percentage point increase in their employment at work rate following school reopenings. We also split our sample according to whether the job can be done from home, and find stronger impacts for those whose jobs cannot easily be done from home.

La réouverture des écoles primaires et le travail des parents. Dans cet article, nous exploitons la dispersion géographique des réouvertures d'écoles primaires durant la pandémie de COVID­19 au Canada afin d'estimer l'impact des réouvertures d'écoles sur l'emploi des parents et leurs heures de travail. Nous utilisons une approche de triple différence, dans laquelle nous comparons tout d'abord les parents d'enfants à l'école primaire dans les régions où les écoles ont réouvert aux parents similaires dans les régions où les écoles sont restées fermées, puis nous ajoutons les parents d'enfants plus âgés, à l'école secondaire, comme groupe de contrôle additionnel. Nous estimons l'impact des réouvertures d'écoles séparément pour les mères et les pères, et pour les parents monoparentaux et ceux dans les ménages à deux parents. Nous trouvons un impact positif des réouvertures d'écoles sur l'emploi et les heures effectivement travaillées. Les effets tendent à être plus marqués pour les mères monoparentales, mais sont aussi présents pour les mères et les pères dans les ménages à deux parents au printemps 2020. En tout, les mères monoparentales ont connu une hausse de 18 points de pourcentage de leur taux d'emploi (au travail) suite aux réouvertures d'écoles. Nous séparons aussi notre échantillon selon que l'emploi puisse être fait de la maison et trouvons des impacts plus forts pour ceux dont l'emploi ne peut facilement être fait de la maison.

The distribution of COVID-19-related risks.

We document two COVID-19-related risks, viral risk and employment risk, and their distributions across the Canadian population. The measurement of viral risk is based on the VSE COVID-19 Risk/Reward Assessment Tool, created to assist policy-makers in determining the impacts of pandemic-related economic shutdowns and re-openings. Women are more concentrated in high-viral-transmission-risk occupations, which is the source of their greater employment loss over the first part of the pandemic. They were also less likely to maintain contact with their former employers, reducing employment recovery rates. Low-educated workers face the same viral risk rates as high-educated workers but much higher employment losses. This is largely due to their lower likelihood of switching to working from home. For both women and the low-educated, existing inequities in their occupational distributions and living situations have resulted in them bearing a disproportionate amount of the risk emerging from the pandemic. Assortative matching in couples has tended to exacerbate risk inequities.

Dans cet article, nous documentons deux risques associés à la COVID­19, soit le risque de contracter le virus étant donné l'emploi occupé et le risque de perdre son emploi dans le contexte de la pandémie. La répartition de ces risques dans la population canadienne est aussi documentée. La mesure du risque viral est basée sur l'outil de visualisation des risques par profession et industrie liés à la COVID­19 de la VSE, créée pour aider les décideurs à déterminer les impacts des fermetures et réouvertures des différents secteurs de l'économie durant la pandémie. On note que les femmes sont plus présentes dans les professions à haut risque viral, ce qui explique en partie leur plus grande perte d'emploi durant la première partie de la pandémie. Durant la pandémie, elles étaient également moins susceptibles de demeurer en contact avec leurs anciens employeurs, ce qui a affecté négativement leur taux de retour au travail. Le risque viral était similaire pour les travailleurs peu éduqués et les travailleurs hautement qualifiés, mais les pertes d'emplois ont été beaucoup plus importantes pour les travailleurs peu éduqués. Cette différence peut être attribuable à leur plus faible capacité à effectuer leur travail à domicile étant donné la nature de leur emploi. Tant pour les femmes que pour les personnes peu éduquées, les inégalités existantes dans leurs conditions de vie et leur répartition professionnelle les ont conduites à subir une part plus élevée du risque lié à la pandémie. Enfin, l'appariement assortatif des couples selon les professions a eu tendance à exacerber les inégalités face aux risques.

Adaptation of the cecal bacterial microbiome of growing pigs in response to resistant starch type 4.

Resistant starch (RS) exacerbates health benefits on the host via modulation of the gut bacterial community. By far, these effects have been less well explored for RS of type 4. This study aimed at gaining a community-wide insight into the impact of enzymatically modified starch (EMS) on the cecal microbiota and hindgut fermentation in growing pigs. Castrated male pigs (n = 12/diet; 29-kg body weight) were fed diets with either 70% EMS or control starch for 10 days. The bacterial profile of each cecal sample was determined by sequencing of the V345 region of the 16S rRNA gene using the Illumina MiSeq platform. EMS diet reduced short-chain fatty acid concentrations in cecum and proximal colon compared to the control diet. Linear discriminant analyses and K means clustering indicated diet-specific cecal community profiles, whereby diversity and species richness were not different among diets. Pigs showed host-specific variation in their most abundant phyla, Firmicutes (55%), Proteobacteria (35%), and Bacteroidetes (10%). The EMS diet decreased abundance of Ruminococcus, Parasutterella, Bilophila, Enterococcus, and Lactobacillus operational taxonomic units (OTU), whereas Meniscus and Actinobacillus OTU were increased compared to those with the control diet (P < 0.05). Quantitative PCR confirmed results for host effect on Enterobacteriaceae and diet effect on members of the Lactobacillus group. The presence of less cecal short-chain fatty acids and the imputed metabolic functions of the cecal microbiome suggested that EMS was less degradable for cecal bacteria than the control starch. The present EMS effects on the bacterial community profiles were different than the previously reported RS effects and can be linked to the chemical structure of EMS.

Reliability and Predictive Validity of the Juvenile Sex Offender Assessment Protocol-II in an Australian Context.

This study investigated the reliability and predictive validity of the Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II), in an Australian context, and for Australian Indigenous and non-Indigenous youth. Participants were 123 (n = 91 non-Indigenous; n = 32 Indigenous) youth assessed using the J-SOAP-II and followed up over an average period of 4 years. The reliability of the J-SOAP-II was assessed using measures of internal consistency (Cronbach's alphas and inter-item correlations). Receiver operating characteristic (ROC) analyses were conducted to assess the J-SOAP-II's validity in predicting sexual and non-sexual (violent and non-violent) recidivism. Overall, the J-SOAP-II demonstrated moderate to high levels of reliability and weak to moderate levels of validity for predicting sexual and non-sexual (violent and non-violent) recidivism for the whole sample. While the J-SOAP-II total score was significantly associated with non-sexual (violent and non-violent) recidivism for non-Indigenous youth, it was not significantly associated with any of the outcome variables for Indigenous youth. Across all analyses, the dynamic scales of the J-SOAP-II predicted recidivism with greater accuracy than the static scales. However, the static scales had greater accuracy in predicting the risk of sexual recidivism for Indigenous youth. While a reliable measure, these preliminary findings raise questions about the validity of the J-SOAP-II for predicting sexual recidivism for Indigenous and non-Indigenous youth in an Australian context, and warrant further investigation.

Short-Term Amygdala Low-Frequency Stimulation Does not Influence Hippocampal Interneuron Changes Observed in the Pilocarpine Model of Epilepsy.

Temporal lobe epilepsy (TLE) is characterized by changes in interneuron numbers in the hippocampus. Deep brain stimulation (DBS) is an emerging tool to treat TLE seizures, although its mechanisms are not fully deciphered. We aimed to depict the effect of amygdala DBS on the density of the most common interneuron types in the CA1 hippocampal subfield in the lithium-pilocarpine model of epilepsy. Status epilepticus was induced in male Wistar rats. Eight weeks later, a stimulation electrode was implanted to the left basolateral amygdala of both pilocarpine-treated (Pilo, n = 14) and age-matched control rats (n = 12). Ten Pilo and 4 control animals received for 10 days 4 daily packages of 50 s 4 Hz regular stimulation trains. At the end of the stimulation period, interneurons were identified by immunolabeling for parvalbumin (PV), neuropeptide Y (NPY), and neuronal nitric oxide synthase (nNOS). Cell density was determined in the CA1 subfield of the hippocampus using confocal microscopy. We found that PV+ cell density was preserved in pilocarpine-treated rats, while the NPY+/nNOS+ cell density decreased significantly. The amygdala DBS did not significantly change the cell density in healthy or in epileptic animals. We conclude that DBS with low frequency applied for 10 days does not influence interneuron cell density changes in the hippocampus of epileptic rats.

Do health insurers innovate? Evidence from the anatomy of physician payments.

One of private health insurers' main roles in the United States is to negotiate physician payment rates on their beneficiaries' behalf. We show that these rates are often set in reference to a government benchmark, and ask how often private insurers customize their fee schedules away from this default. We exploit changes in Medicare's payments and dramatic bunching in markups over Medicare's rates to address this question. Although Medicare's rates are influential, 25 percent of physician services in our data, representing 45 percent of covered spending, deviate from the benchmark. Heterogeneity in the pervasiveness and direction of deviations suggests that the private market coordinates around Medicare's pricing for simplicity but abandons it when sufficient value is at stake.

Transglycosylated Starch Improves Insulin Response and Alters Lipid and Amino Acid Metabolome in a Growing Pig Model.

Due to the functional properties and physiological effects often associated with chemically modified starches, significant interest lies in their development for incorporation in processed foods. This study investigated the effect of transglycosylated cornstarch (TGS) on blood glucose, insulin, and serum metabolome in the pre- and postprandial phase in growing pigs. Eight jugular vein-catheterized barrows were fed two diets containing 72% purified starch (waxy cornstarch (CON) or TGS). A meal tolerance test (MTT) was performed with serial blood sampling for glucose, insulin, lipids, and metabolome profiling. TGS-fed pigs had reduced postprandial insulin (p < 0.05) and glucose (p < 0.10) peaks compared to CON-fed pigs. The MTT showed increased (p < 0.05) serum urea with TGS-fed pigs compared to CON, indicative of increased protein catabolism. Metabolome profiling showed reduced (p < 0.05) amino acids such as alanine and glutamine with TGS, suggesting increased gluconeogenesis compared to CON, probably due to a reduction in available glucose. Of all metabolites affected by dietary treatment, alkyl-acyl-phosphatidylcholines and sphingomyelins were generally increased (p < 0.05) preprandially, whereas diacyl-phosphatidylcholines and lysophosphatidylcholines were decreased (p < 0.05) postprandially in TGS-fed pigs compared to CON. In conclusion, TGS led to changes in postprandial insulin and glucose metabolism, which may have caused the alterations in serum amino acid and phospholipid metabolome profiles.

High versus low energy administration in the early phase of acute pancreatitis (GOULASH trial): protocol of a multicentre randomised double-blind clinical trial.

INTRODUCTION: Acute pancreatitis (AP) is an inflammatory disease with no specific treatment. Mitochondrial injury followed by ATP depletion in both acinar and ductal cells is a recently discovered early event in its pathogenesis. Importantly, preclinical research has shown that intracellular ATP delivery restores the physiological function of the cells and protects from cell injury, suggesting that restoration of energy levels in the pancreas is therapeutically beneficial. Despite several high quality experimental observations in this area, no randomised trials have been conducted to date to address the requirements for energy intake in the early phase of AP. METHODS/DESIGN: This is a randomised controlled two-arm double-blind multicentre trial. Patients with AP will be randomly assigned to groups A (30 kcal/kg/day energy administration starting within 24 hours of hospital admission) or B (low energy administration during the first 72 hours of hospital admission). Energy will be delivered by nasoenteric tube feeding with additional intravenous glucose supplementation or total parenteral nutrition if necessary. A combination of multiorgan failure for more than 48 hours and mortality is defined as the primary endpoint, whereas several secondary endpoints such as length of hospitalisation or pain will be determined to elucidate more detailed differences between the groups. The general feasibility, safety and quality checks required for high quality evidence will be adhered to. ETHICS AND DISSEMINATION: The study has been approved by the relevant organisation, the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (55961-2/2016/EKU). This study will provide evidence as to whether early high energy nutritional support is beneficial in the clinical management of AP. The results of this trial will be published in an open access way and disseminated among medical doctors. TRIAL REGISTRATION: The trial has been registered at the ISRCTN (ISRTCN 63827758).

Enzymatically Modified Starch Ameliorates Postprandial Serum Triglycerides and Lipid Metabolome in Growing Pigs.

Developing host digestion-resistant starches to promote human health is of great research interest. Chemically modified starches (CMS) are widely used in processed foods and although the modification of the starch molecule allows specific reduction in digestibility, the metabolic effects of CMS have been less well described. This short-term study evaluated the impact of enzymatically modified starch (EMS) on fasting and postprandial profiles of blood glucose, insulin and lipids, and serum metabolome in growing pigs. Eight jugular-vein catheterized pigs (initial body weight, 37.4 kg; 4 months of age) were fed 2 diets containing 72% purified starch (EMS or waxy corn starch (control)) in a cross-over design for 7 days. On day 8, an 8-hour meal tolerance test (MTT) was performed with serial blood samplings. Besides biochemical analysis, serum was analysed for 201 metabolites through targeted mass spectrometry-based metabolomic approaches. Pigs fed the EMS diet showed increased (P<0.05) immediate serum insulin and plasma glucose response compared to pigs fed the control diet; however, area-under-the-curves for insulin and glucose were not different among diets. Results from MTT indicated reduced postprandial serum triglycerides with EMS versus control diet (P<0.05). Likewise, serum metabolome profiling identified characteristic changes in glycerophospholipid, lysophospholipids, sphingomyelins and amino acid metabolome profiles with EMS diet compared to control diet. Results showed rapid adaptations of blood metabolites to dietary starch shifts within 7 days. In conclusion, EMS ingestion showed potential to attenuate postprandial raise in serum lipids and suggested constant alteration in the synthesis or breakdown of sphingolipids and phospholipids which might be a health benefit of EMS consumption. Because serum insulin was not lowered, more research is warranted to reveal possible underlying mechanisms behind the observed changes in the profile of serum lipid metabolome in response to EMS consumption.