Increasing Insulin Pump Use Among 12- to 26-Year-Olds With Type 1 Diabetes: Results From the T1D Exchange Quality Improvement Collaborative.

Insulin pump therapy in pediatric type 1 diabetes has been associated with better glycemic control than multiple daily injections. However, insulin pump use remains limited. This article describes an initiative from the T1D Exchange Quality Improvement Collaborative aimed at increasing insulin pump use in patients aged 12-26 years with type 1 diabetes from a baseline of 45% in May 2018 to >50% by February 2020. Interventions developed by participating centers included increasing in-person and telehealth education about insulin pump technology, creating and distributing tools to assist in informed decision-making, facilitating insulin pump insurance approval and onboarding processes, and improving clinic staff knowledge about insulin pumps. These efforts yielded a 13% improvement in pump use among the five participating centers, from 45 to 58% over 22 months.

Drink, Don't Think: The Role of Masculinity and Thought Suppression in Men's Alcohol-Related Aggression.

Alcohol consumption is a well-established risk factor for aggressive behavior. However, evidence suggests that alcohol's effect on aggression varies as a function of individual- and situational-based instigating and inhibiting factors. Endorsement of traditional masculine gender norms has been consistently identified as an instigating factor for alcohol-related aggression. Likewise, individuals who habitually engage in thought suppression (i.e., the attempt to inhibit the occurrence of unwanted thoughts) have been shown to be at increased risk for behavioral disinhibition and aggression. In the present study, we test the hypothesis that thought suppression mediates the association between masculine norms and alcohol-related aggression. Two hundred forty-five men with a history of recent heavy episodic alcohol use completed surveys assessing their endorsement of traditional masculine norms, use of thought suppression, and both trait and alcohol-related aggression. Results indicated that thought suppression fully mediated the association between the toughness masculine norm and alcohol-related aggression. In addition, thought suppression partially mediated the association between the toughness norm and trait aggression. Findings are discussed in terms of the potential utility of cognitive-emotion regulation and norm-based interventions for reducing alcohol-related aggression.

Changes in Differentiation-Relatedness During Psychoanalysis.

This study sought to determine (a) if the Differentiation-Relatedness Scale of Self and Object Representations (D-RS), a coding model used with the Object Relations Inventory (Blatt, Wein, Chevron, & Quinlan, 1979 ) could be reliably applied to transcripts of psychoanalyses, and (b) if levels of differentiation-relatedness improve over the course of psychoanalysis. Participants were 4 creative writers who underwent psychoanalysis as part of a longitudinal research project focused on the processes and outcomes of psychoanalysis. Transcripts from the beginning and termination phases of psychoanalysis were coded by 2 independent raters for global, low, and high levels of self and other differentiation-relatedness and compared. There was good interrater agreement, suggesting that, like other forms of narrative material, psychoanalysis transcripts can be reliably rated for levels of object relations. Analysands showed an increase in global levels of differentiation-relatedness from a predominance of emergent ambivalent constancy (M = 6.2) at the beginning of analysis to consolidated, constant representations of self and other (M = 7.5) at the end of analysis. These preliminary findings contribute significantly to the empirical literature with regard to the measurement of self and object representations and change in these representations over the course of psychoanalysis.

Meta-Analysis Comparing Nominal and Measured Concentrations of Perfluorooctanoic Acid and Perfluorooctane Sulfonate in Aquatic Toxicity Studies Across Various Experimental Conditions.

Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are among the most frequently detected chemicals among the per- and polyfluoroalkyl substances in aquatic environments. Because of their high detection frequency, persistence, and potential toxicity, interest in both PFOA and PFOS has increased in recent years. However, a substantial number of PFOA and PFOS toxicity tests only report nominal, or unmeasured, treatment concentrations, which may complicate the determination of protective values. In addition, previous literature has indicated that differences between nominal and measured concentrations of both PFOA and PFOS could be linked to experimental conditions (e.g., feeding regimes for test organisms, test vessel material [glass or plastic], use of solvent, and the presence of substrate). Therefore, this critical review examined whether nominal and measured concentrations were in close agreement with each other among the current PFOA and PFOS aquatic toxicity literature and if experimental conditions were associated with any observed differences. Nominal and measured concentrations in the current PFOA and PFOS aquatic toxicity literature generally displayed a high degree of linear correlation and relatively low median percent differences. Correlations between measured and nominal concentrations were >0.98 for PFOA and >0.95 for PFOS in freshwater tests across experimental conditions. For saltwater tests, correlations of >0.84 were observed for PFOA and PFOS (separate and combined) across experimental conditions. While measured PFOA and PFOS toxicity tests are generally preferred, the present meta-analysis demonstrated that experimental conditions had little influence on observed discrepancies between nominal and measured concentrations, with the exception of PFOS saltwater tests and PFOA and PFOS freshwater studies that contained substrate. Unmeasured tests with these conditions should be considered carefully based on project needs, with the caveat that the data sets for these two experimental conditions were limited. Environ Toxicol Chem 2023;42:2289-2301. Published 2023. This article is a U.S. Government work and is in the public domain in the USA.

Liquid courage or liquid fear: alcohol intoxication and anxiety facilitate physical aggression.

Participants were 138 male social drinkers between 18 and 30 years of age from a university community in the southeastern United States in 2000. Trait and state anxiety was measured using the Trait Anxiety Inventory and the Facial Action Coding System, respectively. Participants consumed an alcoholic or nonalcoholic control beverage and completed a shock-based aggression task. Regression analysis indicated that alcohol-facilitated elevations in anxiety mediated the relation between alcohol consumption and aggression and that trait anxiety and physical provocation moderated this effect. Implications and limitations of this study are noted and future research directions are suggested.

Effects of GLP-1 and GIP on Islet Function in Glucose-Intolerant, Pancreatic-Insufficient Cystic Fibrosis.

Impaired insulin and incretin secretion underlie abnormal glucose tolerance (AGT) in pancreatic insufficient cystic fibrosis (PI-CF). Whether the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) can enhance pancreatic islet function in cystic fibrosis (CF) is not known. We studied 32 adults with PI-CF and AGT randomized to receive either GLP-1 (n = 16) or GIP (n = 16) during glucose-potentiated arginine (GPA) testing of islet function on two occasions, with either incretin or placebo infused, in a randomized, double-blind, cross-over fashion. Another four adults with PI-CF and normal glucose tolerance (NGT) and four matched control participants without CF underwent similar assessment with GIP. In PI-CF with AGT, GLP-1 substantially augmented second-phase insulin secretion but without effect on the acute insulin response to GPA or the proinsulin secretory ratio (PISR), while GIP infusion did not enhance second-phase or GPA-induced insulin secretion but increased the PISR. GIP also did not enhance second-phase insulin in PI-CF with NGT but did so markedly in control participants without CF controls. These data indicate that GLP-1, but not GIP, augments glucose-dependent insulin secretion in PI-CF, supporting the likelihood that GLP-1 agonists could have therapeutic benefit in this population. Understanding loss of GIP's insulinotropic action in PI-CF may lead to novel insights into diabetes pathogenesis.

Perfluorooctane Sulfonate in US Ambient Surface Waters: A Review of Occurrence in Aquatic Environments and Comparison to Global Concentrations.

Perfluorooctane sulfonate (PFOS) is one of the dominant perfluoroalkyl substances (PFAS) detected in aquatic ecosystems. It has been used in a wide range of industrial and consumer products for decades. The unique properties of PFOS, including its stability and resistance to degradation, have made it highly persistent in the aquatic environment. Because of its persistence, potential toxicity, and occurrence in aquatic ecosystems, interest in PFOS has increased in recent decades. Despite this interest, current information on the environmental distribution of PFOS in ambient surface waters of the United States is fairly limited. This critical review summarizes the currently available literature on PFOS occurrence in surface waters across the United States and highlights existing data gaps. Available data are largely from a handful of study areas with known PFAS manufacturing or industrial uses, with much of the data collected from freshwater systems in eastern states and the upper Midwest. Measured PFOS concentrations in surface waters vary widely, over 8 orders of magnitude, with the highest concentrations occurring downstream from manufacturing and industrial use plants, areas near aqueous film-forming foam-use sites, and sites where PFOS precursors were used in textile treatment. Non-point source-related occurrences are highest near urbanized areas with high population densities. Current data illustrate the occurrence of PFOS in surface waters across multiple US states. Additional data are needed to better understand PFOS occurrence in US aquatic ecosystems, particularly in estuarine and marine systems and where monitoring data are not available (e.g., southwestern, central, and western United States). Additional PFOS occurrence data would provide valuable information on potential spatial and temporal variability in surface waters and possible risks posed to aquatic ecosystems. Environ Toxicol Chem 2021;40:2425-2442. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.

Direct and Delayed Mortality of Ceriodaphnia dubia and Rainbow Trout Following Time-Varying Acute Exposures to Zinc.

The potential for delayed mortality following short-term episodic pollution events was evaluated by exposing cladocerans (Ceriodaphnia dubia) and rainbow trout (Oncorhynchus mykiss) to zinc (Zn) in various 1- to 48-h and 1- to 96-h exposures, respectively, followed by transferring the exposed organisms to clean water for up to 47 h for C. dubia and up to 95 h for trout for additional observation. For C. dubia, 1-h exposures of up to 3790 µg Zn/L never resulted in mortality during the actual Zn exposures, but by 48 h, a 1-h exposure to 114 µg/L, a concentration similar to the present US national water quality acute criterion for the test water conditions, ultimately killed 70% of C. dubia. With C. dubia, the speed of action of Zn toxicity was faster for intermediate concentrations than for the highest concentrations tested. For rainbow trout, pronounced delayed mortalities by 96 h only occurred following ≥8-h exposures. For both species, ultimate mortalities from Zn exposures ≤8 h mostly presented as delayed mortalities, whereas for exposures ≥24 h, almost all ultimate mortalities presented during the actual exposure periods. With Zn, risks of delayed mortality following exposures to all concentrations tested were much greater for the more sensitive, small-bodied invertebrate (C. dubia) than for the less sensitive, larger-bodied fish (rainbow trout). These results, along with previous studies, show that delayed mortality is an important consideration in evaluating risks to aquatic organisms from brief, episodic exposures to some substances. Environ Toxicol Chem 2021;40:2484-2498. © 2021 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Power of being present: the role of mindfulness on the relation between men's alcohol use and sexual aggression toward intimate partners.

The primary aim of this investigation was to examine the association between men's level of mindfulness and histories of alcohol consumption and sexual aggression toward intimate partners. Participants were 167 heterosexual drinking males who completed self-report measures of mindfulness, frequency and quantity of alcohol consumption during the past 12 months and sexual aggression against intimate partners during the past 12 months. Results indicated that a history of consuming larger amounts when drinking was associated with more frequent sexual coercion/aggression among men who reported low, but not high, levels of mindfulness. However, drinking more frequently by itself was not associated with more frequent sexual coercion/aggression. These results support the attention-allocation model and suggest implications for future intervention research aimed at reducing alcohol-related aggression.

State of the Science on Metal Bioavailability Modeling: Introduction to the Outcome of a Society of Environmental Toxicology and Chemistry Technical Workshop.

A Society of Environmental Toxicology and Chemistry technical workshop was held in December 2017 to critically evaluate the current state of the science of metal bioavailability modeling. The availability of mechanistic models such as the biotic ligand model and the rapid development of empirical models such as multiple linear regressions means that choices are available in terms of bioavailability normalization approaches that can be used in metal risk assessments and the development of risk-based protective values for aquatic life. A key goal of the workshop was to provide potential users of metal bioavailability models with the information required to make appropriate decisions when choosing among mechanistic and empirical models. Workshop participants focused on the state of the science of metal bioavailability modeling, mechanistic and empirical model frameworks, validation of bioavailability models, and application of bioavailability models in risk-based decision-making approaches. The output of this workshop provides the necessary scientific information to incorporate bioavailability normalization in regulations pertaining to metals in freshwater systems. Environ Toxicol Chem 2019;39:42-47. © 2019 SETAC.

U.S. Environmental Protection Agency's activities to prepare for regulatory and risk assessment applications of genomics information.

Genomics is expected to have significant implications for risk assessment and regulatory decision making. Since 2002, the U.S. Environmental Protection Agency (EPA) has undertaken a number of cross-agency activities to further prepare itself to receive, interpret, and apply genomics information for risk assessment and regulatory purposes. These activities include: (1) the issuance of an Interim Genomics Policy on the use of genomics information in risk assessments and decision making, (2) the release of the 2004 Genomics White Paper, which outlines potential applications and implications of genomics for EPA, and (3) the recent release of the external review draft of the Interim Guidance on Microarray-Based Assays, which outlines data submission, quality, analysis, management, and training considerations for such data. This manuscript discusses these activities and more recent follow-up activities with the aim of further communicating these efforts to the broader scientific and stakeholder community.

A self-awareness intervention manipulation for heavy-drinking men's alcohol-related aggression toward women.

OBJECTIVE: The primary aim of the present investigation was to directly examine a theoretically based, self-awareness intervention manipulation for at-risk men's alcohol-related aggression toward women. This study was developed in response to a call in the literature for research to (a) empirically investigate specific intervention techniques that reduce aggression, and (b) identify in whom such interventions will have the greatest impact. METHOD: A community sample (77% African American) of 94 heavy-drinking males age 21 years and older (M = 35.61) completed a battery of questionnaires that assessed alcohol consumption and perpetration of aggression toward women during the past year as well as dispositional masculine gender role stress. Participants were randomly assigned to an intervention manipulation designed to focus attention onto inhibitory, self-awareness cues, or a control group. Following beverage consumption, participants were provoked with a gender-relevant provocation from a female confederate and participants' physical aggression was measured using a shock-based aggression task. RESULTS: Men who received the intervention manipulation, relative to control, enacted significantly less alcohol-related physical aggression toward the female confederate. This finding held for men who reported lower, but not higher, levels of masculine gender role stress. CONCLUSION: Findings support the development of interventions that aim to redirect intoxicated men's attention toward stimuli that are nonaggressive, nonprovocative, or prohibitive of aggressive behavior. However, caution is warranted that en masse dissemination of such interventions may not impact the most at-risk men for alcohol-related violence toward women. (PsycINFO Database Record

Reducing alcohol-related aggression: Effects of a self-awareness manipulation and locus of control in heavy drinking males.

Alcohol Myopia Theory (AMT; Steele & Josephs, 1990) purports that alcohol facilitates aggression by narrowing attentional focus onto salient and instigatory cues common to conflict situations. However, few tests of its counterintuitive prediction - that alcohol may decrease aggression when inhibitory cues are most salient - have been conducted. The present study examined whether an AMT-inspired self-awareness intervention manipulation would reduce heavy drinking men's intoxicated aggression toward women and also examined whether a relevant individual variable, locus of control, would moderate this effect. Participants were 102 intoxicated male heavy drinkers who completed a self-report measure of locus of control and completed the Taylor Aggression Paradigm (Taylor, 1967). In this task, participants administered electric shocks to, and received electric shocks from, a fictitious female opponent while exposed to an environment saturated with or devoid of self-awareness cues. Results indicated that the self-awareness manipulation was associated with less alcohol-related aggression toward the female confederate for men who reported an internal, but not an external, locus of control. Findings support AMT as a theoretical framework to inform preventative interventions for alcohol-related aggression and highlight the importance of individual differences in receptivity to such interventions.

Does educational intervention affect resident competence in sonographic cervical length measurement?

OBJECTIVE: To determine if a structured teaching module improves resident competency in transvaginal sonographic cervical length measurements. METHODS: This was a prospective cohort study involving obstetrics and gynecology residents at a single institution. Residents collected 10 transvaginal cervical images from patients with threatened preterm labor presenting to Labor and Delivery. After initial image acquisition, residents participated in a lecture-based teaching module involving a pre- and post-intervention assessment. Following the didactic session, they collected 10 additional images. All the images were scored independently by two Maternal-Fetal Medicine attending physicians based on the quality and accuracy of the measured cervical length. Pre-and post- intervention test results were compared, as well as pre- and post- intervention image scores. Parametric and nonparametric tests were used as appropriate with p < 0.05 considered significant. RESULTS: Ninety-three percent of the residents (14/15) improved their scores from pre-test to post-test or maintained an already perfect score (p < 0.01). Improvement was most significant with the junior residents. Seventy-nine percent of the residents (11/14) improved their cervical image scores after the educational session. Mean score for total residents was 73.7 + 12.6 pre-intervention and 90.2 + 9.9 post-intervention (p < 0.01) out of a total of 120. CONCLUSIONS: There is an improvement in the competence of resident measured cervical lengths via transvaginal ultrasound when a structured educational module is implemented for resident education.

"Demonstrating Masculinity" Via Intimate Partner Aggression: The Moderating Effect of Heavy Episodic Drinking.

The aim of the present study was to examine the mediational effect of masculine gender role stress on the relation between adherence to dimensions of a hegemonic masculinity and male-to-female intimate partner physical aggression. Men's history of heavy episodic drinking was also examined as a moderator of the proposed mediation effect. A sample of 392 heterosexual men from the southeastern United States who had been in an intimate relationship within the past year completed measures of hegemonic masculine norms (i.e., status, toughness, and antifemininity), masculine gender role stress, alcohol use patterns, and intimate partner physical aggression. Results indicated that the indirect effects of adherence to the antifemininity and toughness norms on physical aggression toward female intimate partners via masculine gender role stress were significant and marginal, respectively. A significant indirect effect of status was not detected. Moreover, subsequent analyses revealed that the indirect effects of antifemininity and toughness were significant only among men with a history of heavy episodic drinking. These findings suggest that heavy episodic drinking exacerbates a gender-relevant stress pathway for intimate partner aggression among men who adhere to specific norms of masculinity. Overall, results suggest that the proximal effect of heavy episodic drinking focuses men's attention on gender-based schemas associated with antifemininity and toughness, which facilitates partner-directed aggression as a means to demonstrate these aspects of their masculinity. Implications for the intersection between men's adherence to specific norms of hegemonic masculinity, cognitive appraisal of gender relevant situations, and characteristic patterns of alcohol consumption are discussed.

Development of the Abbreviated Masculine Gender Role Stress Scale.

Data gathered from 6 independent samples (n = 1,729) that assessed men's masculine gender role stress in college and community males were aggregated used to determine the reliability and validity of an abbreviated version of the Masculine Gender Role Stress (MGRS) Scale. The 15 items with the highest item-to-total scale correlations were used to create an abbreviated MGRS Scale. Psychometric properties of each of the 15 items were examined with item response theory (IRT) analysis, using the discrimination and threshold parameters. IRT results showed that the abbreviated scale may hold promise at capturing the same amount of information as the full 40-item scale. Relative to the 40-item scale, the total score of the abbreviated MGRS Scale demonstrated comparable convergent validity using the measurement domains of masculine identity, hypermasculinity, trait anger, anger expression, and alcohol involvement. An abbreviated MGRS Scale may be recommended for use in clinical practice and research settings to reduce cost, time, and patient/participant burden. Additionally, IRT analyses identified items with higher discrimination and threshold parameters that may be used to screen for problematic gender role stress in men who may be seen in routine clinical or medical practice.

Effects of Thought Suppression on Provoked Men's Alcohol-Related Physical Aggression in the Laboratory.

OBJECTIVE: This study utilized a comprehensive theoretical approach to provide the first data on the impact of thought suppression on provoked men's alcohol-related aggression. METHOD: A diverse community sample (58% African-American) of males between the ages of 21 and 35 (M = 25.25) were randomly assigned to one of two beverage conditions (i.e., alcohol, no-alcohol control). Following beverage consumption, participants were provoked via reception of electric shocks and a verbal insult from a fictitious male opponent. Participants' physical aggression was measured using a shock-based aggression task. RESULTS: Results indicated that acute alcohol intoxication significantly increased physical aggression among lower, but not higher, thought suppressing men. CONCLUSIONS: Results suggest that, under conditions of interpersonal provocation, alcohol intoxication produces a myopic focus on hostile thoughts and angry affect in lower, but not higher, suppression men. This pattern of results provides support for the durability of the alcohol myopia effect and highlights the need for continued examination of alcohol's role in the disruption of protective factors for men's aggression. It is important for research to continue to identify modifiable cognitive variables that influence self-regulation of behavior; however, it is imperative that researchers consider the extent to which these variables withstand alcohol's effects.

What accounts for men's hostile attitudes toward women? The influence of hegemonic male role norms and masculine gender role stress.

This study examined masculine gender role stress (MGRS) as a mediator of the relation between adherence to dimensions of a hegemonic masculinity and hostility toward women (HTW). Among a sample of 338 heterosexual men, results indicated that MGRS mediated the relation between adherence to the status and antifemininity norms, but not the toughness norm, and HTW. Adherence to the toughness norm maintained a positive association with HTW. These findings suggest that men's HTW develops via multiple pathways that are associated with different norms of hegemonic masculinity. Implications for the prediction of men's aggression against women are discussed.

Does distraction reduce the alcohol-aggression relation? A cognitive and behavioral test of the attention-allocation model.

OBJECTIVE: This study provided the first direct test of the cognitive underpinnings of the attention-allocation model and attempted to replicate and extend past behavioral findings for this model as an explanation for alcohol-related aggression. METHOD: A diverse community sample (55% African American) of men (N = 159) between 21 and 35 years of age (M = 25.80) were randomly assigned to 1 of 2 beverage conditions (i.e., alcohol, no-alcohol control) and 1 of 2 distraction conditions (i.e., distraction, no-distraction). Following beverage consumption, participants were provoked via reception of electric shocks and a verbal insult from a fictitious male opponent. Participants' attention allocation to aggression words (i.e., aggression bias) and physical aggression were measured using a dot probe task and a shock-based aggression task, respectively. RESULTS: Intoxicated men whose attention was distracted displayed significantly lower levels of aggression bias and enacted significantly less physical aggression than intoxicated men whose attention was not distracted. However, aggression bias did not account for the lower levels of alcohol-related aggression in the distraction, relative to the no-distraction, condition. CONCLUSIONS: These results replicated and extended past evidence that cognitive distraction is associated with lower levels of alcohol-related aggression in highly provoked males and provide the first known cognitive data to support the attentional processes posited by the attention-allocation model. Discussion focused on how these data inform intervention programming for alcohol-related aggression.