The emergence of the EEG dominant rhythm across the first year of life.

The spectral composition of EEG provides important information on the function of the developing brain. For example, the frequency of the dominant rhythm, a salient features of EEG data, increases from infancy to adulthood. Changes of the dominant rhythm during infancy are yet to be fully characterized, in terms of their developmental trajectory and spectral characteristics. In this study, the development of dominant rhythm frequency was examined during a novel sustained attention task across 6-month-old (n = 39), 9-month-old (n = 30), and 12-month-old (n = 28) infants. During this task, computer-generated objects and faces floated down a computer screen for 10 s after a 5-second fixation cross. The peak frequency in the range between 5 and 9 Hz was calculated using center of gravity (CoG) and examined in response to faces and objects. Results indicated that peak frequency increased from 6 to 9 to 12 months of age in face and object conditions. We replicated the same result for the baseline. There was high reliability between the CoGs in the face, object, and baseline conditions across all channels. The developmental increase in CoG was more reliable than measures of mode frequency across different conditions. These findings suggest that CoG is a robust index of brain development across infancy.

Untangling Concepts of Financial Circumstances for Public Health Professionals and Scholars: A Glossary and Concept Map.

Public health discipline and practice have prioritized work on poverty and populations at high risk for material deprivation, with less consideration for the full spectrum of financial circumstances relative to well-being. Public health can make a much-needed contribution to this area, which is currently dominated by the financial industry, focused on individual behaviors, and lacking the definitional consensus needed for research and evaluation. A population-level lens can reveal the social determinants and health consequences of real or perceived poor financial circumstances. This article aims to improve conceptual understanding of financial circumstances among public health scholars and professionals. We identified concepts through a critical literature review of peer-reviewed and practice-based resources on financial well-being and financial strain. We developed a glossary of concepts related to financial circumstances and categorized concepts according to their level of influence using an approach informed by socioecological models. We provide a concept map that illustrates the relationships between concepts in the context of their levels of influence. This article will help to advance an agenda on financial well-being promotion in public health research and practice. (Am J Public Health. 2024;114(1):79-89. https://doi.org/10.2105/AJPH.2023.307449).

An action-oriented public health framework to reduce financial strain and promote financial wellbeing in high-income countries.

BACKGROUND: Perceived financial security impacts physical, mental, and social health and overall wellbeing at community and population levels. Public health action on this dynamic is even more critical now that the COVID-19 pandemic has exacerbated financial strain and reduced financial wellbeing. Yet, public health literature on this topic is limited. Initiatives targeting financial strain and financial wellbeing and their deterministic effects on equity in health and living conditions are missing. Our research-practice collaborative project addresses this gap in knowledge and intervention through an action-oriented public health framework for initiatives targeting financial strain and wellbeing. METHODS: The Framework was developed using a multi-step methodology that involved review of theoretical and empirical evidence alongside input from a panel of experts from Australia and Canada. In an integrated knowledge translation approach, academics (n = 14) and a diverse group of experts from government and non-profit sectors (n = 22) were engaged throughout the project via workshops, one-on-one dialogues, and questionnaires. RESULTS: The validated Framework provides organizations and governments with guidance for the design, implementation, and assessment of diverse financial wellbeing- and financial strain-related initiatives. It presents 17 priority actionable areas (i.e., entry points for action) likely to have long-lasting, positive effects on people's financial circumstances, contributing to improved financial wellbeing and health. The 17 entry points relate to five domains: Government (All Levels), Organizational & Political Culture, Socioeconomic & Political Context, Social & Cultural Circumstances, and Life Circumstances. CONCLUSIONS: The Framework reveals the intersectionality of root causes and consequences of financial strain and poor financial wellbeing, while also reinforcing the need for tailored actions to promote socioeconomic and health equity for all people. The dynamic, systemic interplay of the entry points illustrated in the Framework suggest opportunities for multi-sectoral, collaborative action across government and organizations towards systems change and the prevention of unintended negative impacts of initiatives.

HPV vaccine narratives on Twitter during the COVID-19 pandemic: a social network, thematic, and sentiment analysis.

INTRODUCTION: The COVID-19 pandemic has increased online interactions and the spread of misinformation. Some researchers anticipate benefits stemming from improved public awareness of the value of vaccines while others worry concerns around vaccine development and public health mandates may have damaged public trust. There is a need to understand whether the COVID-19 pandemic, vaccine development, and vaccine mandates have influenced HPV vaccine attitudes and sentiments to inform health communication strategies. METHODS: We collected 596,987 global English-language tweets from January 2019-May 2021 using Twitter's Academic Research Product track. We determined vaccine confident and hesitant networks discussing HPV immunization using social network analysis. Then, we used a neural network approach to natural language processing to measure narratives and sentiment pertaining to HPV immunization. RESULTS: Most of the tweets in the vaccine hesitant network were negative in tone (54.9%) and focused on safety concerns surrounding the HPV vaccine while most of the tweets in the vaccine confident network were neutral (51.6%) and emphasized the health benefits of vaccination. Growth in negative sentiment among the vaccine hesitant network corresponded with legislative efforts in the State of New York to mandate HPV vaccination for public school students in 2019 and the WHO declaration of COVID-19 as a Global Health Emergency in 2020. In the vaccine confident network, the number of tweets concerning the HPV vaccine decreased during the COVID-19 pandemic but in both vaccine hesitant and confident networks, the sentiments, and themes of tweets about HPV vaccine were unchanged. CONCLUSIONS: Although we did not observe a difference in narratives or sentiments surrounding the HPV vaccine during the COVID-19 pandemic, we observed a decreased focus on the HPV vaccine among vaccine confident groups. As routine vaccine catch-up programs restart, there is a need to invest in health communication online to raise awareness about the benefits and safety of the HPV vaccine.

Geospatial analysis and participant characteristics associated with colorectal cancer screening participation in Alberta, Canada: a population-based cross-sectional study.

BACKGROUND: Colorectal cancer (CRC) is a leading cause of death in Canada and early detection can prevent deaths through screening. However, CRC screening in Alberta, Canada remains suboptimal and varies by sociodemographic and health system characteristics, as well as geographic location. This study aimed to further the understanding of these participant and health system characteristics associated with CRC screening in Alberta and identify clusters of regions with higher rates of overdue or unscreened individuals. METHODS: We included Albertans aged 52 to 74 as of December 31, 2019 (index date) and we used data from administrative health data sources and linked to the Alberta Colorectal Cancer Screening Program database to determine colorectal cancer screening rates. We used multivariable multinomial logistic regression analysis to investigate the relationship between sociodemographic, health system characteristics and participation in CRC screening. We used optimized Getis-Ord Gi* hot-spot analysis to identify hot and cold-spots in overdue for and no record of CRC screening. RESULTS: We included 919,939 Albertans, of which 65% were currently up to date on their CRC screening, 21% were overdue, and 14% had no record of CRC screening. Compared to Albertans who were currently up to date, those who were in older age groups, those without a usual provider of care, those who were health system non-users, and those living in more deprived areas were more likely to have no record of screening. Areas with high number of Albertans with no record of screening were concentrated in the North and Central zones. CONCLUSIONS: Our study showed important variation in colorectal cancer screening participation across sociodemographic, health system and geographical characteristics and identified areas with higher proportions of individuals who have no record of screening or are under-screened in Alberta, Canada.

Face race and sex impact visual fixation strategies for upright and inverted faces in 3- to 6-year-old children.

Everyday face experience tends to be biased, such that infants and young children interact more often with own-race and female faces leading to differential processing of faces within these groups relative to others. In the present study, visual fixation strategies were recorded using eye tracking to determine the extent to which face race and sex/gender impact a key index of face processing in 3- to 6-year-old children (n = 47). Children viewed male and female upright and inverted White and Asian faces while visual fixations were recorded. Face orientation was found to have robust effects on children's visual fixations, such that children exhibited shorter first fixation and average fixation durations and a greater number of fixations for inverted compared to upright face trials. First fixations to the eye region were also greater for upright compared to inverted faces. Fewer fixations and longer duration fixations were found for trials with male compared to female faces and for upright compared to inverted unfamiliar-race faces, but not familiar-race faces. These findings demonstrate evidence of differential fixation strategies toward different types of faces in 3- to 6-year-old children, illustrating the importance of experience in the development of visual attention to faces.

A Policy-Ready Public Health Guidebook of Strategies and Indicators to Promote Financial Well-Being and Address Financial Strain in Response to COVID-19.

INTRODUCTION: The COVID-19 pandemic has adversely affected the financial well-being of populations globally, escalating concerns about links with health care and overall well-being. Governments and organizations need to act quickly to protect population health relative to exacerbated financial strain. However, limited practice- and policy-relevant resources are available to guide action, particularly from a public health perspective, that is, targeting equity, social determinants of health, and health-in-all policies. Our study aimed to create a public health guidebook of strategies and indicators for multisectoral action on financial well-being and financial strain by decision makers in high-income contexts. METHODS: We used a multimethod approach to create the guidebook. We conducted a targeted review of existing theoretical and conceptual work on financial well-being and strain. By using rapid review methodology informed by principles of realist review, we collected data from academic and practice-based sources evaluating financial well-being or financial strain initiatives. We performed a critical review of these sources. We engaged our research-practice team and government and nongovernment partners and participants in Canada and Australia for guidance to strengthen the tool for policy and practice. RESULTS: The guidebook presents 62 targets, 140 evidence-informed strategies, and a sample of process and outcome indicators. CONCLUSION: The guidebook supports action on the root causes of poor financial well-being and financial strain. It addresses a gap in the academic literature around relevant public health strategies to promote financial well-being and reduce financial strain. Community organizations, nonprofit organizations, and governments in high-income countries can use the guidebook to direct initiative design, implementation, and assessment.

Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability.

BACKGROUND: Retrospective analyses suggest that pulmonary embolism is ruled out by a d-dimer level of less than 1000 ng per milliliter in patients with a low clinical pretest probability (C-PTP) and by a d-dimer level of less than 500 ng per milliliter in patients with a moderate C-PTP. METHODS: We performed a prospective study in which pulmonary embolism was considered to be ruled out without further testing in outpatients with a low C-PTP and a d-dimer level of less than 1000 ng per milliliter or with a moderate C-PTP and a d-dimer level of less than 500 ng per milliliter. All other patients underwent chest imaging (usually computed tomographic pulmonary angiography). If pulmonary embolism was not diagnosed, patients did not receive anticoagulant therapy. All patients were followed for 3 months to detect venous thromboembolism. RESULTS: A total of 2017 patients were enrolled and evaluated, of whom 7.4% had pulmonary embolism on initial diagnostic testing. Of the 1325 patients who had a low C-PTP (1285 patients) or moderate C-PTP (40 patients) and a negative d-dimer test (i.e., <1000 or <500 ng per milliliter, respectively), none had venous thromboembolism during follow-up (95% confidence interval [CI], 0.00 to 0.29%). These included 315 patients who had a low C-PTP and a d-dimer level of 500 to 999 ng per milliliter (95% CI, 0.00 to 1.20%). Of all 1863 patients who did not receive a diagnosis of pulmonary embolism initially and did not receive anticoagulant therapy, 1 patient (0.05%; 95% CI, 0.01 to 0.30) had venous thromboembolism. Our diagnostic strategy resulted in the use of chest imaging in 34.3% of patients, whereas a strategy in which pulmonary embolism is considered to be ruled out with a low C-PTP and a d-dimer level of less than 500 ng per milliliter would result in the use of chest imaging in 51.9% (difference, -17.6 percentage points; 95% CI, -19.2 to -15.9). CONCLUSIONS: A combination of a low C-PTP and a d-dimer level of less than 1000 ng per milliliter identified a group of patients at low risk for pulmonary embolism during follow-up. (Funded by the Canadian Institutes of Health Research and others; PEGeD ClinicalTrials.gov number, NCT02483442.).

An analysis of ALA-accredited MLS curricula indicates deficiencies in the initial training provided for public librarians.

BACKGROUND: Public librarians often address patron inquiries regarding health concerns. However, prior research indicates that public librarians may be unprepared to meet the health information requests of patrons. OBJECTIVE: This study examined the availability of health-themed courses in American Library Association (ALA) accredited Master of Library and Information Studies/Science (MLIS) programs. METHODS: Accredited MLIS programs were identified using the ALA directory. Curricula were reviewed for health content and public librarianship, children's, and young adult concentrations. Descriptive and bivariate analyses assessed the percent of programs that offered various health-related course content and the differences in availability of such content. RESULTS: Of the 59 accredited MLIS programs, only 35 (59.32%) listed at least one health elective and none listed a required health course. No MLIS programs that had a public library concentration (n = 21) listed a required or elective health course, two programs with a children's concentration (n = 25) listed health course electives, and one program with a young adult concentration (n = 25) listed a health course elective. CONCLUSION: ALA-accredited MLIS programs should consider increasing their offerings or requiring health-related courses to improve the training of public librarians to meet the health information needs of communities.

Bird expertise does not increase motion sensitivity to bird flight motion.

While motion information is important for the early stages of vision, it also contributes to later stages of object recognition. For example, human observers can detect the presence of a human, judge its actions, and judge its gender and identity simply based on motion cues conveyed in a point-light display. Here we examined whether object expertise enhances the observer's sensitivity to its characteristic movement. Bird experts and novices were shown point-light displays of upright and inverted birds in flight, or upright and inverted human walkers, and asked to discriminate them from spatially scrambled point-light displays of the same stimuli. While the spatially scrambled stimuli retained the local motion of each dot of the moving objects, it disrupted the global percept of the object in motion. To estimate a detection threshold in each object domain, we systematically varied the number of noise dots in which the stimuli were embedded using an adaptive staircase approach. Contrary to our predictions, the experts did not show disproportionately higher sensitivity to bird motion, and both groups showed no inversion cost. However, consistent with previous work showing a robust inversion effect for human motion, both groups were more sensitive to upright human walkers than their inverted counterparts. Thus, the result suggests that real-world experience in the bird domain has little to no influence on the sensitivity to bird motion and that birds do not show the typical inversion effect seen with humans and other terrestrial movement.

Impact of Pharmacist Involvement on the Utility of a Gram-Negative Blood Culture Identification Panel on Antimicrobial Usage.

Background: A rapid molecular diagnostic test (MDT) is a test used to identify several different species of gram-negative bacteria and their genetic resistance markers. However, the impact of rapid MDT has not been established when combined with pharmacist involvement. Objective: To determine the impact of pharmacy involvement on patient outcomes when using rapid MDT. The primary outcome is the time from gram stain result to the first dose of the targeted antibiotic. Methods: This is a single-center, quasi-experimental, 1-group pretest-posttest design study of patients with gram-negative bacteremia in a community hospital. Hospitalized patients 18 years or older were included if they had a gram-negative blood culture. Patients were excluded if they were discharged or expired prior to culture results. Outcomes were compared between patients prior to and after implementation of the automated MDT. This research was determined to be exempt from institutional review board oversight consistent with West Florida Healthcare and in accordance with institutional policy. Results: The use of rapid MDT combined with pharmacist intervention resulted in a statistically significant decrease in the time to targeted antibiotic therapy (pre-intervention group, n = 77, 44.8 ± 17.8 hours versus post-intervention group, n= 80, 4.4 ± 5.8 hours; P ≤.001). There was no significant difference found between secondary outcomes. Limitations included small sample size as well as inconsistent documentation. Conclusions: The use of rapid MDT combined with pharmacist intervention resulted in a statistically significant decrease in the time to targeted antibiotic therapy.

Neural and behavioral effects of subordinate-level training of novel objects across manipulations of color and spatial frequency.

Perceptual expertise is marked by subordinate-level recognition of objects in the expert domain. In this study, participants learned one family of full-color, artificial objects at the subordinate (species) level and another family at the basic (family) level. Discrimination of trained and untrained exemplars was tested before and after training across several image manipulations [full-color, grayscale, low spatial frequency (LSF) and high spatial frequency (HSF)] while event-related potentials (ERPs) were recorded. Regardless of image manipulation, discrimination (indexed by d') of trained and of untrained exemplars was enhanced after subordinate-level training, but not after basic-level training. Enhanced discrimination after subordinate-level training generalized to untrained exemplars and to grayscale images and images in which LSF or HSF information was removed. After training, the N170 and N250, recorded over occipital and occipitotemporal brain regions, were both more enhanced after subordinate-level training than after basic-level training. However, the topographic distribution of enhanced responses differed across components. The N170 latency predicted reaction time after both basic-level training and subordinate-level training, highlighting an association between behavioral and neural responses. These findings further elucidate the role of the N170 and N250 as ERP indices of subordinate-level expert object processing and demonstrate how low-level manipulations of color and spatial frequency impact behavior and the N170 and N250 components independent of training or expertise.

Rivaroxaban Compared to Placebo for the Treatment of Leg Superficial Vein Thrombosis: A Randomized Trial.

The role of rivaroxaban in the treatment of leg superficial venous thrombosis (SVT) is uncertain. This article aims to determine if rivaroxaban is an effective and safe treatment for leg SVT. Patients with symptomatic leg SVT of at least 5 cm length were randomized to 45 days of rivaroxaban 10 mg daily or to placebo, and followed for a total of 90 days. Treatment failure (required a nonstudy anticoagulant; had proximal deep vein thrombosis or pulmonary embolism; or had surgery for SVT) at 90 days was the primary efficacy outcome. Secondary efficacy outcomes included leg pain severity, and venous disease-specific and general health-related quality of life over 90 days. Major bleeding at 90 days was the primary safety outcome. Poor enrollment led to the trial being stopped after 85 of the planned 600 patients were randomized to rivaroxaban (n = 43) or placebo (n = 42). One rivaroxaban and five placebo patients had a treatment failure by 90 days (absolute risk reduction = 9.0%, 95% confidence interval: -22 to 5.9%). Leg pain improvement did not differ at 7 (p = 0.16) or 45 days (p = 0.89), but was greater with rivaroxaban at 90 days (p = 0.011). There was no difference in venous disease-specific (p = 0.99) or general health-related (p = 0.37) quality of life over 45 days. There were no major bleeds or deaths in either group. There were no identifiable differences in efficacy or safety between rivaroxaban and placebo in patients with symptomatic SVT but comparisons were undermined by a much smaller than planned sample size (NCT1499953).

Factors Associated With the Need for Pharmacological Management of Neonatal Opioid Withdrawal Syndrome.

BACKGROUND: Neonatal opioid withdrawal syndrome (NOWS) is a significant and growing health problem that affects more than 23,000 infants annually, with an estimated hospital cost of more than $720 million. PURPOSE: The purpose of this study was to examine factors associated with the need to initiate medication for the treatment of NOWS. METHODS: A retrospective review of medical records was conducted of 204 infants born to mothers who used opioids during pregnancy from April 2011 to September 2017. Associations between maternal, infant, and environmental factors and the need for neonatal pharmacological management were examined using χ, t tests, and regression analysis. RESULTS: Of 204 neonates exposed to opioids prenatally, 121 (59%) developed symptoms of NOWS, requiring treatment with morphine. Neonates requiring morphine had significantly higher gestational ages (37.7 weeks vs 36.4 weeks; P < .001), and mothers were present at the neonate's bedside for a lower proportion of their total hospital stay (57% vs 74% of days; P < .001). Maternal factors associated with the need for neonatal medication treatment included the mother's reason for opioid use (P = .014), primary type of opioid used (P < .001), tobacco use (P = .023), and use of benzodiazepines (P = .003). IMPLICATIONS FOR PRACTICE: This research provides information regarding the proportion of infants exposed to opioids prenatally who develop NOWS that requires treatment, as well as maternal, infant, and environmental factors associated with the need for neonatal medication use. IMPLICATIONS FOR RESEARCH: Future research is needed to examine these relationships prospectively in a larger and more diverse sample.

Policy perceptions of US state public health and child and family services regarding maternal opioid use and neonatal exposure.

OBJECTIVE: To explore how state legislatures and departments of health are responding to the public health and economic issues of increases in opioid use disorder and the impact on pregnant women and infants. DESIGN: The design was a non-experimental descriptive study using a mixed methods survey research approach. SETTING: Electronic and telephone survey of individuals from state departments of health associated with departments of behavioral health and substance use, or child and family services. PARTICIPANTS: Fifty-two respondents employed by individual state departments of health and child and family services. METHODS: Univariate analysis and frequency distribution of ordinal variables was completed. Thematic analysis was used to analyze free text questions and identify themes. RESULTS: All states reported recent changes or plans to address the problem of opioid misuse in their state. Many respondents feel their state continues to lack adequate services for treatment. Some states are exploring unique methods for addressing this in a safe and timely fashion, such as moving medication-assisted treatment to primary care and expanding licensure to Primary Care Physicians (PCPs) and nurse practitioners. CONCLUSIONS: Our findings demonstrate an increased commitment throughout the United States to enhance access to clinically appropriate treatment of substance use disorder particularly during pregnancy, consider unique methods for addressing the problem of opioid dependency, and increase education and primary prevention programs.

Learning to Individuate: The Specificity of Labels Differentially Impacts Infant Visual Attention.

This study examined differences in visual attention as a function of label learning from 6 to 9 months of age. Before and after 3 months of parent-directed storybook training with computer-generated novel objects, event-related potentials and visual fixations were recorded while infants viewed trained and untrained images (n = 23). Relative to a pretraining, a no-training control group (n = 11), and to infants trained with category-level labels (e.g., all labeled "Hitchel"), infants trained with individual-level labels (e.g., "Boris," "Jamar") displayed increased visual attention and neural differentiation of objects after training.

A New Modeling Approach To Prioritize Riparian Restoration To Reduce Sediment Loading in Two Virginia River Basins.

Human impact, particularly land cover changes (e.g., agriculture, construction) increase erosion and sediment loading into streams. Benthic species are negatively affected by silt deposition that coats and embeds stream substrate. Given that riparian buffers are effective sediment filters, riparian restoration is increasingly implemented by conservation groups to protect stream habitats. Limited funding and a multitude of impaired streams warrant the need for cost-effective prioritization of potential restoration actions. We created a decision-support framework for conservation agencies and aquatic resource managers to prioritize riparian restoration efforts. Our framework integrates GIS data and field surveys into a statistical model to predict instream silt from estimates of upland soil loss and riparian filtration capacity. We focus specifically on prioritizing sites in upper sections of the Roanoke and Nottoway river basins (Virginia, US) based on observed records of Roanoke logperch (Percina rex), an imperiled sediment-sensitive species. Our statistical approach examines soil characteristics, land cover, precipitation, topography, and annual soil loss estimates from the empirically derived Revised Universal Soil Loss Equation, combined with land cover-based riparian filtration capacity as potential stream habitat predictors. We found riparian filtration capacity to be a significant predictor of silt cover, while precipitation was a significant predictor of embeddedness. Spatial scale was also a factor, in that spatial variance in silt cover and embeddedness was more accurately predicted at smaller spatial extents. Ultimately, our model can be used as a prioritization tool for mitigating high siltation areas, or for protecting low soil erosion areas.

Low Income Suburban Residents Perceive a Greater Lack of Specialty But not Primary Care Physicians than Those with Higher Incomes.

As the number of low income residents in suburban areas increases, they may present new healthcare delivery challenges. We compared residents' perceptions of access to primary care (PCP) and specialty (SCP) physicians by income categories in two adjacent counties of New York, which differ in physician density and public healthcare delivery models. Telephone interviews of 812 residents of Nassau (NC, 6.9 physicians/1000) and Suffolk (SC, 3.5 physicians/1000) counties were conducted, assessing perceptions of whether there were "too few," or "about the right number" of PCPs and SCPs. Counties were compared using bivariate analysis; multivariate analyses examined the association of perceptions of PCP and SCP access with demographic variables, including income. Twice as many SC respondents perceived too few SCPs compared to NC (35.31 vs. 18.27%, p = .001) and 50% more perceived too few PCPs (32.56 vs. 23.85%, p = .06). Thus, physician access was a perceived problem for many in SC despite a supply greater than the national average. For both counties combined, those with household incomes less than $35,000/year were twice as likely to perceive too few SCPs (p = .05), while in SC, this group was more than three times as likely to perceive too few SCPs (p = .02). There were no significant associations between income and perception of PCP availability. Thus, both counties have eliminated income-related differences in perceived access to PCPs. However, this is not the case for SCPs, especially in SC, which, unlike NC, has no publically supported specialty care. As the number of low income suburban residents increases, access to specialty care presents an important challenge for some areas.

Improving Adherence to Care Recommendations Using a Community Health Worker (CHW) Intervention with the Pediatric Medical Home.

While CHW interventions improve health outcomes, evidence identifying specific domains of CHW-delivered support resulting in positive outcomes is limited. Our goals were to identify domains of CHW-delivered support that assist families with adhering to recommended pediatric care; and, to identify predictors of successful completion of an enriched medical home intervention (EMHI) using trained CHWs making home visits to provide health education and support positive health behaviors. We performed a prospective descriptive study of 88 families participating in a protocol-based EMHI. Completers (N = 46) finished the program with mutual agreement that the family can independently adhere to recommended clinical care. Non-completers (N = 42) were lost to follow-up or dropped out of the program before reaching this milestone. Using Grounded Theory, two trained coders evaluated CHW tasks recorded in an electronic database and classified these tasks across 17 domains. We assessed predictors of EMHI completion using logistic regression. The 88 EMHI participants were primarily <24 months of age (80 %), Hispanic (56 %), and Medicaid enrollees (67 %). Hispanic families (OR = 2.76, p = 0.04) and those with self-reported program goals to 'facilitate family's creation of a system to keep track of child's medical information' (OR = 3.11, p = 0.02) or a 'newborn-specific goal' (OR = 3.21, p = 0.04), such as feeding and safety tips, were more likely to complete the EMHI compared to their counterparts. The most consistent CHW tasks were supporting medical appointments, medication maintenance, and providing health education. CHW interventions designed to improve health behavior outcomes of 'at-risk' families, including Medicaid enrollees, may benefit from support in goal-setting and strategies to systematically manage their child's medical care.

Follow My Gaze: Face Race and Sex Influence Gaze-Cued Attention in Infancy.

Using the eye gaze of others to direct one's own attention develops during the first year of life and is thought to be an important skill for learning and social communication. However, it is currently unclear whether infants differentially attend to and encode objects cued by the eye gaze of individuals within familiar groups (e.g., own race, more familiar sex) relative to unfamiliar groups (e.g., other race, less familiar sex). During gaze cueing, but prior to the presentation of objects, 10-month-olds looked longer to the eyes of own-race faces relative to 5-month-olds and relative to the eyes of other-race faces. After gaze cueing, two objects were presented alongside the face and at both ages, infants looked longer to the uncued objects for faces from the more familiar-sex and longer to cued objects for the less familiar-sex faces. Finally, during the test phase, both 5- and 10-month-old infants looked longer to uncued objects relative to cued objects but only when the objects were cued by an own-race and familiar-sex individual. Results demonstrate that infants use face eye gaze differently when the cue comes from someone within a highly experienced group.