Longitudinal patterns of companion animals in families with children during the COVID-19 pandemic: Findings from the Adolescent Brain Cognitive Development (ABCD) Study®.

Pet acquisition purportedly increased during the COVID-19 pandemic with individuals acquiring pets during periods of social isolation. Families with children experienced unique challenges during the COVID-19 pandemic, balancing childcare, remote schooling, and other needs and therefore patterns of pet acquisition and loss may differ from the broader population. The goal of this study was to understand patterns of pet ownership within families with adolescents during the pandemic to help identify areas for improved support and programmatic recommendations. Using self-reported survey data from a sample of 7,590 American adolescents from the Adolescent Brain Cognitive Development (ABCD) Study® COVID Survey, we found no evidence for large-scale changes in pet acquisition or relinquishment during the first year of the pandemic for families with adolescents in the U.S. Future research should explore the effects of pet acquisition and pet loss on families with adolescents and what resources are needed to support pet ownership during stressors such as the COVID-19 pandemic.

The 2nd Alarm Project: Bridging Social Work and Public Health to Improve Mental Wellness in the Fire Service.

Firefighters are trained to respond to a wide range of emergencies, and over the course of responding to emergencies, are exposed to a variety of potentially traumatic events. Repeated exposure to traumatic events may adversely impact firefighters' mental health. Combined with stigma surrounding help-seeking, lack of systematic resources and referral programs, and other barriers to care, firefighters do not routinely receive a continuum of trauma informed, assessment and treatment services from trained professionals. The purpose of this paper is to describe an evidence-informed approach to a reciprocal, collaborative model among social work and public health practice, policy, and research; and to offer a framework for researchers, clinicians, and policy advocates to more effectively achieve goals of preventing and treating trauma exposure in firefighters. This paper provides a comprehensive literature review, as well as describes a case study of a successful public health intervention for mitigating exposure to trauma among a population of firefighters. The significant contribution of mental health issues to the burden of disease among our firefighters is a matter of considerable public health concern. Effective approaches to mitigating behavioral health needs must bridge both mental health disciplines and public health to minimally, include access to evidence-based assessment and treatment, peer support capacity building, widely available mental health education, and leadership development to promote culture change. When considering a model for services with firefighters, reciprocal collaboration among researchers, health care professionals, first responder organizations, families, and other relevant community stakeholders is essential for success.

Companion animals and the relationship between peer victimization and emotion regulation in youth.

Peer victimization can negatively impact emotion regulation in youth and is associated with harmful mental health outcomes. One protective factor against the impacts of peer victimization is a strong attachment to family and positive peer relationships. Given that pets are commonly seen as family members and that youth report turning to their pet for emotional comfort, companion animals could provide an avenue of support for youth experiencing victimization. A geographically diverse sample of 5725 adolescents in the United States from the Adolescent Brain Cognitive Development (ABCD) Study® was used to explore whether the relationship between peer victimization and emotion regulation was moderated by whether a pet lives in the home. Having a pet in the home did not moderate the relationship between peer victimization and emotion regulation; however, mean-level differences were present across types of household pet (i.e., youth with no pets, youth with at least one dog, and youth with non-dog pets). Participants who did not live with a companion animal showed higher levels of both maladaptive emotion regulation (expressive suppression) and adaptive emotion regulation (cognitive reappraisal), suggesting that having a pet might lower overall emotion regulation pathways regardless of adaptive directionality. Relational victimization was a significant predictor of expressive suppression regardless of whether there was a pet in the home, although overt victimization was not a predictor of either kind of emotion regulation. This research demonstrates the complex nature of human-animal relationships and suggests more research is needed to understand the nuanced relationship between pets, peer victimization, and emotion regulation.

Combining high dose therapy, bilateral motor priming, and vagus nerve stimulation to treat the hemiparetic upper limb in chronic stroke survivors: a perspective on enhancing recovery.

Stroke is a leading cause of disability worldwide and upper limb hemiparesis is the most common post-stroke disability. Recent studies suggest that clinically significant motor recovery is possible in chronic stroke survivors with severe impairment of the upper limb. Three promising strategies that have been investigated are (1) high dose rehabilitation therapy (2) bilateral motor priming and (3) vagus nerve stimulation. We propose that the future of effective and efficient upper limb rehabilitation will likely require a combination of these approaches.

Companion animals and profiles of peer social behavior in adolescence.

INTRODUCTION: Relationships with companion animals have been associated with higher levels of prosocial behavior and lower levels of socioemotional difficulties for children and adolescents. Companion animals may be supportive of developing prosocial behavior in youth through practice with positive social interactions and the development of empathy and reciprocity skills. The goal of this study was to use a person-centered approach to investigate if living with a pet (including pet species) is associated with profiles of adolescent peer social behaviors (i.e., prosocial, aggressive), and size of their peer network. METHODS: This study used data from the Adolescent Brain Cognitive Development (ABCD) Study®, a large, nationally representative data set of American adolescents. RESULTS: In a cross-sectional sample of 5218 adolescents, we found that youth clustered into four different distinct profiles of peer social behavior. Female youth living with dogs were less likely to be in the High Aggression profile as compared to youth without pets or youth with other types of pets. However, having a pet was not associated with whether youth were in the profiles characterized by prosocial behaviors or size of peer network. CONCLUSIONS: Overall, future research should explore how gender intersects with companion animal interactions-both in terms of frequency of interactions as well as relationship quality/emotional attachment-as well as examine these relationships over time to assess causality.

Peptides that Mimic RS repeats modulate phase separation of SRSF1, revealing a reliance on combined stacking and electrostatic interactions.

Phase separation plays crucial roles in both sustaining cellular function and perpetuating disease states. Despite extensive studies, our understanding of this process is hindered by low solubility of phase-separating proteins. One example of this is found in SR and SR-related proteins. These proteins are characterized by domains rich in arginine and serine (RS domains), which are essential to alternative splicing and in vivo phase separation. However, they are also responsible for a low solubility that has made these proteins difficult to study for decades. Here, we solubilize the founding member of the SR family, SRSF1, by introducing a peptide mimicking RS repeats as a co-solute. We find that this RS-mimic peptide forms interactions similar to those of the protein's RS domain. Both interact with a combination of surface-exposed aromatic residues and acidic residues on SRSF1's RNA Recognition Motifs (RRMs) through electrostatic and cation-pi interactions. Analysis of RRM domains from human SR proteins indicates that these sites are conserved across the protein family. In addition to opening an avenue to previously unavailable proteins, our work provides insight into how SR proteins phase separate and participate in nuclear speckles.

Omphalitis Hospitalizations at a US Children's Hospital.

OBJECTIVES: To describe demographics, presentation, resource use, and outcomes of patients diagnosed with omphalitis. METHODS: This was a retrospective descriptive study of infants with omphalitis at a children's hospital system between January 2006 and December 2020. Presentation, resource use, and outcomes (omphalitis complications [eg, necrotizing fasciitis], 30-day related cause revisit, and death) were described. RESULTS: Ninety-one patients had a primary or secondary International Classification of Diseases, Ninth or 10th Revision, code for omphalitis. Seventy-eight patients were included in analysis (47 with omphalitis as primary reason for admission). Patients with omphalitis as the primary reason for admission presented with rash (44 of 47, 93.6%), fussiness/irritability (19 of 47, 40.4%), and fever (6 of 47, 12.8%). C-reactive protein was minimally elevated, with a median of 0.4 mg/dL (interquartile range 0.29-0.85).Among all patients, blood cultures were positive in 3 (3 of 78, 3.8%) and most had positive wound cultures (70 of 78, 89.7%), with primarily gram-positive organisms. Median duration of intravenous antibiotics was 5 days (interquartile range 3-7). No patients had complications of omphalitis or death. Five patients (5 of 78, 6.4%) had a 30-day revisit for a related cause. CONCLUSIONS: We found variation in presentation and management of patients with omphalitis at our tertiary children's hospital system. Wound cultures, but not blood tests, were helpful in guiding management in the majority of cases. There were no complications of omphalitis or deaths.

Companion Animals and Adolescent Stress and Adaptive Coping During the COVID-19 Pandemic.

The COVID-19 pandemic has resulted in significant social disruptions for youth caused by lockdowns, school closures, and a lack of in-person social interactions. Companion animals are prevalent in US households and may provide a source of emotional support and motivation for youth to engage in adaptive coping behaviors during social challenges. The goals of this study were to assess if dog owners, non-dog pet owners, and non-pet owners differed in stress levels, positive affect, and use of adaptive coping strategies such as increased time outdoors, regular walking, and healthy behaviors. This study used data collected during the COVID-19 pandemic from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study, a large, nationally representative dataset of American youth. In a cross-sectional sample of 6,069 adolescents, there were significant, but small, relationships between owning a non-dog pet and lower levels of positive affect, and both dog owners and non-dog pet owners reported higher perceived stress compared with non-pet owners. Dog ownership was associated with higher odds of using healthy coping strategies compared with non-pet owners, but this relationship was not significant when controlling for demographic variables. Dog owners reported higher odds of having a walking routine and spending time outdoors compared with non-pet owners. Overall, the results suggest no buffering effect of pet ownership on youth mental wellbeing, but dog ownership is associated with some healthy coping behaviors linked to walking.

Effects of short-term arm immobilization on motor skill acquisition.

Learning to sequence movements is necessary for skillful interaction with the environment. Neuroplasticity, particularly long-term potentiation (LTP), within sensorimotor networks underlies the acquisition of motor skill. Short-term immobilization of the arm, even less than 12 hours, can reduce corticospinal excitability and increase the capacity for LTP-like plasticity within the contralateral primary motor cortex. However, it is still unclear whether short-term immobilization influences motor skill acquisition. The current study aimed to evaluate the effect of short-term arm immobilization on implicit, sequence-specific motor skill acquisition using a modified Serial Reaction Time Task (SRTT). Twenty young, neurotypical adults underwent a single SRTT training session after six hours of immobilization of the non-dominant arm or an equivalent period of no immobilization. Our results demonstrated that participants improved SRTT performance overall after training, but there was no evidence of an effect of immobilization prior to task training on performance improvement. Further, improvements on the SRTT were not sequence-specific. Taken together, motor skill acquisition for sequential, individuated finger movements improved following training but the effect of six hours of immobilization was difficult to discern.

Barriers to Accessing Video-Based Telehealth Appointments at a Community Veterinary Clinic During the COVID-19 Pandemic.

Objective: To assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic, to explore the impact of the pandemic on marginalized communities, and to understand perceptions regarding barriers and incentives of telehealth appointments as a method to increase care access. Sample: 205 active Community Veterinary Medicine Clinic clients at Tufts at Tech Community Veterinary Clinic in Worcester, MA. Procedures: This cross-sectional study used a survey-based method to assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic. The survey measured client perceptions regarding potential barriers and incentives of telehealth appointments. Participants were randomly sampled from a list of active clients and completed the survey either by email or over the phone. The survey was available in both English and Spanish. Clients who completed the questionnaire received credit for a free examination. Results: A total of 205 clients submitted survey responses. Factors affecting access to veterinary care were impacted by the COVID-19 pandemic. Access to reliable internet in the home was reported by 87% (n = 177) of participants. Digital access was correlated with education when controlling for race, income, age, and gender. Education was predictive of comfort with using video-chat (χ2 = 65, df = 24, p ≤ 0.01) and of whether or not clients reported need for assistance for using video-chat (χ2 = 52, df = 18, p ≤ 0.01). Patient education level was significantly predictive of wanting to use telehealth for at least one type of appointment (p ≤ 0.05). Conclusions and Clinical Relevance: The findings indicate that implementing telehealth services at this Community Medicine Clinic is feasible for much of the active clientele and offers a new avenue to provide veterinary care during times of social distancing restrictions and beyond.

Pain, Side Effects, and Abortion Experience Among People Seeking Abortion Care in the Second Trimester.

Background: There is limited documentation about pain and side effects associated with dilation and evacuation (D&E) abortion, yet, pain and side effects are important factors that can affect a client's abortion experience. In 2016, Hope Clinic for Women, an independent abortion clinic in Illinois, altered its cervical preparation protocols before D&E to reduce the total time of the abortion process and improve the client experience. This analysis addresses the gap in data on client experience of abortion in the later second trimester by evaluating pain, side effects, and acceptability by gestational age. Methods: Abortion clients obtaining services at the clinic between March 2017 and June 2018 were eligible to participate if they had viable singleton pregnancies of 16-23.6 weeks' gestation, spoke English, and were at least 18 years old. Eligible participants completed a two-part survey about their abortion experience. Results: We found that respondents seeking abortion care at later gestations in the second trimester were more likely to report pain during their abortions. We did not find any association between side effects and gestational age. Conclusion: Although most respondents were prepared for the pain they experienced, some reported experiencing more pain than they expected, and more effective pain relief was commonly reported as a way to improve the service. More research on patient experiences of later abortion is needed, particularly on experiences of pain and options for pain management.

Bilateral upper extremity motor priming (BUMP) plus task-specific training for severe, chronic upper limb hemiparesis: study protocol for a randomized clinical trial.

BACKGROUND: Various priming techniques to enhance neuroplasticity have been examined in stroke rehabilitation research. Most priming techniques are costly and approved only for research. Here, we describe a priming technique that is cost-effective and has potential to significantly change clinical practice. Bilateral motor priming uses the Exsurgo priming device (Exsurgo Rehabilitation, Auckland, NZ) so that the less affected limb drives the more affected limb in bilateral symmetrical wrist flexion and extension. The aim of this study is to determine the effects of a 5-week protocol of bilateral motor priming in combination with task-specific training on motor impairment of the affected limb, bimanual motor function, and interhemispheric inhibition in moderate to severely impaired people with stroke. METHODS: Seventy-six participants will be randomized to receive either 15, 2-h sessions, 3 times per week for 5 weeks (30 h of intervention) of bilateral motor priming and task-specific training (experimental group) or the same dose of control priming plus the task-specific training protocol. The experimental group performs bilateral symmetrical arm movements via the Exsurgo priming device which allows both wrists to move in rhythmic, symmetrical wrist flexion and extension for 15 min. The goal is one cycle (wrist flexion and wrist extension) per second. The control priming group receives transcutaneous electrical stimulation below sensory threshold for 15 min prior to the same 45 min of task-specific training. Outcome measures are collected at pre-intervention, post-intervention, and follow-up (8 weeks post-intervention). The primary outcome measure is the Fugl-Meyer Test of Upper Extremity Function. The secondary outcome is the Chedoke Arm and Hand Activity Index-Nine, an assessment of bimanual functional tasks. DISCUSSION: To date, there are only 6 studies documenting the efficacy of priming using bilateral movements, 4 of which are pilot or feasibility studies. This is the first large-scale clinical trial of bilateral priming plus task-specific training. We have previously completed a feasibility intervention study of bilateral motor priming plus task-specific training and have considerable experience using this protocol. TRIAL REGISTRATION: ClinicalTrials.gov NCT03517657 . Retrospectively registered on May 7, 2018.

Short-term arm immobilization modulates excitability of inhibitory circuits within, and between, primary motor cortices.

Previous research has suggested that short-term immobilization of the arm may be a low-cost, non-invasive strategy to enhance the capacity for long-term potentiation (LTP)-like plasticity in primary motor cortex (M1). Short-term immobilization reduces corticospinal excitability (CSE) in the contralateral M1, and interhemispheric inhibition (IHI) from ipsi- onto contralateral M1 is increased. However, it is unclear whether reduced CSE and increased IHI are associated with changes in intracortical inhibition, which has been shown to be important for regulating neuroplasticity in M1. The current study used transcranial magnetic stimulation to evaluate the effects of short-term (6 h) arm immobilization on CSE, IHI, and intracortical inhibition measured bilaterally in 43 neurotypical young adults (23 immobilized). We replicated previous findings demonstrating that immobilization decreased CSE in, and increased IHI onto, the immobilized hemisphere, but a significant change in intracortical inhibition was not observed at the group level. Across individuals, decreased CSE was associated with a decreased short-interval intracortical inhibition, an index of GABAA -ergic inhibition, within the immobilized hemisphere only in the immobilization group. Previous research has demonstrated that decreases in GABAA -ergic inhibition are necessary for the induction of LTP-like plasticity in M1; therefore, decreased intracortical inhibition after short-term arm immobilization may provide a novel mechanism to enhance the capacity for LTP-like plasticity within M1 and may be a potential target for strategies to augment plasticity capacity to enhance motor learning in health and disease.

Financial fragility and demographic factors predict pet owners' perceptions of access to veterinary care in the United States.

OBJECTIVE: Access to veterinary care is critical for pet, human, and community health. However, inequities in how easily pet owners can access veterinary care may exacerbate health disparities in vulnerable populations. This research analyzed pet owners' perceptions of access to veterinary care in order to understand how demographic characteristics and financial fragility predict perceived access to veterinary services. SAMPLE: This study utilized survey data (n = 750) from a larger cross-sectional survey of adults in the US conducted by the Tufts University Equity Research Group. PROCEDURES: Survey data were collected in May and June of 2020 from a nationally representative group of pet owners via an online panel. Descriptive statistics, ANOVAs, and a sequential linear regression model were conducted in order to predict perceived access to veterinary care. RESULTS: Results of a sequential linear regression model indicated that race or ethnicity, education, and financial fragility significantly predicted perceived ease of access to veterinary care (F[7,617] = 19.80; P < .001). Additionally, financial fragility was prevalent among most pet owners of almost all income brackets, highlighting the need for more research into the cost burden of veterinary care. CLINICAL RELEVANCE: Future studies should focus on diverse sampling strategies that capture the experiences of minority pet owners in order to further understand issues of access in veterinary medicine.

Assessing equity in health, wealth, and civic engagement: a nationally representative survey, United States, 2020.

BACKGROUND: The principle of equity is fundamental to many current debates about social issues and plays an important role in community and individual health. Traditional research has focused on singular dimensions of equity (e.g., wealth), and often lacks a comprehensive perspective. The goal of this study was to assess relationships among three domains of equity, health, wealth, and civic engagement, in a nationally representative sample of U.S. residents. METHODS: We developed a conceptual framework to guide our inquiry of equity across health, wealth, and civic engagement constructs to generate a broad but nuanced understanding of equity. Through Ipsos' KnowledgePanel service, we conducted a cross-sectional, online survey between May 29-June 20, 2020 designed to be representative of the adult U.S. POPULATION: Based on our conceptual framework, we assessed the population-weighted prevalence of health outcomes and behaviors, as well as measures of wealth and civic engagement. We linked individual-level data with population-level environmental and social context variables. Using structural equation modeling, we developed latent constructs for wealth and civic engagement, to assess associations with a measured health variable. RESULTS: We found that the distribution of sociodemographic, health, and wealth measures in our sample (n = 1267) were comparable to those from other national surveys. Our quantitative illustration of the relationships among the domains of health, wealth, and civic engagement provided support for the interrelationships of constructs within our conceptual model. Latent constructs for wealth and civic engagement were significantly correlated (p = 0.013), and both constructs were used to predict self-reported health. Beta coefficients for all indicators of health, wealth, and civic engagement had the expected direction (positive or negative associations). CONCLUSION: Through development and assessment of our comprehensive equity framework, we found significant associations among key equity domains. Our conceptual framework and results can serve as a guide for future equity research, encouraging a more thorough assessment of equity.

Barriers to Healthy Eating and Physical Activity in the Mississippi Delta.

Rural regions in the United States are home to approximately 15-20% of the country's population. These regions are often characterized by low access to medical care and high rates of disease and death. The literature has detailed the heterogeneous nature of rural health disparities, calling for research detailing regional factors that influence individual-level risk factors such as diet and physical activity. Approximately 54% of Mississippi residents live in rural areas. The Mississippi Delta population is largely characterized by high obesity rates, poor diet, and low levels of physical activity. This study presents detailed observations of the community-level barriers and facilitators to healthy eating and physical activity within Mississippi Delta communities, contextualizing the findings of a survey of 352 individuals across 25 communities to provide implications and direction for future activities aimed at reducing obesity in the Mississippi Delta. Study participants reported a high prevalence of overweight (22.9%) and obese (62.1%) body mass index classifications. Chi-square analyses revealed significant relationships between body mass index, age, and health conditions. Community food and physical activity environments and rural characteristics were largely implicated as barriers to fruit and vegetable consumption and physical activity. Next steps involve using qualitative research techniques to guide the development of programmatic strategies for reducing obesity through diet and physical activity in these communities and other rural regions in the United States.

Demographic and contextual factors as moderators of the relationship between pet ownership and health.

OBJECTIVE: Companion animals are an important feature of the family system, and human-animal interaction is increasingly being recognized as an important social determinant of health. However, there is a need for more nuanced assessment of not only who owns pets, but how pet ownership is related to various health outcomes, and which sociodemographic and contextual factors moderate these associations. DESIGN: Secondary analysis of cross-sectional data collected from an online, probability-based panel to generate a nationally representative sample of adults in the United States (n = 1267). Data were analyzed using hierarchical and logistic regression models. RESULTS: Results suggested that pet owners are systematically different from non-pet owners on a number of key demographic and contextual characteristics, and these differences vary somewhat when looking at dog owners and cat owners. When controlling for individual and family-level covariates, pet ownership was not associated with overall health status or Body Mass Index, but dog ownership was associated with higher levels of physical activity. Pet ownership was associated with higher odds of having an anxiety disorder with gender moderating this relationship, but this association was not present for dog or cat owners, suggesting this relationship is limited to other types of pets. Higher odds of depression were associated with pet ownership (for both dog and cat owners), with employment status significantly moderating the relationship between dog ownership status and depression. CONCLUSIONS: These findings suggest that pet ownership is a complex and context specific phenomenon. Future research should carefully consider and control for sociodemographic predictors and use measurement and analysis approaches sensitive to the variations in human-animal relationships to fully understand how pets contribute to individual and family health and well-being.

Wearable myoelectric interface enables high-dose, home-based training in severely impaired chronic stroke survivors.

BACKGROUND: High-intensity occupational therapy can improve arm function after stroke, but many people lack access to such therapy. Home-based therapies could address this need, but they don't typically address abnormal muscle co-activation, an important aspect of arm impairment. An earlier study using lab-based, myoelectric computer interface game training enabled chronic stroke survivors to reduce abnormal co-activation and improve arm function. Here, we assess feasibility of doing this training at home using a novel, wearable, myoelectric interface for neurorehabilitation training (MINT) paradigm. OBJECTIVE: Assess tolerability and feasibility of home-based, high-dose MINT therapy in severely impaired chronic stroke survivors. METHODS: Twenty-three participants were instructed to train with the MINT and game for 90 min/day, 36 days over 6 weeks. We assessed feasibility using amount of time trained and game performance. We assessed tolerability (enjoyment and effort) using a customized version of the Intrinsic Motivation Inventory at the conclusion of training. RESULTS: Participants displayed high adherence to near-daily therapy at home (mean of 82 min/day of training; 96% trained at least 60 min/day) and enjoyed the therapy. Training performance improved and co-activation decreased with training. Although a substantial number of participants stopped training, most dropouts were due to reasons unrelated to the training paradigm itself. INTERPRETATION: Home-based therapy with MINT is feasible and tolerable in severely impaired stroke survivors. This affordable, enjoyable, and mobile health paradigm has potential to improve recovery from stroke in a variety of settings. Clinicaltrials.gov: NCT03401762.

Assessing Service-Learning in Community-Based Veterinary Medicine as a Pedagogical Approach to Promoting Student Confidence in Addressing Access to Veterinary Care.

Community-based veterinary medicine is a growing field, and veterinary students need to be able to work with clients facing complex barriers to receiving veterinary care for their pet. Many veterinary clients experience challenges accessing veterinary care due to financial limitations, transportation access, language comprehension, the ability to comply to the care plan (e.g., disabilities, physical, or mental health challenges, substance use), the ability to come to the clinic during the hours that it is open, and the ability to communicate outside of the appointment. The goal of this study was to assess student confidence levels working in accessible care before and after participating in a service-learning-based community veterinary rotation. Results show significantly higher student confidence levels for every barrier after completing the Tufts at Tech (TAT) Clinical Rotation at Cummings Veterinary School of Medicine. Additionally, 86% (n = 85) of students strongly agreed or agreed that TAT affected their thoughts about community medicine, and 77% (n = 76) strongly agreed or agreed that the rotation affected their feelings about underserved clients. Service-learning rotations in community-based veterinary medicine could be one pedagogical approach in training veterinary students to work with a diverse clientele.