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BACKGROUND: Pyrotechnic displays often lead to significant increases in poor air quality. The widespread environmental fate-involving air, water, and spatial-temporal analyses-of fireworks-produced pollutants has seldom been investigated. OBJECTIVE: This study examined the environmental fate of pollutants from the largest fireworks event in the U.S.: Macy's Fourth of July Fireworks show in New York City (NYC). METHODS: Real-time PM2.5 and gravimetric PM2.5 and PM10 were collected at locations along the East River of NYC. Airborne particles were assayed for trace elements (X-ray fluorescence) and organic and elemental carbon (OC/EC). River water samples were evaluated by ICP-MS for heavy-metal water contamination. Spatial-temporal analyses were created using PM2.5 concentrations reported by both EPA and PurpleAir monitoring networks for NYC and 5 other major metropolitan areas. RESULTS: The fireworks event resulted in large increases in PM2.5 mass concentrations at the river-adjacent sampling locations. While background control PM2.5 was 10-15 µg/m3, peak real-time PM2.5 levels exceeded 3000 µg/m3 at one site and 1000 µg/m3 at two other locations. The integrated gravimetric PM2.5 and PM10 concentrations during the fireworks event ranged from 162 to 240 µg/m3 and 252 to 589 µg/m3, respectively. Zn, Pb, Sb, and Cu more than doubled in river water samples taken after the event, while S, K, Ba, Cu, Mg, Fe, Sr, Ti, and Zn increased in airborne PM2.5 from the fireworks. Data from hyperlocal monitoring networks for NYC and other metropolitan areas yielded similar, but generally smaller, increases in PM2.5 levels. IMPACT: Fireworks shows have been associated with environmental contamination. This comprehensive analysis considers the fate of pollutants from the largest annual U.S. pyrotechnic show through air, water, and hyperlocal temporal characterization.
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The current study examines the efficacy of an 8-week pretend play intervention targeting social-cognitive abilities in children with Prader-Willi syndrome (PWS), ages 6-9. PWS is a rare disorder associated with various social, emotional, and cognitive challenges linked to pretend play impairments, and for which interventions are sparse. Nineteen children were quasi-randomized to receive the intervention or be part of a waitlist control group. Participants who received the intervention (n = 10) demonstrated significant improvements in various components of pretend play, most notably in organization of play, which may generalize to broader social-cognitive gains. These findings provide evidence of the intervention's efficacy in enhancing pretend play skills and related social-cognitive abilities during this critical period of development for children with PWS.
Subject(s)
Prader-Willi Syndrome , Humans , Prader-Willi Syndrome/therapy , Male , Female , Child , Play and Playthings , Play Therapy/methods , Social Cognition , Social SkillsABSTRACT
It is important to understand the impact of consumer chemical exposure and fecundity, a couple's measure of probability of successful conception, given approximately 15% of couples experience infertility. Prior research has generally found null associations between bisphenol and phthalate exposure and fecundability, measured via time to pregnancy (TTP). However, this research has not been updated with current chemical exposures and have often lacked diversity in their study populations. We evaluated the associations between common bisphenol and phthalate chemical exposure groups and TTP as well as subfecundity (TTP>12 months) in the New York University Children's Health Study, a diverse pregnancy cohort from 2016 onward. Using first-trimester spot-urine samples to measure chemical exposure and self-reported TTP from first-trimester questionnaires, we observed a significant adverse association between total bisphenol exposure and certain phthalate groups on TTP and odds of subfecundity. Furthermore, in a mixtures analysis to explore the joint effects of the chemical groups on the outcomes, we found evidence of a potential interaction between total bisphenol exposure and low-molecular weight phthalates on TTP. Future research should continue to update our knowledge regarding the complex and potentially interacting effects of these chemicals on reproductive health.
Subject(s)
Benzhydryl Compounds , Environmental Pollutants , Phenols , Phthalic Acids , Female , Pregnancy , New York City , Humans , Adult , Cohort Studies , Time-to-Pregnancy/drug effects , Maternal Exposure/statistics & numerical data , Young Adult , Environmental Exposure/statistics & numerical data , Infertility/chemically inducedABSTRACT
PROBLEM: Due to generational exposure to the Black Lives Matter movement, other anti-bias social movements, and diverse peer advocacy groups, health professions students are often more knowledgeable than their teachers about ways in which systemic racism and bias have led to scientific inaccuracies that contribute to health inequities. However, traditional hierarchies and concerns about retaliation may limit educational communities from benefiting maximally from students' contributions. APPROACH: In spring 2021, faculty and students at the Vagelos College of Physicians and Surgeons, Columbia University, designed a structural innovation to engage faculty and students in partnership toward decreasing bias in medical education. This article discusses development and implementation of a Statement of Partnership and Humility (SPH) disclosure slide on which faculty acknowledge consideration of potential teaching biases and invite student feedback. OUTCOMES: The initial primary goal of the SPH slide was to increase faculty awareness and engagement in anti-bias topics; however, the unexpected dividends of decreasing faculty anxiety about receiving student feedback and promoting student engagement have proven equally powerful in promoting a healthy, inclusive learning environment. NEXT STEPS: Next steps include gathering qualitative and quantitative data to elicit both faculty and student perspectives on the use of the SPH slide, particularly with regard to psychological safety and openness to feedback.
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COVID-19 , Child Care , Adult , Child , Humans , Pandemics , Child Day Care Centers , Child HealthABSTRACT
ABSTRACT: Sickle cell disease (SCD) is a genetic disorder affecting 100 000 people with an estimated annual medical cost of $3 billion in the United States; however, the economic impact on patients is not well described. We aimed to examine the indirect economic burden and test the hypothesis that socioeconomic status and greater social vulnerability risks are associated with increased absenteeism and employment loss. We surveyed adults and caregivers of children with SCD at 5 US centers from 2014 to 2021. Logistic regression models were used to examine the associations of employment loss and missed days of work with demographics and social determinants. Indirect costs were estimated by multiplying the self-reported missed days of work and job loss by 2022 average wages by the state of the participating institution. Of the 244 participants, 10.3% reported employment loss in the last 5 years, and 17.5% reported missing 10 or more days of work. Adults had 3 times more employment loss compared with caregivers of children with SCD (OR, 3.18; 95% CI, 1.12-9.01) but fewer missed days of work (OR, 0.24; 95% CI, 0.11-0.0.51). Participants who did not live with a partner reported increased employment loss (OR, 4.70; 95% CI, 1.04-21.17) and more missed days of work (OR, 4.58; 95% CI, 1.04-20.15). The estimated annual indirect economic burden was $2 266 873 ($9290 per participant). Adults with SCD and caregivers of children with SCD commonly report employment loss and missed days of work as important risk factors. The high indirect economic burden suggests that future economic evaluations of SCD should include SCD-related indirect economic burden.
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Absenteeism , Anemia, Sickle Cell , Adult , Child , Humans , United States , Caregivers , Cost of Illness , Employment , Anemia, Sickle Cell/epidemiologyABSTRACT
Progress in maternal child health has been hampered by poor rates of outpatient follow up for postpartum individuals. Primary care after delivery can effectively detect and treat several pregnancy-related complications and comorbidities, but postpartum linkage to primary care remains low. In this manuscript, we share the experience of implementing a novel mother-infant dyad program, the Multimodal Maternal Infant Perinatal Outpatient Delivery System (MOMI PODS), to improve primary care linkage and community resource access postpartum via integration into pediatric care structures. With a focus on providing care for people who are publicly insured, we designed a program to mitigate maternal morbidity risk factors in postpartum individuals with chronic disease or pregnancy complications. We discuss the systematic process of designing, executing, and evaluating a collaborative clinical program with involvement of internal medicine/pediatric, family medicine, and obstetric clinicians via establishing stakeholders, identifying best practices, drawing from the evidence base, designing training and promotional materials, training partners and providers, and evaluating clinic enrollment. We share the challenges encountered such as in achieving sufficient provider capacity, consistent provision of care, scheduling, and data tracking, as well as mitigation strategies to overcome these barriers. Overall, MOMI PODS is an innovative approach that integrates outpatient postpartum care into traditional pediatric structures to increase access, showing significant promise to improve healthcare utilization and promote postpartum health.
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LAY ABSTRACT: In this article, we outline a stakeholder-driven research agenda to guide future early intervention research for children with autism. Our research team collaborated with autism service providers, parents of individuals with autism, and autistic people to create this research agenda by (1) conducting workshops with community members and (2) distributing a survey to a larger number of community members around the country. The finalized research agenda includes (1) Guiding Principles for current and future research, (2) Research Priorities focused on early intervention for individuals with autism, and (3) Systems Implications to consider in future clinical, research, and policy efforts for early intervention. The full version of the research agenda is available in Supplemental Material. This article lists the main points of the research agenda and discusses unique themes highlighted by the community members. One main conclusion is that researchers need to include community members in decision-making and consultant positions throughout the research process to best meet the needs of the broader autism community. We have created a researcher workbook which we hope may facilitate these community consultation efforts. This workbook is available in Supplemental Material.
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BACKGROUND: The number of new HIV diagnoses in the United States continues to slowly decline; yet, transgender women and men who have sex with men remain disproportionately affected. Key to improving the quality of prevention services are providers who are comfortable broaching the subjects of sexual health and HIV prevention with people across the spectrum of gender identities and sexual orientations. Preservice training is a critical point to establish HIV prevention and sexual health education practices before providers' practice habits are established. OBJECTIVE: The study aimed to develop participative web-based educational modules and test their impact on HIV prevention knowledge and awareness in future providers. METHODS: Sexual health providers at an academic hospital, research clinicians, community engagement professionals, and New York City community members were consulted to develop 7 web-based educational modules, which were then piloted among medical students. We assessed knowledge of HIV and sexually transmitted infection prevention and comfort assessing the prevention needs of various patients via web-based questionnaires administered before and after our educational intervention. We conducted exploratory factor analysis of the items in the questionnaire. RESULTS: Pre- and postmodule surveys were completed by 125 students and 89 students, respectively, from all 4 years of training. Before the intervention, the majority of students had heard of HIV pre-exposure prophylaxis (122/123, 99.2%) and postexposure prophylaxis (114/123, 92.7%). Before the training, 30.9% (38/123) of the students agreed that they could confidently identify a patient who is a candidate for pre-exposure prophylaxis or postexposure prophylaxis; this increased to 91% (81/89) after the intervention. CONCLUSIONS: Our findings highlight a need for increased HIV and sexually transmitted infection prevention training in medical school curricula to enable future providers to identify and care for diverse at-risk populations. Participative web-based modules offer an effective way to teach these concepts.
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Determining the factors that influence implementation of school-based wellbeing and health programs is essential for achieving desired program effects. Using a convergent mixed-methods, multiple informant design, this study considered factors that influence implementation of health programs for ninth grade students and in what ways implementation is differentially perceived by multiple informants (i.e., participants, instructors, and independent observers). Two types of programs-mindfulness and health education-were implemented with ninth graders (N = 70) in three schools situated in low-resourced urban neighborhoods. Study outcomes were derived from four data sources: (1) focus group participants (N = 45); (2) program instructor fidelity ratings; (3) independent observer fidelity ratings and notes; and (4) instructor open-ended session responses. Using thematic and mixed methods integration analyses, we identified themes related to implementation promoting or challenging factors. Theme names differed when data sources were separately analyzed by informant. Mixed methods integration analysis indicated that four themes were common across all informant groups: (1) competent, attentive, and engaging instructors are essential; (2) programs should involve interactive components (e.g., physical activities, applied learning opportunities); (3) adequate time for program delivery is key for student exposure and engagement; and (4) students' availability and preferences should guide program scheduling. A fifth theme, unique to instructor and observer perspectives, was that program implementation was negatively impacted by distractions from multiple sources, including instructors, students, and settings. Recommendations from students, instructors, and observers for implementation optimization are discussed.
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Adolescent Health , Schools , Adolescent , Humans , Students , LearningABSTRACT
School-based assessments of students' self-reported social-emotional competencies (SECs) are an essential part of social and emotional learning (SEL) initiatives. Few studies, however, have investigated whether such assessments align with the frameworks that inform SEL practices, especially for diverse populations. In the present study we investigated the dimensional structure of the 40-item Washoe County School District Social-Emotional Competency Assessment (WCSD-SECA), which was designed to measure the five domains of SECs defined by the widely used Collaborative for Academic Social and Emotional Learning framework (CASEL 5). Findings showed that a subset of 21 items fit a 3-factor solution that reflected Intrapersonal, Interpersonal, and Emotion-Focused competencies, a structure consistent with previous theorizing of broad SEC constructs. This 3-dimensional structure was partially invariant, with differences especially evident in item thresholds across subpopulations (defined by the intersection of grade level, gender, and race/ethnicity). Accounting for differences in item thresholds increased mean differences among subpopulations in the three domains. Across subpopulations, Intrapersonal scores were positively associated with students' standardized test scores and GPAs, and negatively related to the number of days they were absent from school, in multilevel models that adjusted for school-level clustering and included all three SEC scores and student demographic controls. Interpersonal scores were associated with fewer suspensions. Interpersonal and Emotion-Focused scores demonstrated unexpectedly negative associations with some outcomes in these models. Findings contribute to an emerging body of research that aims to deepen understandings of the content and structure of students' SECs as well as the factors that contribute to growth in these competencies.
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Social Learning , Social Skills , Students , Emotions , Female , Hispanic or Latino , Humans , Interpersonal Relations , Male , Schools , Social Adjustment , Students/psychology , White PeopleABSTRACT
In the context of rising inequality and eroding safety nets for marginalized communities, research is needed to demonstrate the ways in which settings can facilitate community, agency, and capabilities for low-income women. The purpose of this study is to examine if and how an organizational setting designed to support homeless, low-income, and other marginalized women can facilitate empowering changes and increased wellbeing among the women who participate. A thematic analysis of interviews conducted with 22 participants who attend a women's day center identified three ways in which the organizational setting impacted women's lived experiences: (a) increasing a sense of agency through acceptance, active and participatory roles, and ownership over the physical environment, (b) promoting a sense of community through rituals of care and attentiveness, alleviated social isolation, and mutual relationships, and (c) improving life circumstances by offering a safe environment, access to basic resources such as housing, and support for health and wellbeing. Findings highlight the setting features and psychosocial processes that foster flourishing and resist patterns of exclusion and devaluation imposed on marginalized women by dominant neoliberal values, institutions, and policies.
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Ill-Housed Persons , Female , Housing , Humans , Population GroupsABSTRACT
This cross-sectional study sought to determine whether HIV-related interpersonal stigma was associated with the presence of sexual compulsivity (SC) in a national online sample of 936 men who have sex with men (MSM) living with HIV who reported recent suboptimal adherence to their antiretroviral therapy (ART) or virologic non-suppression. A modest association was found between perceptions of HIV-related interpersonal stigma and SC that was partially mediated by current mental health symptoms. White MSM were significantly more likely than Black MSM to report SC or HIV-related interpersonal stigma. Findings signal the need for therapeutic interventions that include behavioral and/or pharmacologic therapy to address overlapping intervention targets, including mental health, substance use, and sexual health. Future research should assess temporality of HIV-related interpersonal stigma and SC, as well as racial differences in relation to these constructs.
Subject(s)
HIV Infections , Sexual and Gender Minorities , Cross-Sectional Studies , HIV Infections/drug therapy , HIV Infections/psychology , Homosexuality, Male/psychology , Humans , Male , Mental Health , Social StigmaABSTRACT
Preschool classrooms are rich with emotions, from a teacher's enthusiastic praise for a child's work to a child's anger at another child who is using wanted materials. A wide variety of teaching behaviors may help children learn about their own and others' emotional states as well as regulation strategies to manage their emotions. In the present study, we relate teachers' emotion-focused teaching behaviors (including how teachers model emotions, instruct about emotions, and respond to children's emotions) using a new observational tool, the EMOtion TEaching Rating Scale (EMOTERS). In addition, social and learning behaviors with teachers, peers, and tasks were observed for 77 children in 18 classrooms. We used the EMOTERS to predict children's social and learning behaviors within time (fall, spring) and over time (from fall to spring). Results affirm that emotion-focused teaching practices (modeling, responding, instructing) vary across classrooms. We also found instances of these practices being related-within time and over time-to children's social interactions with teachers and peers, and engagement in tasks. Most significant associations were found with emotion instructing, despite its relatively infrequent use in classrooms. Findings offer valuable initial evidence about EMOTERS as a tool for measuring emotion-focused teaching behaviors and potentially as a tool for supporting professional development. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Emotions , Schools , Child , Child, Preschool , Humans , Child Behavior/psychology , Learning , Social AdjustmentABSTRACT
Physical appearance during the transition into adolescence matters for youths' socioemotional development. This study explored these implications by adding visual data to the NICHD Study of Early Child Care and Youth Development (n = 1,049) to test how others' ratings of youths' looks (1 = very unattractive to 5 = very attractive) at the beginning (grade 3) and end (grade 9) of this transition shaped their emotional well-being, popularity/likability, and dating/sexual behavior. Results revealed recency effects of grade 9 looks on popularity/likability and dating/sexual behaviors and a lingering amplification effect of grade 3 looks on popularity/likability at the start of high school. Few associations were evident for emotional well-being. Thus, physical appearance offers an important lens for studying adolescent development.
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Adolescent Behavior , Sexual Behavior , Adolescent , Adolescent Behavior/psychology , Child , Humans , SchoolsABSTRACT
ABSTRACT: Faculty with a career focus on education in the health professions often have difficulty representing their academic accomplishments for due consideration in promotion decisions at their respective institutions. This problem occurs because the traditional curriculum vitae (CV) format which is most often used tends to focus on peer-reviewed accomplishments easily presented in lists, such as grants and publications. In some institutions, an educator portfolio is required in place of or in addition to the CV. However, creating or reviewing such a narrative-oriented document takes large amounts of time-time that most faculty or reviewers do not have. Having to use an educator portfolio also calls out the educator as different from the traditional research faculty member. To address this problem, we propose the solution of an Enhanced CV. The Enhanced CV includes much of what is presented in an educator portfolio but in a format closer to the traditional CV. Unlike a traditional CV, the Enhanced CV includes categories inclusive of educational contributions (eg, teaching, mentoring, and course leadership) and includes brief descriptions and/or impact statements to clarify the significance of the listed accomplishments. The Enhanced CV has been adopted at two very different institutions, where evidence is accumulating regarding the viability of the Enhanced CV as a solution to educators' problem of presenting their accomplishments for promotions. The lessons learned from these institutions illustrate how the Enhanced CV can increase the ability of educators to present their accomplishments and advance in rank in their academic careers.
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Faculty , Leadership , Humans , Faculty, Medical , Health Occupations , MentorsABSTRACT
OBJECTIVE: During the COVID-19 pandemic, limitations on in-person medical school clerkships created a deficit in urologic learning opportunities. We sought to develop and evaluate a blended curriculum of interactive online modules with small-group discussion to enhance the educational experience for medical students in urology. MATERIALS AND METHODS: We created a curriculum of four online case-based urology modules. Between July and October 2020, 14 fourth-year medical students completed the modules. Students answered questions on a discussion board and engaged in asynchronous dialogue with 16 physicians, in addition to a weekly live review session. Students and physicians completed anonymous surveys to assess satisfaction and perceived learning outcomes, with questions scored on a 5-point Likert scale. RESULTS: Thirteen students (93% response rate) and 12 physicians (75% response rate) completed the survey. Overall, 12/13 students and 11/12 physicians "strongly agree" or "somewhat agree" that the modules improved the rotation. Students and physicians perceived that the modules were effective for learning/teaching foundational knowledge (average ratings 4.8 and 4.5, respectively) and facilitating performance assessment (4.4 and 4.0). Students reported high learning scores across multiple Accreditation Council for Graduate Medical Education core competencies, and 12/13 students found the modules fun/engaging. The majority of students (12/13) and physicians (10/12) felt that the online modules should be incorporated into future urology electives. CONCLUSIONS: A blended learning curriculum utilizing online modules is an effective tool for enhancing urologic education, improving perceived learning outcomes and facilitating performance assessment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01427-3.
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About 90% of grapefruit in Florida are affected by Huanglongbing (HLB). HLB negatively affects the organoleptic properties of grapefruit juice because affected trees overproduce bitter secondary-metabolites, mostly naringin. The objective of this research was to remove naringin from HLB-affected grapefruit juice using microporous-adsorbents and to investigate how debittering affected narirutin, limonoids, bergamottin, and consumer acceptability. The adsorption kinetics of naringin on seven adsorbent resins obeyed pseudo-second order. PAD550 and PAD600 showed better static adsorption/desorption. Adsorption-isotherms on these resins were better fitted on Temkin-Pyzhev-model. On a fixed-bed-column packed with PAD550 resin, a slower loading rate increased its breakthrough volume before naringin in effluent reached its taste-threshold. In addition to naringin being reduced to below its taste-threshold, debittering significantly decreased the content of limonin, nomilin, and bergamottin. A consumer taste panel rated debittered and half-debittered juices higher for overall acceptability than the untreated. The half-debittered juice was ranked the most preferred while untreated was the least preferred.
Subject(s)
Citrus paradisi/chemistry , Citrus paradisi/microbiology , Fruit and Vegetable Juices/analysis , Furocoumarins/analysis , Plant Diseases/microbiology , Resins, Synthetic/chemistry , Taste , PorosityABSTRACT
This case report highlights an unusual presentation of herpes zoster mandibularis in an immunocompromised patient with previous head and neck surgery, with relative sparing of the cheek. It demonstrates the importance of critically considering past medical and surgical history in clinical diagnosis and management of the disease.