Examining the relationship between civic engagement and mental health in young adults: a systematic review of the literature.

Researchers have examined civic engagement as a health promotion tool among older adults and adolescents, yet less is known about its mental health implications for young adults. This systematic review identified 53 articles on civic engagement and well-being in young adults. Five key themes emerged: (1) varying associations between type of civic engagement and well-being, (2) duration and frequency of civic behaviors, (3) directionality in the civic-to-well-being pathway, (4) mediation and moderation factors affecting the civic-to-well-being pathway, and (5) civic engagement as a tool for coping with adversity or systemic oppression. Civic engagement demonstrates a heterogeneous relationship to well-being; future research should focus on the explanatory pathways for positive, negative, and null correlations particularly among historically marginalized young adults.

Cytomegalovirus surveillance after antiviral prophylaxis in CMV mismatched transplant patients: Does recurrent cytomegalovirus DNAemia impact patient survival?

BACKGROUND: Cytomegalovirus (CMV) mismatched, donor IgG-positive/recipient IgG-negative, solid organ transplant recipients (SOTRs) are at high risk of CMV invasive disease. Post-prophylaxis disease is an issue in this population. Some programs employ surveillance after prophylaxis (SAP) to limit the incidence of post-prophylaxis disease. METHODS: This was a single-center retrospective cohort study that included all CMV mismatched SOTRs from 2003 to 2017. Patients underwent SAP with weekly CMV plasma viral load for 12 weeks. The subjects were classified into three post-prophylaxis DNAemia patterns: no DNAemia, one episode of DNAemia, and multiple episodes of DNAemia. We calculated the cumulative incidence of each DNAemia pattern. We also determined 5-year mortality based on DNAemia pattern stratified by organ transplant type. RESULTS: Post-prophylaxis recurrent DNAemia occurred in 63% of lung recipients and 32% of non-lung recipients (p =  .003). Tissue invasive CMV disease was diagnosed in 3% of the population and CMV syndrome was diagnosed in 33%. Recurrent DNAemia was not associated with 5-year mortality. CONCLUSION: In this cohort, undergoing SAP tissue invasive disease was uncommon and CMV DNAemia recurrence did not have an impact on long-term mortality.

Increasing the impact of vertebrate scientific collections through 3D imaging: The openVertebrate (oVert) Thematic Collections Network.

The impact of preserved museum specimens is transforming and increasing by three-dimensional (3D) imaging that creates high-fidelity online digital specimens. Through examples from the openVertebrate (oVert) Thematic Collections Network, we describe how we created a digitization community dedicated to the shared vision of making 3D data of specimens available and the impact of these data on a broad audience of scientists, students, teachers, artists, and more. High-fidelity digital 3D models allow people from multiple communities to simultaneously access and use scientific specimens. Based on our multiyear, multi-institution project, we identify significant technological and social hurdles that remain for fully realizing the potential impact of digital 3D specimens.

Development of transtheoretical model measures for assessing decisional balance and temptation to vape.

Introduction: Vaping is common among young adults in the United States. The Transtheoretical Model (TTM) has demonstrated success in smoking cessation efforts; however, it has not been comprehensively applied to vaping cessation, and core TTM vaping measures have not been developed. Method: A cross-sectional survey including measures of stage of change (SOC), temptation to vape, and decisional balance (DCBL) was disseminated (n = 459). Items were adapted from TTM smoking scales. The sample was split for exploratory and confirmatory factor analyses (EFA/CFA). Analyses of variance assessed relationships between constructs and SOC. Results: EFA/CFA resulted in one Temptation scale (CFI = .95; α = .87) and two DCBL scales (CFI = .91; Pros α = .72; Cons α = .72). Temptation to vape and Pros of vaping decreased significantly across SOC, while Cons increased significantly. Conclusions: TTM vaping measures for two key TTM constructs were developed utilizing a college sample. Results suggest that the developed measures map well onto the TTM framework.

Transtheoretical Model for Exercise: Measure Redevelopment and Assessing the Role of Barriers in a Diverse Population.

PURPOSE: To redevelop and improve Transtheoretical Model (TTM) exercise measures for Black and Hispanic/Latinx adults. The redeveloped scales will address barriers to exercise potentially relevant to populations of color in the United States (US). DESIGN: Cross-sectional, split-half measure development. SETTING: Online survey in the US. SUBJECTS: 450 Black and/or Hispanic/Latinx adults. MEASURES: Demographics, exercise engagement (IPAQ-SF), stage of change (SOC), decisional balance (DCBL), self-efficacy (SE), and barriers to exercise. ANALYSIS: Split-half exploratory (EFA) and confirmatory factor analyses (CFA) were executed to establish measurement structure and fit, followed by multivariate analyses to assess constructs by SOC. RESULTS: EFA/CFA for DCBL revealed three factors (α = .85, .70, .75) which represented Pros of exercise, Cons of exercise related to time and safety, and Cons of exercise related to physical or emotional discomfort. Model fit was adequate (CFI = .89). For SE, two factors (α = .85, .77) resulted with good model fit (CFI = .91). These factors reflected self-efficacy to exercise when confronted with generally challenging situations, and self-efficacy to exercise when specifically experiencing affective difficulties, such as depression or anxiety. Lastly, a novel Barriers measure resulted in three factors (α = .82, .77, .76), representing barriers encountered due to family responsibilities, work obligations, and health challenges, with good model fit (CFI = .95). Shifts in the core TTM constructs by SOC largely mapped onto the theoretical trends expected under the TTM. CONCLUSION: This study produced systematically developed TTM exercise measures for Black and Hispanic/Latinx adults in the US that address and incorporate important barriers to exercise. This research represents an important step forward in broadening the inclusion of diverse populations to TTM measure development processes and may lead to a better understanding of relevant factors impeding exercise engagement in the US.

Development and Validation of a Measure of Self-Efficacy for Advance Care Planning.

Medical care received at end-of-life is often not aligned with individuals' values and care preferences. Much can get in the way of an individual communicating and documenting their preferences to care providers and close others, even if it is a goal to do so. The objective of this work was to develop a measure of Advance Care Planning Self-Efficacy (ACP SE) focused on three important behaviors: completing a living will, documenting a healthcare agent, and discussing quality versus quantity of life issues. Measure development was framed by the Transtheoretical Model (TTM) of behavior change. Following the completion of focus groups and formative qualitative work, an independent sample (N = 310, adults aged 50+) was randomly split into two halves for exploratory and confirmatory factor analyses (EFA/CFA). Multivariate analyses examined relationships between ACP SE and other TTM constructs. Results of the CFA demonstrated excellent internal consistency (α = .95) and good model fit (CFI = .89, RMSEA = .13). Self-efficacy was framed by the TTM as situation-specific confidence. Through the measure development process, it was found that confidence to do ACP was impacted by various situational and attitudinal variables. ACP Self-Efficacy was found to differ significantly by Stage of Change. This study produced a reliable and valid measure of situation-specific confidence for ACP grounded within the TTM that could enhance future interventions aimed at increasing participation in ACP.

Universal behavior in fragmenting brittle, isotropic solids across material properties.

A bonded particle model is used to explore how variations in the material properties of brittle, isotropic solids affect critical behavior in fragmentation. To control material properties, a model is proposed which includes breakable two- and three-body particle interactions to calibrate elastic moduli and mode I and mode II fracture toughnesses. In the quasistatic limit, fragmentation leads to a power-law distribution of grain sizes which is truncated at a maximum grain mass that grows as a nontrivial power of system size. In the high-rate limit, truncation occurs at a mass that decreases as a power of increasing rate. A scaling description is used to characterize this behavior by collapsing the mean-square grain mass across rates and system sizes. Consistent scaling persists across all material properties studied, although there are differences in the evolution of grain size distributions with strain as the initial number of grains at fracture and their subsequent rate of production depend on Poisson's ratio. This evolving granular structure is found to induce a unique rheology where the ratio of the shear stress to pressure, an internal friction coefficient, decays approximately as the logarithm of increasing strain rate. The stress ratio also decreases at all rates with increasing strain as fragmentation progresses and depends on elastic properties of the solid.

Using the theory of planned behavior to assess willingness and attitudes towards COVID-19 vaccination among a predominantly white U.S. college sample.

Objective: Through the lens of behavioral models such as the Theory of Planned Behavior (TPB) and the Health Belief Model, the present study (1) investigated U.S. university students' willingness to receive the COVID-19 vaccine and (2) examined predictors (e.g. demographics, past vaccine experience, TPB constructs) of vaccine willingness. Method: University students (n = 170) completed a survey assessing demographics, health behaviors, attitudes, perceived severity/susceptibility, norms, and vaccine intentions related to the COVID-19 pandemic. Data were collected from April 2020 through July 2020. Results: Overall, 56.5% of participants indicated that they would be willing to receive the COVID-19 vaccine once it is available, 39.4% were unsure of whether they would receive the vaccine, and 4.1% indicated they would not receive the vaccine. Multinomial logistic regression indicated that greater adherence to CDC guidelines (p = .030) and greater perceived pro-vaccine norms (p < .001) predicted greater vaccine willingness. Conclusions: Results from this study are consistent with previous literature on vaccine hesitancy, whereby normative beliefs and adherence to CDC guidelines were found to be determinants of vaccine willingness. To reduce transmission of the COVID-19 pandemic, interventions aimed at promoting positive attitudes towards vaccination should aim to incorporate these observed determinants.

Measuring Motivation for COVID-19 Vaccination: An Application of the Transtheoretical Model.

PURPOSE: In the United States (US), individuals vary widely in their readiness to get vaccinated for COVID-19. The present study developed measures based on the transtheoretical model (TTM) to better understand readiness, decisional balance (DCBL; pros and cons), self-efficacy (SE), as well as other motivators for change such as myths and barriers for COVID-19 vaccination. DESIGN: Cross-sectional measurement development. SETTING: Online survey. SAMPLE: 528 US adults ages 18-75. MEASURES: Demographics, stage of change (SOC), DCBL, SE, myths, and barriers. ANALYSIS: The sample was randomly split into halves for exploratory factor analysis using principal components analysis (EFA/PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Correlation matrices were assessed and multivariate analyses examined relationships between constructs and sub-constructs. RESULTS: For DCBL, EFA/PCA revealed three correlated factors (one pros, two cons) (n1 = 8, α = .97; n2 = 5, α = .93; n3 = 4, α = .84). For SE, two correlated factors were revealed (n1 = 12, α = .96; n2 = 3, α = .89). Single-factor solutions for Myths (n = 13, α = .94) and Barriers (n = 6, α = .82) were revealed. CFA confirmed models from EFAs/PCAs. Follow-up analyses of variance aligned with past theoretical predictions of the relationships between SOC, pros, cons, and SE, and the predicted relationships with myths and barriers. CONCLUSION: This study produced reliable and valid measures of TTM constructs, myths, and barriers to understand motivation to receive COVID-19 vaccination that can be used in future research.

Civic engagement and well-being among noncollege young adults: Investigating a mediation model.

Young adults may benefit from civic engagement as a health promotion tool, as civic engagement is generally associated with positive well-being. However, more information is needed to examine civic engagement among lesser-educated young adults who are least likely to civically engage, and more likely to demonstrate mental health needs. We surveyed noncollege young adults (N = 621) to measure their civic engagement, meaning, civic efficacy, well-being, and sociodemographic factors. Using an a priori model, direct, indirect, and full effects path analyses were conducted across men and women, and then the entire sample. The full effects model best fit the data with mediation by civic efficacy and meaning (χ2 (2) = 0.59, p = 0.74; comparative fit index = 1.0; root mean square error of approximation = 0.00, 90% confidence interval [0.00-0.06]; R2 = 0.42). Types of engagement (civic, electoral, activism, and online) demonstrated differing relationships with well-being. Stakeholders should resource young adults with civic skills and coping strategies to address the many challenges that civic experiences often elicit.

Immune-Based Therapy for Hospitalized Patients With COVID-19 and Risk of Secondary Infections: A Systematic Review and Meta-analysis.

Background: Immune-based therapies are standard-of-care treatment for coronavirus disease 2019 (COVID-19) patients requiring hospitalization. However, safety concerns related to the potential risk of secondary infections may limit their use. Methods: We searched OVID Medline, Ovid EMBASE, SCOPUS, Cochrane Library, clinicaltrials.gov, and PROSPERO in October 2020 and updated the search in November 2021. We included randomized controlled trials (RCTs). Pairs of reviewers screened abstracts and full studies and extracted data in an independent manner. We used RevMan to conduct a meta-analysis using random-effects models to calculate the pooled risk ratio (RR) and 95% CI for the incidence of infection. Statistical heterogeneity was determined using the I 2 statistic. We assessed risk of bias for all studies and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation methodology. We conducted a meta-regression using the R package to meta-explore whether age, sex, and invasive mechanical ventilation modified risk of infection with immune-based therapies. The protocol is registered with PROSPERO (CRD42021229406). Results: This was a meta-analysis of 37 RCTs including 32 621 participants (mean age, 60 years; 64% male). The use of immune-based therapy for COVID-19 conferred mild protection for the occurrence of secondary infections (711/15 721, 4.5%, vs 616/16 900, 3.6%; RR, 0.82; 95% CI, 0.71-0.95; P = .008; I 2 = 28%). A subgroup analysis did not identify any subgroup effect by type of immune-based therapies (P = .85). A meta-regression revealed no impact of age, sex, or mechanical ventilation on the effect of immune-based therapies on risk of infection. Conclusions: We identified moderate-certainty evidence that the use of immune-based therapies in COVID-19 requiring hospitalization does not increase the risk of secondary infections.

From Molecular to Multiasperity Contacts: How Roughness Bridges the Friction Scale Gap.

The tangential force required to observe slip across a whole frictional interface can increase over time under a constant load, due to any combination of creep, chemical, or structural changes of the interface. In macroscopic rate-and-state models, these frictional aging processes are lumped into an ad hoc state variable. Here we explain, for a frictional system exclusively undergoing structural aging, how the macroscopic friction response emerges from the interplay between the surface roughness and the molecular motion within adsorbed monolayers. The existence of contact junctions and their friction dynamics are studied through coupled experimental and computational approaches. The former provides detailed measurements of how the friction force decays, after the stiction peak, to a steady-state value over a few nanometers of sliding distance, while the latter demonstrates how this memory distance is related to the evolution of the number of cross-surface attractive physical links, within contact junctions, between the molecules adsorbed on the rough surfaces. We also show that roughness is a sufficient condition for the appearance of structural aging. Using a unified model for friction between rough adsorbed monolayers, we show how contact junctions are a key component in structural aging and how the infrajunction molecular motion can control the macroscopic response.

Limited movement of an avian hybrid zone in relation to regional variation in magnitude of climate change.

Studies of natural hybrid zones can provide documentation of range shifts in response to climate change and identify loci important to reproductive isolation. Using a temporal (36-38 years) comparison of the black-capped (Poecile atricapillus) and Carolina (P. carolinensis) chickadee hybrid zone, we investigated movement of the western portion of the zone (western Missouri) and assessed whether loci and pathways underpinning reproductive isolation were similar to those in the eastern portion of the hybrid zone. Using 92 birds sampled along the hybrid zone transect in 2016 and 68 birds sampled between 1978 and 1980, we generated 11,669 SNPs via ddRADseq. These SNPs were used to assess movement of the hybrid zone through time and to evaluate variation in introgression among loci. We demonstrate that the interface has moved ~5 km to the northwest over the last 36-38 years, that is, at only one-fifth the rate at which the eastern portion (e.g., Pennsylvania, Ohio) of the hybrid zone has moved. Temperature trends over the last 38 years reveal that eastern areas have warmed 50% more than western areas in terms of annual mean temperature, possibly providing an explanation for the slower movement of the hybrid zone in Missouri. Our results suggest hybrid zone movement in broadly distributed species, such as chickadees, will vary between areas in response to local differences in the impacts of climate change.

Critical Scaling of Solid Fragmentation at Quasistatic and Finite Strain Rates.

Using two-dimensional simulations of sheared, brittle solids, we characterize the resulting fragmentation and explore its underlying critical nature. Under quasistatic loading, a power-law distribution of fragment masses emerges after fracture which grows with increasing strain. With increasing strain rate, the maximum size of a grain decreases and a shallower distribution is produced. We propose a scaling theory for distributions based on a fractal scaling of the largest mass with system size in the quasistatic limit or with a correlation length that diverges as a power of rate in the finite-rate limit. Critical exponents are measured using finite-size scaling techniques.

Lyme Disease, Anaplasmosis, and Babesiosis, Atlantic Canada.

In July 2021, a PCR-confirmed case of locally acquired Babesia microti infection was reported in Atlantic Canada. Clinical features were consistent with babesiosis and resolved after treatment. In a region where Lyme disease and anaplasmosis are endemic, the occurrence of babesiosis emphasizes the need to enhance surveillance of tickborne infections.

Influenza B presenting as cardiogenic shock and progressing to multiorgan failure: A case report.

Influenza induced cardiogenic shock is rare and the majority of reported cases are a result of Influenza A myocarditis. We describe a patient with Influenza B who developed myocarditis and cardiogenic shock, with no known pre-existing heart disease. The patient's disease progressed to include rhabdomyolysis, compartment syndrome, renal failure, and pneumonia. He was successfully managed with Oseltamivir, renal replacement therapy, antimicrobials and intubation. This case is notable due to the rarity of influenza B induced cardiogenic shock and reinforces the importance of recognition and treatment.

Double valve infective endocarditis due to Capnocytophaga canimorsus.

Infective endocarditis caused by Capnocytophaga canimorsus, a commensal organism commonly found in dog saliva, is uncommon. We describe a case of a 76-year-old male with native aortic and mitral valve endocarditis with ventricular-atrial fistulization due to Capnocytophaga canimorsus. He was successfully treated with intravenous antimicrobials and surgery. Capnocytophaga canimorsus should be considered as a cause of infective endocarditis in patients with negative blood cultures, in asplenic patients, and in those with appropriate exposures.

Empathy, better patient care, and how interprofessional education can help.

Interprofessional education (IPE) has been promoted as one way to prepare healthcare students for interprofessional encounters they might experience in the workplace. However, the link between IPE, interprofessional care in the workforce, and better patient outcomes is tenuous, perhaps in part due to the inability of IPE programs to adequately address barriers associated with interprofessional care (e.g., power differentials, role disputes). Empathy, or understanding the experiences of others, has emerged as a critical tool to breaking down barriers inherent to working in teams. Given the evidence connecting empathy to stronger team collaboration and better patient care, researchers significantly revamped programming from a prior training called Interprofessional Education for Complex Neurological Cases (IPE Neuro) to enhance empathy, foster stronger team collaboration, and improve information integration among participants. In this improved three-session program, participants from seven different professions were grouped into teams, assessed a patient volunteer with neurological disorder, and created and presented an integrated, patient-centric treatment plan. Students (N = 31) were asked to report general empathy levels, as well as attitudes, team skills, and readiness toward interprofessional care, before and after the program. We conducted paired samples t-tests and thematic analysis to analyze the data. Results showed that participants reported higher empathy levels, more positive attitudes, and greater team skills pre- to posttest with moderate to large effects. Results bolster IPE Neuro programming as one approach to prepare students for interprofessional care while underscoring the potential implications of IPE to improve empathy levels of healthcare professionals.

How Ready Are Young Adults to Participate in Community Service? An Application of the Transtheoretical Model of Behavior Change.

PURPOSE: Engaging in community service, or unpaid work intended to help people in a community, is generally associated with greater overall well-being. However, the process of beginning and maintaining community service engagement has been sparsely examined. The current study applied the Transtheoretical Model (TTM) of behavior change to understanding community service readiness among young adults. DESIGN: Cross-sectional design using an online survey. SETTING: Participants were undergraduate students recruited at a mid-sized Northeastern US university in Spring 2018. SAMPLE: Participants (N = 314) had a mean age of 20.36 years (SD = 3.69), were primarily White (78%), female (72%), and from moderately high socioeconomic backgrounds (as measured by parental level of education). MEASURES: Socio-demographics including age, gender, race-ethnicity, and parental level of education; readiness, pros, cons, and self-efficacy for community service; civic engagement behavior; well-being. ANALYSIS: Participants were classified into very low (n = 62), low (n = 59), moderate (n = 92), high (n = 46), and very high (n = 55) readiness for community service groupings. A MANOVA was conducted to assess relationships between groupings and community service TTM constructs, civic engagement, and well-being. RESULTS: There were significant differences between readiness groupings on all main outcome variables, F(20, 1012) = 10.34, p < .001; Wilks' Λ = 0.54, η2 = .14. Post-hoc Games-Howell tests showed that those exhibiting higher levels of readiness reported fewer cons, greater pros, higher self-efficacy, more overall civic engagement, and greater well-being compared to lower readiness individuals. CONCLUSION: Consistent with previous TTM applications, self-efficacy and the importance of pros increased across readiness groupings while the importance of cons decreased. Study findings may be used to inform readiness-tailored interventional work for increasing community service. This area of study would benefit from longitudinal research examining community service readiness beyond the college environment.