Single mothers' perceptions of neighborhood social cohesion, parenting stress, adverse childhood experiences in early childhood and Black children's behavior problems in middle childhood and adolescence.

This study examined the roles of neighborhood social cohesion, adverse childhood experiences (ACEs), and parenting stress in early childhood on child behavioral outcomes in middle childhood and adolescence among socioeconomically disadvantaged Black families. To test a model linking perceptions of neighborhood social cohesion, single mothers' parenting stress, ACEs, and behavior problems in middle childhood and adolescence. We used four waves of longitudinal data from a subsample of 800 unmarried Black mothers and their children (at child birth and ages 3, 5, 9, and 15) from the Future of Families and Child Wellbeing Study, a nationally representative data set. Structural equation modeling with latent variables was used to measure direct and indirect effects. Mothers' perceptions of neighborhood social cohesion were significantly and negatively associated parenting stress (ß = -0.34, p < 0.05); parenting stress was significantly and positively related to adverse childhood experiences (ß = 0.40, p < 0.05) and behavior problems (ß = 0.32, p < 0.05); Adverse childhood experiences were significantly and positively related to behavior problems (ß = 0.26, p < 0.05); and behavior problems were indirectly influenced by neighborhood social cohesion through adverse childhood experiences (ß = -0.14, p < 0.05) and parenting stress (ß = 0.10, p < 0.05). Neighborhood factors may play a significant role in parenting stress, adverse childhood experiences in early childhood, and children's behavior problems in middle childhood and adolescence among some single mothers and children in economically and socially disadvantaged Black families. Interventions that enhance neighborhood social cohesion and foster supportive interactions among community members and organizations are recommended.

The relationship between colon polyps and colonic diverticulosis: a retrospective review.

Background: Colonic diverticulosis and colon polyps are common findings on colonoscopy. There is currently no consensus regarding a possible connection between the development of polyps and diverticulosis. Multiple research studies have sought to analyze whether the presence of both conditions is associated with the development of colorectal cancer. Our study aims to add to this body of data and to better assess the relationship between diverticulosis and colon polyps. Methods: A retrospective chart review was performed of all patients who underwent screening and diagnostic colonoscopies between January 2011 and December 2020. Data collection included patient demographics; number, pathology, and location of colon polyps; incidence of colon cancer; and presence and location of colonic diverticulosis. Results: Our study demonstrated that the overall presence of diverticulosis in any location increases the likelihood of having nearby colon polyps, regardless of subtype. The presence of left colonic diverticulosis was particularly associated with adjacent adenomatous and non-adenomatous colon polyps. Conclusions: Colonic diverticulosis in any location may lead to an increased incidence of adenomatous colon polyps. It is important to perform careful examination of the mucosa surrounding colon diverticulosis to avoid missing colon polyps.

Lower Gastrointestinal Tract Disorders: Clinical Updates in Women's Health Care Primary and Preventive Care Review.

ABSTRACT: Lower gastrointestinal (GI) diseases and associated symptoms account for a large number of health care visits each year. Many women visit their obstetrician-gynecologists more often than their primary care physicians or use them as primary health care providers. Many gynecologic and lower GI disorders share symptoms, such as lower abdominal or pelvic pain and bloating. Some diseases are more common in women compared with men, such as irritable bowel syndrome (IBS), or warrant special consideration in women, for example, for inflammatory bowel disease (IBD). This monograph outlines the major diseases that affect the lower GI tract and reviews epidemiology, pathology, presentation, and treatment of these diseases. Concerns specific to women are addressed, including reproductive issues, changes in GI physiology during pregnancy, and management of lower GI disease during pregnancy.

Abdominal Actinomycosis Abscess Presenting as an Isolated Gastrointestinal Pseudotumor.

Actinomyces is a gram-positive anaerobic bacterium that is ubiquitous in nature. It typically presents as respiratory, cervicofacial, or abdominopelvic abscesses. We present a 66-year-old man with a progressive enlarging abdominal wall nodule concerning for malignancy. The patient had a negative workup, including an ultrasound-guided fine-needle aspiration and colonoscopy, with biopsy for a possible extension to the colonic wall. Diagnosis of an Actinomyces abscess was obtained through surgical resection with right hemicolectomy. He was successfully treated with a prolonged course of intravenous antibiotics. This is a rare case of an isolated abdominal wall Actinomyces abscess mimicking a gastrointestinal malignancy.

Atypical Autosomal-Dominant Inheritance of Familial Mediterranean Fever.

Familial Mediterranean fever (FMF) was previously believed to be an autosomal recessive disease. We present a patient with only one pathogenic variation of the MEFV gene due to the c.2177T>C mutation. The patient had clinical features of recurrent fevers and abdominal pain, serositis, and a history of multiple abdominal surgeries for pain. He was eventually diagnosed with FMF. This case report demonstrates an example of the rare autosomal-dominant phenotype of FMF.

Adverse childhood experiences and behavior problems among poor Black children: Nonresident father involvement and single mothers' parenting stress.

BACKGROUND: Adverse childhood experiences (ACEs) in early childhood and developmental outcomes during the middle childhood and adolescent years have been understudied among low-income Black families. OBJECTIVE: To test a model linking economic hardship, single mothers' parenting stress, ACEs, and nonresident fathers' involvement in early childhood to behavior problems in middle childhood and adolescence. PARTICIPANTS AND SETTING: We used six waves of longitudinal data from a subsample of 800 unmarried Black mothers, nonresident fathers, and their children (at child birth and ages 1, 3, 5, 9, and 15) from the Fragile Families and Child Wellbeing Study, a nationally representative data set. METHOD: Structural equation models with latent variables that incorporate path analysis and confirmatory factor analysis were tested. RESULTS: Mothers' economic hardship was associated directly with parenting stress (beta = 0.27, p < .001) and related both directly (beta = 0.22, p < .001) and indirectly (through parenting stress) to the children's increased likelihood of exposure to ACEs (indirect effect = 0.05, p < .001). Nonresident fathers' involvement early on (child's age 1 to 5) was associated directly with reductions in the mothers' economic hardship (beta = -0.18, p < .001), children's reduced exposure to ACEs (beta = -0.15, p < .001), and fewer behavior problems in middle childhood and adolescence (beta = -0.10, p < .001). CONCLUSION: Nonresident Black fathers' involvement in single-mother families may buffer the adverse consequences over time for economically and socially disadvantaged Black children of exposure to ACEs in early childhood. Interventions that encourage sustained involvement by nonresident Black fathers with young children and their single mothers are recommended.

Crowdsourcing hypothesis tests: Making transparent how design choices shape research results.

To what extent are research results influenced by subjective decisions that scientists make as they design studies? Fifteen research teams independently designed studies to answer five original research questions related to moral judgments, negotiations, and implicit cognition. Participants from 2 separate large samples (total N > 15,000) were then randomly assigned to complete 1 version of each study. Effect sizes varied dramatically across different sets of materials designed to test the same hypothesis: Materials from different teams rendered statistically significant effects in opposite directions for 4 of 5 hypotheses, with the narrowest range in estimates being d = -0.37 to + 0.26. Meta-analysis and a Bayesian perspective on the results revealed overall support for 2 hypotheses and a lack of support for 3 hypotheses. Overall, practically none of the variability in effect sizes was attributable to the skill of the research team in designing materials, whereas considerable variability was attributable to the hypothesis being tested. In a forecasting survey, predictions of other scientists were significantly correlated with study results, both across and within hypotheses. Crowdsourced testing of research hypotheses helps reveal the true consistency of empirical support for a scientific claim. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sporadic Porphyria Cutanea Tarda as the Initial Manifestation of Hereditary Hemochromatosis.

Porphyria cutanea tarda (PCT) is a skin disorder characterized by abnormal heme synthesis. We present a 45-year-old man with intermittent skin lesions recurring annually for years. Skin biopsy and measurement of serum heme precursors confirmed a diagnosis of PCT. He had persistently elevated alanine and aspartate transferase. He was referred to hematology and had genetic testing with iron studies which also revealed hereditary hemochromatosis (HH). Therapeutic phlebotomy was initiated, which led to resolution of iron overload and skin lesions. We highlight the associated conditions of PCT and HH, their common therapy of phlebotomy, and initial manifestations of HH.

Sex hormone-dependent regulation of cilia beat frequency in airway epithelium.

Previous studies have demonstrated a female disadvantage in airway diseases, such as asthma and bronchiectasis. The basis for this sex disparity is unknown. We hypothesized that the female sex hormone, progesterone (P4), inhibits functions of the normal airway mucociliary apparatus. P4 receptor (PR) expression was evaluated in human lung and cultured primary human airway epithelial cells isolated from male and female lung transplant donors. PR expression was restricted to the proximal region of the cilia of airway epithelia, and was similar in men and women. Expression of isoform PR-B was more abundant than PR-A in cells from both sexes. Airway epithelial cell exposure to P4 decreased cilia beat frequency (CBF) by 42.3% (±7.2). Inhibition of CBF was prevented by coadministration of P4 with the active form of estrogen, 17ß-estradiol, or the PR antagonist, mifepristone. P4 inhibition was time and dose dependent, with a significant decrease by 8 hours and maximal effect at 24 hours, accompanied by translocation of PR from the cilia to the nucleus. Inhibition of cilia beat was also prevented by treatment of cells with actinomycin D, suggesting that CBF inhibition is a transcriptionally mediated event. Together, these findings indicate that sex hormones influence the function of a key component of the mucociliary apparatus. These mechanisms may contribute to the sex disparity present in airway diseases and provide therapeutic targets for the treatment of these debilitating airway diseases.

Federal declaration of a Public Health Emergency.

During certain emergencies (naturally caused or deliberate) that can have a significant impact on the public's health, the Secretary of the U.S. Department of Health and Human Services (HHS) has broad discretion to declare a Public Health Emergency (PHE). While many public health emergencies will not require a formal declaration, this type of declaration can be an important and necessary step to authorize the secretary to take a variety of actions that enable the department to respond optimally to an emergency. This article outlines the HHS Secretary's PHE authority, discusses possible discretionary actions that the secretary may take after declaring a PHE, and provides examples of PHE declarations that have been issued.

A statistical test for the equality of differently adjusted incidence rate ratios.

An incidence rate ratio (IRR) is a meaningful effect measure in epidemiology if it is adjusted for all important confounders. For evaluation of the impact of adjustment, adjusted IRRs should be compared with crude IRRs. The aim of this methodological study was to present a statistical approach for testing the equality of adjusted and crude IRRs and to derive a confidence interval for the ratio of the two IRRs. The method can be extended to compare two differently adjusted IRRs and, thus, to evaluate the effect of additional adjustment. The method runs immediately on existing software. To illustrate the application of this approach, the authors studied adjusted IRRs for two risk factors of type 2 diabetes using data from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study from 2005. The statistical method described may be helpful as an additional tool for analyzing epidemiologic cohort data and for interpreting results obtained from Cox regression models with adjustment for different covariates.

Eating out of home and its correlates in 10 European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC) study.

OBJECTIVE: To compare the average out-of-home (OH) consumption of foods and beverages, as well as energy intake, among populations from 10 European countries and to describe the characteristics of substantial OH eaters, as defined for the purpose of the present study, in comparison to other individuals. DESIGN: Cross-sectional study. Dietary data were collected through single 24-hour dietary recalls, in which the place of consumption was recorded. For the present study, substantial OH eaters were defined as those who consumed more than 25% of total daily energy intake at locations other than the household premises. Mean dietary intakes and the proportion of substantial OH eaters are presented by food group and country. Logistic regression analyses were used to estimate the odds of being a substantial OH eater in comparison to not being one, using mutually adjusted possible non-dietary determinants. SETTING: Ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). SUBJECTS: The subjects were 34 270 individuals, 12 537 men and 21 733 women, aged 35-74 years. RESULTS: The fraction of energy intake during OH eating was generally higher in northern European countries than in the southern ones. Among the food and beverage groups, those selectively consumed outside the home were coffee/tea/waters and sweets and, to a lesser extent, cereals, meats, added lipids and vegetables. Substantial OH eating was positively associated with energy intake and inversely associated with age and physical activity. Substantial OH eating was less common among the less educated compared with the more educated, and more common during weekdays in central and north Europe and during the weekend in south Europe. CONCLUSIONS: Eating outside the home was associated with sedentary lifestyle and increased energy intake; it was more common among the young and concerned in particular coffee/tea/waters and sweets.

Corneal endothelial injury thresholds for exposures to 1.54 micro m radiation.

The endothelial injury threshold was determined in rabbit for an 11-s exposure to 1.54 micro m radiation from an Erbium fiber laser. The beam was Gaussian with a 1/e diameter of 7 mm. Cell damage was detected with a wet staining technique. The threshold dose for these conditions is 4.4 x 10(5) J m(-2) (44 J cm) and is only 9% greater than the threshold for epithelial damage for the same exposure conditions. Exposures just above the threshold caused substantial endothelial damage, including loss of cells. The calculated endothelial temperature increase at the threshold is similar to that calculated for the epithelium at its injury threshold for the same exposure conditions. The results suggest that endothelial damage can be correlated with a critical temperature damage model with a critical temperature increase near 40 degrees C. The results also suggest that if a person were to receive an exposure only slightly above the epithelial injury threshold from a beam having a diameter of 7 mm (which is the diameter of the exit pupil of 7 x 50 binoculars) he or she would risk sustaining substantial endothelial damage.

Light-scattering and ultrastructure of healed penetrating corneal wounds.

PURPOSE: To investigate quantitatively for the first time the relationship between light-scattering and ultrastructure of semitransparent scars resulting from penetrating wounds in rabbit cornea. METHODS: Penetrating wounds, 2 mm in diameter, were made in the central cornea and allowed to heal for 3.6 to 4.5 years at which time the rabbits were killed. The scar and cornea thickness outside the scar were measured using ultrasonic pachymetry. Corneas were excised immediately and their transmissivity was measured from 400 to 700 nm. The tissue was then prepared for transmission electron microscopy. Transmission electron micrographs (TEMs) were analyzed to determine fibril positions and radii. Scattering was calculated using the direct summation of fields (DSF) METHOD: RESULTS: Scar thickness averaged 0.26 +/- 0.04 mm, and the scars were flat. Thickness outside the scars averaged 0.40 +/- 0.04 mm. Three scars were moderately transparent, five were less transparent, and one was much less transparent. The wavelength dependence of the measured total scattering cross- section was indicative of the presence of voids (lakes) in the collagen fibril distribution, and lakes were evident in the TEMs. The images showed enlarged fibrils and some showed bimodal distributions of fibril diameters. Calculated scattering was characteristic of that expected from regions containing lakes-a finding consistent with the scattering measurements. CONCLUSIONS: Despite the long healing time, these scars remained highly scattering. A combination of lakes, disordered fibril distributions, and a significant population of enlarged fibrils can explain the scattering. A possible cellular contribution cannot be ruled out.

Effect of rotator cuff pathology on shoulder rhythm.

The purpose of this study was to test the hypothesis that shoulder rhythm is affected by rotator cuff pathology during arm elevation. We divided 42 subjects into 3 groups: those with full-thickness rotator cuff tears (RCTs) (n = 14), those with tendinopathy (n = 13), and control subjects (n = 15). Shoulder kinematics was recorded while subjects performed elevation in the sagittal and scapular planes. Euler angles were computed for scapular and humeral elevation. Data were divided into 3 equal phases. Lines were fit and the slope determined for each phase. Significant differences in slopes ( P < .05) were found between experimental groups for both motions. The RCT group had higher slopes in the initial and middle phases for sagittal elevation and in the middle phase for scapular abduction. The scapula was elevated more in the RCT group in the initial two thirds of movement. This motion may change the length of remaining muscles so that they operate on a more effective part of their length-tension curve.

corneal epithelial injury thresholds for exposures to 1.54 microm radiation-dependence on beam diameter.

Corneal epithelial injury thresholds have been determined for exposures to 1.54 mum infrared radiation from an Erbium fiber laser. Thresholds were determined for beam diameters from 0.05 to 0.7 cm for exposures having durations from approximately 1 to 100 s and for a fixed beam diameter of 0.1 cm for exposures with durations between 0.036 and 0.26 s. Near-threshold damage appeared within 30 min post-exposure. There was no evidence of latent damage from lesser exposures appearing up to 24-48 h post-exposure. The dependence of the threshold radiant exposures on laser beam diameter for exposures >1 s provides strong evidence supporting a critical temperature damage model. However, the shorter exposures are not in accord with a critical temperature damage model. Thresholds for exposures longer than 1 s are greater than 10 times the maximum permissible exposure (MPE) in ANSI Z-136.5-2000; however, the safety factor decreases to less than 10 for exposures less than 0.1 s with a 0.1-cm-diameter beam.