Relationships among adverse childhood experiences, delay discounting, impulsivity, and diabetes self-management.

OBJECTIVE: Adverse childhood experiences (ACEs) have been linked to risky health behaviors, as well as the development of chronic health conditions such as both type 1 and type 2 diabetes mellitus. A connection between ACEs and diabetes self-management has not yet been established. The current study aims to investigate the relationships among ACEs, delay discounting, impulsivity, and diabetes self-management. METHOD: A total of 227 adults aged 18 to 77 with type 1 diabetes, type 2 diabetes, and prediabetes were recruited to complete an online survey via Amazon's mechanical Turk. Participants completed validated measures of diabetes self-care, delay discounting, and impulsivity, as well as questions regarding diabetes history and financial strain. RESULTS: In the overall sample and controlling for financial strain, increased number of ACEs was significantly associated with poorer diabetes management (r = -.15, p < .05). Higher delay discounting was associated with fewer ACEs (r = -.31, p < .05) and better diabetes care (r = .42, p < .01), as well as increased number of diabetes-related complications (r = .33, p < .01), controlling for financial strain. Participants who use insulin to manage their diabetes had significantly better diabetes self-care scores (t(225) = 8.19, p < .01), higher levels of delay discounting (t(101) = 3.15, p < .01), and fewer reported ACEs (t(224) = -2.19, p < .05). CONCLUSIONS: ACEs are associated with poorer diabetes self-management later in life. This may be an important consideration for clinicians treating patients with diabetes and prediabetes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Drug use-related right-sided infective endocarditis complicated by empyema and bronchopleural fistula.

Right-sided infective endocarditis is frequently accompanied by septic pulmonary emboli, which may result in a spectrum of respiratory complications. We present the case of a 25-year-old woman diagnosed with infective endocarditis secondary to intravenous drug use. During a long and arduous hospital course, the patient developed empyema with bronchopleural fistula, representing severe but uncommon sequelae that may arise from this disease process. She was treated with several weeks of antibiotics as well as surgical thorascopic decortication and parietal pleurectomy.

Hemothorax Following Traumatic Dobhoff Tube Insertion.

Dobhoff tube is a specialized small-bore and flexible nasogastric tube that makes it more comfortable for placement than a usual nasogastric tube. Dobhoff tube insertion is commonly considered a relatively safe bedside procedure, but it is not without its associated risks. Inadvertent tracheobronchial placement of Dobhoff tube has been associated with severe complications, most notably pneumothorax. We present a rare cause of right-sided hemothorax following tracheobronchial insertion of a Dobhoff tube with a prolonged and arduous clinical course.

Comparing Parent and Child Self-report Measures of the State-Trait Anxiety Inventory in Children and Adolescents with a Chronic Health Condition.

Anxiety symptoms in children and adolescents with a chronic health condition have been estimated as high as 40% lifetime prevalence. Clinicians often rely on parent/caregiver information to supplement or substitute child self-report related to pediatric physical and mental health. We developed a caregiver proxy version (STAI-P) for the State-Trait Anxiety Inventory (STAI) State Anxiety Scale that was compared with a child self-report version in 201 parent-child dyads to evaluate its utility in measuring state anxiety in chronically ill youth. For patients aged 7-12, self-reports of state anxiety were moderately associated with parent distress and health provider-reported functional status, but negatively associated with parent STAI-P scores. For patients aged 13-17, self-reports of state anxiety were significantly associated with STAI-P scores, parent distress, and health provider-reported functional status. The STAI-P parent version may be a useful tool in identifying and addressing anxiety symptoms in youth living with a chronic health condition.

The Recognition of Solid Object Shape: The Importance of Inhomogeneity.

A single experiment evaluated the haptic-visual cross-modal matching of solid object shape. One set of randomly shaped artificial objects was used (sinusoidally modulated spheres, SMS) as well as two sets of naturally shaped objects (bell peppers, Capsicum annuum and sweet potatoes, Ipomoea batatas). A total of 66 adults participated in the study. The participants' task was to haptically explore a single object on any particular trial and subsequently indicate which of 12 simultaneously visible objects possessed the same shape. The participants' performance for the natural objects was 60.9 and 78.7 percent correct for the bell peppers and sweet potatoes, respectively. The analogous performance for the SMS objects, while better than chance, was far worse (18.6 percent correct). All of these types of stimulus objects possess a rich geometrical structure (e.g., they all possess multiple elliptic, hyperbolic, and parabolic surface regions). Nevertheless, these three types of stimulus objects are perceived differently: Individual members of sweet potatoes and bell peppers are largely identifiable to human participants, while the individual SMS objects are not. Analyses of differential geometry indicate that these natural objects (e.g., bell peppers and sweet potatoes) possess heterogeneous spatial configurations of distinctly curved surface regions, and this heterogeneity is lacking in SMS objects. The current results therefore suggest that increases in surface structure heterogeneity facilitate human object recognition.

Aging and the Visual Perception of Motion Direction: Solving the Aperture Problem.

An experiment required younger and older adults to estimate coherent visual motion direction from multiple motion signals, where each motion signal was locally ambiguous with respect to the true direction of pattern motion. Thus, accurate performance required the successful integration of motion signals across space (i.e., accurate performance required solution of the aperture problem) . The observers viewed arrays of either 64 or 9 moving line segments; because these lines moved behind apertures, their individual local motions were ambiguous with respect to direction (i.e., were subject to the aperture problem). Following 2.4 seconds of pattern motion on each trial (true motion directions ranged over the entire range of 360° in the fronto-parallel plane), the observers estimated the coherent direction of motion. There was an effect of direction, such that cardinal directions of pattern motion were judged with less error than oblique directions. In addition, a large effect of aging occurred-The average absolute errors of the older observers were 46% and 30.4% higher in magnitude than those exhibited by the younger observers for the 64 and 9 aperture conditions, respectively. Finally, the observers' precision markedly deteriorated as the number of apertures was reduced from 64 to 9.

Haptic shape discrimination and interhemispheric communication.

In three experiments participants haptically discriminated object shape using unimanual (single hand explored two objects) and bimanual exploration (both hands were used, but each hand, left or right, explored a separate object). Such haptic exploration (one versus two hands) requires somatosensory processing in either only one or both cerebral hemispheres; previous studies related to the perception of shape/curvature found superior performance for unimanual exploration, indicating that shape comparison is more effective when only one hemisphere is utilized. The current results, obtained for naturally shaped solid objects (bell peppers, Capsicum annuum) and simple cylindrical surfaces demonstrate otherwise: bimanual haptic exploration can be as effective as unimanual exploration, showing that there is no necessary reduction in ability when haptic shape comparison requires interhemispheric communication. We found that while successive bimanual exploration produced high shape discriminability, the participants' bimanual performance deteriorated for simultaneous shape comparisons. This outcome suggests that either interhemispheric interference or the need to attend to multiple objects simultaneously reduces shape discrimination ability. The current results also reveal a significant effect of age: older adults' shape discrimination abilities are moderately reduced relative to younger adults, regardless of how objects are manipulated (left hand only, right hand only, or bimanual exploration).

Aging and visual 3-D shape recognition from motion.

Two experiments were conducted to evaluate the ability of younger and older adults to recognize 3-D object shape from patterns of optical motion. In Experiment 1, participants were required to identify dotted surfaces that rotated in depth (i.e., surface structure portrayed using the kinetic depth effect). The task difficulty was manipulated by limiting the surface point lifetimes within the stimulus apparent motion sequences. In Experiment 2, the participants identified solid, naturally shaped objects (replicas of bell peppers, Capsicum annuum) that were defined by occlusion boundary contours, patterns of specular highlights, or combined optical patterns containing both boundary contours and specular highlights. Significant and adverse effects of increased age were found in both experiments. Despite the fact that previous research has found that increases in age do not reduce solid shape discrimination, our current results indicated that the same conclusion does not hold for shape identification. We demonstrated that aging results in a reduction in the ability to visually recognize 3-D shape independent of how the 3-D structure is defined (motions of isolated points, deformations of smooth optical fields containing specular highlights, etc.).

The visual perception of distance ratios outdoors.

We conducted an experiment to evaluate the ability of 32 younger and older adults to visually perceive distances in an outdoor setting. On any given trial, the observers viewed 2 environmental distances and were required to estimate the distance ratio-the length of the (usually) larger distance relative to that of the shorter. The stimulus distance ratios ranged from 1.0 (the stimulus distances were identical) to 8.0 (1 distance interval was 8.0 times longer than the other). The stimulus distances were presented within a 26 m × 60 m portion of a grassy field. The observers were able to reliably estimate the stimulus distance ratios: The overall Pearson r correlation coefficient relating the judged and actual distance ratios was 0.762. Fifty-eight percent of the variance in the observers' perceived distance ratios could thus be accounted for by variations in the actual stimulus ratios. About half of the observers significantly underestimated the distance ratios, while the judgments of the remainder were essentially accurate. Significant modulatory effects of sex and age occurred, such that the male observers' judgments were the most precise, while those of the older males were the most accurate.

Measuring a conceptual model of the relationship between compulsive cell phone use, in-vehicle cell phone use, and motor vehicle crash.

OBJECTIVES: Previous research suggests that anticipation of incoming phone calls or messages and impulsivity are significantly associated with motor vehicle crash. We took a more explanative approach to investigate a conceptual model regarding the direct and indirect effect of compulsive cell phone use and impulsive personality traits on crash risk. METHODS: We recruited a sample of 307 undergraduate college students to complete an online survey that included measures of cell phone use, impulsivity, and history of motor vehicle crash. Using a structural equation model, we examined the direct and indirect relationships between factors of the Cell Phone Overuse Scale-II (CPOS-II), impulsivity, in-vehicle phone use, and severity and frequency of previous motor vehicle crash. Self-reported miles driven per week and year in college were included as covariates in the model. RESULTS: Our findings suggest that anticipation of incoming communication has a direct association with greater in-vehicle phone use, but was not directly or indirectly associated with increasing risk of previous motor vehicle crash. Of the three latent factors comprising the CPOS-II, only anticipation was significantly associated with elevated cell phone use while driving. Greater impulsivity and use of in-vehicle cell phone use while driving were directly and significantly associated with greater risk of motor vehicle crash. CONCLUSIONS: Anticipation of incoming cellular contacts (calls or texts) is associated with greater in-vehicle phone use, while greater in-vehicle cell phone use and impulsive traits are associated with elevated risk of motor vehicle crashes.