Supportive Relationships Mitigate the Effect of Cumulative Exposure to Adverse Childhood Experiences on Depression, Anxiety, Stress, and Suicide Considerations-The Arizona Youth Risk Behavior Survey.

Declining adolescent mental health is a significant public health concern during the COVID-19 pandemic. Social distancing and stay-at-home orders have led to missed social connections with peers and adults outside households, and this has increased the risk of mental health problems in children and adolescents, particularly those with adverse childhood experiences (ACEs). Studies have shown that strong interpersonal support improves adolescent mental health. We examined the association between ACEs and poor mental health (including stress, anxiety, and depression) and how the presence of interpersonal support from caring adults and friends and school connectedness can mitigate this relationship among adolescents in Arizona. This study analyzed data from the 2021 Arizona Youth Risk Behavior Survey (YRBS; n = 1181), a population-based survey conducted biennially across the United States. The Arizona sample included high school students in grades 9-12 who were enrolled in public and charter schools. This study revealed that nearly three of four adolescents experienced an ACE, and one of five experienced ≥4 ACEs. Compared with adolescents who experienced zero ACEs, those with ≥4 ACEs experienced less interpersonal support from caring adults, friends, and school and more frequently reported poor mental health and suicidal thoughts. However, adolescents with interpersonal support consistently reported lower rates of mental health issues, even with exposure to multiple ACEs. Post-pandemic programs to improve social relationships with adults, peers, and schools are critical, especially for adolescents with multiple adversities.

Association of mobile health (mHealth) use with health status and COVID-19-related concerns by people with mobility impairments.

PURPOSE: Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates. METHODS: PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals). RESULTS: Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models. DISCUSSION: PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities.Implications for RehabilitationMany people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare.COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities.Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management.

Preschoolers' parent and teacher/director perceptions of returning to early childcare education during the COVID-19 pandemic.

BACKGROUND: Early Care and Education (ECE) sites are critical hubs for social, emotional, and physical learning development of preschool children (ages 3-5). The COVID-19 pandemic has impacted ECE enrollment and participation; until June 2022, preschool children in the US were ineligible for COVID-19 vaccines. It is critical to identify perceptions of teachers/directors and parents to enhance safe return-to-school efforts. METHODS: Focus groups (n = 7; 22 participants) were conducted with ECE teachers/directors throughout Arizona to examine perceptions of COVID-19 testing for families and staff at ECE sites, and current and possible COVID-19 mitigation strategies during Summer 2021. Preschool parents from underserved families in Phoenix (n = 41) completed a brief survey on their perceptions of benefits of ECE for themselves and their children, thoughts on COVID-19 mitigation strategies, and timing for safe return to school during Spring 2021. Focus groups were transcribed and analyzed for themes using constant comparison. RESULTS: There were 4 focus group themes: 1) perceptions of saliva-based COVID-19 testing, 2) logistical strategies for COVID-19 testing at ECE sites; 3) successes and challenges with current COVID-19 mitigation strategies; 4) ideas to support improved COVID-19 mitigation, including outdoor gardening. Parents rated peace of mind about the child's education as the most important benefit for themselves of in-person ECE (74.6%), and social development for children as the most important benefit for their children (54.4%). Over 40% of parents reported it would not be safe to send children back until 2022. CONCLUSIONS: COVID-19 continues to impact attendance at ECE sites, despite parents reporting key benefits to attending ECE sites. Teachers/directors supported COVID-19 mitigation strategies including saliva-based testing and gardening education to improve safe return to schools.

Developing and Evaluating Newsletters for Parent Engagement in Sustainability via Active Garden Education (SAGE).

Physical activity and nutrition preschool programming must involve parents in positive long-term healthy habits. This paper describes parent outreach in the Sustainability via Active Garden Education (SAGE) study. Newsletters were sent home with children to promote family opportunities to increase physical activity and fruit and vegetable intake. The content was generated via a community advisory board participatory process. Messages linked SAGE curriculum topics with home and community activities. Parents rated frequency of receipt, helpfulness, satisfaction, and use of content. Most participants were Hispanic (>78%) and women (>95%). Most reported receiving newsletters; nearly all reported that they were helpful. Favorite newsletter components included recipes, pictures of their children and seasonal produce spotlights. Most reported doing physical activities from the newsletters (51.9%). Few reported doing featured physical activity (8.9%) and fruit and vegetable (12.7%) community activities. Newsletter outreach methods are a simple strategy to add value to preschool-based interventions promoting healthy families.

Psychometric properties of the Food Environment Assessment Survey Tool (FEAST) in people with mobility impairment.

OBJECTIVE: Approximately one in ten adults under the age of 65 in the USA has a mobility impairing disability. People with mobility impairment generally have poorer dietary habits contributing to obesity and related negative health outcomes. This article presents the psychometric properties of the Food Environment Assessment Survey Tool (FEAST) instrument that measures barriers to accessing healthy food from the perspective of people with mobility impairment (PMI). DESIGN: The current study presents cross-sectional data from two sequential independent surveys. SETTING: Surveys were administered online to a national sample of PMI. PARTICIPANTS: Participants represented PMI living throughout the USA. The pilot FEAST survey involved 681 participants and was used to shape the final instrument; 25 % completed a retest survey. After following empirically and theoretically guided item reduction strategies, the final FEAST instrument was administered to a separate sample of 304 PMI. RESULTS: The final twenty-seven-item FEAST instrument includes items measuring Neighbourhood Environment, Home Environment, Personal Control and Access to Support (Having Help, Food Delivery Services, Parking/Transportation). The final four scales had acceptable intra-class correlations, indicating that the scales could be used as reliable measures of the hypothesised constructs in future studies. CONCLUSIONS: The FEAST instrument is the first of its kind developed to assess the food environment from the perspective of PMI themselves. Future studies would benefit from using this measure in research and practice to help guide the development of policy aimed at improving access to healthy food and promoting healthy eating in community-dwelling PMI.

Adverse childhood experiences among youth from high-achieving schools: Appraising vulnerability processes toward fostering resilience.

Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in relation to (a) internalizing and externalizing symptoms in adolescence (n = 527), and (b) symptoms plus psychiatric diagnoses-based on multiple annual interviews-in adulthood (n = 316). Also examined were associations for a "Proxy ACEs" (P-ACEs) measure, containing items similar to those on standard ACEs measures without reference to abuse or neglect. Rates of ACEs were comparable with those in other studies; most commonly endorsed were perceived parental depression followed by aspects of emotional neglect. Groups exposed to zero, 1, 2, 3, and 4+ ACEs differed on symptoms in adulthood, with small to moderate effect sizes; in parallel comparisons of P-ACEs groups on Grade 12 symptoms, differences had large effect sizes. In relation to psychiatric diagnoses, comparisons with the zero ACEs group showed that groups with 1, 2, 3 ACEs, versus 4+ ACES, respectively, had twofold and over fivefold greater odds of having any lifetime diagnosis. The odds for internalizing diagnoses specifically were 2-6 times greater for individuals with 1, 2, and 3 ACEs, and 12 times greater for those reporting 4 ACEs. Remarkably, Grade 12 reports of 2, 3, and 4+ P-ACEs were linked to 2-3 times greater odds of a psychiatric disorder in adulthood, and 3-6 times greater odds for internalizing diagnoses specifically. In the future, assessments of ACEs and P-ACEs could facilitate early detection of problems among HAS students, informing interventions to mitigate vulnerability processes and promote resilience among these youth and their families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Optimal NH4 + /NO3 - ratios enhance the shade tolerance of soybean seedlings under low light conditions.

In the maize-soybean intercropping system, shade is the major chronic restraint that affects normal growth of soybean. Different spatial patterns of this system affect the microclimate of soybean through shading from maize plants. However, the negative impacts of shading stress can be mitigated by providing optimal ratios of different fertilizers. Therefore, to test this hypothesis, soybean plants were grown under different light conditions (normal light or shade) to evaluate the response to varying NH4 + /NO3 - ratios. Seeds of soybean (Glycine max L. cv. Nan-99-6) were grown in nutrient solution with a total concentration of 5 mM N using different NH4 + /NO3 - ratios (T0  = 0:0, T1  = 0:100, T2  = 25:75, T3  = 50:50 and T4  = 75:25) for 40 days in a greenhouse at PPFD 320.95 µmol m-2  s-1 (low light) or 967.53 µmol m-2  s-1 (normal light). Under low light, growth and photosynthesis of soybean seedlings significantly decreased as compared to normal light conditions. However, the optimal ratios of NH4 + / NO3 - improved growth and photosynthesis of soybean seedlings under both light conditions. Our results indicated that soybean seedlings supplied with optimal NH4 + /NO3 - ratios (25:75 and 50:50) have maximum biomass yield, chlorophyll pigments, leaf gas exchange, photochemical activity and root growth as compared to low and high NH4 + /NO3 - ratios (T1 and T4 ). High ratios of NH4 + /NO3 - (T4 ) resulted in reduced plant growth due to nutrient accumulation in plant tissues; therefore, we suggest that optimal ratios of NH4 + /NO3 - (T2 and T3 ) can enhance the shade tolerance of soybean seedlings.

Five-year long-term clinical outcome after bariatric metabolic surgery: A multi-ethnic Asian population in Singapore.

Bariatric surgery is an effective treatment for morbid obesity and its metabolic related comorbidities; type 2 diabetes, hypertension and hyperlipidaemia.1 However, the literature is scarce regarding the long-term outcome after bariatric surgery, especially among multi-ethnic Asian populations. Considering the growing number of bariatric metabolic surgeries in Asia, we have attempted to provide a regional perspective on 5-year long-term clinical outcomes post bariatric surgery in Singapore. Between 2010 and 2016, all bariatric operative cases were included, and these comprised: laparoscopic sleeve gastrectomy (LSG), 393; laparoscopic Roux-En-Y gastric bypass (RYGB), 125; laparoscopic mini-gastric bypass (MGB), 43. The primary outcome measure was the percentage of excess weight loss (% EWL) at 6 months, 1, 2, 3, 4 and 5 years, with % remission of type 2 diabetes mellitus (T2DM) at 1 year following LSG (49.7%, 61.2%, 56.1%, 47.8%, 40.8% and 47.3%; 82.2%), RYGB (60.2%, 62.1%, 57.6%, 50.1%, 48.7% and 47.7%; 86.9%) and MGB (58%, 68.1%, 62.7%, 66.2%, 64.0%, 65.2%; 71.9%). In conclusion, MGB and RYGB showed the greatest % EWL at 5 years and are recommended for moderate T2DM. LSG is an effective bariatric operation with a high % EWL up to 2 years, and a high remission rate of mild T2DM. The remission rate of T2DM was equally high in all 3 surgical groups, independent of ethnic differences.

[Effect of comprehensive schistosomiasis control strategy with focus on cattle and sheep removal in Junshan District, Yueyang City].

Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District, Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human, cattle, sheep and Oncomelania hupensis snails, and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44% in 2006 to 0.59% in 2012 (F = 14.501, P = 0.013). After removal of all the cattle and sheep in 2013, the prevalence of schistosome infection in the residents decreased to zero in 2016 (F = 14.148, P = 0.033). The density of living snails decreased from 0.883 3/0.1 m2 in 2006 to 0.308 8/0.1 m2 in 2012 (F = 76.250, P = 0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.

Blood glucose fluctuation aggravates lower extremity vascular disease in type 2 diabetes.

OBJECTIVES: Lower-extremity vascular diseases are important complication of diabetes. In the present study, we investigated the influence of blood glucose fluctuation in type 2 diabetes-associated lower-extremity vascular diseases, and explore the possible mechanism. PATIENTS AND METHODS: Patients with type 2 diabetes was assigned to Group B (without lower-extremity vascular disease) and group C (with lower-extremity vascular disease). Healthy subjects (Group A) served as normal controls. All patients received dynamic blood glucose monitoring for 72 h. The mean amplitude of glycemic excursion (MAGE) and the largest amplitude of glycemic excursion (LAGE) were estimated. The levels of von Willebrand factor (vWF), ischemia-modified albumin (IMA), glycosylated hemoglobin (HbA1c), and biochemical indices were examined, and the lower-extremity vascular diseases were scored in patients from group C. RESULTS: Groups B and C have higher systolic blood pressure (SBP), total cholesterol (TC) level, high-density lipoprotein cholesterol (HDL-C) level, HbA1c level, and vWF level and lower IMA level than those in Group A (p < 0.05). Elevated MAGE and LAGE were observed in groups B and C as compared with Group A. Correlation analysis revealed that the score of lower-extremity vascular diseases was associated with MAGE, LAGE, SBP, LDL-C, vWF, HbA1c, and IMA (p < 0.05). Stepwise multiple-linear regression analysis revealed that lower-extremity vascular diseases were involved with MAGE, IMA, and vWF. CONCLUSIONS: Enhanced fluctuation in patients with type 2 diabetes may promote the occurrence and development of lower-extremity vascular diseases through aggravating vascular endothelial injury.

[Alcohol consumption among traveling Chilean older people]. / Consumo de alcohol en el adulto mayor chileno que viaja.

BACKGROUND: Problems associated with alcohol consumption are prevalent in Chile, but little is known about the situation in the elderly. AIM: To perform a screening to detect alcohol-related problems and risks in the Chilean older people who travel. MATERIAL AND METHODS: The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was answered by 1,076 travelers aged 60 to 93 years (66% females), who participated in trips organized by the Chilean National Tourism Service (SERNATUR). RESULTS: Seventy six percent of respondents acknowledged to have ingested an alcoholic drink during the last month. The average AUDIT score was of 2.2 ± 2.6. Only 3.7% of the sample had a score equal or higher than eight, considered as risky use. Within this last group, 60% had symptoms of alcohol dependence. A higher alcohol consumption was associated with male gender (p < 0.01), being younger than 75 years of age (p < 0.01), having a medium-low economic income (p < 0.01) and having a higher education level (p = 0.03). There was no significant association with the respondents' occupation. CONCLUSIONS: In this sample of Chilean traveling older people, there was a high prevalence of alcohol consumption, and nearly 4% of respondents had alcohol related problems.

Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC).

PURPOSE: We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. METHODS: We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. RESULTS: We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95% confidence interval [CI] 0.55-0.72)], showing a 37% rate reduction. CONCLUSIONS: Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.

Solid-state dye-sensitized solar cells based on ZnO nanocrystals.

We report on the development of solution-processed ZnO-based dye-sensitized solar cells. We fabricate mesoporous ZnO electrodes from sol-gel processed nanoparticles, which are subsequently sensitized with conventional ruthenium complexes and infiltrated with the solid-state hole transporter medium 2, 2', 7, 7'-tetrakis-(N, N-di-p-methoxyphenylamine)-9, 9'-spirobifluorene (spiro-OMeTAD). Starting from ZnO nanorods synthesized from solution, we investigate the porous ZnO film morphology using various precursor formulations. The nature of the polymeric additive used in the initial ZnO formulation, as well as the ZnO electrode sintering treatment, is varied and its influence on device performance and charge dynamics, probed by transient perturbation techniques, is discussed. We show that using ethyl-cellulose in the initial ZnO formulation is responsible for an improved dye loading on the ZnO porous electrode, while a gradual sintering step at 350 degrees C is suitable for the proper removal of the organic phases that can be found in the ZnO films after their deposition by spin-coating. Using only 800 nm thick porous ZnO electrodes sensitized by N719, the best performing device exhibits a short-circuit current density of 2.43 mA cm(-2) under simulated solar emission of (100 mW cm(-2)), associated with an overall power conversion efficiency of 0.50%.

Nanoscale control of the network morphology of high efficiency polymer fullerene solar cells by the use of high material concentration in the liquid phase.

Despite the constant improvement of their power conversion efficiencies, organic solar cells based on an interpenetrating network of a conjugated polymer as donor and fullerene derivatives as acceptor materials still need to be improved for commercial use. In this context, we present a study on the optimization of solar cells based on poly(3-hexylthiophene) (P3HT) and [6,6]-phenyl C61 butyric acid methyl ester (PCBM) by varying a specific cell parameter, namely the concentration of the active layer components in the liquid phase before blend film deposition, in order to improve device performance and to better understand the relation between morphology and device operation. Our study shows a significant increase of the short-circuit current, open-circuit voltage and cell efficiency by properly choosing the formulation of the initial blend before film deposition. We demonstrate that the active layer morphology, which is strongly dependent on the initial material concentrations and the processing conditions, can greatly impact the electronic characteristics of the device, especially regarding charge recombination dynamics at the donor-acceptor interface. Our optimized P3HT:PCBM device exhibits both slow recombination and high photocurrent generation associated with an overall power conversion efficiency of 4.25% under 100 mW cm(-2) illumination (AM1.5G).

Effect of sublethal doses of cadmium on the phototactic behavior of Daphnia magna.

The effect of a sublethal concentration of cadmium (0.06 mg/ L) was tested on the phototactic behavior of a positively phototactic Daphnia magna clone. In experiments lasting 10 min, using animals that had been exposed to cadmium for 1 to 6 h, it was observed that the animals became significantly less positively phototactic after 4 h of exposure to 0.06 mg/L cadmium compared to control animals that had not been exposed to cadmium. In flow-through experiments that lasted for 6 h and during which there were repeated measurements, there was again a significant effect of cadmium exposure on the phototactic behavior of the animals. Irrespective of treatment, time had a significant effect. Results suggest that phototactic behavior can be used to detect sublethal concentrations of pollutant within a few hours, in short-term as well as in longer-lasting experiments with continuous flow-through and repeated stimulation of the animals.

Tight association of loss of merlin expression with loss of heterozygosity at chromosome 22q in sporadic meningiomas.

Mutations of NF2, the gene for neurofibromatosis 2, are detected in 20-30% of sporadic meningiomas, and almost all mutations lead to loss of merlin expression. However, loss of heterozygosity (LOH) at chromosome 22q is found at a much higher frequency, up to 50-70%, and the possibility of another tumor suppressor gene in this region has not been excluded. Furthermore, a recent report proposed that abnormal activation of a protease micro-calpain can be an alternative pathway for merlin loss in meningiomas and schwannomas. To determine the correlation of merlin loss with NF2 genetic alteration or micro-calpain activation, we performed a molecular genetic analysis of 50 sporadic meningiomas and also examined the expression status of merlin and active form micro-calpain. LOH assay of five microsatellite markers franking NF2 revealed LOH in 22 cases, and single-strand conformation polymorphism assay detected six frameshift mutations, two splicing mutations, one nonsense mutation, and one missense mutation, all accompanied by 22q LOH. In addition, a multiplex PCR assay indicated homozygous deletion of NF2 in two cases. Interestingly, a marked decrease of merlin expression was seen exclusively in the 22 cases with 22q LOH. Activated micro-calpain expression was observed in 28 cases at various levels but showed no correlation with merlin status. These data strongly support the notion that NF2 is the sole target of 22q LOH in meningiomas and that loss of merlin expression is always caused by genetic alteration of NF2, following the classic "two hit" theory.

Abattoir condemnation of pigs and its economic implications in Singapore.

Losses due to mortality and rejection of carcases and viscera in a population of 2,959,607 pigs admitted for slaughter in Singapore abattoirs between 1984 and 1986 were studied. Mortality losses were 2822 pigs (9.5 per 10,000 admissions) while 3039 whole carcases (10.3 per 10,000 admissions) were condemned at post-mortem examination. The main reason for rejection of carcases was pyaemia (30.3%). Kidneys and livers were the two main organs of economic value rejected. Rejection of kidneys was primarily due to nephritis (54.8%) while liver condemnation was mainly due to cirrhosis (38.6%). The financial loss from abattoir rejection was S$5.27 millions or S$1.78 per pig admitted. The value of abattoir condemnation data as a tool in preventive medicine is discussed.

Treatment of "idiopathic midline destructive disease" by irradiation. A case report.

An unusual case with an aggressive destructive granulomatous lesion of the maxilla is reported. Although the possibility of infection and neoplasm could be ruled out, a definite diagnosis could not be established even by repeated biopsies which showed the lesion to be a non-specific inflammatory process. Since Wegener's granulomatosis was most unlikely, the patient was treated by radiotherapy which caused rapid remission of the lesion with no sign of recurrence after 4 years. The clinical and histological findings as well as the responsiveness to the treatment were most indicative of idiopathic midline destructive disease. Effective management of lethal midline granuloma of unknown aetiology is discussed.