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Approximately 13.8 million U.S. households face food insecurity, which severely affects child development, with more than half of these households including children. Research links food insecurity to cognitive deficits and mental health challenges, highlighting the need for thorough understanding and intervention. Although existing studies have explored the association between food insecurity and internalizing symptomatology, less research has examined food insecurity in relation to attention-deficit/hyperactivity disorder (ADHD) symptoms. Further, no studies have explored the connection between food insecurity and cognitive disengagement syndrome (CDS) symptoms, closely related to ADHD symptoms. Despite extant research linking CDS to environmental factors, empirical attention to its potential association with food insecurity is notably lacking. Additionally, adolescents, almost twice as likely as younger children to experience household food insecurity, are likely more aware and respond differently to challenges during this developmental period. Accordingly, this study investigated the unique associations of parent-, teacher-, and youth self-reported ADHD dimensions and CDS symptoms in relation to parent-reported food insecurity in early adolescents (N = 136, ages 10-12). Controlling for age, sex, race, and medication use, no informant's ratings of ADHD symptom dimensions were uniquely related to food insecurity. In contrast, higher parent-, teacher-, and youth self-reported CDS symptoms were uniquely associated with greater food insecurity. This finding was robust to additional control of family income for teacher- and youth self-reported CDS symptoms. These findings highlight the complex link between food insecurity and mental health, suggest a connection with CDS symptoms, and stress the need to address food insecurity as a public health priority, especially in early adolescence.
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OBJECTIVES: To determine the association of intraoperative pulmonary artery catheter (PAC) use with in-hospital outcomes in cardiac surgical patients. METHODS: MEDLINE, Embase, and Cochrane Library (Wiley) databases were screened for studies that compared cardiac surgical patients receiving intraoperative PAC with controls and reporting in-hospital mortality. Secondary outcomes included intensive care unit length of stay, cost of hospitalization, fluid volume administered, intubation time, inotropes use, acute kidney injury (AKI), stroke, myocardial infarction (MI), and infections. RESULTS: Seven studies (25 853 patients, 88.6% undergoing coronary artery bypass graft surgery) were included. In-hospital mortality was significantly increased with PAC use [odds ratio (OR) 1.57; 95% confidence interval (CI) 1.12-2.20, P = 0.04]; PAC use was also associated with greater intraoperative inotrope use (OR 2.61; 95% CI 1.54-4.41) and costs [standardized mean difference (SMD) = 0.20; 95% CI 0.16-0.23], longer intensive care unit stay (SMD = 0.29; 95% CI 0.25-0.33), and longer intubation time (SMD = 0.44; 95% CI 0.12-0.76). CONCLUSIONS: PAC use is associated with significantly increased odds of in-hospital mortality, but the amount and quality of the available evidence is limited. Prospective randomized trials testing the effect of PAC on the outcomes of cardiac surgical patients are urgently needed.
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INTRODUCTION: Women continue to be underrepresented in academic anesthesiology. This study assessed guidelines in anesthesia journals over the past 5 years, evaluating differences in woman-led versus man-led guidelines in terms of author gender, quality, and changes over time. We hypothesized that anesthesia guidelines would be predominately man-led, and that there would be differences in quality between woman-led versus man-led guidelines. METHODS: All clinical practice guidelines published in the top 10 anesthesia journals were identified as per Clarivate Analytics Impact Factor between 2016 and 2020. Fifty-one guidelines were included for author, gender, and quality analysis using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Each guideline was assessed across 6 domains and 23 items and given an overall score, overall quality score, and overall rating/recommendation. Stratified and trend analyses were performed for woman-led versus man-led guidelines. RESULTS: Fifty out of 51 guidelines were included: 1 was excluded due to unidentifiable first-author gender. In total, 255 of 1052 (24%) authors were women, and woman-led guidelines (woman-first author) represented 12 of 50 (24%) overall guidelines. Eighteen percent (9 of 50) of guidelines had all-male authors, and a majority (26 of 50, 52%) had less than one-third of female authors. The overall number and percentage of woman-led guidelines did not change over time. There was a significantly higher percentage of female authors in woman-led versus man-led guidelines, median 39% vs 20% (P = .012), as well as a significantly higher number of female coauthors in guidelines that were woman-led median 3.5 vs 1.0, P = .049. For quality, there was no significant difference in the overall rating or objective quality of woman- versus man-led guidelines. However, there was a significant increase in the overall rating of all the guidelines over time (P = .010), driven by the increase in overall rating among man-led guidelines, P = .002. The overall score of guidelines did not increase over time; however, they increased in man-led but not woman-led guidelines. There was no significant correlation between the percentage of female authors per guideline and either overall score or overall rating. CONCLUSIONS: There is a substantial disparity in the number of women leading and contributing to guidelines which has not improved over time. Woman-led guidelines included more women and a higher percentage of women. There was no difference in quality of guidelines by first-author gender or percentage of female authors. Further systematic and quota-driven sponsorship is needed to promote gender equity, diversity, and inclusion in anesthesia guidelines.
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Aggression and violence against educators and school personnel have raised public health concerns that require attention from researchers, policymakers, and training providers in U.S. schools. School aggression and violence have negative effects on school personnel health and retention and on student achievement and development. In partnership with several national organizations, the American Psychological Association (APA) Task Force on Violence Against Educators and School Personnel administered two national, multi-informant, cross-sectional surveys. Time 1 data were collected in 2020-2021 from 14,966 respondents; participants reflected on their experiences of violence and aggression before COVID-19 and during COVID-19 restrictions in this survey. One year later, in 2022, 11,814 respondents completed the Time 2 survey after COVID-19 restrictions ended. Participants included teachers, school psychologists, social workers, counselors, staff members, and administrators from all 50 states and Puerto Rico. Rates of violence and aggression directed against educators by students, parents, colleagues, and administrators were substantial before COVID-19, were lower during COVID-19 restrictions, and returned to prepandemic levels or higher after COVID-19 restrictions. After COVID-19 restrictions, 22%-80% of respondents reported verbal or threatening aggression, and 2%-56% of respondents reported physical violence at least once during the year, varying by stakeholder role and aggressor. Rates of intentions to quit the profession ranged from 21% to 43% during COVID-19 restrictions (2020-2021) and from 23% to 57% after COVID-19 restrictions (2021-2022), varying by stakeholder role. Participants across roles reported substantial rates of anxiety and stress, especially during and after COVID-19 restrictions, and identified specific training needs. Implications for theory, research, training, and policy are presented. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Strategies are needed to better identify patients that will benefit from immunotherapy alone or who may require additional therapies like chemotherapy or radiotherapy to overcome resistance. Here we employ single-cell transcriptomics and spatial proteomics to profile triple negative breast cancer biopsies taken at baseline, after one cycle of pembrolizumab, and after a second cycle of pembrolizumab given with radiotherapy. Non-responders lack immune infiltrate before and after therapy and exhibit minimal therapy-induced immune changes. Responding tumors form two groups that are distinguishable by a classifier prior to therapy, with one showing high major histocompatibility complex expression, evidence of tertiary lymphoid structures, and displaying anti-tumor immunity before treatment. The other responder group resembles non-responders at baseline and mounts a maximal immune response, characterized by cytotoxic T cell and antigen presenting myeloid cell interactions, only after combination therapy, which is mirrored in a murine model of triple negative breast cancer.
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Neoplasias de Mama Triplo Negativas , Humanos , Animais , Camundongos , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/radioterapia , Anticorpos Monoclonais Humanizados/uso terapêutico , Terapia Combinada , ImunoterapiaRESUMO
In this study, we examined how school policies and strategies (i.e., positive discipline, hardening strategies, and positive behavioral strategies) affect teacher relational factors and teacher reports of victimization and safety. Specifically, we examined the mediational roles of teacher support of student learning, maltreatment of students by teachers, and teachers' differential treatment of students in schools. Using a sample of 6643 pre-K-12th-grade teachers, path analysis results revealed that positive behavior strategies, hardening strategies, and positive discipline were indirectly associated with teacher victimization and sense of safety. Additionally, teachers' perceptions of other teachers maltreating students had the greatest contributions to their sense of safety and victimization by students. Positive discipline was directly and indirectly associated with teacher victimization and safety. Implications and directions for future studies are discussed.
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Bullying , Vítimas de Crime , Pessoal de Educação , Humanos , Professores Escolares , Instituições Acadêmicas , Bullying/prevenção & controleAssuntos
Estenose da Valva Aórtica , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Humanos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Aorta/cirurgia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Biomechanical effects of transcatheter (TAVR) versus surgical (SAVR) aortic valve interventions on the distal aorta have not been studied. This study utilized global circumferential strain (GCS) to assess post-procedural biomechanics changes in the descending aorta after TAVR versus SAVR. METHODS: Patients undergoing TAVR or SAVR for aortic stenosis were included. Transesophageal (TEE) and transthoracic (TTE) echocardiography short-axis images of the aorta were used to image the descending aorta immediately before and after interventions. Image analysis was performed with two-dimensional speckle tracking echocardiography and dedicated software. Delta GCS was calculated as: post-procedural GCS-pre-procedural GCS. Percentage delta GCS was calculated as: (delta GCS/pre-procedural GCS) × 100. RESULTS: Eighty patients, 40 TAVR (median age 81 y/o, 40% female) and 40 SAVR (median 72 y/o, 30% female) were included. The post-procedure GCS was significantly higher than the pre-procedural GCS in the TAVR (median 10.7 [interquartile range IQR 4.5, 14.6] vs. 17.0 [IQR 6.1, 20.9], p = 0.009) but not in the SAVR group (4.4 [IQR 3.3, 5.3] vs. 4.7 [IQR 3.9, 5.6], p = 0.3). The delta GCS and the percentage delta GCS were both significantly higher in the TAVR versus SAVR group (2.8% [IQR 1.4, 6] vs. 0.15% [IQR - 0.6, 1.5], p < 0.001; and 28.8% [IQR 14.6%, 64.6%] vs. 4.4% [IQR - 10.6%, 5.6%], p = 0.006). Results were consistent after multivariable adjustment for key clinical and hemodynamic characteristics. CONCLUSIONS: After TAVR, there was a significantly larger increase in GCS in the distal aorta compared to SAVR. This may impact descending aortic remodeling and long-term risk of aortic events.
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Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Substituição da Valva Aórtica Transcateter , Humanos , Feminino , Idoso de 80 Anos ou mais , Masculino , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/métodos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/métodos , Fenômenos Biomecânicos , Resultado do Tratamento , Estenose da Valva Aórtica/cirurgia , Fatores de RiscoRESUMO
Teacher well-being and experiences of violence have become issues of national concern, and teacher shortages have increased since the onset of COVID-19. In this national study, we examined verbal and physical violence against teachers from multiple aggressors and the role of anxiety and stress in predicting intentions to transfer positions or quit the profession. The majority of the sample of 9,370 pre-Kindergarten-12th grade teachers was White (79%) and female (79%). Descriptive analyses revealed that 25% of teachers reported intentions to transfer schools and 43% of teachers reported intentions to quit teaching. Structural equation model results indicated pre-COVID-19 verbal and threatening violence from students, parents, colleagues, and administrators predicted teacher anxiety and stress and intentions to transfer schools (R² ranged from .18 to .23) and quit the profession during COVID-19 (R² ranged from .34 to .36). Anxiety and stress significantly mediated the relation between verbal and threatening violence across all aggressors and teacher intentions to transfer schools and quit the profession. Physical violence from certain aggressors predicted anxiety and stress and intention to transfer schools (R² ranged from .15 to .18) and quit the profession (R² ranged from .32 to .34). Further, teacher and school characteristics, such as identifying as a person of color and teaching at the middle and high school levels, were associated with greater intentions to transfer schools and quit the profession. Implications for school-based research, practice, and policy are discussed to address violence and promote positive work and learning environments for all school stakeholders. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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The mouse olfactory system regenerates constantly throughout life. While genes critical for the initial projection of olfactory sensory neurons (OSNs) to the olfactory bulb have been identified, what genes are important for maintaining the olfactory map during regeneration are still unknown. Here we show a mutation in Protocadherin 19 (Pcdh19), a cell adhesion molecule and member of the cadherin superfamily, leads to defects in OSN coalescence during regeneration. Surprisingly, lateral glomeruli were more affected and males in particular showed a more severe phenotype. Single cell analysis unexpectedly showed OSNs expressing the MOR28 odorant receptor could be subdivided into two major clusters. We showed that at least one protocadherin is differentially expressed between OSNs coalescing on the medial and lateral glomeruli. Moreover, females expressed a slightly different complement of genes from males. These features may explain the differential effects of mutating Pcdh19 on medial and lateral glomeruli in males and females.
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Indigenous Peoples are reimagining their relationship with research and researchers through greater self-determination and involvement in research governance. The emerging discourse around Indigenous Data Sovereignty has provoked discussions about decolonizing data practices and highlighted the importance of Indigenous Data Governance to support Indigenous decision-making and control of data. Given that much data are generated from research, Indigenous research governance and Indigenous Data Governance overlap. In this paper, we broaden the concept of Indigenous Data Sovereignty by using the CARE Principles for Indigenous Data Governance to discuss how research legislation and policy adopted by Indigenous Peoples in the US set expectations around recognizing sovereign relationships, acknowledging rights and interests in data, and enabling Indigenous Peoples' participation in research governance.
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Cognitive disengagement syndrome (CDS), previously referred to as sluggish cognitive tempo, is a set of symptoms characterized by excessive daydreaming, mental fogginess, and slowed behavior/thinking. Studies examining the association between CDS and academic functioning have reported mixed findings and have relied upon limited measures of CDS, broad ratings of academic impairment, and/or focused only on elementary-aged children. The current study examined the relationship between CDS and academic functioning in adolescents using a comprehensive, multi-informant, multi-method design. Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD) recruited in the fall of their 8th grade. Above and beyond ADHD inattentive symptoms, CDS symptoms were related to poorer homework performance, lower math fluency, and lower daily academic motivation across multiple informants, and teacher-reported CDS symptoms were related to lower grades. Findings were not moderated by ADHD diagnosis, suggesting that associations between CDS and academic outcomes do not differ for adolescents with and without ADHD. Findings demonstrate that CDS symptoms are uniquely associated with daily academic difficulties as well as global indices of academic performance. These findings have implications for assessing and monitoring CDS symptoms in interventions aiming to improve the academic functioning in adolescents with and without ADHD.
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School personnel safety and well-being have received increased attention via national outlets; however, research is limited. The current investigation is the first to examine the reported use and perceived effectiveness of commonly used school-based intervention approaches for addressing school violence, specifically violence against teachers in U.S. schools. A sample of 4,471 prekindergarten-12th grade teachers was asked to rate the use and perceived effectiveness of common school-based approaches, namely exclusionary discipline (e.g., suspensions), school hardening (e.g., metal detectors, school police), prevention (e.g., school climate improvement, social-emotional learning, classroom management), and crisis intervention practices (e.g., de-escalation, physical restraint) to address verbal/threatening, physical, and property violence against teachers. Findings revealed that teachers rated prevention practices as most effective in reducing violence against teachers. The use of exclusionary discipline and crisis intervention practices at school was positively associated with all three forms of violence. Ratings of the effectiveness of specific practices were associated with lower likelihoods of verbal/threatening (i.e., hardening, prevention), physical (i.e., exclusionary discipline, hardening, prevention), and property (i.e., hardening) violence. Implications for school practice, research, and policy are presented. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Violence against teachers is a public health crisis that has devastating effects on school personnel well-being, health, and retention, as well as students' educational outcomes. In collaboration with national organizations, the American Psychological Association Task Force on Violence against Educators conducted the first national survey on educator victimization that included 4,136 pre-K through 12th-grade teachers from all 50 U.S. states and Puerto Rico during the pandemic. In the current study, 43.7% of teachers reported experiencing at least one verbal threat, physical assault, and/or property damage, with verbal threats being the most prevalent form of victimization during the pandemic. Using a social-ecological framework and logistic regression analyses, characteristics of teachers, school climate, and school organizational and community factors were examined as predictors of teacher victimization (i.e., verbal threats, physical, property violence) during the pandemic. Findings revealed that teacher role (i.e., special educators), negative and positive dimensions of school climate, as well as school organizational and community factors (i.e., percent of students receiving free and reduced lunch, instructional modality, school level, and urbanicity) significantly predicted greater teacher victimization. While findings revealed that in-person instruction significantly predicted teacher violence across aggressors, teacher victimization was reported across instructional modality (in-person, hybrid, remote). Results offer insights into possible contextual antecedents to teacher victimization, sense of safety, and well-being in schools. Implications for research and school practice are presented. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Indigenous Peoples' right to sovereignty forms the foundation for advocacy and actions toward greater Indigenous self-determination and control across a range of domains that impact Indigenous Peoples' communities and cultures. Declarations for sovereignty are rising throughout Indigenous communities and across diverse fields, including Network Sovereignty, Food Sovereignty, Energy Sovereignty, and Data Sovereignty. Indigenous Research Sovereignty draws in the sovereignty discourse of these initiatives to consider their applications to the broader research ecosystem. Our exploration of Indigenous Research Sovereignty, or Indigenous self-determination in the context of research activities, has been focused on the relationship between Indigenous Data Sovereignty and efforts to describe Indigenous Peoples' Rights in data.
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Estrogen and progesterone have been extensively studied in the mammary gland, but the molecular effects of androgen remain largely unexplored. Transgender men are recorded as female at birth but identify as male and may undergo gender-affirming androgen therapy to align their physical characteristics and gender identity. Here we perform single-cell-resolution transcriptome, chromatin, and spatial profiling of breast tissues from transgender men following androgen therapy. We find canonical androgen receptor gene targets are upregulated in cells expressing the androgen receptor and that paracrine signaling likely drives sex-relevant androgenic effects in other cell types. We also observe involution of the epithelium and a spatial reconfiguration of immune, fibroblast, and vascular cells, and identify a gene regulatory network associated with androgen-induced fat loss. This work elucidates the molecular consequences of androgen activity in the human breast at single-cell resolution.
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BACKGROUND: People with Down syndrome often present with balance deficits, which compromise safety during daily activity. While evidence shows that exercise can improve balance in the Down syndrome population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Down syndrome. METHODS: Eighteen low-active participants with Down syndrome completed a 12-week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: TUG, MCTSIB, FICSIT-4, and FRT. This study was registered as a clinical trial on ClinicalTrials.gov, identifier: NCT04647851. RESULTS: Significant improvement was seen in the TUG (p = .043), FICSIT-4 (p = .019) and FRT (p = .019). All participants achieved maximum scores on the MCTSIB in pre- and post-testing. CONCLUSIONS: Balance in low-active adults with Down syndrome significantly improved following the telehealth exercise program, which we attribute to the tailored exercises that address visual/vestibular deficits and hip muscle weakness.
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Síndrome de Down , Deficiência Intelectual , Telemedicina , Adulto , Humanos , Exercício Físico , Terapia por Exercício/métodos , Equilíbrio Postural/fisiologiaRESUMO
Racial disparities and a corresponding lack of trust have been documented within the criminal legal system. In response, criminal legal system actors have sought to strengthen the legitimacy of their agencies. However, legitimizing these agencies can be problematic. Some argue that the current criminal legal system continues the legacy of slavery and Jim Crow as Blacks are disproportionately policed and incarcerated. As a framework, procedural injustice can offer a unique backdrop and interrogate ways in which the criminal legal system engages in delegitimizing actions that provoke noncompliance and enable social control. Using a procedural injustice lens, this study examines how justice-involved Black adults experience mistreatment by justice system actors. Semistructured interviews were conducted with 84 Black adults in Newark and Cleveland. Study findings offer a comprehensive account of how participants experience procedural injustice as arrestees, defendants, and incarcerated persons. More specifically, participant narratives describe deliberately antagonistic, abusive, and dehumanizing treatment by justice-system agents-often depicted as racially motivated. Participant accounts also describe this mistreatment as occurring in a context of coercion and powerlessness and as being institutionally sanctioned. Implications for the preservation of racial hierarchies, research, practice, and community psychology are discussed.
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Direito Penal , Polícia , Humanos , Adulto , Grupos Raciais , ConfiançaRESUMO
Research has examined racial socialization practices within families of color, but less is known regarding what White parents teach their children about race and/or racism. To explore White racial socialization processes, we interviewed 30 White parents of White children ages 7-17 years living in the Midwest. Using thematic analysis, we identified 22 themes organized into four domains: Content of conversations, factors to consider in socialization, developmental differences, and White identity/privilege. A majority of parents reported conversations about current or historic racial events, while relatively few also reported speaking specifically about systemic racism and microaggressions. Parents viewed adolescents as better able to handle difficult topics than children. Findings contribute to theoretical frameworks and may inform the development of educational resources.