The COVID-19 Pandemic, Rising Inflation, and Their Influence on Dining Out Frequency and Spending.

BACKGROUND: High intake of food away from home is associated with poor diet quality. This study examines how the COVID-19 pandemic period and Food Away from Home (FAFH) inflation rate fluctuations influenced dining out behaviors. METHODS: Approximately 2800 individuals in Texas reported household weekly dining out frequency and spending. Responses completed prior to the COVID-19 pandemic (2019 to early 2020) were compared to the post-COVID-19 period (2021 through mid-2022). Multivariate analysis with interaction terms was used to test study hypotheses. RESULTS AND CONCLUSION: From the COVID-19 period (before vs. after), the unadjusted frequency of dining out increased from 3.4 times per week to 3.5 times per week, while the amount spent on dining out increased from $63.90 to $82.20. Once the relationship between dining out (frequency and spending) was adjusted for FAFH interest rate and sociodemographic factors, an increase in dining out frequency post-COVID-19 remained significant. However, the unadjusted increase in dining out spending did not remain significant. Further research to understand the demand for dining out post-pandemic is warranted.

State-dependent effects of neural stimulation on brain function and cognition.

Invasive and non-invasive brain stimulation methods are widely used in neuroscience to establish causal relationships between distinct brain regions and the sensory, cognitive and motor functions they subserve. When combined with concurrent brain imaging, such stimulation methods can reveal patterns of neuronal activity responsible for regulating simple and complex behaviours at the level of local circuits and across widespread networks. Understanding how fluctuations in physiological states and task demands might influence the effects of brain stimulation on neural activity and behaviour is at the heart of how we use these tools to understand cognition. Here we review the concept of such 'state-dependent' changes in brain activity in response to neural stimulation, and consider examples from research on altered states of consciousness (for example, sleep and anaesthesia) and from task-based manipulations of selective attention and working memory. We relate relevant findings from non-invasive methods used in humans to those obtained from direct electrical and optogenetic stimulation of neuronal ensembles in animal models. Given the widespread use of brain stimulation as a research tool in the laboratory and as a means of augmenting or restoring brain function, consideration of the influence of changing physiological and cognitive states is crucial for increasing the reliability of these interventions.

Impact of ablation index settings on pulmonary vein reconnection.

PURPOSE: Ablation index (AI) is a radiofrequency lesion quality marker. The AI value that allows effective and safe pulmonary vein isolation (PVI) is still debated. We evaluated the incidence of acute and late PV reconnection (PVR) with different AI settings and its predictors. METHODS: The Ablation Index Registry is a multicenter study that included patients with paroxysmal/persistent atrial fibrillation (AF) who underwent first-time ablation. Each operator performed the ablation using his preferred ablation catheter (ThermoCool® SmartTouch or Surround Flow) and AI setting (380 posterior-500 anterior and 330 posterior-450 anterior). We divided the study population into two groups according to the AI setting used: group 1 (330-450) and group 2 (380-500). Incidence of acute PVR was validated within 30 min after PVI, whereas the incidence of late PVR was evaluated at repeat procedure. RESULTS: Overall, 490 patients were divided into groups 1 (258) and 2 (232). There was no significant difference in the procedural time, fluoroscopy time, and rate of the first-pass PVI between the two study groups. Acute PVR was observed in 5.6% PVs. The rate of acute PVR was slightly higher in group 2 (64/943, 6.8%, PVs) than in group 1 (48/1045, 4.6% PVs, p = 0.04). Thirty patients (6%) underwent a repeat procedure and late PVR was observed in 57/116 (49%) PVs (number of reconnected PV per patient of 1.9 ± 1.6). A similar rate of late PVR was found in the two study groups. No predictors of acute and late PVR were found. CONCLUSION: Ablation with a lower range of AI is highly effective and is not associated with a higher rate of acute and late PVR. No predictors of PV reconnection were found.

Prevalence of maternal obesity at delivery and association with maternal and neonatal outcomes.

INTRODUCTION: Maternal obesity has been linked to adverse outcomes for mothers and their offspring, including, but not limited to gestational hypertension (gHTN), gestational diabetes (GDM), pre-eclampsia, fetal macrosomia, and emergency cesarean section. Recent investigations have also shown that obesity, as defined by a body mass index (BMI) ≥ 30, especially severe obesity (BMI ≥ 40), is a risk factor for both hospitalization and death from COVID-19. OBJECTIVES: The objective of this study is to determine the prevalence and association of maternal obesity at delivery with adverse antenatal, intrapartum, and neonatal outcomes in a cohort of consecutive delivering patients at a tertiary care center in Iowa from May to September 2020. A secondary objective is to determine if maternal obesity has any relationship to past or current COVID-19 infection status at the time of delivery. This is a secondary analysis of a prospective cohort study to analyze obstetric outcomes among COVID-19 infected and uninfected patients. METHODS: We conducted a prospective cohort study using demographic and clinical data obtained from the electronic medical record. Excess plasma was collected from routine blood samples obtained at delivery admission to determine the seroprevalence of COVID-19 antibody using the DiaSorin and Roche antibody assays. Frequency variables were each calculated separately, and a comparison of maternal and neonatal outcomes was conducted using the generalized linear mixed modeling (GLMM) framework to account for varying distributions (normal and binary). RESULTS: 1001 women delivered during the study period and 89.7% met criteria for being overweight or obese; 17.9% met criteria for severe obesity. Women with obesity had 49.8% lower odds of possessing private insurance, and women with severe obesity were less than half as likely to plan to breastfeed at the time of discharge. Women with obesity of any kind had a significantly increased odds of GDM and gHTN, and an increased risk of an infant with macrosomia, hypoglycemia, and NICU admission. No significant association was found between BMI and COVID-19 infection or disease severity. CONCLUSION: This study provides insight into obstetric complications facing women with obesity, especially those with severe obesity. This report serves to highlight potential challenges, such as insurance status and labor complications, that impact women of high BMI to a greater degree when compared to their normal-weight counterparts.

SARS-CoV-2 Infection during Pregnancy in a Rural Midwest All-delivery Cohort and Associated Maternal and Neonatal Outcomes.

OBJECTIVE: This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy. STUDY DESIGN: This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births. RESULTS: In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive during pregnancy. Three of 1,000 (0.3%) were viral positive on admission but antibody negative. The median age was 30 years (interquartile range [IQR]: 26-33 years) and body mass index was 31.75 kg/m2 (IQR 27.7-37.5 kg/m2). The cesarean delivery rate was 34.0%. The study population was primarily white (71.6%); however, 41.0% of SARS-CoV-2 infected patients identified as Black, 18.0% as Hispanic/Latino, 3.3% as Native Hawaiian/Pacific Islander, and only 27.9% as White (p < 0.0001). SARS-CoV-2 infection was more likely in patients without private insurance (p = 0.0243). Adverse maternal and/or neonatal outcomes were not more likely in patients with evidence of infection during pregnancy. Two SARS-CoV-2 infected patients were admitted to the intensive care unit. There were no maternal deaths during the study period. CONCLUSION: In this largely rural Midwest population, 6.1% of delivering patients had evidence of past or current SARS-CoV-2 infection. Rates of SARS-CoV-2 during pregnancy were higher among racial and ethnic minorities and patients without private insurance. The SARS-CoV-2 infected patients and their neonates were not found to be at increased risk for adverse outcomes. KEY POINTS: · SARS-CoV-2 seroprevalence rate in pregnant population in Iowa is 5.8%.. · Infections are higher among minorities, non-English speakers, and patients without private insurance.. · No increased adverse maternal/neonatal outcomes observed for SARS-CoV-2 infected mothers..

Effects of tDCS on visual statistical learning.

Visual statistical learning describes the encoding of structure in sensory input, and it has important consequences for cognition and behaviour. Higher-order brain regions in the prefrontal and posterior parietal cortices have been associated with statistical learning behaviours. Yet causal evidence of a cortical contribution remains limited. In a recent study, the modulation of cortical activity by transcranial direct current stimulation (tDCS) disrupted statistical learning in a spatial contextual cueing phenomenon; supporting a cortical role. Here, we examined whether the same tDCS protocol would influence statistical learning assessed by the Visual Statistical Learning phenomenon (i.e., Fiser and Aslin, 2001), which uses identity-based regularities while controlling for spatial location. In Experiment 1, we employed the popular exposure-test design to tap the learning of structure after passive viewing. Using a large sample (N = 150), we found no effect of the tDCS protocol when compared to a sham control nor to an active control region. In Experiment 2 (N = 80), we developed an online task that was sensitive to the timecourse of learning. Under these task conditions, we did observe a stimulation effect on learning, consistent with the previous work. The way tDCS affected learning appeared to be task-specific; expediting statistical learning in this case. Together with the existing evidence, these findings support the hypothesis that cortical areas are involved in the visual statistical learning process, and suggest the mechanisms of cortical involvement may be task-dependent and dynamic across time.

The Human Odontoblast Cell Layer and Dental Pulp Proteomes and N-Terminomes.

The proteome and N-terminome of the human odontoblast cell layer were identified for the first time by shotgun proteomic and terminal amine isotopic labeling of substrates (TAILS) N-terminomic analyses, respectively, and compared with that of human dental pulp stroma from 26 third molar teeth. After reverse-phase liquid chromatography-tandem mass spectrometry, >170,000 spectra from the shotgun and TAILS analyses were matched by 4 search engines to 4,888 and 12,063 peptides in the odontoblast cell layer and pulp stroma, respectively. Within these peptide groups, 1,543 and 5,841 protein N-termini, as well as 895 and 2,423 unique proteins, were identified with a false discovery rate of ≤1%. Thus, the human dental pulp proteome was expanded by 974 proteins not previously identified among the 4,123 proteins in our 2015 dental pulp study. Further, 222 proteins of the odontoblast cell layer were not found in the pulp stroma, suggesting many of these proteins are synthesized only by odontoblasts. When comparing the proteomes of older and younger donors, differences were more apparent in the odontoblast cell layer than in the dental pulp stroma. In the odontoblast cell layer proteome, we found proteomic evidence for dentin sialophosphoprotein, which is cleaved into dentin sialoprotein and dentin phosphoprotein. By exploring the proteome of the odontoblast cell layer and expanding the known dental pulp proteome, we found distinct proteome differences compared with each other and with dentin. Moreover, between 61% and 66% of proteins also occurred as proteoforms commencing with a neo-N-terminus not annotated in UniProt. Hence, TAILS increased proteome coverage and revealed considerable proteolytic processing, by identifying stable proteoforms in these dynamic dental tissues. All mass spectrometry raw data have been deposited to ProteomeXchange with the identifier , with the accompanying metadata at Mendeley Data ( https://data.mendeley.com/datasets/b57zfh6wmy/1 ).

Cathodal electrical stimulation of frontoparietal cortex disrupts statistical learning of visual configural information.

Attentional performance is facilitated by exploiting regularities and redundancies in the environment by way of incidental statistical learning. For example, during visual search, response times to a target are reduced by repeating distractor configurations-a phenomenon known as contextual cueing (Chun & Jiang, 1998). A range of neuroscientific methods have provided evidence that incidental statistical learning relies on subcortical neural structures associated with long-term memory, such as the hippocampus. Functional neuroimaging studies have also implicated the prefrontal cortex (PFC) and posterior parietal cortex (PPC) in contextual cueing. However, the extent to which these cortical regions are causally involved in statistical learning remains unclear. Here, we delivered anodal, cathodal, or sham transcranial direct current stimulation (tDCS) to the left PFC and left PPC online while participants performed a contextual cueing task. Cathodal stimulation of both PFC and PPC disrupted the early cuing effect, relative to sham and anodal stimulation. These findings causally implicate frontoparietal regions in incidental statistical learning that acts on visual configural information. We speculate that contextual cueing may rely on the availability of cognitive control resources in frontal and parietal regions.

Prevalence of Lassa virus among rodents trapped in three South-South States of Nigeria.

BACKGROUND & OBJECTIVES: Lassa fever has been endemic in Nigeria since 1969. The rodent Mastomys natalensis has been widely claimed to be the reservoir host of the Lassa virus. This study was designed to investigate the dis- tribution of species of rodents in three states (Edo, Delta and Bayelsa) of Nigeria and to determine the prevalence of Lassa virus amongst trapped rodents in the selected states. METHODS: Rodents were trapped during November 2015 to October 2016 from the three states in South-South re- gion of Nigeria. Total RNA was extracted from the blood collected from the trapped rodents. Reverse transcription polymerase chain reaction (RT-PCR) was used to confirm the presence of Lassa virus in the rodents. RESULTS: The results revealed that six species of rodents were predominantly present in these geographical locations. Mus musculus (39.4%) had the highest prevalence, closely followed by Rattus rattus (36.1%), R. fuscipus (20.3%), M. natalensis (2%), Myosoricinae soricidae (1.2%) and R. norvegicus (1%). The overall positivity (carrier rate) of Lassa virus was 1.6% amongst the 1500 rodents caught in the three states. In Edo and Delta States, the RT-PCR results showed presence of Lassa virus in R. rattus, M. musculus and M. natalensis. On the other hand, only M. na- talensis was detected with the virus, amongst the species of rodents caught in Bayelsa State. M. natalensis recorded the highest Lassa virus among rodents trapped in Edo (87%), Delta (50%) and Bayelsa (11%) States respectively. INTERPRETATION & CONCLUSION: The rather low Lassa virus positive among rodents in Bayelsa State of Nigeria may explain the absence of reports of outbreak of Lassa fever over the past 48 yr in the state. The results also confirmed that apart from Mastomys natalensis, other rodents such as Rattus rattus and Mus musculus may also serve as res- ervoirs for Lassa virus. From the findings of this cross-sectional study, it was concluded that a more comprehensive study on rodents as reservoir host, need to be undertaken across the entire states of Nigeria, for better understanding of the epidemiology and endemicity of Lassa fever.

Stimulus uncertainty enhances long-term potentiation-like plasticity in human motor cortex.

Plasticity can be induced in human cortex using paired associative stimulation (PAS), which repeatedly and predictably pairs a peripheral electrical stimulus with transcranial magnetic stimulation (TMS) to the contralateral motor region. Many studies have reported small or inconsistent effects of PAS. Given that uncertain stimuli can promote learning, the predictable nature of the stimulation in conventional PAS paradigms might serve to attenuate plasticity induction. Here, we introduced stimulus uncertainty into the PAS paradigm to investigate if it can boost plasticity induction. Across two experimental sessions, participants (n = 28) received a modified PAS paradigm consisting of a random combination of 90 paired stimuli and 90 unpaired (TMS-only) stimuli. Prior to each of these stimuli, participants also received an auditory cue which either reliably predicted whether the upcoming stimulus was paired or unpaired (no uncertainty condition) or did not predict the upcoming stimulus (maximum uncertainty condition). Motor evoked potentials (MEPs) evoked from abductor pollicis brevis (APB) muscle quantified cortical excitability before and after PAS. MEP amplitude increased significantly 15 min following PAS in the maximum uncertainty condition. There was no reliable change in MEP amplitude in the no uncertainty condition, nor between post-PAS MEP amplitudes across the two conditions. These results suggest that stimulus uncertainty may provide a novel means to enhance plasticity induction with the PAS paradigm in human motor cortex. To provide further support to the notion that stimulus uncertainty and prediction error promote plasticity, future studies should further explore the time course of these changes, and investigate what aspects of stimulus uncertainty are critical in boosting plasticity.

Psychological Outcomes of Living Liver Donors From a Multicenter Prospective Study: Results From the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2).

Although single-center and cross-sectional studies have suggested a modest impact of liver donation on donor psychological well-being, few studies have assessed these outcomes prospectively among a large cohort. We conducted one of the largest, prospective, multicenter studies of psychological outcomes in living liver donors within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2) consortium. In total, 271 (91%) of 297 eligible donors were interviewed at least once before donation and at 3, 6, 12, and 24 mo after donation using validated measures. We found that living liver donors reported low rates of major depressive (0-3%), alcohol abuse (2-5%), and anxiety syndromes (2-3%) at any given assessment in their first 2 years after donation. Between 4.7% and 9.6% of donors reported impaired mental well-being at various time points. We identified significant predictors for donors' perceptions of being better people and experiencing psychological growth following donation, including age, sex, relationship to recipient, ambivalence and motivation regarding donation, and feeling that donation would make life more worthwhile. Our results highlight the need for close psychosocial monitoring for those donors whose recipients died (n=27); some of those donors experienced guilt and concerns about responsibility. Careful screening and targeted, data-driven follow-up hold promise for optimizing psychological outcomes following this procedure for potentially vulnerable donors.

Social and Financial Outcomes of Living Liver Donation: A Prospective Investigation Within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2).

Because results from single-center (mostly kidney) donor studies demonstrate interpersonal relationship and financial strains for some donors, we conducted a liver donor study involving nine centers within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2) consortium. Among other initiatives, A2ALL-2 examined the nature of these outcomes following donation. Using validated measures, donors were prospectively surveyed before donation and at 3, 6, 12, and 24 mo after donation. Repeated-measures regression models were used to examine social relationship and financial outcomes over time and to identify relevant predictors. Of 297 eligible donors, 271 (91%) consented and were interviewed at least once. Relationship changes were positive overall across postdonation time points, with nearly one-third reporting improved donor family and spousal or partner relationships and >50% reporting improved recipient relationships. The majority of donors, however, reported cumulative out-of-pocket medical and nonmedical expenses, which were judged burdensome by 44% of donors. Lower income predicted burdensome donation costs. Those who anticipated financial concerns and who held nonprofessional positions before donation were more likely to experience adverse financial outcomes. These data support the need for initiatives to reduce financial burden.

Associative plasticity in the human motor cortex is enhanced by concurrently targeting separate muscle representations with excitatory and inhibitory protocols.

Paired associative stimulation (PAS) induces changes in the excitability of human sensorimotor cortex that outlast the procedure. PAS typically involves repeatedly pairing stimulation of a peripheral nerve that innervates an intrinsic hand muscle with transcranial magnetic stimulation over the representation of that muscle in the primary motor cortex. Depending on the timing of the stimuli (interstimulus interval of 25 or 10 ms), PAS leads to either an increase (PAS25) or a decrease (PAS10) in excitability. Both protocols, however, have been associated with an increase in excitability of nearby muscle representations not specifically targeted by PAS. Based on these spillover effects, we hypothesized that an additive, excitability-enhancing effect of PAS25 applied to one muscle representation may be produced by simultaneously applying PAS25 or PAS10 to a nearby representation. In different experiments prototypical PAS25 targeting the left thumb representation [abductor pollicis brevis (APB)] was combined with either PAS25 or PAS10 applied to the left little finger representation [abductor digiti minimi (ADM)] or, in a control experiment, with PAS10 also targeting the APB. In an additional control experiment PAS10 targeted both representations. The plasticity effects were quantified by measuring the amplitude of motor evoked potentials (MEPs) recorded before and after PAS. As expected, prototypical PAS25 was associated with an increase in MEP amplitude in the APB muscle. This effect was enhanced when PAS also targeted the ADM representation but only when a different interstimulus timing (PAS10) was used. These results suggest that PAS-induced plasticity is modified by concurrently targeting separate motor cortical representations with excitatory and inhibitory protocols.

Prevention Services for Externalizing and Anxiety Symptoms in Low-Income Children: the Role of Parent Preferences in Early Childhood.

Dissemination of prevention programs targeting young children is impeded by challenges with parent engagement. Matching program characteristics to parent preferences is associated with increased retention in clinical/intervention settings, but little is known about the types of prevention programs that interest parents. The objectives of this study were to better understand parents' preferences for services designed to prevent externalizing and anxiety disorders and to identify factors associated with preferences. Ethnically diverse, low-income caregivers (n = 485) of young children (11-60 months) completed surveys on child anxiety and externalizing symptoms, parental worry about their children, parent anxiety symptoms, and preferences for prevention group topics. Parents were more likely to prefer a group targeting externalizing behaviors compared to anxiety. Cluster analysis revealed four groups of children: low symptoms, moderate anxiety-low externalizing, moderate externalizing-low anxiety, and high anxiety and externalizing. Parents' preferences varied according to co-occurrence of child anxiety and externalizing symptoms; interest in a program targeting externalizing problems was associated with elevated externalizing problems (regardless of anxiety symptom level), parent anxiety symptoms, and parent worry about their child. Only parent anxiety symptoms predicted parents' interest in an anxiety-focused program, and preference for an anxiety-focused program was actually reduced if children had co-occurring anxiety and externalizing symptoms versus only anxiety symptoms. Results suggest that parents' interest in a program to prevent externalizing problems was well-aligned with the presenting problem, whereas preferences for anxiety programming suggest a more complex interplay among factors. Parent preferences for targeted programming are discussed within a broader framework of parent engagement.

Respiratory plasticity is insufficient to alleviate blood acid-base disturbances after acclimation to ocean acidification in the estuarine red drum, Sciaenops ocellatus.

The changes in ocean chemistry stemming from anthropogenic CO2 release--termed ocean acidification (OA)--are predicted to have wide-ranging effects on fish and ultimately threaten global populations. The ability of fish to adapt to environmental change is currently unknown, but phenotypic plasticity has been highlighted as a crucial factor in determining species resilience. Here we show that red drum, a long-lived estuarine-dependent fish species native to the Gulf of Mexico, exhibit respiratory plasticity that increases CO2 excretion capacity when acclimated to OA conditions. Specifically, fish exposed to 14 days of 1000 µatm CO2 had a 32% reduction in branchial diffusion distance and increased expression of two putative CO2 channel proteins--rhag and rhcg1. No changes were observed in the erythrocyte CO2 transport pathways. Surprisingly, no significant changes in blood chemistry were observed between acclimated and acutely challenged animals; however, a non-significant 30 % drop in the magnitude of plasma C(CO2) elevation was observed. Reduced diffusion distance also comes with the cost of increased diffusive water loss, which would require greater osmoregulatory investment by the animal. OA exposure induced increased gill Na(+), K(+) ATPase activity and intestinal nkcc2 expression, supporting both the presumed osmotic stress and increased osmoregulatory investment. However, no differences in standard metabolic rate, maximum metabolic rate or aerobic scope were detected between control and OA acclimated individuals. Similarly, no differences in critical swim speed were detected between groups, suggesting the energetic cost related to respiratory plasticity is negligible against background metabolism. The current study demonstrated that red drum exhibit respiratory plasticity with only mild physiological trade-offs; however, this plasticity is insufficient to fully offset the OA-induced acid-base disturbance and as such is unlikely to impact species resilience.

Canadian Society of Transplantation Members' Views on Anonymity in Organ Donation and Transplantation.

BACKGROUND: Anonymity has been central to medical, psychosocial, and societal practices in organ donation and transplantation. The purpose of this investigation was to explore transplant professionals' views on anonymity in the context of organ transplantation. METHODS: The study consisted of an electronic 18-item survey distributed to the Canadian Society of Transplantation membership, asking about anonymity vs open communication/contact between organ recipients and donor families. RESULTS: Of the 541 members surveyed, 106 replied. Among respondents, 71% felt that organ recipients and donor families should only communicate anonymously, yet 47% felt that identifying information could be included in correspondence between consenting recipients and donor families. When asked whether organ recipients and donor families should be allowed to meet, 53% of respondents agreed, 27% disagreed, and 20% neither agreed nor disagreed. With social media facilitating communication and eliminating the ability to maintain donor/recipient anonymity, 38% of respondents felt that a reexamination of current policies and practices pertaining to anonymity was necessary. CONCLUSION: In conclusion, there was no dominant position on the issue of anonymity/communication between donor families and transplant recipients. Further research and discussion concerning the views of healthcare professionals, organ recipients, and donor families on the mandate of anonymity is needed and may influence future policy.

Targeted prevention of childhood anxiety: engaging parents in an underserved community.

Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety-focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11-71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6% of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community-based interventions.

Pathways to service receipt: modeling parent help-seeking for childhood mental health problems.

Understanding parent appraisals of child behavior problems and parental help-seeking can reduce unmet mental health needs. Research has examined individual contributors to help-seeking and service receipt, but use of structural equation modeling (SEM) is rare. SEM was used to examine parents' appraisal of child behavior, thoughts about seeking help, and receipt of professional services in a diverse, urban sample (N = 189) recruited from women infant and children offices. Parents of children 11-60 months completed questionnaires about child behavior and development, parent well-being, help-seeking experiences, and service receipt. Child internalizing, externalizing, and dysregulation problems, language delay, and parent worry about child behavior loaded onto parent appraisal of child behavior. Parent stress and depression were positively associated with parent appraisal (and help-seeking). Parent appraisal and help-seeking were similar across child sex and age. In a final model, parent appraisals were significantly associated with parent thoughts about seeking help, which was significantly associated with service receipt.

Prevalence of Coxiella burnetii in western grey kangaroos (Macropus fuliginosus) in Western Australia.

We investigated the role of the western grey kangaroo (Macropus fuliginosus) in the maintenance and transmission of Coxiella burnetii in Western Australia. Sera from 1,017 kangaroos were tested using an indirect enzyme-linked immunosorbent assay (ELISA) for the presence of C. burnetii antibodies. The overall antibody prevalence across 12 locations throughout mid- to southwestern Western Australia was 24.1% (95% CI: 21.6-26.8). Feces from 990 of the same animals were tested using PCR to identify active shedding of C. burnetii in excreta. Coxiella burnetii DNA was detected in 4.1% (95% CI: 3.1-5.6) of samples. Our results suggest that kangaroos are reservoirs for C. burnetii in Western Australia and may contribute to transmission of the organism to domestic livestock and humans.

Prevalence of Salmonella in fecal samples of western grey kangaroos (Macropus fuliginosus).

This is the first extensive study of the prevalence of naturally acquired Salmonella infection in wild-caught kangaroos in Australia. Given the close association between kangaroos, livestock, and humans and the growing popularity of kangaroo meat, it is important to identify epidemiologic factors associated with infection in these marsupials in order to minimize the risk of Salmonella transmission. The overall prevalence of fecal Salmonella in 645 western grey kangaroos (Macropus fuliginosus) sampled across 10 locations in Western Australia was 3.6% (95% CI: 2.3-5.3). Seven Salmonella serovars were identified including Salmonella enterica serovar Muenchen, Kiambu, Rubislaw, Lindern, Champaign, Saintpaul and II 42:g,t:-. Prevalence was significantly associated with rainfall (P<0.05) and was highest in the April-June quarter (P<0.05). There was no association between age or sex and the prevalence of Salmonella in fecal samples. Our results suggest that, while kangaroos are infected with Salmonella in their natural habitat, infection is less common than in hand-reared joeys, pet kangaroos, and macropods raised in captivity. Care should be taken to maintain hygiene during the evisceration, processing, and handling of kangaroos and to adequately cook kangaroo meat prior to consumption to reduce the risk of salmonellosis.