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Objectives. To determine whether the number of children tested for lead exposure and the number of case rates increased (rate ratio [RR] > 1), decreased (RR < 1), or remained stable (RR = 1) during COVID-19 pandemic year 2020 compared with prepandemic year 2019. Methods. We analyzed more than 415 000 children's records reported to the Illinois Department of Public Health in 2019 and 2020 by demographic characteristics. The testing rate was the number of children tested yearly per population. The case rate was the proportion of children whose yearly tests showed a blood lead level of 5 or more micrograms per deciliter. RR was the 2020 case rate divided by the 2019 case rate. Results. In 2020, 19.6% of children were tested for lead compared with 25.5% in 2019. Testing decreased in 97% of counties. The 24% decreased testing in 2020 was notably in African Americans (36.4% decrease), high-risk zip codes (29.8% decrease), and rural counties (26.9% decrease). Case rates increased in rural counties, high-risk zip codes, Whites, and Hispanics. Conclusions. During pandemic year 2020, the number of children tested for lead decreased by 24%, and case rates increased in 51% of counties. Public Health Implications. Redesignation of high-risk zip codes is recommended to increase the testing of at-risk populations. (Am J Public Health. 2023;113(1):89-95. https://doi.org/10.2105/AJPH.2022.307109).
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COVID-19 , Criança , Humanos , COVID-19/epidemiologia , Pandemias , Chumbo , Illinois/epidemiologia , Fatores de RiscoRESUMO
[This corrects the article DOI: 10.3389/fpsyt.2023.1278823.].
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Background: To date, few randomized controlled trials of psilocybin with non-directive support exist for obsessive-compulsive disorder (OCD). Results and participant feedback from an interim analysis of an ongoing single-dose trial (NCT03356483) converged on the possibility of administering a higher fixed dose and/or more doses of psilocybin in future trials for presumably greater benefits. Objectives: This trial aims to evaluate the safety, feasibility, tolerability, and clinical effects of two doses of psilocybin paired with non-directive support in the treatment of OCD. This trial also seeks to examine whether two doses of psilocybin lead to greater OCD symptom reduction than a single dose, and to elucidate psychological mechanisms underlying the effects of psilocybin on OCD. Design: A randomized (1:1), waitlist-controlled design with blinded ratings will be used to examine the effects of two doses of oral psilocybin paired with non-directive support vs. waitlist control on OCD symptoms. An adaptive dose selection strategy will be implemented (i.e., first dose: 25 mg; second dose: 25 or 30 mg). Methods and analysis: This single-site trial will enroll 30 adult participants with treatment-refractory OCD. Aside from safety, feasibility, and tolerability metrics, primary outcomes include OCD symptoms assessed on the Yale-Brown Obsessive-Compulsive Scale - Second Edition (Y-BOCS-II). A blinded independent rater will assess primary outcomes at baseline and the primary endpoint at the end of the second dosing week. Participants will be followed up to 12 months post-second dosing. Participants randomized to waitlist will be rescreened after 7 weeks post-randomization, and begin their delayed treatment phase thereafter if still eligible. Ethics: Written informed consent will be obtained from participants. The institutional review board has approved this trial (protocol v. 1.7; HIC #2000032623). Discussion: This study seeks to advance our ability to treat refractory OCD, and catalyze future research seeking to optimize the process of psilocybin treatment for OCD through understanding relevant psychological mechanisms.Clinical trial registration: ClinicalTrials.gov, identifier NCT05370911.
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Memory-guided movements, vital to daily activities, are especially impaired in Parkinson's disease (PD). However, studies examining the effects of how information is encoded in memory and the effects of common treatments of PD, such as medication and subthalamic nucleus deep brain stimulation (STN-DBS), on memory-guided movements are uncommon and their findings are equivocal. We designed two memory-guided sequential reaching tasks, peripheral-vision or proprioception encoded, to investigate the effects of encoding type (peripheral-vision vs. proprioception), medication (on- vs. off-), STN-DBS (on- vs. off-, while off-medication), and compared STN-DBS vs. medication on reaching amplitude, error, and velocity. We collected data from 16 (analyzed n = 7) participants with PD, pre- and post-STN-DBS surgery, and 17 (analyzed n = 14) healthy controls. We had four important findings. First, encoding type differentially affected reaching performance: peripheral-vision reaches were faster and more accurate. Also, encoding type differentially affected reaching deficits in PD compared to healthy controls: peripheral-vision reaches manifested larger deficits in amplitude. Second, the effect of medication depended on encoding type: medication had no effect on amplitude, but reduced error for both encoding types, and increased velocity only during peripheral-vision encoding. Third, the effect of STN-DBS depended on encoding type: STN-DBS increased amplitude for both encoding types, increased error during proprioception encoding, and increased velocity for both encoding types. Fourth, STN-DBS was superior to medication with respect to increasing amplitude and velocity, whereas medication was superior to STN-DBS with respect to reducing error. We discuss our findings in the context of the previous literature and consider mechanisms for the differential effects of medication and STN-DBS.