What Kinds of Support are Alaska Native Youth and Young Adults Reporting? An Examination of Types, Quantities, Sources, and Frequencies of Support.

American Indian and Alaska Native (AI/AN) youth, particularly males, experience disproportionately high rates of suicide compared to other young people in the United States. Therefore, enacting suicide prevention efforts for AI/AN youth is especially important. Since research shows that strengthening social, cultural, and emotional support can reduce suicide risk, many recent prevention efforts focus on these strategies. Yet, to reinforce and to extend the positive impact of these strategies for suicide risk reduction, we argue it is useful to identify baseline levels and other features of already-existing support. Toward this end, we describe the types (i.e., category), quantities (i.e., distribution and average number), sources (i.e., from whom), and frequencies (i.e., how often) of social support that AN young people report receiving, and we examine if these "support profiles" differ by age and sex. We use survey data from 165 ANs under age 30, collected as part of a participatory intervention study focused on Promoting Community Conversations About Research to End Suicide (PC CARES). We find that: 1) most ANs reported receiving nearly all supports, 2) compared with females, males reported receiving fewer supports on average, 3) family was the most selected support source, followed by close friends and service providers, and 4) family (e.g., parents, siblings, and grandparents) provided support regularly (i.e., monthly or more). Though our findings may suggest fruitful avenues for interventions targeted toward AN males, we discuss these findings in relation to the gendered nature of suicide prevention and assessment.

Would I Have Your Support? Family Network Features and Past Support Exchanges Associated with Anticipated Support for a Substance Problem.

Objective: Assessment of social processes underlying anticipation for recovery-related support from family in the event of a substance problem. We drew from literature on social support, substance use, and social networks to develop a path model connecting emotionally close family relationships, closeness among members in the wider family network (density), previous emotional support exchanges, and anticipated support. Subjects and Methods: We used a sample from the 2019 Nebraska Annual Social Indicators Survey (284 adults; 57% female; 94% white; 46.26% living in rural areas) and employed generalized structural equation modeling with logistic regression equations for our binary dependent variable (anticipated support). Results: Denser family networks were associated with individuals' close relations with family (b = .18, p < .001), close family relations were associated with support received by (b = .25, p < .05) and given to (b = .47, p < .001) family, and only support given to family increased the odds of anticipated support (IRR = 4.32, CI = 1.13, 16.48). Conclusions: Family-wide dynamics are important for understanding how support exchange relates to anticipated support. Prioritizing efforts to strengthen family relationships and improve the likelihood that at-risk individuals, especially in rural areas, can overcome substance problems is important.

Practical problems and positive experiences with ecological momentary assessment: reflections from people who use drugs.

Background: Ecological momentary assessment (EMA) is an increasingly popular and feasible form of data collection, but it can be intensive and intrusive. Especially for at-risk, vulnerable populations like people who use drugs (PWUD), poor experiences with EMA may exacerbate existing chronic struggles while decreasing response rates. However, little research queries participants' experiences with EMA studies.Objectives: We explore participants' positive and negative experiences with EMA, identifying what they liked about the study, the problems they experienced, and suggested solutions to these problems.Methods: Results come from semi-structured interviews from 26 PWUD (6 women; 20 men) in Nebraska who participated in a two-week EMA pilot study on drug use with a study-provided smartphone. Participant responses were recorded by interviewers into open-text fields in Qualtrics. Data were analyzed with an iterative open coding procedure.Results: We found that many participants enjoyed the study and seamlessly incorporated the phone into their daily lives. There were a number of negative study aspects identified, however, as many participants experienced functional issues (e.g., running out of high-speed data, trouble keeping the phone charged, not able to answer questions within the two-hour timeframe) that detracted from their experience, especially if they were homeless.Conclusion: Our findings provide methodological considerations for studies with EMA components among at-risk, vulnerable populations, like PWUD. These suggestions are targeted toward the continued ethical collection of high-quality data in clinical and non-clinical settings.

Short Take: Collecting Data from a Vulnerable Population during the COVID-19 Pandemic.

Conducting field research with a vulnerable population is difficult under the most auspicious conditions, and these difficulties only increase during a pandemic. Here, we describe the practical challenges and ethical considerations surrounding a recent data collection effort with a high-risk population during the COVID-19 pandemic. We detail our strategies related to research design, site selection, and ethical review.

Patterns of Missing Data With Ecological Momentary Assessment Among People Who Use Drugs: Feasibility Study Using Pilot Study Data.

BACKGROUND: Ecological momentary assessment (EMA) is a set of research methods that capture events, feelings, and behaviors as they unfold in their real-world setting. Capturing data in the moment reduces important sources of measurement error but also generates challenges for noncompliance (ie, missing data). To date, EMA research has only examined the overall rates of noncompliance. OBJECTIVE: In this study, we identify four types of noncompliance among people who use drugs and aim to examine the factors associated with the most common types. METHODS: Data were obtained from a recent pilot study of 28 Nebraskan people who use drugs who answered EMA questions for 2 weeks. We examined questions that were not answered because they were skipped, they expired, the phone was switched off, or the phone died after receiving them. RESULTS: We found that the phone being switched off and questions expiring comprised 93.34% (1739/1863 missing question-instances) of our missing data. Generalized structural equation model results show that participant-level factors, including age (relative risk ratio [RRR]=0.93; P=.005), gender (RRR=0.08; P=.006), homelessness (RRR=3.80; P=.04), personal device ownership (RRR=0.14; P=.008), and network size (RRR=0.57; P=.001), are important for predicting off missingness, whereas only question-level factors, including time of day (ie, morning compared with afternoon, RRR=0.55; P<.001) and day of week (ie, Tuesday-Saturday compared with Sunday, RRR=0.70, P=.02; RRR=0.64, P=.005; RRR=0.58, P=.001; RRR=0.55, P<.001; and RRR=0.66, P=.008, respectively) are important for predicting expired missingness. The week of study is important for both (ie, week 2 compared with week 1, RRR=1.21, P=.03, for off missingness and RRR=1.98, P<.001, for expired missingness). CONCLUSIONS: We suggest a three-pronged strategy to preempt missing EMA data with high-risk populations: first, provide additional resources for participants likely to experience phone charging problems (eg, people experiencing homelessness); second, ask questions when participants are not likely to experience competing demands (eg, morning); and third, incentivize continued compliance as the study progresses. Attending to these issues can help researchers ensure maximal data quality.

H blood group detection by the L-fucose binding lectin of the green marine alga Ulva lactuca.

Extracts of the green marine alga Ulva lactuca collected along the seashore of Tel-Aviv exhibit hemagglutinating activity towards papain-treated human erythrocytes. This hemagglutinating activity was shown to be inhibited by L-fucose and EDTA, and to be relatively resistant to heating at 60 degrees C, while sensitive to low pH. Like the lectin of Ulex europeus, the Ulva lectin exhibits blood group H specificity. It agglutinates most strongly erythrocytes of blood group 0(H) followed by B greater than A greater than AB. A2 and A2B erythrocytes are agglutinated by it considerably more strongly than A1 and A1B respectively. Bombay 0(hh) type erythrocytes are almost non-reactive. The lectin can be stored at -20 degrees C for years.

Differentiation between human red cells of Pk and p blood types using Pseudomonas aeruginosa PA-I lectin.

BACKGROUND: The red cells of almost all human beings bear P antigen. Type P1 cells (around 75% of the population) contain P1 antigen in addition to P, and type P2 cells (around 25% of the population) contain only P. The red cells of only a few individuals are devoid of P: these cells may be of either Pk-positive (P1k and P2k[Pk]) or p type (the latter lack all the above-described antigens of the P system). Differentiation between them is of clinical importance, but there is a shortage of specific reagents. This article offers reliable means for differentiation. STUDY DESIGN AND METHODS: Agglutination of washed, papain-treated red cells of all the P types by PA-1 and soybean lectins and adsorption of the lectins onto the red cells were examined. RESULTS: PA-1 strongly agglutinated papain-treated red cells. Examination of its interactions with red cells having different P system antigens revealed that Pk (both P1k and P2k) red cells of O, A, and B blood types were agglutinated significantly faster than p red cells. The agglutination intensities of Pk red cells of types O and A (most people) was considerably stronger than those of p red cells. P1 and P2 type red cell agglutination was intermediate (P1>P2). Adsorption tests with all the red cells, exhibited the same order of PA-1 affinities for the P system blood types: Pk>P1,>P2>p. The soybean lectin exhibited opposite behavior (p>P2>P1>Pl). CONCLUSION: The galactose-binding lectins PA-1 and soybean may facilitate the determination of Pk and p red cells.

Early treatment by plasmapheresis in a woman with multiple abortions and the rare blood group p.

Women with the rare blood group p are known to have an increased rate of abortions. The case of a 36-year-old woman is presented who had had 7 spontaneous abortions in the first trimester and no live child. When treated by plasma exchange begun early in pregnancy and continued until the 29th week, she delivered a normal child. Time to begin, amount and length of time necessary to continue plasma exchange in these patients are considered. In addition, the question of which fraction of the anti-PP1Pk could be responsible for abortion is discussed. To our knowledge, this is the first case of a woman of p phenotype with no live children but with multiple abortions treated by this method, which should be seriously considered in similar cases.

Further examples of human anti-Me found in sera of Israeli donors.

A number of Israeli donors had anti-M in their sera, a proportion of which cross-reacted with N He(+) red cells. Anti-Me was detected and while the reactivity with M and He determinants could be separated by using trypsin-treated red cells, the cross-reactivity for M and He determinants was complete in absorption experiments. One serum had anti-M separable from anti-Me and another apparent anti-M was absorbed by trypsin-treated N He(+) red cells.

Intravascular [correction of intracellular] hemolysis and renal failure in a patient with T polyagglutination.

A patient with postoperative intravascular hemolysis aggravated by transfusion with fresh whole blood and fresh plasma products had acute renal failure. Screening with Arachis hypogaea and Glycine soja lectins showed that his red cells were T-transformed. Only washed red cells were transfused subsequently, and no further fresh plasma products were given. All hemolysis ceased, the renal function returned to normal, and the T-polyagglutination as measured by lectin tests disappeared 4 months after surgery. Early diagnosis of polyagglutination using lectin screening tests is simple to perform, and will facilitate the immediate choice of the correct transfusion therapy, which in this case may have been life-saving.

A family showing inheritance of the Anton blood group antigen AnWj and independence of AnWj from Lutheran.

A 43-year-old Arab woman was found to be negative for the high incidence AnWj antigen and her serum contained anti-AnWj. Two of her seven siblings were also AnWj-negative, which provides evidence for the first time that the AnWj-negative phenotype may be an inherited character. Blood groups of the family, in which the parents of the proposita are consanguineous, show that AnWj is not part of the ABO, Rh, MNSs, Kell, Duffy, Kidd, Xg and, notably, Lutheran blood group systems and neither is it X or Y linked.

Erythrina lectins detect the H/HI blood groups.

The lectin purified from Erythrina corallodendron seeds which binds N-acetyllactosamine greater than N-acetyl-D-galactosamine greater than alpha and beta galactosides greater than D-galactose was examined for its ABO(H) blood group specificity. It has been shown that this lectin causes the strongest hemagglutination of O(H) and weakest of Oh(Bombay) red blood cells, and interacts with the H antigen in association with the I antigen. The reactions of Erythrina corallodendron and Erythrina indica lectins (which are similar in sugar specificity) with erythrocytes of different ABO(H) and Ii blood groups (the I bloods were all from adults and the i from either cord or adult bloods) revealed the following order of activity: O(H)I greater than A2 I greater than O(H)i adult greater than A2BI greater than BI greater than O(H)i cord greater than A1I greater than A1i adult greater than Bi cord greater than A1BI greater than Ai cord greater than ABi cord greater than OhI. The Erythrina indica lectin showed a lower differentiation between the agglutination of O(H) and Oh erythrocytes. Both Erythrina lectins exhibited H/HI blood group preference but were not inhibited by the saliva from ABO(H) "secretors". Thus they may be classified with the Cytisus sessilifolius, Lotus tetragonolobus and Laburnum alpinum lectins which are inhibited by lactose but not by H blood group substances in secretions.

PA-I and PA-II lectin interactions with the ABO(H) and P blood group glycosphingolipid antigens may contribute to the broad spectrum adherence of Pseudomonas aeruginosa to human tissues in secondary infections.

Pseudomonas aeruginosa may cause serious infections in most human tissues/organs. Its adherence to them is mediated by a battery of adhesins including the PA-I and PA-II lectins, which are produced in this bacterium in high quantities. PA-I binds to the D-galactose of the erythrocyte glycosphingolipids exhibiting highest affinities for B and Pk (followed by P1) antigens, while PA-II preferentially binds to the L-fucose of H, A and B antigens. Intact P. aeruginosa cells also exhibit a clear Pk and P1 over p preference. Such affinities for the most common human ABH and P system antigens may underlie the widespread tissue infectivity and pathogenicity of this bacterium.

Dr(a) (Cromer-related blood group antigen)-incompatible renal transplantation.

BACKGROUND AND OBJECTIVES: Cromer system antigens, a series of blood group antigens of very high frequency, are not considered to be clinically significant in transfusion. In renal transplantation only the ABO blood group antigens are considered essential. The Drori blood group antigen is present in serum and has been found to reside on the renal tubular basement membrane and Bowman's capsule. The effect of anti-Dra on the renal parenchyma has not been evaluated. MATERIALS AND METHODS: A unique case of renal transplantation of an incompatible Dr(a+) kidney to a Dr(a-) patient with anti-Dra in her serum is presented. RESULTS: Graft function was immediately good. The titer of anti-Dra remained unchanged following transplantation. CONCLUSION: The successful outcome of a case of a Drori (Dra)-incompatible kidney transplantation confirmed the lack of clinical significance of the anti-Dra relating to transplantation.

Hemolytic disease of the newborn due to anti-PP1 P k (anti-Tj a).

A newborn infant of genotype P2p suffering from ABO-like hemolytic disease was born to a mother of the very rare genotype pp. The disease was severe enough to require exchange transfusions with pp blood. The mother and other members of the family with the same rare pp blood provided compatible donor blood for transfusions of the mother herself and for replacement transfusion of her affected infant. The mothers serum contained IgM molecules and also IgG molecules capable of crossing the placenta to induce a hemolytic process on the infant's red blood cells. The genotype of the P1 negative father was very likely P2P2 so that the genotype of the affected infant had to be P2p. A search of the literature revealed an earlier report from Japan in which the genotype of the P1 positive father was P1P2. As was to be expected the genotype of this affected infant was P2p.

K22, a 'new' para-Kell antigen of high frequency.

An alloantibody is described which detects a high frequency blood group antigen absent from Ko cells but different from all the reported Kell and para-Kell antigens. The family study shows the antigen to be inherited but gives no information about its relationship to the Kell locus. It is suggested that this 'new' para-Kell antigen be called K22.

The Rh antigen Tar (Rh40) causing haemolytic disease of the newborn.

Haemolytic disease of the newborn (HDN), in the fifth child of an Israeli of Moroccan origin, disclosed anti-Tar in the serum of the mother. This anti-Tar, the second reported example, is the first to cause HDN and was stimulated by previous pregnancies. Tests on blood from the family show that the Tar antigen in this family is associated with a CDe complex which gives rise to a weak expression of the D antigen. A study of 1327 donors in Jerusalem revealed one Tar + propositus.

Autoimmunity and the Kell blood groups: auto-anti-Kpb in a Kp(a+b-) patient.

An example of auto-anti-Kpb in a Kp(a+b-) patient is described. The antibody present in the patient's serum and in eluates from her red cells was IgG. It did not bind complement, and did not cause in vivo hemolysis. 9 months after recognition of the autoimmune state the direct antiglobulin test had become negative and anti-Kpb was no longer detectable. It is postulated that autoimmunity involving the Kell blood group may be precipitated by antigens or enzymes of microbial origin.

Human alloantibodies detecting a red cell antigen apparently identical to MER2.

Three examples of an antibody were found to be detecting a red cell polymorphism probably identical to MER2. The antibodies were made by Jews originating from India and living in Israel. Two of them were sibs and the third was unrelated. All 3 had kidney disease requiring renal dialysis and regular blood transfusion. In 2 cases the antibodies were detected before dialysis was started and before the patients had been transfused. The human antibodies reacted with red cells of 90% of Israeli blood donors tested. In tests on selected blood donors, 82 English and 56 Israeli, one of the human antibodies gave almost identical reactions to those given by monoclonal anti-MER2. Anomalous reactions were probably due to anti-Bga. Two of the human antibodies completely blocked, and one partially blocked, the reaction of monoclonal anti-MER2 with MER2+ red cells.