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Identifying developmental endophenotypes on the pathway between genetics and behavior is critical to uncovering the mechanisms underlying neurodevelopmental conditions. In this proof-of-principle study, we explored whether early disruptions in visual attention are a unique or shared candidate endophenotype of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). We calculated the duration of the longest look (i.e., peak look) to faces in an array-based eye-tracking task for 335 14-month-old infants with and without first-degree relatives with ASD and/or ADHD. We leveraged parent-report and genotype data available for a proportion of these infants to evaluate the relation of looking behavior to familial (n = 285) and genetic liability (using polygenic scores, n = 185) as well as ASD and ADHD-relevant temperament traits at 2 years of age (shyness and inhibitory control, respectively, n = 272) and ASD and ADHD clinical traits at 6 years of age (n = 94).
Results showed that longer peak looks at the face were associated with elevated polygenic scores for ADHD (β = 0.078, p = .023), but not ASD (β = 0.002, p = .944), and with elevated ADHD traits in mid-childhood (F(1,88) = 6.401, p = .013,
=0.068; ASD: F (1,88) = 3.218, p = .076), but not in toddlerhood (ps > 0.2). This pattern of results did not emerge when considering mean peak look duration across face and nonface stimuli. Thus, alterations in attention to faces during spontaneous visual exploration may be more consistent with a developmental endophenotype of ADHD than ASD. Our work shows that dissecting paths to neurodevelopmental conditions requires longitudinal data incorporating polygenic contribution, early neurocognitive function, and clinical phenotypic variation.
Cognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.
A randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.
Intention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up).
Group IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.
To evaluate the effect of the burden of Staphylococcus aureus colonization of nursing home residents on the risk of S. aureus transmission to healthcare worker (HCW) gowns and gloves.
Multicenter prospective cohort study.
Setting and participants:
Residents and HCWs from 13 community-based nursing homes in Maryland and Michigan.
Residents were cultured for S. aureus at the anterior nares and perianal skin. The S. aureus burden was estimated by quantitative polymerase chain reaction detecting the nuc gene. HCWs wore gowns and gloves during usual care activities; gowns and gloves were swabbed and then cultured for the presence of S. aureus.
In total, 403 residents were enrolled; 169 were colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA) and comprised the study population; 232 were not colonized and thus were excluded from this analysis; and 2 were withdrawn prior to being swabbed. After multivariable analysis, perianal colonization with S. aureus conferred the greatest odds for transmission to HCW gowns and gloves, and the odds increased with increasing burden of colonization: adjusted odds ratio (aOR), 2.1 (95% CI, 1.3–3.5) for low-level colonization and aOR 5.2 (95% CI, 3.1–8.7) for high level colonization.
Among nursing home patients colonized with S. aureus, the risk of transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. Our findings inform future infection control practices for both MRSA and MSSA in nursing homes.
OBJECTIVES/GOALS: Women with diabetes (DM) have higher rates of unplanned pregnancy and pregnancy complications, indicating a need for DM-specific counseling. Our aim is to use the Health Belief Model (HBM), widely applied to DM interventions, to create a conceptual model of contraceptive decision-making for women with DM. METHODS/STUDY POPULATION: Our convergent mixed methods study integrates quantitative survey data and qualitative interview data from women aged 18-50 with DM. We will interview until theoretical saturation is achieved. Descriptive statistics will be calculated to summarize demographics, health history, and contraceptive use and knowledge. Using a grounded theory approach, qualitative analysis will be conducted by JW and EJ with special focus on exploring HBM constructs. A joint display will be used to integrate key quantitative variables by qualitative themes. Finally, we will aim to implement these HBM constructs within the context of contraceptive decision-making for women with DM. RESULTS/ANTICIPATED RESULTS: To date, we have interviewed 16 women with average age of 35 and an equal mix of type 1 vs. type 2 DM and those who identify their health as poor/fair vs. good/very good. The following HBM domains have emerged as relevant to contraceptive decision-making: perceived threats, perceived barriers, cues to action and self-efficacy. An analysis of the cues to action domain suggests that patients’ responses to provider counseling are substantially dependent on provider tone and awareness of patient context. Effective cues were delivered supportively with focus on health promotion, while ineffective cues focused on adverse outcomes or were delivered to women not at risk of pregnancy. DISCUSSION/SIGNIFICANCE OF IMPACT: The application of the HBM to contraceptive decision making among women with DM will provide insight into critical factors that inform both patient and provider attitudes and behaviors and can be targeted for future interventions to reduce unplanned pregnancy in this vulnerable population.
At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case–control and one nested case–cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.
Workers across the globe have evolved in their patterns of work, with increased flexibility emerging as a central theme. We highlight three forms of flexibility that workers have increasingly demanded: flexibility in location, schedule, and work design. We argue these capture the broad ways in which workers seek to structure and balance their work and nonwork lives, as well as their careers overall. We describe the evolution of each form of flexibility, review the benefits and challenges, and outline avenues for future research. Finally, we highlight a unique work arrangement, or setting, that infuses flexibility in unique ways – coworking spaces. We review what we know so far about coworking spaces, which have proliferated far faster than the scientific research that seeks to understand them. We conclude by outlining questions that may be good first priorities for emerging scholarly research in this area.
Pediatric long-term care facilities were surveyed to assess infection control and antimicrobial stewardship practices. Policies mandated by the Centers of Medicare and Medicaid Services (CMS) were included. Only 40% of sites reported implementing >90% of surveyed CMS policies. The survey also identified several gaps in non–CMS-mandated policies.
Sugar-sweetened beverage (SSB) consumption in early childhood is a public health concern. Adequate hydration in early childhood is also important. We developed a national research agenda to improve beverage consumption patterns among 0–5-year-olds. This article focuses on the process used to develop this research agenda.
A mixed methods, multi-step process was used to develop the research agenda, including: (i) a scientific advisory committee; (ii) systematic reviews on strategies to reduce SSB consumption and increase water access and consumption; (iii) two stakeholder surveys to first identify and then rank strategies to reduce SSB consumption and increase water access and consumption; (iv) key informant interviews to better understand determinants of beverage consumption and strategies to improve beverage consumption patterns among high-risk groups; (v) an in-person convening with experts; and (vi) developing the final research agenda.
This process included research and stakeholders from across the United States.
A total of 276 participants completed survey 1 and 182 participants completed survey 2. Key informant interviews were conducted with 12 stakeholders. Thirty experts attended the convening, representing academia, government, and non-profit sectors.
Thirteen key issue areas and 59 research questions were developed. Priority topics were beverage consumption recommendations, fruit-flavoured drink consumption, interventions tailored to high-risk groups, and family engagement in childcare.
This research agenda lays the groundwork for research efforts to improve beverage patterns of young children. The methods used can be a template to develop research agendas for other public health issues.
FEMINIST critics of Thomas Middleton's A Chaste Maid in Cheapside have focused carefully on the leaky, grotesque female bodies of the play and have argued that they represent cultural anxieties about economic and social order, which these female bodies have the potential to undermine. Such readings have been highly influenced by Gail Kern Paster's “Leaky Vessels: The Incontinent Women of City Comedy,” in which Paster suggests that such representations of the female body “display that body as beyond the control of the female subject, and thus as threatening the acquisitive goals of the family and its maintenance of status and power.” Following Paster, Shannon Miller argues that the play presents women “as both insatiable consumers of value and unstable receptacles of value.” Recent criticism of the play, however, which explores the cultural and ideological work of the play and comments on the economic transactions within it suggests that the complexity of the play necessitates a reexamination of the roles of female characters within the play's economy, particularly one that considers female agency. Despite the fact that a number of scholars recognize that the play “insists on equivalences in the exercise of appetite, both male and female alike” and that, as a “blistering satire,” it “pokes fun” at everyone, the women of the play are frequently described as commodities within a male-controlled economy and thus divested of agency. Kathleen McLuskie, though, argues that “In A Chaste Maid, Middleton presents city dwellers who adapt to social change by learning to exploit it” and that this play, among Middleton's other plays, “is at its most original in extending the roles of city women.” This certainly seems to be the case. I argue that aside from being consumers of goods, the women of the play demonstrate strategic control in a broader economy in which sex, marriage, reproduction, land, and commodities intersect. Not only do these women meet the demand for “honesty” through strategies that allow them to control their value, they are also members of female communities that reinforce subversive agency within a complex urban economy.
Scholars have repeatedly shown that the female body was a locus of anxiety during the early modern period, and Middleton's play taps into those anxieties by presenting the female body as leaky or grotesque and the economy to which it is linked as carnivalesque.
As a new cohort of religious conservatives became major players in U.S. political discourse during the 1970s and 1980s, they expressed ambivalence about the political realm and often represented their religious motivations as simultaneously separate from politics and as justification for their political activism. Prominent conservative evangelical women drew on this ambivalence in specifically gendered ways, referencing their religious commitments as well as their roles as mothers, which they asserted both compelled them to speak out on political issues, and proved that these issues were not fundamentally political. Building on scholarship about women’s grassroots support in conservative movements, this article underscores the importance of women’s national leadership in the New Christian Right. It focuses on the career of singerturned- activist Anita Bryant, who offers a particularly instructive example due to her public and explicit transformation from representative symbol of American motherhood to outspoken political activist in the late 1970s. Within the context of a flourishing evangelical subculture and shifting political landscape, Bryant’s negotiations of her political authority exemplify conservative evangelical women’s ways of understanding their leadership in support of a platform that emphasized women’s domestic roles. It demonstrates how they invoked an existing tension between religious and political identification to expand the ideology of “traditional gender roles” without overstepping its bounds. More broadly, Bryant’s career offers insight into the importance of women’s national leadership in framing the rhetoric and priorities of the New Christian Right, including its central emphases on gender and its relationship with contemporary feminist movements.
Circadian rhythms of parasites and their hosts can influence processes such as transmission, pathology and life cycle evolution. For trematode parasites that depend on free-living infectious stages (i.e. cercariae) to move among host species, the timing of parasite release is hypothesized to increase the likelihood of contacting a host. Yet, a persistent challenge in studying such biorhythms involves selection of appropriate analytical techniques. Here, we extend a generalized linear mixed modelling (GLMM) framework to cosinor analyses, thereby allowing flexibility in the statistical distribution of the response variable, incorporation of multiple covariates and inclusion of hierarchical grouping effects. By applying this approach to 93 snails infected with trematode parasites from freshwater pond ecosystems, we detected non-random rhythms in six of eight species, with variation in both the timing of peak cercariae release (between 5:10 and 21:46 h) and its magnitude (between 13 and 386). The use of GLMM yielded more accurate and precise estimates of the cosinor parameters compared with classical least-squares (LS) based on a simulation-based sensitivity analysis. The sensitivity analysis revealed that the amplitude and rhythm-adjusted mean values from the LS models diverged from the true values at some limits. We highlight the importance of novel analytical approaches for evaluating parasite circadian rhythms and investigating their underlying mechanisms.