Experiences of a Loss of a Parent to AIDS During Adolescence on Young Adults

Acquired immunodeficiency syndrome (AIDS) continues to be a major healthcare issue for many countries, including the United States. Millions of adolescent children under the age of 18 have lost 1 or both parents to AIDS-related complications. The death of a parent to AIDS-related complications is severe; however, limited data describes how this type of death affects adolescents after they have become young adults. It is important to determine how these adolescents are affected by exploring their lived experiences of losing a parent to AIDS-related complications. The purpose of this qualitative phenomenological study was to understand the lived experiences associated with losing a parent to AIDS-related complications during adolescence and how it may or may not have a significant impact on individuals as young adults. The conceptual framework for this study was based on the transactional stress and coping model that emphasizes appraisal of the threat of harm and the challenges to coping with stressful events. After conducting interviews with 8 participants, I coded, grouped, and analyzed the interview data into themes. The results yielded themes such as anger, sadness, substance abuse, negative judgement, self-isolation, loneliness, grief, stigma/discrimination, and availability of resources. The 3 most prominent themes shared among all participants were sadness, stigma/discrimination, and negative beliefs. The results of this study will help communities understand how to address individuals who have experienced such a loss and how to assist them in addressing their current needs resulting in positive social change

Accessing Sleep, Sedentary Behaviors, and Physical Activity among College students: The Roles of Ethnicity and Obesity

Physical inactivity/sedentary behavior and sleep disorder have been identified as emerging public health problems. Only half of on-campus college students report meeting recommended moderate-to-vigorous physical activity (MVPA) and over 60% of US adults between the ages of 20–39 years were either overweight or obese. PURPOSE: The purposes of this study were to: 1) identify the relationships between physical activity (light PA [LPA], MVPA), sedentary behavior, and sleep patterns among college students; and 2) examine the effects of the ethnicity (Hispanic vs. non-Hispanic) and obesity (normal weight vs. overweight/obese) on study variables. METHODS: There were 139 college students participated in the study (89 non-Hispanics; 96 females; Mage = 22.2 ± 3.71). Among them, 56% were normal weight and 44% were overweight/obese (BMI ³ 25). The accelerometer (ActiGraph GT9X) was used to assess sleep patterns (i.e., sleep efficiency, number of awakenings, and awakening length), LPA, MVPA, and sedentary behavior. Data was analyzed using descriptive analysis, Pearson correlation analysis, and a 2 (Hispanic vs. non-Hispanic) x 2 (normal weight vs. overweight/obese) multivariate analysis of covariance (MANCOVA) by controlling for gender. RESULTS: College students experienced fair sleep efficiency (M = 86.42) but more sleep disturbances with an average of 24 awakenings per night lasting 2.77 minutes per time. College students spent 55.2%, 16.2%, and 28.6%% of their time in LPA, MVPA, and sedentary behavior, respectively. Only MVPA was positively associated with sleep patterns (awakening length; r = 0.19, p \u3c 0.05), but not with LPA and sedentary behavior. The MANCOVA resulted no statistically significant group differences among study variables (p \u3e .05). It was noticed that Hispanic students had less sleep efficiency (d = .23) and more awakenings (d = .33) than non-Hispanic peers. Hispanic children also showed slightly more MVPA (d = .06) and spent more time being sedentary (d = 0.09) than non-Hispanic peers. Compared to normal-weight peers, overweight/obese college students had lower sleep efficiency (d = .18) and spent more time on MVPA (d = .05) and sedentary behavior (d = 0.22). CONCLUSION: The findings indicate that MVPA during weekdays might have negative effects on sleep quality among this population regardless of their sedentary behavior. The study provides a unique perspective of factors (i.e., ethnicity and obesity) associated with movement behaviors among college students which allow for targeted interventions to improve the health of young adults

Grounded in Relationships of Support: Indigenous Teacher Mentorship in the Rural West

This article explores the power of Indigenous teacher mentorship as essential to address “the change in point of view” long called for in Indigenous education. Drawing from a longitudinal, ethnographic study of an Indigenous teacher education program in a predominantly rural, high need region, we examine the basic questions: What do Indigenous master teachers uniquely bring to teacher education? In what ways do Indigenous master teachers support the development of socially, culturally, linguistically, and place-responsive teachers? Using the theoretical frameworks of Tribal Critical Race Theory (TribalCrit) and situated learning, our findings elucidate the importance of Indigenous mentorship for re-membering and re-claiming Indigenous epistemologies, ontologies, and axiologies in relational and intergenerational learning—practices that interrupt coloniality in teacher education and school leadership. Discussion of Indigenous teacher mentorship centers the importance of relationships between people and place in teaching and learning and asks educators and school leaders to conceptualize Indigenous teacher education as a long-term project of tribal nation building and community wellbeing

A Recurrent Intragenic Deletion in the Desmoglein 4 Gene Underlies Localized Autosomal Recessive Hypotrichosis

6 páginas, 2 figuras.A newly defined form of inherited hair loss, named localized autosomal recessive hypotrichosis (LAH, OMIM 607903), was recently described in the literature (Kljuic et al. 2003a; Rafique et al. 2003) and shown to be linked to chromosome 18. We identified a large, intragenic deletion in the desmoglein 4 gene (DSG4) as the underlying mutation in two unrelated families of Pakistani origin (Kljuic et al. 2003a). LAH is an autosomal recessive form of hypotrichosis affecting the scalp, trunk, and extremities, and largely sparing the facial, pubic, and axillary hair. Typical hairs are fragile and break easily, leaving short sparse scalp hairs with a characteristic appearance. Using comparative genomics, we also demonstrated that human LAH is allelic with the lanceolate hair (lah) mouse (Kljuic et al. 2003a), as well as the lanceolate hair (lah) rat phenotype (Jahoda et al. 2004). In order to expand the series of allelic mutations in the desmoglein 4 gene underlying LAH in humans, we begin molecular analysis of DSG4 in families from around the world. Here, we describe the study of a family of Pakistani origin with two siblings affected with LAH (Figure 1).This study was supported in part by grants USPHS NIH R01-AR44924 and the March of Dimes Birth Defects Foundation (A. M. C.).Peer reviewe

The influence of a positive empathetic interaction on conditioned pain modulation and manipulation induced analgesia in people with lateral epicondylalgia

Objective: Conditioned pain modulation (CPM) and manipulation induced analgesia (MIA) are two forms of endogenous analgesia. Many forms of analgesia can be influenced by the nature of the patient clinician interaction. The aim of this study was to evaluate the influence of an empathetic and supportive interaction on CPM and MIA in people with Lateral Epicondylalgia (LE). Methods: In a double-blind, randomised, controlled trial, 68 participants with LE were assigned to two groups: the empathetic and neutral interaction groups. The interactions were carried out by a trained, professional role play actor, playing the part of a research assistant (RA). The RA actor spent 15min prior to CPM and MIA assessment interacting with the participants in an empathetic or neutral manner. Immediately after the interaction, a blinded assessor measured pressure pain threshold (PPT) at the symptomatic elbow and ipsilateral wrist during CPM and MIA testing. Linear mixed models were used to evaluate differences in CPM and MIA responses between the interaction groups. Results: There was a significant difference in CARE scores between the groups (p\u3c0.001), indicating that the intervention group experienced a more empathic interaction. Both groups showed a significant increase in PPT measures, indicative of a CPM and MIA analgesic response (p\u3c0.001), however the analgesic responses were greater in the group that had experienced a supportive, empathetic interaction (post CPM, wrist: p\u3c0.001; elbow: p=0.001), (post MIA wrist: p=\u3c0.001; elbow: p=0.001). Discussion: A single session of empathetic interaction positively influenced both CPM and MIA responses in people with LE

From climate change to pandemics: decision science can help scientists have impact

Scientific knowledge and advances are a cornerstone of modern society. They improve our understanding of the world we live in and help us navigate global challenges including emerging infectious diseases, climate change and the biodiversity crisis. For any scientist, whether they work primarily in fundamental knowledge generation or in the applied sciences, it is important to understand how science fits into a decision-making framework. Decision science is a field that aims to pinpoint evidence-based management strategies. It provides a framework for scientists to directly impact decisions or to understand how their work will fit into a decision process. Decision science is more than undertaking targeted and relevant scientific research or providing tools to assist policy makers; it is an approach to problem formulation, bringing together mathematical modelling, stakeholder values and logistical constraints to support decision making. In this paper we describe decision science, its use in different contexts, and highlight current gaps in methodology and application. The COVID-19 pandemic has thrust mathematical models into the public spotlight, but it is one of innumerable examples in which modelling informs decision making. Other examples include models of storm systems (eg. cyclones, hurricanes) and climate change. Although the decision timescale in these examples differs enormously (from hours to decades), the underlying decision science approach is common across all problems. Bridging communication gaps between different groups is one of the greatest challenges for scientists. However, by better understanding and engaging with the decision-making processes, scientists will have greater impact and make stronger contributions to important societal problems

Torsade de pointes caused by polypharmacy and substance abuse in a patient with human immunodeficiency virus

Drug-induced QT prolongation is a potentially dangerous adverse effect of some medication combinations. When QT prolongation progresses to torsade de pointes, life-threatening or fatal outcomes may result. A 57-year-old man with a history of human immunodeficiency syndrome on abacavir, nevirapine, tenofovir, voriconazole, and methadone presented to the emergency department with a chief complaint of new-onset seizures. The physical exam was unremarkable. The electrocardiogram demonstrated sinus bradycardia and a prolonged QTc interval of 690 ms. In the emergency department, he had several episodes of torsade de pointes (TdP) and ventricular tachycardia that resolved spontaneously. These episodes were accompanied by an alteration in mentation and generalized twitching. Magnesium and amiodarone were effective in terminating the dysrhythmia. The patient had multiple risk factors for prolonged QT syndrome including human immunodeficiency virus infection, methadone therapy, and polypharmacy leading to potential drug interactions. Physicians must be aware of multidrug interactions potentiating QT prolongation and leading to torsade de pointes

Human adaptations to multiday saturation on NASA NEEMO

Human adaptation to extreme environments has been explored for over a century to understand human psychology, integrated physiology, comparative pathologies, and exploratory potential. It has been demonstrated that these environments can provide multiple external stimuli and stressors, which are sufficient to disrupt internal homeostasis and induce adaptation processes. Multiday hyperbaric and/or saturated (HBS) environments represent the most understudied of environmental extremes due to inherent experimental, analytical, technical, temporal, and safety limitations. National Aeronautic Space Agency (NASA) Extreme Environment Mission Operation (NEEMO) is a space-flight analog mission conducted within Florida International University's Aquarius Undersea Research Laboratory (AURL), the only existing operational and habitable undersea saturated environment. To investigate human objective and subjective adaptations to multiday HBS, we evaluated aquanauts living at saturation for 9-10 days via NASA NEEMO 22 and 23, across psychologic, cardiac, respiratory, autonomic, thermic, hemodynamic, sleep, and body composition parameters. We found that aquanauts exposed to saturation over 9-10 days experienced intrapersonal physical and mental burden, sustained good mood and work satisfaction, decreased heart and respiratory rates, increased parasympathetic and reduced sympathetic modulation, lower cerebral blood flow velocity, intact cerebral autoregulation and maintenance of baroreflex functionality, as well as losses in systemic bodyweight and adipose tissue. Together, these findings illustrate novel insights into human adaptation across multiple body systems in response to multiday hyperbaric saturation

COVID-19 Risk Factors for Cancer Patients: A First Report with Comparator Data from COVID-19 Negative Cancer Patients

none32siSimple SummaryThe COVID-19 pandemic has had a detrimental impact on cancer patients globally. Whilst there are several studies looking at the potential risk factors for COVID-19 disease and related death, most of these include non-cancerous patients as the COVID-19 negative comparator group, meaning it is difficult to draw hard conclusions as to the implications for cancer patients. In our study, we utilized data from over 2000 cancer patients from a large tertiary Cancer Centre in London. In summary, our study found that patients who are male, of Black or Asian ethnicity, or with a hematological malignancy are at an increased risk of COVID-19. The use of cancer patients as the COVID-19 negative comparator group is a major advantage to the study as it means we can better understand the true impact of COVID-19 on cancer patients and identify which factors pose the biggest risk to their likelihood of infection with SARS-CoV2.Very few studies investigating COVID-19 in cancer patients have included cancer patients as controls. We aimed to identify factors associated with the risk of testing positive for SARS CoV2 infection in a cohort of cancer patients. We analyzed data from all cancer patients swabbed for COVID-19 between 1(st) March and 31(st) July 2020 at Guy's Cancer Centre. We conducted logistic regression analyses to identify which factors were associated with a positive COVID-19 test. Results: Of the 2152 patients tested for COVID-19, 190 (9%) tested positive. Male sex, black ethnicity, and hematological cancer type were positively associated with risk of COVID-19 (OR = 1.85, 95%CI:1.37-2.51; OR = 1.93, 95%CI:1.31-2.84; OR = 2.29, 95%CI:1.45-3.62, respectively) as compared to females, white ethnicity, or solid cancer type, respectively. Male, Asian ethnicity, and hematological cancer type were associated with an increased risk of severe COVID-19 (OR = 3.12, 95%CI:1.58-6.14; OR = 2.97, 95%CI:1.00-8.93; OR = 2.43, 95%CI:1.00-5.90, respectively). This study is one of the first to compare the risk of COVID-19 incidence and severity in cancer patients when including cancer patients as controls. Results from this study have echoed those of previous reports, that patients who are male, of black or Asian ethnicity, or with a hematological malignancy are at an increased risk of COVID-19.openRussell, Beth; Moss, Charlotte L; Palmer, Kieran; Sylva, Rushan; D'Souza, Andrea; Wylie, Harriet; Haire, Anna; Cahill, Fidelma; Steel, Renee; Hoyes, Angela; Wilson, Isabelle; Macneil, Alyson; Shifa, Belul; Monroy-Iglesias, Maria J; Papa, Sophie; Irshad, Sheeba; Ross, Paul; Spicer, James; Kordasti, Shahram; Crawley, Danielle; Zaki, Kamarul; Sita-Lumsden, Ailsa; Josephs, Debra; Enting, Deborah; Swampillai, Angela; Sawyer, Elinor; Fields, Paul; Wrench, David; Rigg, Anne; Sullivan, Richard; Van Hemelrijck, Mieke; Dolly, SaoirseRussell, Beth; Moss, Charlotte L; Palmer, Kieran; Sylva, Rushan; D'Souza, Andrea; Wylie, Harriet; Haire, Anna; Cahill, Fidelma; Steel, Renee; Hoyes, Angela; Wilson, Isabelle; Macneil, Alyson; Shifa, Belul; Monroy-Iglesias, Maria J; Papa, Sophie; Irshad, Sheeba; Ross, Paul; Spicer, James; Kordasti, Shahram; Crawley, Danielle; Zaki, Kamarul; Sita-Lumsden, Ailsa; Josephs, Debra; Enting, Deborah; Swampillai, Angela; Sawyer, Elinor; Fields, Paul; Wrench, David; Rigg, Anne; Sullivan, Richard; Van Hemelrijck, Mieke; Dolly, Saoirs

The health of rural Black communities during COVID: Some affirmations, some surprises

Background and objectiveThere are overwhelming health disparities in the Deep South. It is important to include the voice of communities affected by these disparities when developing interventions. The goal of the current study was to develop an academic community engaged partnership to strengthen the ability to address priority health concerns of rural African American communities with a focus on health literacy and health advocacy.MethodsA community-based participatory research approach was used to administer a 15-item community health survey in five rural communities led by African American mayors in Alabama (N = 752). The survey assessed the health concerns and the potential behaviors that may be associated with those health concerns.ResultsThe five communities demonstrated similarities as well as differences in both the health concerns endorsed and the potential health behaviors that may contribute to those concerns. All five communities identified cardiovascular disease as a health concern with three endorsing mental health issues and 2 dental health. With respect to behaviors, all five communities identified either unhealthy eating/exercise and substance use as concerns with one community identifying racism as a risky behavior affecting health.ConclusionThe results presented replicate CBPR studies demonstrating that communities are important sources of information about local health priorities and concerns