14 research outputs found
Perceived Discrimination, Coping Styles, and Internalizing Symptoms Among a Community Sample of Hispanic and Somali Adolescents
Get PDFPurpose: Perceived discrimination, perceptions of receiving differential treatment due to negative attitudes, and stereotypes about one\u27s racial/ethnic group can increase vulnerability to depression and anxiety. Although ethnic minority youth now represent over half of the U.S. youth population, few studies have investigated potential protective factors in the relationship between perceived discrimination and mental health across diverse ethnic minority immigrant youth from different cultural backgrounds. Methods: We examined the association between perceived discrimination and past week symptoms of depression and anxiety and whether patterns of problem and emotion-focused coping moderate these relationships among Somali and Hispanic immigrant youth (N = 353) in an urban midwestern setting (mean age = 15; 53% male, 39% first generation, 75% low income). Path analysis models examined the main effects of perceived discrimination for depression and anxiety and whether problem and emotion-focused coping moderated these associations. Results: Path analysis models suggest that perceived discrimination was positively associated with past week symptoms of depression (β = .37, standard error = .06) and anxiety (β = .16, standard error = .06) across ethnicity. However, adolescents who reported high levels of discrimination and who used predominantly problem-focused coping strategies experienced fewer internalizing problems than youth who relied predominantly on emotion-focused coping strategies. Conclusions: Our findings suggest that strengthening youths’ problem-focused coping strategies in the face of discriminatory stress is a promising health promotion and risk prevention approach
Distinct microbial and immune niches of the human colon.
Get PDFGastrointestinal microbiota and immune cells interact closely and display regional specificity; however, little is known about how these communities differ with location. Here, we simultaneously assess microbiota and single immune cells across the healthy, adult human colon, with paired characterization of immune cells in the mesenteric lymph nodes, to delineate colonic immune niches at steady state. We describe distinct helper T cell activation and migration profiles along the colon and characterize the transcriptional adaptation trajectory of regulatory T cells between lymphoid tissue and colon. Finally, we show increasing B cell accumulation, clonal expansion and mutational frequency from the cecum to the sigmoid colon and link this to the increasing number of reactive bacterial species
Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children.
Get PDFBACKGROUND: Inpatient case fatality from severe malaria remains high in much of sub-Saharan Africa. The majority of these deaths occur within 24 hours of admission, suggesting that pre-hospital management may have an impact on the risk of case fatality. METHODS: Prospective cohort study, including questionnaire about pre-hospital treatment, of all 437 patients admitted with severe febrile illness (presumed to be severe malaria) to the paediatric ward in Sikasso Regional Hospital, Mali, in a two-month period. FINDINGS: The case fatality rate was 17.4%. Coma, hypoglycaemia and respiratory distress at admission were associated with significantly higher mortality. In multiple logistic regression models and in a survival analysis to examine pre-admission risk factors for case fatality, the only consistent and significant risk factor was sex. Girls were twice as likely to die as boys (AOR 2.00, 95% CI 1.08-3.70). There was a wide variety of pre-hospital treatments used, both modern and traditional. None had a consistent impact on the risk of death across different analyses. Reported use of traditional treatments was not associated with post-admission outcome. INTERPRETATION: Aside from well-recognised markers of severity, the main risk factor for death in this study was female sex, but this study cannot determine the reason why. Differences in pre-hospital treatments were not associated with case fatality
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
Get PDFIMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
A longitudinal study of the impact of COVID-19 restrictions on students’ health behavior, mental health and emotional well-being
No full textBackground COVID-related restrictions impacted the lives of students on and off campus during Academic Year 2020/2021. Methods Our study collected data on student health behavior and habits as well as their mental and emotional health using anonymous surveys. We compared these data with data collected prior to COVID in the longitudinal part of our study (n = 721) and analyzed them for the cross-sectional part of the study (n = 506). Results The longitudinal data show a significant difference for some student behaviors and habits, such as sleeping habits, physical activity, breakfast consumption, time spent online or playing video games, vaping, and marijuana use, during the COVID pandemic compared with pre-COVID data. Respondents also reported a significant increase in difficulty concentrating, remembering, or making decisions, as well as being impacted by feelings of sadness or hopelessness. Yet, there was no increase in the proportion of respondents considering, planning or attempting suicide during COVID. The cross-sectional data illuminate the negative effect of the overall situation and the restrictions on students’ mental and emotional well-being. Three-quarters of respondents reported having craved human interaction during the past six months, more than half felt that their mental/emotional health had been impacted by the lack of social events or the switch to virtual (online) teaching. Two-thirds or more of respondents also expressed that they felt less connected to their peers and less motivated in their studies than in previous semesters. Fifty percent or more of respondents selected anxious, stressed, overwhelmed, disconnected, tired, and fatigued as words that best described their emotional state during the pandemic. Conclusions The impact of COVID-related restrictions on students’ behaviors and habits as well as their mental and emotional health was less severe than one would have expected based on studies during the early stage of the pandemic. While some behaviors and habits changed during the COVID pandemic compared with the pre-COVID period, the changes were not substantial overall. Our study did not find an increase in the proportion of respondents considering, planning or attempting suicide during COVID, although the cross-sectional data from our survey make the negative effect of the overall situation and the restrictions on students’ mental and emotional well-being evident. The impact of the pandemic will unquestionably be long-lasting and will necessitate further and future investigations
The Effect of Timing of Exercise and Eating on Postprandial Response in Adults: A Systematic Review
No full textType 2 diabetes is a major public health concern. Management of this condition has focused on behavior modification through diet and exercise interventions. A growing body of evidence has focused on temporality of dietary intake and exercise and potential effects on health. This review summarizes current literature that investigates the question “how does the timing of exercise relative to eating throughout the day effect postprandial response in adults?” Databases PubMed, Scopus, Cochrane Library, CINAHL, and SPORTDiscus were searched between March–May 2019. Experimental studies conducted in healthy adults (≥18 y) and those with type 2 diabetes were included. Full texts were examined by at least two independent reviewers. Seventeen studies with a total of 332 participants met the inclusion criteria. The primary finding supports that exercise performed post-meal regardless of time of day had a beneficial impact on postprandial glycemia. There was insufficient evidence regarding whether timing of exercise performed pre- vs. post-meal or vice versa in a day is related to improved postprandial glycemic response due to inherent differences between studies. Future studies focusing on the investigation of timing and occurrence of meal intake and exercise throughout the day are needed to inform whether there is, and what is, an optimal time for these behaviors regarding long-term health outcomes
Peer power: Implementing a social work peer mentoring scheme
No full textPeer-mentoring is known to have value for both mentors and mentees and on professional degree programmes. For mentors this can build confidence and support students to develop skills which align with the standards and expectations of social workers. For mentees benefits include increasing engagement, reducing worries and developing resilience. Although previous research has suggested that peer-mentoring is widely adopted in social work education programmes, there remains limited research on this topic for qualifying social work programmes in the UK. Recent research on this topic from members of our team, which was undertaken in another university, indicated the effectiveness of peer-mentoring in building a community of practice, supporting transitions, complementing the role of academic staff and in facilitating academic and professional development for both mentors and mentees. Indeed, those who had been mentors were keen to develop these skills further such as becoming practice educators supporting ongoing CPD. However, this research also noted problems encountered in establishing a peer-mentoring scheme.
Building on some of the authors’ previous experience in co-producing a peer-mentoring scheme, this short oral presentation will outline how staff, students and former peer-mentors, who are now qualified social workers, have worked together to establish a mentoring scheme on an undergraduate programme. The presentation will outline the motivations for having a peer-mentoring scheme on the programme. It will also provide reflections on how we have used knowledge and experience from the previous scheme to avoid some of the challenges which can emerge with setting up peer-mentoring schemes. Student mentors will share their experiences of being involved in the scheme and former mentors will also reflect on how being involved in peer-mentoring has influenced their newly qualified practice. Implications for practice for educators, students, new social workers and employers will be discussed
