Adverse Childhood Experiences in Children Presenting to Integrated Pediatric Primary Care

The prevalence of adverse childhood experiences (ACEs) has created a significant public health concern in the United States. A vast body of literature examining adult populations has displayed a dose-response association between cumulative ACEs and chronic illnesses (Chapman et al., 2004; Felitti et al., 1998). ACEs research conducted with children and adolescents has indicated higher ACE scores associated with learning and behavioral problems (Burke et al., 2011), health risk behaviors (Garrido et al., 2018), and mental health challenges (Mackner et al., 1997). However, ACEs research and subsequent interventions have largely relied upon retrospective data retrieved from adults (Felitti et al., 1998) and national datasets (Centers for Disease Control and Prevention, 2019; Greeson et al., 2014). Given the growing literature on ACEs in children and adolescents, the goal of the thesis project was to investigate the ACEs, psychosocial functioning, and healthcare utilization of youth presenting to a pediatric integrated primary care clinic (IPC) in an urban community. Participants were patients who complete an initial visit with the Pediatric Behavioral Health Team (Peds BHT) at VCU’s Children’s Hospital of Richmond. This IPC clinic serves a low income, racially diverse pediatric population (ages 3-17). This study utilized clinical data obtained from caregivers of patients presenting to the Peds BHT. Measures of cumulative childhood adversity (Adverse Childhood Experiences Questionnaire), child mental health (Pediatric Symptom Checklist-17), and demographic characteristics were examined. The present study utilized descriptive statistical analyses and linear regression models to examine relations between ACEs, mental health, and healthcare utilization in a pediatric sample presenting to IPC. The results indicated 81.3% of participants experienced at least 1or more Original ACEs (an ACE score ≥ 1), and 58.7% experienced ≥ 2 or more Original ACEs. For children in the 3-12 age group, Original ACE scores predicted overall mental health, (p =.008). The results also indicated a relationship between medical diagnoses and healthcare utilization. The results underscore the importance of screening for ACEs and mental health in pediatric primary care as early childhood stressors emerge

Implementing ideal health policy in a fragile health system: the example of expanding the use of malaria rapid diagnostic tests in mainland Tanzania

Malaria confirmation before treatment provides an opportunity for improving the quality of malaria case management in endemic regions. However, increased coverage of this strategy is facing many organizational, logistical and technical challenges that threaten its success. Introducing an intervention with system-wide effect, such as the use of malaria rapid diagnostic tests in areas where malaria is still a public health problem, should be accompanied by system strengthening measures to better attain the goal of improving quality of care

An Empirical Analysis of Racial Categories in the Algorithmic Fairness Literature

Recent work in algorithmic fairness has highlighted the challenge of defining racial categories for the purposes of anti-discrimination. These challenges are not new but have previously fallen to the state, which enacts race through government statistics, policies, and evidentiary standards in anti-discrimination law. Drawing on the history of state race-making, we examine how longstanding questions about the nature of race and discrimination appear within the algorithmic fairness literature. Through a content analysis of 60 papers published at FAccT between 2018 and 2020, we analyze how race is conceptualized and formalized in algorithmic fairness frameworks. We note that differing notions of race are adopted inconsistently, at times even within a single analysis. We also explore the institutional influences and values associated with these choices. While we find that categories used in algorithmic fairness work often echo legal frameworks, we demonstrate that values from academic computer science play an equally important role in the construction of racial categories. Finally, we examine the reasoning behind different operationalizations of race, finding that few papers explicitly describe their choices and even fewer justify them. We argue that the construction of racial categories is a value-laden process with significant social and political consequences for the project of algorithmic fairness. The widespread lack of justification around the operationalization of race reflects institutional norms that allow these political decisions to remain obscured within the backstage of knowledge production.Comment: 13 pages, 2 figures, FAccT '2

TgDrpC, an atypical dynamin‐related protein in Toxoplasma gondii, is associated with vesicular transport factors and parasite division

Dynamin‐related proteins (Drps) are involved in diverse processes such as organelle division and vesicle trafficking. The intracellular parasite Toxoplasma gondii possesses three distinct Drps. TgDrpC, whose function remains unresolved, is unusual in that it lacks a conserved GTPase Effector Domain, which is typically required for function. Here, we show that TgDrpC localizes to cytoplasmic puncta; however, in dividing parasites, TgDrpC redistributes to the growing edge of the daughter cells. By conditional knockdown, we determined that loss of TgDrpC stalls division and leads to rapid deterioration of multiple organelles and the IMC. We also show that TgDrpC interacts with proteins that exhibit homology to those involved in vesicle transport, including members of the adaptor complex 2. Two of these proteins, a homolog of the adaptor protein 2 (AP‐2) complex subunit alpha‐1 and a homolog of the ezrin–radixin–moesin (ERM) family proteins, localize to puncta and associate with the daughter cells. Consistent with the association with vesicle transport proteins, re‐distribution of TgDrpC to the IMC during division is dependent on post‐Golgi trafficking. Together, these results support that TgDrpC contributes to vesicle trafficking and is critical for stability of parasite organelles and division

The New Era for Reno-Cardiovascular Treatment in Type 2 Diabetes

Diabetes; Diabetic kidney disease; Dipeptidyl peptidase 4 inhibitorsDiabetis; Nefropatia diabètica; Inhibidors de la dipeptidil peptidasa 4Diabetes; Nefropatía diabética; Inhibidores de la dipeptidil peptidasa 4Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease in the developed world. Until 2016, the only treatment that was clearly demonstrated to delay the DKD was the renin-angiotensin system blockade, either by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. However, this strategy only partially covered the DKD progression. Thus, new strategies for reno-cardiovascular protection in type 2 diabetic patients are urgently needed. In the last few years, hypoglycaemic drugs, such as sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists, demonstrated a cardioprotective effect, mainly in terms of decreasing hospitalization for heart failure and cardiovascular death in type 2 diabetic patients. In addition, these drugs also demonstrated a clear renoprotective effect by delaying DKD progression and decreasing albuminuria. Another hypoglycaemic drug class, dipeptidyl peptidase 4 inhibitors, has been approved for its use in patients with advanced chronic kidney disease, avoiding, in part, the need for insulinization in this group of DKD patients. Studies in diabetic and non-diabetic experimental models suggest that these drugs may exert their reno-cardiovascular protective effect by glucose and non-glucose dependent mechanisms. This review focuses on newly demonstrated strategies that have shown reno-cardiovascular benefits in type 2 diabetes and that may change diabetes management algorithms.The authors are current recipients of research grants from the FONDO DE INVESTIGACIÓN SANITARIA-FEDER, ISCIII, PI17/00257, and REDINREN, RD16/0009/0030

The Iowa Homemaker vol.15, no.6

A Serve-Yourself party, page 2 Your Own Greeting Cards, by Betty Blanco, page 3 Merry Christmas to a Bookworm, page 3 Something She can Wear, by Kay Hoffman, page 4 Add To Her Dressing Table, by Dorothy Fedderson, page 5 A Tiny Manger Scene, by Gay Starrak, page 6 Package Be Gay! by Ethelavis Hendriks, page 7 Everybody Makes Candy At Christmas, by Stella Mae Brinkman, page 8 Let It be a Tea, by Ruth Cook, page 9 Let Your Christmas Tree Express Itself, by Ruth Kunerth, page 10 A Man “Hec” Student? by Irene Jacobs, page 11 Need and Idea? by Vera Joyce Horswell, page 13 Give Her Silver, page 14 Come Out-of-Doors, by Betty Taylor, page 1