124 research outputs found

    The Impact of Managed Care on Physicians

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    Longitudinal associations between parental support and parental knowledge on behavioral and emotional problems in adolescents.

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    When testing longitudinal effects of parenting practices on adolescent adjustment, an integrated consideration of externalizing and internalizing behaviors is a gap in research. This study analyzed how parental support and parental knowledge directly and indirectly influence both antisocial behavior and emotional problems. The sample had 642 adolescents aged 12-15 (mean age = 12.49; 45.4% females) from Spain, who participated in a three-year long study. The results showed longitudinal bidirectional associations between parental support and parental knowledge. Only parental knowledge, however, directly predicted antisocial behavior and emotional problems. Parental support had an indirect effect on outcomes through the mediating effect of parental knowledge. This study has practical implications by indicating that increasing parental knowledge should be the target of educational-prevention programsS

    Feasibility, Acceptability and Utility of the Evidence-based “keepin’ it REAL” Substance Use Prevention Program for Early Adolescents in Kenyan Schools

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    The growing prevalence of youth substance use in Kenya calls for the implementation of efficacious substance use prevention programs. The overall aim of this study was to evaluate the feasibility, acceptability, and utility of an evidence-based substance use prevention program, keepin’ it REAL (kiR), in Kenyan secondary schools. The study had three objectives: (1) Test if the program can be successfully delivered by assessing whether teachers agreed that kiR was well suited to their educational context and engaged student participation (i.e., feasibility); (2) Test if teachers and students found the prevention program’s components applicable, appropriate and satisfactory (i.e., acceptability); (3) Test if teachers and students found the kiR program useful in imparting knowledge and motivating changes in attitudes and behaviors related to substance use (i.e., utility). Data were drawn from post-test evaluations completed by kiR students (N=348) and teacher-implementers (N=7) during a pilot test in two Nairobiarea secondary schools. Quantitative data were analyzed using descriptive statistics. Qualitative data were coded and contentanalyzed. Students evaluated kiR positively: large majorities participated highly (feasibility); viewed kiR as highly satisfactory, interesting, and capturing their attention (acceptability); and reported it provided useful and highly applicable information (utility). Teachers were nearly unanimous that kiR was feasible, addressed youth substance use well and engaged student interest, but also noted technical issues in delivery (equipment, power interruptions), insufficient time to complete lessons, and a need for more training. Findings demonstrated that kiR is feasible for implementation in Kenya with attention to technical and class size challenges; with highly acceptable, applicable and satisfactory content; and demonstrable impact on acquiring knowledge and skills to help adolescents resist substance use. Future research is needed to adapt the implementation model for Kenya and test the efficacy of kiR in a randomized controlled trial with a larger and more representative sample of schools

    Applicability of the Theory of Planned Behavior for Predicting Alcohol Use in Spanish Early Adolescents

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    According to the theory of planned behavior (TPB), intentions to perform a specific behavior are the result of attitudes, norms, and perceived control, and in turn, intentions and perceived control are the main predictors of the behavior. This study aimed to test the applicability of TPB in predicting alcohol use in normative pre-adolescents. The sample was composed of 755 Spanish adolescents aged 11 to 15 (M = 12.24; SD = 0.56), 47.1% females, from 12 state secondary schools in Spain. The results of path analysis indicate that positive attitudes towards alcohol, favorable norms towards alcohol, and offer vulnerability (perceived control) are significantly positively related to intentions to use alcohol as well as negatively related to actual behavioral control (i.e., actual strategies to avoid alcohol use). In turn, intentions to use and actual control predict higher alcohol frequency and heavy drinking. Significant indirect effects of these antecedents were found on alcohol outcomes through the mediation of intentions and actual control. The findings suggest that the validity and applicability of the TPB in normative pre-adolescents depend on the severity of alcohol use and point to a need to consider negative social influence in decision making processes in early adolescenceThis research was funded by the Global Center for Applied Health Research (GCAHR; Arizona State University) and supported by the Programa de Axudas á etapa posdoutoral da Xunta de Galicia (Consellería de Cultura, Educación e Ordenación Universitaria) and by FEDER/Ministerio de Ciencia, Innovación y Universidades—Agencia Estatal de Investigación (Grant PSI2015-65766-R)—under the Axuda para a consolidación e estruturación de unidades de investigación competitivas e outras accións de fomento nas universidades do SUG (GRC, 2018)S

    Effectiveness of the mantente REAL program for preventing alcohol use in spanish adolescents

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    Mantente REAL is a school-based universal program to prevent drug use and other problematic behaviors specifically designed to be implemented in schools at the beginning of adolescence. This program, which is a culturally adapted version of the Keepin’ it REAL intervention, focuses on skills training for resisting social pressure to use drugs and improving psychosocial development. This study aims to evaluate the effectiveness of Mantente REAL on alcohol use in the Spanish context. The sample was composed of 755 adolescents from 12 state secondary schools in Spain, aged 11 to 15 (M = 12.24, SD = 0.56), 47.1% females. The 12 schools were randomly assigned to control and experimental groups, six to each condition. Pre-test and post-test questionnaires data were collected to evaluate the effectiveness of the program. The results indicated that a culturally adapted version of Mantente REAL was effective in preventing alcohol use among youth from northern and southern Spain. Students participating in the program demonstrated changes in the desired direction on alcohol frequency and intoxication episodes. Implications of these results regarding intervention programs aimed at preventing substance use in adolescence are discussed“Mantente REAL” es un programa universal que utiliza la escuela para prevenir el consumo de drogas y otras conductas problemáticas diseñado específicamente para ser implementado en las escuelas al comienzo de la adolescencia. Este programa, que es una versión culturalmente adaptada de la intervención Keepin’ it REAL, se centra en el entrenamiento de habilidades para resistir la presión social para consumir drogas y mejorar el desarrollo psicosocial. Este estudio tiene como objetivo evaluar la eficacia de “Mantente REAL” en el consumo de alcohol en el contexto español. La muestra estuvo compuesta por 755 adolescentes de 12 escuelas secundarias públicas en España, de 11 a 15 años (M = 12.24, DT = 0.56), el 47.1% mujeres. Las 12 escuelas fueron asignadas aleatoriamente a grupo control y experimental, seis en cada condición. Los datos se recopilaron a través de cuestionarios antes y después de la intervención para evaluar la eficacia del programa. Los resultados indicaron que la versión culturalmente adaptada de “Mantente REAL” fue eficaz para prevenir el consumo de alcohol entre los jóvenes del norte y sur de España. Los estudiantes que participaron en el programa demostraron cambios en la dirección deseada en la frecuencia del alcohol y los episodios de intoxicación. Se discuten las implicaciones de estos resultados con respecto a los programas de intervención destinados a prevenir el consumo de sustancias en la adolescenciaThis study was funded by the Global Center for Applied Health Research (Arizona State University) and supported by the Programa de Axudas á etapa posdoutoral da Xunta de Galicia (Consellería de Cultura, Educación e Ordenación Universitaria) and by FEDER/Ministerio de Ciencia, Innovación y Universidades – Agencia Estatal de Investigación (Grant PSI2015-65766-R) – under the Axuda para a consolidación e estruturación de unidades de investigación competitivas e outras accións de fomento nas universidades do SUG (GRC, 2018)S

    Dihydrodinophysistoxin-1 produced by Dinophysis norvegica in the Gulf of Maine, USA and its accumulation in shellfish

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    © The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Deeds, J. R., Stutts, W. L., Celiz, M. D., MacLeod, J., Hamilton, A. E., Lewis, B. J., Miller, D. W., Kanwit, K., Smith, J. L., Kulis, D. M., McCarron, P., Rauschenberg, C. D., Burnell, C. A., Archer, S. D., Borchert, J., & Lankford, S. K. Dihydrodinophysistoxin-1 produced by Dinophysis norvegica in the Gulf of Maine, USA and its accumulation in shellfish. Toxins, 12(9), (2020): E533, doi:10.3390/toxins12090533.Dihydrodinophysistoxin-1 (dihydro-DTX1, (M-H)−m/z 819.5), described previously from a marine sponge but never identified as to its biological source or described in shellfish, was detected in multiple species of commercial shellfish collected from the central coast of the Gulf of Maine, USA in 2016 and in 2018 during blooms of the dinoflagellate Dinophysis norvegica. Toxin screening by protein phosphatase inhibition (PPIA) first detected the presence of diarrhetic shellfish poisoning-like bioactivity; however, confirmatory analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS) failed to detect okadaic acid (OA, (M-H)−m/z 803.5), dinophysistoxin-1 (DTX1, (M-H)−m/z 817.5), or dinophysistoxin-2 (DTX2, (M-H)−m/z 803.5) in samples collected during the bloom. Bioactivity-guided fractionation followed by liquid chromatography-high resolution mass spectrometry (LC-HRMS) tentatively identified dihydro-DTX1 in the PPIA active fraction. LC-MS/MS measurements showed an absence of OA, DTX1, and DTX2, but confirmed the presence of dihydro-DTX1 in shellfish during blooms of D. norvegica in both years, with results correlating well with PPIA testing. Two laboratory cultures of D. norvegica isolated from the 2018 bloom were found to produce dihydro-DTX1 as the sole DSP toxin, confirming the source of this compound in shellfish. Estimated concentrations of dihydro-DTX1 were >0.16 ppm in multiple shellfish species (max. 1.1 ppm) during the blooms in 2016 and 2018. Assuming an equivalent potency and molar response to DTX1, the authority initiated precautionary shellfish harvesting closures in both years. To date, no illnesses have been associated with the presence of dihydro-DTX1 in shellfish in the Gulf of Maine region and studies are underway to determine the potency of this new toxin relative to the currently regulated DSP toxins in order to develop appropriate management guidance.Partial support for this research was received from the National Oceanic and Atmospheric Administration, National Centers for Coastal Ocean Science Competitive Research, Ecology and Oceanography of Harmful Algal Blooms Program under awards NA17NOS4780184 and NA19NOS4780182 to Juliette Smith (VIMS) and Jonathan Deeds (US FDA), and Prevention, Control, and Mitigation of Harmful Algal Blooms program award NA17NOS4780179 to Stephen Archer. This paper is ECOHAB publication number EC0956

    IgE and IgG4 epitopes of the peanut allergens shift following oral immunotherapy

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    Background Oral immunotherapy (OIT) with peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; Aimmune Therapeutics) is an FDA-approved treatment to desensitize peanut allergic participants. Objective Here we assessed shifts in IgE and IgG4 binding to peanut allergens and their epitopes recognized by United States (US) peanut allergic participants (n = 20) enrolled in phase 3 PTAH OIT clinical trials. Methods Pre- and post- trial participant sera were collected approximately 12 months apart and tested for IgE binding to intact peanut proteins via ImmunoCAP ISAC immunoassays. IgE and IgG4 linear epitopes were identified based on binding to synthetic overlapping 15-mer linear peptides of 10 peanut allergens (Ara h 1-11) synthesized on microarray slides. Results Statistically significant decreases in IgE binding were identified for intact Ara h 2, 3, and 6, and known and newly identified IgE epitopes were shown to exhibit shifts towards IgG4 binding post-OIT, with most linear peptides having increased IgG4 binding after treatment with PTAH. While PTAH does not seem to alter the actual peptide binding patterns significantly after one year of treatment, the IgE and IgG4 binding ratios and intensity are altered. Conclusion At a population level, the linear IgE and IgG4 epitopes of 10 peanut allergens overlap and that increase in IgG4 with OIT results in displacement of IgE binding to both conformational and linear epitopes. Furthermore, it appears as though the increase in IgG4 is more important to achieve desensitization at the 12-month timepoint than the decrease in IgE. This type of knowledge can be useful in the identification of IgE and IgG4-binding allergen and peptide biomarkers that may indicate desensitization or sustained unresponsiveness of allergic individuals to peanut
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