Aligning Community-Engaged Research to Context.

Community-engaged research is understood as existing on a continuum from less to more community engagement, defined by participation and decision-making authority. It has been widely assumed that more is better than less engagement. However, we argue that what makes for good community engagement is not simply the extent but the fit or alignment between the intended approach and the various contexts shaping the research projects. This article draws on case studies from three Community Engagement Cores (CECs) of NIEHS-funded Environmental Health Science Core Centers (Harvard University, UC Davis and University of Arizona,) to illustrate the ways in which community engagement approaches have been fit to different contexts and the successes and challenges experienced in each case. We analyze the processes through which the CECs work with researchers and community leaders to develop place-based community engagement approaches and find that different strategies are called for to fit distinct contexts. We find that alignment of the scale and scope of the environmental health issue and related research project, the capacities and resources of the researchers and community leaders, and the influences of the sociopolitical environment are critical for understanding and designing effective and equitable engagement approaches. These cases demonstrate that the types and degrees of alignment in community-engaged research projects are dynamic and evolve over time. Based on this analysis, we recommend that CBPR scholars and practitioners select a range of project planning and management techniques for designing and implementing their collaborative research approaches and both expect and allow for the dynamic and changing nature of alignment

Probiotic administration in congenital heart disease: a pilot study.

ObjectiveTo investigate the impact of probiotic Bifidobacterium longum ssp. infantis on the fecal microbiota and plasma cytokines in neonates with congenital heart disease.Study designSixteen infants with congenital heart disease were randomly assigned to receive either B. infantis (4.2 × 10(9) colony-forming units two times daily) or placebo for 8 weeks. Stool specimens from enrolled infants and from six term infants without heart disease were analyzed for microbial composition. Plasma cytokines were analyzed weekly in the infants with heart disease.ResultsHealthy control infants had increased total bacteria, total Bacteroidetes and total bifidobacteria compared to the infants with heart disease, but there were no significant differences between the placebo and probiotic groups. Plasma interleukin (IL)10, interferon (IFN)γ and IL1β levels were transiently higher in the probiotic group.ConclusionCongenital heart disease in infants is associated with dysbiosis. Probiotic B. infantis did not significantly alter the fecal microbiota. Alterations in plasma cytokines were found to be inconsistent

Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy A Systematic Review and Meta-analysis

IMPORTANCE Universal ultrasonographic screening for developmental dysplasia of the hip (DDH) has gained increasing popularity despite the lack of benefit in terms of reducing the rates of late-detected cases (age >= 12 weeks) in randomized clinical trials.OBJECTIVE To report the reported incidence of DDH in the English scientific literature and compare rates of late-detected cases in settings with different DDH screening strategies.DATA SOURCES PubMed, Scopus, and Web of Science databases were searched on November 25 and 27, 2021. No time filters were used in the search.STUDY SELECTION All observational studies reporting the incidence of early-detected or late-detected (age >= 12 weeks) DDH were included. Non-English reports were excluded if the abstract did not include enough information to be included for analysis.DATA EXTRACTION AND SYNTHESIS The number of newborns screened and the detection rates were extracted. Meta-analysis calculated the pooled incidence of DDH per 1000 newborns with 95% CIs using a random- or fixed-effects model. This study is reported according to the PRISMA and MOOSE guidelines.MAIN OUTCOMES AND MEASURES The main outcome measures were early detection, early treatment, late detection, and operative treatment incidences.RESULTS A total of 1899 studies were identified. 203 full texts were assessed, and 76 studies with 16 901079 infants were included in final analyses. The early detection rate was 8.4 (95% CI. 4.8-14.8) infants with DDH per 1000 newborns with clinical screening, 4.4(95% CI, 2.4-8.0) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 23.0 (95% CI, 15.7-33.4) infants with DDH per 1000 newborns with universal ultrasonographic screening. Rates for nonoperative treatment were 5.5 (95% CI, 2.1-14) treatments per 1000 newborns with clinical screening, 3.1(95% CI, 2.0-4.8) treatments per 1000 newborns with selective ultrasonographic screening, and 9.8 (95% CI, 6.7-14.4) treatments per 1000 newborns with universal ultrasonographic screening. The incidence of late-detected DDH was 0.5 (95% CI, 0.2-1.5) infants with DDH per 1000 newborns with clinical screening, 0.6 (95% CI. 0.3-1.3) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 0.2 (95% CI, 0.0-0.8) infants with DDH per 1000 newborns with universal ultrasonographic screening. The corresponding incidences of operative treatment were 0.2 (95% CI, 0.0-0.9) operations per 1000 newborns with clinical screening, 0.5 (95% CI, 0.4-0.7) operations per 1000 newborns with selective ultrasonographic screening, and 0.4(95% CI, 0.2-0.7) operations per 1000 newborns with universal ultrasonographic screening.CONCLUSIONS AND RELEVANCE This meta-analysis found that early detection rates and nonoperative treatments were higher with universal screening. The late detection and operative treatment rates with universal screening were similar to those among selectively and clinically screened newborns. Based on these results, universal screening may cause initial overtreatment without reducing the rates of late detection and operative treatment.Peer reviewe

Neuropsychological intervention of dyslexia has a positive effect on aspects of psychological well-being in young adults - a randomized controlled study

Effectiveness of individual- and group-based neuropsychological intervention on aspects of psychological well-being of dyslexic adults was evaluated. Dyslexic young adults (n = 120) were randomly assigned into individual intervention, group intervention or wait-list control group. Both interventions focussed on cognitive strategy learning, supporting self-esteem, and using psychoeducation. In group format peer support was also utilized. Cognitive and behavioural strategies, mood states, quality of life and self-esteem were assessed via self-report questionnaires at baseline, after the intervention/wait-list control time at 5 months and 10 months. Results indicated that the neuropsychological interventions had a positive effect on self-evaluated cognitive and behavioural strategies, especially in increasing success expectations and to a lesser degree in diminishing task-avoidance and in group intervention in diminishing social pessimism. The interventions also improved cognition-related quality of life and, to a lesser degree, self-esteem. These results indicate that structured neuropsychological interventions can positively affect self-evaluated psychological well-being, especially on cognitive and behavioural strategies. Considering the secondary consequences of dyslexia, support among young adults is often needed beyond the cognitive and reading-based challenges dyslexia poses.Peer reviewe

Retirement age and type as predictors of frailty : a retrospective cohort study of older businessmen

Objectives To study the association between retirement characteristics and frailty in a homogenous population of former business executives. Design Cross-sectional cohort study using data from the Helsinki Businessmen Study. Setting Helsinki, Finland. Participants 1324 Caucasian men, born in 1919-1934, who had worked as business executives and managers and of whom 95.9% had retired by the year 2000. Questions on age at and type of retirement, lifestyle and chronic conditions were embedded in questionnaires. Primary and secondary outcome measures Frailty assessed according to a modified phenotype definition at mean age 73.3 years. Results Mean age at retirement was 61.3 years (SD 4.3) and 37.1% had retired due to old age. The prevalence of frailty was lowest among men retiring at ages 66-67 years but increased among those who worked up to age 70 years or older. Compared with men who retired before age 55 years, those retiring at ages 58-69 years were at decreased risk of frailty in old age relative to non-frailty (adjusted ORs 0.07-0.29, pPeer reviewe