Stability and Change in Self-Reported Sexual Orientation Identity in Young People: Application of Mobility Metrics

This study investigated stability and change in self-reported sexual orientation identity over time in youth. We describe gender- and age-related changes in sexual orientation identity from early adolescence through emerging adulthood in 13,840 youth ages 12–25 employing mobility measure M, a measure we modified from its original application for econometrics. Using prospective data from a large, ongoing cohort of U.S. adolescents, we examined mobility in sexual orientation identity in youth with up to four waves of data. Ten percent of males and 20% of females at some point described themselves as a sexual minority, while 2% of both males and females reported ever being “unsure” of their orientation. Two novel findings emerged regarding gender and mobility: (1) Although mobility scores were quite low for the full cohort, females reported significantly higher mobility than did males. (2) As expected, for sexual minorities, mobility scores were appreciably higher than for the full cohort; however, the gender difference appeared to be eliminated, indicating that changing reported sexual orientation identity throughout adolescence occurred at a similar rate in female and male sexual minorities. In addition, we found that, of those who described themselves as “unsure” of their orientation identity at any point, 66% identified as completely heterosexual at other reports and never went on to describe themselves as a sexual minority. Age was positively associated with endorsing a sexual-minority orientation identity. We discuss substantive and methodological implications of our findings for understanding development of sexual orientation identity in young people

Effects of Gender on the Health and Development of Medically At‐Risk Infants

To examine gender-differentiated health and cognitive/motor/language developmental outcomes among medically at-risk infants

Effects of Maternal Depressive Symptoms and Infant Gender on the Interactions Between Mothers and Their Medically At-Risk Infants

To examine the effects of maternal depressive symptoms and infant gender on interactions between mothers and medically at-risk infants

Life course theory as a framework to examine becoming a mother of a medically fragile preterm infant

Life course theory, a sociological framework, was used to analyze the phenomenon of becoming a mother, with longitudinal narrative data from 34 women who gave birth prematurely after a high-risk pregnancy, and whose infant became medically fragile. Women faced challenges of mistimed birth and mothering a technologically-dependent infant. Before social ties were established, legal and biological ties required mothers to make critical decisions about their infants. Liminality characterized mothers’ early involvement with their infants. The mothers worked to know, love, and establish deeper attachments to this baby. The infant’s homecoming was a key turning point; it decreased liminality of early mothering, increased mothers’ control of infants’ care, and gave them time and place to know their infants more intimately

Effect of vitamin K2 on postural sway in older people who fall:a randomized controlled trial

OBJECTIVES: Vitamin K is thought to be involved in both bone health and maintenance of neuromuscular function. We tested the effect of vitamin K2 supplementation on postural sway, falls, healthcare costs, and indices of physical function in older people at risk of falls.DESIGN: Parallel-group double-blind randomized placebo-controlled trial.SETTING: Fourteen primary care practices in Scotland, UK.PARTICIPANTS: A total of 95 community-dwelling participants aged 65 and older with at least two falls, or one injurious fall, in the previous year.INTERVENTION: Once/day placebo, 200 μg or 400 μg of oral vitamin K2 for 1 year.MEASUREMENTS: The primary outcome was anteroposterior sway measured using sway plates at 12 months, adjusted for baseline. Secondary outcomes included the Short Physical Performance Battery, Berg Balance Scale, Timed Up &amp; Go Test, quality of life, health and social care costs, falls, and adverse events.RESULTS: Mean participant age was 75 (standard deviation [SD] = 7) years. Overall, 58 of 95 (61%) were female; 77 of 95 (81%) attended the 12-month visit. No significant effect of either vitamin K2 dose was seen on the primary outcome of anteroposterior sway (200 μg vs placebo: -.19 cm [95% confidence interval [CI] -.68 to .30; P = .44]; 400 μg vs placebo: .17 cm [95% CI -.33 to .66; P = .50]; or 400 μg vs 200 μg: .36 cm [95% CI -.11 to .83; P = .14]). Adjusted falls rates were similar in each group. No significant treatment effects were seen for other measures of sway or secondary outcomes. Costs were higher in both vitamin K2 arms than in the placebo arm.CONCLUSION: Oral vitamin K2 supplementation did not improve postural sway or physical function in older people at risk of falls.</p

Repeated Changes in Reported Sexual Orientation Identity Linked to Substance Use Behaviors in Youth

Purpose—Previous studies have found that sexual minority (e.g., lesbian, gay, bisexual) adolescents are at higher risk of substance use than heterosexuals, but few have examined how changes in sexual orientation over time may relate to substance use. We examined the associations between change in sexual orientation identity and marijuana use, tobacco use, and binge drinking in U.S. youth. Methods—Prospective data from 10,515 U.S. youth ages 12-27 years in a longitudinal cohort study were analyzed using sexual orientation identity mobility measure M (frequency of change from 0 [no change] to 1 [change at every wave]) in up to five waves of data. Generalized estimating equations were used to estimate substance use risk ratios and 95% confidence intervals; interactions by sex and age group were assessed. Results—All substance use behaviors varied significantly by sexual orientation. Sexual minorities were at higher risk for all outcomes, excluding binge drinking in males, and mobility score was positively associated with substance use in most cases (p\u3c.05). The association between mobility and substance use remained significant after adjusting for current sexual orientation and varied by sex and age for selected substance use behaviors. This association had a higher positive magnitude in females than males and in adolescents than young adults. Conclusions—In both clinical and research settings it is important to assess history of sexual orientation changes. Changes in reported sexual orientation over time may be as important as current sexual orientation for understanding adolescent substance use risk

The harvest plot: A method for synthesising evidence about the differential effects of interventions

<p>Abstract</p> <p>Background</p> <p>One attraction of meta-analysis is the forest plot, a compact overview of the essential data included in a systematic review and the overall 'result'. However, meta-analysis is not always suitable for synthesising evidence about the effects of interventions which may influence the wider determinants of health. As part of a systematic review of the effects of population-level tobacco control interventions on social inequalities in smoking, we designed a novel approach to synthesis intended to bring aspects of the graphical directness of a forest plot to bear on the problem of synthesising evidence from a complex and diverse group of studies.</p> <p>Methods</p> <p>We coded the included studies (n = 85) on two methodological dimensions (suitability of study design and quality of execution) and extracted data on effects stratified by up to six different dimensions of inequality (income, occupation, education, gender, race or ethnicity, and age), distinguishing between 'hard' (behavioural) and 'intermediate' (process or attitudinal) outcomes. Adopting a hypothesis-testing approach, we then assessed which of three competing hypotheses (positive social gradient, negative social gradient, or no gradient) was best supported by each study for each dimension of inequality.</p> <p>Results</p> <p>We plotted the results on a matrix ('harvest plot') for each category of intervention, weighting studies by the methodological criteria and distributing them between the competing hypotheses. These matrices formed part of the analytical process and helped to encapsulate the output, for example by drawing attention to the finding that increasing the price of tobacco products may be more effective in discouraging smoking among people with lower incomes and in lower occupational groups.</p> <p>Conclusion</p> <p>The harvest plot is a novel and useful method for synthesising evidence about the differential effects of population-level interventions. It contributes to the challenge of making best use of all available evidence by incorporating all relevant data. The visual display assists both the process of synthesis and the assimilation of the findings. The method is suitable for adaptation to a variety of questions in evidence synthesis and may be particularly useful for systematic reviews addressing the broader type of research question which may be most relevant to policymakers.</p

TESS asteroseismology of the known red-giant host stars HD 212771 and HD 203949

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Vitamin K supplementation to improve vascular stiffness in CKD:The K4Kidneys randomized controlled trial

BACKGROUND:Vascular calcification, a risk factor for cardiovascular disease, is common among patients with CKD and is an independent contributor to increased vascular stiffness and vascular risk in this patient group. Vitamin K is a cofactor for proteins involved in prevention of vascular calcification. Whether or not vitamin K supplementation could improve arterial stiffness in patients with CKD is unknown. METHODS:To determine if vitamin K supplementation might improve arterial stiffness in patients in CKD, we conducted a parallel-group, double-blind, randomized trial in participants aged 18 or older with CKD stage 3b or 4 (eGFR 15-45 ml/min per 1.73 m2). We randomly assigned participants to receive 400 μg oral vitamin K2 or matching placebo once daily for a year. The primary outcome was the adjusted between-group difference in carotid-femoral pulse wave velocity at 12 months. Secondary outcomes included augmentation index, abdominal aortic calcification, BP, physical function, and blood markers of mineral metabolism and vascular health. We also updated a recently published meta-analysis of trials to include the findings of this study. RESULTS:We included 159 randomized participants in the modified intention-to-treat analysis, with 80 allocated to receive vitamin K and 79 to receive placebo. Mean age was 66 years, 62 (39%) were female, and 87 (55%) had CKD stage 4. We found no differences in pulse wave velocity at 12 months, augmentation index at 12 months, BP, B-type natriuretic peptide, or physical function. The updated meta-analysis showed no effect of vitamin K supplementation on vascular stiffness or vascular calcification measures. CONCLUSIONS:Vitamin K2 supplementation did not improve vascular stiffness or other measures of vascular health in this trial involving individuals with CKD. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER:Vitamin K therapy to improve vascular health in patients with chronic kidney disease, ISRCTN21444964 (www.isrctn.com)

Design and implementation of multicenter pediatric and congenital studies with cardiovascular magnetic resonance:Big data in smaller bodies

Cardiovascular magnetic resonance (CMR) has become the reference standard for quantitative and qualitative assessment of ventricular function, blood flow, and myocardial tissue characterization. There is a preponderance of large CMR studies and registries in adults; However, similarly powered studies are lacking for the pediatric and congenital heart disease (PCHD) population. To date, most CMR studies in children are limited to small single or multicenter studies, thereby limiting the conclusions that can be drawn. Within the PCHD CMR community, a collaborative effort has been successfully employed to recognize knowledge gaps with the aim to embolden the development and initiation of high-quality, large-scale multicenter research. In this publication, we highlight the underlying challenges and provide a practical guide toward the development of larger, multicenter initiatives focusing on PCHD populations, which can serve as a model for future multicenter efforts.</p