Timing and Persistence of Material Hardship Among Children in the United States

OBJECTIVE: Screening for social determinants of health (SDH) has been widely adopted to identify child health risks associated with exposure to material hardship. Whereas SDH screening typically addresses a 12-month span, we sought to compare the prevalence of exposure to present (within the past year) as compared to recent (2–4 years ago) hardship among children in the United States. METHODS: We analyzed the 2014 Survey of Income and Program Participation, a nationally representative survey that interviewed participating households annually between 2014 and 2017. We included data from households with children in all waves. As of 2017, households were categorized as (1) experiencing present hardship (within the last year); (2) experiencing recent but not present hardship (any year between 2014 and 2016); and (3) experiencing no hardship over the 4-year period. RESULTS: Of 2422 households, 27% experienced present hardship and 29% experienced recent but not present hardship. Households presently experiencing hardship were more likely to have Medicaid insurance, less likely to be married, and had more children than families who had experienced recent hardship. However, these groups were similar on caregivers’ educational attainment, race/ethnicity, language spoken in the home, and age of the youngest child. CONCLUSIONS: Our results suggest that clinical screening tools for SDH that use a 12-month time frame risk missing many children who have recently (within the past 4 years) experienced material hardship and may benefit from interventions to improve social support; a longer time frame could provide clinicians with valuable information for understanding social factors that impact child health and development

Abnormal Involuntary Movement Scale in Tardive Dyskinesia:Minimal Clinically Important Difference

Background A minimal clinically important difference has not been established for the Abnormal Involuntary Movement Scale in patients with tardive dyskinesia. Valbenazine is a vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia in adults. Efficacy in randomized, double�blind, placebo�controlled trials was defined as the change from baseline in Abnormal Involuntary Movement Scale total score (sum of items 1�7). Objectives To estimate an minimal clinically important difference for the Abnormal Involuntary Movement Scale using valbenazine trial data and an anchor�based method. Methods Data were pooled from three 6�week double�blind, placebo�controlled trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), and KINECT 3 (NCT02274558). Valbenazine doses were pooled for analyses as follows: “low dose,� which includes 40 or 50 mg/day; and “high dose,� which includes 75 or 80 mg/day. Mean changes from baseline in Abnormal Involuntary Movement Scale total score were analyzed in all participants (valbenazine� and placebo�treated) with a Clinical Global Impression of Change�Tardive Dyskinesia or Patient Global Impression of Change score of 1 (very much improved) to 3 (minimally improved). Results The least squares mean improvement from baseline to week 6 in Abnormal Involuntary Movement Scale total score was significantly greater with valbenazine (low dose: –2.4; high dose: –3.2; both, P < 0.001) versus placebo (–0.7). An minimal clinically important difference of 2 points was estimated based on least squares mean changes in Abnormal Involuntary Movement Scale total score in participants with a Clinical Global Impression of Change�Tardive Dyskinesia score ≤3 at week 6 (mean change: –2.2; median change: –2) or Patient Global Impression of Change score ≤3 at week 6 (mean change: –2.0; median change: –2). Conclusions Results from an anchor�based method indicate that a 2�point decrease in Abnormal Involuntary Movement Scale total score may be considered clinically important. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society

Changes to Cigarette Packaging Influence US Consumers’ Choices: Results of Two Discrete-Choice Experiments to Inform Regulation

Introduction While plain packaging of tobacco products has emerged as a policy intervention to reduce smoking, regulators in the US have limited ability to implement plain packaging. We sought to identify the impact of subtle changes to cigarette packaging (Study 1) and how packaging design influenced participant choices based on appeal, harm, and style (Study 2). Methods We conducted two discrete-choice experiments with US adult smokers online in 2018. In Study 1 (n=285), we assessed participants’ selections based on subtle changes to pack design features (dimensions, color saturation, logo size). In Study 2 (n=284), we assessed three choices in which participants selected packs based on appeal, harmfulness, and best match to their personal style. Study 2 packs varied by color hue, design with different levels of organic labeling and natural imagery, and color saturation. Results Pack designs influenced smokers’ choices. In Study 1, pack dimensions and color saturation emerged as the most important features, and, in Study 2, design and color hue were the most influential characteristics. Conclusions Regulators should consider how the design of cigarette packages may influence consumers’ perceptions and choices

Some behavioral aspects of energy descent: How a biophysical psychology might help people transition through the lean times ahead

This article is part of the Research Topic: Nature and environment: The psychology of its benefits and its protection.We may soon face biophysical limits to perpetual growth. Energy supplies may tighten and then begin a long slow descent while defensive expenditures rise to address problems caused by past resource consumption. The outcome may be significant changes in daily routines at the individual and community level. It is difficult to know when this scenario might begin to unfold but it clearly would constitute a new behavioral context, one that the behavioral sciences least attends to. Even if one posits a less dramatic scenario, people may still need to make many urgent and perhaps unsettling transitions. And while a robust response would be needed, it is not at all clear what should be the details of that response. Since it is likely that no single response will fix things everywhere, for all people or for all time, it would be useful to conduct many social experiments. Indeed, a culture of small experiments should be fostered which, at the individual and small group level, can be described as behavioral entrepreneurship. This may have begun, hidden in plain sight, but more social experiments are needed. To be of help, it may be useful to both package behavioral insights in a way that is practitioner-oriented and grounded in biophysical trends and to propose a few key questions that need attention. This paper begins the process of developing a biophysical psychology, incomplete as it is at this early stage.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109261/1/De Young, R. (2014) Some behavioral aspects of energy descent, How a biophysical psychology might help people transition through the lean times ahead, Frontiers in Psychology, 5, 1255.pdfDescription of De Young, R. (2014) Some behavioral aspects of energy descent, How a biophysical psychology might help people transition through the lean times ahead, Frontiers in Psychology, 5, 1255.pdf : Main articl

Recapitulating the tumor ecosystem along the metastatic cascade using 3D culture models

Advances in cancer research have shown that a tumor can be likened to a foreign species that disrupts delicately balanced ecological interactions, compromising the survival of normal tissue ecosystems. In efforts to mitigate tumor expansion and metastasis, experimental approaches from ecology are becoming more frequently and successfully applied by researchers from diverse disciplines to reverse engineer and re-engineer biological systems in order to normalize the tumor ecosystem. We present a review on the use of 3D biomimetic platforms to recapitulate biotic and abiotic components of the tumor ecosystem, in efforts to delineate the underlying mechanisms that drive evolution of tumor heterogeneity, tumor dissemination, and acquisition of drug resistance.ope

A study of the assimilation of overseas nurses into the NHS nursing cadre

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Mundane monsters : cultural readings of paternal failure

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

What are teachers saying about new managerialism?

Since the mid-1970s, successive federal and state governments have redefined the governance structure of Australian schooling in accordance with the principles of the market and its corollary new managerialism (Hartley 1997; Marginson 1997; Robertson 2000; Yeatman 1990). Morley and Rassool (1999, p 61) argue that ‘the introduction of markets and managers has been a generic transformational device designed to restructure and reorient public service provision’. According to Yeatman (1990, p 14), this structural and ideological shift has resulted in a corporate-style bureaucracy whereby public sector activity is ‘reduced to the effective, efficient and economic management of human and capital resources’. As the dominant style of public administration and public service, it seeks to make government efficient by doing more with less, focusing on outcomes and results and managing change better. The common elements have involved site-based management, the language of improvement and budgetary devolution (Morley & Rassool 1999). Commenting on the British experience, Hoggett (1996, p 12) argues that three fundamental but interrelated strategies of control have been implemented over the last decade to drive these reforms. First, competition has been introduced as a means of coordinating the activities of decentralised units. Second, there has been an attempt to decentralise operations whilst centralising strategic command. Third, there has been the extended development of performance management techniques. Against this backdrop, we set out in this article to examine how six senior teachers in one secondary school in the northern suburbs of Perth, Western Australia have experienced and responded to these generic managerial reforms. In doing so, we are keen to re-insert ‘the missing voices of teachers’ (Smyth 2001, p 149) back into the reform debate that raged in Western Australian schools in the late 1980s and simmered throughout the 1990s following the introduction of the mandated Better schools in Western Australia: a programme for improvement (Ministry of Education, Western Australia 1987)

Mesenchymal stem cell-based treatment for microvascular and secondary complications of diabetes mellitus

The worldwide increase in the prevalence of Diabetes mellitus (DM) has highlighted the need for increased research efforts into treatment options for both the disease itself and its associated complications. In recent years, mesenchymal stromal cells (MSCs) have been highlighted as a new emerging regenerative therapy due to their multipotency but also due to their paracrine secretion of angiogenic factors, cytokines, and immunomodulatory substances. This review focuses on the potential use of MSCs as a regenerative medicine in microvascular and secondary complications of DM and will discuss the challenges and future prospects of MSCs as a regenerative therapy in this field. MSCs are believed to have an important role in tissue repair. Evidence in recent years has demonstrated that MSCs have potent immunomodulatory functions resulting in active suppression of various components of the host immune response. MSCs may also have glucose lowering properties providing another attractive and unique feature of this therapeutic approach. Through a combination of the above characteristics, MSCs have been shown to exert beneficial effects in pre-clinical models of diabetic complications prompting initial clinical studies in diabetic wound healing and nephropathy. Challenges that remain in the clinical translation of MSC therapy include issues of MSC heterogeneity, optimal mode of cell delivery, homing of these cells to tissues of interest with high efficiency, clinically meaningful engraftment, and challenges with cell manufacture. An issue of added importance is whether an autologous or allogeneic approach will be used. In summary, MSC administration has significant potential in the treatment of diabetic microvascular and secondary complications but challenges remain in terms of engraftment, persistence, tissue targeting, and cell manufactur