Gender Differences in the Social Motivation and Friendship Experiences of Autistic and Non-autistic Adolescents

This mixed-methods study examined gender differences in the social motivation and friendship experiences of adolescent boys and girls with autism relative to those without autism, all educated within special education settings. Autistic girls showed similar social motivation and friendship quality to non-autistic girls, while autistic boys reported having both qualitatively different friendships and less motivation for social contact relative to boys without autism and to girls with and without autism. Semi-structured interviews with the adolescents corroborated these findings, with one exception: autistic girls reported high levels of relational aggression within their friendships, suggesting that girls on the autism spectrum in particular may struggle with identifying and dealing with conflict in their social lives

A low burden of severe illness: the COVID-19 Omicron outbreak in the remote Torres and Cape region of Far North Queensland

A coronavirus disease 2019 (COVID-19) outbreak was declared in the remote Torres and Cape region of Far North Queensland soon after the Queensland border opened for quarantine-free domestic travel in December 2021, with a total of 7,784 cases notified during the first ten-month outbreak period. We report a crude attack rate among residents of 25.6% (95% confidence interval [95% CI]: 25.1–26.1%), a hospitalisation rate of 1.6% (95% CI: 1.3–1.9%) and a crude case fatality rate of 0.05% (95% CI: 0.01–0.13%). Hospitalisation and case fatality rates were similar among First Nations and non-Indigenous people, with double dose COVID-19 vaccination rates higher among First Nations than non-Indigenous people by the end of the outbreak period. We attribute the low burden of severe illness to local community leadership, community engagement, vaccination coverage and recency, and community participation in a local culturally considered COVID-19 care-in-the-home program

Effect of Neighborhood Sanitation Coverage on Fecal Contamination of the Household Environment in Rural Bangladesh.

Enteric pathogens can be transmitted within the household and the surrounding neighborhood. The objective of this study was to understand the effect of neighborhood-level sanitation coverage on contamination of the household environment with levels of fecal indicator bacteria in rural Bangladesh. We conducted spot-check observations of sanitation facilities in neighboring households (NHs) within a 20-m radius of target households with children aged 6-24 months. Sanitation facilities were defined as improved (a private pit latrine with a slab or better) or unimproved. Fecal coliforms (FCs) on children's hands and sentinel toy balls were measured and used as indicators of household-level fecal contamination. We visited 1,784 NHs surrounding 428 target households. On average, sentinel toy balls had 2.11(standard deviation [SD] = 1.37) log10 colony-forming units (CFUs) of FCs/toy ball and children's hands had 2.23 (SD = 1.15) log10 CFU of FCs/two hands. Access to 100% private improved sanitation coverage in the neighborhood was associated with a small and statistically insignificant difference in contamination of sentinel toy balls (difference in means = -0.13 log10 CFU/toy ball; 95% confidence intervals [CI]: -0.64, 0.39; P = 0.63) and children's hands (difference in means = -0.11 log10 CFU/two hands; 95% CI: -0.53, 0.32; P = 0.62). Improved sanitation coverage in the neighborhood had limited measurable effect on FCs in the target household environment. Other factors such as access to improved sanitation in the household, absence of cow dung, presence of appropriate water drainage, and optimal handwashing practice may be more important in reducing FCs in the household environment

Predictors of Enteric Pathogens in the Domestic Environment from Human and Animal Sources in Rural Bangladesh.

Fecal indicator organisms are measured to indicate the presence of fecal pollution, yet the association between indicators and pathogens varies by context. The goal of this study was to empirically evaluate the relationships between indicator Escherichia coli, microbial source tracking markers, select enteric pathogen genes, and potential sources of enteric pathogens in 600 rural Bangladeshi households. We measured indicators and pathogen genes in stored drinking water, soil, and on mother and child hands. Additionally, survey and observational data on sanitation and domestic hygiene practices were collected. Log10 concentrations of indicator E. coli were positively associated with the prevalence of pathogenic E. coli genes in all sample types. Given the current need to rely on indicators to assess fecal contamination in the field, it is significant that in this study context indicator E. coli concentrations, measured by IDEXX Colilert-18, provided quantitative information on the presence of pathogenic E. coli in different sample types. There were no significant associations between the human fecal marker (HumM2) and human-specific pathogens in any environmental sample type. There was an increase in the prevalence of Giardia lamblia genes, any E. coli virulence gene, and the specific E. coli virulence genes stx1/2 with every log10 increase in the concentration of the animal fecal marker (BacCow) on mothers' hands. Thus, domestic animals were important contributors to enteric pathogens in these households

Cluster-randomised controlled trials of individual and combined water, sanitation, hygiene and nutritional interventions in rural Bangladesh and Kenya: the WASH Benefits study design and rationale.

INTRODUCTION: Enteric infections are common during the first years of life in low-income countries and contribute to growth faltering with long-term impairment of health and development. Water quality, sanitation, handwashing and nutritional interventions can independently reduce enteric infections and growth faltering. There is little evidence that directly compares the effects of these individual and combined interventions on diarrhoea and growth when delivered to infants and young children. The objective of the WASH Benefits study is to help fill this knowledge gap. METHODS AND ANALYSIS: WASH Benefits includes two cluster-randomised trials to assess improvements in water quality, sanitation, handwashing and child nutrition-alone and in combination-to rural households with pregnant women in Kenya and Bangladesh. Geographically matched clusters (groups of household compounds in Bangladesh and villages in Kenya) will be randomised to one of six intervention arms or control. Intervention arms include water quality, sanitation, handwashing, nutrition, combined water+sanitation+handwashing (WSH) and WSH+nutrition. The studies will enrol newborn children (N=5760 in Bangladesh and N=8000 in Kenya) and measure outcomes at 12 and 24 months after intervention delivery. Primary outcomes include child length-for-age Z-scores and caregiver-reported diarrhoea. Secondary outcomes include stunting prevalence, markers of environmental enteropathy and child development scores (verbal, motor and personal/social). We will estimate unadjusted and adjusted intention-to-treat effects using semiparametric estimators and permutation tests. ETHICS AND DISSEMINATION: Study protocols have been reviewed and approved by human subjects review boards at the University of California, Berkeley, Stanford University, the International Centre for Diarrheal Disease Research, Bangladesh, the Kenya Medical Research Institute, and Innovations for Poverty Action. Independent data safety monitoring boards in each country oversee the trials. This study is funded by a grant from the Bill & Melinda Gates Foundation to the University of California, Berkeley. REGISTRATION: Trial registration identifiers (http://www.clinicaltrials.gov): NCT01590095 (Bangladesh), NCT01704105 (Kenya)

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Understanding the experience of social anxiety in adolescent girls with autism spectrum disorders

Literature Review: Pathways to social anxiety often reflect a set of complex and interacting factors including intrinsic and environmental factors. Theoretical models of social anxiety have highlighted that children and adolescents’ peer experiences can increase risk for social anxiety. This systematic review explored the role of peers in the development of social anxiety in adolescent girls. It aimed to identify peer-related risk factors (i.e., peer acceptance, peer attachment, friendship quality, peer support, and victimisation) that place adolescents at risk for social anxiety, including those specific to girls. The results showed that while some peer experiences were relevant to understanding risk across genders, others placed girls at increased risk. For example, low peer acceptance was significantly associated with increased social anxiety in boys and girls, both concurrently and over time. Those factors that placed girls at increased risk of social anxiety and avoidance, relative to boys, included limited close friendships, negative friendship experiences and relational victimisation. The review suggested that researchers might usefully start to develop frameworks that capture generic as well as gender-specific risk for social anxiety. These will facilitate the development of prevention and intervention methods to support girls at increased risk, that focus on improving the quality of their peer relationships.Empirical Paper: The onset of adolescence represents an age where young people are at risk for the development of social anxiety. Increasingly, research has highlighted an increased risk of social anxiety in girls with Autism Spectrum Disorders (ASD). However, there remains a lack of understanding of their experiences and the extent to which they are consistent with current models of anxiety in ASD. This qualitative study aimed to develop an understanding of the experience of social anxiety in adolescent girls with ASD from the perspective of young people themselves, their parents and teachers. Semi-structured interviews were conducted with four triads, with girls interviewed using an ‘ideal classroom’ activity to explore their perception of school-based social situations. Four interrelated themes emerged from the data across all four triads including (1) barriers to social situations, (2) quality of relationships, (3) coping with social situations, and (4) desire to ‘fit in’. The results found that girls’ experiences were underpinned by factors present in typical pathways to social anxiety (e.g. negative peer experiences and poor social skills) and that girls’ sensory sensitivity to noise acted as an autism-specific pathway. Implications for professionals who work with adolescent girls diagnosed with ASD were discussed, including the delivery of targeted training and workshops to increase staff understanding and raise peer acceptance

The relationship between copy number variations and tick resistance in South African Nguni cattle

Thesis (MScAgric)--Stellenbosch University, 2017.ENGLISH ABSTRACT: The impact of ticks and tick-borne diseases on global livestock industries is an area of major concern. The ability of an animal to resist these arthropods varies within and between breeds. Tick resistance is a heritable trait, which can be exploited by using resilient breeds and incorporating them into selective breeding programmes. One such breed, known for its resilience to ticks and tick-borne diseases, is the South African Nguni. The Nguni is a locally adapted cattle breed, which has undergone minimal synthetic breeding, and is well adapted to harsh environmental conditions. Copy number variations (CNVs), present within the bovine genome, are attributable to the differences observed in adaptive and disease resistance traits in cattle. These variations comprise of deletions, duplications and insertions greater than 1kb in size. Copy number variable regions (CNVRs) overlap or lie within close proximity of genes responsible for multiple biological and molecular functions and could explain the underlying mechanisms of resistance. This study investigated the non-genetic effects of tick count and the association of CNVRs with tick resistance in South African Nguni cattle. In the first experiment, tick counts were recorded over a two-year period on 347 Nguni cattle across three different provinces in South Africa. Using SAS (Version 7.1) a general linear model was run on log transformed tick counts to determine the non-genetic effects of tick resistance. The effects of location, season, year of tick count, sex and age of the animal on tick count were tested. Factors which significantly affected tick resistance included location, season, year of tick count and the animal’s age. In the second experiment, summary statistics of tick count per location were used to classify 347 Nguni cattle as susceptible (0) or resistant (1) across two levels of resistance (L1 and L2). Deoxyribonucleic acid extracted from hair and blood samples was genotyped using the Illumina BovineSNP 50 assay. After quality control and sample pruning using PLINK, 41 193 SNPs remained for further analyses. PennCNV identified 1 501 CNVs which were merged into 344 unique CNVRs. An association analyses using STATISTICA 64 was run which identified CNVRs associated with tick count. Seventeen CNVRs located on chromosomes 1, 2, 6, 7, 8, 9, 12, 15, 17, 20, 21, 22, 24 and 29 demonstrated a significant (p<0.05) association with tick resistance. Seventeen genes overlapped or lay in close proximity to these CNVRs and played a vital role in various molecular and biological processes. These processes all play an integral role in determining various cellular, immune, metabolic and reproductive responses.AFRIKAANSE OPSOMMING: Die globale impak van bosluise en bosluis-oordraagbare siektes op veebedrywe word as ʼn belangrike kwessie beskou. Die vermoë van 'n dier om weerstand teen hierdie geleedpotiges te bied, wissel tussen rasse maar ook binne ʼn ras. Bosluisweerstand is 'n oorerflike eienskap wat gebruik kan word om vir weerstandbiedende rasse te selekteer, wat op hulle beurt dan in selektiewe teelprogramme ingesluit kan word. Die Suid-Afrikaanse Nguni beesras is bekend vir sy vermoë om weerstand te bied teen bosluise en bosluisoordraagbare siektes. Die Nguni is 'n plaaslik aangepaste beesras wat minimale sintetiese teling en seleksie ondergaan het en is veral goed aangepas by moeilike omgewingstoestande. Kopie getalvariasies (CNVs) wat binne die beesgenoom voorkom, kan toegeskryf word aan die verskille in aanpassings en siekteweerstandseienskappe wat by beeste waargeneem word. Hierdie variasies bestaan uit verwyderde gene, duplikasies en invoegings groter as 1kb. Kopiegetal veranderlike streke (CNVRs) oorvleuel of lê naby aan gene wat verantwoordelik is vir verskeie biologiese en molekulêre funksies en kan moontlik ʼn verklaring bied vir onderliggende weerstandsmeganismes. Hierdie studie het die verwantskap van CNVR's met bosluisweerstand in Suid-Afrikaanse Nguni-beeste ondersoek. In die eerste eksperiment is die aantal bosluise op 347 Nguni beeste, wat in drie verskillende provinsies in Suidd-Afrika voorgekom het, oor 'n tydperk van twee jaar aangeteken. Deur gebruik te maak van SAS (weergawe 7.1) is 'n algemene lineêre model analise op loggetransformeerde bosluisgetalle uitgevoer om die nie-genetiese effekte van bosluisweerstand te bepaal. Die effekte van die plek, seisoen, jaar van bosluistelling, geslag en ouderdom van die dier is in die analise ingesluit. Faktore wat ʼn beduidende invloed op mate van bosluisweerstand gehad het, het plek, seisoen, jaar van bosluistelling en die dier ouderdom, ingesluit. In die tweede eksperiment is opsomming statistieke van bosluistelling per plek gebruik om die 347 Nguni-beeste as vatbaar (0) of weerstandig (1) oor twee vlakke van weerstand (L1 en L2) te klassifiseer. Deoksiribonukleïensuur wat uit hare en bloedmonsters verkry is, is aan genotipe analise met behulp van die Illumina BovineSNP 50-toets onderwerp. Na gehaltebeheer en verwydering van verdagte data met PLINK, het 41 193 SNPs vir verdere ontledings behoue gebly. PennCNV het 1 501 CNVs geïdentifiseer wat in 344 unieke CNVR's saamgevoeg is. 'n Assosiasie-ontleding met behulp van STATISTICA 64 het 17 beduidende CNVRs geïdentifiseer wat met bosluistelling geassosieer kon word. Sewentien gene oorvleuel of lê naby aan hierdie CNVRs en speel 'n belangrike rol in verskeie molekulêre en biologiese prosesse. Hierdie prosesse speel ʼn belangrike in verskeie sel-, immuun-, metaboliese en reproduksie response