Miracle-dz/UniFAR-FTUs huggingface dataset:
Cues to Action as Motivators for Children’s Brushing

Dental caries is the most common chronic childhood disease. Home self-care procedures are the most important strategies to prevent tooth decay. Brushing is the most important single intervention for the prevention of tooth decay, yet compliance is not practiced and there is limited understanding of children’s behavioral decisions. Guided by the Health Belief Model, this study consisted of eight focus groups with children in the second through fifth grades at three different socioeconomic-level school districts to determine the cues to action that are motivating or can motivate their brushing behavior. Results indicated children are primarily motivated to brush for aesthetic reasons, mainly due to viewed media pictures of “perfect” teeth. Other less commonly expressed motivations for brushing stemmed from interpersonal connections, such as relatives with dentures. Social media, on the other hand, played a key role in some children’s understanding of more advanced oral health connections such as links between cardiovascular and oral disease, and smoking and oral cancer. These links were viewed as threatening to children to motivate better brushing. Additionally, the study found that home computers can be used as an external motivator to deliver tailored messages to encourage better brushing.
Immunologic Outcomes of Antiretroviral Therapy Among HIV-infected Nigerian Children and Its Association With Early Infant Feeding and Nutritional Status at Treatment Initiation

Objectives: To evaluate immunologic response to antiretroviral treatment (ART) among HIV-infected Nigerian children (<36 months old) and to assess its association with early infant feeding pattern and nutritional status at treatment initiation. Design: Mixed prospective and retrospective cohort study. Methods: One hundred fifty HIV-infected children were followed for 12 months from initiation of ART. CD4 count/CD4% was assessed at baseline and every 4–6 months. Nutritional status was assessed by height-for-age, weight-for-age and weight-for-height Z scores using the 2006 World Health Organization growth reference. Children were classified into 4 feeding groups—exclusively breast-fed, predominantly breast-fed, mixed fed and exclusively formula fed. Logistic regression was used to model odds of failure to reach CD4% of ≥25% at the 12-month follow-up. Linear random effects models were used to model the longitudinal change in CD4%. Results: There was a significant increase in CD4% for all children from 13.8% at baseline to 28.5% after 12 months (&Dgr;CD4% = 14.7%, 95% confidence interval: 12.1%–17.4%). There was no association of feeding pattern with immunologic outcomes. In adjusted analyses, children who were underweight (weight-for-age < –2.0) or with CD4% <15% at baseline were 4.30 (95% confidence interval: 1.16, 15.87; P < 0.05) times and 3.41 (95% confidence interval: 1.10, 10.52; P < 0.05) times, respectively, more likely not to attain CD4% of ≥25% at 12 months. Conclusion: Baseline nutritional status and CD4% were independently associated with failure to reach CD4% ≥25% at 12 months among HIV-infected Nigerian children on ART. These results emphasize the importance of early screening and initiation of ART among children in resource-poor settings before malnutrition and severe immunosuppression sets in.
Pharmacists’ Interprofessional Communication About Medications in Specialty Hospital Settings

Effective communication between pharmacists, doctors, and nurses about patients’ medications is particularly important in specialty hospital settings where high-risk medications are frequently used. This article describes the nature of communication about medications that occurs between pharmacists and other health professionals, including doctors and nurses, in specialty hospital settings. Semistructured interviews with, and participant observations of, pharmacists, nurses, and doctors were conducted in specialty settings of an Australian public, metropolitan teaching hospital. Twenty-one individuals working in the settings of emergency care, oncology care, intensive care, cardiothoracic care, and perioperative care were interviewed. In addition, participant observations of 56 individuals were conducted in emergency care, oncology care, intensive care, and cardiothoracic care. Detailed thematic analysis of the data was performed. Across all of the settings, pharmacy was less visible than medicine and nursing in terms of pharmacists’ work performed, pharmacy documentation and resources, and pharmacists’ physical visibility. Pharmacists, doctors, and nurses largely worked alongside one another rather than with each other. When collaboration occurred, the professional groups engaged in mostly reactive communication to accomplish specific medication tasks that needed completing. Interprofessional differences in attitudes toward medications and medication management communication behaviors were evident. Pharmacists need to engage in more proactive communication in order to reduce the risk of medication errors occurring.
Journal of Anxiety Disorders

In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression a b s t r a c t Mindfulness has received considerable attention as a correlate of psychological well-being and potential mechanism for the success of mindfulness-based interventions (MBIs). Despite a common emphasis of mindfulness, at least in name, among MBIs, mindfulness proves difficult to assess, warranting consideration of other common components. Self-compassion, an important construct that relates to many of the theoretical and practical components of MBIs, may be an important predictor of psychological health. The present study compared ability of the Self-Compassion Scale (SCS) and the Mindful Attention Awareness Scale (MAAS) to predict anxiety, depression, worry, and quality of life in a large community sample seeking self-help for anxious distress (N = 504). Multivariate and univariate analyses showed that self-compassion is a robust predictor of symptom severity and quality of life, accounting for as much as ten times more unique variance in the dependent variables than mindfulness. Of particular predictive utility are the self-judgment and isolation subscales of the SCS. These findings suggest that self-compassion is a robust and important predictor of psychological health that may be an important component of MBIs for anxiety and depression.
State Psychological Reactance to Depression Public Service Announcements Among People With Varying Levels of Depressive Symptomatology

Campaigns seeking to help people with depression can be effective, but they can also backfire. Psychological reactance is proposed as a partial explanation. Two experimental studies examined the effect of two depression messages (i.e., autonomy-supportive language, controlling language) for participants (n = 2027, n = 777) with varying levels of depressive symptomatology. For Study 1, two versions of a print public service announcement about seeking help for depression served as the experimental stimulus. Study 2 used an existing video public service announcement about seeking help for depression, but the text was altered to create the two conditions. In both studies, increased depressive symptomatology was associated with reduced help-seeking attitudes and intentions, as well as greater state reactance to a public service announcement about depression. Increased state reactance mediated the relationship between increased depressive symptomology and unfavorable help-seeking outcomes. Further, across the two studies, participants with high levels of depressive symptomatology who were exposed to the autonomy-supportive language ad reported either as much, or more, state reactance than participants with high levels of depressive symptomatology who were in the control condition. These results warn that language perceived as autonomy-supportive by people without depression might be perceived as controlling among people with depression.
Determining Population and Developmental Pharmacokinetics of Metronidazole Using Plasma and Dried Blood Spot Samples From Premature Infants

Background: Limited pharmacokinetic (PK) data of metronidazole in premature infants have led to various dosing recommendations. Surrogate efficacy targets for metronidazole are ill-defined and therefore aimed to exceed minimum inhibitory concentration of organisms responsible for intra-abdominal infections. Methods: We evaluated the PK of metronidazole using plasma and dried blood spot samples from infants ⩽32 weeks gestational age in an open-label, PK, multicenter (N = 3) study using population PK modeling (NONMEM). Monte Carlo simulations (N = 1000 virtual subjects) were used to evaluate the surrogate efficacy target. Metabolic ratios of parent and metabolite were calculated. Results: Twenty-four premature infants (111 plasma and 51 dried blood spot samples) were enrolled: median (range) gestational age at birth 25 (23–31) weeks, postnatal age 27 (1–82) days, postmenstrual age 31 (24–39) weeks and weight 740 (431–1466) g. Population clearance (L/h/kg) was 0.038 × (postmenstrual age/30)2.45 and volume of distribution (L/kg) of 0.93. PK parameter estimates and precision were similar between plasma and dried blood spot samples. Metabolic ratios correlated with clearance. Conclusion: Simulations suggested the majority of infants in the neonatal intensive care unit (>80%) would meet the surrogate efficacy target using postmenstrual age–based dosing.
Disparities in Health Information Access: Results of a County-Wide Survey and Implications for Health Communication

ABSTRACT Health knowledge and behavior can be shaped by the extent to which individuals have access to reliable and understandable health information. Based on data from a population-based telephone survey of 1,503 respondents of ages 18 years and older living in Douglas County, Nebraska, in 2013, this study assesses disparities in health information access and their related covariates. The two most frequently reported sources of health information are the Internet and health professionals, followed by print media, peers, and broadcast media. Relative to non-Hispanic Whites, Blacks are more likely to report health professionals as their primary source of health information (odds ratio [OR] = 2.61, p < .001) and less likely to report peers (OR = 0.39, p < .05). A comparison between Whites and Hispanics suggests that Hispanics are less likely to get their health information through the Internet (OR = 0.51, p < .05) and more likely to get it from broadcast media (OR = 4.27, p < .01). Relative to their counterparts, participants with no health insurance had significantly higher odds of reporting no source of health information (OR = 3.46, p < .05). Having no source of health information was also associated with an annual income below $25,000 (OR = 2.78, p < .05 compared to middle income range) and being born outside of the United States (OR = 5.00, p < .05). Access to health information is lowest among society’s most vulnerable population groups. Knowledge of the specific outlets through which people are likely to obtain health information can help health program planners utilize the communication channels that are most relevant to the people they intend to reach.
Risk Factors and Outcomes for Respiratory Syncytial Virus–related Infections in Immunocompromised Children

Background: Respiratory syncytial virus (RSV) is associated with significant morbidity and mortality in immunocompromised children. Data on the risk factors for acquisition and outcomes from RSV infections in this population are limited. Methods: This cohort study (2006 to 2011) included RSV-positive immunocompromised pediatric inpatients. Nasopharyngeal swabs were tested for RSV by direct immunofluorescence. Purposeful multiple regression was used to assess risk factors associated with community-acquired RSV (CA-RSV) infections and their outcomes compared with nosocomial (N-RSV) infections. Means and medians were compared using Student’s t test and a nonparametric test, respectively. Proportions were compared using &khgr;2 or Fisher’s exact test, as appropriate. Results: There were 117 RSV-positive patients of whom 42 (35.9%) presented with (N-RSV) infection. Overall, more than a third presented with lower respiratory tract infections, which resulted in a 28% admission rate to the intensive care unit and a mortality rate of 5%; the latter solely among patients with community-acquired infection. Subjects with CA-RSV presented with more advanced clinical evidence of lower tract disease with respiratory distress (eg, intercostal recession; odds ratio 2.5; 95% confidence interval: 1.1–5.6; P = 0.03) compared with those with N-RSV. Subjects with CA-RSV infections were less likely to have a prolonged hospital admission (odds ratio 0.7; 95% confidence interval: 0.5–0.8; P < 0.0001) relative to those with N-RSV infections. Conclusions: RSV-related infections in immunocompromised children may result in poor outcomes, including mortality. Differences in mortality rates among those with CA-RSV compared with N-RSV warrant further study, with enhanced opportunities for prevention and early detection of infection.
Narratives of Food Insecurity in Tippecanoe County, Indiana: Economic Constraints in Local Meanings of Hunger

Abstract Food insecurity and its most extreme form, hunger, have increased exponentially in the United States since 2006. This essay seeks to contribute to our understanding of hunger by attending to the context of the financial crisis as an organizing frame for understanding local meanings of hunger. Within a broader framework of the culture-centered approach (CCA) that works to identify and develop locally rooted solutions to food insecurity, we describe through locally grounded stories of food insecurity the financial climate where large percentages of U.S. households have been cast into poverty because of the crash of an unregulated economy. These local understandings of hunger in the context of the economy offer entry points for organizing a food-insecure coalition that seeks to address the stigma around food insecurity.
Nonprotective Responses to Pediatric Vaccines Occur in Children Who Are Otitis Prone

Objective: We recently found that children who experience recurrent otitis media despite individualized care (stringently-defined otitis prone [sOP]) do not develop an antibody response to several vaccine candidate protein antigens expressed by Streptococcus pneumonia (Spn) and Haemophilus influenzae. Here we sought to determine if these same children also failed to develop antibody to routine pediatric vaccinations. Study Design: One hundred forty sera collected from children age 6–24 months were analyzed. sOP (n = 34) and age-matched non-sOP (n = 34) children were assessed for IgG concentrations to diphtheria toxoid, tetanus toxoid, pertussis toxoid, filamentous hemagglutinin, pertactin (DTaP), polio, hepatitis B, H. influenzae type b capsule polyribosyl-ribitol-phosphate (PRP) and Spn capsular polysaccharide conjugate vaccine. Results: IgG protective titers to diphtheria toxoid (P = 0.006), tetanus toxoid (P < 0.0001), pertussis toxoid (P < 0.0001), filamentous hemagglutinin (P = 0.001), pertactin (P = 0.005), hepatitis B (P < 0.0001), polio 3 (P = 0.03) and Spn 23F (P = 0.01) but not polio 1,2, PRP or Spn 6B, and 14 were decreased in sOP versus non-sOP children using generalized estimating equations. A high percentage of sOP children had nonprotective antibody values that persisted until 24 months of age despite routine boosters. Conclusion: sOP children may fail to achieve protective antibody concentrations after several routine vaccinations.
Effect of transgenic extrahepatic expression of betaine-homocysteine methyltransferase on alcohol or homocysteine-induced fatty liver.

BACKGROUND Chronic alcohol feeding induces hyperhomocysteinemia (HHcy). Previously, we reported a protective role of betaine-homocysteine methyltransferase (BHMT) in homocysteine-induced injury in cultured hepatocytes. In this study, we investigated the direct role of BHMT in alcohol or homocysteine-induced liver injury. METHODS Betaine-homocysteine methyltransferase transgenic (Tg) mice were generated. Comparisons were made between the Tg and wild type (WT) mice in their response to intragastric alcohol infusion or to oral feeding of a high methionine low folate diet (HMLF). RESULTS Expression of the Tg BHMT was increased in organs peripheral to the liver. The alcohol infusion for 4 weeks increased: plasma ALT by 5-fold in WT mice and 2.7-fold in Tg mice; plasma homocysteine by 7-fold in WT mice and 2-fold in Tg mice; liver triglycerides by 4-fold in WT mice and 2.5-fold in Tg mice. The alcohol-induced fatty liver was more severe in WT than in Tg mice based on H&E staining. The HMLF feeding for 4 weeks increased plasma ALT by 2-fold in WT mice and 1-fold in Tg mice; plasma homocysteine by 21-fold in WT mice and 3.3-fold in Tg mice; liver triglycerides by 2.5-fold in WT mice and 1.5-fold in Tg mice. HMLF induced accumulation of macro fat droplets in WT but not Tg mice. Betaine supplementation decreased partially the alcohol or HMLF-induced increase of ALT, homocysteine and liver lipids in WT mice. However, Tg mice were normal when fed both HMLF and betaine. In WT mice, both alcohol and HMLF induced moderate increase of sterol regulatory element binding protein 1 (SREBP1) protein which was partially reduced by betaine supplementation. In Tg mice, alcohol but not HMLF increased SREBP1. Carbohydrate responsive element-binding protein was increased by alcohol in either WT or Tg mice which was not affected by betaine supplementation. Ratio of S-adenosylmethionine (SAM) to S-adenosylhomocysteine (SAH) was reduced by 50% in WT and by 20% in Tg mice fed alcohol. Ratio of phosphatidylcholine (PC) to phosphatidylethanolamine (PE) was reduced in WT but not Tg mice fed alcohol. Changes in PE methyltransferase activities were not detected in response to alcohol or HMLF feeding but were increased by betaine. CONCLUSIONS The BHMT Tg mice are resistant to alcohol or HMLF-induced HHcy and liver steatosis indicating that peripheral metabolism of homocysteine protected the liver without a direct effect of BHMT in the liver. Multiple mechanisms are involved in protection by betaine including increased SAM/SAH and PC/PE ratios.
Gender differences in response to emotional stress: an assessment across subjective, behavioral, and physiological domains and relations to alcohol craving.

BACKGROUND Women and men are at risk for different types of stress-related disorders, with women at greater risk for depression and anxiety and men at greater risk for alcohol-use disorders. The present study examines gender differences in emotional and alcohol craving responses to stress that may relate to this gender divergence in disorders. METHOD Healthy adult social drinkers (27 men, 27 women) were exposed to individually developed and calibrated stressful, alcohol-related, and neutral-relaxing imagery, 1 imagery per session, on separate days and in random order. Subjective emotions, behavioral/bodily responses, cardiovascular arousal [heart rate (HR), blood pressure (BP)], and self-reported alcohol craving were assessed. RESULTS Women reported and displayed greater sadness and anxiety following stress than men and men had greater diastolic BP response than women. No gender differences in alcohol craving, systolic BP or HR were observed. Subjective, behavioral, and cardiovascular measures were correlated in both genders. However, for men, but not women, alcohol craving was associated with greater subjective emotion and behavioral arousal following stress and alcohol cues. CONCLUSIONS These data suggest that men and women respond to stress differently, with women experiencing greater sadness and anxiety, while men show a greater integration of reward motivation (craving) and emotional stress systems. These findings have implications for the gender-related divergence in vulnerability for stress-related disorders, with women at greater risk for anxiety and depression than men, and men at greater risk for alcohol-use disorders than women.
Exploring Family Support for Older Chinese Singaporean Women in a Confucian Society

ABSTRACT This study investigated the functions of family support in older Chinese Singaporean women’s daily health management in a Confucian cultural context, wherein family solidarity and women’s caregiving responsibilities are emphasized. Thirty-eight interviews were conducted with ethnic Chinese women above the age of 60 in Singapore. Our thematic analysis showed that older women played dual roles as support providers and recipients in the family. Their caregiver identity and intent to preserve tradition resulted in a downward transmission of informational and physical support and their hesitance to accept resources provided by younger family members. The asymmetrical flow of family support generated mixed impacts on the women’s daily health management. In their transition between tradition and modernity, older women fulfilled their family responsibilities but did not require their children to do so. Our findings suggested an integration of familial and institutional resources to meet older women’s support needs and help them enhance their health behavior.
Alcohol outlets, youth drinking, and self-reported ease of access to alcohol: a constraints and opportunities approach.

BACKGROUND Despite recent research examining youth access to alcohol, the extent to which relative ease of access to alcohol from various sources translates into the use of these sources is not known. METHODS Patterns of adolescent alcohol access in California were studied using a hierarchical analysis of self-reported and archival measures. A survey of 30 youths age 14 to 16 in each of 50 zip codes selected to maximize variability in median household income and off-premise outlet densities was conducted. RESULTS (1) Both actual use of and perceived ease of access to formal sources were positively associated with off-premise outlet density (a measure of formal access). (2) Actual use of informal sources was negatively associated with outlet densities. (3) Perceived and realized informal access were associated positively with deviance and negatively with conventionality. (4) Deviance was associated with increased perceived and realized access from both formal and social sources, whereas conventionality was only associated with realized and perceived informal access. CONCLUSIONS Correlates of perceived and actual alcohol access differ somewhat, and the differences between informal and formal access (both perceived and actual) are many, creating a complex picture of the patterns of underage access to alcohol. Youth drinking is affected by opportunities and constraints. Specifically, as one form of access becomes constrained, youth appear to circumvent restrictions by relying on other modes of access. Thus interventions targeting formal alcohol access by youth may result in a shift to reliance on social sources. This complex problem requires a multi-faceted intervention approach.