Suchergebnisse

Abstract

Aims
This study assessed contributions of exposure to neighborhood stressors (violent victimization, witnessing crime, greater alcohol and drug availability) to variation in alcohol use disorder (AUD) symptoms among drinkers in three cities in Texas, USA.


Methods
We used data from interviews conducted from 2011 to 2013 with Mexican-origin adults (ages 16–65) in the US-Mexico Study of Alcohol and Related Conditions who were past-year drinkers (N = 1960; 55% male) living in two cities in the Texas-Mexico border region (Laredo, n = 751 and Brownsville/McAllen, n = 814) and one interior comparison site (San Antonio, n = 771). Analyses (conducted in 2018 and 2019) examined overall and gender-stratified multilevel mediated effects of each border site (versus San Antonio) on AUD symptoms through the neighborhood-level factors, adjusting for individual- and neighborhood-level covariates.


Results
Overall, drinkers in Laredo reported more AUD symptoms than drinkers in the other cities, and their neighborhoods had more witnessing of crime and greater perceived drug availability, as well as higher levels of disadvantage and a lower proportion non-Hispanic White residents, than neighborhoods in San Antonio. Witnessing neighborhood crime was associated with increased AUD symptoms, while neighborhood disadvantage and proportion non-Hispanic White residents each were negatively associated with AUD symptoms. Perceived neighborhood insecurity, crime victimization, perceived neighborhood drug availability and neighborhood alcohol availability (off- and on-premise) were not significantly associated with AUD symptoms. Stratified models suggested possible gender differences in indirect effects through witnessing neighborhood crime.


Conclusion
Reducing witnessing of neighborhood crime may help reduce AUD symptoms among adults living in the US border region.

Both scholarly analyses and main political documents have not focused enough on research into social mobility in Lithuania. Such a case is partly understandable as the issue of ensuring social mobility has never been a prevailing one on the political agenda. This article seeks to describe different perspectives on measuring social mobility between generations in Lithuania and to present their empirical expressions. Intergenerational mobility is understood as the difference between the socio-economic situation of parents and adult children, i. y. a comparison of the person's current circumstances with those from which the person originated. Social positions that can be compared are usually based on occupational, income, education or other social class or socio-economic situation schemes. This article is based on European Social Survey data from wave 9 and reviews the intergenerational social mobility of 1970-1984 generation in terms of education, occupations, income and health dimensions.. The results show that occupational and educational mobility increases between generations. There has been a significant decline in the number of people with only a basic education and at the lowest levels of the occupational scale. However, there is a lack of data on intergenerational social mobility in health and income. Therefore, conclusions about this mobility can only be drawn from the work of previous researchers. Intergenerational mobility can also be a tool to achieve greater economic efficiency. Low intergenerational mobility may mean that some individuals are unable to realize their talents due to their low socio-economic status. Therefore, in the light of the findings of the study, it would make sense to consider developing a social mobility strategy.

Purpose: To evaluate the effectiveness of a telephone navigation intervention for increasing use of cancer control services among underserved 2-1-1 callers. Design: Randomized controlled trial. Setting: 2-1-1 call centers in Houston and Weslaco, Texas (located in the Rio Grande Valley near the Mexican border). Participants: 2-1-1 callers in need of Pap test, mammography, colorectal cancer screening, smoking cessation counseling, and/or HPV vaccination for a daughter (n = 1,554). A majority were low-income and described themselves as Black or Hispanic. Intervention: Participants were randomly assigned to receive either a cancer control referral for the needed service(s) with telephone navigation from a trained cancer control navigator (n = 995) or a referral only (n = 559). Measures: Uptake of each individual service and any needed service. Analysis: Assessed uptake in both groups using bivariate chi-square analyses and multivariable logistic regression analyses, adjusted for sociodemographic covariates. Both per-protocol and intent-to-treat approaches were used. Results: Both interventions increased cancer control behaviors. Referral with navigation intervention resulted in significantly greater completion of any needed service (OR = 1.38; p = .042), Pap test (OR = 1.56; p = .023), and smoking cessation counseling (OR = 2.66; p = .044), than referral-only condition. Other outcomes showed the same trend although the difference was not statistically significant: mammography (OR = 1.53; p = .106); colorectal cancer screening (OR = 1.80; p = .095); and HPV vaccination of a daughter (OR = 1.61; p = .331). Conclusion: Adding cancer control referrals and navigation to an informational service like the 2-1-1 program can increase overall participation in cancer control services.

Abstract
Our previous gene expression studies in a PCB-exposed cohort of young children in Slovakia revealed that early-life exposures to PCBs and other organochlorine compounds were associated with significant alterations across several pathogenetic pathways. The present study was undertaken to further explore the high-throughput qRT-PCR-based gene expression effects by using TaqMan low-density array (TLDA) for selected genes in a sample of 55 children from the cohort. We analyzed the transcriptional changes of 11 genes in relation to PCB and organochlorine pesticide exposure levels (including DDT, DDE, HCH, and HCB), and to BMI and ethnicity in this cohort. The results indicated an overall downregulation of expression of these genes. Maximum downregulation (in fold change) was observed in the ENTPD3 gene, and the minimum level of downregulation was in CYP2D6. As per our multinomial regression model study, downregulation of LEPR gene was significantly directly correlated with all the exposure variables. Downregulation of APC, ARNT, CYP2D6, LEPR, LRP12, and MYC genes was directly correlated with BMI (kg/m2) of the individuals. Gender-specific differences in gene expression were observed in CYP2D6 (p-value 0.0001) and LEPR (p-value 0.028), while downregulation of CYP2D6 (p-value 0.01), LEPR (p-value 0.02), LRP12 (p-value 0.04), and MYC (p-value 0.02) genes was consistently observed in Roma children compared to Caucasians. The investigation of such health disparities must be emphasized in future research, together with interventions to reduce the health consequences of PCB exposures. In this context, we emphasize the importance of biomarker-based approaches to future research on genetic susceptibility to the effects of these compounds.

Mental alterations were described during the COVID-19 pandemic and sleep deprivation has been reported as a consequence of social isolation. In Italy, the COVID-19 pandemic spread out at the beginning of 2020 determining severe lockdown periods. The aim of our study was to observe the effects of lockdown on sleep and anxiety in trained non-professional subjects and professional athletes who continued to train during the lockdown period. Forty-six subjects (21 trained non-professional subjects and 25 professional athletes) were recruited from a variety of team and individual sports to complete a battery of previously validated and widely used questionnaires assessing psychometric and anthropometric parameters, physical activity levels, lifestyle habits, and sleep quality. Subjects were aged 27.0 ± 5.14. All items were evaluated as percentages and chi-square and Fisher's exact tests were performed, as appropriate. Our data showed that the prevalence of the difficulty of falling asleep (over 30%), the tendency of nocturnal awakenings (over 30%), and moderate anxiety (over 38%) were at the same extent in the two groups. Of the professional athletes, 72.73% declared snoring during sleep vs 42.86% of non-professional subjects. No other significant differences were found between the two groups except for the perception of being constant in daily activity, significantly more reported by trained subjects (p < 0.005). Our data show a similar scenario of anxiety and sleep disturbances for the two groups, suggesting that lockdown by the COVID-19 pandemic has partially mitigated the known beneficial effects due to physical activity on mental health and sleep quality. Further analyses are necessary to define the associated risk factors.

The ability to communicate empowers individuals, enabling them to share information, needs and experiences
with others (Cockerill, 2002). For many, society's general reliance upon verbal and written communication is
taken for granted. However for the vulnerable minority, including people with learning disabilities (PWLD), this is a key
issue. Physiological, psychological, environmental and social barriers make traditional methods of communication
extremely frustrating or impossible, continuing their legacy of exclusion from decision-making society. Moreover, whilst
the Habermas ideal of a society where "communication will no longer be distorted by the effects of power, self-interest
or ignorance" (Tewdwr-Jones & Allmendinger, 1998 citing Norris, 1985, p. 149) propels the acceptance of communicative
rationality in policy and practice (Healey, 1999), there is limited evidence regarding its practical employment to
extend inclusion to underrepresented groups such as PWLD. In order to address this evident lack in employment of
participatory processes that value difference, the Experiemic process was developed as part of a two year research
program funded by the UK Leverhulme Trust. Through its employment, it is seen how we can facilitate more inclusive
partnerships that have the capability to augment and challenge current consultation techniques. We illustrate this
through a longitudinal qualitative fieldwork study into a United Kingdom (UK) city's local public transport system. Here,
the Experiemic process's catalytic capability is revealed in its ability to empower and facilitate PWLD. As a consequence
the learning disability participants evolve as key players in environmental decision-making, whilst partnerships
developed across academia, the community, practice and policy result in positive environmental and social change.

PurposeDrawing on the "shocks to the system" concept in image theory, a mid-range theoretical model is developed to illuminate understanding on why cross-cultural experience is so conducive to stimulating entrepreneurship yet has remained largely unexplained at the individual level.Design/methodology/approachThe novel idea is put forth that experience of foreignness, in itself, can be harnessed as a powerful cognitive resource for entrepreneurship – particularly the nascent stages of new venture development. Providing cross-cultural exposures arouse "self-image shocks", they manifest over time as skill clusters that reflect the sensing, seizing and transforming capabilities at the heart of entrepreneurship. This paper's pivot helps delineate a common mechanism to explain how a diverse range of seemingly disparate cross-cultural experiences can be processed in a way that enhances entrepreneurial pursuits.FindingsThe insights of this paper reinforce the need for educators and policymakers to encourage and provide opportunities for aspiring entrepreneurs to engage in cross-cultural and overseas exposures as they are influential for stimulating each of the core sets of entrepreneurial capabilities. The model and synthesis table also help to practically unpack how to design and plan such cultural experiences to optimize the enduring entrepreneurial advantages.Originality/valueThe author turns a long-standing assumption surrounding cultural differences in entrepreneurship on its head. The shocks and tensions arising from intercultural interactions are not always inevitable liabilities to be "managed away" or attenuated. Rather, cross-cultural experience can be explicitly leveraged as an asset for nascent venturing as the juxtapositions they evoke provide both proximal and distal enhancements to ways in which entrepreneurs think and develop skills at the core of venturing.

There is growing interest in monitoring gait patterns in people with neurological conditions. The democratisation of wearable inertial sensors has enabled the study of gait in free living environments. One pivotal aspect of gait assessment in uncontrolled environments is the ability to accurately recognise gait instances. Previous work has focused on wavelet transform methods or general machine learning models to detect gait; the former assume a comparable gait pattern between people and the latter assume training datasets that represent a diverse population. In this paper, we argue that these approaches are unsuitable for people with severe motor impairments and their distinct gait patterns, and make the case for a lightweight personalised alternative. We propose an approach that builds on top of a general model, fine-tuning it with personalised data. A comparative proof-of-concept evaluation with general machine learning (NN and CNN) approaches and personalised counterparts showed that the latter improved the overall accuracy in 3.5% for the NN and 5.3% for the CNN. More importantly, participants that were ill-represented by the general model (the most extreme cases) had the recognition of gait instances improved by up to 16.9% for NN and 20.5% for CNN with the personalised approaches. It is common to say that people with neurological conditions, such as Parkinson's disease, present very individual motor patterns, and that in a sense they are all outliers; we expect that our results will motivate researchers to explore alternative approaches that value personalisation rather than harvesting datasets that are may be able to represent these differences.

This qualitative study explores the impact of non-pharmaceutical interventions (NPIs), including social distancing, travel restrictions and quarantine, on lived experiences during the first wave of the COVID-19 pandemic in Thailand (TH), Malaysia (MY), Italy (IT) and the United Kingdom (UK). A total of 86 interviews (TH: n = 28; MY: n = 18; IT: n = 20; UK: n = 20) were conducted with members of the public, including healthcare workers (n = 13). Participants across countries held strong views on government imposed NPIs, with many feeling measures lacked clarity. Most participants reported primarily negative impacts of NPIs on their lives, including through separation, isolation and grief over missed milestones; work-related challenges and income loss; and poor mental health and wellbeing. Nonetheless, many also experienced inadvertent positive consequences, including more time at home to focus on what they most valued in life; a greater sense of connectedness; and benefits to working life. Commonly employed coping strategies focused on financial coping (e.g. reducing spending); psycho-emotional coping (e.g. engaging in spiritual practices); social coping and connectedness (e.g., maintaining relationships remotely); reducing and mitigating risks (e.g., changing food shopping routines); and limiting exposure to the news (e.g., checking news only occasionally). Importantly, the extent to which participants' lived experiences were positive or negative, and their ability to cope was underpinned by individual, social and economic factors, with the analysis indicating some salient differences across countries and participants. In order to mitigate negative and unequal impacts of NPIs, COVID-19 policies will benefit from paying closer attention to the social, cultural and psychological-not just biological-vulnerabilities to, and consequences of public health measures.

There is growing interest in monitoring gait patterns in people with neurological conditions. The democratisation of wearable inertial sensors has enabled the study of gait in free living environments. One pivotal aspect of gait assessment in uncontrolled environments is the ability to accurately recognise gait instances. Previous work has focused on wavelet transform methods or general machine learning models to detect gait; the former assume a comparable gait pattern between people and the latter assume training datasets that represent a diverse population. In this paper, we argue that these approaches are unsuitable for people with severe motor impairments and their distinct gait patterns, and make the case for a lightweight personalised alternative. We propose an approach that builds on top of a general model, fine-tuning it with personalised data. A comparative proof-of-concept evaluation with general machine learning (NN and CNN) approaches and personalised counterparts showed that the latter improved the overall accuracy in 3.5% for the NN and 5.3% for the CNN. More importantly, participants that were ill-represented by the general model (the most extreme cases) had the recognition of gait instances improved by up to 16.9% for NN and 20.5% for CNN with the personalised approaches. It is common to say that people with neurological conditions, such as Parkinson's disease, present very individual motor patterns, and that in a sense they are all outliers; we expect that our results will motivate researchers to explore alternative approaches that value personalisation rather than harvesting datasets that are may be able to represent these differences.

INTRODUCTION: SARS-CoV-2 has disproportionately affected disadvantaged communities across the USA. Risk perceptions for social interactions and essential activities during the COVID-19 pandemic may vary by sociodemographic factors. METHODS: We conducted a nationally representative online survey of 1592 adults in the USA to understand risk perceptions related to transmission of COVID-19 for social (eg, visiting friends) and essential activities (eg, medical visits or returning to work). We assessed relationships for activities using bivariate comparisons and multivariable logistic regression modelling, between responses of safe and unsafe, and participant characteristics. Data were collected and analysed in 2020. RESULTS: Among 1592 participants, risk perceptions of unsafe for 13 activities ranged from 29.2% to 73.5%. Large gatherings, indoor dining and visits with elderly relatives had the highest proportion of unsafe responses (>58%), while activities outdoor, accessing healthcare and going to the grocery store had the lowest (<36%). Older respondents were more likely to view social gatherings and indoor activities as unsafe but less likely for other activities, such as going to the grocery store and accessing healthcare. Compared with white/Caucasian respondents, black/African-American and Hispanic/Latino respondents were more likely to view activities such as dining and visiting friends outdoor as unsafe. Generally, men versus women, Republicans versus Democrats and independents, and individuals with higher versus lower income were more likely to view activities as safe. CONCLUSION: Evidence-based interventions should be tailored to sociodemographic differences in risk perception, access to information and health behaviours when implementing efforts to control the COVID-19 pandemic.

European policy has seen a number of changes and innovations in the field of early childhood preschool education over the last decade, which have been reflected in various forms in the policies of individual EU countries. Within the Czech preschool policy, certain innovations and approaches have been implemented in the field of early children education, such as the introduction of compulsory preschool education before entering primary school from 2017, emphasis on inclusive education, equal conditions in education and enabling state-supported diversity in the education concepts of kindergartens. The aim of our study was to assess the influence of various preschool education systems in the Czech Republic in the context of psychological variables reflecting selected children's outcomes which may contribute to future school achievement. The monitored variables were the attitudes, motivations and executive functions of children in the last year of preschool education. A comparison was made between the traditional preschool education program and the so-called alternative types of preschool education, such as Montessori, Waldorf and religious schools. The total sample was divided into four subgroups, namely a group of children attending traditional kindergartens (731, 84.9%), religious (65, 7.5%), Montessori (35, 4.1%), and Waldorf (30, 3.5%) kindergartens. To determine empirical data, the following research methods were used: Attitude Questionnaire, School Performance Motivation Scale, and Behavior Rating Inventory of Executive Function (BRIEF). The results of our survey show the fact that the type of kindergarten attended has a significant effect on the child's level of school performance motivation, attitudes toward school as well as executive functions. Significant differences were found between the different types of kindergartens attended in the monitored variables.

In this study, entrepreneurial intentions (EI) among individuals in six ASEAN (Association of Southeast Asian Nations) countries (Vietnam, the Philippines, Indonesia, Thailand, Malaysia, and Singapore) were investigated by applying the theory of planned behavior (TPB) to understand the underlying predictors of EI among three different stages of economic development. To investigate the predictors of EI according to TPB, the datasets of 13,358 respondents from the Global Entrepreneurship Monitor (GEM) national teams were analyzed using a binary logistic regression (BLR) model for each country, which was then grouped concerning the status of national economic development to compare the differences. The GEM datasets showed that attitude towards behavior (ATB) was highest in the Philippines (ATB1 = 81.8, ATB2 = 78.1), the subjective norm (SN) was highest in Vietnam (SN1 = 86.8), and Indonesia (SN2 = 69.2), the perceived behavioral control (PBC) was highest in the Philippines (PBC1 = 66.2) and Thailand (PBC2 = 47.3), which predicted that the Philippines, Indonesia, Thailand, and Vietnam have the highest EI amongst this group of six ASEAN nations. Furthermore, the analysis used multi-variables to predict EI, showing that the predictors influencing EI in factor-driven economies (Vietnam and Philippines) are only subjective norms (SNs) and PBC. However, predictors which influence the EI in efficiency-driven economies (Indonesia, Thailand, and Malaysia) and innovation-driven economies (Singapore) are ATB and SNs. The results strongly support that PBC can be the best predictor of EI for ASEAN adult populations (ages 18–64). These findings potentially give government and private sectors an advantage in policy management for new business creation concerning each stage of economic development for each respective nation.

Developing and implementing new immunization policies in response to shifting epidemiology is a critical public health component. We adopted a mixed-methods approach (via narrative literature review [101 articles] and 9 semi-structured interviews) to evaluate policy development in response to shifting measles epidemiology in six European countries (Italy, Belgium, Germany, Romania, UK, and Ukraine); where policies and strategies have evolved in response to country-specific disease and vaccination patterns. Periodic outbreaks have occurred in all countries against a background of declining measles-containing-vaccine (MCV) uptake and increasing public vaccine hesitancy (with substantial regional or social differences in measles burden and vaccine uptake). Health-care worker (HCW) vaccine skepticism is also seen. While many outbreaks arise or involve specific susceptible populations (e.g., minority/migrant communities), the broader pattern is spread to the wider (and generally older) population; often among incompletely/non-vaccinated individuals as a legacy of previous low uptake. Immunization policy and strategic responses are influenced by political and social factors, where public mistrust contributes to vaccine hesitancy. A strong centralized immunization framework (allied with effective regional implementation and coherent political commitment) can effectively increase uptake. Mandatory vaccination has increased childhood MCV uptake in Italy, and similar benefits could be anticipated for other countries considering vaccine mandates. Although possible elsewhere, socio-political considerations render mandating impractical in other countries, where targeted immunization activities to bolster routine uptake are more important. Addressing HCW skepticism, knowledge gaps, improving access and increasing public/community engagement and education to address vaccine hesitancy/mistrust (especially in communities with specific unmet needs) is critical.

PURPOSE: To use government-curated databases to produce incidence estimates for pediatric tibial spine fractures (TSFs) by age and sex. This study also describes the relative frequency of operative versus nonoperative management for TSFs by age and sex. METHODS: US Healthcare Cost and Utilization Project databases were used to identify cases of TSF among patients aged 7 to 18 years in the year 2016. Patient-linked deidentified data from New York, Maryland, and Florida were gathered from state databases, and repeat visits by the same patient were collapsed into individual records. TSF incidence was then calculated, with U.S. census data used to determine the number of children at risk. The proportion of cases treated nonoperatively was determined based upon procedural codes. RESULTS: In New York, Florida, and Maryland, 185 cases of TSF were found. Male patients accounted for 69.7% of cases. Incidence peaked at 9.3 per 100,000 at age 14 years for male patients and at 3.4 per 100,000 at age 9 years for female patients. In total, 57.9% of TSF cases were treated nonoperatively. The overall incidence of TSF was 2.8 cases per 100,000 for people aged 7 to 18 years. CONCLUSIONS: This study confirms a difference in incidence by sex for pediatric TSFs, with male patients having a greater peak incidence that also occurs at an older age. Most cases in this study were treated nonoperatively. CLINICAL RELEVANCE: Due to the relative infrequency of TSFs in the pediatric population, there is a limited understanding of the epidemiology and treatment of these fractures. The use of data from a large patient database may provide valuable epidemiologic information about this uncommon injury.