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Timely prenatal diagnosis of CHD allows families to participate in complex decisions and plan for the care of their child. This study sought to investigate whether timing of initial fetal echocardiogram and the characteristics of fetal counselling were impacted by parental socio-economic factors.
Methods:
Retrospective chart review of fetal cardiac patients from 1 January, 2017 to 31 December, 2018. We reviewed gestational age at first fetal echo, maternal age and ethnicity, zip code, rurality index, and hospital distance. Counselling was evaluated based on documentation regarding use of interpreter, time billed for counselling, and treatment option chosen.
Results:
Total of 139 maternal–fetal dyads were included, and 29 dyads had single-ventricle heart disease. There was no difference in income, hospital distance or rurality index, and first fetal echo timing. There was no significant difference between maternal ethnicity and maternal age, gestational age at initial visit, or follow-up. Patients in rural areas had increased counselling time (p < .05). There was no difference between socio-economic factors and ultimate parental choices (termination, palliative delivery, or cardiac interventions).
Conclusion:
Oregon comprises a heterogeneous population from a large geographical catchment. While prenatal counselling and family decision-making are multifaceted, we demonstrated that dyads were referred from across the state and received care in a uniformly timely manner, and once at our centre received consistent counselling despite differences in parental socio-economic factors.
In the target article, Cristia, Foushee, Aravena-Bravo, Cychosz, Scaff, and Casillas (2023) convincingly show the need to broaden the current language acquisition research base, not only in linguistic diversity, but also in terms of regions and cultural groups studied. In conducting acquisition research in understudied populations, such as in rural settings, the authors highlight the importance of using a multi-method approach. They present the challenges in adapting these methods to new settings and offer possible ways to promote this type of research. In this commentary, we extend the discussion to understudied urban communities, as we encounter several of the concerns raised in Cristia et al. when collecting observational and experimental language acquisition data from Metro Manila, Philippines. We first describe the community we study, the challenges and modifications needed for conducting research in this setting, and end with a discussion of possible strategies to promote research in communities with understudied populations.
Objective: To characterise perceptions of the Philadelphia Beverage Tax among low-income parents. Design: We conducted semi-structured interviews and administered demographic questions via telephone. We based the interview guide and initial codebook on a conceptual model illustrating perceived fairness and effectiveness as essential for successfully adopting food policies. We performed thematic analysis using NVivo 12. Setting: We recruited from a primary care paediatrics clinic in Philadelphia, Pennsylvania from July to August 2020. Participants: Philadelphia parents/caregivers of 2- to 11-year-old children with Medicaid insurance. Results: Participants were predominantly African American (97 %), female (100 %), and had annual household incomes <$50 000 (80 %). Participants were 26- to 72-years old, with an average aged child of 5 years (range 7 months to 20 years). Themes emerged regarding tax perceptions, revenue use and behaviour change due to the tax. Using revenue for highly valued programmes and accountability of city government to use revenue as promised were critical elements in perceptions of tax fairness. Some parents avoided the tax through cross-border shopping and buying drink powders or concentrates, influencing perceptions of tax effectiveness. The tax signalled the health dangers of sweetened beverage consumption to most parents. Conclusion: Our findings bring to light four key takeaways for policymakers designing sweetened beverage taxes. (1) Dedication of tax revenue to programmes highly valued by parents and (2) transparency in revenue spending may improve acceptability. (3) State or national taxes may be more effective at decreasing consumption due to cross-border shopping. (4) Pairing taxes with health promotion campaigns may enhance behaviour change.
To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers.
Design:
The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5–17·5 years.
Setting:
Nine European countries.
Participants:
European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated.
Results:
Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, β-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05).
Conclusions:
zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents.
The aim of this review is to synthesize empirical studies on undergraduate language learners’ experience abroad during a time period of a year or less. To help provide a framework to this synthesis, we begin our review by tracing the recent evolution of empirical mixed-method research on the learner, identifying problems and characteristics that language learners generally encounter in the study abroad (SA) experience. We take a closer look at variables related to individual difference such as anxiety, motivation, and attitudes to more recent views of learner identity in language learning. We highlight the shift to language learner agency, a topic that merits more discussion in SA literature. We then review how the SA learning environments are treated. This review takes a closer look at research informed by socially grounded theories. Finally, we review the role that SA plays in undergraduate language curricula, where the objectives of the experience are aligned with at-home (AH) curricula, a topic that has not been fully discussed in SA literature. The conclusions offer suggestions for keeping pace with the broader field of applied/educational linguistics.
The present study aimed to examine the association between different breakfast consumption patterns and vitamin intakes and blood vitamin concentrations in European adolescents.
Design
Breakfast consumption was assessed by a questionnaire. Vitamin intake was calculated from two 24 h recalls. Blood vitamin and total homocysteine (tHcy) concentrations were analysed from fasting blood samples.
Setting
The European Commission-funded HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study.
Subjects
Participants were 1058 (52·8 % females) European adolescents (aged 12·5–17·5 years) from ten cities.
Results
Lower vitamin D and vitamin C concentrations were observed in male and female breakfast skippers than in consumers (P<0·05). Female breakfast consumers presented higher holo-transcobalamin and lower tHcy (P<0·05), while males had higher cobalamin concentrations, compared with skippers (P<0·05). Higher vitamin D and total folate intakes were observed in adolescents who consumed breakfast compared with skippers (P<0·05). Likewise, female consumers had higher intakes of vitamin B6 and vitamin E than occasional consumers (P<0·05).
Conclusions
Regular breakfast consumption is associated with higher blood vitamin D and cobalamin concentrations in males and with higher vitamin D and holo-transcobalamin and lower tHcy concentrations in females. Moreover, breakfast consumption is associated with high intakes of vitamin D and total folate in both sexes, and with high intakes of vitamin B6 and vitamin E in females.
Climate changes are multivariate in nature, and disentangling the proximal drivers of biotic responses to paleoclimate events requires time series of multiple environmental proxies. We reconstruct a multivariate time series of local environmental change for the early Miocene Newport Member of the Astoria Formation (20.26–18 Ma), using proxies for temperature (δ18O), productivity (δ13C), organic carbon flux (Δδ13C), oxygenation (δ15N), and sedimentary grain size (% mud). Our data suggest increases in productivity and declines in oxygenation on the Oregon shelf during this interval of global warming. We evaluate the association of individual environmental factors, and combinations of factors, with changes in faunal composition observed in benthic foraminiferal and molluscan communities collected from the exact same sediments as the environmental data. The δ15N values are the most parsimonious correlates with major changes in foraminiferal composition, whereas molluscan composition is most closely related to δ13C values, suggesting that different components of the environment are influencing each group. When the proxies that have the best supported relationships with the faunal gradients are removed from the analyses to simulate the absence of those proxy data, significant relationships between the faunal gradients and the remaining environmental proxies can still be found. This suggests that environmental drivers can be incorrectly attributed to faunal changes when key proxy data are missing. Paleoecological studies of biotic response that test multiple environmental drivers for multiple taxonomic groups are powerful tools for identifying the ecological consequences of past warming events and the regional drivers of ecological changes.
The degree of development and operability of the indicators for the Marine Strategy Framework Directive (MSFD) using Descriptor 1 (D1) Biological Diversity was assessed. To this end, an overview of the relevance and degree of operability of the underlying parameters across 20 European countries was compiled by analysing national directives, legislation, regulations, and publicly available reports. Marked differences were found between countries in the degree of ecological relevance as well as in the degree of implementation and operability of the parameters chosen to indicate biological diversity. The best scoring EU countries were France, Germany, Greece and Spain, while the worst scoring countries were Italy and Slovenia. No country achieved maximum scores for the implementation of MSFD D1. The non-EU countries Norway and Turkey score as highly as the top-scoring EU countries. On the positive side, the chosen parameters for D1 indicators were generally identified as being an ecologically relevant reflection of Biological Diversity. On the negative side however, less than half of the chosen parameters are currently operational. It appears that at a pan-European level, no consistent and harmonized approach currently exists for the description and assessment of marine biological diversity. The implementation of the MSFD Descriptor 1 for Europe as a whole can therefore at best be marked as moderately successful.
The present study aimed to investigate the relationships between macronutrient intake and serum lipid profile in adolescents from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) cross-sectional study (2006–7), and to assess the role of body fat-related variables in these associations. Weight, height, waist circumference, skinfold thicknesses, total cholesterol, HDL-cholesterol (HDL-C), LDL-cholesterol, TAG, apoB and apoA1 were measured in 454 adolescents (44 % boys) aged 12·5–17·5 years. Macronutrient intake (g/4180 kJ per d (1000 kcal per d)) was assessed using two non-consecutive 24 h dietary recalls. Associations were evaluated by multi-level analysis and adjusted for sex, age, maternal education, centre, sum of four skinfolds, moderate-to-vigorous physical activity, sedentary behaviours and diet quality index for adolescents. Carbohydrate intake was inversely associated with HDL-C (β = − 0·189, P< 0·001). An inverse association was found between fat intake and TAG (β = − 0·319, P< 0·001). Associations between macronutrient intake and serum lipids varied according to adiposity levels, i.e. an inverse association between carbohydrate intake and HDL-C was only observed in those adolescents with a higher waist:height ratio. As serum lipids and excess body fat are the major markers of CVD, these findings should be considered when developing strategies to prevent the risk of CVD among adolescents.
Short gamma-ray bursts (GRBs) are an extremely elusive family of cosmic explosions. They are thought to be related to the violent merger of compact objects (such as a neutron stars or black holes). Their optical counterparts were not discovered until 2005, and since then, there had been no successful spectroscopic observations. Here we present the first spectra of a short GRB, which we use to study the environment and derive implications on the progenitors of these cosmic explosions. This poster is based on the work by de Ugarte Postigo et al. (2014).
Recent research has suggested that the contribution of individual sociolinguistic variables to the social perception of a speaker is influenced by other available information about the speaker (Campbell-Kibler, 2007; Pharao, Maegaard, Spindler Møller, & Kristiansen, 2014). Here we investigate the impact of listener awareness of regional sociolinguistic variation on sociolinguistic perception. Specifically, we compare how the social meanings attributed to word-internal, preconsonantal /s/ differ based on whether the listeners and speakers use predominantly /s/-weakening Puerto Rican Spanish or predominantly non–/s/-weakening Mexican Spanish. We find that for measures of status, Puerto Rican and Mexican listeners both show a smaller effect of /s/ when rating Puerto Rican as opposed to Mexican speakers. However, we see no effect of speaker nationality on heteronormativity, and Puerto Rican listeners and male Mexican listeners rate strong /s/ as less heteronormative across the board. Mexican female listeners, however, rate strong /s/ as more heteronormative. These results suggest that listeners integrate their own local ideologies with their understanding of regional differences when socially evaluating language variation.
Emerging data indicate that higher levels of insulin resistance (IR) are common among children and adolescents and are related to cardiometabolic risk; therefore, IR requires consideration early in life. In addition, there is a lack of conclusive evidence regarding the role of dietary nutrients on IR. The Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) was conducted in European adolescents aged 12·5–17·5 years. A total of 637 participants with valid homeostasis model assessment (HOMA) index data and who completed at least a 2 d 24 h dietary recall were included in the study (60 % of the total HELENA-CSS sample). There were two dietary indices calculated, with the only difference between them being the inclusion or not of physical activity (PA). Markers of IR such as HOMA and the quantitative insulin sensitivity check index (QUICKI) were calculated. Pubertal status, BMI and cardiorespiratory fitness (CRF) were measured as potential confounders. The dietary index including PA was inversely associated with HOMA and directly with the QUICKI in females, but not in males, after adjusting for pubertal status, centre, BMI and CRF. In conclusion, the present study indicates that considering PA as part of the dietary index is of relevance as the resulted index is inversely related to IR independently of potential confounders including CRF. Overall, these findings suggest that intervention studies aimed at preventing IR in young people should focus on increasing the quality of the diet and also on including an optimal PA level in healthy adolescents.
A mid-sixteenth-century cemetery was investigated at the colonial Mixtec site of Teposcolula Yucundaa and is shown to be related to the cocoliztli pandemic of 1544–1550. This is the earliest colonial epidemic cemetery to be identified in Mexico. Through archaeogenetic and oxygen stable isotope analysis it is demonstrated that the interred individuals were local Mixtecs, and mortuary analysis sheds light on both Christian and traditional religious practices at the site. Mitochondrial haplogroup frequencies support long-term genetic continuity in the region, and carbon stable isotopes of bone collagen and enamel carbonates suggest no decrease in maize consumption during the early colonial period, despite historical evidence for a changing agricultural economy and increased wheat production at the site. The Teposcolula cemetery provides a rich and complex perspective on early colonial life in the Mixteca Alta and reaffirms the importance of archaeological and bioarchaeological evidence in investigating complex social and biological processes of the past.
Food-based dietary guidelines (FBDG) aim to address the nutritional requirements at population level in order to prevent diseases and promote a healthy lifestyle. Diet quality indices can be used to assess the compliance with these FBDG. The present study aimed to investigate whether the newly developed Diet Quality Index for Adolescents (DQI-A) is a good surrogate measure for adherence to FBDG, and whether adherence to these FBDG effectively leads to better nutrient intakes and nutritional biomarkers in adolescents. Participants included 1804 European adolescents who were recruited in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. Dietary intake was assessed by two, non-consecutive 24 h recalls. A DQI-A score, considering the components' dietary quality, diversity and equilibrium, was calculated. Associations between the DQI-A and food and nutrient intakes and blood concentration biomarkers were investigated using multilevel regression analysis corrected for centre, age and sex. DQI-A scores were associated with food intake in the expected direction: positive associations with nutrient-dense food items, such as fruits and vegetables, and inverse associations with energy-dense and low-nutritious foods. On the nutrient level, the DQI-A was positively related to the intake of water, fibre and most minerals and vitamins. No association was found between the DQI-A and total fat intake. Furthermore, a positive association was observed with 25-hydroxyvitamin D, holo-transcobalamin and n-3 fatty acid serum levels. The present study has shown good validity of the DQI-A by confirming the expected associations with food and nutrient intakes and some biomarkers in blood.
Accumulation of homocysteine and S-adenosylhomocysteine in bone has been shown to be associated with reduced bone quality in rats. The aim of the present study was to investigate whether high bone concentrations of homocysteine and S-adenosylhomocysteine as well as a low methylation capacity are related to an impaired bone morphology in humans. Concentrations of homocysteine and its precursors S-adenosylhomocysteine and S-adenosylmethionine were measured in femoral bone samples of eighty-two males and females (age 71 (sd 8) years) who underwent elective hip arthroplasty. Cancellous bone structure was analysed by histomorphometry. In addition, blood was sampled to measure serum concentrations of homocysteine. Results of bone and serum analyses were grouped for individuals with high or low bone concentrations of homocysteine, S-adenosylhomocysteine and S-adenosylmethionine, as well as for individuals with a high or a low methylation capacity, which is indicated by a low or a high S-adenosylhomocysteine:S-adenosylmethionine ratio (n 41, each). Histomorphometry showed a higher trabecular separation and a lower trabecular thickness, trabecular number and trabecular area in individuals with high bone concentrations of homocysteine and S-adenosylhomocysteine compared with individuals with low bone concentrations of homocysteine and S-adenosylhomocysteine. There was no association between the S-adenosylhomocysteine:S-adenosylmethionine ratio and bone morphology. It was found that 48 % of bone homocysteine was bound to the collagen of the extracellular bone matrix. Blood analyses demonstrated a significant correlation between serum and bone homocysteine. The results of the present study indicate an association between altered bone morphology and elevated bone concentrations of homocysteine and S-adenosylhomocysteine, but not between altered bone morphology and methylation capacity.
Massive O- and B-type stars are “cosmic engines” in the Universe and can be the dominant source of luminosity in a galaxy. The class of Be stars are rapidly rotating B-type stars that lose mass in an equatorial, circumstellar disk (Porter & Rivinius 2003) and cause Balmer and other line emission. Currently, we are unsure as to why these stars rotate so quickly but three scenarios are possible: they may have been born as rapid rotators, spun up by binary mass transfer, or spun up during the main-sequence evolution of B stars. In order to investigate these scenarios for this population of massive stars, we have been spectroscopically observing a set of 115 field Be stars with the Kitt Peak Coudè Feed telescope in both the Hα and Hγ wavelength regimes since 2004. This time baseline allows for examination of variability properties of the circumstellar disks as well as determine candidates for closer examination for binarity. We find that 90% of the observed stars show some variability with 8% showing significant variability over the 5-year baseline. Such values may be compared with the significant variability seen in some clusters such as NGC 3766 (McSwain 2008). Also, while ~20% of the sample consists of known binaries, we find that another 15–30% of the sample shows indications of binarity.
Background: Very few studies have compared the efficacy of individual and group cognitive behaviour therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) by taking into consideration the change in OCD severity in both the short and long term. Aims: To conduct an open trial of individual versus group CBT for OCD, comparing the clinical and statistically significant changes in severity both at post-treatment and one year later. Method: Forty-two OCD subjects were assigned to individual (n = 18) or group CBT (n = 24, in four groups). Sixteen and 22 subjects completed the treatment in the individual and group conditions, respectively. The Yale-Brown Obsessive Compulsive Scale was recorded at pre-treatment, post-treatment and at the one-year follow-up. Results: At the end of treatment, the clinically significant change was comparable for the two treatment conditions and remained stable at the one-year follow-up. Of the 16 participants who completed the individual CBT treatment, 68.75% were classified as recovered at post-treatment, compared to 40.9% of those receiving group CBT. At follow-up the rate of recovery decreased to 62.5% in individual CBT and to 31.8% in group CBT. Conclusions: Group CBT is effective in decreasing OCD severity. The post-treatment changes were maintained one year later. Nevertheless, these changes were higher in the individual delivery of CBT.
To investigate the association of a posteriori dietary patterns with overall survival of older Europeans.
Design and setting
This is a multi-centre cohort study. Cox regression analysis was used to investigate the association of the prevailing, a posteriori-derived, plant-based dietary pattern with all-cause mortality in a population of subjects who were 60 years or older at recruitment to the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort). Analyses controlled for all known potential risk factors.
Subjects
In total, 74 607 men and women, 60 years or older at enrolment and without previous coronary heart disease, stroke or cancer, with complete information about dietary intakes and potentially confounding variables, and with known survival status as of December 2003, were included in the analysis.
Results
An increase in the score which measures the adherence to the plant-based diet was associated with a lower overall mortality, a one standard deviation increment corresponding to a statistically significant reduction of 14% (95% confidence interval 5–23%). In country-specific analyses the apparent association was stronger in Greece, Spain, Denmark and The Netherlands, and absent in the UK and Germany.
Conclusions
Greater adherence to the plant-based diet that was defined a posteriori in this population of European elders is associated with lower all-cause mortality. This dietary score is moderately positively correlated with the Modified Mediterranean Diet Score that has been constructed a priori and was also shown to be beneficial for the survival of the same EPIC-Elderly cohort.