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Graduates from life sciences, including nutrition, will be at the forefront of promoting environmental, social, and food systems sustainability. The requisite competencies for their future roles include systems thinking, interdisciplinary collaboration, and effective communication, which are essential to navigating the complex interrelationship between human health and the environment [1,2]. To address this need, a 'Living Laboratory’ (LL) within a higher education (HE) food service setting could enrich the traditional laboratory experience, allowing students to cultivate these skills through experiential learning. This project aimed to i) scope the published literature to characterise LL examples within a HE food environment and ii) explore the understanding and perceptions of a LL concept in a food service setting for final year student research projects among students and academics at King’s College London.
A systematic scoping review was conducted in accordance with PRISMA-ScR guidelines (Registration OSF:d7y96). Two databases were searched (PubMed/Medline, Web of Science) from January 2010 to July 2024 to identify articles reporting the design, implementation or evaluation of LL in HE food service settings. A narrative synthesis was performed, and the resulting themes were used to inform focus groups (KCL Ethics:LRM-23/24-42657) with academic staff (two groups, nine participants) and students (four groups, seven postgraduate and nine undergraduate participants). Focus group discussions were audio-recorded and transcribed verbatim. Data were analysed using an inductive thematic approach [3].
Twenty-one articles were included in the scoping review. Common terms used to describe the LL concept included ‘innovation’, ‘collaboration’, ‘diverse stakeholders’, ‘enabling students’ and ‘practical learning experiences’. Recommendations for implementing LLs were provided in six articles and included engagement and outreach with stakeholders; managing conflicts; assessing impact; and establishing ethical and governance frameworks. The focus group findings indicated that both students and academics view the LL concept as a dynamic, real-world setting, emphasizing engagement and collaboration with internal and external stakeholders. Academics perceived the educational benefits of LLs as fostering experiential learning and perceived the barriers to implementation as including a lack of resources, scheduling conflicts, insufficient stakeholder engagement and unclear governance frameworks. Students highlighted the importance of aligning projects with taught programme content. and identified challenges such as limited awareness, unequal engagement across disciplines, time constraints, and concerns about inclusivity and equity across campuses. Students agreed that the LL provided opportunities to develop skills and knowledge in sustainability, science communication and real-world evidence studies, opening new career options after graduation. Lastly, altruism to improve food environments for peers and future students was a significant driving factor in student engagement.
Implementing LLs in HE food service settings requires input from multiple stakeholders. This scoping project identified key considerations from both academic staff and students to inform the co-design of a LL in a HE food service setting.
Background: Nipocalimab is a human IgG1 monoclonal antibody targeting FcRn that selectively reduces IgG levels without impacting antigen presentation, T- and B-cell functions. This study describes the effect of nipocalimab on vaccine response. Methods: Open-label, parallel, interventional study randomized participants 1:1 to receive intravenous 30mg/kg nipocalimab at Week0 and 15mg/kg at Week2 and Week4 (active) or no drug (control). On Day 3, participants received Tdap and PPSV®23 vaccinations and were followed through Wk16. Results: Twenty-nine participants completed the study and are included (active, n=15; control, n=14). Participants with a positive anti-tetanus IgG response was comparable between groups at Wk2 and Wk16, but lower at Wk4 (nipocalimab 3/15 [20%] vs control 7/14 [50%]; P=0.089). All maintained anti-tetanus IgG above the protective threshold (0.16IU/mL) through Wk16. While anti-pneumococcal-capsular-polysaccharide (PCP) IgG levels were lower during nipocalimab treatment, the percent increase from baseline at Wk2 and Wk16 was comparable between groups. Post-vaccination, anti-PCP IgG remained above 50mg/L and showed a 2-fold increase from baseline throughout the study in both groups. Nipocalimab co-administration with vaccines was safe and well-tolerated. Conclusions: These findings suggest that nipocalimab does not impact the development of an adequate IgG response to T-cell–dependent/independent vaccines and that nipocalimab-treated patients can follow recommended vaccination schedules.
Short-term, immersive international placements are common and have been recognised for facilitating cultural learning, intercultural sensitivity, global-mindedness, and critical thinking. These outcomes are not guaranteed and the impact and inclusion of these experiences in an already comprehensive curriculum remain to be carefully evaluated. This study explores the impact of 4-week international placements on professional and personal development (short-term and enduring) of participating final-year undergraduate and postgraduate dietetic and undergraduate nutrition students. Recent nutrition and dietetic graduates (n = 8) of the program, implemented in underserved communities in the Philippines, Indonesia, and Vanuatu for four weeks during 2022–2021, were interviewed using semi-structured questions until saturation, followed by thematic analysis using a six-step process(1). Graduates were interviewed about their in-country experience and its impact on their professional practice, within 12–18 months of graduating. Findings were further analysed against the national competency standards for dietitians in Australia. Participants expressed significant cultural awareness (appreciation of the strength of other cultures, stronger communitarian values of hosts), greater critical and systems thinking (about socio-economic determinants of health, systems-level thinking) and deeper capacity for empathy and compassion (emotional quotient development). When viewed against the national competency standards, participants did not understand how international placements from developed to developing countries can perpetuate colonisation principles and global-mindedness was not identified as a strong theme. These findings suggest that immersive, international placements result in profound, transformational, and enduring learning that extends into participants’ professional life, especially respect for cultural safety and the development of systems thinking. There is an alignment with accrediting professional peak body competencies for cultural competency, professional practice and collaborative practice with findings suggesting areas for strengthening the nutrition and dietetic curriculum include enhancing learning outcomes of global-mindedness thinking and decolonisation principles.
Historical changes from shifting land use, the natural meandering of waterways, and the aftereffects of erosion complicate modern environments and obfuscate precontact landscapes. Although archaeologists can create stratified sampling models or employ systematic surveys, traditional field methodologies are often not suitable for site discovery, thereby limiting knowledge of ancient cultural landscapes. Many water systems in southern Louisiana, and in many parts of the world, have been covered or concealed in backswamps by natural geomorphological processes, development, or environmental degradation. Investigation standards that do not account for these changes will not be effective at identifying archaeological sites in such transformed landscapes. Discoveries made during ongoing archaeological research in Iberville Parish, Louisiana, provide examples of what can be missed and offer solutions through changes in archaeological field methods. This article advocates for a mixed-methodology approach, drawing from historical research and shallow geophysics to look at landforms and landscape changes. Strictly following state survey guidelines can muddle the archaeological record, particularly in places subject to significant landscape change from historical land-use alteration. By applying these approaches, we offer a way to reconstruct ancient landscapes and landforms that are culturally significant but often missed given the nature of modern environmental conditions.
Diagnostic criteria for major depressive disorder allow for heterogeneous symptom profiles but genetic analysis of major depressive symptoms has the potential to identify clinical and etiological subtypes. There are several challenges to integrating symptom data from genetically informative cohorts, such as sample size differences between clinical and community cohorts and various patterns of missing data.
Methods
We conducted genome-wide association studies of major depressive symptoms in three cohorts that were enriched for participants with a diagnosis of depression (Psychiatric Genomics Consortium, Australian Genetics of Depression Study, Generation Scotland) and three community cohorts who were not recruited on the basis of diagnosis (Avon Longitudinal Study of Parents and Children, Estonian Biobank, and UK Biobank). We fit a series of confirmatory factor models with factors that accounted for how symptom data was sampled and then compared alternative models with different symptom factors.
Results
The best fitting model had a distinct factor for Appetite/Weight symptoms and an additional measurement factor that accounted for the skip-structure in community cohorts (use of Depression and Anhedonia as gating symptoms).
Conclusion
The results show the importance of assessing the directionality of symptoms (such as hypersomnia versus insomnia) and of accounting for study and measurement design when meta-analyzing genetic association data.
Poor air quality can both trigger and aggravate lung and heart conditions, as well as affecting child development. It can even lead to neurological and mental health problems. However, the precise mechanisms by which air pollution affect human health are not well understood.
Aims
To promote interdisciplinary dialogue and better research based on a critical summary of evidence on air quality and health, with an emphasis on mental health, and to do so with a special focus on bioaerosols as a common but neglected air constituent.
Method
A rapid narrative review and interdisciplinary expert consultation, as is recommended for a complex and rapidly changing field of research.
Results
The research methods used to assess exposures and outcomes vary across different fields of study, resulting in a disconnect in bioaerosol and health research. We make recommendations to enhance the evidence base by standardising measures of exposure to both particulate matter in general and bioaerosols specifically. We present methods for assessing mental health and ideal designs. There is less research on bioaerosols, and we provide specific ways of measuring exposure to these. We suggest research designs for investigating causal mechanisms as important intermediate steps before undertaking larger-scale and definitive studies.
Conclusions
We propose methods for exposure and outcome measurement, as well as optimal research designs to inform the development of standards for undertaking and reporting research and for future policy.
Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people.
Aims
To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness.
Method
A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach.
Results
A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions.
Conclusion
Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
The influence of geomorphological site characteristics on soil clay mineral stability of montmorillonite-containing horizons of a southern Wisconsin soil catena was interpreted in terms of the solute activity function values of pSi(OH)4, pH-1/2pMg2+ and pH-1/3pAl3+ in suspensions of the separated clay fractions. Montmorillonite stability and/or formation vs that of kaolinite for the soil clays was evaluated by a plot of the solute activity functions on a three dimensional diagram derived for montmorillonite, kaolinite, and gibbsite at constant temperature (25°C) and constant pressure (one atm.). Although all the soil clays contained both montmorillonite and kaolinite, the position of the soil clay solute activity functions in the stability diagram clearly reflected the influence of the geomorphological—geochemical site conditions in which each soil horizon was developed, with corresponding differences in the SiO2/Al2O3 molar ratio of the reactive fraction. Montmorillonite stability positions of the solute activity functions were induced by soils (clays with reactive fractions with SiO2/Al2O3 molar ratios = 3–4) from calcareous or poorly drained horizons, while kaolinite stability positions of the functions were induced by soils (clays with reactive fractions of SiO2/Al2O3 molar ratios = 2) from acid, freely drained horizons.
Titanium in TiO2 minerals was differentiated from that isomorphously substituted into minerals by the use of dihydrogen hexafluorotitanate (hydrofluotitanic acid, H2TiF6), which selectively dissolved minerals containing substituted Ti4+, leaving free crystalline TiO2 minerals in the residue. Titanium analyses on the original samples and the residues remaining after H2TiF6 treatment, by both wet chemical (Tiron) and neutron activation methods, indicated that an average of 86 per cent of the titanium in seven kaolinite samples was present in the residual TiO2 form (largely anatase), whereas only 28 per cent in two bentonites was present in the TiO2 form. Residual Ti accounted for 100 per cent of the Ti in synthetic anatase and for 92 per cent of the Ti in coarse clay sized rutile, the latter value suggesting that about 8 per cent amorphous TiO2 was removed from the mechanically dry ground rutile by the H2TiF6 reagent. The Ti present as residual TiO2 in a variety of other samples ranged from 0 to 100 per cent.
A steady state reaction of apparent equilibrium of K mica + Ca2+ ⇄ Ca vermiculite + K+ was indicated by prolonged dissolution extractions from Blount soil clay (from northern Indiana) abundant in dioctahedral mica and vermiculite, with log Keq = 2.92 for the reaction when extrapolated to infinite time. From this and published free energies of formation of mica and kaolinite, a mineral phase stability diagram depicting the phase joins of Ca vermiculite, muscovite, and kaolinite was constructed with the solute activity functions pH-pK+, 2pH-pCa2+, and pSi(OH)4. These solute functions for 14-day reactions of calcareous (and dolomitic), poorly drained Harps soil (from central Iowa) fell near the calcite-dolomite-CO2-H2O phase join, suggesting equilibrium. These functions for Harps soil and the control minerals muscovite, biotite, and (or) vermiculite plus calcite were plotted on the mica-vermiculite stability diagram for various CO2 partial pressures. The points fell on the vermiculite-stable side of the mica-vermiculite plane at CO2 partial pressures of 0.15 and 0.20 atm (similar to soil air that would exist under frozen soil during winter and early spring; 2pH-pCa2+ ≃ 10.3). They fell on the muscovite-stable side of the muscovite-vermiculite plane at CO2 partial pressures of 0.0001 and 0.001 atm (similar to soil air under natural summer conditions; 2pH-pCa2+, 13.6 and 12.6, respectively) and therefore K+ (and 137Cs+ in rainfall) would be expected to be fixed.
The 2pH-pMg2+ values determined for Harps soil at the various CO2 partial pressures plotted either in the Mg montmorillonite stability field or on the Mg-montmorillonite-kaolinite phase join, in concordance with the abundance of montmorillonite and some kaolinite in the medium and fine clay fractions. The solute values for the nearby Clarion soil (upland, noncalcareous) plotted on the montmorillonite-kaolinite join, or with higher CO2 partial pressure, in the kaolinite stability area. The Gibbs free energy of formation (△Gf0) for a dioctahedral Ca vermiculite of −1303.7 kcal per 010 was determined from the Keq. The solute functions for the Blount soil showed kaolinite to be the thermodynamically stable phase with respect to dioctahedral mica and (or) vermiculite. The 14-day solute values for the Harps and upland Clarion soils were also on the kaolinite stability side of the kaolinite-vermiculite join. The kinetics of kaolinite formation in the upper midwestern U.S.A. are apparently slow on a scale of ~ 104 years.
Deferration by reduction of free Fe2O3 with Na2S2O4 in the presence of Na citrate and NaHCO3 caused a change in valence state of 10 to 35 per cent of the total structural iron in micaceous vermiculites, soils, nontronite, and muscovite. An increase in Fe2+ on deferration was accompanied by an equivalent decrease in Fe3+. Subsequent treatment with H2O2 reoxidized the structural Fe2+ previously formed.
Sesquioxide coatings on micaceous vermiculites were examined electron microscopically. These coatings were composed predominantly of Fe2O3 with approximately 10 per cent by weight of Al2O3 and small amounts of SiO2, as determined by chemical analysis of the deferration extracts.
The cation exchange capacity (CEC) increased 10–60 per cent as a result of deferration of micaceous vermiculites and soils. Treatment of the deferrated sample with H2O2 restored the Fe3+ content to approximately the original value but the CEC was not affected. Consequently, the increase in CEC on deferration was attributed to the removal of the positively charged sesquioxide coating. The reversible change in valence of structural iron without an equivalent change in CEC was attributed to deprotonation-protonation of the structure (OH− ⇄ O2−) simultaneous with the oxidation-reduction of iron (Fe2+ ⇄ Fe3+) in the phyllosilicate layer.
The shrinkage of osmotically swollen natural and artificial blisters on vermiculite cleavages by exchange saturation with fixing cations such as Cs+, Rb+, NH4+, and K+ was investigated by replica electron microscopy. Incomplete collapse of either the natural or artificially produced blisters occurred with Cs+, Rb+, and NH4+ saturation, while K+ saturation completely collapsed the artificially produced blisters but not the natural blisters. The reason for incomplete collapse with Cs+, Rb+ and NH4+ was the incomplete replacement (trapping in the flakes) of interlayer hydrated cations such as Na+ shown by electron probe microanalysis. Much less trapping occurred with K+ saturation. Na+ entrapment increased with increasing size and decreasing hydration of cations, i.e. Cs+ >Rb+ >NH4+ >K+.
Semiquantitative determination of Na+, by electron probe microanalysis, in vermiculite flakes near the edge revealed that 1 N CsCl entrapped as much as 45·6 per cent while 1 N KCl entrapped only 7·5 per cent. In general, more Na+ was entrapped by 1 N solutions than by dilute solutions. With 0·01 N KCl solution, the Na+ entrapment was only 4·4 per cent. The amount of Na+ at the center of the macroflakes was less than at the edge, apparently as a result of more CEC at frayed edges and (or) because of incomplete diffusion of Na+ to the center. Shrinkage of artificial blisters by K+ could thus be attributed to its more effective removal of the interlayer hydrated cations, whereas the other fixing cations were less effective. Natural blisters on vermiculite from Libby, Montana were not completely collapsed even by K+, apparently because the layer charge density was too low in the blister areas.
Three kinds of opal-cristobalite, differentiated by the sharpness of the 4·1 Å XRD peak, were isolated from the Helms (Texas) bentonite by selective chemical dissolution followed by specific gravity separation. The δ18O value (oxygen isotope abundance) for these cristobalite isolates ranged from approximately 26–30‰ (parts per thousand), increasing with increased breadth of the 4·1 Å XRD peak. Opal-cristobalite isolated from the Monterey diatomite had a δ18O value of 34‰. These δ18O values are in the range for Cretaceous cherts (approximately 32‰) and are unlike the values of 9–11‰ obtained for low-cristobalite (XRD peaks at 4·05, 3·13, 2·4, and 2·49) formed hydrothermally or isolated from the vesicles of obsidian. The morphology pseudomorphic after diatoms, observed with the scanning electron microscope, was more apparent in the opal-cristobalite from the Monterey diatomite of Miocene age (approximately 10 million yr old) than in the spongy textured opal-cristobalite from the Helms bentonite, reflecting the 40 million yr available for crystallization since Upper Eocene.
The oxygen isotope abundance of Helms montmorillonite (δ18O = 26‰) indicates that it was formed in sea water while the δ18O values of the associated opal-cristobalite indicate that this SiO2 polymorph probably formed at approximately 25°C in meteoric water. Although both cristobalite and mont-montmorillonite in the bentonite were authigenic, the crystallization of the SiO2 phase apparently required a considerably longer period and occurred mainly after tectonic uplift.
In contrast to the results for cristobalite, quartz from the Helms and Upton (Wyoming) bentonites had δ18O values of 15 and 21‰ respectively. Such intermediate values, similar to those of aerosolic dusts of the Northern Hemisphere, loess, and many fluvial sediments and shales of the North Central United States (U.S.A.), preclude either a completely authigenic or a completely igneous origin for the quartz. These values probably result from a mixing of quartz from high and low temperature sources, detritally added to the ash or bentonite bed.
Micaceous clays (“illites”) of a number of sediments, subjected to quantitative mineralogical analysis, ranged in different samples from 58 to 65% of a dioctahedral mica of muscovite type, from 3 to 8% vermiculite, from 0 to 10% montmorillonite, from 2 to 12% quartz, from 0 to 4% feldspars, from 1 to 2% rutile and anatase, from 0.3 to 1.2% free iron oxides, and from 16 to 30% chlorite. The soil clays contained less mica (13 to 35%) but more vermiculite (13 to 16%), montmorillonite (6 to 14%) and chlorite (30 to 33%), besides kaolinite (3 to 8%) and amorphous material (6 to 15%). The presence of the various minerals was verified by X-ray diffraction. When the interlayer K of these micaceous clays was replaced by hydrated Na ions through treatment with 0.2 n sodium tetraphenylboron in 1 n NaCl, the analytically determined vermiculite and montmorillonite contents increased. The freshly produced vermiculites had an interlayer charge of 177 to 198 me/100 g. During this replacement of interlayer K in a 1 N salt solution, the pH of the equilibrium matrix solution was observed to increase instead of decreasing as would be expected if oxonium (OH3+) ions were associated with K in the interlayer space, thus precluding the possibility of interlayer ONz+. The calculated stoichiometric equivalent of the pH rise established a significant uptake of protons by the lattice as K was released.
Thermal analyses of vermiculites show 0.5 to 0.7% higher OH water content than the parent micas. Oxidation of ferrous iron in the silicate structure, suggested as a possible mechanism for lowering of layer charge during weathering of mica to vermiculite, accounted for about 66% of this in samples high in iron (16.0% FeO) and only 30% of this in samples fairly low in iron. The rate of extraction of K from muscovite with no ferrous iron was found to be pH dependent, increasing at lower pH values. The data indicate proton incorporation with structural oxygens of the silicate sheet to form OH as a charge reduction mechanism in weathering of mica, independent of and additional to that involving the oxidation of ferrous iron.
Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.
Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk.
Methods
Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11–36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones.
Results
Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20).
Conclusions
Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.
OBJECTIVES/GOALS: This study engaged Black adults who reside in a rural area of Kentucky to explore their beliefs, norms, knowledge, attitudes, and health-related behaviors about Alzheimer’s disease (AD) (RQ1) and what message elements are most relevant for designing a health message aimed at encouraging them to get screened for AD (RQ2). METHODS/STUDY POPULATION: This qualitative study was guided bythe Integrative Model of Behavior. Participants were recruited from a faith-based institution in rural Kentucky. Black adults aged 50+ years were invited to participate in the study, which consisted of two focus groups. Group 1 gained information about behavioral determinants (RQ1) and examined which message design elements were important to Black adults by asking for feedback on a handout from the Alzheimer’s Association that encouraged AD screening (RQ2). The handout was redesigned based on feedback from Group 1. Group 2 was involved in a discussion of the redesigned handout, asking for further feedback. Focus groups were audio recorded and transcribed verbatim. Data analysis included thematic analysis of transcripts of the focus groups and quantitative analysis. RESULTS/ANTICIPATED RESULTS: Participants (N=18) were all female and Black with a mean age of sixty-two years. For RQ1, Results revealed that 1) limited knowledge of AD led to feelings of not being able to do anything about the disease, whereas awareness and education led to hope; 2) past healthcare experiences informed subsequent beliefs and behaviors, and 3) culture impacted beliefs, with a cultural norm of “what happens in our house, stays in our house” being prominent. For RQ2, results revealed the importance of regionally specific messaging for AD. Generic statements that applied broadly did not appeal to participants. Message delivery, layout, and format for low literacy individuals are key for maximizing audience impact. Pictures give hints about the message and aid in understanding. DISCUSSION/SIGNIFICANCE: Barriers such as past experiences, lack of knowledge, and cultural norms negatively impact the likelihood that Black adults will get screened for AD, resulting in delayed healthcare or healthcare avoidance. Regionally specific health messaging for AD has the potential to encourage modifications in health-related behaviors.
Clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) for treatment of treatment-resistant depression (TRD) vary widely and there is no mood rating scale that is standard for assessing rTMS outcome. It remains unclear whether TMS is as efficacious in older adults with late-life depression (LLD) compared to younger adults with major depressive disorder (MDD). This study examined the effect of age on outcomes of rTMS treatment of adults with TRD. Self-report and observer mood ratings were measured weekly in 687 subjects ages 16–100 years undergoing rTMS treatment using the Inventory of Depressive Symptomatology 30-item Self-Report (IDS-SR), Patient Health Questionnaire 9-item (PHQ), Profile of Mood States 30-item, and Hamilton Depression Rating Scale 17-item (HDRS). All rating scales detected significant improvement with treatment; response and remission rates varied by scale but not by age (response/remission ≥ 60: 38%–57%/25%–33%; <60: 32%–49%/18%–25%). Proportional hazards models showed early improvement predicted later improvement across ages, though early improvements in PHQ and HDRS were more predictive of remission in those < 60 years (relative to those ≥ 60) and greater baseline IDS burden was more predictive of non-remission in those ≥ 60 years (relative to those < 60). These results indicate there is no significant effect of age on treatment outcomes in rTMS for TRD, though rating instruments may differ in assessment of symptom burden between younger and older adults during treatment.
This chapter reviews the physiologic changes of pregnancy and how they relate specifically to major arterial vascular diseases – namely, thoracic aortopathies, pulmonary hypertension, and splenic artery aneurysms. It summarizes the key management strategies throughout preconception, pregnancy, intra-partum, and post-partum stages.