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Large stratovolcanoes in the Cascade Range have high equilibrium-line altitudes that support glaciers whose Holocene and latest Pleistocene advances are amenable to dating. Glacier advances produced datable stratigraphic sequences in lateral moraines, which complement dating of end moraines. New mapping of glacial deposits on Mount Rainier using LIDAR and field observations supports a single latest Pleistocene or early Holocene advance. Rainier R tephra overlies deposits from this advance and could be as old as >11.6 ka; the advance could be of Younger Dryas age. Radiocarbon ages on wood interbedded between tills in the lateral moraines of Nisqually, Carbon, and Emmons glaciers and the South Tahoma glacier forefield suggest glacier advances between 200 and 550 CE, correlative with the First Millennium Advance in western Canada, and during the Little Ice Age (LIA) beginning as early as 1300 CE.
These results resolve previous contradictory interpretations of Mount Rainier's glacial history and indicate that the original proposal of a single pre-Neoglacial cirque advance is correct, in contrast to a later interpretation of two advances of pre- and post-Younger Dryas age, respectively. Meanwhile, the occurrence of the pre-LIA Burroughs Mountain Advance, interpreted in previous work as occurring 3–2.5 ka, is questionable based on inherently ambiguous interpretations of tephra distribution.
There are numerous adverse health outcomes associated with dementia caregiving, including increased stress and depression. Caregivers often face time-related, socioeconomic, geographic, and pandemic-related barriers to treatment. Thus, implementing mobile health (mHealth) interventions is one way of increasing caregivers’ access to supportive care. The objective of the current study was to collect data from a 3-month feasibility trial of a multicomponent mHealth intervention for dementia caregivers.
Participants and Methods:
40 community-dwelling dementia caregivers were randomized to receive the CARE-Well (Caregiver Assessment, Resources, and Education) App or internet links connected to caregiver education, support, and resources. Caregivers were encouraged to use the App or links at least 4 times per week for 3 months. The App consisted of self-assessments, caregiver and stress reduction education, behavior problem management, calendar reminders, and online social support. Caregivers completed measures of burden, depression, and desire to institutionalize at baseline and post-intervention. Feasibility data included App usage, retention and adherence rates, and treatment satisfaction. Data were analyzed via descriptive statistics.
Results:
Caregivers were mostly white (95%), female (68%), in their mid-60s, (M= 66.38, SD= 10.64), and well-educated (M= 15.52 years, SD= 2.26). Caregivers were mainly spouses (68%) or adult children (30%). Care recipients were diagnosed with mild (60%) or moderate (40%) dementia, with 80% diagnosed as having Alzheimer’s disease. Overall, the study had an 85% retention rate (80% for App group; 90% for links group). 58% of caregivers in the App group were considered high users, using the App >120 minutes over the course of 3 months (M= 362.42, SD= 432.68), and an average of 16.44 days (SD= 15.51). 15% of the sample was non-adherent due to time constraints, disinterest, and/or technology issues. Most participants (75%) using the App were mostly or very satisfied, about 87% would be likely or very likely to seek similar programs in the future, and 93% found the App mostly or very understandable. Groups did not significantly differ on clinical outcomes, although the study was not powered for an efficacy analysis. Within groups analysis revealed significant increases in depressive symptoms at post-treatment for caregivers in both groups.
Conclusions:
This study demonstrated initial feasibility of the CARE-Well App for dementia caregivers. App use was lower than expected, however, high satisfaction, ease of use, and willingness to use similar programs in the future were endorsed. Some caregivers did not complete the intervention due to caregiving responsibilities, general disinterest, and/or technology issues. Although the study was not designed to assess clinical outcomes, we found that both groups reported higher depressive symptoms at post-treatment. This finding was unexpected and might reflect pandemic-related stress, which has been shown to particularly impact dementia caregivers. Future studies should address the efficacy of multicomponent mHealth interventions for dementia caregivers and the effects of increased dose on clinical outcomes. mHealth interventions should be refined to cater to varying levels of technology literacy among caregivers, and further research should aim to better integrate interventions into caregivers’ routines to enhance treatment engagement.
Depression and anxiety are common and highly comorbid, and their comorbidity is associated with poorer outcomes posing clinical and public health concerns. We evaluated the polygenic contribution to comorbid depression and anxiety, and to each in isolation.
Methods
Diagnostic codes were extracted from electronic health records for four biobanks [N = 177 865 including 138 632 European (77.9%), 25 612 African (14.4%), and 13 621 Hispanic (7.7%) ancestry participants]. The outcome was a four-level variable representing the depression/anxiety diagnosis group: neither, depression-only, anxiety-only, and comorbid. Multinomial regression was used to test for association of depression and anxiety polygenic risk scores (PRSs) with the outcome while adjusting for principal components of ancestry.
Results
In total, 132 960 patients had neither diagnosis (74.8%), 16 092 depression-only (9.0%), 13 098 anxiety-only (7.4%), and 16 584 comorbid (9.3%). In the European meta-analysis across biobanks, both PRSs were higher in each diagnosis group compared to controls. Notably, depression-PRS (OR 1.20 per s.d. increase in PRS; 95% CI 1.18–1.23) and anxiety-PRS (OR 1.07; 95% CI 1.05–1.09) had the largest effect when the comorbid group was compared with controls. Furthermore, the depression-PRS was significantly higher in the comorbid group than the depression-only group (OR 1.09; 95% CI 1.06–1.12) and the anxiety-only group (OR 1.15; 95% CI 1.11–1.19) and was significantly higher in the depression-only group than the anxiety-only group (OR 1.06; 95% CI 1.02–1.09), showing a genetic risk gradient across the conditions and the comorbidity.
Conclusions
This study suggests that depression and anxiety have partially independent genetic liabilities and the genetic vulnerabilities to depression and anxiety make distinct contributions to comorbid depression and anxiety.
OBJECTIVES/GOALS: Biomedical research fields are facing the challenges of demand for skilled workers as well as challenges related to diversity in that workforce. It is important that the healthcare workforce reflect the population it serves. The Exposures Internship seeks to address this by building pathways for youth to pursue careers in research and medicine. METHODS/STUDY POPULATION: In 2021, the Yale Cultural Ambassadors expressed concern about the lack of free high quality, educational offerings for youth that summer. They asked YCCI to consider developing a summer program for students aged 15 and older that focused on spurring interest in careers in healthcare, medicine, and clinical and translational research. The result was a 4-week virtual learning experience for 34 interns who met daily via Zoom and participated in course work, lectures, journal clubs, group projects, and virtual lunches with internationally renowned clinical research and healthcare leaders. Sessions were designed to help interns gain knowledge of and exposure to current topics in clinical and translational science and to observe the various steps of proposing, designing, undertaking, and analyzing clinical trials. RESULTS/ANTICIPATED RESULTS: YCCI received over 900 inquiries from around the world with more than 200 completed applications for participation in the internship for the pilot year. Since then, YCCI leadership has worked with community partners to engage young scholars from 17 different states, Canada, Mexico and Puerto Rico. Of those, we estimate 75% are minority, ~50% female and 20% from rural areas with limited similar opportunities. During the four weeks of the program these highly motivated students worked on projects aimed at increasing participation in pediatric research through a revised Informed consent and adolescent assent process and a youth centered awareness campaign. Interns were so inspired that they requested the program be continued beyond the initial four weeks. As such, YCCI continued to offer sessions throughout the year. DISCUSSION/SIGNIFICANCE: In evaluation of the pilot program 95% of respondents strongly agreed that the program exposed them to new information about clinical and translational research. One intern shared, This program has unquestionably made me consider becoming a researcher in the future with the goal of becoming a principal investigator within my interest in medicine.
In this article I propose an erotic theosis as a fruitful possibility for conceptualising our final participation in union with God in the beatific vision and for imaging said participation on earth. Particularly, I propose a synthesis of recent work from Oliver Crisp on theosis with that of Sarah Coakley on sexual desire as an especially helpful way in which to conceive of our ever-deepening participation in God's love. Further, this synthesis uses contributions from Erin Dufault-Hunter on the intersections of sexual desire and ethics as a catalyst for its recommendations.
We detected no correlation between standardized antimicrobial administration ratios (SAARs) and healthcare facility-onset Clostridioides difficile infection (HO-CDI) rates in 102 acute-care Veterans Affairs medical centers over 16 months. SAARs may be useful for investigating trends in local antimicrobial use, but no ratio threshold demarcated HO-CDI risk.
Cyberbullying is the wilful and repeated infliction of harm on an individual using the Internet and digital technologies. Similar to face-to-face bullying, cyberbullying can be captured formally using the Routine Activities Model (RAM) whereby the potential victim and bully are brought into proximity of one another via the interaction on online social networking (OSN) platforms. Although the impact of the COVID-19 (SARS-CoV-2) restrictions on the online presence of minors has yet to be fully grasped, studies have reported that 44% of pre-adolescents have encountered more cyberbullying incidents during the COVID-19 lockdown. Transparency reports shared by OSN companies indicate an increased take-downs of cyberbullying-related comments, posts or content by artificially intelligen moderation tools. However, in order to efficiently and effectively detect or identify whether a social media post or comment qualifies as cyberbullying, there are a number factors based on the RAM, which must be taken into account, which includes the identification of cyberbullying roles and forms. This demands the acquisition of large amounts of fine-grained annotated data which is costly and ethically challenging to produce. In addition where fine-grained datasets do exist they may be unavailable in the target language. Manual translation is costly and expensive, however, state-of-the-art neural machine translation offers a workaround. This study presents a first of its kind experiment in leveraging machine translation to automatically translate a unique pre-adolescent cyberbullying gold standard dataset in Italian with fine-grained annotations into English for training and testing a native binary classifier for pre-adolescent cyberbullying. In addition to contributing high-quality English reference translation of the source gold standard, our experiments indicate that the performance of our target binary classifier when trained on machine-translated English output is on par with the source (Italian) classifier.
Evidence-based mass-reach health communication campaigns can increase tobacco cessation, use of cessation resources such as quitlines, and change tobacco-related social norms. These interventions have been associated with a lower likelihood of cigarette smoking relapse in studies conducted internationally; however, no studies have assessed this outcome for a national campaign in the United States. This study examined the relationship between Tips from Former Smokers® (Tips®) campaign exposure and the odds of cigarette smoking relapse among adults who formerly smoked. Using data from the 2014 to 2019 Tips longitudinal campaign surveys, we estimated first episode of relapse (versus remaining a former smoker) as a function of Tips gross rating points (GRPs, a measure of media exposure). Higher levels of Tips GRPs were associated with lower odds of relapse (aOR = 0.63, 95% CI: 0.50-0.78). These results suggest that the Tips campaign may reduce smoking relapse, in addition to the established effect of increasing smoking cessation. Former smokers can be considered a secondary target audience for smoking cessation mass media campaigns, and mass media campaigns could be considered a component of smoking relapse prevention efforts.