New Jersey Leaves No Bite Behind: A Climate Change and Food Waste Curriculum Intervention for Adolescents in the United States.

Food waste is a major contributor to climate change. Schools offer a unique opportunity to educate on this issue while also reducing food waste generation; however, few climate-change education curricula that include a food waste component have been developed and tested with fidelity. Thus, the purpose of this cluster randomized controlled study was to assess the effectiveness of a climate change and food waste education program called NJ Leaves No Bite Behind (NJLNBB) among fifth-grade students. Lessons on food waste and sustainable food behaviors were developed that aligned with NJ Student Learning Standards for Climate Change and Next-Generation Science Standards. Participants (n = 162) completed pre- and post-test surveys that assessed knowledge, attitudes, self-efficacy, and behaviors. Post-test, the experimental group (n = 102) had significantly (p < 0.05) higher mean scores in knowledge, social norms, behavioral intentions, and perceived behavioral control compared to the control group (n = 60), with medium effect sizes, as determined by partial eta-squared. There were no significant between-group differences in mean score attitudes, self-efficacy, motivation to comply, or climate-friendly behaviors post-test. Almost three-quarters of participants who received the program agreed or strongly agreed the lessons were fun (75.5%), liked the card games (72.5), and learned a lot (78.4%). These findings are promising in terms of teaching adolescents the impacts of food waste on the climate.

Bipolar disorder and cumulative trauma: A systematic review of prevalence and illness outcomes.

BACKGROUND: The experience of cumulative trauma may be common in bipolar disorder (BD). However, it is not frequently reported as most studies focus on childhood trauma without examining differences in the amount of trauma experienced. This systematic review aimed to determine the prevalence of lifetime cumulative trauma in BD as well as explore associated illness outcomes. METHODS: A systematic review was completed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both the prevalence and outcomes of cumulative trauma in BD were assessed. Five electronic databases were searched (Embase, MEDLINE, PsycINFO, Web of Science, and PTSD Pubs) for records from January 2010 until December 2022. RESULTS: A total of 20 studies, with 9304 participants were included in the narrative synthesis. At least one-third of BD participants had experienced cumulative trauma, with a prevalence range from 29% to 82%. The main outcomes associated with a history of cumulative trauma were earlier age of onset, longer episode duration, more lifetime mood episodes, greater likelihood of experiencing psychotic features, and higher likelihood of past suicide attempts. LIMITATIONS: This review has been limited by the lack of studies directly assessing cumulative trauma in BD. CONCLUSIONS: Cumulative trauma is prevalent in BD. Preliminary evidence indicates an association with a range of adverse outcomes, emphasizing the need for clinicians to obtain a detailed trauma history and to consider these risks in the management of the disorder. Future studies should report on the prevalence of cumulative trauma, particularly in adulthood as this area remains unexplored.

Childhood cumulative trauma, social support and stress as predictors of illness outcomes and quality of life in bipolar disorder.

OBJECTIVE: Trauma, social support and stress have been identified as factors which may be associated with the bipolar disorder illness course. However, these are yet to be examined in prospective studies as predictors of illness outcomes and overall quality of life in bipolar disorder. METHOD: One hundred and fourteen participants (N = 97; 85.1% female) living with bipolar disorder I (41.2%) or II (58.8%) completed a semi-structured interview and a range of self-report measures assessing trauma history, social support, perceived stress, depression, anxiety, mania, suicidality, number of mood episodes and quality of life, at baseline and 6-month follow-up. RESULTS: Childhood cumulative trauma, social support and perceived stress accounted for a substantial and significant portion of the variance in quality of life (62%; 23.6%), anxiety severity (34.6%; 24.5%) and depression severity (49.6%; 26.7%), at both baseline and 6-month follow-up. Perceived stress made significant unique contributions to the prediction of all outcomes, and social support made significant unique contributions to depression and quality of life in bipolar disorder. CONCLUSION: Stress and social support play an important role in bipolar disorder and in quality of life for people living with this condition. Given that stress and social support are modifiable risk factors, this provides a promising direction for future intervention-based research.

Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents.

BACKGROUND: Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia. METHODS: A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12-14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term. DISCUSSION: If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control. TRIAL REGISTRATION: The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023).

Cumulative trauma in bipolar disorder: An examination of prevalence and outcomes across the lifespan.

BACKGROUND: Trauma is highly prevalent in bipolar disorder, and while considerable research has been undertaken in relation to childhood trauma, little is known about the experience and the impact of exposure to multiple trauma types across the lifespan, otherwise known as cumulative trauma. This study aimed to examine the prevalence of cumulative trauma in bipolar disorder and explore its association with illness and other outcomes. METHODS: Participants were recruited online globally and comprised 114 adults aged 23 to 73 years with BD-I (41.2 %) or BD-II (58.8 %). Participants completed an online questionnaire containing items regarding symptoms and trauma history followed by a diagnostic interview to confirm their BD diagnosis and assess BD symptoms. RESULTS: Cumulative trauma accounted for most of the trauma exposure across both childhood (n = 89; 78.1 %) and adulthood (n = 72; 63.2 %). Those with lifetime cumulative trauma (n = 64; 56 %) were more likely to experience at least one other co-morbid mental health condition in addition to their BD diagnosis (88 %) and report significantly lower ratings of perceived social support compared to those who did not experience any cumulative trauma (N = 15; 13 %). LIMITATIONS: This study has been limited by the cross-sectional retrospective design as well as the use of self-selection to participate. CONCLUSIONS: Cumulative trauma is highly prevalent in bipolar disorder and is associated with greater likelihood of experiencing a psychiatric comorbidity and decreased levels of social support. More research is needed to explore the nature of this relationship and determine whether increasing social support may be of benefit.

School-based preventive interventions targeting e-cigarette use among adolescents: a systematic review protocol.

INTRODUCTION: Electronic cigarette (e-cigarette) use has drastically increased in recent years, particularly among adolescents. This poses several acute and chronic harms to young people, including poisonings, burns, serious lung injury and-where nicotine e-liquid is used-the potential to impact healthy brain development and precipitate future nicotine addiction. School-based prevention programmes have the potential to address this growing public health concern by reaching large numbers of young people during a critical period for intervention; however, the efficacy of such interventions has not been systematically explored. This systematic review aims to determine the existence and efficacy of school-based preventive interventions targeting e-cigarette use. METHODS AND ANALYSIS: A systematic search of MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Database of Systematic Reviews and international clinical trials registries will be conducted from 2000 to April 2022 to identify eligible studies (randomised controlled trials, cluster randomised controlled trials and quasiexperimental studies) evaluating school-based interventions to prevent e-cigarette use among adolescents. Two reviewers will independently screen title, abstract and full text of all studies for eligibility. Both reviewers will independently extract the data and assess the risk of bias. Any discrepancies will be resolved by a third reviewer. Results will be summarised in a narrative synthesis and data will be meta-analysed if appropriate. Heterogeneity in findings will be assessed narratively, and using the I2 statistic (where meta-analysis is feasible), meta-regression will be used to explore potential factors associated with programme efficacy, where data permit. ETHICS AND DISSEMINATION: This research is conducted on published work and does not require ethics approval. The findings will be published in a peer-reviewed journal and used to guide the development of new school-based e-cigarette preventive interventions. TRIAL REGISTRATION NUMBER: CRD42022323352.

Effects of education on nurse confidence and cardiac surgical glycemic control.

This research was conducted to (1) determine the relationship between nurses' confidence levels using an endocrine order set after educational interventions and experience and (2) measure glycemic control after cardiac surgery with the use of order sets. Findings showed that nurses' confidence increased with ongoing education and experience. Furthermore, tighter glycemic control was achieved on postoperative days 1 and 2, as the protocol was refined, and as the nurses became more comfortable with its use.

Air-water exchange of polychlorinated biphenyls in the Delaware River.

The air-water exchange of polychlorinated biphenyls (PCBs) often results in net volatilization, which is thought to be the most important loss process for PCBs in many systems. Previous investigations of the air-water exchange of PCBs have been hampered by difficulties in treatment of the uncertainty in the calculation of air/water fugacity ratios. This work presents a new framework for the treatment of uncertainty, where uncertainty in physical constants is handled differently from random measurement uncertainty associated with random samples, and it further investigates the sorption of PCBs to colloids (dissolved organic carbon). Simultaneous measurements of PCBs in the air and water of five water quality management zones of the Delaware River were taken in 2002 in support of the total maximum daily load (TMDL) process. Gas-phase concentrations of IPCBs ranged from 110 to 1350 pg m(-3), while dissolved water concentrations were between 420 and 1650 pg L(-1). Shallow slopes of log Koc vs. log Kow plots indicated a colloidal contribution to the apparent dissolved-phase concentrations, such that a three-phase partitioning model was applied. Fugacity ratios for individual congeners were calculated under the most conservative assumptions, and their values (log-transformed) were examined via a single-sample T-test to determine whether they were significantly less than 1 at the 95% confidence level. This method demonstrated that air-water exchange resulted in net volatilization in all zones over all cruises for all but seven high molecular weight congeners. Calculated net fluxes ranged from +360 to +3000 ng m(-2) d(-1) for sigma PCBs. The colloidal correction decreased the volatilization flux of sigma PCBs by approximately 30%. The decachlorinated congener (PCB 209), exhibited unusually high concentrations in the suspended solids, especially in the southern portions of the river, indicating that there is a distinct source of PCB 209 in the Delaware River.

Watershed processing of atmospheric polychlorinated biphenyl inputs.

Indirect atmospheric deposition of PCBs was examined in subwatersheds of the Delaware River Estuary. Tributary PCB loads and atmospheric PCB concentrations were used to understand the pass-through efficiencies for nine rivers/ creeks for which PCB inputs appeared to be dominated by atmospheric deposition. The pass-through efficiency, E, was calculated from tributary loads and atmospheric deposition fluxes. Unfortunately, uncertainties in the gaseous and dry particle deposition velocities, vg and vd, respectively, render the calculated atmospheric deposition fluxes highly uncertain. In order to circumvent this problem, export of PCBs from the watershed was related directly to atmospheric PCB concentrations via a new mass transfer coefficient, the watershed delivery rate or vws, which describes the process by which the watershed transfers PCBs from the airto the River's main stem. vws increases with increasing chlorination and is significantly correlated with vapor pressure. This trend suggests that the transfer of PCBs from the atmosphere to the River via the watershed is more efficient for high molecular weight PCBs than for low molecular weight PCBs. This may indicate that the selected watersheds are at or close to equilibrium with respect to gaseous exchange of PCBs, such that lower molecular weight congeners undergo substantial revolatilization after deposition. The magnitude of the pass-through efficiency, E, depends on the deposition velocities used to calculate the atmospheric deposition flux, but when congener-specific deposition velocities are used, E is independent of vapor pressure and is relatively constant at about 3%.

Recurrent adjacent-2 segregation of a familial t(14;21)(q11.2;q11.2): phenotypic comparison of two brothers and a paternal aunt inheriting the der(14).

A 14-year-old boy was referred for a genetics evaluation after high-resolution chromosome analysis showed a small amount of extra material in the proximal long arm of chromosome 21. Five years prior, his karyotype analysis was interpreted as normal with a variant chromosome 21. The patient has short palpebral fissures, strabismus, flat antihelices of the ears, long thumbs with bilaterally absent interphalangeal creases, proximal bilateral 3/4 syndactyly, small testes, hypotonia, mental retardation, and speech problems. He has significant depression and behavioral problems including hyperactivity, aggression, and impulsivity. His 8-year-old brother has more severe behavioral disturbances and depression, but less significant mental retardation. A paternal aunt has mental retardation, is unusually docile, and appears similar to our patient. Chromosome analysis and fluorescence in situ hybridization (FISH) whole chromosome paint of chromosome 21 showed that the patient's father carries a "cryptic" balanced translocation, 46,XY, t(14;21)(q11.2;q11.2), as does the patient's paternal grandmother. Uniparental disomy studies using seven informative polymorphic nucleotide repeat markers from 14q and 21q confirmed biparental inheritance of the number 14 and 21 chromosomes for each brother, and indicate that they and the paternal aunt, all of whom inherited the der(14), are monosomic for proximal 21q and trisomic for proximal 14q. These karyotypes arose through an adjacent-2 segregation in the father on two occasions, and from the paternal grandmother on one occasion. This family is an example of recurrent malsegregation with translocations involving the acrocentrics.

Asthma among homeless children: undercounting and undertreating the underserved.

BACKGROUND: In the United States, children of color, children who live in urban medically underserved communities, and children whose families have limited economic resources have excessively high rates of asthma. The identification of high-risk subgroups of underserved children is crucial for understanding the determinants and scope of the childhood asthma epidemic and for developing successful interventions. OBJECTIVE: To determine the population prevalence of asthma among homeless children. DESIGN: Cross-sectional study. SETTING: Three family shelters in New York City. PARTICIPANTS: A total of 740 children whose families entered 3 family shelters from June 30, 1998, to September 18, 1999. MAIN OUTCOME MEASURES: Prior physician asthma diagnosis, current asthma symptoms using National Asthma Education and Prevention Program symptom criteria, current medications, and emergency department use in the past year. RESULTS: Of the children, 26.9% had a prior physician diagnosis of asthma. In addition, 12.9% of the children without a prior physician diagnosis of asthma reported symptoms consistent with moderate or severe persistent asthma. Overall, 39.8% of homeless children in New York City are likely to have asthma. Few children with persistent asthma received any anti-inflammatory treatment. Almost 50% (48.6%) of children with severe persistent asthma had at least 1 emergency department visit in the past year; 24.8% of children with symptoms of mild intermittent asthma had at least 1 visit. CONCLUSIONS: The prevalence of asthma among a random sample of homeless children in New York City is likely to be 39.8%-more than 6 times the national rate for children. Asthma in homeless children is also likely to be severe and substantially undertreated.