Urinary speciated arsenic and depression among US adults.

Arsenic is a naturally occurring chemical in the environment. The International Agency for Research on Cancer (IARC) declared arsenic a class 1 human carcinogen. The inorganic form of arsenic is considered toxic to the human population; arsenic is a neurotoxin and can cause memory dysfunction. Very few studies have investigated the association between exposure to arsenic and depression in humans. The purpose of this study was to assess the association between urinary speciated arsenic and depression among adults in the USA using the 2015-2016 National Health and Nutrition Examination Survey (NHANES) III dataset. Depression was measured using the nine-item Patient Health Questionnaire (PHQ-9). We computed a total depression score from the PHQ-9 and categorized individuals with a score ≥ 10 as depressed. The exposure included six different speciated arsenic concentrations dichotomized as at or above the limit of detection and below the limit of detection. We conducted a crude and multivariate logistic regression analysis using complex survey procedures to assess the association between speciated arsenic concentrations and depression. The sample included 1619 adults, of whom approximately half were females (51.69%) and married (53.29%). Seven percent of the sample had depression. Urinary arsenous acid was significantly associated with depression. In the adjusted model, arsenous acid was associated with depression with an odds ratio of 1.76 (95% CI 1.05-2.96, p = 0.035). No other forms of arsenic were significantly associated with depression. In this study, urinary arsenous acid was significantly associated with depression. Future research in humans is required to confirm or refute this finding.

The effect of glenosphere size on functional outcome for reverse shoulder arthroplasty.

PURPOSE: Reverse shoulder arthroplasty (RSA) is an effective surgery for a variety of patients with difficult shoulder pathology. Since postsurgical outcomes are often variable, there has been great effort made to optimize the design and use of these implants. Previous studies demonstrated an association between increased glenosphere size and improved range of motion. The purpose of this study is to assess the relationship between glenosphere size, range of motion, and functional outcome scores. METHODS: This is a retrospective cohort study of 140 patients (148 shoulders) undergoing reverse shoulder arthroplasty. All patients were assessed pre- and postoperatively for range of motion, Constant score, ASES score, and Subjective Shoulder Value. Improvements in these variables were compared for patients treated with three different glenosphere sizes (36, 40, 42 mm). RESULTS: All groups had a mean improvement in range of motion and functional outcome scores, but there were no statistically significant differences between groups when controlling for preoperative differences. CONCLUSIONS: Our findings do not support a strong role for glenosphere size as a singular factor affecting range of motion or patient-reported outcome following RSA. These problems are most likely due to the multifactorial nature of shoulder dynamics. For this reason, assessing the effect a single surgical or biomechanical parameter on function has been challenging.

The Better Beginnings, Better Futures project: findings from grade 3 to grade 9.

Although comprehensive and ecological approaches to early childhood prevention are commonly advocated, there are few examples of long-term follow-up of such programs. In this monograph, we investigate the medium- and long-term effects of an ecological, community-based prevention project for primary school children and families living in three economically disadvantaged neighborhoods in Ontario, Canada. The Better Beginnings, Better Futures (BBBF) project is one of the most ambitious Canadian research projects on the long-term impacts of early childhood prevention programming to date. Bronfenbrenner's ecological model of human development informed program planning, implementation, and evaluation. Using a quasi-experimental design, the BBBF longitudinal research study involved 601 children and their families who participated in BBBF programs when children were between 4 and 8 years old and 358 children and their families from sociodemographically matched comparison communities. We collected extensive child, parent, family, and community outcome data when children were in Grade 3 (age 8­9), Grade 6 (age 11­12), and Grade 9 (age 14­15). The BBBF mandate was to develop programs that would positively impact all areas of child's development; our findings reflect this ecological approach. We found marked positive effects in social and school functioning domains in Grades 6 and 9 and evidence of fewer emotional and behavioral problems in school across the three grades. Parents from BBBF sites reported greater feelings of social support and more positive ratings of marital satisfaction and general family functioning, especially at the Grade 9 follow-up. Positive neighborhood-level effects were also evident. Economic analyses at Grade 9 showed BBBF participation was associated with government savings of $912 per child. These findings provide evidence that an affordable, ecological, community-based prevention program can promote long-term development of children living in disadvantaged neighborhoods and produce monetary benefits to government as soon as 7 years after program completion.