Community Controls Research Articles

Understanding the Impact of Healthcare Providers’ Perspectives on Cancer Control in Rural Communities: A Qualitative Study

This study seeks to understand how healthcare providers perceive systemic- and individual-level factors affecting rural patients’ access to care and how this information impacts providers’ approach to cancer screening and prevention recommendations. Over a six-month period in 2021, we conducted semi-structured interviews with primary care providers, nurse navigators, and community health workers affiliated with a regional health system to better understand their perceptions of cancer control in rural communities. Thematic analysis was conducted to identify key themes and develop a conceptual framework to describe the pathway between information-gathering and care coordination – as well as how trust affects these relationships. We found that provider beliefs about barriers facing rural patients influence care recommendations and patient interactions. These beliefs and subsequent interactions affect trust between providers and patients, which influences whether rural patients are willing to believe providers, their adherence to care recommendations, and the information patients are willing to share with providers.

Spatial Patterns and Environmental Control of Polychaete Communities in the Southwestern Barents Sea

The Barents Sea region is influenced by an increased inflow of warm Atlantic water, which impacts all components of the local ecosystem. Information on the state of benthic communities is required to predict alterations in the food web’s structure and functioning. The spatial distribution of polychaete communities was investigated in relation to environmental conditions at nine stations along the Kola Transect (70°00′–74°00′ N, 33°30′ E) in April 2019. A taxonomically diverse fauna containing 114 taxa was found, with 95 identified at the species level. The fauna was composed predominantly of boreo-Arctic species (63%), followed by boreal (22%) and Arctic species (13%). The polychaete abundance and biomass exhibited considerable variability, ranging from 910 to 3546 ind. m−2 and from 3.4 to 72.7 g m−2, with average values of 1900 ind. m−2 and 18.7 g m−2, respectively. Cluster analysis revealed three distinct polychaete communities differing in dominant species composition, abundance, and biomass. The southern region featured the most abundant community, the middle part exhibited the highest diversity, and the northern area presented the community with the highest biomass. These spatial variations in community structure corresponded closely to the distribution and properties of water masses within the study area. Multivariate analysis identified depth as the primary driver of diversity indices, with higher values observed at shallow water sites. Salinity and water temperature together explained 46% of the variation in abundance, reflecting warming effects and showing positive or negative effects, depending on the taxa. Furthermore, an increase in water temperature had a positive impact on the contribution of boreal species to the total material, while exerting a strong negative effect on the overall community biomass, underscoring the potential of polychaetes in biological indication.

Sexual dysfunction among long-term survivors of Hodgkin lymphoma.

Survival rates from childhood cancer continue to increase, with an ongoing interest in long-term survivorship. Although infertility and gonadal failure are well recognized in Hodgkin lymphoma (HL) survivors, sexual dysfunction is less studied. The objective of this study was to compare the prevalence of sexual dysfunction in HL survivors with that in matched community controls. Long-term survivors of HL (n=186; female, 51.61%; mean age at diagnosis. 14.41 years [range, 3.01-22.60 years]; current mean±standard deviation age, 36.73±7.93 years) and matched community controls (n=182; female, 50.55%; mean±standard deviation age, 36.41±9.02 years) completed a comprehensive, in-person clinical assessment, laboratory battery, and the International Index of Erectile Function or the Female Sexual Function Index questionnaire. Male survivors had increased levels of erectile dysfunction (18.89% vs. 6.67%; p=.0239) but indicated no difference in sexual desire. Female survivors had a higher prevalence of sexual dysfunction compared with female controls (46.88% vs. 15.22%; p<.0001) and an increased prevalence of moderate-to-severe loss of sexual desire (38.04% vs. 23.26%; p=.0361). Female survivors with sexual dysfunction indicated increased levels of anxiety (p=.0184), depression (p=.0153), and worse physical and mental health (p=.0141 and p=.0419, respectively). Male survivors with erectile dysfunction had higher rates of anxiety and impaired physical health (p=.0147 and p=.0266, respectively). Sexual dysfunction was prevalent in this childhood and adolescent Hodgkin lymphoma survivor cohort and was associated with effects on quality of life. Health care providers must recognize the need for screening and intervention in this group to hopefully contribute to improved overall quality of life.

How Does Our Voice Reflect Who We Are? Connecting the Voice and the Self Using Implicit Association Tests

PurposeThis study examined the contribution of voice to the self via implicit associations. MethodAn implicit association test (IAT) of the voice and the self was created and presented to vocal performers and community controls. One-hundred eleven participants completed this voice-self IAT, the Vocal Congruence Scale (VCS), and the Voice Handicap Index (VHI) via an in-person, monitored, and timed Qualtrics survey. Student t tests comparing timing differences between congruent and incongruent conditions revealed the presence of an implicit relationship. ResultsThe findings demonstrated an implicit relationship between the voice and the self as measured using the IAT. Strength of implicit relationships between self and voice was significantly greater for community controls than vocal performers. Additionally, this IAT revealed divergent validity with the VCS, and the VHI using Spearman’s correlation. ConclusionImplications suggest that even if overt declarations are absent, individuals with an implicit voice-self relationship rely on their voice to contribute to their sense of self. This implicit relationship is greater for community members than vocal performers.

Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the PERCH study experience

ObjectivesAfter respiratory syncytial virus (RSV), human metapneumovirus (hMPV) was the second-ranked pathogen attributed to severe pneumonia in the PERCH study. We sought to characterize hMPV-positive cases in high burden settings, which have limited data, by comparing to RSV-positive and other cases. MethodsChildren aged 1-59 months hospitalized with suspected severe pneumonia and age/season-matched community controls in seven African and Asian countries had nasopharyngeal/oropharyngeal swabs tested by multiplex PCR for 32 respiratory pathogens, among other clinical and lab assessments at admission. Odds ratios adjusted for age and site (aOR) were calculated using logistic regression. Etiologic probability was estimated using Bayesian nested partial latent class analysis. Latent class analysis identified syndromic constellations of clinical characteristics. ResultsHMPV was detected more frequently among cases (267/3887, 6.9%) than controls (115/4976, 2.3%), among cases with pneumonia chest X-ray findings (8.5%) than without (5.5%), and among controls with respiratory tract illness (3.8%) than without (1.8%; all p≤0.001). HMPV-positive cases were negatively associated with the detection of other viruses (aOR=0.18), especially RSV (aOR=0.11; all p<0.0001), and positively associated with the detection of bacteria (aORs 1.77, p=0.03). No single clinical syndrome distinguished hMPV-positive from other cases. Among hMPV-positive cases, 65.2% were aged <1 year and 27.5% had pneumonia danger signs; positive predictive value was 74.5%; mortality was 3.9%, similar to RSV-positive (2.4%) and lower than other cases (9.6%). ConclusionsHMPV-associated severe pediatric pneumonia in high burden settings was predominantly in young infants and clinically indistinguishable from RSV. HMPV-positives had low case fatality, similar to that in RSV-positives.

Gut Microbiome in Human Melioidosis: Composition and Resistome Dynamics from Diagnosis to Discovery

Abstract Background Melioidosis, attributable to the soil-dwelling bacterium Burkholderia pseudomallei, stands as a paramount global health challenge, necessitating extended courses of antibiotics. While murine studies identified the gut microbiota as a modulator of bacterial dissemination during melioidosis, the human intestinal microbiota during melioidosis remains uncharacterized. Here, we characterized gut microbiota composition and antimicrobial resistance (AMR) genes at diagnosis, during treatment, and postdischarge for melioidosis. We hypothesized that the gut microbiota of melioidosis patients would be extensively distorted. Methods In this prospective observational cohort, stool samples of patients with culture-confirmed melioidosis admitted to a tertiary care hospital in India were collected at diagnosis, 14 days after diagnosis, or discharge (whichever occurred first) and at 6 months postinfection. Family members or neighbors served as community controls. The gut microbiota and resistome were profiled by shotgun metagenomic sequencing. Results We longitudinally analyzed the gut microbiota of 70 fecal samples from 28 patients and 16 community controls. At diagnosis, the gut microbiota of patients differed from that of controls, characterized by high abundances of potentially pathogenic bacteria, a loss of butyrate-producing bacteria, and higher levels of AMR genes. Microbiota composition and resistome remained different from community controls at 6 months, driven by total antibiotic exposure. During hospitalization, gut microbiota profiles were associated with secondary Klebsiella pneumoniae infections. Conclusions This first study on gut microbiota composition and resistome in human melioidosis showed extensive disruptions during hospitalization, with limited signs of restoration 6 months postinfection. Given the adverse outcomes linked with microbiome perturbations, limiting microbiota disruptions or using microbiota-restorative therapies (eg, butyrate-producing probiotics) may be beneficial.

Promoting ownership in local community health promotion interventions

Abstract Background A prerequisite for successful and sustainable implementation of local community health interventions is strong community ownership. Ownership is related to the level of perceived control of an intervention and its program components. Facilitation of community ownership involves engagement of the stakeholders within the community, e.g. in deciding what the problem is to whom and how to solve it. Much is known about methods to facilitate community engagement at a continuum between informing the community and community control. However, less is known about how different methods for community engagement work to foster and sustain ownership among local stakeholders. Aim To generate knowledge about how ownership is fostered or hindered among stakeholders across three different communities in a local community intervention with whole-of-community characteristics implemented to reduce overweight among children. The study also explores how synergies of ownership between various types of stakeholders at different organizational levels influence overall ownership and implementation of the intervention. Methods The study is designed as a multiple case study based on Robert K. Yin’s principles for case study evaluation. The study takes place in three different Danish Municipalities with different local contextual conditions. Various data sources are collected including sources of qualitative data comprising document analysis, observations, and interviews with key stakeholders. Preliminary results An influential contextual factor on local ownership is that implementation of the intervention and commitment to this in 10 years is a top-down decision at the policy level. Local stakeholders find the goals of the intervention meaningful to their day-to-day practices. However, they also experience a shortage of resources for participating and lack trust in higher management stakeholders to take shared leadership when the implementation phase ends. Key messages • Ownership is influenced by the degree of engagement. • Ownership is influence by the synergy of ownership between different stakeholders.

Efficacy of Praziquantel in Treating Schistosoma haematobium Infection Among Ethiopian Children

Background/Objectives: Praziquantel is a cornerstone of schistosomiasis control and elimination efforts. Continued surveillance of praziquantel efficacy is needed to monitor for the development of resistance, as well as to help public health officials gauge the effect of mass praziquantel administration on schistosomiasis control in communities, since it is the only drug used in schistosomiasis control programs. The objective of this study was to assess the praziquantel cure rate and egg reduction rate against urogenital schistosomiasis. Methods: This study enrolled 977 children from 12 villages in Afar and Gambella, Ethiopia, who provided urine samples that were checked for Schistosoma haematobium infection at baseline using urine filtration microscopy. Infected individuals were provided a single dose of praziquantel (40 mg/kg body weight) and retested six weeks post-treatment. Results:S. haematobium was recovered from baseline urine specimens in 177 of 977 (18%) participating children. One hundred six of these children completed therapy and presented for subsequent evaluation at six weeks; 91 children were egg-free. The egg reduction rate was 97%; changes in egg burden among the 15 children who did not achieve cure varied widely. Cure rates were better among children with light-intensity infections. No significant differences in egg reduction rates were found based on the demographic variables examined. Conclusions: Standard praziquantel monotherapy remains an effective treatment against urogenital schistosomiasis in Ethiopia.

Selective colonization of microplastics, wood and glass by antimicrobial-resistant and pathogenic bacteria.

The Plastisphere is a novel niche whereby microbial communities attach to plastic debris, including microplastics. These communities can be distinct from those found in the surrounding environment or those attached to natural substrates and may serve as a reservoir of both pathogenic and antimicrobial-resistant (AMR) bacteria. Owing to the frequent omission of appropriate comparator particles (e.g. natural substrates) in previous studies, there is a lack of empirical evidence supporting the unique risks posed by microplastics in terms of enrichment and spread of AMR pathogens. This study investigated selective colonization by a sewage community on environmentally sampled microplastics with three different polymers, sources and morphologies, alongside natural substrate (wood), inert substrate (glass) and free-living/planktonic community controls. Culture and molecular methods (quantitative polymerase chain reaction (qPCR)) were used to ascertain phenotypic and genotypic AMR prevalence, respectively, and multiplex colony PCR was used to identify extra-intestinal pathogenic Escherichia coli (ExPECs). From this, polystyrene and wood particles were found to significantly enrich AMR bacteria, whereas sewage-sourced bio-beads significantly enriched ExPECs. Polystyrene and wood were the least smooth particles, and so the importance of particle roughness on AMR prevalence was then directly investigated by comparing the colonization of virgin vs artificially weathered polyethylene particles. Surface weathering did not have a significant effect on the AMR prevalence of colonized particles. Our results suggest that the colonization of plastic and non-plastic particles by AMR and pathogenic bacteria may be enhanced by substrate-specific traits.

Interdependent Effects of Agro-input Node Interventions on the Adoption of Cattle milk Production Technologies among Smallholder Farmers in Kericho County, Kenya

Agricultural extension service delivery system is a vital component in agricultural development initiatives of any nation. Several extension approaches are used to achieve these initiatives. Globally, many Governments and development partners in rural agricultural development initiatives have gradually transitioned away from total state control of rural community and agricultural extension service delivery into adopting and supporting a more multifaceted system built on holistic participatory approach commonly referred to as Agricultural Value Chain Extension Approach (AVCEA). This AVCEA is relatively new in developing countries, including Kenya, and specifically in Kericho County where exploration on its impact on farm-level technology adoption has yet to be undertaken. The purpose of this study was to investigate the interdependent effects of agro-input node interventions on the adoption of cattle milk production technologies among smallholder farmers in Kericho, Kenya. This study adopted an ex-post-facto research design and systematic random sampling technique to select a sample of 132 farmers who previously exposed to AVCEA. Interviews were conducted for eight (8) dairy production experts and 6 Dairy organization representatives as key informants. The primary data were collected using interview schedules, questionnaires and focus group discussion tools. The data were analyzed for descriptive statistics like frequencies, percentages and inferential statistics like Chi-square tests with the aid of SPSS version 26.0. The results of the study indicated that there was a significant interdependence between some agro-input value chain node interventions and the adoption of cattle milk production technologies. There was also Interdependence between ease of access to farmers ‘groups/cooperative societies and the adoption of cattle milk production technologies by the smallholder farmers. Based on findings of this study, Agricultural experts, stakeholders, and other concerned bodies should focus on developing strategies to strengthen interventions at the agro-input node, particularly by fostering cooperation among smallholder farmers to enhance collective actions.

Low prevalence of soil transmitted helminth infection in Ugandan children hospitalized with severe malaria.

Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed 202 stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014-2017 and asymptomatic community children from the same household or neighborhood and enrolled at the same time, all 6 months to 48 months of age. We investigated if intestinal helminth infection modified risk of severe malaria. We extracted nucleic acids from stool and tested them for six helminth species (Anyclostoma duodenale, Ascaris lumbricoides, Necator americanus, Strongyloides stercolaris, Trichuris trichiura, Shistosoma mansoni) using highly sensitive quantitative PCR. We found a low prevalence of infection by ≥1 intestinal helminth species in children with severe malaria (5.1%, n=9/177) and community control children (4.0%, n=1/25). Infection by ≥1 of the helminths assessed was not associated with severe malaria (aRR = 1.0, 95% Confidence Interval = 0.82, 1.3, p = 0.78). In 2003 Uganda instituted a national deworming program, with anti-helminth medication provided twice annually to children 6 months to 5 years of age. In these areas of Uganda, the national deworming campaign has been highly successful, as stool-based helminth infection was rare even when using highly sensitive methods of detection and was not a major contributor to risk of severe malaria.

No Viral No Justice in the Law Enforcement System: The Study of Domestic Violence

Social media can indirectly have a great influence on the current law enforcement system. In principle, public participation through social media has a positive impact arising from community control on social media, one of which is as an effort in law enforcement to be more transparent and accountable. Regarding cases of domestic violence, in fact, until now, there are still many victims of domestic violence who do not speak up to voice their suffering. Even though the case has gone viral on social media and has received much public attention, the cases will likely be quickly processed by law enforcement officials and escorted by the community on social media, so it is hoped that the victim will get justice. The research method used is descriptive analysis, which describes or provides an overview of the object being researched, either through data or through samples collected as they are. A form of analysis is carried out, and a conclusion is made that applies to the general public. The materials used in this study are literature, consisting of primary, secondary, and tertiary materials. The phenomenon of domestic violence (KDRT) has been increasing lately. Data collected from January to August 2024 recorded 15,490 cases of violence. Domestic violence cases dominated the report, with a total of 9,503 cases. One of the law enforcement processes in tackling domestic violence cases is also triggered by the virality that arises in social media.

Validation of the French version of the preschool form of the social responsiveness scale-second edition (SRS-2-P)

ObjectivesTo evaluate the psychometric properties of the French form of the preschool social responsiveness scale-2 (SRS-2-P-Fr). ParticipantsA sample of French children aged 2 to 4 years comprising a group of 93 children with autism spectrum disorder (ASD) and a community control group of 201 children. Materials and methodsStudy of internal consistency using Cronbach's α coefficient, convergent validity using correlations with the ADI-R and ADOS-2, and diagnostic accuracy using the receiver operating characteristic curve to determine the best threshold scores useful for screening ASD in preschool children. ResultsGood internal consistency (0.78 to 0.98) according to Cronbach's alpha coefficients for the total score and the sub-scores of the SRS-2-P scale. The study of convergent validity showed strong correlations with the total score of the ADOS-2 Toddlers and the communication and reciprocal social interaction sub-scores of the ADI-R. Diagnostic accuracy indicated that the best cut-off score for detecting ASDs was 56 (area under the curve=0.97, sensitivity 0.925, specificity 0.98). ConclusionThe SRS-2-P-Fr is a valid instrument for the early detection of ASD in preschool children in France and can facilitate diagnosis.

Field Effectiveness of a Typhoid Conjugate Vaccine: The 2018 Navi Mumbai Pediatric TCV Campaign.

Typbar-TCV®, a typhoid conjugate vaccine (TCV), was prequalified by the World Health Organization in 2017. We evaluated its effectiveness in a mass vaccination program targeting children 9 months to 14 years in Navi Mumbai, India, from September 2018 to July 2020. We compared laboratory-confirmed typhoid cases from six clinical sites with age-matched community controls. Of 38 cases, three (8.6%) received TCV through the campaign, compared with 53 (37%) of 140 controls. The adjusted odds ratio of typhoid fever among vaccinated children was 0.16 (95% CI: 0.05-0.55), equivalent to a vaccine effectiveness of 83.7% (95% CI: 45.0-95.3). Vaccine effectiveness of Typbar-TCV in this large public sector vaccine introduction was similar to prior randomized controlled trials, providing reassurance to policymakers that TCV effectiveness is robust in a large-scale implementation.

Social Support for Thai Adults with Type 2 Diabetes: A Case-Control Study.

Non-communicable diseases, including type 2 diabetes (T2DM), are the number one cause of death in Thailand. With its well-known social networking and strong kinship, evidence of social support may be a potential of low-cost approach for T2DM self- management. Social support is quite important for T2DM prevention and control but such evidence in Thai setting is still limited. Therefore, we aimed to study social support and associated determinants for T2DM patients compared to non-diabetes people. An observational study with a case-control study design was conducted in Chiang Mai, Thailand, in 2019-2020. Using inclusion and exclusion criteria, a total of 300 participants: 150 cases, 150 controls were recruited. Participants were selected based on outcome status of having "T2DM". Cases were defined as newly diagnosed (diagnosis of T2DM within 6 months) adult Thai residents and community controls were non-diabetes participants from the same residential area of cases. Data were analyzed by STATA 17. Descriptive analysis compared the characteristics between case and control group. The relation between social support and T2DM was investigated using multivariable Robust regression analysis. About 96.7% of T2DM patients had good social support. T2DM had a significant association with social support in all models defined by potential confounders. Social support was significantly positively associated with having family mealtimes in model 2 and model 3 and increasing age in model 2. BMI and T2DM family history had significant negative association in model 2 and model 3. Social support of Thai T2DM patients is higher than control group. It can either be originated from a newly acquired peer groups network or from the positive social support by family. Future research should focus on behavioral intervention including family and peers to help them understand their role in life-style modification and management of such a prevalent chronic disease.

Strong large‐scale structure–function coupling in benthic bacteria is mediated by algae in a geodiverse river network

AbstractBenthic bacteria in stream ecosystems drive organic matter mineralization. However, knowledge on how this ecosystem function is driven by bacterial community composition in interaction with environmental conditions and organic matter resources is poor. This is especially true when considering the regional scale of river networks, at which environmental conditions vary in a scale‐dependent manner and are spatially structured due to asymmetrical water flow. Similarly, organic matter resources may have a terrestrial origin in remote headwaters or be sourced locally from algae living in close proximity to bacteria in benthic biofilms. We investigated benthic biofilm meta‐community structure and function across the &gt; 6700 km2 river network of the near‐natural Vjosa in Albania and Greece and found a strong control of the benthic algal community on bacterial community composition (13.4% of variability explained). In addition, bacterial community composition has linkages to water chemistry, which itself is strongly shaped by the diverse geology in the catchment, and to dispersal, shaping metacommunity structure as a neutral process. Notably, bacterial community composition explained the largest single fraction of variability (31.5%) in extracellular enzymatic activities, while there was no dependency of enzyme ratios on organic matter nor environmental conditions. Synergistic effects between bacteria and algae accounted for additional 47.3% of variability in heterotrophic functioning, emphasizing the importance of algal–bacterial interactions in benthic biofilms. Our findings shed new light on bacterial structure–function coupling highlighting the importance of algal–bacterial interactions at the river network scale.

Autonomic Dysfunction Among Adult Survivors of Childhood Cancer in the St. Jude Lifetime Cohort Study

BackgroundThe burden and functional significance of autonomic dysfunction among survivors of childhood cancer is unknown. ObjectivesWe evaluated the prevalence, risk factors, and functional relevance of autonomic dysfunction in survivors. MethodsWe conducted a cross-sectional prospective evaluation of 1,041 adult survivors of childhood cancer treated with anthracyclines (31.1%), chest-directed radiation (13.5%), both (19.5%), or neither (35.9%), and 286 community control subjects enrolled in the SJLIFE (St Jude Lifetime Cohort Study). Four measures of autonomic dysfunction were evaluated: elevated resting heart rate, decreased heart rate reserve, decreased systolic blood pressure response to exercise, and delayed heart rate recovery. Logistic regression tested associations with impaired cardiorespiratory fitness (peak Vo2 < 80% predicted). ResultsSurvivors (50.7% female) were 9.0 ± 5.8 years at cancer diagnosis and 35.5 ± 8.9 years at evaluation. Prevalence (survivors vs control subjects) of elevated resting heart rate (17.9% vs 7.0%), decreased heart rate reserve (21.7% vs 9.1%), decreased systolic blood pressure response to exercise (25.3% vs 12.6%), and delayed heart rate recovery (24.3% vs 10.6%) was more than 2-fold higher among survivors (P < 0.001 for all). Carboplatin (adjusted OR: 2.50; 95% CI: 1.42-4.40; P = 0.001), chest-directed radiation therapy (adjusted OR: 2.06; 95% CI: 1.52-2.75; P < 0.001), and cranial radiation (adjusted OR: 1.49; 95% CI: 1.08-2.05; P = 0.015) were associated with an increased likelihood of having ≥2 measures of autonomic dysfunction. Survivors with ≥2 measures of autonomic dysfunction were at increased risk for impaired cardiorespiratory fitness (adjusted OR: 2.71; 95% CI: 1.82-4.02; P < 0.001). ConclusionsSurvivors of childhood cancer manifest a higher prevalence of autonomic dysfunction associated with impaired cardiorespiratory fitness.

Perceived Community Control in Adults with Acute Low Back Pain: A Community-Based Study.

Low back pain (LBP) is the leading cause of disability for individuals and societies globally. Prior investigations have predominantly centered around biological and psychological factors. Addressing social determinants is critical for enhancing the effectiveness and equity of pain interventions. We aimed to characterize social factors, sleep, and pain among adults with acute LBP, focusing on perceived community control. A community-based sample of adults with acute LBP was recruited from two cities in North Carolina, United States, and followed up at 3 months. We used descriptive statistics to characterize social factors, sleep, and pain, overall and by levels of perceived community control. In total, 110/131 enrolled participants had data on perceived community control (lower scores indicate higher control). Overall, the median perceived community control was 14 (interquartile range [IQR] = 11, 15). People with high perceived community control also had, on average, higher perceived individual control, better-perceived neighborhood walkability, lower number of sites with bothersome comorbid pain, and higher sleep quality. A higher proportion of participants with high perceived community control were of male sex, White race, and had a higher socioeconomic position. Community control and related constructs may be further explored in future intervention development as potentially modifiable social factors that may reduce pain burden.

Universal personality dimensions and dysfunctional obsessional beliefs in the DSM-5’s OCD and related disorders (OCRDs)

ABSTRACT This study aimed to determine the extent to which personality and cognitive factors contribute to the identification of shared associations between the DSM-5’s OCD and Related Disorders (OCRDs). Participants (n = 239) were treatment-seeking outpatients with a principal diagnosis of obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), trichotillomania (TTM), or excoriation disorder (EXC), as compared to healthy community controls (n = 100). Analyses examined the relationships between diagnostic group, personality dimensions, and obsessive beliefs. Results demonstrated that compared to non-clinical controls, all diagnostic groups scored significantly higher on neuroticism and lower on extraversion and conscientiousness. Few significant differences were found across diagnostic groups: extraversion was higher in the TTM group (vs. all OCRDs), conscientiousness was lower in the HD group (vs. OCD, TTM, EXC), and openness to experience was higher in the TTM and EXC groups (vs. OCD, HD). Obsessional beliefs were significantly elevated in all clinical conditions (vs. controls) except for beliefs surrounding responsibility and threat estimation, which were only significantly higher in OCD and BDD groups. These results highlight shared personality and cognitive vulnerability in the OCRDs as well as unique disorder-specific vulnerabilities related to OCD.

Fine Motor Impairment and Its Impact on Social Outcomes in Survivors of Pediatric Acute Lymphoblastic Leukemia: St. Jude Lifetime Cohort Study.

The impact of fine motor impairment among adult survivors of childhood acute lymphoblastic leukemia (ALL) on life after treatment is unknown. This study evaluated prevalence and utilized multivariate logistic regression to identify risk factors for fine motor impairment among survivors of ALL, and associations with educational attainment and social independence. Latent class analysis defined social independence (independent, moderately independent, dependent), using employment, independent living, personal care assistance, routine need assistance, driver's license status, and marital status inputs. Among 875 survivors who were ≥ 25years old (age when most adults achieve independence) and ≥ 5years from diagnosis (mean = 28.97years), 33.6% had fine motor impairment, with scores at or below the 10th percentile of the scores of community controls (n = 460) on fine motor components of the physical performance test and the grooved peg-board test. Survivors exposed to cranial radiation had more fine motor impairment than those without (45.8% vs 20.2%). Male sex (exposed: odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.65-3.92; unexposed: OR = 3.02, 95% CI = 1.69-5.38) and lower scores on the Wechsler abbreviated scale of intelligence (exposed: OR = 0.46, 95% CI = 0.36-0.58; unexposed: OR = 0.43, 95% CI = 0.31-0.58) were risk factors for neuropathy. A 1-point-higher total neuropathy score was associated with 8% (95% CI = 1%-17%) increased odds of fine motor impairment. Fine motor impairment was associated with less than a college education (less than high school: OR = 2.23, 95% CI = 1.20-4.14; high school diploma/general equivalency diploma: OR = 2.66, 95% CI = 1.65-4.30; vocational education: OR = 2.07, 95% CI = 1.38-3.13) and less social independence (moderately independent: OR = 1.80, 95% CI = 1.15-2.83; dependent: OR = 2.65, 95% CI = 1.25-5.64). Fine motor impairment in survivors of childhood ALL may interfere with optimal educational attainment and social independence. Early identification of survivors at risk for fine motor impairment, with timely intervention, may improve long-term outcomes.