Early Adulthood Research Articles

A Proposed Algorithm for the Pharmacological Treatment of Generalized Anxiety Disorder in the Older Patient.

This is a new algorithm from the Psychopharmacology Algorithm Project at the Harvard South Shore Program, focused on generalized anxiety disorder (GAD) in older adults. Pertinent articles were identified and reviewed. Selective serotonin reuptake inhibitors (SSRIs) are considered to be first-line medications, with a preference for sertraline or escitalopram. If avoiding sexual side effects is a priority, buspirone is an option for the relatively healthy older adult. If response is inadequate, the second recommended trial is with a different SSRI or one of the serotonin-norepinephrine update inhibitors (SNRIs), venlafaxine or duloxetine. For a third medication trial, additional alternatives added to the previous options now include pregabalin/gabapentin, lavender oil, and agomelatine. If there is an unsatisfactory response to the third option chosen, quetiapine may be considered. We recommend caution with the following for acute treatment in this population: benzodiazepines and hydroxyzine. Other agents given low priority but having some supportive evidence were vilazodone, vortioxetine, mirtazapine, and cannabidiol. Acknowledging that the median age of onset of GAD is in early adulthood, many patients with GAD will have been started on benzodiazepines (or other medications that require caution in the elderly) for GAD at a younger age. These medications may be continued with regular observation to see if the potential harms are starting to exceed the benefits and a switch to other recommended agents may be justified.

Psychosocial Impact of Covid-19 Pandemic on Women’s Mental Health

Women mental health and impact of psychosocial factors on it, is highlighted in various psychological & clinical studies, due to pandemic made it a matter of more focus. Studying the long-term impacts of the coronavirus on society, our mind, body and its analysis perhaps will take more time. Out of the total population, a number of people felt a disrupted sleep as a hallmark of the pandemic, and suffered from depression, insomnia, irritability, violence including domestic violence, distress, work pressure due to online culture of work, and other related negative mental health symptoms as idiosyncratic attributes especially in covid sufferers. Covid-19 pandemic has altered family dynamics. More screen time, unended & fluctuated routines, for working women dissolving boundaries in workplace and personal life altered & flicking habits, all impacted mental health adversely. The human brain is evolved to live in social groups & wired for social interactions, epidemiological studies conducted on covid survivors, convalescents & victims shows altered brain biochemistry due to various psychosocial factors including financial losses, social isolation, intimate partner’s negative mental state, discrimination, disrupted sleep & routines, etc. Pandemic might has altered the romantic and loving relationships, and adversity of such psychosocial factors impacted people. Psychological strengths and resilience mainly depend on social determinants like social support, social culture, respect, engagement at workplace, parenting style in childhood & emotional attachment, society & family bonds, self-regulation & behavior controlling, and collective efficacy, all these determinants are positively associated with self-esteem that have direct impact on enhancing psychological strengths. Population for the study as participants were females in early adulthood & studying, professional and housewives. For data analysis, the statistical tools, descriptive, co-relational and regression analysis is used. The study focuses on effect of adverse aspects of adversity like pandemics financial crises like job losses, allowances or salary deductions, led to economic abuses, and somewhere gender discrimination, sexual abuse, household workload, escalation in family members expectations and responsibilities, adverse impact of these psychosocial factors on women’s mental health and role of education, knowledge, skills, and aptitude i.e. abilities & cognitive competencies in coping and managing the adversities like pandemic.

The Effect of Mindfulness and Loneliness on Sense of Purpose in Individuals in the Age of Quarter Life Crisis

Sustainable Development Goals (SDGs) represent a global effort to achieve sustainable prosperity for all, with a strong focus on the quality of the next generation, particularly the youth. The future of a nation is closely tied to the quality of its young population. Early adulthood is a crucial period for determining career paths and life goals, which directly impact personal development and self-quality. One of the critical challenges faced during this period is the quarter life crisis (QLC), characterized by confusion over life purpose. In Indonesia, data shows that more than half of youth experience QLC, typically occurring between the ages of 18 and 35. This study aims to explore the factors influencing a sense of purpose to offer effective strategies for addressing the quarter life crisis. The research was conducted using a quantitative approach with non-probability sampling and survey methods. The sample consisted of 196 respondents (71.7% female and 28.3% male). Data analysis was performed using multiple linear regression with the assistance of SPSS version 8.0 software. Results revealed that mindfulness and loneliness have a significant impact (p<0.05) on the sense of purpose in individuals experiencing QLC, with an R-squared value of 0.090, indicating a 9% influence. These findings highlight the need for targeted counseling and psychological support services to address the quarter life crisis. Providing counseling that focuses on enhancing mindfulness and reducing loneliness can help individuals strengthen their sense of purpose, ultimately enabling them to navigate this challenging life stage more effectively.

Dynamics in the heritability of leadership role occupancy: Evidence from a three-wave twin sample

Studies show that genetics matter in who becomes a leader. However, we know little about the dynamic properties of the heritability of leadership emergence or how genetics might interact with environmental conditions to shape leadership emergence. We track leadership role occupancy at three time points among a cohort of 1,079 Danish twin pairs over ten years. Our results suggest that genetics matter less when the cohort is young and increase over time as the cohort grows older. We argue that labor market entry costs coupled with free access to education constrain the effect of genetics in the cohort during early adulthood, suggesting differing effects of the environment on genetic expression as the cohort ages. Sorting based on individual predisposition towards leadership likely strengthens as the cohort grows older and gains labor market experience. This result implies that we should not view the effect of genes on leadership role occupancy as static and that environmental experiences could disproportionately affect critical early leadership advancement. Our study reinforces calls to consider dynamic properties such as gene x environment interactions to advance our broader understanding of leadership’s biology.

Long term outcome of IgE-mediated cow's milk allergy and risk factors for persistence

Resolution rates of IgE-mediated cow's milk allergy (IgE-CMA) by age 5 years, and risk factors for its persistence were previously described. To extend follow-up until the end of adolescence. An extension study of 23 of 54 patients diagnosed with IgE-CMA from a population-based study of 13,019 newborns, who remained allergic at age 5 years. Patients were examined at age 17 and their history reviewed. Resolution was determined by regular milk consumption without adverse reactions, or a negative oral food challenge (OFC). Allergy was defined by a recent objective reaction to milk and a positive skin prick test (SPT), or by sensitization ≥95% PPV to milk. Risk factors for persistence at age 17 were examined in the entire cohort. Of the 23 patients followed, 8/23 (35%) had spontaneous resolution, and 15 had persistent IgE-CMA. Overall, 39 (72.2%) of the 54 patients initially diagnosed with IgE-CMA had spontaneous resolution by age 17. Risk factors for IgE-CMA persistence at age 17 years included SPT >6 mm at time of diagnosis (p=0.03), no cow's milk formula feeding in the nursery (p=0.008), and wheezing on diagnostic OFC/initial reaction to milk (p=0.04). Seven patients experienced objective reactions after age 5 years. These patients had more wheezing (p=0.045) or anaphylaxis (p=0.02) on diagnostic OFC/initial reaction and more current asthma (p=0.007). Significant rate of spontaneous resolution of IgE-CMA still occurs beyond age 5 and few patients with IgE-CMA, mostly asthmatics, experience objective reactions by early adulthood. This should be considered in the treatment approach of IgE-CMA patients.

The Impact Of Physical Activity In Adolescence On Cardiovascular Health In Early Adulthood

The Impact Of Physical Activity In Adolescence On Cardiovascular Health In Early Adulthood

Association of youth climate change worry with present and past mental health symptoms: a longitudinal population-based study

Young people are worried about climate change but the association with current and past mental health symptoms is rarely examined in longitudinal population-based samples. Drawing on a population-based birth cohort from the Canadian province of Quebec (n = 1325), this study used a cross-over design to (1) test the association between climate change worry at age 23-years and concurrent mental health symptoms assessed on standardised instruments, and (2) test the association between adolescent (15 and 17 years) symptoms of anxiety, depression, inattention-hyperactivity, and aggression-opposition and climate worry at age 23-years. Participant sex, cognitive ability, socioeconomic status, and parental mental health were adjusted for. Descriptive statistics showed that most participants were worried about climate change: 190 (14.3%) were extremely worried, 383 (28.9%) were very worried, 553 (41.7%) were somewhat worried, and 199 (15.0%) were not at all worried. In analysis 1, worry about climate change was associated with significantly higher concurrent anxiety, depression, and self-harm symptoms, even after adjustment for adolescent symptoms. In analysis 2, anxious adolescents were significantly more likely to be extremely worried about climate change six years later (RRR = 1.51, 95%CI = 1.10–2.07), while aggressive-oppositional adolescents were significantly less likely to be somewhat worried (RRR = 0.79, 95%CI = 0.63–0.0.99), very worried (RRR = 0.61, 95%CI = 0.48–0.78), or extremely worried (RRR = 0.51, 95%CI = 0.37–0.72). Taken together, participants who were worried about climate change had more concurrent mental health symptoms but were also more likely to have prior symptoms. Adolescents with higher anxiety were more likely to worry about climate change in early adulthood, while those with higher aggression-opposition were less likely to worry. Future studies should track climate worry longitudinally alongside symptoms using prospective follow-up studies.

Life stage-specific effects of heat stress on spermatogenesis and oogenesis in Drosophila melanogaster.

Biodiversity is increasingly threatened by unpredictable, frequent, and intense climatic events like heatwaves that pose harmful impacts on ectotherms. Beyond the health and survival of organisms, reduced reproductive performance has emerged as a critical fitness consequence of thermal stress induced by high temperatures. Many studies on these effects expose organisms to heat stress during the adult stage or throughout development, often focusing on cumulative effects across life stages, and they tend to examine one or the other sex. This approach may not reflect the short-term nature of many extreme heat events and limits our understanding of stage- and sex-specific fitness consequences in short-lived organisms. To address this gap, we used Drosophila melanogaster to investigate the sex-specific reproductive performance following short heat stress of varying intensity at different developmental stages. We found the thermal sensitivity to be higher in males than females, and to increase toward adult emergence, leading to nearly complete reproductive failure and substantially slowed recovery. These results highlight how even brief bouts of heat stress during a sensitive phase could affect population dynamics and persistence. Our findings also underscore that incorporating both sex and life stage could improve predictions of species persistence.

Optimizing the incubation conditions of third-stage larvae of the camel nasal bot Cephalopina titillator (Diptera: Oestridae) for harvesting adult flies

Background and Aim: Understanding the developmental conditions of Cephalopina titillator larvae and their effect on the success of pupation and adult emergence can help prevent and control this disease in camels. Incubating C. titillator larvae in vitro requires optimized conditions that have not been adequately reported in the literature. This study aimed to optimize conditions for harvesting adult flies from third-stage larvae (L3). Materials and Methods: L3 collected from naturally infested camels was washed in sterile saline, weighed, and placed in vials containing local sand. The vials were covered with gauze and incubated at 30°C–36°C with 60%–62% relative humidity in an environmental chamber. Results: A minimum critical weight of 754 mg per larva was found to be essential for the successful eclosion of the adults, regardless of the sex of the emerged flies. The pupariation period lasted 1–8 days (d) and took 5–13 days. Most incubated L3 formed puparia, but most failed to emerge as adults. The success rate of eclosion was 37.1%. The hatched adults survived for up to 18 days, and the females survived longer (12 d; 6–18) than the males (8.1 d; 3–16). Conclusion: The higher eclosion success tendency of certain sand types might be influenced by the sand’s physical and/ or chemical characteristics. The current in vitro conditions resemble those during the hot seasons and are suitable for harvesting viable adults of C. titillator from L3. Keywords: camel nasal bot, Cephalopina titillator, eclosion success, in vitro incubation, life span, myiasis.

Adherence Patterns and Health Outcomes in Spanish Young Women Participating in a Virtual-Guided HIIT Program: Insights from the Randomized Controlled WISE Trial

Background/Objectives. A notable decline in physical activity from late adolescence to early adulthood affects young women especially. This study aimed to investigate adherence to an unsupervised virtual-guided high-intensity interval training (HIIT) exercise program among young women in Spain. Methods. A total of 106 participants were recruited and randomized to the Women’s Involvement in Steady Exercise (WISE) trial exercise program, administered remotely via a mobile app, and a control group. The primary outcome was adherence measured through daily steps. Secondary variables were patient-reported outcomes of physical activity, quality of sleep, and quality of life, assessed with the International Physical Activity Questionnaire (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), and the Health Lifestyle and Personal Control Questionnaire (HLPCQ), respectively. The assessments were performed over 6 months, before the intervention (T0), at the halfway of the program (T1), and at the end (T2). Results. Daily steps revealed a decrease from baseline to final assessment in both groups. Secondary outcomes indicated a shift in physical activity levels, showing a transition from low to moderate and high activity perception. While sleep quality deteriorated post-intervention, quality of life showed no changes. Conclusions. The WISE trial highlights the potential and challenges of an unsupervised virtual-guided HIIT program for young women. While an improvement in physical activity levels was noticed, it also led to a decrease in daily steps and poorer sleep quality. These findings suggest a complex relationship between exercise and lifestyle factors, which could potentially have the greatest impact.

Comparing the cardiorespiratory safety of parenteral olanzapine and benzodiazepines to parenteral haloperidol/droperidol and benzodiazepines in emergency department patients

IntroductionThis study sought to assess the cardiorespiratory safety of parenteral olanzapine and benzodiazepine combination treatment compared to parenteral droperidol or haloperidol and benzodiazepine combination treatment. Materials and methodsThis was a retrospective chart review conducted in adult emergency department patients who received intramuscular (IM) or intravenous (IV) droperidol, haloperidol, or olanzapine within one hour of IM or IV benzodiazepine. Patients were stratified into groups based on whether they received either olanzapine in combination with a benzodiazepine (n = 48) or droperidol or haloperidol in combination with a benzodiazepine (n = 48). ResultsPatients in each group had a decrease in their systolic blood pressure (SBP) after IM/IV olanzapine and IM/IV droperidol or haloperidol when used in combination with an IM/IV benzodiazepine ((Olanzapine + benzodiazepine (mmHg), median (IQR): Pre-SBP: 132 (117–151) vs. Post-SBP: 117 (99–131), p < 0.01) (Droperidol or haloperidol + benzodiazepine (mmHg), median (IQR): Pre-SBP: 138 (122–149) vs. Post-SBP: 106 (98–127), p < 0.01)). Both groups had similar percent SBP decreases post-combination treatment (Olanzapine + benzodiazepine (15.6 %) vs. Droperidol or haloperidol + benzodiazepine (15.2 %); p = 0.55). We did not observe any statistically significant between group differences for hypotension (Olanzapine + benzodiazepine: 1/48, 2.1 % vs. Droperidol or haloperidol + benzodiazepine: 3/48, 6.3 %; p = 0.62)), escalation in oxygen requirements (Olanzapine + benzodiazepine: 7/48, 14.6 %) vs. Droperidol or haloperidol + benzodiazepine: 5/48, 10.4 %; p = 0.76)), or intubation due to cardiorespiratory depression (Olanzapine + benzodiazepine: 0/0, 0 % vs. Droperidol or haloperidol + benzodiazepine: 0/0, 0 %; p = 1.00)). ConclusionThis study found decreases in SBP after administering parenteral olanzapine and parenteral droperidol or haloperidol in combination with a parenteral benzodiazepine. The percent change in SBP and the frequency of hypotensive episodes post-combination treatment were not different between groups. There were also no differences between groups in need of increased oxygen requirements post-combination treatment or need for intubation due to cardiorespiratory depression. This study suggests parenteral olanzapine in combination with a parenteral benzodiazepine may have comparable cardiorespiratory safety versus parenteral droperidol or haloperidol in combination with a parenteral benzodiazepine when treating agitation in the adult ED.

The effect of childhood emotional abuse on binge eating in early adulthood : mediating effect of internalized shame and mediated moderating effect of decentering

The effect of childhood emotional abuse on binge eating in early adulthood : mediating effect of internalized shame and mediated moderating effect of decentering

Metabolic syndrome is associated with reduced default mode network functional connectivity in young post-9/11 Veterans.

Metabolic syndrome is a collection of health factors that increases risk for cardiovascular disease. A condition of aging, metabolic syndrome is associated with reduced brain network integrity, including functional connectivity alterations among the default mode, regions vulnerable to neurodegeneration. Prevalence of metabolic syndrome is elevated in younger populations including post-9/11 Veterans and individuals with posttraumatic stress disorder, but it is unclear whether metabolic syndrome affects brain function in earlier adulthood. Identifying early effects of metabolic syndrome on brain network integrity is critical, as these impacts could contribute to increased risk for cognitive disorders later in life for Veterans. The current study examined whether metabolic syndrome and its individual components were associated with default mode functional connectivity. We also explored the contribution of posttraumatic stress disorder and traumatic brain injury on these metabolic syndrome-brain relationships. Post-9/11 Veterans with combat deployment history (95 with and 325 without metabolic syndrome) underwent functional magnetic resonance imaging to capture seed-based resting-state functional connectivity within the default mode. The metabolic syndrome group demonstrated reduced positive functional connectivity between the posterior cingulate cortex seed and the bilateral superior frontal gyrus. Data-driven analyses demonstrated that metabolic syndrome components, particularly cholesterol and central adiposity, were associated with widespread reductions in default mode network connectivity. Functional connectivity was also reduced in participants with metabolic syndrome but without current posttraumatic stress disorder diagnosis and with traumatic brain injury history. These results suggest that metabolic syndrome disrupts resting-state functional connectivity decades earlier than prior work has shown.

성격 잠재계층에 따른 사회적 고립과 심리적 유연성의 차이

Objective: To investigate the psychosocial variables related to social isolation, which is emerging as a common social problem in early, middle, and late adulthood, and to identify how latent personality traits class is related to social isolation and psychological flexibility. Methods: One-way analysis of variance, correlation analysis, and latent profile analysis were conducted on 469 adults aged 20-69 using BFI-SF, ESLI, and K-AAQ-II. Results: First, in terms of age differences, social isolation was not statistically significant, and psychological flexibility was statistically significant, with old age being higher than other age groups. Second, each variable showed a mostly significant correlation. Social isolation showed a negative correlation with extroversion, conscientiousness, and agreeableness, and a positive correlation with neuroticism. Psychological flexibility showed a positive correlation with extroversion, openness, conscientiousness, and agreeableness, and a negative correlation with neuroticism. Social isolation and psychological flexibility showed a negative correlation. Third, the latent profiles of personality traits were classified into four types: “unstable energetic” (16%), “normal average” (58%), “adaptive flexible” (18%), and “passive avoidant” (8%). Fourth, the differences in social isolation and psychological flexibility according to the latent class of personality traits were found to be significant. In social isolation, the “passive avoidant” was the highest and “adaptive flexible” the lowest, while in psychological flexibility, the “adaptive flexible” was the highest and “passive avoidant” the lowest. Conclusions: This study predicted a relationship between social isolation and age and psychosocial variables. It broadens the comprehensive understanding of personality traits vulnerable to social isolation and personality traits with high psychological flexibility according to adult personality traits. Therefore, it has implications for counseling interventions and preventive approaches based on social isolation group considering individual differences in age, various personality traits, and psychological flexibility.

Temperature and relative humidity mediated life processes of Spodoptera species (Lepidoptera: Noctuidae)

AbstractAnthropogenic-mediated climate change is expected to negatively affect pest management in agriculture. Hence, we investigated the oviposition, immature mortality, and developmental processes of Spodoptera species (Spodoptera exigua (Hübner) and Spodoptera litura (Fabricius)) under different temperatures (20, 25, and 30°C) and relative humidity (RH) (30–35, 50–55, 70–75, and 90–95%) conditions. For fecundity, mouths of each Spodoptera species were released into a rectangular box whose inner walls were covered with a sheet of white paper for each combination of temperature and RH. The mouths were kept inside the box to deposit eggs for 72 h. Temperature and RH significantly affected the fecundity, with the maximum number of eggs laid in 70–75% at 30°C. The highest egg and larval mortalities were recorded in 30–35 and 90–95% RH, respectively. Temperature and RH greatly affected the developmental period (egg–adult) and adult emergence rate. The rapid development was recorded in 70–75% RH at 30°C. Higher number of adults was found with an increase in temperature and RH. Adult longevity was significantly higher in 70–75% RH at 20°C. Based on the present study's findings, temperature and RH had an individual apparent effect on the developmental processes of Spodoptera species instead of an interactive effect. Therefore, there is need for an in-depth study of the influence of several climatic factors, including CO2, on the developmental modality and demographic changes of Spodoptera species to assess the impacts of climatic components and the sustainable development of management strategies.

INVESTIGATION OF COMBINED EFFECT OF THREE PLANT POWDERS WITH DIATOMACEOUS EARTH AGAINST CALLOSOBRUCHUS MACULATUS

The study was conducted to investigate the combined effects of various plant powders and Silico-sec, a diatomaceous earth, on Callosobruchus maculatus at the research laboratory of the Department of Crop Pest and Soil Management, the Federal University of Technology, Akure. The study included three replications. The treatments consisted of three (3) plant materials derived from the dry flower buds of Eugenia aromatica, seeds of Piper guineense, and leaves of Nicotiana tabacum and their combination with Silico-sec. In one experiment, 0.4g of each plant material was added to 20 C. maculatus adults (10 couples, aged 1-2 days) in 20g of Ife Brown cowpea seeds, all contained within an air-tight plastic container. Another experiment involved the addition of 0.4g mixtures of Silico-sec and each plant powder (E. aromatica, P. guineense, and N. tabacum) in various ratios (1:5, 5:1, 1:10, 10:1, and 1:1) to the same number of C. maculatus adults in 20g of cowpea seeds, also in separate air-tight plastic containers. All the treatments and their combination were laid out in a completely randomized design (CRD) repeated three times. Data were collected at 12, 24, and 48 at p,0hours post-treatment. Oviposition, adult emergence, and seed weight loss were evaluated. The results demonstrated that both the plant powders and Silico-sec were effective in controlling C. maculatus infestation on cowpea by causing significant adult mortality at p&lt; 0.05, reducing oviposition, suppressing F1 adult emergence, and minimizing seed damage. Among single applications, Silico-sec and E. aromatica powder provided the best protection for stored cowpea, yielding the highest adult mortality, lowest oviposition, most suppressed F1 adult emergence, and minimal seed damage. However, the mixture of Silico-sec and P. guineense at ratios of 5:1 and 10:1 offered the best protection, exhibiting significantly higher mortality, lower oviposition rates, suppressed F1 adult emergence, and reduced seed damage compared to other treatments. This study suggests that combination of P. guineense and Silico-sec is particularly effective in controlling cowpea storage pests and could serve as a viable alternative to synthetic insecticides for protecting stored cowpea against C. maculatus.

Proximal Humerus Fractures In The Older Adult: A Retrospective Review Of Proximal Humerus Fractures In The Emergency Department

Abstract Background This study aimed to describe the epidemiology and outcomes of older adults diagnosed with proximal humeral fractures (PHFs) in an Irish adult emergency department (ED). Methods A retrospective chart review was conducted on all patients (&amp;gt;65) who had a diagnosis of a PHF, in 2022 within an ED of a large suburban academic teaching hospital in Dublin. Assessment by the Frailty at the Front Door (FFD) team (older adults &amp;gt;75) for those with a PHF was also analysed. Results A total of 53 older adults (&amp;gt;65) were identified within the study period with a PHF while 43 patients (&amp;lt;65) were identified. In the &amp;gt;65 group, seventy-nine percent (N=42) were female. The mean age was 75.6 years of age (Range 65-95). Only 21% (N=11) had operative management. Two-thirds of PHFs in the &amp;gt;65 group required admission to hospital (N=24) (P&amp;lt;0.001). The mean length of stay (LOS) was 12.9 days compared to only 4.5 days in those under the age of 65 (P= 0.14). There were 26 older adults (&amp;gt;75) diagnosed with a PHF. The FFD team assessed 49% (N=11) of older adults (&amp;gt;75) with a PHF. Only 31% (N=8) presented to ED within FFD team operational hours. The average Clinical Frailty Sale was 5 (N=11). The FFD team completed 22 inpatient MDT referrals, four HSCP community referrals, one Public Health Nurse Referral and one application for increase in home care package. Conclusion PHFs tended to occur in older female patients. The majority of PHFs in older adults do not have operative treatment and were associated with higher LOS. FFD teams can play a pivotal role in the assessment and treatment of older adults with a PHF. This may represent opportunities to develop integrated care pathways to maximize an individuals’ independence, to support people at home with PHFs.

Policing of youth in the hospital

BackgroundEach year millions of children seek care in emergency departments, many of whom are from marginalized and minoritized groups who lack access to primary and preventive care. Law enforcement personnel are also commonly present in pediatric and adult emergency departments serving in a range of roles. Therefore, pediatric emergency departments sit at the nexus of the health system and the legal system for many vulnerable youth and families. ObjectiveHerein, we explore several common specific legal issues surrounding policing of youth in the hospital setting: patient privacy and disclosure of information, questioning and visitation restriction, autonomy and decision making, restraints and use of force, and patient property. MethodsOur team of legal scholars and clinician researchers examined the literature on policing of youth in healthcare settings and patients' legal rights in healthcare settings through searches using PubMed, Westlaw, and Lexis. FindingsThrough rigorous analysis of the medical literature, legal scholarship, and relevant case law, several important themes were identified which present challenges to clinicians caring for vulnerable children. Conclusions and relevancePediatric clinicians, highly trained professionals in the medical and social care of youth and children, are often unaware of legal rules and procedures that guide law enforcement interaction with youth. This lack of knowledge may result in unknowing and unwitting violations of patients' rights while also compromising the quality of health care provided. Therefore, it is imperative that clinicians are educated on their roles and their institutions' roles in safeguarding patients' privacy and autonomy while still promoting effective collaboration with law enforcement.

Side effects of semi-synthetic insecticide spinetoram on the whitefly parasitoid Encarsia formosa.

Insecticide risk assessment for biological control agents is essential for implementing integrated pest management (IPM) programs. Spinetoram is a naturally derived insecticide used to control a variety of agricultural sap-sucking insect pests, and Encarsia formosa Gahan (Hymenoptera: Aphelinidae) plays a key role in the biocontrol of greenhouse whiteflies. Despite its presumed safe ecotoxicological profile, the side effects of spinetoram on E. formosa are partially unknown, especially at sublethal doses. In the laboratory, we estimated the lethal concentrations (LC) of spinetoram on E. formosa by topical exposure of pupae and 48 h residual contact exposure of emerged adults. Afterwards, we assessed the impact of spinetoram LCs on the life history traits (juvenile development, adult longevity, parasitism, adult emergence) and population growth parameter (the instantaneous rate of increase, ri) of the parasitoid. Probit analysis allowed the estimation of LC10 = 0.10 mg/L, LC50 = 0.56 mg/L, and LC90 = 3.28 mg/L. Spinetoram at LC10 had no impact on the observed parameters of E. formosa. Conversely, spinetoram at LC50 and LC90 significantly reduced adult longevity by 19.2% and 40.6%, total parasitism by 33.4% and 38.7%, and total adult emergence by 29.6% and 39.1%, respectively. Also, the ri of E. formosa was significantly affected by spinetoram LC50 and LC90 with a reduction of 8.17 and 29.83%, respectively. Our results suggested that spinetoram significantly threatens the effectiveness of E. formosa when applied at the field recommended rate. However, further validation of spinetoram under greenhouse conditions is required for a comprehensive risk assessment for E. formosa in IPM programs. © 2024 Society of Chemical Industry.

Assessment of emergency physicians’ awareness and knowledge of hereditary angioedema

Aims: Hereditary angioedema can occur with life-threatening attacks of severe laryngeal edema, and epinephrine is insufficient in the treatment of attacks. We sought an answer to the question, 'Do emergency physicians, who frequently encounter angioedema cases that are so important for the emergency department, have sufficient awareness about this issue?' Methods: In this study, the online questionnaire was conducted among physicians working in adult emergency departments between April and August 2022. The questionnaire form consisted of two parts. The first part contained three questions about medical experience, academic degree, and encounter with hereditary angioedema patients. The second part of the questionnaire contained seven questions about the diagnosis and treatment of hereditary angioedema. Results: A total of 103 physicians working in emergency departments participated in the survey. The proportion of physicians is as follows: The percentage of physicians with less than 15 years of experience was 92.2%. Research assistants represented the largest group of participants at 51.5%. When asked "What is not a symptom of hereditary angioedema?" Only 40.6% of physicians could answer the question correctly. While 39.8% of physicians thougt that epinephrine and antihistamines were useful in treating these attacks, 53.4% felt that epinephrine and antihistamines were not. While there was a difference in hereditary angioedema awareness between the group with more than 15 years of professional experience and the group with less experience, there was no meaningful difference between research assistants, specialists, and academicians. According to this survey, professional experience was important, but academic title did not make a difference in terms of disease awareness. Conclusion: It is necessary to increase the awareness of emergency physicians about hereditary angioedema, which can cause fatal attacks and whose diagnosis and treatment are different from other angioedemas.