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Women left behind by migration represent a unique and growing population yet remain understudied as key players in the context of migration and development. Using a unique longitudinal survey of life in Bangladesh, the Matlab Health and Socioeconomic Surveys, we examined the role of spousal migration in healthcare utilization for women. The objective of this study was to assess realized access to care (do women actually get healthcare when it is needed) and consider specific macrostructural, predisposing, and resource barriers to care that are related to migration. In a sample of 3,187 currently married women, we estimated multivariate logistic and multinomial regression models controlling for a wide range of baseline sociodemographic factors measured as far back as 1982. Our analyses also controlled for selection effects and explored two mechanisms through which spousal migration can affect healthcare utilization for women, remittances and frequent contact with spouses. We found that women with migrant spouses were approximately half as likely to lack needed healthcare compared to women whose spouses remained in Bangladesh (predicted probability of not getting needed healthcare 11.7% vs. 21.8%, p<0.001). The improvements in access (logistic regression coefficient for lacking care for left-behind women -0.761 p<0.01) primarily occurred through a reduction in financial barriers to care for women whose spouses were abroad. Wives of international migrants showed significantly better access to healthcare even when accounting for selection into a migrant family. While the overall story is one of positive migration effects on healthcare access due to reductions in financial barriers to care, results also showed an increase in family-related barriers such as not being permitted to get care by a family member or travel alone to a facility, indicating that some of the benefits of migration for women left behind may be diluted by gendered family structures.

Bronchopulmonary dysplasia (BPD) remains the most common respiratory complication of prematurity as younger and smaller infants are surviving beyond the immediate neonatal period. The recognition that oxidative stress (OS) plays a key role in BPD pathogenesis has been widely accepted since at least the 1980s. In this article, we examine the interplay between OS and genetic regulation and review ‘omics’ data related to OS in BPD. Data from animal models (largely models of hyperoxic lung injury) and from human studies are presented. Epigenetic and transcriptomic analyses have demonstrated several genes related to OS to be differentially expressed in murine models that mimic BPD as well as in premature infants at risk of BPD development and infants with established lung disease. Alterations in the genetic regulation of antioxidant enzymes is a common theme in these studies. Data from metabolomics and proteomics have also demonstrated the potential involvement of OS-related pathways in BPD. A limitation of many studies includes the difficulty of obtaining timely and appropriate samples from human patients. Additional ‘omics’ studies could further our understanding of the role of OS in BPD pathogenesis, which may prove beneficial for prevention and timely diagnosis, and aid in the development of targeted therapies.

Bronchopulmonary dysplasia (BPD), a common complication of preterm birth, is associated with pulmonary hypertension (PH) in 25% of infants with moderate to severe BPD. Neonatal mice exposed to hyperoxia for 14d develop lung disease similar to BPD, with evidence of associated PH. The cyclic guanosine monophosphate (cGMP) signaling pathway has not been well studied in BPD-associated PH. In addition, there is little data about the natural history of hyperoxia-induced PH in mice or the utility of phosphodiesterase-5 (PDE5) inhibition in established disease. C57BL/6 mice were placed in room air or 75% O2 within 24h of birth for 14d, followed by recovery in room air for an additional 7 days (21d). Additional pups were treated with either vehicle or sildenafil for 7d during room air recovery. Mean alveolar area, pulmonary artery (PA) medial wall thickness (MWT), RVH, and vessel density were evaluated at 21d. PA protein from 21d animals was analyzed for soluble guanylate cyclase (sGC) activity, PDE5 activity, and cGMP levels. Neonatal hyperoxia exposure results in persistent alveolar simplification, RVH, decreased vessel density, increased MWT, and disrupted cGMP signaling despite a period of room air recovery. Delayed treatment with sildenafil during room air recovery is associated with improved RVH and decreased PA PDE5 activity, but does not have significant effects on alveolar simplification, PA remodeling, or vessel density. These data are consistent with clinical studies suggesting inconsistent effects of sildenafil treatment in infants with BPD-associated PH.

Background There is increasing evidence of problematic rates of food insecurity among college students, yet few studies have gone beyond this to examine housing insecurity rates or rates of basic need insecurity (BNI), which is defined as having both food and housing insecurity, among the postsecondary population. BNI may have significant impacts on the mental and social health, and academic outcomes of college students, yet remains understudied. The researchers of this study are among the first to assess the prevalence of food insecurity, housing insecurity, and basic needs insecurity among college students enrolled at a large, public university in the Southeast and to identify factors associated with experiencing food, housing, and basic needs insecurity. Methods A cross-sectional online survey was conducted at a large, public university in the Southeast United States. All eligible, enrolled students ( n  = 23,444) were asked to complete an online survey, 2634 responded (11.2% response rate). Multivariate logistic regression models were used to assess relationships between demographic and financial factors and the outcomes of interest (food, housing, and basic needs insecurity). Results High rates of food insecurity (48.5%), housing insecurity (66.1%), and basic needs insecurity (37.1%) were identified. After controlling for confounders, factors that were significantly associated with increased odds of students having basic needs insecurity included previous food insecurity ( p  < 0.001; Odds Ratio (OR) = 3.36; Confidence Interval (CI) = 2.64–4.28), being employed ( p  < 0.001, OR = 1.70; CI = 1.34–2.17), not receiving family financial support ( p  < 0.001, OR = 1.61; CI = 1.30–2.00), and living off-campus ( p  < 0.001, OR = 1.67; CI = 1.25–2.22). Juniors ( p  < 0.001, OR = 1.78; CI = 1.31–2.42), seniors ( p  < 0.001, OR = 2.06; CI = 1.52–2.78), Masters ( p  = 0.004, OR = 1.68; CI = 1.18–2.40), and PhD or EdD ( p  = 0.029, OR = 1.55; CI = 1.05–2.31) students were significantly more likely to experience basic needs insecurity than sophomore students. Conclusions This research identifies high rates of food, housing, and basic needs insecurity among college students enrolled at a large, public university. Financial factors such as being food insecure prior to attending college, working during college, and not having familial financial support were all related to BNI in this sample. Students who were more advanced in their education experienced more BNI than less advanced students. Innovative interventions with enhanced BNI measures, for example, partnering with financial aid offices to screen and refer students to food resources, are likely needed to address this multi-faceted problem.

Bronchopulmonary dysplasia remains a significant cause of neonatal morbidity; however, the identification of novel targets to predict or prevent the development of bronchopulmonary dysplasia remains elusive. Proper microRNA (miR)-17∼92 cluster is necessary for normal lung development, and alterations in expression are reported in other pulmonary diseases. The overall hypothesis for our work is that altered miR-17∼92 cluster expression contributes to the molecular pathogenesis of bronchopulmonary dysplasia. The current studies tested the hypothesis that alterations in miR-17∼92 cluster and DNA methyltransferase expression are present in bronchopulmonary dysplasia. miR-17∼92 cluster expression, promoter methylation, and DNA methyltransferase expression were determined in autopsy lung samples obtained from premature infants who died with bronchopulmonary dysplasia, or from term/near-term infants who died from nonrespiratory causes. Expression of miR-17∼92 cluster members miR-17 and -19b was measured in plasma samples collected in the first week of life from a separate cohort of preterm infants at a second institution in whom bronchopulmonary dysplasia was diagnosed subsequently. Autopsy tissue data indicated that miR-17∼92 expression is significantly lower in bronchopulmonary dysplasia lungs and is inversely correlated with promoter methylation and DNA methyltransferase expression when compared with that of control subjects without bronchopulmonary dysplasia. Plasma sample analyses indicated that miR-17 and -19b expression was decreased in infants who subsequently developed bronchopulmonary dysplasia. Our data are the first to demonstrate altered expression of the miR-17∼92 cluster in bronchopulmonary dysplasia. The consistency between our autopsy and plasma findings further support our working hypothesis that the miR-17∼92 cluster contributes to the molecular pathogenesis of bronchopulmonary dysplasia.

Introduction This study analyzed survey responses from 84 teachers of students with visual impairments who had provided literacy instruction to dual-media students who used both print and braille. Methods These teachers in the United States and Canada completed an online survey during spring 2015. Results The teachers reported that they introduced braille to their students at the mean age of 7.8 years. The three most common reasons reported for introducing a student to braille were the student's diagnosis, print reading speed, and print reading stamina. The amount of instructional time in braille literacy varied widely, and slightly more than 60% of the students were initially introduced to uncontracted braille. The teachers reported that approximately half of their students were at or above grade level with their print literacy skills, but only about 25% were at or above grade level with their braille literacy skills. Discussion Both contracted and uncontracted braille were used when beginning braille instruction for students reading both print and braille. The roles of student motivation and confidence appeared to be important considerations when designing and providing braille literacy instruction. Implications for practitioners There are many factors that should be considered when determining if a student should transition from print to braille as a primary literacy medium. Motivating students to want to learn and use braille is critical. A comprehensive curriculum is needed for use with established print readers at various reading levels who are making the transition to braille.

Traditional perpetual pavement thickness design is based, in part, on controlling strain levels at the bottom of the asphalt concrete layer below an endurance limit to prevent bottom-up fatigue cracking (FC). A field-based limiting strain threshold was developed from cumulative distributions of field-measured tensile strains in the 2003 and 2006 research cycles at the National Center for Asphalt Technology Pavement Test Track to understand the limiting strain necessary to control FC. Additionally, the fatigue ratio, the ratio of the nth percentile strain to the fatigue endurance limit, was developed. Both the tensile strain distributions and fatigue ratios showed a clear difference between sections that experienced bottom-up FC and those that did not. However, it is necessary to adapt these thresholds to strains predicted by perpetual pavement design tools. PerRoad, a stochastic perpetual pavement design programme, was used to predict strains for the same 2006 sections. Previously developed strain distributions and fatigue ratios were adjusted to reflect observed differences in predicted and measured strains. Cumulative distributions and fatigue ratios based on predicted strains for the 2009 research cycle validated the updated limiting strain distribution and maximum fatigue ratios for designing perpetual pavements to resist bottom-up FC.

Certified transcribers, non-certified transcribers, volunteers, paraeducators, and teachers of students with visual impairments transcribe braille materials for K-12 students (those in kindergarten through 12th grade), and their training and level of preparedness varies greatly (Corn & Wall, 2002; Herzberg & Stough, 2007; Rosenblum & Herzberg, 2011). During the development of the content for the refresher course, material was reviewed by a National Library Service for the Blind and Physically Handicapped (NLS) literary certified braille transcriber who was also a certified teacher of students with visual impairments; however, even with this person's input, there were still minor errors within the course content.

Intensive group-based treatment (IBGT) is a targeted intervention for selective mutism adapted from established, evidence-based treatments for other forms of childhood anxiety. Selective mutism (SM) is a severe anxiety disorder occurring in early childhood that presents unique challenges for treatment, given the early onset and the inability to respond verbally in some settings (Furr et al., 2019). The broader treatment literature supports cognitive-behavioral therapy (CBT), delivered in a weekly outpatient format, as the gold standard for childhood anxiety. However, some have proposed brief or intensive interventions as an alternative modality to maximize learning through repeated exposure and to increase access to evidence-based intervention and trained providers (Craske et al., 2012; Ost & Ollendick, 2017). In response to the identified need, Kurtz (2016) developed intensive group-based treatment (IGBT) for selective mutism. IGBT for SM incorporates graduated exposure to speech and targets interaction patterns between children and adults that reinforce symptoms (Cornacchio et al., 2019). Providers deliver the intervention in a high dose, one-week format that allows children to interact with peers and generalize learning to new settings. Theory and emerging evidence support the adaptation of established interventions to an intensive group format, but only one randomized controlled trial and a few feasibility studies have investigated IGBT to date. The current pilot case series study evaluated the feasibility and effectiveness of an existing intensive group program. This study was the first to assess the acceptability and feasibility of IGBT from the perspective of parents of children receiving the treatment and counselors who delivered the intervention using standardized measures. Additionally, we assessed the effectiveness of the intervention immediately following treatment and at a 10-week follow-up with a reliable and valid measure of parent-rated speaking behavior (Bergman et al, 2008). Results of our study indicated that the intervention is acceptable, appropriate for the identified population, and feasible for implementation in an outpatient setting. There was also preliminary evidence supporting its effectiveness at increasing speech across settings. Taken together, these findings justify research on a larger scale to further evaluate the effectiveness of intensive group-based treatment for selective mutism and the subgroups that respond best.