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Peer victimization has been assessed by using various methods, with little attention to methodological variance. Peer victimization assessments of 238 girls (M age = 9.77 years; 50% Black, 50% White) made by peers, teachers, and self in school, and peers and observers in afterschool playgroups, enabled examination of context and reporter effects on measurement. Results underscored the importance of context: (1) Victimization reported by informants in the same context (i.e., teachers and peers in school setting, and peers and observers in playgroup setting) correlated more strongly than with self-reported victimization. (2) Informant ratings of victimization made within similar contexts (school and afterschool playgroups) showed higher agreement than those made in different contexts (school vs. playgroups) even if the same reporter was used across both contexts (peer report in schools and peer report in playgroups). (3) Teacher-reported victimization was more strongly associated with objective academic outcomes than were peer-, self-, or observer-reported victimization, due to the shared academic context.

Popularity and likability—two measures of adolescent peer status—have been examined frequently within Western cultures but relatively rarely within Eastern cultures. This study offered a cross-cultural comparison of adolescent peer status to examine whether these constructs and their correlates vary between the United States and China. The study consisted of a sample of adolescents from China and the United States (N = 864, M age = 15.95; 50.5% female). Adolescents completed sociometric peer nominations assessing popularity, likability, and five behavioral correlates: aggression, victimization, prosocial behavior, sad affect, and anxious behavior. Results suggest that popularity may be more differentiated from likability in the United States than in China. More specifically, the association between popularity and likability was stronger in China, and the behavioral correlate profiles of these peer constructs was more similar within China than within the United States. Another notable finding was that popularity was significantly positively associated with aggression in the United States but was significantly negatively associated with aggression in China. Results are discussed through the lens of cultural differences in the meaning of peer status.

Land application of wastewater has been accepted as an effective wastewater treatment method and disposal option in semiarid and arid areas in the world. Although it has economical, environmental, and social benefits, it is sometimes questioned as an environmentally sound method. Water mass balance method has proved to be an effective approach to designing a wastewater land application system to remove nitrogen at the municipal wastewater treatment plant at the City of Littlefield, Texas, USA. The study in this paper was to evaluate the short-term effects of wastewater land application on soil chemical properties at the same site from 16 June 2006 to 28 June 2007 with the system designed by the water mass balance method. Soil samples were taken at the start and at the end of this study at different depths from soil surface down to 91 cm at the research site (54 × 18 m), and analyzed for pH, total Kjeldahl nitrogen, nitrate-nitrogen, ammonia-nitrogen, electrical conductivity, calcium, magnesium, sodium, and sodium adsorption ratio. The results showed that there was no negative change of those soil chemical properties during the research period in this wastewater land application system designed by water mass balance method.

Wastewater land application is a cost-effective method to treat and dispose wastewater; however, it may cause soil salinization. Salt mass balance and the potential soil salinization caused by the wastewater land application were investigated in the crop root zone in a wastewater land application system at the City of Littlefield, TX, USA from October 7, 2005 to September 28, 2007 using a lysimeter system. This study showed that, after 2 years of wastewater land application, the ranges of soil salinity were still lower than the threshold (8,500 μS/cm) for Bermuda grass assuming a 10% yield reduction. The leached salt mass showed large spatial and temporal variation. The average values of electrical conductivity of the saturated paste extract of the soil samples increased from 1,433 μS/cm in June 2006 to 1,840 μS/cm in June 2007. The average values of the soil sodium adsorption ratio between June 2006 and June 2007 increased from 11 to 14 resulting in a potential risk of soil dispersion and decreasing the soil infiltration rate. Although the measured leaching fractions in nearly all sampling periods, except one, were higher than the leaching requirement, salt accumulations in the root zone were still found with only two exceptions. Since the time required for reaching equilibrium between cumulative salt mass input and cumulative salt mass output varies from 1 year to a few years, or even longer, the long-term investigation is recommended for the study of salt mass balance in the root zone of this wastewater land application system.

The current study involved an examination of the impact of a peer-led substance use intervention program on the peer leaders beyond the substance use-related goals of the intervention. Specifically, unintended consequences of an adult-sanctioned intervention on the targeted peer leader change agents were investigated, including whether their participation affected their peer status, social influence, or self perceptions. Twenty-two 7th grade peer-identified intervention leaders were compared to 22 control leaders (who did not experience the intervention) and 146 cohort peers. Three groups of measures were employed: sociometric and behavioral nominations, social cognitive mapping, and leadership self-perceptions. Results indicated that unintended consequences appear to be a legitimate concern for females. Female intervention leaders declined in perceived popularity and liked most nominations over time, whereas males increased in total leader nominations. Explanations for these results are discussed and further directions suggested.

Potential contamination of groundwater because of nitrogen leaching has been an important concern in municipal wastewater land application systems; however, few efforts have made to measure nitrogen leaching (total N, NO₃⁻-N, and NH₄⁺ -N) under field conditions. This research successfully developed a conceptual nitrogen mass balance model and quantified its components at a wastewater land application system located at the City of Littlefield, Texas, from October 2005 to September 2007. The concentrations of total nitrogen and nitrate-nitrogen in the leachate were significantly less than 10 mg/L, therefore, there was no potential nitrogen contamination to groundwater found at this site during the research period. Linear regression models were analyzed and resulted in R² values of 0.918, 0.966, and 0.833 between cumulative applied total nitrogen mass and cumulative leached total nitrogen mass, cumulative applied nitrate-nitrogen mass and cumulative leached nitratenitrogen mass, and cumulative applied ammonia-nitrogen mass and cumulative leached ammonia-nitrogen mass, respectively. The nitrogen mass balance design approach for this site resulted in significant nitrogen removal. Organic nitrogen may leach with other forms of nitrogen, and denitrification plays an important role in nitrogen removal during the winter and spring seasons when the grass is dry.

Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progression in secondary progressive multiple sclerosis, independent of relapses. ASCEND was a phase 3, randomised, double-blind, placebo-controlled trial (part 1) with an optional 2 year open-label extension (part 2). Enrolled patients aged 18–58 years were natalizumab-naive and had secondary progressive multiple sclerosis for 2 years or more, disability progression unrelated to relapses in the previous year, and Expanded Disability Status Scale (EDSS) scores of 3·0–6·5. In part 1, patients from 163 sites in 17 countries were randomly assigned (1:1) to receive 300 mg intravenous natalizumab or placebo every 4 weeks for 2 years. Patients were stratified by site and by EDSS score (3·0–5·5 vs 6·0–6·5). Patients completing part 1 could enrol in part 2, in which all patients received natalizumab every 4 weeks until the end of the study. Throughout both parts, patients and staff were masked to the treatment received in part 1. The primary outcome in part 1 was the proportion of patients with sustained disability progression, assessed by one or more of three measures: the EDSS, Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9HPT). The primary outcome in part 2 was the incidence of adverse events and serious adverse events. Efficacy and safety analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01416181. Between Sept 13, 2011, and July 16, 2015, 889 patients were randomly assigned (n=440 to the natalizumab group, n=449 to the placebo group). In part 1, 195 (44%) of 439 natalizumab-treated patients and 214 (48%) of 448 placebo-treated patients had confirmed disability progression (odds ratio [OR] 0·86; 95% CI 0·66–1·13; p=0·287). No treatment effect was observed on the EDSS (OR 1·06, 95% CI 0·74–1·53; nominal p=0·753) or the T25FW (0·98, 0·74–1·30; nominal p=0·914) components of the primary outcome. However, natalizumab treatment reduced 9HPT progression (OR 0·56, 95% CI 0·40–0·80; nominal p=0·001). In part 1, 100 (22%) placebo-treated and 90 (20%) natalizumab-treated patients had serious adverse events. In part 2, 291 natalizumab-continuing patients and 274 natalizumab-naive patients received natalizumab (median follow-up 160 weeks [range 108–221]). Serious adverse events occurred in 39 (13%) patients continuing natalizumab and in 24 (9%) patients initiating natalizumab. Two deaths occurred in part 1, neither of which was considered related to study treatment. No progressive multifocal leukoencephalopathy occurred. Natalizumab treatment for secondary progressive multiple sclerosis did not reduce progression on the primary multicomponent disability endpoint in part 1, but it did reduce progression on its upper-limb component. Longer-term trials are needed to assess whether treatment of secondary progressive multiple sclerosis might produce benefits on additional disability components. Biogen.

BackgroundNumerous strategies have been developed to rapidly rule-out acute coronary syndrome (ACS) using high-sensitivity troponin. We aimed to establish their performance in terms of emergency care length of stay (LOS) in real-world practice.MethodsA multicentre observational cohort study in 94 UK sites between March and April 2023. Recruitment was preferably prospective, with retrospective recruitment also allowed. Adults presenting to the ED with chest pain triggering assessment for possible ACS were eligible. Primary outcome was emergency care LOS. Secondary outcomes were index rate of acute myocardial infarction (MI), time to be seen (TTBS), disposition and discharge diagnosis. Details of ACS rule-out strategies in use were collected from local guidelines. Mixed effects linear regression models tested the association between rule-out strategy and LOS.Results8563 eligible patients were recruited, representing 5.3% of all ED attendances. Median LOS for all patients was 333 min (IQR 225, 510.5), for admitted patients was 460 min (IQR 239.75, 776.25) and for discharged patients was 313 min (IQR 221, 451). Heterogeneity was seen in the rule-out strategies with regard to recommended troponin timing. There was no significant difference in LOS in discharged patients between rule-out strategies defined by single and serial troponin timing (p=0.23 and p=0.41). The index rate of acute MI was 15.2% (1301/8563). Median TTBS was 120 min (IQR 57, 212). 24.4% (2087/8563) of patients were partly managed in a same day emergency care unit and 70% (5934/8563) of patients were discharged from emergency care.ConclusionDespite heterogeneity in the ACS rule-out strategies in use and widespread adoption of rapid rule-out approaches, this study saw little effect on LOS in real-world practice. Suspected cardiac chest pain still accounts for a significant proportion of UK ED attendances. ED system pressures are likely to be explanatory, but further research is needed to understand the reasons for the unrealised potential of these strategies.

A review of the literature for this study explained how low distress tolerance and increased need for tension reduction predict symptomatic cannabis usage. Current literature supports distress tolerance and need for tension reduction as being predictive of cannabis use resulting in psychological symptomatology. Negative internal states of pain and anxiety are linked to hazardous use patterns qualifying for cannabis use disorder. Psychological variables of distress tolerance and need for tension reduction have been suggested as moderating and mediating symptomatic use outcomes. The relationship between precipitating negative internal states, distress tolerance ability, and need/options for tension reduction is explored to help improve clinical knowledge of predictors of symptomatic cannabis use outcomes. Understanding how symptomatic cannabis use outcomes are predicted by distress tolerance and need for tension reduction may assist in symptomatic use prevention. This review established the need for research examining the influence predictors have on symptomatic cannabis use outcomes in a sample of retail cannabis users.

Peer Victimization has long been recognized as a major problem among youth and is conceptualized as a psychosocial stressor that encompasses a range of multiple intentional acts (e.g., teasing, hitting) that are intended to do harm to an individual. Over the last several decades our understanding of the form, consequences, causes, and mechanisms of peer victimization has increased substantially. Nevertheless, there is still considerable work to be done to better understand and subsequently reduce the frequency and impact of peer victimization. This dissertation is composed of three studies that attempt to address three notable challenges or gaps in the peer victimization literature. Study 1 addressed the limited association between victimization and psychosocial maladjustment by assessing the impact of the inconsistency in measurement of peer victimization. Findings from this study revealed that different informants may be capturing different aspects of peer victimization and that indices of peer victimization were highly dependent upon the context in which assessments took place. Study 2 sought to determine if previously unexplored subgroups of peer victims could be identified and if subgroup membership conferred unique risk from peer victimization. Findings revealed that while unique subgroups were identified, they were not consistent with past findings with respect to initial identification and unique subgroup membership did not appear to confer unique risk for maladjustment. Study 3 sought to extend knowledge of the long-term impact of victimization that occurs during youth (i.e., the impact of victimization as it extends into adulthood). Findings from this study suggest that victimization may impact a broad array of outcomes, especially physical health, and the predominant focus on mental health outcomes may overlook important adult correlates of peer victimization. When considered together, patterns from these three studies suggest three overarching conclusions. First, these studies provide evidence that self-report has clinical utility for assessing peer victimization and is meaningfully distinct from input provided by other reporters of peer victimization. Second, these three studies provide additional evidence that the link between peer victimization and psychopathology is limited. Third, these studies provide evidence that peer victimization impacts outcomes beyond the domain of mental health.