Food Insecurity and Associated Factors in Brazilian Undergraduates during the COVID-19 Pandemic

Undergraduates may face challenges to assure food security, related to economic and mental distress, especially during the COVID-19 pandemic. This study aimed to assess food insecurity and its associated factors in undergraduates during the COVID-19 pandemic. An online cross-sectional study was conducted from August 2020 to February 2021 with 4775 undergraduates from all Brazilian regions. The questionnaire contained socio-economic variables, the validated Brazilian food insecurity scale, and the ESQUADA scale to assess diet quality. The median age of the students was 22.0 years, and 48.0% reported income decreasing with the pandemic. Food insecurity was present in 38.6% of the students, 4.5% with severe food insecurity and 7.7% moderate. Logistic regressions showed students with brown and black skin color/race presented the highest OR for food insecurity; both income and weight increase or reduction during the pandemic was also associated with a higher OR for food insecurity, and better diet quality was associated with decreased OR for food insecurity. Our study showed a considerable presence of food insecurity in undergraduates. Policy for this population must be directed to the most vulnerable: those with brown and black skin color/race, who changed income during the pandemic, and those presented with difficulties maintaining weight and with poor diet quality.

Systemic Profile of Cytokines in Arteriovenous Fistula Patients and Their Associations with Maturation Failure

Background: Systemic cytokines are elevated in chronic kidney disease (CKD) and hemodialysis patients compared to the general population. However, whether cytokine levels interfere with vascular remodeling increasing the risk of arteriovenous fistula (AVF) failure remains unknown. Methods: This is a case-control study of 64 patients who underwent surgery for AVF creation (32 with AVF maturation failure and 32 matching controls with successful maturation). A total of 74 cytokines, including chemokines, interferons, interleukins, and growth factors, were measured in preoperative plasma samples using multiplex assays. Sixty-two patients were included in the statistical analyses. Associations with AVF failure were assessed using paired comparisons and conditional logistic regressions accounting for paired strata. Results: Seven cytokines were significantly higher in patients with AVF maturation failure than in matching controls (G-CSF, IL-6, MDC, RANTES, SDF-1α/β, TGFα, and TPO). Of these, G-CSF (odds ratio 1.71 [1.05-2.79] per 10 pg/mL), MDC (1.60 [1.08-2.38] per 100 pg/mL), RANTES (1.55 [1.10-2.17] per 100 pg/mL), SDF-1α/β (1.18 [1.04-1.33] per 1000 pg/mL), and TGFα (OR 1.39 [1.003-1.92] per 1 pg/mL) showed an incremental association by logistic regression. Conclusions: This study identified a profile of plasma cytokines associated with adverse maturation outcomes in AVFs. These findings may open the doors for future therapeutics and markers for risk stratification.

Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study

This multicenter cohort study investigated the differences between coronavirus disease 2019 (COVID-19) related symptoms and post-COVID symptoms between male and female COVID-19 survivors. Clinical and hospitalization data were collected from hospital medical records in a sample of individuals recovered from COVID-19 at five public hospitals in Spain. A predefined list of post-COVID symptoms was systematically assessed, but patients were free to report any symptom. Anxiety/depressive levels and sleep quality were also assessed. Adjusted multivariate logistic regressions were used to identify the association of sex with post-COVID related-symptoms. A total of 1969 individuals (age: 61, SD: 16 years, 46.4% women) were assessed 8.4 months after discharge. No overall significant sex differences in COVID-19 onset symptoms at hospital admission were found. Post-COVID symptoms were present in up to 60% of hospitalized COVID-19 survivors eight months after the infection. The number of post-COVID symptoms was 2.25 for females and 1.5 for males. After adjusting by all variables, female sex was associated with ≥3 post-COVID symptoms (adj OR 2.54, 95%CI 1.671–3.865, p < 0.001), the presence of post-COVID fatigue (adj OR 1.514, 95%CI 1.040–2.205), dyspnea (rest: adj OR 1.428, 95%CI 1.081–1.886, exertion: adj OR 1.409, 95%CI 1.109–1.791), pain (adj OR 1.349, 95%CI 1.059–1.720), hair loss (adj OR 4.529, 95%CI 2.784–7.368), ocular problems (adj OR 1.981, 95%CI 1.185–3.312), depressive levels (adj OR 1.606, 95%CI 1.002–2.572) and worse sleep quality (adj OR 1.634, 95%CI 1.097–2.434). Female sex was a risk factor for the development of some long-term post-COVID symptoms including mood disorders. Healthcare systems should consider sex differences in the management of long haulers.

Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

Everyday Functioning in a Community-Based Volunteer Population: Differences Between Participant- and Study Partner-Report

Introduction: Impaired awareness in dementia caused by Alzheimer’s disease and related disorders made study partner-report the preferred method of measuring interference in “instrumental activities of daily living” (IADL). However, with a shifting focus toward earlier disease stages and prevention, the question arises whether self-report might be equally or even more appropriate. The aim of this study was to investigate how participant- and study partner-report IADL perform in a community-based volunteer population without dementia and which factors relate to differences between participant- and study partner-report.Methods: Participants (N = 3,288; 18–97 years, 70.4% females) and their study partners (N = 1,213; 18–88 years, 45.8% females) were recruited from the Dutch Brain Research Registry. IADL were measured using the Amsterdam IADL Questionnaire. The concordance between participant- and study partner-reported IADL difficulties was examined using intraclass correlation coefficient (ICC). Multinomial logistic regressions were used to investigate which demographic, cognitive, and psychosocial factors related to participant and study partner differences, by looking at the over- and underreport of IADL difficulties by the participant, relative to their study partner.Results: Most A-IADL-Q scores represented no difficulties for both participants (87.9%) and study partners (89.4%). The concordance between participants and study partners was moderate (ICC = 0.55, 95% confidence interval [CI] = [0.51, 0.59]); 24.5% (N = 297) of participants overreported their IADL difficulties compared with study partners, and 17.8% (N = 216) underreported difficulties. The presence of depressive symptoms (odds ratio [OR] = 1.31, 95% CI = [1.12, 1.54]), as well as memory complaints (OR = 2.45, 95% CI = [1.80, 3.34]), increased the odds of participants overreporting their IADL difficulties. Higher IADL ratings decreased the odds of participant underreport (OR = 0.71, 95% CI = [0.67, 0.74]).Conclusion: In this sample of community-based volunteers, most participants and study partners reported no major IADL difficulties. Differences between participant and study partner were, however, quite prevalent, with subjective factors indicative of increased report of IADL difficulties by the participant in particular. These findings suggest that self- and study partner-report measures may not be interchangeable, and that the level of awareness needs to be considered, even in cognitively healthy individuals.

What Drives Selective Exposure to Political Information in Spain?

Communication research underlines two types of selective exposure to the media: one guided by ideological-partisan affiliations and one guided by interest in politics. This work will compare both motivations in the consumption of political information through three media types (digital press, television, and radio) by Spanish citizens during the 2019 November General Election. Through multinomial logistic regressions applied to a representative post-electoral survey, results show that ideological-partisan orientations are the most important variables governing selective exposure, especially for the digital press and the radio. Besides confirming ideological selective exposure, the data highlight an important tendency towards selective avoidance of news media perceived as ideologically incongruent. For television, however, both socio-demographic trends and ideological orientations exhibit a similar explanatory weight, which suggests that political segmentation of the Spanish television market is still being deployed by communication groups, in comparison with the press and the radio.

Social Entrepreneurship Typologies

Despite the increasing research in the field of social entrepreneurship (SE), unfortunately there is not yet consensus on its conceptualization. The main points of disagreement are related to the business mission and to the source of income. Based on these two dimensions and a bottom-up approach, this chapter contributes to previous literature by proposing and empirically exploring a categorization of three types of social entrepreneurs—socially responsible entrepreneur (SRE), social enterprise entrepreneur (SEE), and social initiative entrepreneur (SIE)—which is applied empirically to explore the social entrepreneurs' personal characteristics (gender, age, and education), similarities, and differences. Multinomial logistic regressions are applied on an international sample of GEM data that includes 11,280 commercial entrepreneurs and 3,373 social entrepreneurs. The findings of the study will permit researchers and practitioners to understand previous empirical findings on social entrepreneurship more clearly and to advance in the study of this evolving phenomenon.

Disparities in Access to Cranial Remodeling Orthosis for Deformational Plagiocephaly

Objective Moderate to severe cases of deformational plagiocephaly (DP) may be treated with cranial remolding orthoses (CRO). This study investigated the socioeconomic disparities in access to care for CRO for DP correction. Design This was a retrospective review of medical records from a single CRO company in Connecticut from 2014 to 2020. Methods Demographic variables were collected from all patients. Univariable logistic regressions were used to identify differences for presenting age at consultation, whether CRO was pursued, and length of CRO treatment by insurance payor and household income quartile. Results Of the 5620 patients identified, 4100 (73.0%) received CRO, with 674 (12.0%) receiving a second helmet. Of those receiving CRO, 1536 (37.5%) had Medicaid insurance while 2558 (62.4%) were commercially insured. Patients on Medicaid were 1.30 times more likely to have delayed presentation ( P = .017), while patients from the lowest income quartile were 1.26 1.50 ( P < .001) and 1.58 ( P < .001) times more likely to have a delayed presentation relative to those in the highest and second-highest income quartiles, respectively. Patients in the highest and second-highest income quartiles were also 1.55 ( P < .001) and 1.45 ( P < .001) more likely, respectively, to receive CRO after consultation than those from the lowest income quartile. Conclusions Lower income and Medicaid-insured patients had delayed presentation for CRO consultation. Those from the lowest income quartile were more likely to never receive CRO than those from wealthier backgrounds. Low socioeconomic status and Medicaid insurance, which can have more restrictive coverage policies for CRO, may result in the delayed treatment of DP.