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7%) (adjusted prevalence ratio = 1.09, 95% confidence interval 1.05-1.13). Less than half of children with heart conditions (48.2%) and without (49.5%) had a medical home (adjusted prevalence ratio = 1.02, 95% confidence interval 0.91-1.14). For children with heart conditions, preventive care was slightly more common among younger children and less common among those with family incomes 200-399% of the federal poverty level. Having a medical home was less common among younger children, non-Hispanic “other” race, and those with ≥2 other health conditions. Most children with heart conditions received preventive care, but less than half had a medical home, with disparities by age, socioeconomic status, race, and concurrent health conditions. These findings highlight opportunities to improve care for children with heart conditions.

This study examined the differential impact of Hurricane Harvey on adolescent standardized Body Mass Index (zBMI), physical activity, diet, and perceived stress.

Prior to Hurricane Harvey, 175 ethnic minority adolescents were recruited from an independent school district in Houston. Height and weight were directly measured. The School Physical Activity and Nutrition Questionnaire assessed diet and physical activity. Stress was assessed with the Perceived Stress Scale. High hurricane impact was classified as at least 1 affirmative response to house damage, rescue, displacement, or going without food, water, or medicine. Repeated measures such as ANCOVA models were developed to assess differences in zBMI, physical activity, diet, and stress between the hurricane impact groups. Regression models were used to assess stress as a mediator of the hurricane impact and zBMI change relationship.

Students who were highly impacted by the hurricane had a greater decrease in zBMI than those less impacted from pre-hurricane to 15 weeks post-hurricane (95% CI 0.02 to 0.25, p<0.05). Physical activity and diet did not differ by impact. Perceived stress at 3 weeks post-hurricane mediated the impact and zBMI change relationship (β=-0.04 95% CI -0.12 to -0.002).

The decrease in zBMI among highly impacted students warrants further monitoring. Perceived stress, immediately following the hurricane, impacted student growth months later.

The decrease in zBMI among highly impacted students warrants further monitoring. Perceived stress, immediately following the hurricane, impacted student growth months later.

This study examines the relationship of serum total tau, neurofilament light (NFL), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) with neurocognitive performance in service members and veterans with a history of traumatic brain injury (TBI).

Service members (n = 488) with a history of uncomplicated mild (n = 172), complicated mild, moderate, severe, or penetrating TBI (sTBI; n = 126), injured controls (n = 116), and non-injured controls (n = 74) prospectively enrolled from Military Treatment Facilities. selleckchem Participants completed a blood draw and neuropsychological assessment a year or more post-injury. Six neuropsychological composite scores and presence/absence of mild neurocognitive disorder (MNCD) were evaluated. Within each group, stepwise hierarchical regression models were conducted.

Within the sTBI group, increased serum UCH-L1 was related to worse immediate memory and delayed memory (R2Δ = .065-.084, ps < .05) performance, while increased GFAP was related to worse perceptual reasoning (R2Δ = .030, p = .036). Unexpectedly, within injured controls, UCH-L1 and GFAP were inversely related to working memory (R2Δ = .052-.071, ps < .05), and NFL was related to executive functioning (R2Δ = .039, p = .021) and MNCD (Exp(B) = 1.119, p = .029).

Results suggest GFAP and UCH-L1 could play a role in predicting poor cognitive outcome following complicated mild and more severe TBI. Further investigation of blood biomarkers and cognition is warranted.

Results suggest GFAP and UCH-L1 could play a role in predicting poor cognitive outcome following complicated mild and more severe TBI. Further investigation of blood biomarkers and cognition is warranted.

Incidental learning and memory, as well as processing speed, were examined in human immunodeficiency virus (HIV)-positive adults and a seronegative control group.

Participants completed a computerized Symbol-Digit Modalities Test (cSDMT) with two blocked conditions a set of trials with the standard symbol-digit pairings and the second set with a rearranged symbol-digit pairings.

HIV-positive adults showed slower overall reaction time compared to the HIV-negative group. More importantly, the most cognitively impaired HIV-positive group showed no interference in the rearranged set of symbol-digit pairings from the standard pairings on the cSDMT.

The relative slowing, or interference, in the HIV-negative group and two HIV-positive groups (unimpaired and impaired) was quite large (between 122 and 131 ms). We argue that the lack of such relative slowing in the most cognitively impaired HIV-positive group indicates a deficit in incidental learning and memory.

The relative slowing, or interference, in the HIV-negative group and two HIV-positive groups (unimpaired and impaired) was quite large (between 122 and 131 ms). We argue that the lack of such relative slowing in the most cognitively impaired HIV-positive group indicates a deficit in incidental learning and memory.

Mounting evidence indicates that vascular risk factors (VRFs) are elevated in HIV and play a significant role in the development and persistence of HIV-associated neurocognitive disorder. Given the increased longevity of people living with HIV (PLWH), there is a great need to better elucidate vascular contributions to neurocognitive impairment in HIV. This systematic review and meta-analysis examine relationships between traditional VRFs, cardiovascular disease (CVD), and cognition in PLWH in the combination antiretroviral therapy era.

For the systematic review, 44 studies met inclusion criteria and included data from 14,376 PLWH and 6,043 HIV-seronegative controls. To better quantify the contribution of VRFs to cognitive impairment in HIV, a robust variance estimation meta-analysis (N = 11 studies) was performed and included data from 2139 PLWH.

In the systematic review, cross-sectional and longitudinal studies supported relationships between VRFs, cognitive dysfunction, and decline, particularly in the domains of attention/processing speed, executive functioning, and fine motor skills.