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Background: Adverse childhood experiences are demonstrated risk factors for depression, a common co-morbidity of multiple sclerosis, but are understudied among people with multiple sclerosis., Objective: Estimate the association between adverse childhood experiences and depression among 1,990 adults with multiple sclerosis., Methods: Participants were members of Kaiser Permanente Northern California from two studies between 2006 and 2021 and were diagnosed with multiple sclerosis by a neurologist. Adverse childhood experiences were assessed using two instruments, including the Behavioral Risk Factor Surveillance System. Participants self-reported ever experiencing a major depressive episode. Meta-analysis random effects models and logistic regression were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between adverse childhood experiences and a history of depression across study samples. Adverse childhood experiences were expressed as any/none, individual events, and counts. Models adjusted for sex, birth year, race, and ethnicity., Results: Exposure to any adverse childhood experiences increased the odds of depression in people with multiple sclerosis (OR: 1.71, 95% CI: 1.21-2.42). Several individual adverse childhood experiences were also strongly associated with depression, including "significant abuse or neglect" (OR: 2.79, 95% CI: 2.11-3.68)., Conclusion: Findings suggest that adverse childhood experiences are associated with depression among people with multiple sclerosis. Screening for depression should be done regularly, especially among people with multiple sclerosis with a history of adverse childhood experiences., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2023.)

Background and Objectives: Migraine is common among people with multiple sclerosis (MS), but the reasons for this are unknown. We tested 3 hypothesized mechanisms for this observed comorbidity, including migraine is a risk factor of MS, genetic variants are shared between the conditions, and migraine is because of MS., Methods: Data were from 2 sources: publicly available summary statistics from genome-wide association studies of MS (N = 115,748) and migraine (N = 375,752 and N = 361,141) and a case-control study of MS recruited from the Kaiser Permanente Northern California Health Plan (N = 1,991). For the latter participants, migraine status was ascertained using a validated electronic health record migraine probability algorithm or self-report. Using the public summary statistics, we used 2-sample Mendelian randomization to test whether a migraine genetic instrumental variable was associated with MS. We used linkage disequilibrium score regression and LOGODetect to ascertain whether MS and migraine shared genetic variants across the genome and regionally. Using the Northern California MS cohort, we used logistic regression to identify whether people with both MS and migraine had different odds of clinical characteristics (e.g., age at MS onset, Perceived Deficits Questionnaire, and depression) or MS-specific risk factors (e.g., body mass index, smoking status, and infectious mononucleosis status) compared with people with MS without migraine., Results: We did not find evidence supporting migraine as a causal risk factor of MS ( p = 0.29). We did, however, identify 4 major histocompatibility complex (MHC) loci shared between MS and migraine. Among the Northern California MS cohort, 774 (39%) experienced migraine. People with both MS and migraine from this cohort were more likely to ever smoke (odds ratio [OR] = 1.30, 95% CI: 1.08-1.57), have worse self-reported cognitive deficits (OR = 1.04, 95% CI: 1.02-1.06), and ever experience depression (OR = 1.48, 95% CI: 1.22-1.80)., Discussion: Our findings do not support migraine as a causal risk factor of MS. Several genetic variants, particularly in the MHC, may account for some of the overlap. It seems likely that migraine within the context of MS is because of MS. Identifying what increases the risk of migraine within MS might lead to an improved treatment and quality of life., (© 2023 American Academy of Neurology.)

Background: The Kaiser Permanente Research Bank (KPRB) is collecting biospecimens and surveys linked to electronic health records (EHR) from approximately 400,000 adult KP members. Within the KPRB, we developed a Cancer Cohort to address issues related to cancer survival, and to understand how genetic, lifestyle and environmental factors impact cancer treatment, treatment sequelae, and prognosis. We describe the Cancer Cohort design and implementation, describe cohort characteristics after 5 years of enrollment, and discuss future directions., Methods: Cancer cases are identified using rapid case ascertainment algorithms, linkage to regional or central tumor registries, and direct outreach to KP members with a history of cancer. Enrollment is primarily through email invitation. Participants complete a consent form, survey, and donate a blood or saliva sample. All cancer types are included., Results: As of December 31, 2020, the cohort included 65,225 cases (56% female, 44% male) verified in tumor registries. The largest group was diagnosed between 60 and 69 years of age (31%) and are non-Hispanic White (83%); however, 10,076 (16%) were diagnosed at ages 18-49 years, 4208 (7%) are Hispanic, 3393 (5%) are Asian, and 2389 (4%) are Black. The median survival time is 14 years. Biospecimens are available on 98% of the cohort., Conclusions: The KPRB Cancer Cohort is designed to improve our understanding of treatment efficacy and factors that contribute to long-term cancer survival. The cohort's diversity - with respect to age, race/ethnicity and geographic location - will facilitate research on factors that contribute to cancer survival disparities., (© 2022. The Author(s).)

Background: Adverse childhood experiences (ACEs) are linked to numerous health conditions but understudied in multiple sclerosis (MS). This study's objective was to test for the association between ACEs and MS risk and several clinical outcomes., Methods: We used a sample of adult, non-Hispanic MS cases (n = 1422) and controls (n = 1185) from Northern California. Eighteen ACEs were assessed including parent divorce, parent death, and abuse. Outcomes included MS risk, age of MS onset, Multiple Sclerosis Severity Scale score, and use of a walking aid. Logistic and linear regression estimated odds ratios (ORs) (and beta coefficients) and 95% confidence intervals (CIs) for ACEs operationalized as any/none, counts, individual events, and latent factors/patterns., Results: Overall, more MS cases experienced ≥1 ACE compared to controls (54.5% and 53.8%, respectively). After adjusting for sex, birthyear, and race, this small difference was attenuated (OR = 1.01, 95% CI: 0.87, 1.18). There were no trends of increasing or decreasing odds of MS across ACE count categories. Consistent associations between individual ACEs between ages 0-10 and 11-20 years and MS risk were not detected. Factor analysis identified five latent ACE factors, but their associations with MS risk were approximately null. Age of MS onset and other clinical outcomes were not associated with ACEs after multiple testing correction., Conclusion: Despite rich data and multiple approaches to operationalizing ACEs, no consistent and statistically significant effects were observed between ACEs with MS. This highlights the challenges of studying sensitive, retrospective events among adults that occurred decades before data collection., Competing Interests: The authors have declared that no competing interests exist.

Objectives: Determine the validity and reliability of a remote, technician-guided cognitive assessment for multiple sclerosis (MS), incorporating the Symbol Digit Modalities Test (SDMT) and the California Verbal Learning Test, Second Edition (CVLT-II)., Methods: In 100 patients, we compared conventional in-person testing to remote, web-assisted assessments, and in 36 patients, we assessed test-retest reliability using two equivalent, alternative forms., Results: In-person and remote-administered SDMT ( r  = 0.85) and CVLT-II ( r  = 0.71) results were very similar. Reliability was adequate and alternative forms of SDMT ( r  = 0.92) and CVLT-II ( r  = 0.81) produced similar results., Conclusions: Findings indicate remote assessment can provide valid, reliable measures of cognitive function in MS.

Objective: To use the case-only gene-environment (G [Formula: see text] E) interaction study design to estimate interaction between pregnancy before onset of MS symptoms and established genetic risk factors for MS among White adult females., Methods: We studied 2,497 female MS cases from 4 cohorts in the United States, Sweden, and Norway with clinical, reproductive, and genetic data. Pregnancy exposure was defined in 2 ways: (1) [Formula: see text] live birth pregnancy before onset of MS symptoms and (2) parity before onset of MS symptoms. We estimated interaction between pregnancy exposure and established genetic risk variants, including a weighted genetic risk score and both HLA and non-HLA variants, using logistic regression and proportional odds regression within each cohort. Within-cohort associations were combined using inverse variance meta-analyses with random effects. The case-only G × E independence assumption was tested in 7,067 individuals without MS., Results: Evidence for interaction between pregnancy exposure and established genetic risk variants, including the strongly associated HLA-DRB1*15:01 allele and a weighted genetic risk score, was not observed. Results from sensitivity analyses were consistent with observed results., Conclusion: Our findings indicate that pregnancy before symptom onset does not modify the risk of MS in genetically susceptible White females., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

Background: In 2016 the Nursing and Midwifery Council in the UK introduced revalidation, which is the process nurses are required to follow to renew their registration. This provides an opportunity for nurses to shape, develop and evolve social media to meet their professional requirements., Aims: to examine different ways nurses can use social media tools for continuous professional development (CPD) and revalidation., Methods: using a qualitative reflective design, data were gathered from content on the @WeNurses platform and activities organised with other leading health organisations in England. These data were analysed using the social media relationship triangle developed by the authors with a thematic analysis approach., Findings: analysis revealed that social media was used in six categories: publishing, sharing, messaging, discussing, collaborating, and networking. Organised social media events such as: blogs, tweetchats, Twitter storms, webinars, infographics, podcasts, videos and virtual book clubs can support nurses with revalidation and professional development., Conclusion: Through using a participatory CPD approach and embracing professional social media applications nurses have moved social media from the concept of a revolution to an evolution.

We used the California Verbal Learning Test, Second Edition (CVLT-II), one component of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), to determine feasibility of a remote assessment protocol. We compared telephone-administered CVLT-II data from MS patients to data acquired in person from an independent sample of patients and healthy controls. Mixed factor analyses of variance (ANOVAs) showed no significant differences between patient groups, but between-group effects comparing patients and healthy controls were significant. In this study, CVLT-II assessment by conventional in-person and remote telephone assessment yielded indistinguishable results. The findings indicate that telephone-administered CVLT-II is feasible. Further validation studies are underway.

The International Space Station (ISS) National Laboratory is dedicated to studying the effects of space on life and physical systems, and to developing new science and technologies for space exploration. A key aspect of achieving these goals is to operate the ISS National Lab more like an Earth-based laboratory, conducting complex end-to-end experimentation, not limited to simple microgravity exposure. Towards that end NASA developed a novel suite of molecular biology laboratory tools, reagents, and methods, named WetLab-2, uniquely designed to operate in microgravity, and to process biological samples for real-time gene expression analysis on-orbit. This includes a novel fluidic RNA Sample Preparation Module and fluid transfer devices, all-in-one lyophilized PCR assays, centrifuge, and a real-time PCR thermal cycler. Here we describe the results from the WetLab-2 validation experiments conducted in microgravity during ISS increment 47/SPX-8. Specifically, quantitative PCR was performed on a concentration series of DNA calibration standards, and Reverse Transcriptase-quantitative PCR was conducted on RNA extracted and purified on-orbit from frozen Escherichia coli and mouse liver tissue. Cycle threshold (Ct) values and PCR efficiencies obtained on-orbit from DNA standards were similar to Earth (1 g) controls. Also, on-orbit multiplex analysis of gene expression from bacterial cells and mammalian tissue RNA samples was successfully conducted in about 3 h, with data transmitted within 2 h of experiment completion. Thermal cycling in microgravity resulted in the trapping of gas bubbles inside septa cap assay tubes, causing small but measurable increases in Ct curve noise and variability. Bubble formation was successfully suppressed in a rapid follow-up on-orbit experiment using standard caps to pressurize PCR tubes and reduce gas release during heating cycles. The WetLab-2 facility now provides a novel operational on-orbit research capability for molecular biology and demonstrates the feasibility of more complex wet bench experiments in the ISS National Lab environment.

Aims: To ask: (i) is it feasible to include Twitter as an assessed element of the first-year nursing curriculum; (ii) how should it be introduced and assessed; and (iii) do students think it worthwhile and learn anything from its use?, Background: Nursing students need to use social media professionally, avoiding pitfalls but using learning opportunities., Design: This case study (2014-2015) comprised: (i) pilot introduction of Digital Professionalism (including Twitter) with second- and third-year students; (ii) introduction and assessment with a first cohort of 450 first-year students. Based on feedback, methods were revised for; (iii) a second cohort of 97., Methods: Students received a face-to-face lecture, two webinars, used chat rooms and were asked to create course Twitter accounts and were assessed on their use., Results: Few second and third year students started optional Twitter use whereas nearly all first years used it. Most students (70·1% first, 88·0% second cohort) thought inclusion of Twitter was worthwhile. Changes from first to second cohort included better peer-peer support, more contextualization and more emphasis on nursing communities. More second cohort students learned from Twitter (44·4% vs. 70·8%) and used Twitter recently (43·3% vs. 81·6%). Students gained wider perspectives on nursing, better understanding of social media, 'being student nurses' and topics like health promotion. Students mostly followed not only online nursing communities but also patient organizations., Conclusion: Including Twitter as an assessed element for first-year nursing students was feasible, students think it worthwhile and other nursing schools should consider introducing it in the broader context of Digital Professionalism., (© 2016 John Wiley & Sons Ltd.)

Aim: A discussion on how nurse leaders are using social media and developing digital leadership in online communities., Background: Social media is relatively new and how it is used by nurse leaders and nurses in a digital space is under explored., Design: Discussion paper., Data Sources: Searches used CINAHL, the Royal College of Nursing webpages, Wordpress (for blogs) and Twitter from 2000-2015. Search terms used were Nursing leadership + Nursing social media., Implications for Nursing: Understanding the development and value of nursing leadership in social media is important for nurses in formal and informal (online) leadership positions. Nurses in formal leadership roles in organizations such as the National Health Service are beginning to leverage social media. Social media has the potential to become a tool for modern nurse leadership, as it is a space where can you listen on a micro level to each individual. In addition to listening, leadership can be achieved on a much larger scale through the use of social media monitoring tools and exploration of data and crowd sourcing. Through the use of data and social media listening tools nursing leaders can seek understanding and insight into a variety of issues. Social media also places nurse leaders in a visible and accessible position as role models., Conclusion: Social media and formal nursing leadership do not have to be against each other, but they can work in harmony as both formal and online leadership possess skills that are transferable. If used wisely social media has the potential to become a tool for modern nurse leadership., (© 2016 John Wiley & Sons Ltd.)

Social media are playing a bigger and bigger part in our personal lives and what's more they are now infiltrating our professional lives, too. Moving from just 'being on' social media to using social media effectively as a midwife, is a huge challenge that many midwives are facing. To be effective and to really utilise social media to their full potential, midwives need to consider role-modelling, leading, social capital, digital footprint, visibility and continuing professional development. If all of these aspects are considered and midwives take a more considered approach to social media, they can really start to benefit from engaging in these online spaces.

Social media is becoming a facet of our lives and a tool for connecting, uniting and supporting people. Its use is growing in nursing, medical and health settings. This article describes the process, development and growth of an online community to connect nurses via Twitter using hashtags. Data was analysed to identify the benefits, barriers and enablers for the creation of an online nursing community. Methods consisted of key word searches in Twitter relevant to nursing, visits to the WeNurses website and tracking the number of followers on the website. A social media monitoring tool (SM2) was used to monitor visibility to establish baseline data and identify trends. WeNurses was launched in July 2012 and has over 7000 followers. Visits to the website are between 500 and 1500 each day. The use of a systematic nursing approach including the key principles of both nursing and social media (honesty, transparency, listening and reacting) helped to create and develop an online nursing community. It was found that WeNurses provides a platform for nurses to discuss issues in nursing, or complain about reforms. Nurses are free to question on how they can improve skills and contemplate their understanding of changes in the health service. Enablers included a committed group who openly discussed their thoughts, opinions and practices, a shared identity, an understanding each other's perspective and ownership by members. Using a nursing framework in a digital space added a unique dimension that resonated with members and provided a structured approach to the project. Nurses have begun to not only embrace social media but also use it for their own development. Health employers also need to encourage use of social media to help develop expertise, experience and knowledge in nurses and nursing practice. Social media can provide a social and professional space for nurses, and has potential to influence the health and wellness of different population groups involved in both giving and receiving nursing care.

Nurses can use social networking sites for professional development. This article provides advice on using social media professionally and ensuring this usean complies with the code of conduct.

Adherence of participants in a long-term clinical trial is necessary to assure validity of findings. This article examines adherence differences between single-parent and two-parent families in the Childhood Asthma Management Program (CAMP). Adherence was defined as the percentage of completed daily diary cards and scheduled study visits during the course of the trial. Logistic regression and ordinal logistic regression analyses were used. Children from single-parent families had a lower percentage of completed diary cards (72% vs. 84%) than two-parent families. Single-parent families were also more likely to reschedule visits (62% vs. 45%) and miss more clinic visits (23% vs. 17%) than two-parent families. Suggestions are given for study coordinators to assist participants in completing a long-term clinical trial. Many suggestions may be adapted for nurses in inpatient or outpatient settings for assisting parents of patients with chronic diseases.

Understanding the timings of interhemispheric climate changes during the Holocene, along with their causes, remains a major problem of climate science. Here, we present a high-resolution 10Be chronology of glacier fluctuations in New Zealand's Southern Alps over the past 7000 years, including at least five events during the last millennium. The extents of glacier advances decreased from the middle to the late Holocene, in contrast with the Northern Hemisphere pattern. Several glacier advances occurred in New Zealand during classic northern warm periods. These findings point to the importance of regional driving and/or amplifying mechanisms. We suggest that atmospheric circulation changes in the southwest Pacific were one important factor in forcing high-frequency Holocene glacier fluctuations in New Zealand.

We assessed the influence of perinatal melatonin on reproductive development and adult responsiveness to melatonin. Testicular growth in an intermediate day length (14 : 10 h light/dark cycle) was substantially reduced in Siberian hamsters gestated by pinealectomised compared to pineal-intact females; gonadal development was normalised in offspring of pinealectomised dams that were pinealectomised at 3-4 days of age. Hamsters deprived of melatonin only during gestation, or both pre- and postnatally, underwent testicular involution during treatment with melatonin in adulthood. Photoperiodic histories acquired prenatally did not endure as long as those acquired by adult hamsters. Hamsters first exposed to melatonin in adulthood were not more proficient in acquiring photoperiodic histories than were normal males. These findings indicate that pre- versus postnatal differences in melatonin signal duration determine rates of testicular development. Exposure to melatonin perinatally does not appear to organise the neuroendocrine substrate that mediates effects of day length and melatonin on the gonads of adult hamsters.

Background: Home exposure to high levels of house dust mite allergen has been shown to aggravate airways reactivity and asthma., Objective: The purpose of this study was to determine whether specific house dust mite control measures could reduce exposure levels and asthma severity., Methods: This double-blinded, randomized trial compared asthma progression over 1 year in children whose homes received standard environmental control intervention with those whose homes received aggressive intervention for dust mite elimination. The primary end point was doubling in PD20 methacholine., Results: Symptom scores and quality-of-life scores were similar for the standard and aggressive intervention groups. PD20 methacholine doubling occurred in 9 members of the aggressive intervention group vs 4 control patients (P <.05). Dust mite levels decreased in the aggressive intervention homes compared with the standard intervention homes (P <.05)., Conclusion: Aggressive dust mite intervention decreased dust mite levels and improved bronchial hyperresponsiveness.

Bretylium tosylate was compared with lidocaine hydrochloride as initial drug therapy in 146 victims of out of hospital ventricular fibrillation in a randomized blinded trial. An organized rhythm was achieved in 89 and 93 percent and a stable perfusing rhythm in 58 and 60 percent of the patients who received bretylium and lidocaine, respectively. After initiation of advanced life support, an organized rhythm was first established after an average of 10.4 minutes and 10.6 minutes in the two respective groups, requiring an average of 2.8 defibrillatory shocks in those who received bretylium and 2.4 in the lidocaine-treated patients. Comparable numbers of patients were discharged from the hospital: 34 percent of those given bretylium and 26 percent of the patients whose initial therapy was lidocaine. No instance of chemical defibrillation was observed with either drug. In this study, bretylium afforded neither significant advantage nor disadvantage compared with lidocaine in the initial management of ventricular fibrillation.