Modeling Glucose Transport From Systemic Circulation to Sweat

Sweat sensing may provide a noninvasive means of estimating blood biomarker levels if a number of technological hurdles can be overcome. This report describes progress on a physiologically based transport model relating sweat glucose and key electrolyte concentrations to those in blood. Iontophoretically stimulated sweat glucose and fasted blood glucose were simultaneously measured in 2 healthy human subjects. Sweat glucose was measured with a novel, prototype skin sweat collection/analysis system and blood glucose with a commercial fingerstick glucometer. These data, in combination with data from 3 published studies, were used to calibrate a dynamic mathematical model for glucose transport and uptake in human skin, followed by extraction into sweat. Model simulations revealed that experimental and literature sweat glucose values were well represented under varying physiologic conditions. The glucose model, calibrated under a variety of experimental conditions including electrical enhancement, revealed a 10 min blood-to-sweat lag time and a sweat/blood glucose level ranging from 0.001 to 0.02, depending on the sweat rate. These values are consistent with those reported in the literature. The developed model satisfactorily described the sweat-to-blood relationship for glucose concentrations measured under different conditions in 4 human studies including the present pilot study. The algorithm may be used to facilitate sweat biosensor development.     

Diagnostic specificity and mental health service utilization among veterans with newly diagnosed anxiety disorders

Objective

This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization.

Method

This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization.

Results

Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29).

Conclusion

Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings.     

Individual and perceived community determinants of sense of community: The role of universalistic values

Research on the determinants of the psychological sense of community (PSoC) is of particular importance to community interventions. A cross-sectional study involving 778 residents in an Italian local community explored through a mediation model the effects on PSoC of an individual cultural variable that has been scarcely investigated in PSoC research, that is, values–specifically, universalism–, and a perceived contextual variable, that is, the assessment of community services (a component of residential satisfaction). Results showed that universalism increased PSoC both directly and indirectly, having an effect also on the evaluation of community services, which, in comparison to values, showed a greater direct impact on PSoC. Limitations and implications for community interventions are discussed.     

Perceptions of School Climate Among Subgroups of Aggressive and Victimized Youth

The present study examined how perceptions of school climate differ across subgroups of early adolescents with distinct patterns of involvement in aggression and victimization. We identified subgroups among 800 sixth-grade students (87% African American, 51% female) based on latent class analysis of items assessing aggression and victimization. Consistent with previous research, we found support for a four-class solution that identified the following subgroups: aggressive-victims (8%), predominant-victims (12%), predominant-aggressors (28%), and youth with limited involvement (52%). Predominant-aggressors and aggressive-victims reported lower levels of teacher support and consistency and clarity of school rules than nonaggressive subgroups. Among male adolescents, aggressive-victims reported more positive perceptions of peer interactions than predominant-aggressors. Findings provide evidence that perceptions of school climate are related to early adolescents’ pattern of involvement in aggression and victimization, which has implications for school-based interventions targeting aggressive behavior.