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The increasing need for mental health support and a shortage of therapists have led to the development of the eXtended-reality Artificial Intelligence Assistant (XAIA). This platform combines spatial computing, virtual reality (VR), and artificial intelligence (AI) to provide immersive mental health support. Utilizing GPT-4 for AI-driven therapy, XAIA engaged participants with mild-to-moderate anxiety or depression in biophilic VR environments. Speaking with an AI therapy avatar in VR was considered acceptable, helpful, and safe, with participants observed to engage genuinely with the program. However, some still favored human interaction and identified shortcomings with using a digital VR therapist. The study provides initial evidence of the acceptability and safety of AI psychotherapy via spatial computing, warranting further research on technical enhancements and clinical impact. [ABSTRACT FROM AUTHOR]

Purpose: The present study examined perceived social support as a mediator of the longitudinal link between ambivalence over emotional expression (AEE) and quality of life among a sample of Chinese breast cancer survivors.Methods: Ninety-six Chinese breast cancer survivors recruited from Southern California completed four surveys in total: (1) a baseline survey (T1), 1-month follow-up (T2), 3-month follow-up (T3), and 6-month follow-up (T4). Participants filled out a paper-pen questionnaire containing the Ambivalence over Emotional Expression Questionnaire (AEQ), the Functional Assessment of Cancer Therapy-General (FACT-G), and the Medical Outcomes Study Social Support Scale (MOS-SSS).Results: Higher T1 AEE was associated with lower T1 social support (B = −0.01, SE = 0.004, p < 0.01) which in turn was associated with lower quality of life at T2 (B = 2.98, SE = 0.64, p < 0.01), T3 (B = 2.14, SE = 0.54, p < 0.01), and T4 (B = 2.08, SE = 0.68, p < 0.01).Conclusions: These results suggest that the harmful effect of AEE on quality of life is explained by reduced social support. Given the detrimental effects of AEE on social support and quality of life, future research on interventions that facilitate emotional disclosure is needed. Implications for the effects of Chinese culture on AEE are discussed. [ABSTRACT FROM AUTHOR]

High smoking prevalence among Korean American (KA) males place KA family members and co-workers at an elevated risk of involuntary tobacco smoke exposure (ITSE). KA emerging adults (EAs) face an additional risk of ITSE by their peers, as emerging adulthood is associated with increased smoking. This paper explores health behaviors, attitudes and beliefs of ITSE among KAEA. Qualitative data analysis was conducted on transcripts from ten focus groups (N = 67). Themes related to attitudes and perceptions of ITSE were identified: high level of cultural tolerance, lack of knowledge/insufficient information, perceived benign health effects, and perceived hopelessness/indifference. Themes related to culturally-held beliefs include: tolerance of male family smokers, allowance of indoor smoking and misconceptions of practices perceived to minimize ITSE. The dissemination of culturally relevant ITSE information is needed in KA communities. Failure to implement indoor smoking bans in ethnic enclaves calls for increased enforcement of regulations by public health officials. [ABSTRACT FROM AUTHOR]

The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) to classify children with ASD, (2) examine psychometric properties of different ASD classification methods, including the SEED method that incorporates rules for resolving ADI-R and ADOS discordance, and (3) determine whether restricted interests and repetitive behaviors were noted for children who had instrument discordance resolved using ADI-R social and communication scores. Results support the utility of SEED criteria when well-defined groups of children are an important clinical or research outcome. [ABSTRACT FROM AUTHOR]

This paper examines inter-method reliability and validity of daily self-reports by smartphone application compared to 14-day recall web-surveys repeated over 6 weeks with people living with HIV (PLH). A participatory sensing framework guided participant-centered design prioritizing external validity of methods for potential applications in both research and self-management interventions. Inter-method reliability correlations were consistent with prior research for physical and mental health quality-of-life (r = 0.26-0.61), antiretroviral adherence (r = 0.70-0.73), and substance use (r = 0.65-0.92) but not for detailed sexual encounter surveys (r = 0.15-0.61). Concordant and discordant pairwise comparisons show potential trends in reporting biases, for example, lower recall reports of unprotected sex or alcohol use, and rounding up errors for frequent events. Event-based reporting likely compensated for modest response rates to daily time-based prompts, particularly for sexual and drug use behaviors that may not occur daily. Recommendations are discussed for future continuous assessment designs and analyses. [ABSTRACT FROM AUTHOR]

Will a pastor refer to a mental health center? If they feel qualified to intervene themselves, they may not. Because pastors often provide grief counseling, it is important to understand the decisions they make when intervening with depressed individuals. A random sample of 204 Protestant pastors completed surveys about their treatment practices for depression. Fisher's exact analyses revealed that more pastors with some secular education yet no degree felt that they were the best person to treat depression than pastors who had no secular education or pastors who had at least a secular bachelor's degree. However, the level of theological education did not influence beliefs about the pastor being the best person to treat depression. In addition, neither secular nor theological education level influenced pastors' views on referring people to mental health centers for depression treatment. Based on findings, this paper discusses implications for best practices in training pastors on depression and other mental health topics. [ABSTRACT FROM AUTHOR]

This paper examines facilitators and barriers to HIV activities within religious congregations, the relative internal or external sources of these influences, and suggestive differences across congregational types. Results are based on in-depth interviews with clergy and lay leaders ( n = 57) from 14 congregations in Los Angeles County, California, purposively selected to reflect diversity in racial-ethnic composition, denomination, size, and HIV activity level. Many common facilitators and barriers were related to norms and attitudes, only a few of which appeared overtly associated with theological orientations. Clergy support was a facilitator particularly prevalent among congregations having higher HIV activity levels, indicating its importance in sustaining and expanding HIV programs. Resource issues were also prominent, with material resource barriers more frequently mentioned by smaller congregations and human resource barriers more among larger congregations. Organizational structure issues were mostly centered on external linkages with various social service, public health, and faith-based entities. Analysis of internal versus external sources highlights the roles of different stakeholders within and outside congregations in promoting HIV activities. Potential differences across congregational types represent fruitful areas for future research. [ABSTRACT FROM AUTHOR]

Background: A growing body of research has found a link between firearm availability and police shootings of citizens across place. The problem, however, is that the previous studies on the topic tend to suffer from several limitations: a near exclusive focus on citizen fatalities, units of analysis at the state or county levels, and a variety of proxy measures tapping into community-level firearm access. The current study set out to address these issues by examining the relationship between different forms of firearm availability and both fatal and nonfatal injurious police shootings of citizens at the city level. Methods: More specifically, it merged The Trace's "Missing Pieces" measures of guns reported lost and stolen to police as well as licensed firearms dealers across jurisdictions from the Bureau of Alcohol, Tobacco, Firearms, and Explosives as proxies for firearm availability with data on police shootings of citizens in California and Florida from California's URSUS system and the Tampa Bay Times' "Why Cops Shoot" database, respectively. Negative binomial regression analyses were performed on a sample of 253 cities across the two states and a sub-sample of cities with licensed firearms dealers. Results: Findings uncovered a small positive association between rates of federally licensed guns stores and the number citizens shot by police as well as police shooting incidents while controlling for several community-level measures (e.g., concentrated disadvantage, gun homicide rates). Rates of guns lost or reported stolen were generally not significantly associated with the outcome measures in the multivariate models. Conclusions: Firearm availability is a significant correlate of police shootings. Pooled counts of both citizens shot by police and police shooting incidents are heightened in jurisdictions with higher rates of licensed gun dealers, which may be due to the fact that all firearms sold in the USA first make their way to the public through these mechanisms. Such licensed gun dealers must be appropriately monitored and audited to reduce illicit behavior and prevent firearms from making their way into secondary markets. Addressing access to firearms can be meaningful for a host of gun-related morbidity and mortality outcomes, including police shootings of citizens. [ABSTRACT FROM AUTHOR]

Background: This paper outlines conclusions from a three-day workgroup hosting the eight authors as well as others with expertise in the evaluation and treatment of youth exposed to war and violence. Objective: The purpose of this meeting was to bring multiple perspectives together to identify components that comprise effective psychosocial interventions for child victims of war and community violence across cultures. The meeting also sought to identify gaps in the existing treatment approaches. Method: In the meeting, personal experiences and previous research were discussed to develop a wide-ranging intervention approach, determine a cohesive definition for 'indirect' exposure, and identify successful methods of intervention delivery for youth exposed to acts of war and violence. Results and Conclusions: Key components of intervention for youth exposed to war/violence, important outcome measures, and cultural differences that may influence effective intervention were identified. A clearer definition of 'indirect' exposure was also developed. Finally, a nine-phase model was developed to provide guidelines for establishing partnerships between trauma teams and other organizations or schools to implement and disseminate treatment for this population. [ABSTRACT FROM AUTHOR]

The quality of propensity scores is traditionally measured by assessing how well they make the distributions of covariates in the treatment and control groups match, which we refer to as 'good balance'. Good balance guarantees less biased estimates of the treatment effect. However, the cost of achieving good balance is that the variance of the estimates increases due to a reduction in effective sample size, either through the introduction of propensity score weights or dropping cases when propensity score matching. In this paper, we investigate whether it is best to optimize the balance or to settle for a less than optimal balance and use double robust estimation to adjust for remaining differences. We compare treatment effect estimates from regression, propensity score weighting, and double robust estimation with varying levels of effort expended to achieve balance using data from a study about the differences in outcomes by HIV status in heterosexually active homeless men residing in Los Angeles. Because of how costly data collection efforts are for this population, it is important to find an alternative estimation method that does not reduce effective sample size as much as methods that aggressively aim to optimize balance. Results from a simulation study suggest that there are instances in which we can obtain more precise treatment effect estimates without increasing bias too much by using a combination of regression and propensity score weights that achieve a less than optimal balance. There is a bias-variance tradeoff at work in propensity score estimation; every step toward better balance usually means an increase in variance and at some point a marginal decrease in bias may not be worth the associated increase in variance. [ABSTRACT FROM AUTHOR]

Objective: We recently described the development of a comprehensive database for assessing phytoestrogen exposure in epidemiologic studies. This paper describes the first application of this database and the primary sources of phytoestrogen consumption in non-Asian women.Methods: Four hundred and forty-seven randomly selected African-American, Latina, and white women, ages 50-79 years, residing in California's San Francisco Bay Area and participating as controls in an ongoing population-based case-control study of breast cancer, were included in the present analysis. Average daily consumption of each of seven phytoestrogenic compounds was determined for each woman by combining the values from the new database with food consumption reported on a food-frequency questionnaire.Results: Phytoestrogens in the non-Asian Bay Area diet appear to come primarily from: (1) traditional soy-based foods (e.g. tofu and soy milk); (2) "hidden" sources of soy (e.g. foods containing added soy protein isolate, soy concentrate, or soy flour, e.g. many brands of doughnuts and white bread); and (3) a variety of foods which contain only low to moderate amounts of phytoestrogens per 100 grams but which are frequently consumed (e.g. coffee and orange juice).Conclusions: In the absence of a comprehensive assessment of various phytoestrogens in a wide variety of foods, epidemiologic studies could suffer from the effects of uncontrolled confounding by unmeasured sources of phytoestrogen exposure potentially leading to biased estimates of effect and misinterpretation of findings. [ABSTRACT FROM AUTHOR]

Many patients have a rudimentary knowledge of their body's anatomy and functioning. In a clinical setting, deficits in patient understanding can lead to miscommunication affecting patient care and satisfaction. Hence, this study aims to estimate a baseline of patient knowledge regarding pelvic anatomy and to assess their educational preferences in learning about related topics. For this cross-sectional study, we developed a 24-item assessment with questions related to pelvic anatomy, health, and function. The questionnaire was validated using feedback from anonymous community focus groups, and then distributed to English-speaking female patients at the Women's Clinic of LAC + USC Medical Center (Los Angeles). The participant performance as a percentage-correct score on the anatomy assessment constituted our primary outcome. As secondary outcomes, educational preferences were inquired. Statistical analysis was conducted using two-sample t tests. The majority of our total sample of 269 were Hispanic (65.4 %) with a mean age of 35.3 years. We documented deficits in patient knowledge with a mean score of 66.1 % correct on anatomy assessment. Statistically significant lower scores were associated with less education and with Hispanic/Latino origin. Additionally, we found that while physicians have played a role in health education, women prefer to receive more education from their providers in the future. The deficits we identified indicate the pressing need to improve the pelvic health literacy of our patients. Understanding what our patients know and want to know is critical to effective communication and is fundamental to providing better clinical care in the future. [ABSTRACT FROM AUTHOR]

HIV researchers use short messaging service (SMS)-based surveys to monitor health behaviors more closely than what would be possible with in-person assessment. Benefits are tempered by nonresponse to completing surveys. Understanding response patterns and their associated study participant characteristics would guide more tailored use of SMS-based surveys for HIV studies. We examined response to weekly 7-item SMS surveys administered as part of an HIV prevention trial. Using Mixture hidden Markov models (MHMM), we identified the underlying response patterns shared by subgroups of participants over time and quantified the association between these response patterns and participant characteristics. Three underlying response patterns were identified; responders, responders with phone-related errors, and non-responders. Non-responders versus responders were more likely to be younger, male, cis-gender, Black and Latinx participants with histories of homelessness, incarceration, and social support service utilization. Responders with phone-related errors compared to non-responders were more likely to be Black, Latinx, female, students, and have a history of incarceration and social support service utilization. More nuanced results from MHMM analyses better inform what strategies to use for increasing SMS response rates, including assisting in securing phone ownership/service for responders with phone-related errors and identifying alternative strategies for non-responders. Actively collecting and monitoring non-delivery notification data available from SMS gateway service companies offers another opportunity to identify and connect with participants when they are willing but unable to respond during follow-up. [ABSTRACT FROM AUTHOR]

There is ample evidence that exposure to Immigration and Customs Enforcement (ICE) activities could widen Latinas' health disparities. Whether or not residing near an ICE detention center (IDC) further impacts their health is unknown. During nationwide increased ICE activities Latinas (N=45) attended an intervention at two separate sites: one near and another one far from an IDC. A focus group discussion and an interview were conducted using a grounded theory approach. Quantitative data were collected and analyzed. Participants residing near an IDC benefited less from the intervention and reported changes in anxiety levels and in mobility, and a sense of powerlessness. They also requested resources to respond to ICE overreach and broadcasting of their reality. Our results suggest that proximity to IDCs impacts immigrant communities and public health programming, which is inevitably embedded in political realities. These need to be addressed when providing much needed interventions. [ABSTRACT FROM AUTHOR]

Poor sleep is common among older adults, affecting a wide range of health outcomes. However, little is known about sleep issues among older Korean immigrants, the fastest growing Asian American subgroup in the United States. We aimed to explore multiple factors associated with sleep among this group. We analyzed cross-sectional survey data from 43 older immigrants living in two large Korean communities in Southern California. Perceived sleep quality was significantly associated with gender, living arrangement, employment status, mental health, and sleep-related beliefs (all p-values < 0.05). Living with someone and being employed for wages were significantly uniquely associated with better sleep quality, accounting for demographic and health-related factors (R2 = 51.8%, adjusted R2 = 38.7%, p = 0.002). These findings suggest a potential role of sociocultural factors on sleep. Further studies are needed to confirm these findings and to inform a sleep intervention program tailored to the characteristics of older Korean immigrants. [ABSTRACT FROM AUTHOR]

The Korean population in the US increased by a third between 2000 and 2010. Korean women in the US report low calcium intake and relatively high rate of fractures. However, little is known about the prevalence of osteoporosis among Korean American women. This paper examined the relationship between prevalence of osteoporosis and milk consumption, and their relationship with acculturation among a representative sample of immigrant California women of Korean descent. Bilingual telephone surveys were conducted from a probability sample (N = 590) in 2007. Lower acculturation significantly related to lower milk consumption for women during the age periods of 12–18 and 19–34 years. Acculturation was related to higher prevalence of osteoporosis among post-menopausal, but not pre-menopausal Korean women in California. Future research should include larger cohorts, objective measures of osteoporosis, other sources of calcium specific to Korean cuisine, and assessment of bone-loading physical activity. [ABSTRACT FROM AUTHOR]

This observational cross-sectional study of 152 people with HIV (PWH) examined the effects of age and estimated duration of HIV infection (EDI) on depressive and anxiety symptoms. All participants were cisgender men and completed the Profile of Moods State (POMS), a self-report inventory of current (i.e., past week) mood states. Overall, study results confirmed higher levels of anxiety and depression in PWH compared to individuals without HIV. Age group (< 50 or ≥ 50 years) moderated the effect of EDI (< 3 or ≥ 3 years) on mood disturbance. Specifically, younger PWH with early diagnosed infection exhibited the highest levels of depression and anxiety, whereas depression and anxiety were attenuated in older PWH with early infection such that their POMS scores did not significantly differ from the HIV-negative and chronically HIV-infected groups. Despite the small sample size and other important limitations in our study design, our preliminary findings confirm previous observations that older people may have some adaptive ability to better handle the acute psychological stressors associated with recent HIV infection. [ABSTRACT FROM AUTHOR]

Background: Asian-Americans and Pacific Islanders comprise 6% of the U.S. population, but 50% of chronic hepatitis B cases and have a cancer mortality that is 60% higher than non-Hispanic Whites. The objective of this study was to assess knowledge of HBV transmission, symptoms/sequelae and treatment among NHPIs in San Diego. Methods: Self-administered surveys were distributed using convenience sampling at the 24th Annual Pacific Islander Festival in San Diego in 2018. Results: Overall knowledge scores were low (mean: 9.8 out of 28) among participants. Compared to U.S.- born (mean: 11.6), participants born in Pacific Island countries and territories (mean: 8.5) had lower knowledge scores (p = 0.017) and lower self-reported vaccination rates (50% vaccinated vs 27%, respectively, p = 0.025). Discussion: Lack of HBV knowledge, low vaccination rates and the discordance between knowledge and behavior regarding HBV vaccination elicits an urgent need to collaborate with NHPI communities for HBV education, screening, immunization and treatment. [ABSTRACT FROM AUTHOR]

Background: Electronic referrals can improve access to subspecialty care in safety net settings. In January 2007, San Francisco General Hospital (SFGH) launched an electronic referral portal that incorporated subspecialist triage, iterative communication with referring providers, and existing electronic health record data to improve access to subspecialty care.Objective: We surveyed primary care providers (PCPs) to assess the impact of electronic referrals on workflow and clinical care.Design: We administered an 18-item, web-based questionnaire to all 368 PCPs who had the option of referring to SFGH.Measurements: We asked participants to rate time spent submitting a referral, guidance of workup, wait times, and change in overall clinical care compared to prior referral methods using 5-point Likert scales. We used multivariate logistic regression to identify variables associated with perceived improvement in overall clinical care.Results: Two hundred ninety-eight PCPs (81.0%) from 24 clinics participated. Over half (55.4%) worked at hospital-based clinics, 27.9% at county-funded community clinics, and 17.1% at non-county-funded community clinics. Most (71.9%) reported that electronic referrals had improved overall clinical care. Providers from non-county-funded clinics (AOR 0.40, 95% CI 0.14-0.79) and those who spent > or =6 min submitting an electronic referral (AOR 0.33, 95%CI 0.18-0.61) were significantly less likely than other participants to report that electronic referrals had improved clinical care.Conclusions: PCPs felt electronic referrals improved health-care access and quality; those who reported a negative impact on workflow were less likely to agree. While electronic referrals hold promise as a tool to improve clinical care, their impact on workflow should be considered. [ABSTRACT FROM AUTHOR]

The development of new pharmaceutical interventions for persons with human immunodeficiency virus (HIV) infection has resulted in extended survival and a need for valid, reliable and responsive instruments to assess health-related QoL (HRQoL). This paper reviews the reliability and validity of an HRQoL instrument, the AIDS Health Assessment Questionnaire (AIDS-HAQ), among persons participating in an observational database of HIV infection. The AIDS-HAQ includes nine subscales: disability, energy, general health, pain, cognitive functioning, mental health, social functioning, health distress and symptoms. Individuals complete the AIDS-HAQ quarterly. Data are reported for 440 individuals entering the study with early HIV infection. Fifty-nine progressed to symptomatic disease and 109 to AIDS after 1 year. The subscales of the instrument resulted in high internal consistency reliability (range = 0.79-0.88). Concurrent validity data reflected the ability to distinguish between patients with increasing disease severity. In all domains, except cognitive functioning, individuals who progressed to AIDS had significant decrements (p < 0.01) in HRQoL compared with symptomatic and asymptomatic patients. Significant decrements (p < 0.01) were observed for disability, general health, energy and symptoms for patients who progressed to symptomatic disease from an asymptomatic status. Individuals who had decreasing CD4+ counts also had significant declines (p < 0.001) in disability, general health, social functioning, pain and symptoms. The AIDS-HAQ is an instrument that can be used when comparing group differences and within group changes in observational databases, naturalistic studies and clinical trials. [ABSTRACT FROM AUTHOR]

Many ED patients have limited English proficiency (LEP). Under Title VI of the 1964 Civil Rights Act, LEP patients are entitled to language assistance, however, multiple studies demonstrate that language assistance is underutilized. We aimed to characterize the knowledge, practice patterns, and preferences of ED providers and staff regarding language assistance for LEP patients. We performed a self-administered, anonymous questionnaire in an urban, public ED where most patients have LEP. Subjects included all ED providers and staff with substantial patient contact. We recorded ED role, knowledge of language assistance policy, prior training on working with interpreters, non-English language skills and bilingual certification. Outcomes included frequency of and comfort level with respondent's own non-English language (NEL) use in the ED, and the preferred and most frequently used modalities of language assistance. Of the 354 total ED employees, 261 were approached and 259 agreed to participate, which represents a 73% response rate (259/354). Respondents were 37% MD/NPs, 34% RNs and 29% other ED staff. Only 50/259 (19%) had prior training on working with interpreters. 171/257 (67%) were "unsure" if the hospital had a policy on language assistance. The most frequent modalities accessed for spoken language assistance were "Other ED staff" 106/259 (41%) or "ad hoc interpreter" 62/259 (24%). Although 227/274 (83%) use a non-English language with patients regularly, comfort levels in using their NEL for clinical care were variable. Most ED providers and staff had little training in the use of language assistance and were unaware of hospital policy. Use of NEL skills by providers for clinical care is common. Dissemination of best practices for the provision of language assistance and the clinical use of NEL skills has the potential to improve communication with LEP patients. [ABSTRACT FROM AUTHOR]

This study explored the adjustment phase of the resiliency model of family adjustment and adaptation, particularly how stress and food insecurity interact with protective mechanisms to influence children's dietary adjustment. With increasing rates of Hispanic childhood obesity and disproportionate health disparities, this is an issue that must be better understood. Altogether, 137 Mexican immigrant mothers from Illinois and California completed questionnaires reporting their stressors, protective mechanisms, and family health behaviors. Multiple regression analyses revealed that higher perceived stress levels for mothers predicted non-nutritive snacking reasons. Furthermore, mother's dietary patterns predicted child's poor dietary quality. Taken together, maternal stressors play a role in family health behaviors, and future studies should consider household food environment factors when trying to understand protective mechanisms for families. [ABSTRACT FROM AUTHOR]

Background/objectives: This study examined the long-term relation of lipid-soluble micronutrients with diet quality as assessed by four a priori-defined dietary patterns.Subjects/methods: In a prospective design, nutritional biomarkers (carotenoids, tocopherols, retinol, and coenzyme Q10) were measured using a validated HPLC-based assay. General linear models were applied to obtain covariate-adjusted means of biomarkers for tertiles of four a priori diet quality indices: Healthy Eating Index (HEI) 2010, Alternative HEI (AHEI) 2010, Alternate Mediterranean Diet Score (aMED), and Dietary Approaches to Stop Hypertension (DASH). For a subcohort of 8367 participants within the Multiethnic Cohort (MEC), diet was assessed by a validated quantitative food frequency questionnaire in 1993-96 and serum was collected in 2001-06.Results: Participants with the highest diet-quality scores had significantly higher serum concentrations of all carotenoids, total tocopherols, and α-tocopherol, whereas γ-tocopherol was inversely associated with diet quality. Adjusted means for the lowest vs. highest tertile of HEI 2010 were 1.2 vs. 1.5 mg/L for total carotenoids, 11.4 vs. 12.3 mg/L for total tocopherols, and 1.9 vs. 1.6 mg/L for γ-tocopherol (ptrend < 0.0001). The associations for the other dietary indices were similar; no indication for sex and ethnic differences was detected. Vegetable and fruit components were major predictors of most circulating micronutrients, but most other components were also associated.Conclusions: Higher diet-quality scores measured by four a priori diet quality indices were significantly associated higher serum concentrations of carotenoids and α-tocopherol, whereas γ-tocopherol was inversely associated with diet quality. [ABSTRACT FROM AUTHOR]

While individual-level determinants of health, such as education and income, have been well documented among breast cancer survivors, little is known about the role of neighborhood context on survivorship outcomes among this population. The present study examined the association of neighborhood stress with multiple health outcomes among ethnic minority breast cancer survivors (BCS). A mixed-methods approach was used to recruit 320 African-American and Hispanic BCS who were 26-89 years and lived in metropolitan Los Angeles, CA. Neighborhood stress was assessed by six items taken from the Life Stress Scale. Health outcomes included (1) self-rated health, measured by the Short-Form-36 Health Survey, (2) number of comorbidities (0-14), (3) depressive symptoms, assessed by the Center for Epidemiological Studies-Depression scale, and (4) psychological difficulties. Greater neighborhood stress was significantly associated with poorer self-reported health (adjusted β = −.22, 95% confidence interval [CI] −.40, −.05), greater number of comorbidities (adjusted risk ratio = .19, 95% CI .07, .30), more depressive symptoms (adjusted β = .10, 95% CI .06, .15), and a higher likelihood of psychological difficulties (adjusted odds ratio = 2.28, 95% CI 1.51, 3.45) among ethnic minority BCS. These findings underscored the importance of taking neighborhood context into account in examining the determinants of health, survivorship, and quality of life outcomes among cancer patients. Our findings may inform population health, health services, and interventions addressing neighborhood and individual-level factors to promote post treatment health and survivorship outcomes as well as to identify high-risk patients, especially among medically vulnerable communities. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet few patients disclose CAM use to medical doctors. Our objectives were to (1) assess Latino herbal use, (2) explore the most commonly used herbs for common ailments, and (3) examine patients' disclosure of herb use to their physicians. Self-administered questionnaires were collected from 318 Latino patients seeking treatment at community health centers. Descriptive statistical analysis was conducted to determine the frequency of stated objectives among the participants. Fisher's exact test was used to compare differences among CAM users and non-users. Most respondents (90%) reported using herbs. Less than a third (31%) of those herb users felt comfortable speaking English to their physician. A majority (74.8%) of the respondents utilizing herbs reported never disclosing their herbal use to their healthcare providers, and of those that did, majority (63%) were under the age of 36 years. Of those that disclosed their herbal use, only 31% perceived receiving a positive reaction about herbal use from their providers. Chamomile, cinnamon, Aloe vera, spearmint, and key lime were the top used herbs in this population. Herbal use disclosure reflects a greater sense of trust and communication between patient and provider. Therefore, a need exists to increase provider competency for patients using herbs in order to improve consistency of care and facilitate healthy patients and communities, especially among Spanish-speaking Latinos in Southern California. [ABSTRACT FROM AUTHOR]

Interventions are needed to address frailty and other behaviors (e.g., drug and alcohol use) among prefrail and frail homeless women (P/FHW). The purpose of this pilot randomized controlled trial (RCT) was to compare the efficacy of a Frailty Intervention (FI) versus a Health Promotion (HP) program among P/FHW (N = 32). Structured instruments assessed sociodemographics, individual, situational, health-related, and behavioral factors. While program differences were not statistically significant with the main outcome variables, medium-to-large effect sizes were found in favor of the HP program as it relates to physical and overall frailty, as well as, any drug use, alcohol use, and drug dependency. Based on these findings, it is critical to strengthen the HP program to optimize all domains of frailty (e.g., physical, psychological, and social) and substance use for P/FHW. [ABSTRACT FROM AUTHOR]

The Epic electronic health record (EHR) platform supports structured data entry systems (SDES), which allow developers, with input from users, to create highly customized patient-record templates in order to maximize data completeness and to standardize structure. There are many potential advantages of using discrete data fields in the EHR to capture data for secondary analysis and epidemiological research, but direct data acquisition from clinicians remains one of the largest obstacles to leveraging the EHR for secondary use. Physician resistance to SDES is multifactorial. A 35-item questionnaire based on Unified Theory of Acceptance and Use of Technology, was used to measure attitudes, facilitation, and potential incentives for adopting SDES for clinical documentation among 25 pediatric specialty physicians and surgeons. Statistical analysis included chi-square for categorical data as well as independent sample t-tests and analysis of variance for continuous variables. Mean scores of the nine constructs demonstrated primarily positive physician attitudes toward SDES, while the surgeons were neutral. Those under 40 were more likely to respond that facilitating conditions for structured entry existed as compared to the two older age groups ( p = .02). Pediatric surgeons were significantly less positive than specialty physicians about SDES effects on Performance ( p = .01) and the effect of Social Influence ( p = .02); but in more agreement that use of forms was voluntary ( p = .02). Attitudinal differences likely reflect medical training, clinical practice workflows, and division specific practices. Identified resistance indicate efforts to increase SDES adoption should be discipline-targeted rather than a uniform approach. [ABSTRACT FROM AUTHOR]

Predictors of the physical and relational aggressive behavior of children in foster care were examined ( N = 160, 50.9% male, M age = 7.57, SD = 2.39). First, predictors representative of children's placement histories were examined in relation to the children's aggression at T1. Next, predictors representing characteristics of the current family environment were examined in relation to the children's aggression at T2 (4 months later). Results revealed that a greater number of prior group home placements and being in a non-kinship home were associated with higher physical aggression at T1. A greater number of prior group home placements, a fewer number of regular home placements, being in a non-kinship home, and prior removal from the home due to neglect were associated with higher relational aggression at T1. The results also revealed that higher foster sibling relational aggression at T1 predicted lower child physical aggression at T2. If foster siblings were biological children of the foster parent, higher levels of a foster sibling's physical aggression at T1 predicted reduced child physical aggression at T2. The opposite pattern was observed if foster siblings were not biological children of the foster parent. Lastly, longer time in the current placement, more children in the home, and the presence of a sibling that was a biological child of the parent predicted higher child relational aggression at T2. These findings provide initial insights into how placement history and current family environment are associated with the physical and relational aggressive behavior of children in foster care. [ABSTRACT FROM AUTHOR]

Objectives Food insecurity in the United States is a stubborn public health issue, affecting more than one in five households with children and disproportionately impacting racial and ethnic minority women and their children. Past research and policy has focused on household predictors of food insecurity, but neglected broader factors, such as perceived neighborhood social cohesion, that might protect those most vulnerable to food insecurity. Methods We use a racially and ethnically diverse data set from the Geographic Research on Wellbeing study (N = 2847) of women and their young children in California to investigate whether social cohesion influences food insecurity and whether it moderates the relationship between race/ethnicity and food insecurity. Results We find that lower levels of perceived residential neighborhood social cohesion associate with higher odds of food insecurity even after considering important household socioeconomic factors. In addition, our results suggest that social cohesion is most relevant for reducing the risk of food insecurity among racial and ethnic minority mothers. For example, the probability of food insecurity for immigrant Latina mothers is nearly 0.40 in neighborhoods where mothers perceive little to no cohesion and less than 0.10 in neighborhoods where mothers perceive high cohesion. Conclusions for Practice Higher levels of neighborhood perceived social cohesion are protective against food insecurity in households with children and especially so for racial and ethnic minority households who are at a heightened risk of food insecurity. Supporting programs that focus on building closer knit communities may be a key to reducing food insecurity overall and for reducing disparities in food insecurity by race and ethnicity. [ABSTRACT FROM AUTHOR]

Objective To provide preliminary descriptive data on caregiver and child weight status, parenting styles, feeding styles, and feeding practices of a small American Indian sample. Methods Participants included a subsample of American Indian caregivers ( n = 23) identified from a larger study that was conducted in five states. Using previously validated instruments, means, standard deviations, and ranges for general parenting styles, feeding styles, and feeding practices were explored. Results In general, most caregivers reported healthy feeding practices. Most caregivers scored higher on responsive compared to restrictive or permissive in general parenting. Of the sample, 12 caregivers (52.2 %) were classified in the indulgent feeding style category, 5 caregivers (21.7 %) were classified as authoritative, 5 (21.7 %) uninvolved, and 1 (4.3 %) authoritarian. Conclusions More investigations are needed to explore questions raised by this study about using common tools that measure childhood obesity with American Indian families. [ABSTRACT FROM AUTHOR]

As medical technology continues increasing the possibility of living a longer life, the public's valuing of these developments must be considered. This study examines attitudes toward extending the human life span within a student population at a Christian university. Religious factors were hypothesized to affect life extension desirability. Scores on measures of willingness to defer to God's will, meaning derived from religion, positive afterlife beliefs, and intrinsic religiosity were significantly and inversely related to life extension desirability. Implications of these findings are discussed, including encouraging medical practitioners to respect decision-making processes of religious persons who may find life extension interventions undesirable. [ABSTRACT FROM AUTHOR]

Childhood and adolescent adversity have been shown to predict later mental and physical health outcomes. Understanding which aspects and developmental timings of adversity are important, and the mechanisms by which they have their impact may help guide intervention approaches. A large subset of adolescents ( N = 457; Female 68.9 %) from the 10-year longitudinal Youth Emotion Project was examined to better understand the associations among childhood/adolescent adversity, substance use disorder, and later health quality. Adolescent (but not childhood) adversities were associated with poorer health in late adolescence/early adulthood, adolescent adversities were associated with subsequent onset of substance use disorder, and adolescent adversities continued to be associated with poorer health in late adolescence/early adulthood after accounting for the variance explained by substance use disorder onset. These associations were observed after statistically accounting for emotional disorders and socioeconomic status. Specific domains of adversity uniquely predicted substance use disorder and poorer health outcomes. In contrast with current recent research, our findings suggest the association between childhood/adolescent adversity and poorer health outcomes in late adolescence and emerging adulthood are not entirely accounted for by substance use disorder, suggesting efforts to curtail family-based adolescent adversity may have downstream health benefits. [ABSTRACT FROM AUTHOR]

This study of child welfare-affiliated maltreated youth ( n = 216) and comparison youth ( n = 128) from the same community (age M = 18.21, SD = 1.42) examined: 1. whether child/caregiver characteristics and maltreatment status were associated with lifetime number of residences; and 2. whether child/caregiver characteristics, residences, and maltreatment status were associated with delinquency and marijuana use. Maltreatment status, ever living with a nonparent caregiver, and being older were associated with more residences during childhood. More residences and male sex were associated with person offense delinquency and marijuana use. It is important to help caregivers who live in disadvantaged neighborhoods, especially families with child welfare involvement, understand the behavioral consequences of a high number of residences during childhood and adolescence and provide support for stable long-term housing. [ABSTRACT FROM AUTHOR]

The quality of early student-teacher relationships (STRs) has been shown to predict children's school adjustment, and children with autism spectrum disorder (ASD) are at risk for poor quality STRs. The present study examined 162 children with ASD (ages 4-7) and their teachers to evaluate student, teacher, and classroom characteristics that predicted concurrent and prospective STR quality across one school year. Child oppositional behavior, autism severity and teacher degree predicted changes in student-teacher conflict over a 1-year period, while child social skills and IQ positively predicted change in student-teacher closeness. Teacher preparedness, trainings in ASD, and classroom setting were unrelated to STR quality. Implications for intervention are discussed. [ABSTRACT FROM AUTHOR]

Over the past decade, the concept of family resilience among impoverished families has increased as a main focus area for family scholars. Similarly, individual, family, and community-level factors that promote family resilience and their impact on behavioral health outcomes have particularly received increased amounts of attention. To date, however, few empirical studies have simultaneously validated the socioecological determinants of family resilience within multi-dimensional conceptual frameworks. In the current study, we test such a model using a cross-sectional design among 380 women and men with an average age of 35 experiencing poverty as a chronic stressor, the majority of whom are ethnic minorities. Individual, family and community determinants of family resilience are examined for their differential effect on outcomes of physical and mental health, as well as risks for substance abuse. Results from structural equation modeling provide support for the model. Findings suggest that community-level determinants impact health through indirect pathways. In this case, community factors predict family and individual-level determinants, and individual factors then directly predict health. Similarly, the relationship between family-level determinants and health was indirect through individual-level factors. Although, a strong positive relationship was found between individual-level determinants and health, the relationship between individual-level factors and substance abuse was also found to be indirect through health. Methodological limitations and implications for family life education, clinical interventions, policy, and future research that are socioecologically-informed are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Folate, vitamins B12 and B6, riboflavin, and methionine are critical nutrients for the one-carbon metabolism cycle involved in DNA synthesis and epigenetic processes. We examined the association between maternal intake of these nutrients before pregnancy and risk of childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) in a matched case-control study.Methods: Maternal dietary intake and vitamin supplement use in the year before pregnancy was assessed by food frequency questionnaire for 681 ALL cases, 103 AML cases, and 1076 controls. Principal component analysis was used to construct a variable representing combined nutrient intake, and conditional logistic regression estimated the odds ratio (OR) and 95% confidence interval (CI) for the association of ALL and AML with the principal component and each nutrient.Results: Higher maternal intake of one-carbon metabolism nutrients from food and supplements combined was associated with reduced risk of ALL (OR for one-unit change in the principal component = 0.91, CI 0.84-0.99) and possibly AML (OR for the principal component = 0.83, CI 0.66-1.04). When analyzed separately, intake of supplements high in these nutrients was associated with a reduced risk of ALL in children of Hispanic women only.Conclusions: In conclusion, these data suggest that higher maternal intake of one-carbon metabolism nutrients may reduce risk of childhood leukemia. [ABSTRACT FROM AUTHOR]

Alcohol use is related to child physical abuse, although little is known about gender-specific risks factors. This study examines the relationships between alcohol outlets, context-specific drinking, dose-response drinking and child physical abuse for mothers and fathers. Telephone interviews were conducted with 1973 female and 1050 male respondents in 50 California cities. Weighted negative binomial models were used to calculate the frequency of physical abuse in the past year. Drinking more often at restaurants was related to higher frequency of physical abuse for fathers, while mothers who drank more frequently at bars and parties used physical abuse more often. There were no significant dose-response drinking relationships for fathers. Drinking higher amounts at bars, parties, and restaurants was associated with less frequent physical abuse for mothers. Our findings suggest that a focus on drinking contexts may reveal heightened risk for many mothers who do not consume large amounts of alcohol. [ABSTRACT FROM AUTHOR]

March of the Living (MOTL) is a 2-week international educational tour for high school seniors to learn about the Holocaust by visiting concentration/deaths camps and other Jewish historical sites in Poland, culminating in a week-long excursion in Israel. Although the trip is primarily educational, there is recent research evidence to suggest that attendees may suffer from a variety of mental health sequelae. To determine symptoms of anxiety and depression, 196 Los Angeles delegation participants voluntarily completed the State-Trait Anxiety Inventory, composed of a trait anxiety scale (i.e., STAI-T) and a state anxiety scale (i.e., STAI-S), and the Center for Epidemiologic Studies Depression Scale (CES-D). Pre-MOTL, students completed an initial background questionnaire along with the STAI-T, STAI-S, and the CES-D. At end-Poland and end-Israel, the STAI-S and CES-D were administered again. Results demonstrated that depression scores increased during end-Poland and returned to baseline; however, anxiety scores mildly increased end-Poland and rose slightly more and persisted through end-Israel. [ABSTRACT FROM AUTHOR]

Background: Despite the growing presence of immigrant families in the US, little is known about physical fighting in school among youth from those families. Objective: The present study examines the social-ecological determinants of school physical fighting among youth in immigrant families. Implications for practice are also discussed. Method: Using the Children of Immigrants Longitudinal Study data set, the study sample consisted of 4288 immigrant students in 9th-12th grade. Models were estimated using multivariate logistic regression. Variables in the individual, family, friend/peer, and school contexts were included by fitting four hierarchical logistic models to the data. Results: Results indicated that youth in immigrant families who are males, in lower grade level, racial/ethnic minorities, and of low family socio-economic status (individual) were likely to engage in physical fights. Youth in immigrant families who feel detached from their parents (family); speak another language with friends (friend/peer); and perceive school discipline to be unfair, feel discriminated against by teachers, and who perceive school crimes to be a problem (school) are also at an elevated risk of physical fights. Conclusion: Findings from the study contribute to a growing body of research on youth in immigrant families. [ABSTRACT FROM AUTHOR]

Background: Adolescent juvenile offenders are at high risk for problems associated with drug use, including polysubstance use (i.e., use of a variety of drugs). The combination of juvenile offending and polysubstance use presents a significant public and child health concern. Objective: This study explored polysubstance use among a sample of youth incarcerated for serious offenses. We examined several risk factors for substance use and delinquency (i.e., early and frequent substance use, prior history of arrests, school expulsion, Black ethnicity), as well as the association between aggression and polysubstance use. Methods: Data were collected via questionnaires from 373 serious male juvenile offenders upon intake into a secure locked facility. Youth were on average 16 years old, and minority youth were overrepresented (28.1 % Black, 53.1 % Latino). Poisson regressions were used to assess the associations between the risk factors, aggression, and polysubstance use. Results: Consistent with the literature, Black youth reported less polysubstance use and later age of drug use onset than White and Latino youth. Findings suggest that Latino juvenile offenders and those with an early and problematic pattern of substance use are at heightened risk for polysubstance use. Aggression was not significantly related to polysubstance use, over and above the risk factors. Conclusions: Given that Latino youth experience low rates of treatment for substance use, the development of culturally-sensitive interventions for these youth is needed. Interventions should also be multifaceted to address the multitude of risk factors associated with polysubstance use among juvenile offenders. [ABSTRACT FROM AUTHOR]

Objectives To compare certain preconception health (PCH) behaviors and conditions among US-born (USB) and foreign-born (FB) mothers in Los Angeles County (LAC), regardless of race/ethnicity, and to determine if any identified differences vary among Asian/Pacific Islanders (API's) and Hispanics. Methods Data are from the 2012 Los Angeles Mommy and Baby study (n = 6252). PCH behaviors included tobacco use, multivitamin use, unintended pregnancy, and contraception use. PCH conditions comprised being overweight/obese, diabetes, asthma, hypertension, gum disease, and anemia. The relationship between nativity and each PCH behavior/condition was assessed using multivariable logistic regression models. Results USB women were more likely than FB women to smoke (AOR 2.12, 95 % CI 1.49-3.00), be overweight/obese (AOR 1.57, 95 % CI 1.30-1.90), and have asthma (AOR 2.04, 95 % CI 1.35-3.09) prior to pregnancy. They were less likely than FB women to use contraception before pregnancy (AOR 0.59, 95 % CI 0.49-0.72). USB Hispanics and API's were more likely than their FB counterparts to be overweight/obese (AOR 1.57, 95 % CI 1.23-2.01 and AOR 2.37, 95 % CI 1.58-3.56, respectively) and less likely to use contraception (AOR 0.58, 95 % CI 0.45-0.74 and AOR 0.46, 95 % CI 0.30-0.71, respectively). USB Hispanic mothers were more likely than their FB counterparts to smoke (AOR 2.47, 95 % CI 1.46-4.17), not take multivitamins (AOR 1.30, 95 % CI 1.02-1.66), and have asthma (AOR 2.35, 95 % CI 1.32-4.21) before pregnancy. Conclusions US nativity is linked to negative PCH among LAC women, with many of these associations persisting among Hispanics and API's. As PCH profoundly impacts maternal and child health across the lifecourse, culturally-appropriate interventions that maintain positive behaviors among FB reproductive-aged women and encourage positive behaviors among USB women should be pursued. [ABSTRACT FROM AUTHOR]

The article presents a study which analyses facial expressions of negative emotions in romantic relationships. It reveals that under the study, researchers tried to find out whether the ability to recognize facial expressions of negative emotions predicted greater relationship satisfaction with their romantic relationships. It mentions that less conflict engaging behaviors was observed in the study.

Perceived loneliness and social competence were assessed for 127 children with ASD without comorbid ID, 4-7 years old, through child self-report. Using an abbreviated version of the Loneliness and Social Dissatisfaction Questionnaire (LSDQ; Cassidy and Asher in Child Dev 63:250-365, ), the majority of children reported friendships, yet a considerable proportion also reported social difficulties. Factor analysis of the abbreviated LSDQ identified three factors, which were significantly associated with parent- and teacher-reported variables. Regression analyses revealed parent-reported social skills deficits and teacher-reported conflict in the student-teacher relationship to be associated with child-reported loneliness. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Research suggests that impaired social skills are often the most significant challenge for those with autism spectrum disorder (ASD), yet few evidence-based social skills interventions exist for adults on the spectrum. This replication trial tested the effectiveness of PEERS, a caregiver-assisted social skills program for high-functioning young adults with ASD. Using a randomized controlled design, 22 young adults 18-24 years of age were randomly assigned to a treatment ( n = 12) or delayed treatment control ( n = 10) group. Results revealed that the treatment group improved significantly in overall social skills, frequency of social engagement, and social skills knowledge, and significantly reduced ASD symptoms related to social responsiveness following PEERS. Most treatment gains were maintained at a 16-week follow-up assessment with new improvements observed. [ABSTRACT FROM AUTHOR]

We conducted an online survey of adult health care providers at Kaiser Permanente Northern California and semi-structured interviews with a subset of physicians. The survey assessed providers' ability to recognize autism spectrum disorder (ASD), asked them to rate their autism knowledge, comfort level in treating affected patients, and evaluated training and resource needs. 922 providers completed the survey (response rate 25.3 %), and 9 were interviewed by telephone regarding their autism training and experiences caring for patients with autism. Most providers reported lacking skills and tools to care for this adult patient population. A high proportion of adult providers were not aware that they had patients with ASD. These findings underscore the need to educate physicians caring for adults with ASD. [ABSTRACT FROM AUTHOR]

Nationally heterosexuals are an HIV prevention priority. In addition to case based HIV surveillance, behavioral surveillance surveys are conducted among heterosexuals living in high AIDS morbidity neighborhoods. We report on risk behaviors and HIV prevalence among 'high-risk' heterosexuals in San Francisco. National HIV Behavioral Surveillance System is coordinated by the CDC and implemented in 21 health jurisdictions. The studies were conducted in 2006, 2010 and 2013 in San Francisco. Respondent driven sampling was used to sample participants. Eligible persons were 18-50 years old and had sex with at least one opposite gender partner in the past year. We obtained samples of 371, 421, 165 heterosexuals in 2007, 2010 and 2013, respectively. Some demographics varied across the 3 years. Residential neighborhoods changed, homelessness and healthcare coverage increased. Binge drinking, cocaine and heroin use increased while methamphetamine use declined. There were no changes in numbers of partners, unprotected vaginal intercourse or unprotected anal intercourse. Commercial sex work increased. Even with 'fine tuning' of eligibility criteria to attempt to find heterosexual HIV cases, we estimate that HIV prevalence was 0.3, 0.2 and 2.4 % in 2007, 2010 and 2013 respectively. The increase was not statistically significant. For the present, effective prevention among persons in the populations most severely affected by HIV remains the priority, for their own benefit and to prevent transmission to other vulnerable populations to which they may be connected. [ABSTRACT FROM AUTHOR]

Previous research has generally found exclusive breastfeeding to protect against asthma in young children. However, maternal nativity in a Latina population has not been assessed as a potential confounder or effect modifier. Using cross-sectional data restricted to Latina mothers (n = 704) from a birth cohort in Los Angeles interviewed in 2003 and 2006, we estimated risk ratios (RR) for exclusive breastfeeding and asthmatic symptoms in the offspring. 56 children (8 %) had asthmatic symptoms at age 3.5 years. We found a 49 % reduction in risk of asthmatic symptoms with >3 months of exclusive breastfeeding (aRR 0.51, 95 % CI 0.28, 0.90). Foreign-born Latinas were more likely to initiate and continue breastfeeding for at least 3 months compared with US-born Latinas. Three or more months of exclusive breastfeeding reduced the risk of asthmatic symptoms in the offspring of Latinas, and maternal nativity did not confound or modify this association. [ABSTRACT FROM AUTHOR]

Older adults with functional limitations may be at higher risk for depression and suicidal ideation compared to their counterparts without such limits. This study examined the structural relationships between functional limitation, depression, suicidal ideation, and coping strategies in older Korean immigrants. Using data from 220 community dwelling Korean immigrants (age ≧ 65) in Los Angeles County, path analysis was conducted to test the study hypotheses. The resulting model accounted for 56 % of the variance in suicidal ideation, with functional limitation making significant contribution to suicidal ideation. Meanwhile, depression, which had the strongest direct effects on suicidal ideation, also played a significant role in mediating between functional limitation and suicidal ideation. Furthermore, adaptive coping was significantly associated with both functional limitation and suicidal ideation. Findings provide implications for implementing suicide-prevention programs for older Korean immigrants, especially those living with functional disability. [ABSTRACT FROM AUTHOR]

Parents of children with developmental delays (DD) often report significantly heightened levels of stress when compared to families of typically developing (TD) children. While elevated levels of early parenting stress are shown to negatively impact social development in TD children, this effect may be compounded for children with DD, who are already at greater risk of experiencing social difficulties. We sought to examine whether changes in child social skills occur after parent participation in mindfulness based stress reduction (MBSR) intervention, and whether these changes were associated with parent-child relational factors. Parental stress was reduced through an 8-week MBSR training group. Changes in child social skills were measured using the social skills improvement system (SSIS), which was completed by 3 categories of respondents: parents participating in the study, a secondary informant, and the child's teacher. Parent-child relational factors were measured using the parenting relationship questionnaire (PRQ). Data from 24 families of children with DD (ages 2.5-5) was examined in this study. Paired samples t-tests examining pre-post differences revealed that mothers, secondary informants, and teachers acknowledged improvements in child self-control. Mothers and teachers also reported improvements in empathy and engagement, while secondary informants and teachers reported improvements in child assertion. Teachers also reported improvements in children's communication, responsibility, and cooperation. Variance in child self-control was significantly accounted for by changes in two parent-child relational factors: attachment and discipline practices. These results suggest that addressing parental mental health may enhance the efficacy of child-focused interventions by promoting parental consistency in discipline and perceived attachment (i.e. parent-child closeness). [ABSTRACT FROM AUTHOR]

Parent- and adolescent-report of social skill importance and social skill engagement on the Social Skills Rating System (Gresham and Elliott in The social skills rating system, American Guidance Service, Circle Pines, ) were assessed in higher-functioning adolescents with Autism Spectrum Disorder (ASD). Compared to parents, adolescents reported that social skills were less important. Additionally, adolescents reported that they engaged in social skills more frequently than parents reported them to be engaging in social skills. Parents, but not adolescents, reported a discrepancy between importance and engagement, such that the importance of social skills was rated higher than the frequency of adolescent engagement in social skills. These results suggest that social skills interventions for individuals with ASD may need to target awareness of social skill importance and accurate monitoring of social skill engagement. [ABSTRACT FROM AUTHOR]