Search

Professionals with lived experience (LE) of mental distress might better understand service users, educate colleagues, and serve as role models. This exploratory quantitative study asked U.S. social work education leaders if they perceive positives and negatives of professionals having LE; what advice they would offer students with LE; and analyzed whether certain experiences influenced responses. Having LE and/or close relationships with people with LE was associated with perceiving positives, which was associated with advising students about using LE to help others. Perceiving negatives was associated with advising about difficulties. Implications are offered for preparing professionals to use LE in practice. [ABSTRACT FROM AUTHOR]

Without standard guidelines, there is a critical need to examine anal cancer screening uptake in the South which has the highest HIV incidence in the U.S. We identified factors associated with screening among men living with HIV (MLHIV) at a large academic HIV outpatient clinic in Alabama. Relationships between sociodemographic, clinical, sexual risk characteristics and screening were examined using T-tests, Fisher's exact, Chi-square, and logistic regression analyses. Unadjusted and adjusted odds ratios (AOR) were computed to estimate the odds of screening. Among 1,114 men, 52% had received annual anal cytology (pap) screening. Men who were screened were more likely to have multiple sexual partners compared to men who were not screened (22.8% vs. 14.8%, p = 0.002). Among men with one partner, the youngest were almost five times more likely to be screened compared to middle-aged men (AOR = 4.93, 95% CI: 2.34–10.39). Heterosexual men had lower odds and men who reported unprotected anal sex had higher odds of screening. Our findings suggest a racial disparity, with older black MLHIV being the least likely to be screened. In the South, MLHIV who are older, black, heterosexual, or live in high social vulnerability counties may be less likely to receive annual anal cancer screening. [ABSTRACT FROM AUTHOR]

Background: Transgender individuals are known to be at a higher risk for certain chronic conditions compared to cisgender individuals. Similarly, research also shows justice-involved individuals have a higher risk of chronic conditions compared to non-justice-involved individuals.Aim: This study aims to investigate the differences in chronic disease diagnoses between transgender and cisgender individuals who either utilized healthcare services provided by a US county health system or who were incarcerated in the same county’s jail. Method: We leveraged electronic health record data from a United States county health system, including data from the local jail, to evaluate the difference in diagnosis of certain chronic conditions among transgender and cisgender individuals. We also compared individuals who experienced incarceration and those who did not. Results: We found transgender individuals experiencing recent incarceration were more likely to be diagnosed with substance use disorder, HIV/AIDS, and Hepatitis C than cisgender individuals. Transgender individuals not experiencing recent incarceration were more likely to be diagnosed with HIV/AIDS, seizure disorder, major depressive disorder, and bipolar disorder than cisgender individuals. Conclusion: These results highlight how transgender individuals may be disproportionately impacted by certain diseases within and outside carceral settings. [ABSTRACT FROM AUTHOR]

Our analyses aimed to assess health status and critical needs of caregivers of persons with dementia (PWD) during the COVID-19 pandemic by gender. Between March 2021 and August 2021, respondents (n = 267) were recruited from an Alzheimer's disease (AD) listserv at an US academic center to complete a questionnaire to capture sociodemographic data, caregiving characteristics, health status, status of COVID-19 testing, and COVID-19 preventative practices during the pandemic. Women caregivers reported needing assistance with caregiving responsibilities, whereas men caregivers needed assistance with health and social resources. More men caregivers also reported psychological distress compared to women caregivers. Our findings indicated significant differences in the resources needed and psychological distress of women and men who cared for PWD during the COVID-19 pandemic. The development of recommendations and resources with both men and women caregivers in mind may be beneficial to support informal caregivers during emergency situations. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify gender differences in leadership/academic rank and attitudes regarding gender representation among academic Reproductive Endocrinology and Infertility subspecialists. Members of the Society of Reproductive Endocrinology and Infertility (SREI) were surveyed regarding gender, academic rank, and attitudes concerning gender disparity in academic medicine in March 2021. Univariate comparisons were performed using Chi-squared and Fischer-exact tests with significance at p ≤ 0.05. A total of 237 SREI members completed the survey with a response rate of 28.8%. Of those, 176 practiced in academic medicine. The majority (76.7%) have been in practice for greater than 10 years. The female-to-male ratio changed over time with ratios of 1.1:1 for those in practice over 10 years and 5.8:1 for those less than 10 years. Of providers in practice greater than 10 years, there were significantly more male vs. female full professors (72.3% vs. 48.5%, p < 0.01), less frequent male assistant professors (3% vs.17%, p < 0.01) and a similar percentage of male and female associate professors (24.6% vs. 34.3%, p = 0.2). Among those in practice for less than 10 years, there were no differences in academic rank between males and females. When stratified by years in practice, there was no difference in gender among division directors, fellowship directors, or assistant/associate fellowship directors. 68.2% of respondents believe there is a gender disparity in academic rank, with females more likely to have this opinion (79% vs. 52.1%, p < 0.001). The female-to-male ratio in academic REI has dramatically changed with time. Even with this shift, the majority of providers believe in a gender disparity regarding academic rank that is due to systemic factors limiting the academic advancement of females. When stratified by years in practice, women in practice greater than 10 years were less likely to hold the rank of full professor than men despite equal leadership positions. [ABSTRACT FROM AUTHOR]

This study assessed predictors of stable HIV viral suppression in a racially diverse sample of persons living with HIV (PWH) in the southern US. A total of 700 PWH were recruited from one of four HIV clinics in Metro Atlanta, GA. Data were collected from September 2012 to July 2017, and HIV viral loads were retrieved from EMR for 18 months. The baseline visits and EMR data were used for current analyses. Durable viral suppression was categorized as 1. Remain suppressed, 2. Remain unsuppressed, and 3. Unstable suppression. The number of antiretroviral medications and age were significantly associated with durable viral suppression. Older age, fewer ART medications and availability of social support were positively associated with durable viral suppression over the 18-month observation period. Findings suggest that regimen complexity is potentially a better predictor of viral suppression than self-reported medication adherence. The need for consensus on the definition of durable viral suppression is also urged. [ABSTRACT FROM AUTHOR]

The number of children in foster care in the United States has risen while new federal regulations in the USA require states to decrease dependence on congregate placements. As family-based settings are the preferred placement option, there is a pressing need to prioritize effective strategies to recruit and retain foster parents. The purpose of this study is to describe the demographic characteristics and life experiences of families who decided to become foster parents at various key points in time in two states: Missouri and Mississippi. A cross-sectional analysis was conducted at key milestones, which include pre-licensure training, completion of training and licensure, shortly after their initial placement, three months after initial placement, and after initial placement disruption occurred. A total of 656 prospective and current foster parents participated in the study. Survey results provide insight into the demographic characteristics of families who are attracted to fostering, those that are successful in obtaining licensure and accepted child placements, providing permanency to the children they care for, and those that decide to dissolve a foster care placement prematurely. Present in the discussion are concerns of those who have been left out of the recruitment process. Implications for policy and practice are also discussed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disrupted the lives of college students. The psychological distress from the pandemic increased risk for provisional rates of Major Depression Disorder (MDD) during an already crucial developmental period. Using an online survey, participants were assessed for a provisional diagnosis of MDD using a validated screening tool, along with Generalized Anxiety Disorder (GAD) and psychosocial correlates. Findings showed a significant increase in the prevalence of MDD, and significant differences in social support, loneliness, substance use, GAD and suicidality were identified. Early screening and detection for potential MDD symptoms can reduce the severity, duration, and reoccurrence of future MDD episodes for college students. [ABSTRACT FROM AUTHOR]

Throughout social work's history, scholars have debated the impact religiously affiliated colleges and universities have on social work education. Some have viewed religious affiliation as an asset contributing to training in values and ethics, while others question whether institutions' religious commitments conflict with professional values. To date, no national study has examined the perceived influence that institutions' religious affiliation has on Master of Social Work (MSW) programs. Drawing upon data from a national survey of MSW faculty across the United States, we begin to address this gap. Results reveal several ways faculty perceive their institutions' religious cultures influence education and training on social work competencies. [ABSTRACT FROM AUTHOR]

University faculty are considered trusted sources of information to disseminate accurate information to the public that abortion is a common, safe and necessary medical health care service. However, misinformation persists about abortion's alleged dangers, commonality, and medical necessity. Systematic review of popular media articles related to abortion, gun control (an equally controversial topic), and cigarette use (a more neutral topic) published in top U.S. newspapers between January 2015 and July 2020 using bivariate analysis and logistic regression to compare disclosure of university affiliation among experts in each topic area. We included 41 abortion, 102 gun control, and 130 smoking articles, which consisted of 304 distinct media mentions of university-affiliated faculty. Articles with smoking and gun control faculty experts had statistically more affiliations mentioned (90%, n = 195 and 88%, n = 159, respectively) than abortion faculty experts (77%, n = 54) (p = 0.02). The probability of faculty disclosing university affiliation was similar between smoking and gun control (p = 0.73), but between smoking and abortion was significantly less (Ave Marginal Effects – 0.13, p = 0.02). Fewer faculty members disclose their university affiliation in top U.S. newspapers when discussing abortion. Lack of academic disclosure may paradoxically make these faculty appear less 'legitimate.' This leads to misinformation, branding abortion as a 'choice,' suggesting it is an unessential medical service. With the recent U.S. Supreme Court landmark decision, Dobbs v. Jackson Women's Health Organization, and subsequent banning of abortion in many U.S. states, faculty will probably be even less likely to disclose their university affiliation in the media than in the past. [ABSTRACT FROM AUTHOR]

Research over the past 40 years has consistently found that teachers do not report all cases of suspected child abuse and neglect even though they see children on a regular basis. Much of the studies on under-reporting by teachers have focused on public school systems, and there is very little research regarding the impact of cultural values. To address this gap in the literature, the current study examined the determinants of decision-making when it comes to responding to child abuse among a sample of Armenian-American faculty members across several private schools, with a specific focus on cultural values. The results indicated that some cultural values may be important but so too were attitudes toward, and knowledge of, reporting laws. Implications for future research and training for private school teachers are discussed. [ABSTRACT FROM AUTHOR]

Telechaplaincy is the use of telecommunications and virtual technology to deliver religious/spiritual care. It has been used for decades, but chaplains' understanding of telehealth lags behind other disciplines. The purpose of this study was to describe the use of telechaplaincy in the United States and chaplains' perceptions of the practice. Researchers surveyed chaplains through chaplain-certifying-body email-listservs, then conducted in-depth interviews with 36 participants identified through maximum variation sampling. Quantitative analysis and qualitative, thematic analysis were conducted. Quantitative results show that in 2019, approximately half of surveyed chaplains performed telechaplaincy. Rural chaplains were more likely to have practiced. Chaplains who had not practiced were more willing to try if they believed it was effective at meeting religious/spiritual needs. Qualitative findings describe chaplains' perceptions of strengths, weaknesses, and best practices. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention intervention; however, most studies of PrEP adherence and persistence among men who have sex with men (MSM) have been conducted with MSM who live in urban areas. The experiences of PrEP-using MSM in non-urban areas might differ due to increased barriers to culturally competent care. We examined similarities and differences among urban and non-urban PrEP-using MSM in the southern United States, the region with the highest number of annual HIV diagnoses. We surveyed a total of 78 (n = 25 non-urban, n = 53 urban) PrEP-using MSM. Self-reported adherence was high across all participants. No differences were observed with respect to PrEP persistence, source of PrEP, or reasons for PrEP initiation. Fewer non-urban than urban men reported STI testing in the past 12 months. Overall, we observed few differences comparing urban and non-urban PrEP-using MSM. Additional studies are needed to describe differences in PrEP initiation comparing urban and non-urban MSM. [ABSTRACT FROM AUTHOR]

Grounded by the ecological systems perspectives proposed by Bronfenbrenner (1977, 1979) and Fivush and Merrill (2016), the present study was conducted to examine whether autobiographical memory (AM) and self-construal differed in young adults raised in the same macrosystem, but with unique microsystems. European American (EA) participants were born in the United States to mothers who were born in the United States (n = 61) and Chinese American (CA) participants were born in the United States to mothers who were born in China (n = 47). Participants completed an online study in which they reported on and rated aspects of their earliest memory; they also completed measures of self-construal and acculturation. EA participants identified more with mainstream American culture relative to CA participants, who identified to a greater extent with their heritage culture. EA participants also talked and thought more about their earliest memories relative to CA participants; interactions between group and sex were found for social words. Group differences were not observed on measures of self-construal. These findings indicate that microsystem-level factors are associated with differences in AM in young adults even when individuals are born and raised in the same macro-level cultural environment. [ABSTRACT FROM AUTHOR]

Using data from a cross-sectional online survey among social work students (N = 457) in the US, our study explored differences in mental health status based on sociodemographic characteristics and preventive behaviors during the COVID-19 pandemic. Results showed disparate experiences related to anxiety, depression, self-harming thoughts, stress and hopelessness by age, gender, employment status, marital status, education, number of children, living arrangement, and mask-wearing and social distancing preventive behaviors. Findings provide implications to mitigate both the current and prolonged impact of the pandemic among social work students who will be playing crucial roles in the provision and delivery of health and human services. [ABSTRACT FROM AUTHOR]

Despite a series of high-profile media reports of sexual abuse in sport over the past few years, little research has been done to explore the scope of the problem in the United States. The current article reports on prevalence of child sexual assault in elite athletes in the United States. Using a retrospective web survey, adults answered questions on their experiences in sport. Of the 473 elite athletes surveyed, 3.8% (n = 18) reported being sexual assaulted as a minor in the sporting context. Of those reporting assault, most (61%) reported being abused by an adult authority figure (usually a coach) and 44% reported being assaulted by a peer. Abused athletes were significantly more likely to report having been diagnosed with a mental disorder (Fisher's exact test; p <.001). The findings can be utilized to improve prevention and child protection measures and other safeguarding initiatives in sport. [ABSTRACT FROM AUTHOR]

The goal of this study was to conduct an exploratory assessment of COVID-19 mitigation steps and compare workplace experiences during the COVID-19 pandemic with Marshallese workers in other occupations. Marshallese adults residing in the continental United States (US) and Hawaii took part in an online survey. The sample was divided into two categories: food processing workers and workers in all other occupations. To examine differences between food processing workers and workers from all other occupations, we used Wilcoxon-Mann-Whitney U tests and Fisher's Exact tests. Of those employed at the time of the survey (n = 113), 31 were employed in food processing plants, and 82 were employed in another occupation. Food processing workers and workers in other occupations differed significantly on level of education, length of residence in the US, English-speaking ability, and health literacy. More food processing workers reported that their employers installed barriers or provided shields (45%), provided temperature screenings (71%), and tested for COVID-19 (61%) compared with those in other occupations. A larger proportion of food processing workers reported having no sick leave compared with workers in other occupations, although they reported COVID-19 testing and being insured at similar rates. This is the first study to examine Marshallese food processing workers' experiences during the COVID-19 pandemic. Our findings show that while some food processing employers implemented government-recommended guidelines to prevent the spread of COVID-19, preventative and protective measures were not comprehensively applied across the food processing industry, despite efforts by public health agencies and community partners. [ABSTRACT FROM AUTHOR]

Objectives: Examine the social influence of adult children on the cardiovascular-related health behaviors of older South Asian (SA) immigrants to inform lifestyle interventions. Design: This mixed-methods study used data from an ancillary study of social networks (2014–2018) in the Mediators of Atherosclerosis in South Asians Living in America cohort. Phase 1 was a quantitative analysis of self-reported diet and physical activity among SA adults (n = 448, mean age = 58 years, SD 8.4) who named at least one adult child to their social network. The Alternative Healthy Eating Index (AHEI) was used to measure parents' diet; higher numbers indicate a healthier diet (range 0–110). Phase 2 was a thematic content analysis of in-depth qualitative interviews from a subsample of these parents (n = 23, mean age = 55, SD 7.6). Results: Parents with an adult child in their network who consumed uncooked vegetables daily had mean parental AHEI score 1.5 points higher (adjusted p-value = 0.03) than those who had a child in the network who ate uncooked vegetables less often. When at least one adult child in their network ate fresh fruit daily compared to less frequently or when at least one child ate non-SA food daily compared to less frequently, mean parental AHEI scores were higher by 2.0 (adjusted p-value = 0.01) and 1.6 (adjusted p-value = 0.03) points respectively. Parents with an adult child in their network who exercised at least weekly were more likely to meet guideline-recommended physical activity levels than parents with children who exercised less often (76% v. 56%, adjusted p-value = 0.02). Adult children provided social support and were seen as 'role models' for healthy behavior, especially when adopting Western health behaviors. Conclusion: Positive role modeling and support from adult children were important facilitators of healthy behavior change in older SA immigrants and can inform health behavior interventions for SA adults. [ABSTRACT FROM AUTHOR]

(1) identify and compare family-centered care (FCC) and collaborative goal-setting (CGS) beliefs and practices of out-patient pediatric physical therapists (PTs) in Saudi Arabia (SA) and the United States (US); (2) describe CGS approaches; and (3) determine the association between CGS practices and educational level, clinical experience, and FCC beliefs and practices. 87 PTs completed an online survey. Ninety percent of PTs believed in FCC to a great extent. PTs in the US rated their organization's family-centeredness and their own FCC application significantly higher than PTs in SA. PTs believed in CGS with parents (86%) and children (66%) to a great extent while 69% of PTs reported applying CGS with parents to a great extent compared to 39% with children. PTs in SA rated the importance of determining therapy goals by PTs significantly higher than PTs in the US. The most selected CGS strategy was asking about concerns and needs. Low to moderate significant positive associations were found between CGS practices and PTs belief of their organization's family-centeredness and their own FCC application. Similarities and differences were found between the two countries in FCC and CGS beliefs and practices. Organizational and individual FCC practices influence CGS practices. [ABSTRACT FROM AUTHOR]

Over 390,000 child sexual abuse victims in the United States have not yet been identified. Due to the increased prevalence of Internet-driven child-sex offenders (e.g., child pornographers and travelers), detection becomes more elusive, and disclosure elicitations are more challenging for law enforcement. The current retrospective study examines an innovative, investigative method of voice stress analysis use, and describes its possible utility in identifying previously undetected sexual offending within these two offender populations. In the total sample of 82 arrestees with no known history of "hands-on" sexual offending, 0% initially admitted to sexually abusing at least one child. However, coinciding with voice stress analysis procedures, 40.2% of the suspect pool (57.1% of child pornographers and 36.7% of travelers) provided admissions to hands-on offenses. Also, 80.5% admitted to at least one sex crime offense during the pre and posttest stages of the investigation. All voice stress analysis "Stress Indicated" examinations resulted in verifiable disclosures (of victims and sex crimes). Critically, as a result of voice stress analysis procedures, 87 previously undiscovered live victims were identified. Finally, this study's description of specific characteristics and predictive qualities of victimizers vs. non-victimizers in each offender-type should benefit future investigators, researchers, and therapists alike. [ABSTRACT FROM AUTHOR]

Chronic hepatitis B (CHB) infection causes most liver-related morbidity and mortality worldwide. Numerous Chinese-Americans remain unscreened, and many HBV infected individuals are not accessing adequate care. We evaluated the prevalence of chronic HBV infection, patient awareness of infection, and linkage-to-care among Chinese-Americans in northern New Jersey. Screening 898 Chinese Americans revealed 5.5% hepatitis B virus (HBV) infected, 62.7% immune, and 31.8% non-immune. Our study suggests that HBV prevalence among Chinese-American adults may be lower than previously thought, but a large percentage of the population is still at risk for infection. Thirty-one of 49 hepatitis B surface antigen (HBsAg) seropositive subjects knew of their infections, but only 5 had accessed care. Within 6–20 months after screening education, 25 participants were accessing care. These results demonstrate a need to address possibly inadequate education and other important barriers preventing linkage to care (LTC). [ABSTRACT FROM AUTHOR]

This study utilized web-based data collection and latent profile analysis to visualize and describe the relational well-being of youth experiencing foster care-related sibling separation. Legally authorized representatives for 724 youth in seven states in the U.S.A. completed a brief electronic questionnaire assessing youth's social competence, emotional competence, sibling warmth, and sibling interaction quality. Six profiles of relational well-being emerged from the analysis and included youth who were "struggling—all domains," "struggling—sibling relationships," "thriving—all domains," "near struggling—all domains," "mixed—thriving sibling relationships/near-struggling social-emotional competence," and "average—all domains." Significant differences were observed for the proportion of youth in a particular profile based on their current out-of-home care status, permanency plan goal, and the survey respondent's relationship to the youth. Implications for future research and practice are discussed. [ABSTRACT FROM AUTHOR]

Objective: To adapt a fertility care wellness model. Background: Despite availability of a range of diagnostic and therapeutic services for infertility, many do not seek care or discontinue care prior to achieving a live birth. Wellness models can inform research on patient decisions to seek and continue fertility care, as many barriers and drivers are represented within the dimensions of wellness. Methods: A mixed-methods online survey was completed by 135 people of reproductive age who experienced infertility in the USA. Outcomes included drivers and barriers to seeking or continuing fertility care. Identified factors were compared by treatment history using chi-square and Fisher's exact tests. Themes and patterns were identified within 174 responses to 6 open-response items through conventional content analysis. Results: Thematic analysis revealed practical (environmental, financial, and physical) and affective (emotional, social and spiritual) dimensions of wellness in decisions to seek care (67%), with affective rationales more prominent in decisions to return for care (78%). Conclusion: Decisions to seek fertility care and return after failed treatment integrate practical and affective rationales from financial, physical, environmental, emotional, social and spiritual wellness dimensions. Drivers and barriers within these dimensions should be considered to encourage care seeking and improve patient retention. [ABSTRACT FROM AUTHOR]

Parents frequently experience challenges implementing daily routines important for consistent hearing aid management. Education that supports parents in learning new information and gaining confidence is essential for intervention success. We conducted a pilot study to test an eHealth program to determine if we could implement the program with adherence and affect important behavioural outcomes compared to treatment as usual. Randomised controlled trial. Parents of children birth to 42 months who use hearing aids. Eighty-two parents were randomly assigned to the intervention or treatment-as-usual group. Four parents assigned to the intervention group did not continue after baseline testing. The intervention was delivered successfully with low drop out (10%), high session completion (97%), and high program adherence. The intervention conditions showed significantly greater gains over time for knowledge, confidence, perceptions, and monitoring related to hearing aid management. Significant differences between groups were not observed for hearing aid use time. We found that we could successfully implement this eHealth program and that it benefitted the participants in terms of knowledge and confidence with skills important for hearing aid management. Future research is needed to determine how to roll programs like this out on a larger scale. [ABSTRACT FROM AUTHOR]

Aims: To explore and describe current practices in the USA related to the provision of paediatric power wheelchairs (PWCs) from the perspective of professionals involved in recommending, ordering or prescribing a PWC, and to compare and contrast current PWC practices to findings of a 2001 survey. Materials and methods: This descriptive study utilized a web-based survey to collect quantitative and qualitative data related to paediatric PWC evaluation activities, recommendations, decision-making considerations and other issues related to the provision of paediatric PWCs. Results: Both child and non-child related PWC evaluation activities were reported as frequently occurring and important. Recommendations for a child who was evaluated for a PWC but who was not endorsed to receive one included extended PWC practice and determining a child's mobility prognosis. The average age of the youngest child for whom respondents had recommended a PWC was 3 years, 3.56 months. Significant differences between the responses to this 2018 survey and a 2001 survey were found suggesting possible changes in practice pertaining to PWC evaluation activities as well as to recommendations for a child who is not endorsed to receive a PWC. Conclusions: Findings of the current survey suggest that barriers exist to a child, especially a younger child, obtaining a PWC. Findings of the current (2018) survey suggest that barriers exist to a child obtaining a PWC. Respondents reported that the primary reasons for not recommending a paediatric PWC included cognitive, physical and behavioural factors. Respondents reported that the primary reasons a paediatric PWC was not obtained for a child who qualified to receive a PWC related to family support, transportation and home environment. Differences between responses to 2018 survey and the 2001 survey indicate changes in practice. [ABSTRACT FROM AUTHOR]

Background: The incidence of pregnant women with an opioid use disorder (PWOUD) at delivery has quadrupled since 1999. State-specific statutes regarding PWOUD often pose punitive measures to the mother–infant dyad, involving the child welfare and criminal justice systems. Shared decision making (SDM) assists individuals through complex health and recovery processes. Objectives: To determine use of SDM in treating PWOUD and associated factors and to quantify physicians' review and discussion of child welfare statutes. Methods: The American College of Obstetricians and Gynecologists (ACOG) e-mailed the survey to a random sample of members, with 568 responding. Bivariate analyses to identify factors associated with each outcome were performed using Wilcoxon Rank Sum tests or Fisher's Exact tests. Variables yielding p values <.20 were included in initial logistic regression models; the final model included only significant (<.05) variables. Results: Sixty-one percent used SDM most of the time. Logistic regression indicated that those using SDM were more likely to have had training in substance use disorder and felt prepared for caring for PWOUD; 39% reviewed statutes, and 54% discussed them with PWOUDs. Conclusion: Survey results provide evidence for patient-centered care approaches that support PWOUD involvement in treatment decision making. The SDM model provides an empowerment framework for women to be involved in the process during their pregnancies and opioid use disorder treatments. Future studies might assess the effectiveness of SDM dialogs with PWOUD and evaluate CME training and medical curricula regarding the SDM model. [ABSTRACT FROM AUTHOR]

Objective: There are currently three licensed human papillomavirus (HPV) vaccines that protect against cervical cancer. Here we compare the prevalence of bi-, quadri-, and nonavalent vaccine-related HPV genotypes in a multi-ethnic sample of non-Hispanic white, non-Hispanic black, Hispanic, and Asian women. Design: Patients in this analysis (n = 419) represent a subset of women with a previous abnormal Pap test participating in a clinical trial. HPV genotyping was conducted using the Roche Linear Array. Prevalent HPV genotypes were grouped according to their inclusion in each of the vaccines: bivalent (16, 18), quadrivalent (16, 18, 6, 11), and nonavalent (16, 18, 31, 33, 45, 52, 58, 6, 11). Results: The prevalence of HPV genotypes covered by the bi-/quadrivalent vaccines was lowest among non-Hispanic black (15%) and Hispanic women (20%), compared to non-Hispanic white (38%) and Asian women (38%). Across all racial/ethnic groups, a large proportion of infections (38%–49%) were with genotypes included in the nonavalent vaccine. However, the prevalence of HPV genotypes not covered by any vaccine was significantly higher among non-Hispanic black (36%) and Hispanic women (42%), compared to non-Hispanic white (24%) and Asian women (16%) (p < 0.001). Racial/ethnic differences in HPV genotype prevalence were observed when controlling for demographic and sexual behavior characteristics, as well as when restricting the analysis to women with CIN 2+. Conclusion: Our data suggest racial/ethnic differences in the prevalence of vaccine-related HPV genotypes. In particular, non-Hispanic black and Hispanic women had the lowest prevalence of HPV genotypes covered by the bi-/quadrivalent vaccines. While a large proportion of their infections were covered by the nonavalent vaccine, non-Hispanic black and Hispanic women also had the highest prevalence of HPV genotypes not covered by any vaccine. [ABSTRACT FROM AUTHOR]

Although there is substantial rationale for a motor component in the speech of persons with Down syndrome (DS), there presently are no published estimates of the prevalence of subtypes of motor speech disorders in DS. The goal of this research is to provide initial estimates of the prevalence of types of speech disorders and motor speech disorders in adolescents with DS. Conversational speech samples from a convenience sample of 45 adolescents with DS, ages 10 to 20 years old, were analysed using perceptual and acoustic methods and measures in the Speech Disorders Classification System (SDCS). The SDCS cross-classified participants into five mutually exclusive speech classifications and five mutually exclusive motor speech classifications. For participants meeting criteria for Childhood Dysarthria or for Childhood Dysarthria concurrent with Childhood Apraxia of Speech, the SDCS provided information on participants' percentile status on five subtypes of dysarthria. A total of 97.8% of participants met SDCS criteria for Speech Disorders and 97.8% met criteria for Motor Speech Disorders, including Childhood Dysarthria (37.8%), Speech Motor Delay (26.7%), Childhood Dysarthria and Childhood Apraxia of Speech (22.2%), and Childhood Apraxia of Speech (11.1%). Ataxia was the most prevalent dysarthria subtype. Nearly all participants with DS in the present sample had some type of speech and motor speech disorder, with implications for theory, assessment, prediction, and treatment. Specific to treatment, the present findings are interpreted as support for motor speech disorders as a primary explanatory construct to guide the selection and sequencing of treatment targets for persons with DS. Abbreviations: CAS: Childhood Apraxia of Speech; CD: Childhood Dysarthria; DS: Down syndrome; NSA: Normal(ized) Speech Acquisition; PSD: Persistent Speech Delay; PSE: Persistent Speech Errors; SD: Speech Delay; SDCS: Speech Disorders Classification System; SE: Speech Errors; SMD: Speech Motor Delay [ABSTRACT FROM AUTHOR]

Background:The beneficial effect of macrolides for the treatment of community-acquired pneumonia (CAP) in combination with beta-lactams may be due to their anti-inflammatory activity. In patients with pneumococcal meningitis, the use of steroids improves outcomes only if they are administered before beta-lactams. The objective of this study was to compare outcomes in hospitalized patients with CAP when macrolides were administered before, simultaneously with, or after beta-lactams. Methods:Secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study database. Study groups were defined based on the sequence of administration of macrolides and beta-lactams. The study outcomes were time to clinical stability (TCS), length of stay (LOS) and in-hospital mortality. Accelerated failure time models were used to evaluate the adjusted impact of sequential antibiotic administration and time-to-event outcomes, while a logistic regression model was used to evaluate their adjusted impact on mortality. Results:A total of 99 patients were included in the macrolide before group and 305 in the macrolide after group. Administration of a macrolide before a beta-lactam compared to after a beta-lactam reduced TCS (3 vs. 4 days,p = .011), LOS (6 vs. 7 days,p = .002) and mortality (3 vs. 7.2%,p = .228). Conclusions:The administration of macrolides before beta-lactams was associated with a statistically significant decrease in TCS and LOS and a non-statistically significant decrease in mortality. The beneficial effect of macrolides in hospitalized patient with CAP may occur only if administered before beta-lactams. [ABSTRACT FROM AUTHOR]

Background: Increasing use of genetic technologies in clinical and research settings increases the potential for misattributed paternity to be identified. Yet existing guidance from the President's Commission for the Study of Ethical Problems in Biomedical and Behavioral Research and the Institute of Medicine (among others) offers contradictory advice. Genetic health professionals are thus likely to vary in their practice when misattributed paternity is identified, and empirical investigation into the disclosure of misattributed paternity is scarce. Given the relevance of this ethical dilemma and its significance to users of genetic services, this study aimed to investigate the attitudes of lay people with regard to the disclosure of misattributed paternity.Methods: An online questionnaire was hosted and advertised through Amazon's Mechanical Turk to 200 United States residents aged 18 years or older. Respondents were asked to rate (via a Likert scale) the ethical permissibility of possible actions a clinician may carry out when misattributed paternity is identified. Data analysis consisted of preliminary descriptive analysis, chi-squared analysis, and Wilcoxon signed-rank tests.Results: There was no clear majority support for many of the options surveyed across different contexts, with only six out of ten scenarios displaying some general consensus. Men were more likely to support scenarios where the father is informed of paternity. Importantly, participants' views varied according to whether the desires of the father were previously expressed, suggesting that perceptions of the permissibility of a clinician's action will depend on the interests of all parties affected.Conclusions: This sample of the general public showed attitudes that were, at least to some degree, at variance with some professional guidelines. We give arguments for why at least some of these attitudes might be justified. We argue that case-specific judgments should be made and outline some of the relevant ethical considerations. While general guidelines ought to be considered, context-specific moral judgments cannot be avoided. [ABSTRACT FROM PUBLISHER]

Purpose: This study assessed the citation impact of scholarship of African American faculty in the top 25 ranked schools of social work cited in the 2012 U.S. News and World Report. Method: The citation impact scores (Hirsch h-index) of these scholars were examined. Results: The overall mean h-index score for the top 25 ranked schools of social work and African American scholars was 6.62 and 12.14, respectively. The individual h-index for almost 80% of these scholars exceeded their respective school mean h-index scores. Discussion: While the literature revealed long-standing systemic and structural barriers to research productivity for African American scholars overall, these faculty somehow found ways to circumvent these challenges. Future research calls for a more comprehensive exploration into the character and impact of scholarship produced by African American faculty to further expand the knowledge base about elements of research cultures in social work. [ABSTRACT FROM AUTHOR]

Calcium intake has been consistently, modestly inversely associated with colorectal neoplasms, and supplemental calcium reduced adenoma recurrence in clinical trials. Milk products are the major source of dietary calcium in the United States, but their associations with colorectal neoplasms are unclear. Data pooled from three colonoscopy-based case-control studies of incident, sporadic colorectal adenoma (n= 807 cases, 2,185 controls) were analyzed using multivariable unconditional logistic regression. Residuals from linear regression models of milk with dietary calcium were estimated as the noncalcium, insulin-like growth factor 1-containing component of milk. For total, dietary, and supplemental calcium intakes, the adjusted odds ratios (ORs) comparing the highest to the lowest intake quintiles were 0.94 (95% confidence interval [CI] 0.69–1.30), 0.86 (CI 0.62–1.20), and 0.99 (CI 0.77–1.27), respectively. The corresponding ORs for consumption of total milk products, total milk, nonfat milk, total milk product residuals, and nonfat milk residuals were, respectively, 0.99, 0.90, 0.92, 0.94, and 0.95; all CIs included 1.0. For those who consumed any whole milk relative to those who consumed none, the OR was 1.15 (CI 0.89–1.49). These results are consistent with previous findings of modest inverse associations of calcium intakes with colorectal adenoma, but suggest that milk products may not be associated with adenoma. [ABSTRACT FROM PUBLISHER]

Conclusions: This study recommends using soft surgical principal and round window insertion to protect residual hearing with favorable anatomical exposure. Further studies are needed to evaluate the impact of the electrical stimulation on the organ of corti and hearing. Objective: The objective of this study is to analyze various factors that impact on preservation of residual hearing post-implantation. Methods: A retrospective study was performed to analyze loss of residual hearing in a cohort of 225 patients implanted in a large academic center. Sixty-four patients met the inclusion criteria. The impact of age at implantation, gender, etiology of hearing loss, cochleostomy vs round window insertion, partial vs full insertion, and effect of initial stimulation were analyzed using appropriate statistical analysis. Results: The overall hearing preservation rate for all implanted patients was 64%. Loss of residual hearing was significantly more observed in cases of cochleostomy and/or non-soft surgical techniques. No correlation was observed with age at implantation, gender, side of implant, device manufacturer, and presence of pre-lingual deafness vs post-lingual, full or partial electrode insertion. In addition, there was a small but significant decrease in hearing between pre-stimulation and post-stimulation audiograms at 6000 Hz. [ABSTRACT FROM AUTHOR]

The Mexico–US border region is a transit point in the trajectory of Mexican migrants travelling to and from the USA and a final destination for domestic migrants from other regions in Mexico. This region also represents a high-risk environment that may increase risk for HIV among migrants and the communities they connect. We conducted a cross-sectional, population-based survey, in Tijuana, Mexico, and compared Mexican migrants with a recent stay on the Mexico–US border region (Border,n = 553) with migrants arriving at the border from Mexican sending communities (Northbound,n = 1077). After controlling for demographics and migration history, border migrants were more likely to perceive their risk for HIV infection as high in this region and regard this area as a liberal place for sexual behaviours compared to Northbound migrants reporting on their perceptions of the sending communities (p < .05). Male border migrants were more likely to engage in sex, and have unprotected sex, with female sex workers during their recent stay on the border compared to other contexts (rate ratio = 3.0 and 6.6, respectively,p < .05). Binational and intensified interventions targeting Mexican migrants should be deployed in the Mexican border region to address migration related HIV transmission in Mexico and the USA. [ABSTRACT FROM PUBLISHER]

Objective: This study was conducted (1) to examine differences in post-traumatic stress disorder (PTSD) symptoms, perceived quality-of-life (QoL) and post-concussive symptoms (PCS) among veterans who experienced deployment-related mild traumatic brain injuries (mTBIs) with or without loss of consciousness (LOC) and (2) to test the additive role of PCS on QOL. Design: Two hundred and twelve Iraq/Afghanistan veterans who were admitted to a residential programme for PTSD were assessed shortly following intake. A MANCOVA was conducted to examine QoL, PTSD symptom domains and PCS across the No LOC and LOC groups. Multivariate regression models were conducted to examine whether prevalence of PCS might be uniquely linked with veterans’ QoL (physical, psychological and social). Results: When controlling for combat exposure (CE), LOC status was uniquely linked with avoidance symptomatology, Psychological QoL and PCS; LOC status was not significantly linked with other domains of PTSD or QoL. When controlling for CE and PTSD, PCS was similarly linked with QoL in the psychological domain, but not Physical or Social QoL. Conclusion/Implications: LOC associated with a mTBI may contribute to behavioural avoidance and poorer psychological well-being among veterans seeking treatment for PTSD. In addition, PCS associated with mTBI may diminish Psychological QoL for veterans seeking treatment for PTSD. [ABSTRACT FROM PUBLISHER]

We examined the cultural influence on perceived body weight and the level of health practices at a national and individual level. At a national level, we found that Japanese women (n = 80) overestimate body weight more than Korean (n = 82) and American (n = 63) women. At an individual level, individuals with interdependent self-construal were more prone to overestimate weight than those with independent self-construal (N = 182; American women). Based on the data, we identify that the relationship is mediated by self-criticism, and, importantly, it is self-criticism rather than perceived overweight that predicts the level of health activities. Health practitioners and campaign designers across cultures are recommended to concentrate on promoting positive body esteem instead of encouraging engagement in corrective health behaviors for weight loss. [ABSTRACT FROM AUTHOR]

Hispanics who speak Spanish are at risk for low health literacy. We evaluated Spanish language hypertension (HTN) and diabetes mellitus (DM) patient education materials from U.S. federal agency public sector sources using the Suitability of Assessment (SAM) instrument. Mean readability for HTN materials was grade 7.9 and for DM materials was grade 6.6. Mean SAM score for HTN materials was 43.9 and for DM materials was 63.2. SAM scores were significantly better for DM than for HTN materials in overall score, content, graphics, layout, stimulation/motivation, and cultural appropriateness (p < .05). Clinicians should evaluate suitability of Spanish language HTN and DM materials that they use in patient teaching. [ABSTRACT FROM PUBLISHER]

This study examines hospice service experience and quality of death. A survey of 123 community-dwelling adults in the United States found that physical comfort, pain-free, and spiritual peace were more important to respondents reporting a personal experience with hospice. A “good death” was associated with older patients who died at home, and respondent satisfaction with hospice service. A “good death” was mapped as 29 nodes and 79 links using semantic network analysis. Three subjects (patient, family, hospice), three timeframes (end-of-life, moment of dying, death), and four central causes (home, peaceful, pain-free, and expected) were identified. [ABSTRACT FROM AUTHOR]

Objective: To obtain information on varicella prematriculation requirements in US colleges for undergraduate students during the 2014-2015 academic year. Participants: Health care professionals and member schools of the American College Health Association (ACHA). Methods: An electronic survey was sent to ACHA members regarding school characteristics and whether schools had policies in place requiring that students show proof of 2 doses of varicella vaccination for school attendance. Results: Only 27% (101/370) of schools had a varicella prematriculation requirement for undergraduate students. Only 68% of schools always enforced this requirement. Private schools, 4-year schools, northeastern schools, those with <5,000 students, and schools located in a state with a 2-dose varicella vaccine mandate were significantly more likely to have a varicella prematriculation requirement. Conclusions: A small proportion of US colleges have a varicella prematriculation requirement for varicella immunity. College vaccination requirements are an important tool for controlling varicella in these settings. [ABSTRACT FROM AUTHOR]

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants. [ABSTRACT FROM PUBLISHER]

Rates of viral suppression among people living with HIV/AIDS remain low, especially within marginalized populations such as people who are unstably housed. Representative payee is a service in which the US Social Security Administration appoints an individual or an organization to provide financial management for vulnerable individuals who are unable to manage their finances including housing payments. Little or no published research examines the association between financial management services such as representative payee and HIV clinical adherence. We conducted a pilot study with 18 unstably housed participants living with HIV/AIDS to examine the impact of representative payee services on viral suppression. Of the 11 participants who were not virally suppressed at baseline, 9 (81.8%) of them had achieved viral suppression at six-month follow-up (p = .004). Our findings suggest that providing unstably housed people living with HIV/AIDS with representative payee services may help them to improve their housing stability and clinical adherence. Additional research is needed to fully explore correlations between representative payee services and viral suppression. [ABSTRACT FROM PUBLISHER]

Suboptimal adherence to antiretroviral (ARV) therapy among HIV-infected individuals is associated with increased risk of progression to AIDS and the development of HIV resistance to ARV medications. To examine whether the luteal phase of the menstrual cycle is independently associated with suboptimal adherence to single tablet regimen (STR) ARV medication, data were analyzed from a multicenter cohort study of HIV-infected women who reported regular menstrual cycles and were taking an STR. In a cross-sectional analysis, suboptimal adherence to an STR among women in their follicular phase was compared with suboptimal adherence among women in their luteal phase. In two-way crossover analyses, whereby the same woman was assessed for STR medication adherence in both her follicular and luteal phases, the estimated exact conditional odds of non-adherence to an STR was measured. In adjusted logistic regression analysis of the cross-sectional data (N=327), women with ≤12 years of education were more than three times more likely to have suboptimal adherence (OR=3.6,p=.04) compared to those with >12 years of education. Additionally, women with Center for Epidemiological Studies Depression Scale (CES-D) scores ≥23 were 2.5-times more likely to have suboptimal adherence (OR=2.6,p=.02) compared to those with CES-D scores <23. In conditional logistic regression analyses of the crossover data (N=184), having childcare responsibilities was associated with greater odds of ≤95% adherence. Menstrual cycle phase was not associated with STR adherence in either the cross-sectional or crossover analyses. The lack of association between phase of the menstrual cycle and adherence to an STR in HIV-infected women means attention can be given to other more important risk factors for suboptimal adherence, such as depression, level of education, and childcare responsibilities. [ABSTRACT FROM AUTHOR]

Background: The correlates of alcohol misuse among female Veterans are not well understood. The present study explored associations among alcohol misuse, demographic/military-related characteristics, interpersonal violence exposure, and posttraumatic stress disorder (PTSD) and depression symptom severity. Method: Participants were 369 female Veteran patients of the VA New England Healthcare System. Participants completed a paper-and-pencil mail survey that included validated assessments of alcohol misuse, interpersonal violence, and psychological distress. Results: Younger age, adulthood physical abuse, military sexual trauma, past-year psychological aggression by an intimate partner, and PTSD and depression symptom severity showed significant univariate associations with alcohol misuse (as indicated by unsafe drinking levels, presence or incipience of an alcohol use disorder, intrapersonal alcohol-related concerns, and/or interpersonal alcohol-related concerns). A couple of these associations remained significant when examined in logistic regression models. Conclusions: Findings suggest that female Veterans who are at risk for alcohol use disorders and/or are experiencing alcohol-related problems may benefit from screening and intervention efforts that take into account interpersonal violence exposures and mental health symptoms on a case-by-case basis. Results also suggest the importance of future research examining correlates and risk factors for substance misuse among female Veterans. [ABSTRACT FROM AUTHOR]

Background: Recent literature suggests an initial increased risk of diabetes following smoking cessation. Objectives: To compare the risk of developing diabetes among obese smokers who tried to quit smoking using bupropion versus varenicline. Methods: A population-based retrospective cohort study was conducted using the General Electric (GE) electronic medical record database (2006–2011). The cohort consisted of obese adult smokers without a diabetes diagnosis at baseline and newly initiating use of either bupropion or varenicline. This cohort was then followed for 1 year to observe the risk of developing diabetes. The relative risk of bupropion versus varenicline on developing diabetes was assessed using Cox Proportional Hazards regression model after controlling for covariates. Results: The sample comprised of 78,002 obese smokers of which 1,937 (2.36%) developed diabetes during 1 year follow-up. Diabetes incidence rate was relatively comparable who used varenicline and bupropion (23.50 versus 25.80 per 1,000 person-years). Obese smokers who were prescribed bupropion had a statistically significant higher risk of developing diabetes during 1 year following cessation treatment than those who were prescribed varenicline. ([HR]: 1.58, 95% CI: 1.09–2.27) in the multivariate model. Conclusions/Importance: Obese smokers who were prescribed bupropion might have a higher risk of developing diabetes during 1 year follow up compared to those who were prescribed varenicline. The clinical significance of the finding that bupropion had a higher risk of developing diabetes may need further investigation. [ABSTRACT FROM AUTHOR]

Farming is among the most dangerous industries for fatal and nonfatal injuries. A comprehensive agricultural injury surveillance system is absent in North Carolina (NC), and data sets traditionally used to provide estimates of nonfatal farm injuries surveillance in the United States are relatively incomplete. In the absence of a comprehensive farm injury surveillance system, individual local administrative data sources can provide a useful profile of the epidemiology of injuries in a population. The objective of this study was to use emergency department data to help describe the burden of farm-related injuries in NC and explore its usefulness in conducting work-related injury surveillance. Emergency department data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) was utilized to identify farm injury cases. The study sample included all farm injury cases for the period of 2008–2012 that contained International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) E code 919.0 (agricultural machinery) or 849.1 (place of occurrence = farm; this E code excludes farm house and home premises of farm). Results indicated that an average of 459 cases of farm injury occurred annually from 2008 to 2012, with no significant change between years. Among the patients, 79.7% were male, 74.7% were between 18 and 64 years old, and 28.1% had no form of insurance coverage. Injuries were more heavily concentrated in the Piedmont and Coastal Plains regions (41.3% and 42.2%, respectively). Of farm-coded incidents, 73.2% were given injury- or poisoning-related primary diagnosis codes, and of these, the most frequent specific codes were related to open wounds of upper limbs (16.2%), contusions (12.0%), and sprains and strains (9.3%). Some significant relationships between diagnoses and sex, region, and age are also identified. Injuries occurring on a farm have been well documented and constitute a significant public health problem. Exploring emergency department data provides an opportunity to better characterize nonfatal farm-related injuries in NC for prevention purposes. The data provided by this study may serve to direct prevention programs, whereas the methods used offer a potential farm-related injury surveillance tool. [ABSTRACT FROM AUTHOR]

Background: Increased interest in promoting community inclusion of adults with serious mental illnesses will necessitate advances in measuring community participation as an outcome of such efforts. Aims: The primary aim of this study is to examine the intermethod reliability of the Temple University Community Participation (TUCP) measure with a daily checklist approach. Secondary aims are to explore the influence of frequency and importance of participation on recall consistency. Method: One hundred and seven individuals diagnosed with a schizophrenia-spectrum disorder, bipolar disorder, or major depression completed a daily checklist of community participation in 25 areas. Approximately 30 days later they completed the TUCP measure involving recall of participation in these same areas. Results: TUCP responses were highly correlated with totals from the daily checklists. Participation areas with more participation days have higher TUCP-diary checklist correlations. Importance of the participation area did not appear to affect correlations. Conclusions: The TUCP is a usable and relatively unobtrusive measure of community participation. Modest evidence found that more frequent events were recalled more consistently. [ABSTRACT FROM AUTHOR]

Women living with HIV (WLHIV) have rates of post-traumatic stress disorder (PTSD) up to 5 times higher than the general population. Individuals living with HIV and a concurrent diagnosis of PTSD have poorer HIV-related outcomes; however, the prevalence and impact of PTSD on African-American WLHIV seeking mental health treatment is unknown. The aim of this study is to examine the associations between PTSD symptoms with psychiatric symptom severity and psychological/religious coping strategies in African-American WLHIV who are seeking mental health treatment. This is a cross-sectional study of 235 African-American WLHIV attending an urban community mental health clinic. Bivariate analyses were conducted to evaluate associations between a PTSD symptoms scale (PSS ≥ 21 versus PSS < 21) and (1) psychiatric severity, (2) coping strategies, and (3) religious coping strategies. Thirty-six percent reported symptoms consistent with PTSD (PSS ≥ 21). These women were significantly more likely to have worse mental health symptoms and were more likely to employ negative psychological and religious coping strategies. On the contrary, women with a PSS < 21 reported relatively low levels of mental health symptoms and were more likely to rely on positive psychological and religious coping strategies. Over one-third of African-American WLHIV attending an outpatient mental health clinic had symptoms associated with PTSD. These symptoms were associated with worse mental health symptoms and utilization of dysfunctional religious and nonreligious coping strategies. Untreated PTSD in WLHIV predicts poorer HIV-related health outcomes and may negatively impact comorbid mental health outcomes. Screening for PTSD in WLHIV could identify a subset that would benefit from evidence-based PTSD-specific therapies in addition to mental health interventions already in place. PTSD-specific interventions for WLHIV with PTSD may improve outcomes, improve coping strategies, and allow for more effective treatment of comorbid mental health disorders. [ABSTRACT FROM AUTHOR]

Ego mechanisms of defense were studied in a sample of 140 African-U.S. college students using for theoretical approaches Michael Bond’s defense style hierarchy and Daudi Ajani ya Azibo’s nepenthe theory. Each framework was supported in the data. Also, previous findings from an earlier exploratory study were replicated including greater defense style scoring compared to Caucasian norms and association between defense style scores and depression. In addition, this study incorporated measures of normal and abnormal psychological Africanity (racial identity). Defense style scores predicted indices of psychopathologic psychological Africanity (African-U.S. culture‒focused mental disorders). Own-race negation and abjuration indices predicted defense style scores. ANOVAs found highest defense style scores for participants classified as having correct psychological Africanity orientation (highest psychological Africanity/racial identity scores) compared to diffused and incorrect lower classifications. It was concluded that the study of defensive behavior among African-U.S. persons might be tempered by nepenthe theory. [ABSTRACT FROM PUBLISHER]

Objective: Explore relationships among traumatic brain injury (TBI), substance misuse and other mental health disorders in US service members and to identify risk factors for substance misuse. Participants: Service members ( n = 93 in final sample) injured while deployed to Operation Enduring Freedom or Operation Iraqi Freedom. Methods and materials: Longitudinal survey at 6 and 12 months post-intake. The following measures were used: problem substance use, Alcohol Expectancies Questionnaire-III, MINI International Neuropsychiatric Interview Substance Abuse Modules, Ohio State University TBI Identification Method, Neurobehavioural Symptom Inventory, Rivermead Post-Concussion Symptoms Questionnaire, Buss-Perry Aggression Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version, Beck Depression Inventory-II, Beck Anxiety Inventory. Results: More severe TBI and post-traumatic stress disorder (PTSD) symptoms at 6 months post-enrolment were associated with decreased odds of substance misuse 12 months after study enrolment. Alcohol expectancies and incurring a TBI at a younger age increased the odds of substance misuse. Conclusions: While the ability to generalize the current findings to a larger population is limited, the results provide direction for future studies on the prevention and treatment of substance misuse following TBI. The unexpected protective effect of more severe TBI may result from prospective attention to the injury and its consequences. Greater preventive benefit may result from identifying more service members with elevated risk. Lifetime history of TBI and alcohol expectancies may be candidate indicators for greater attention. [ABSTRACT FROM AUTHOR]

Primary objective: To characterize an acute stress reaction (ASR) following an improvised explosive device (IED) blast-related mild traumatic brain injury (mTBI). Research design: Participants were male, US military personnel treated in Afghanistan within 4 days following an IED-related mTBI event ( n = 239). Methods and procedures: Demographics, diagnosis of ASR, injury history and self-reported mTBIs, blast exposures and psychological health histories were recorded. Main outcomes and results: In total, 12.5% of patients met ASR criteria. Patients with ASR were significantly younger and junior in rank ( p < 0.05). Patients with ASR were more likely to experience the IED-blast while dismounted, report a loss of consciousness (LOC) and higher pain levels ( p < 0.05). Adjusting for age and rank, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.405; 95% CI = 1.105-1.786, p < 0.01). Adjusting for mechanism of injury (dismounted vs. mounted), LOC and pain, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.453; 95% CI = 1.132-1.864, p < 0.01). Prior blast exposure and past psychological health issues were not associated with ASR. Conclusions: A history of multiple mTBIs is associated with increased risk of ASR. Future research is warranted. [ABSTRACT FROM AUTHOR]