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Recent discoveries about the role of microorganisms in the establishment of the geological conditions in the planet have lead to the development of courses in Geomicrobiology. Unfortunately, most courses are designed for students with a strong Geology background, which is a limitation for universities that lack such courses. To overcome this limitation at our university, we have designed a special topics course entitled Introductory Geomicrobiology that was offered for the first time to undergraduate students from the Biology, Marine Biology and Microbiology Programs. To attract non-geology majors the course included topics such as description of Early Earth ecosystems, search for geo-biological signatures and current approaches in the search for extra-terrestrial life forms. An active learning environment was fostered throughout the course through different activities including oral reports of research papers in the subject, followed by Gallery Runs and class discussions. Our assessment strategies, both formative and summative, revealed that such presentations were an effective way to introduce students to eight main concepts of Geomicrobiology. Student performance was stronger in group discussions than individually, with Gallery Runs as the preferred class discussion technique. Overall, our assessment system proved that the design of the course was effective in teaching Geomicrobiology to nongeology majors.

This paper describes a highly successful peer tutoring program that has resulted in an improvement in the passing rates of mathematics placement exams from 16% to 42%, on average. Statistical analyses were conducted using a Chi-Squared (?[superscript 2]) test for independence and the results were statistically significant (p-value much less than 0.05). These encouraging results suggest that this type of initiative should be institutionalized at the end of the grant period that funds it. The paper describes the structure of the program, the conditions of the university in which it is being implemented, the details of the statistical analyses, and its impact in engineering education. This model may easily be replicated in academic institutions with similar conditions.

This paper reports on research into developing research skills in human resources management of apprentices through experiential learning. The target groups were undergraduate business students registered in the Introduction to Personnel and Industrial Relations course. The research identified the appreciation level of importance and satisfaction from apprentices since the acquisition and development of research skills for human resources management discipline. Data analysis indicates, firstly the importance of acquisition and development research skills in human resources management are congruent with the needs required for the contemporary organization and career objectives of the apprentices and future human resources professionals. The results obtained have positive implications on apprentices from research skills statements such as organizational goal's achievement, job analysis, human resources audit, strategic planning, statistical analysis, and evidence-based in human resources management to diminish the skills gap through the curriculum development in human resources management.

This paper is a descriptive account of how short-term international and multicultural experiences can be integrated into early design experiences in an aerospace engineering curriculum. Such approaches are considered as important not only in fostering a student's interest in the engineering curriculum, but also exposing them to a multicultural setting that they are likely to encounter in their professional careers. In the broader sense, this programme is described as a model that can be duplicated in other engineering disciplines as a first-year experience. In this study, undergraduate students from Rensselaer Polytechnic Institute (RPI) and Universidad del Turabo (UT) in Puerto Rico collaborated on a substantial design project consisting of designing, fabricating, and flight-testing radio-controlled model aircraft as a capstone experience in a semester-long course on Fundamentals of Flight. The two-week long experience in Puerto Rico was organised into academic and cultural components designed with the following objectives: (i) to integrate students in a multicultural team-based academic and social environment, (ii) to practise team-building skills and develop students' critical thinking and analytical skills, and finally (iii) to excite students about their engineering major through practical applications of aeronautics and help them decide if it is a right fit for them.

Objectives: This paper provides new estimates of disability prevalence for the archipelago and mainland-residing Puerto Rican populations ages 40 and above and compares disability by place of birth and place of residence to investigate drivers of middle and older age health. Methods: Large nationally representative samples from 2013 to 2017 American Community Survey and Puerto Rico Community Survey data are used to estimate age-specific disability prevalence for archipelago-born/archipelago-residing, archipelago-born/mainland-residing, mainland-born/mainland-residing Puerto Ricans. Results: Mainland-born/mainland-residing Puerto Ricans have the lowest age-adjusted disability rates and archipelago-born/archipelago-residing Puerto Ricans have the highest rates. Differences in education explain part of this disparity. Discussion: Similarities in disability prevalence are strongest based on where one was born as opposed to current residence, pointing to early life as a critical period in the disablement process for later-life health. Early life socio-economic disadvantage on the archipelago may have an enduring impact on later-life disability prevalence for archipelago-born Puerto Ricans. [ABSTRACT FROM AUTHOR]

This mixed-methods paper describes the development and preliminary validation of the Behavioral Intentions Questionnaire (BIQ), a multi-scale questionnaire developed to assess determinants influencing Puerto Rican adolescents' intentions to engage in abusive behaviors in dating relationships. Items were developed qualitatively, and face and content validity were established by expert and target population judges via semi-structured interviews (n = 48), discussions, and four focus groups (n = 6 each). The questionnaire was pilot tested twice. An initial pilot test was conducted with students aged 13 to 17 from a private alternative education program in San Juan, Puerto Rico (n = 32). A second pilot test was conducted with a sample of students from the same site (n = 22), in addition to students in the same age range from a private school (n = 88) in San Juan. Confirmatory and Exploratory factor analysis was used to determine construct validity and Cronbach's coefficient alpha determined the subscales internal consistency reliability. Correlations between subscales were examined. Thematic content analysis was used to analyze qualitative data. Qualitative data suggested the need to revise or eliminate items and instructions and incorporate a social desirability measure. Factor analyses yielded a unidimensional structure for each subscale and each subscale demonstrated high internal consistency. Preliminary analysis on the factor structure, internal reliability, and validity of the BIQ were encouraging. However, further psychometric testing is needed before this measure can be considered a useful tool for measuring intentions to engage in abusive behaviors in dating relationships. [ABSTRACT FROM AUTHOR]

The PROTECT research Center funded by the NIH's National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program was launched in 2010 to explore the impact of exposure to pollutants on the high rate of premature births in Puerto Rico. In September 2017, Hurricanes Irma and María devastated the archipelago, which caused: collapse of the electrical system, collapse of the communication system, limited access to clean water, food, gas, and health services, destruction of public (e.g., hospitals) and private property (e.g., houses) and more than 4500 deaths. Pregnant and postpartum individuals are especially vulnerable to natural disasters. They face difficulty obtaining adequate pre- and post-natal care, are exposed to increased risk of miscarriage, premature delivery, and giving birth to low birth weight babies during and after disasters and are also more likely to suffer physical and mental health problems compared to the general population during and after disasters. A face-to-face questionnaire was administered to PROTECT participants who were pregnant during hurricanes Irma or Maria or who became pregnant shortly after in order to identify hurricane-related sources of stress and other adverse effects. This paper is based on the answers to the open-ended question at the end of the questionnaire where participants were asked to share their experiences during and after the hurricanes. Among the 375 participants who completed the survey, 76 answers to the open-ended question were considered due to data saturation. The answers to the open-ended question were transcribed into a document in order to facilitate the coding process. The transcribed text was analyzed first to identify emerging categories and then coded to identify common themes as well as divergence among participants. The following themes were identified: pregnancy and birth challenges, lack of access to basic services, housing conditions, stressful working conditions, concerns about health, concerns about their children, and positive or protective aspects. The results indicate how the disruption in access to basic services has a unique impact on the physical and mental health of pregnant and post-partum women in an emergency situation. These findings point to the potential benefit of developing specific protocols designed for emergency preparedness aimed at this population, which can inform healthcare providers and community organizations in case of future events. [ABSTRACT FROM AUTHOR]

This paper is about naming illnesses--about who determines what categories are used and the implications of these determinations. The central concerns of medical/psychiatric anthropology have been to understand popular categories of and systems for classification of illness, to examine the relationship of illness categories to cultural understandings of the body, and to interpret the role of categories of illness in mediating between the personal and social spheres. At the same time, the paper also discusses the interplay of popular categories and psychiatric diagnoses. This paper examines the multiple experiences of nervios among Puerto Ricans in Puerto Rico and New York City. Our contention is that nervios is more than a diffuse idiom of distress, and that there are different categories and experiences of nervios which provide insights into how distress is experienced and expressed by Puerto Ricans and point to different social sources of suffering. The data in this paper come from the responses to a series of open-ended questions which tapped into people's general conceptions of nervios and ataques de nervios. These questions were incorporated into follow-up interviews to an epidemiological study of the mental health of adults in Puerto Rico. The results suggest ways to incorporate these different categories of nervios into future research and clinical work with different Latino groups in the United States and in their home countries. [ABSTRACT FROM AUTHOR]

ObjctivesSelf-rated health (SRH) is an important indicator of overall health, predicting morbidity and mortality. This paper investigates what individuals incorporate into their self-assessments of health and how acculturation plays a part in this assessment. The relationship of acculturation to SRH and whether it moderates the association between indicators of health and SRH is also examined. DesignThe paper is based on data from adults in the Boston Puerto Rican Health Study, living in the greater Boston area (n=1357) mean age 57.2 (SD = 7.6). We used multiple regression analysis and testing for moderation effects. ResultsThe strongest predictors of poor SRH were the number of existing medical conditions, functional problems, allostatic load and depressive symptoms. Poor SRH was also associated with being female, fewer years of education, heavy alcohol use, smoking, poverty, and low emotional support. More acculturated Puerto Rican adults rated their health more positively, which corresponded to better indicators of physical and psychological health. Additionally, acculturation moderated the association between some indicators of morbidity (functional status and depressive symptoms) and SRH.Self-assessments of overall health integrate diverse indicators, including psychological symptoms, functional status and objective health indicators such as chronic conditions and allostatic load. However, adults' assessments of overall health differed by acculturation, which moderated the association between health indicators and SRH. The data suggest that when in poor health, those less acculturated may understate the severity of their health problems when rating their overall health, thus SRH might thus conceal disparities. Using SRH can have implications for assessing health disparities in this population. [ABSTRACT FROM AUTHOR]

Aim: To assess the validity of the translated Spanish Cancer Symptom Scale. Background: Instruments to facilitate comprehensive and objective assessments of the cancer symptom experience in underrepresented populations are essential. Methods: The Cancer Symptom Scale was translated into Spanish, and a back translation was conducted. During June 2016, a sample of 121 Hispanic Puerto Rican patients with any cancer diagnosis, all undergoing cancer treatments, completed four paper surveys. A subgroup of 15 patients agreed to complete the Spanish Cancer Symptom Scale a second time after a short delay of 1 to 2 hours. Construct validity and reliability (internal consistency via Cronbach alpha and test‐retest reliability) was evaluated. Results: All the Intensity Items of the Spanish Cancer Symptom Scale correlated significantly with the matched items on the MD Anderson Symptom Inventory. In a subgroup of 77 participants, each Cancer Symptom Scale subscale total of scores correlated significantly with the total scores from the Functional Assessment of Cancer Therapy‐General. Discriminant validity was demonstrated between those receiving chemotherapy and those from post treatment. The Spanish Cancer Symptom Scale internal consistency reliability was 0.98. Conclusion: The Spanish Cancer Symptom Scale has excellent evidence of validity and reliability for assessing cancer‐therapy‐related symptoms. SUMMARY STATEMENT: What is already known about this topic? The Cancer Symptom Scale English version has proven to be useful for symptom management research and is currently being used as a method to evaluate the effectiveness of interventions or palliative treatments in ameliorating cancer‐therapy related symptoms. What this paper adds? The Spanish Cancer Symptom Scale is a valid and reliable instrument for determining the symptom profile of Hispanic Puerto Rican patients undergoing cancer treatments. The implications of this paper: The Spanish Cancer Symptom Scale is an easy to answer numeric rating instrument that has the potential to be included in clinical practice settings to achieve a more comprehensive and objective assessment of the symptom experience. [ABSTRACT FROM AUTHOR]

To systematically study and document regional variations in descriptions of nervios, we undertook a multisite comparative study of the illness among Puerto Ricans, Mexicans, Mexican Americans, and Guatemalans. We also conducted a parallel study on susto (Weller et al. 2002, Culture, Medicine and Psychiatry 26(4): 449-472), which allows for a systematic comparison of these illnesses across sites. The focus of this paper is inter- and intracultural variations in descriptions in four Latino populations of the causes, symptoms, and treatments of nervios, as well as similarities and differences between nervios and susto in these same communities. We found agreement among all four samples on a core description of nervios, as well as some overlap in aspects of nervios and susto. However, nervios is a much broader illness, related more to continual stresses. In contrast, susto seems to be related to a single stressful event. [ABSTRACT FROM AUTHOR]

Disasters affect the well‐being of individuals, families and communities. Health and social care providers are essential in response and recovery efforts and are among the most vulnerable to negative physical and mental health impacts of a disaster. Few evidence‐based interventions are available to address the psychological needs of providers. The aim of this study was to examine the psychological distress of health and social care providers before and after participating in the brief group intervention, Resilience and Coping for the Healthcare Community (RCHC) and its expanded version, RCHC+. We conducted a pragmatic non‐randomised cluster trial with 762 health and social care providers in south Texas and Puerto Rico post‐Hurricanes Harvey and Maria. Participants completed surveys assessing post‐traumatic stress (PTSD), anxiety, burnout and secondary traumatic stress (STS) prior to intervention delivery and at two time points post‐intervention. We calculated the frequency of symptom cut‐off scores at baseline, then estimated multilevel ordinal models to examine changes in symptoms across time. Prior to participation in the RCHC (approximately 12 months after the hurricanes), providers reported high levels of PTSD, anxiety and STS symptoms. After participation, providers in both intervention conditions reported a significant reduction in PTSD symptoms from baseline that was sustained over both time points. The likelihood of a reduction in symptoms of anxiety and STS from baseline was sustained at both time points for participants in the RCHC+ condition. These findings indicate that both the RCHC and RCHC+ interventions may reduce psychological distress for health and social care providers and could be an important part of advance planning to support provider's mental health during and after a disaster. Further examination of the RCHC in other disaster contexts could provide additional insight into the responsiveness of the intervention to reducing psychological distress symptoms. [ABSTRACT FROM AUTHOR]

Background: Safe, reliable, high-quality critical care delivery depends upon interprofessional teamwork. Objective: To describe perceptions of intensive care unit (ICU) teamwork and healthy work environments and evaluate whether perceptions vary by profession. Methods: In August 2015, Assessment of Interprofessional Team Collaboration Scale (AITCS) and the American Association of Critical-Care Nurses Healthy Work Environment Assessment Tool (HWEAT) surveys were distributed to all interprofessional members at the 68 ICUs participating in the ICU Liberation Collaborative. Overall scores range from 1 (needs improvement) to 5 (excellent). Results: Most of the 3586 surveys completed were from registered nurses (51.2%), followed by respiratory therapists (17.8%), attending physicians (10.5%), rehabilitation therapists (8.3%), pharmacists (4.9%), nursing assistants (3.1%), and physician trainees (4.1%). Overall, respondents rated teamwork and work environment health favorably (mean [SD] scores: AITCS, 3.92 [0.64]; HWEAT, 3.45 [0.79]). The highest-rated AITCS domain was "partnership/shared decision-making" (mean [SD], 4.00 [0.63); lowest, "coordination" (3.67 [0.80]). The highest-scoring HWEAT standard was "effective decision-making" (mean [SD], 3.60 [0.79]); lowest, "meaningful recognition" (3.30 [0.92]). Compared with attending physicians (mean [SD] scores: AITCS, 3.99 [0.54]; HWEAT, 3.48 [0.70]), AITCS scores were lower for registered nurses (3.91 [0.62]), respiratory therapists (3.86 [0.76]), rehabilitation therapists (3.84 [0.65]), and pharmacists (3.83 [0.55]), and HWEAT scores were lower for respiratory therapists (3.38 [0.86]) (all P ≤.05). Conclusions: Teamwork and work environment health were rated by ICU team members as good but not excellent. Care coordination and meaningful recognition can be improved. [ABSTRACT FROM AUTHOR]

Social discourses regarding gender are responsible for molding people's cognitions, perceptions, behaviors, and interactions with others. Approaching and understanding gender socialization is an important strategy that must be included in the development of HIV/AIDS prevention interventions efforts targeting male-to-female (MTF) transgender people. This paper represents an effort to identify the influence of gender construction among a group of MTF transgenders in Puerto Rico. Using combined methodology, authors examined results from a questionnaire and in-depth interviews with a convenience sample of MTF transgenders living in the San Juan metropolitan area. Quantitative analysis demonstrated that this sample is composed of young, unemployed, and under educated population. Many participated in the sex industry. Participants reported need for basic health and social services and alienation from social networks. Qualitative analysis confirmed their traditional social construction of the 'feminine.' Their discourse underlines their need to reinforce their identity by the construction of a female self which undermine their possibilities for negotiating safer sex, as happens to most females in Latino societies. Social vulnerability, institutional exclusion, and gender construction issues are obstacles for the HIV prevention efforts among these communities. [ABSTRACT FROM AUTHOR]

Previous research has drawn attention to the health risks and poor living conditions that families of Haitian descent contend with in the Dominican Republic, particularly in rural, agricultural communities. Less clearly described is whether these problems persist as households transition to non-agricultural work and increasingly urban residence patterns. This study compares the use of health care services and access to water, sanitation, and food for Haitian and Dominico-Haitian families living in the city of Puerto Plata with households located on the rural-urban fringe. Data were collected during household surveys with 61 urban and 30 rural/peri-urban families. Households residing in the rural/peri-urban community had lower incomes, more unmet sanitation needs, and less stable access to water than urban families. Overall, households lacked adequate food, with 74.4% experiencing food insufficiency. Respondents reported using diverse types of health services and treatments, but households in the rural/peri-urban community had higher rates of health care use than urban families. These findings indicate urban families have better access to some resources that promote health than rural/peri-urban households. By identifying health issues and environmental conditions in rural/peri-urban and urban areas, this study aims to provide guidance for policy-makers, agencies, and organisations that serve Haitian migrant communities. [ABSTRACT FROM AUTHOR]

A locus of the difference in meaning between distributive and collective sentences can be the quantifiers that modify their subjects. A current theoretical account of distributive and collective sentences claims that sentences with quantifiers such as the in English, or los in Spanish, in subject position and an indefinite direct object, modified by a in English, or una in Spanish, are ambiguous as to whether they are distributive or collective, all things being equal. In contrast, the same sentences with each/cada in subject position are unambiguously distributive. This account claims that sentences with quantifiers such as the/los in subject position come to be interpreted collectively, and not distributively, because the distributive meaning could more informatively be constructed using the unambiguous each/cada quantifier. This is the same neo-Gricean reasoning that accounts for the Quantity Implicature that arises for some, given the informativeness of all. On this account, collective and distributive interpretations are intrinsically linked, which predicts that even children's non-adult-like collective and distributive interpretations should nonetheless be statistically associated, which we confirm in a sample of Puerto Rican Spanish-speaking children. We further propose that growth occurs both internal to lexical items, in terms of denotative content, as well as externally, within the lexicon in quantifier networks. Such networks have traditionally been expressed in formal semantics as pragmatic scales. We claim that the growth of both of these lexical dimensions are indexed by general lexical growth and show that a statistical association obtains between them in our sample. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) infection is associated with substantial morbidity and mortality among people who use drugs (PWUD). Health disparities related to race/ethnicity and immigration status also increase the risk of HCV infection and decrease the probability of linkage to care. Effective, curative treatment is now available for HCV infection and, alongside prevention, may eliminate HCV epidemics. Methods: We examined HCV incidence, prevalence and associated risk factors among 5459 Puerto Rican (both PR-born and U.S.-born) and non-Puerto Rican (only U.S.-born) entrants to Mount Sinai Beth Israel drug treatment programs in New York City, from August 2005 to January 2018, to assess the need for HCV screening, prevention and treatment in this population. Results: HCV incidence and prevalence among Puerto Rican PWUD was significantly greater than the non-Puerto Ricans PWUD. Among people who inject drugs (PWID), there was no difference in injection risk behaviours by ethnicity/birth place. Conclusions: Findings suggest HCV treatment is a necessary component of a strategy to eliminate HCV epidemics among PWUD. Findings also underline the interconnectedness of epidemics across regions, such that to eliminate the HCV epidemic in one location may depend on eliminating the HCV epidemics in other locations. [ABSTRACT FROM AUTHOR]

Background. Transgender women (TW) in Puerto Rico (PR) face social stigmatization. Physicians' transgender stigma can have detrimental consequences for TW's health. Purpose. The objective of this study was to document physicians' knowledge, competencies, and attitudes towards TW in PR and study their associations with stigma towards TW. Methods. We implemented an exploratory sequential mixed-methods study. We used in-depth interviews (n=30) and self-administered questionnaire (n=255). Results. Qualitative results illustrated lack of recognition of the needs of TW; they also evidenced the impact of stigmatizing attitudes on clinical decisions. Quantitative results showed that more willingness and knowledge to provide health services to TW were negatively associated with stigma. Participants who reported history of training in working with TW presented significantly less stigma than participants who had not received such training. Conclusion. In order to provide stigma-free services for TW in PR, specialized training regarding the particular needs of this population is needed. [ABSTRACT FROM AUTHOR]

Objective: To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. Methods: Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m2; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. Results: Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). Conclusion: Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Sister Study was designed to address gaps in the study of environment and breast cancer by taking advantage of more frequent breast cancer diagnoses among women with a sister history of breast cancer and the presumed enrichment of shared environmental and genetic exposures. OBJECTIVE: The Sister Study sought a large cohort of women never diagnosed with breast cancer but who had a sister (full or half) diagnosed with breast cancer. METHODS: A multifaceted national effort employed novel strategies to recruit a diverse cohort, and collected biological and environmental samples and extensive data on potential breast cancer risk factors. RESULTS: The Sister Study enrolled 50,884 U.S. and Puerto Rican women 35-74 y of age (median 56 y). Although the majority were non-Hispanic white, well educated, and economically well off, substantial numbers of harder-to-recruit women also enrolled (race/ethnicity other than non-Hispanic white: 16%; no college degree: 35%; household income <$50,000: 26%). Although all had a biologic sister with breast cancer, 16.5% had average or lower risk of breast cancer according to the Breast Cancer Risk Assessment Tool (Gail score). Most were postmenopausal (66%), parous with a first full-term pregnancy <30 y of age (79%), never-smokers (56%) with body mass indexes (BMIs) of <29:9 kg=m² (70%). Few (5%) reported any cancer prior to enrollment. CONCLUSIONS: The Sister Study is a unique cohort designed to efficiently study environmental and genetic risk factors for breast cancer. Extensive exposure data over the life-course and baseline specimens provide important opportunities for studying breast cancer and other health outcomes in women. Collaborations are welcome. [ABSTRACT FROM AUTHOR]

In Puerto Rico, colorectal cancer (CRC) incidence and mortality rates are increasing. Moreover, adherence rates to CRC screening (52.2%) are still below the goals (70.5%) established by Healthy People 2020. Lack of knowledge is described as a significant barrier to adherence to CRC screening. The aim of this study was to assess CRC knowledge and screening rates among Puerto Rican Hispanics. Participants aged 40-85 years were recruited from the internal medicine outpatient clinics at the University of Puerto Rico. Demographic characteristics and knowledge about CRC, including risk factors and CRC screening tests, were obtained through face-to-face interviews. A mean CRC knowledge score was calculated based on correct responses to 13 validated questions. Mean knowledge scores were evaluated according to demographic characteristics using the Wilcoxon-Mann-Whitney test. A total of 101 participants were recruited with mean age of 63 (±10.6) years. Fifty-eight (58%) of participants were females, 59% reported ≥12 years of education, and 71% reported ever screening for CRC. The mean CRC knowledge score was significantly lower (p < 0.05) among participants with lower annual family income, those who had never received a recommendation for CRC screening by a healthcare provider, and those who had no history of CRC screening. Knowledge about CRC must be improved in Puerto Rico. Efforts must be made to promote and develop culturally appropriate CRC educational strategies. Future studies should focus on identifying other barriers and factors that may limit CRC screening in the Puerto Rican Hispanic population. [ABSTRACT FROM AUTHOR]

This study evaluated whether a self-administered stress management training (SSMT) could improve quality of life (QOL) and reduce distress among Hispanics receiving chemotherapy across multiple community clinical settings. Participants were randomized to receive SSMT (n = 106) or usual care (UCO) (n = 113). The primary outcome-QOL (SF-36) and secondary outcomes depression (CES-D), and anxiety (STAI) were assessed longitudinally over four chemotherapy cycles. Acculturation (BAS) and patients' intervention adherence were assessed. About 63% of participants reported distress after the initial chemotherapy cycle. Hispanics with lower acculturation reported greater STAI-Trait scores (p = .003). No significant treatment effects on outcomes measures were observed for participants receiving SSMT. SSMT intervention techniques were reported useful and improved mental health scores were observed with patients on a psychotropic agent (p = .04). Hispanics experience an elevated level of distress, yet SSMT did not significantly improve primary outcomes. SSMT may be potentially effective when combined with a psychotropic agent. SSMT enhancing strategies are discussed. [ABSTRACT FROM AUTHOR]

Formerly incarcerated Latino men (FILM) have been significantly impacted by the HIV/AIDS and alcohol abuse epidemics in the United States. In this analysis, we examine the role of social, economic and cultural marginalization in the likelihood of alcohol-related sexual risk taking behavior among FILM. We recruited a non-random sample of FILM, ages 18-49 (n = 259). We performed logistic regression modeling to test four hypotheses examining the direct and moderating effects of socio-cultural factors. Drinking before sex was strongly associated with high likelihood of condomless intercourse (adjusted odds ratio, AOR = 2.93; 95% CI 1.74, 4.94). Low acculturation and social marginalization factors were significant moderators of the association between high-risk alcohol use and sexual risk behavior among FILM. Our data suggest that risk reduction initiatives geared towards reducing alcohol-related sexual risk taking among FILM should target FILM with low levels of acculturation, and those with high levels loneliness, anxiety, and/or depression. [ABSTRACT FROM AUTHOR]

Little is known about the offending behavior and recidivism factors of Latinos by nativity (U.S. born, foreign-born). The present study focused on Latinos in community corrections ( n = 201) in Miami, Florida, and examined differences in criminal activity, drug use, and mental health by nativity. Data were collected utilizing convenience sampling between June 2014 and December 2015. The research question was: what are the offending, drug use, and mental health histories of Latinos involved in community corrections? Participants were mostly male (n = 120; 59.7%), White (n = 105; 52.2%), and Cuban (n = 97; 48.3%). U.S. born community corrections clients ( n = 141) were more likely to report more lifetime and recent criminal activity; and more likely to report lifetime and recent drug use behavior than foreign-born Latinos ( n = 60). No differences were found in recent mental health. Correctional healthcare should tailor services such as substance abuse treatment differently toward U.S. born and foreign-born Latinos. [ABSTRACT FROM AUTHOR]

Aim Sexual risk behaviour was explored and described using Social Action Theory. Background The sexual transmission of HIV is complex and multi-factorial. Social Action Theory provides a framework for viewing self-regulation of modifiable behaviour such as condom use. Condom use is viewed within the context of social interaction and interdependence. Design Cross-sectional survey. Methods Self-report questionnaire administered to adults living with HIV/ AIDS, recruited from clinics, service organizations and by active outreach, between 2010 - 2011. Findings Having multiple sex partners with inconsistent condom use during a 3-month recall period was associated with being male, younger age, having more years of education,substance use frequency and men having sex with men being a mode of acquiring HIV. In addition, lower self-efficacy for condom use scores were associated with having multiple sex partners and inconsistent condom use. Conclusion Social Action Theory provided a framework for organizing data from an international sample of seropositive persons. Interventions for sexually active, younger, HIV positive men who have sex with men, that strengthen perceived efficacy for condom use, and reduce the frequency of substance use, may contribute to reducing HIV-transmission risk. [ABSTRACT FROM AUTHOR]

Measuring experiences of intimate partner violence is critical for researchers and advocates. One measure, the Abusive Behavior Inventory (ABI), has limited testing but is used more frequently by advocates in domestic violence organizations. This article describes the psychometric evaluation of the ABI through confirmatory and exploratory factor analyses among data collected with 457 female survivors of abuse in seven states and Puerto Rico. The findings provide evidence for the reliability of a revised ABI (ABI-R) with three factors: physical violence, psychological abuse, and sexual abuse. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, and trans (LGBT) people struggle for health and well-being in many contexts. In this article we describe the experiences of discrimination and perceived priorities for well-being in a sample of LGBT people in Puerto Rico. A community based-participatory research approach provided to collect data from 233 LGBT individuals attending a pride event. Nearly half of the sample reported not self-disclosing sexual orientation to healthcare providers and school was found to be the most common setting for experiencing discrimination. The main perceived priority for well-being was marriage equality. Addressing social determinants of health such as discrimination at work and lack of inclusion in healthcare services may lead the way towards health equity for LGBT people in Puerto Rico. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to understand through a quantitative assessment, the views of HPV and HPV vaccination among parents of sons from a FQHC in PR. Methods. A self-administered questionnaire was given to a convenience sample of 200 parents of sons 9-17 years old. Results. Nearly 30% of the parents reported that their sons had initiated the HPV vaccine regimen. Health care provider recommendation was significantly associated with vaccine initiation. Among parents of unvaccinated sons, the main reason for not getting the HPV vaccine was they did not know that boys were allowed to get the vaccine. Conclusions. Future efforts should focus on multilevel interventions aimed to increase knowledge as well as other modified behavioral determinants in parents of young males about HPV and the vaccine. Capacity building efforts should be targeted also to increase health providers' education and communication skills to promote HPV vaccination effectively. [ABSTRACT FROM AUTHOR]

Background Our aim was to examine the association between employment status, depression, drinking, binge drinking, and DSM-5 alcohol use disorder in Puerto Rico. Methods Data are from a 2013 to 2014 household random sample of individuals 18 to 64 years of age in San Juan, Puerto Rico. Results Bivariate analyses showed that depression was 5 times higher among unemployed males than among those employed full time (21% vs. 4%) and 2 times higher among unemployed females compared to those employed part time or full time (18% vs. 7% and 9%). Employment status was not associated with weekly volume of drinking, but nonparticipation in the workforce was protective against drinking (odds ratio [OR] = 2.17; 95% confidence interval [CI]: 1.03 to 4.57; p < 0.05) and binge drinking ( OR = 0.62; 95% CI = 0.39 to 0.97; p < 0.05). This association could be due to the fact that those not in the work force may not be working due to sickness or disability. Male gender was a factor of risk for being a current drinker ( OR = 2; 95% CI = 1.53 to 2.6; p < 0.001) and binge drinking ( OR = 1.69; 95% CI = 1.29 to 2.2; p < 0.001). Male gender was protective against depression ( OR = 0.32; 95% CI = 0.14 to 0.73; p < 0.01), but males employed only part time were almost 5 times more likely than females employed full time to be depressed ( OR = 4.66; 95% CI = 1.25 to 17.38; p < 0.05). Conclusions Employment status in Puerto Rico is associated with depression and with current drinking, but not with other alcohol-related outcomes. Perhaps Puerto Rico is a 'wet' environment, where drinking is already at a relatively high level that is not affected by employment status. Perhaps the chronic high rate of unemployment in the island has also created familial (e.g., support) and personal level accommodations (e.g., participation in the informal economy) that do not include increased drinking. [ABSTRACT FROM AUTHOR]

HIV has increasingly impacted older adults regarding sero-prevalence and sero-incidence as long-term survivors of HIV/AIDS are living longer. This study examines the relationship between age and HIV-related attitudes and risk behaviors among female public housing residents in Puerto Rico. Using a self-administered survey instrument, 1,138 female public housing residents were surveyed between April and August 2006. Bivariate results showed that older women (aged 50+ years) were significantly less likely to report HIV testing and to discuss safer sex with their most recent 'steady' sex partner than women under the age of 50 years. Older women were also more likely to express anxiety associated with condoms and more barriers to using condoms. The older versus younger groups did not significantly differ regarding condom use, which was extremely low across the groups. In the past three and 12 months, older women were less likely than younger women to report having (a) multiple sex partners and; (b) oral and anal sex with their most recent steady sex partner; (c) oral sex with their most recent non-steady sex partner and, (d) engaging in sexual activity in the previous three and 12 months. Age-specific messages concerning their increased risk of HIV among other interventions would likely curtail the increase in the number of new HIV cases being reported among members of this sub-population. [ABSTRACT FROM AUTHOR]

Background: Anxious-depression is a constellation of symptoms, frequently encountered among patients in primary care centers. There is a need to study how anxious-depression presents among Hispanic/Latinos of different backgrounds.Objective: To study the construct of anxious-depression among 16,064 Hispanic/Latinos of different backgrounds participating in the Hispanic Community Health Study/Study of Latinos. We hypothesized that Hispanic/Latinos will cluster in 3 classes: low anxiety/high depression, high anxiety/low depression and a combined anxious-depression construct.Methods: Using latent profile analysis, symptoms of depression and anxiety measured by the 10-item Center for Epidemiologic Studies Depression Scale and 10-item State-Trait Anxiety Inventory were evaluated to determine if an anxious-depression typology would result. A multinomial logistic regression analysis explored the association of the 3-class solution with different Hispanic/Latino backgrounds controlling for age, gender, language, education and income.Results: A 3-class mixed anxious-depression structure emerged with 10% of Hispanic/Latinos in the high, 30% in the moderate and 60% in the low anxious-depression category. After adjusting for age, gender, language preference, income and education, individuals of Puerto Rican background were more likely to experience high (OR = 1.79, p < 0.05) and moderate (OR = 1.36, p < 0.05) (vs. low) anxious-depression symptomatology compared to those of Mexican background. Individuals of Central American and South American background were less likely to experience high (OR = 0.68, p < 0.05) and moderate (OR = 0.8, p < 0.05) (vs. low) anxious-depression compared to those of Mexican background.Conclusion: Anxious-depression symptomatology varied among this sample of Hispanic/Latino groups. These classes should be investigated as to their relationship with different health outcomes relevant to the Hispanic/Latino of different backgrounds. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the relative validity and reproducibility of a semi-quantitative FFQ in Puerto Rican adults.Design: Participants completed an FFQ, followed by a 6 d food record and a second administration of the FFQ, 30 d later. All nutrients were log transformed and adjusted for energy intake. Statistical analyses included correlations, paired t tests, cross-classification and Bland-Altman plots.Setting: Medical Sciences Campus, University of Puerto Rico.Subjects: Convenience sample of students, employees and faculty members (n 100, ≥21 years). Data were collected in 2010.Results: A total of ninety-two participants completed the study. Most were young overweight females. All nutrients were significantly correlated between the two FFQ, with an average correlation of 0·61 (range 0·43-0·73) and an average difference of 4·8 % between them. Most energy-adjusted nutrients showed significant correlations between the FFQ and food record, which improved with de-attenuation and averaged 0·38 (range 0·11-0·63). The lowest non-significant correlations (≤0·20) were for trans-fat, n 3 fatty acids, thiamin and vitamin E. Intakes assessed by the FFQ were higher than those from the food record by a mean of 19 % (range 4-44 %). Bland-Altman plots showed that there was a systematic trend towards higher estimates with the FFQ, particularly for energy, carbohydrate and Ca. Most participants were correctly classified into the same or adjacent quintile (average 66 %) by both methods with only 3 % gross misclassification.Conclusions: This semi-quantitative FFQ is a tool that offers relatively valid and reproducible estimates of energy and certain nutrients in this group of mostly female Puerto Ricans. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the socio-demographic characteristics, awareness of human papillomavirus (HPV), and willingness to vaccinate among a convenience sample of 60 immigrant Dominican parents of adolescent sons in a Federal Qualified Health Clinic in Puerto Rico. Participation involved completing a self-administered survey. Even though more than half of the parents had not received proper HPV vaccine orientation from healthcare provider (58.3 %) nor asked provider for vaccination recommendation for their adolescent sons (56.7 %), most parents were aware of HPV (91.7 %) and HPV vaccination among males (55.0 %). Among those with unvaccinated sons, willingness to vaccinate the son within the next year was high (83.8 %). The low vaccination percentage (31.7 %) and information exchange between the parents and the son's healthcare provider indicates an opportunity for future culturally tailored interventions to target HPV vaccination among healthcare providers and parents of foreign descent in order to increase HPV vaccine uptake among males. [ABSTRACT FROM AUTHOR]

This article presents, for the first time, descriptive research on the status of music education in Puerto Rican public elementary schools. General music education at elementary schools on the island has been part of the school offering for more than 50 years. As yet, music education at this level has not been recognized as an essential discipline in the Department of Education’s official curriculum. The official governmental positions are contradictory to the reality of the teaching of music. As a result, this study is directed at obtaining a true understanding of the factors by performing research using 228 music educators from different areas of the Puerto Rican territory as the main suppliers of information. A questionnaire, validated by 15 experts, was administered to the 228 highly qualified in-service music teachers, and a 100% response rate was obtained. Overall, the results revealed that music teachers from Puerto Rico are performing under less than ideal teaching conditions. [ABSTRACT FROM PUBLISHER]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. As part of a larger project, nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the US enrolled 1211 sexually active PLWHA using convenience sampling. The majority of the sample was male, middle-aged, and from the US. Illicit drug use was strongly associated with sexual risk behavior, but participants with higher self-compassion were less likely to report sexual risk behavior, even in the presence of illicit drug use. Self-compassion may be a novel area for behavioral intervention development for PLWHA. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Introduction. Hispanic women in Puerto Rico share health concerns that affect women generally, and suffer disproportionately from some health concerns relative to non- Hispanic women. The University of Puerto Rico Women's Health Center contributes to the promotion of women's health by developing sustainable preventive services, designing programs according to women's needs, and creating awareness of sex/gender differences in health and disease. Initiatives. A longitudinal breast cancer early detection clinic was developed and a community screening campaign was coordinated. Focus groups were conducted. A course on sex/gender considerations in research was developed and offered. Outcomes. Access to early detection of breast cancer was provided through an annual on-campus clinic and a community screening campaign. A breast cancer support group resulted from focus group recommendations. Health professionals from diverse disciplines participated in a course on sex/gender considerations in research. Conclusions. Synergistic efforts towards eliminating disparities in women's health from an academic perspective provide a valuable tool for the promotion of health among Hispanic women living in Puerto Rico. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetSyn) is related to an increased risk for type 2 diabetes and cardiovascular disease. Smokers are at greater risk than nonsmokers of becoming insulin resistant and to develop cardiovascular disease. This study aimed to explore the association between cigarette smoking, MetSyn and its components among Puerto Rican adults. A representative sample of 856 persons aged 21-79 years from the San Juan Metropolitan area participated in this study. Demographic and lifestyle characteristics, including smoking habits, were gathered from a self-reported questionnaire. MetSyn was defined according to the revised NCEP-ATP III criteria and measured using biochemical measurements and anthropometric indices. Logistic regression models were used to estimate prevalence odds ratios (POR) and its 95 % confidence intervals (CI). MetSyn was significantly ( P < 0.001) more prevalent in former smokers (48.4 %) as compared to current (42.7 %) and never smokers (40.0 %). However, after adjusting for possible confounders, current smokers who used more than 20 cigarettes per day were 2.24 (95 % CI = 1.00-4.99) times more likely to have MetSyn as compared to never smokers. Heavy smokers were also more likely to have high triglyceride levels (POR = 2.22, 95 % CI = 1.12-4.38) and low HDL-cholesterol levels (POR = 2.49, 95 % CI = 1.28-4.86) as compared to never smokers. This study supports previous reports of an increased risk of MetSyn among current smokers, particularly those with a heavier consumption. Tobacco control strategies, such as preventing smoking initiation and disseminating evidence-based cessation programs, are necessary to reduce the burden of MetSyn in Puerto Rico. [ABSTRACT FROM AUTHOR]

We sought objectively to measure, summarize, and contextualize the asthma triggers found in the homes of urban high-risk Puerto Rican children and adolescents with asthma in Chicago. Data were from the baseline home assessments of Project CURA. Research assistants interviewed caregivers, conducted a home visual inspection, and collected saliva samples for cotinine analysis. A trigger behavior summary score was created. The housing inspected was old with multiple units and obvious structural deficiencies Many allergic and irritant triggers were observed. Having a controller medicine or private insurance was associated with lower trigger behavior summary scores; caregiver depression, caregiver perceived stress, and child negative life events were associated with high trigger scores. The final multivariate model retained had a controller medicine, private insurance, and caregiver perceived stress. The data from this high-risk cohort identified modifiable areas where environmental interventions could reduce morbidity in Puerto Rican children and adolescents. [ABSTRACT FROM AUTHOR]

Purpose: Human immunodeficiency virus (HIV) treatment self-efficacy is the confidence held by an individual in her or his ability to follow treatment recommendations, including specific HIV care such as initiating and adhering to antiretroviral therapy (ART). The purpose of this study was to explore the potential mediating role of treatment adherence self-efficacy in the relationships between Social Cognitive Theory constructs and self- reported ART adherence. Design: Cross-sectional and descriptive. The study was conducted between 2009 and 2011 and included 1,414 participants who lived in the United States or Puerto Rico and were taking antiretroviral medications. Methods: Social cognitive constructs were tested specifically: behaviors (three adherence measures each consisting of one item about adherence at 3-day and 30-day along with the adherence rating scale), cognitive or personal factors (the Center for Epidemiology Studies Depression Scale to assess for depressive symptoms, the 12-Item Short Form Health Survey (SF-12) to assess physical functioning, one item about physical condition, one item about comorbidity), environmental influences (the Social Capital Scale, one item about social support), and treatment self-efficacy (HIV Adherence Self-Efficacy Scale). Analysis included descriptive statistics and regression. Results: The average participant was 47 years old, male, and a racial or ethnic minority, had an education of high school or less, had barely adequate or totally inadequate income, did not work, had health insurance, and was living with HIV/acquired immunodeficiency syndrome for 15 years. The model provided support for adherence self-efficacy as a robust predictor of ART adherence behavior, serving a partial mediating role between environmental influences and cognitive or personal factors. Conclusions: Although other factors such as depressive symptoms and lack of social capital impact adherence to ART, nurses can focus on increasing treatment self-efficacy through diverse interactional strategies using principles of adult learning and strategies to improve health literacy. Clinical Relevance: Adherence to ART reduces the viral load thereby decreasing morbidity and mortality and risk of transmission to uninfected persons. Nurses need to use a variety of strategies to increase treatment self-efficacy. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study describes the incidence, clinical and demographic characteristics, and spectrum of chronic kidney disease (CKD) in youths with perinatal HIV-1 infection. Methods: Retrospective analysis between May 1993 and December 2006 of subjects with renal disease followed in the Pediatric AIDS Clinical Trials Group 219/219C multicenter study examining the long-term consequences of perinatal HIV infection. Diagnosis confirmation was made utilizing a questionnaire mailed to research sites. Participants with CKD of other etiology than HIV were excluded. Outcome measures were biopsy-diagnosed CKD and, in the absence of biopsy, HIV-associated nephropathy (HIVAN) using established clinical criteria. Results: Questionnaires on 191 out of 2,102 participants identified 27 cases of CKD: 14 biopsy-diagnosed and 6 clinical cases of HIVAN, and 7 biopsy-diagnosed cases of immune complex-mediated kidney disease (lupus-like nephritis, 3; IgA nephropathy, 2; membranous nephropathy, 2). Incidence rates for CKD associated with HIV in pre-highly active antiretroviral therapy (HAART) (1993-1997) and HAART (1998-2002, 2003-2006) eras were 0.43, 2.84, and 2.79 events per 1,000 person years respectively. In multivariate analysis, black race and viral load ≥100,000 copies/mL (rate ratios 3.28 and 5.05, p ≤ 0.02) were associated with CKD. Conclusions: A variety of immune complex-mediated glomerulonephritides and HIVAN occurs in this population. Black race and uncontrolled viral replication are risk factors for CKD associated with HIV. [ABSTRACT FROM AUTHOR]

Peer outreach models have been successful in addressing HIV risk behaviors of drug users. Patients in methadone maintenance treatment programs who were migrants from Puerto Rico and/or familiar with drug use there were trained to conduct HIV-related peer outreach. A group randomized design was implemented; patients in the Experimental (E) condition (n = 80) received training and conducted 12 weeks of outreach. Half of the patients completed the training and outreach. At follow-up, patients in the E condition who conducted outreach felt they were more helpful to their community, showed a trend for engaging in more vocational activities, and were more likely to talk with others about HIV, compared to those who did not conduct outreach and those in the Control condition (n = 78). Drug treatment patients who are migrants can be trained as peer outreach workers and short-term benefits were found. Longer term maintenance of benefits should be assessed. [ABSTRACT FROM AUTHOR]

Background/Aims: Low vitamin D status is highly prevalent worldwide, and the major determinants are sun exposure and vitamin D intake. We aimed to measure vitamin D status in a sample of overweight/obese adults in Puerto Rico, an area with plenty of sun exposure, and relate it to vitamin D intake, sun exposure and body composition. Methods: Serum 25(OH)D levels (liquid chromatography-tandem mass spectrometry), body weight and fat (bioimpedance), vitamin D intake and sun exposure (questionnaires) were assessed. Analysis included age-adjusted correlations and multivariate regression. Results: In 98 subjects (66% females; 40-65 years), median serum 25(OH)D levels were 30.7 ng/ml (25-75th percentile 25.0-37.3); 55% had levels >30 ng/ml, 31% had levels between 20 and 30 ng/ml and 14% had levels <20 ng/ml. Total vitamin D intake was 180 IU/day (45-615), and the sun exposure score was 22 (17-27). After adjusting for gender, 25(OH)D levels were significantly correlated with vitamin D intake (r = 0.24, p = 0.018), the sum of sun exposure and vitamin D intake indices (r = 0.34, p = 0.001) and percent body fat (r = -0.25, p = 0.01). After adjusting for age, gender and percent body fat, the sum of sun exposure and vitamin D intake indices remained statistically associated with 25(OH)D levels (β = 1.5, p < 0.01). Conclusions: In this group of overweight and obese individuals, 25(OH)D was significantly related to vitamin D intake, sun exposure and vitamin D intake indices and percent body fat. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]