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Background With a drastic shortage of addiction medicine specialists—and an ever-growing number of patients with opioid use disorder (OUD)—there is a dire need for more clinicians to feel confident in prevention and management of OUD and obtain a DEA-X waiver to prescribe medications to treat OUD. Here we determine if it is feasible to certify 4th year medical students with DEA-X waiver training as a component of the PROUD (Prevent and Reduce Opioid Use Disorder) curriculum, and if PROUD enhanced preparedness for medical students to manage OUD as interns. Methods We implemented a sequential mixed-methods IRB approved study to assess feasibility (completing all required components of DEA-X waiver training) and impact of PROUD (measured by knowledge growth, enhancement for residency, and utilization of training during internship). Students completed 11 hours of required OUD training. Quantitative data included pre-/post- knowledge and curriculum satisfaction assessments as well as long-term impact with follow up survey as interns. Qualitative data was collected by survey and semi-structured focus groups. Results All 120 graduating medical students completed the required components of the curriculum. Knowledge improved on the Provider Clinical Support Services (12.9–17.3, p Conclusions PROUD trained 4th year medical students in opioid stewardship. As interns, students felt ready to serve as change agents to prevent, diagnose, and treat OUD.

Arterioenteric fistulas (AEF) are rare and devastating complications of colorectal/pelvic malignancies. These fistulas can be seen following neoadjuvant or adjuvant therapy but are exceptionally rare de novo. The reported incidence of AEF is less than 1% and iliac artery-enteric fistulas make up less than .1% of all AEF. Here we present a patient in hemorrhagic shock secondary to an advanced colorectal malignancy without adjuvant therapies with local invasion of the right external iliac artery. Following initial resuscitation and hemorrhage control with coil embolization, definitive control with ligation and excision of the involved artery, end colostomy, and ureteral stent placement was achieved. It is important to consider malignancy as the source of lower gastrointestinal bleeds, especially in elderly patients without current colonoscopy studies. The management of this unfortunate diagnosis often involves a multidisciplinary approach with early and frequent goals of care discussions.

Aims: Concerns have been raised about the potential negative biological effect of postponed parenthood upon the health of subsequent generations, including reproductive health. This study aimed to estimate if high parental age at birth was associated with accelerated pubertal timing in offspring. Methods: In this large-scale cohort study, 15,819 children born by mothers in the Danish National Birth Cohort from 2000 to 2003 participated in a nationwide puberty cohort (participation rate 71%). Between 2012 and 2018, the children reported half-yearly information on pubertal status using web-based questionnaires from 11 years throughout puberty or 18 years of age. Information on parental age was drawn from nationwide registers. We estimated adjusted mean differences in months for age at attaining the pubertal milestones and pubertal timing overall between the pre-specified parental age groups: 20–29 (reference), 30–34 and advanced parental age groups (35–44 years for mothers and >35 years for fathers). Results: Overall, parental age at birth of the child was not associated with pubertal timing in daughters or sons. For sons of older fathers (>35 years), we observed indications towards slightly earlier pubertal timing in the range of 0.3–2.4 months for nearly all pubertal milestones, but all confidence intervals were wide, and many included the null. Conclusions: We found no strong association between parental age and timing of puberty, and we find it unlikely that the decreasing age in pubertal timing is a result of parental decision to delay childbearing.

The socioeconomic benefits of the Deferred Action for Childhood Arrivals program initiated in 2012 by executive order from then-president Obama have been documented in the recent literature. However, the consequences of the legal challenge brought against the program by the Trump administration have not yet been fully examined. This article analyzes qualitative data from Latino Deferred Action for Childhood Arrivals recipients in California to assess how the legal turmoil around the program is affecting their sense of belonging in the United States. We find that the uncertainty around the program has negative consequences on their sense of belonging, despite the program’s aims at improving it, and despite the respondents’ living in a rather welcoming state in terms of state-level immigration policies. Notably, we find that respondents feel increasingly alienated from and unwanted in American society and postpone major life goals.

Introduction The aim of this study is to compare productivity of the KIRO Oncology compounding robot in three hospital pharmacy departments and identify the key factors to predict and optimize automatic compounding time. Methods The study was conducted in three hospitals. Each hospital compounding workload and workflow were analyzed. Data from the robotic compounding cycles from August 2017 to July 2018 were retrospectively obtained. Nine cycle specific parameters and five productivity indicators were analysed in each site. One-to-one differences between hospitals were evaluated. Next, a correlation analysis between cycle specific factors and productivity indicators was conducted; the factors presenting a highest correlation to automatic compounding time were used to develop a multiple regression model (afterwards validated) to predict the automatic compounding time. Results A total of 2795 cycles (16367 preparations) were analysed. Automatic compounding time showed a relevant positive correlation (ǀrs|>0.40) with the number of preparations, number of vials and total volume per cycle. Therefore, these cycle specific parameters were chosen as independent variables for the mathematical model. Considering cycles lasting 40 minutes or less, predictability of the model was high for all three hospitals (R2:0.81; 0.79; 0.72). Conclusion Workflow differences have a remarkable incidence in the global productivity of the automated process. Total volume dosed for all preparations in a cycle is one of the variables with greater influence in automatic compounding time. Algorithms to predict automatic compounding time can be useful to help users in order to plan the cycles launched in KIRO Oncology.

BackgroundHumoral immune responses to COVID-19 vaccination are diminished in anti-CD20 treated patients with multiple sclerosis (pwMS). In healthy individuals, neutralizing antibodies against the SARS-CoV-2 Omicron variant are only detected after three COVID-19 vaccinations. It was hitherto unknown whether a third or fourth COVID-19 vaccination of anti-CD20 treated pwMS improves SARS-CoV-2 specific humoral immune responses, including neutralizing antibodies against Omicron.MethodsAnti-CD20 treated pwMS vaccinated two (n=61), three (n=57) or four (n=15) times and healthy controls (n=10) vaccinated thrice were included in a prospective cohort study. Anti-SARS-CoV-2 spike S1 IgG and IgA levels, maturation of SARS-CoV-2 IgG avidity, neutralizing capacity against the SARS-CoV-2 Omicron BA.2 variant and SARS-CoV-2 specific T cell responses were analyzed.ResultsThe proportion of anti-CD20 treated pwMS with detectable SARS-CoV-2 S1 IgG was similar after the second (31/61, 50.8%), third (31/57, 54.4%) and fourth (8/15, 53.3%) vaccination. In pwMS with detectable SARS-CoV-2 IgG, the proportion with high affinity antibodies increased from the second (6/31, 19.4%) to the third (17/31, 54.8%) and fourth (6/8, 75%) vaccination. While none (0/10) of the anti-CD20 treated pwMS vaccinated twice had Omicron specific neutralizing antibodies, 3/10 (30%) pwMS vaccinated thrice and 3/5 (60%) pwMS vaccinated four times generated Omicron specific neutralizing antibodies.ConclusionAlthough SARS-CoV-2 specific humoral immune responses remain quantitatively impaired, in those anti-CD20 treated pwMS who do develop SARS-CoV-2 antibodies, the functionality of SARS-CoV-2 antibodies, including neutralizing antibodies against Omicron, improves after three and four SARS-CoV-2 vaccinations, supporting current recommendations for one or two booster vaccination in anti-CD20 treated pwMS.

BackgroundClinical trial articles often lack detailed descriptions of the methods used to randomize participants, conceal allocation, and blind subjects and investigators to group assignment. We describe our systematic approach to implement and measure blinding success in a double-blind phase 2 randomized controlled trial testing the efficacy of acupuncture for the treatment of vulvodynia.MethodsRandomization stratified by vulvodynia subtype is managed by Research Electronic Data Capture software’s randomization module adapted to achieve complete masking of group allocation. Subject and acupuncturist blinding assessments are conducted multiple times to identify possible correlates of unblinding.ResultsAt present, 48 subjects have been randomized and completed the protocol resulting in 87 subject and 206 acupuncturist blinding assessments.DiscussionOur approach to blinding and blinding assessment has the potential to improve our understanding of unblinding over time in the presence of possible clinical improvement.

Understanding the factors that lead to correctional officer (CO) turnover intent is vital. Using a gendered career stage model, this study focused on male and female CO similarities and differences in workplace variable effects on turnover intent across career stages. The results indicated that organizational commitment was a consistent predictor of turnover intent for all correctional officers at all career stages, and, at various career stages, quality of supervision, coworker support, and safety concerns affected both males and females. Male officers were more likely to leave at all career stages, with the impact of job stress and role ambiguity influencing male turnover intent.

Purpose: There is considerable interest in positive allosteric modulators (PAMs) of the α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) subtype of ionotropic glutamate receptors as therapeutic agents for a range of cognitive and mood disorders. However, the challenge is to increase AMPA receptor (AMPAR) function sufficient to enhance cognitive function but not to the extent that there are mechanism-related pro-convulsant or convulsant side effects. In this present study, we report the preclinical pharmacology data for MDI-222, an AMPAR PAM which enhances cognition but has a much reduced side-effect (i.e. convulsant) liability relative to other molecules of this mechanism. Methods: The pharmacological effects of MDI-222 were characterised in in vitro and in vivo preclinical electrophysiology, efficacy (cognition), side-effect (pro-convulsant/convulsant), tolerability and toxicity assays. Results: We demonstrate that MDI-222 is an AMPAR PAM, since it enhanced AMPAR function in vitro at human (hGluA1-4) and rat (rGluA2) homomeric receptors, and potentiated hetero-oligomeric AMPARs in rat neurons. MDI-222 enhanced electrically evoked AMPAR-mediated synaptic transmission in the anaesthetised rat at 10 mg/kg (administered intravenously) and did not significantly lower the seizure threshold in the pro-convulsant maximal electroshock threshold test (MEST) at any dose tested up to a maximum of 30 mg/kg (administered by oral gavage (p.o.)). MDI-222 reversed a delay-induced deficit in novel object recognition (NOR) in rats with a minimum effective dose (MED) of 0.3 mg/kg (p.o.) following acute administration, which was reduced to 0.1 mg/kg following sub-chronic administration, and improved passive avoidance performance in scopolamine-impaired rats with a MED of 10 mg/kg p.o. On the other hand, MDI-222 was not pro-convulsant in the MEST, resulting in a therapeutic window between plasma concentrations that enhanced cognitive performance and those associated with mechanism-related side effects of ⩾1000-fold. Unfortunately, despite the excellent preclinical profile of this compound, further development had to be halted due to non-mechanism-related issues. Conclusions: We conclude that MDI-222 is an AMPAR PAM which enhances cognitive performance in rats and has a significantly improved safety profile in preclinical species.

The Early Childhood Environment Rating Scales, including the Early Childhood Environment Rating Scale–Revised (Harms et al., 2005) and the Early Childhood Environment Rating Scale, Third Edition (Harms et al., 2015) are the most widely used observational assessments in early childhood learning environments. The most recent version of the scale addresses some of the criticisms in the research literature, particularly related to the organization of the Scale and the standard scoring procedures. In the current study, we explore the relationship between the two scales. Specifically, we evaluated the correlations between the Early Childhood Environment Rating Scale–Revised and the Early Childhood Environment Rating Scale, Third Edition, as well as the differences between the overall scores, individual items, and subscales. Implications for practice and future research are also provided.

Objectives: Sickle cell disease (SCD) is a serious illness with disabling acute and chronic pain that needs better therapies, but insufficient patient participation in research is a major impediment to advancing SCD pain management. The purpose of this article is to discuss the challenges of conducting an SCD study and approaches to successfully overcoming those challenges. Design: In a repeated-measures, longitudinal study designed to characterize SCD pain phenotypes, we recruited 311 adults of African ancestry. Adults with SCD completed 4 study visits 6 months apart, and age- and gender-matched healthy controls completed 1 visit. Results: We recruited and completed measures on 186 patients with SCD and 125 healthy controls. We retained 151 patients with SCD with data at 4 time points over 18 months and 125 healthy controls (1 time point) but encountered many challenges in recruitment and study visit completion. Enrollment delays often arose from patients’ difficulty in taking time from their complicated lives and frequent pain episodes. Once scheduled, participants with SCD cancelled 49% of visits often because of pain; controls canceled 30% of their scheduled visits. To facilitate recruitment and retention, we implemented a number of strategies that were invaluable in our success. Conclusion: Patients’ struggles with illness, chronic pain, and their life situations resulted in many challenges to recruitment and completion of study visits. Important to overcoming challenges was gaining the trust of patients with SCD and a participant-centered approach. Early identification of potential problems allowed strategies to be instituted proactively, leading to success.

As undocumented Latino immigrants transition into adulthood, they also transition into illegality. They move from a somewhat protected status under which they had access to education and other social benefits, to the more vulnerable category of undocumented adults without access to social rights. How undocumented immigrants’ interactions with social services contribute to the formation of their ethnic identity and feelings of belonging to the United States is the focus of this research. Drawing on qualitative interview data from undocumented adults who grew up in the United States, this article shows that as undocumented children transition into adulthood, they face a new system that forces them to learn how to become an immigrant if they want to remain part of American society.

Objectives: Heroin-related deaths have increased substantially in the past 10 years in the United States, particularly in Florida. Our objectives were to measure heroin-related morbidity and mortality rates in Orange County, Florida, and to assess trends in those rates during 2010-2014. Methods: We used 3 heroin surveillance methods, based on data from the Florida Medical Examiner, the Florida Agency for Health Care Administration (AHCA), and the Electronic Surveillance System for the Early Notification of Community-Based Epidemics–Florida (ESSENCE-FL). We conducted descriptive and geographic spatial analyses of all 3 data sets, determined heroin-related mortality and morbidity (emergency department [ED] visit) rates, and compared the timeliness of data availability from the 3 data sources. Results: Heroin-related deaths in Orange County increased by 590%, from 10 in 2010 to 69 in 2014. Heroin-related ED visits during the same period increased 12-fold (from 13 to 154) and 6-fold (from 49 to 307) when based on AHCA and ESSENCE-FL data, respectively. ESSENCE-FL identified 140% more heroin-related visits than did AHCA. Spatial analysis found geographic clustering of heroin-related morbidity and mortality. Hospitals facing the greatest burden of heroin-related ED visits were close to communities with the highest crude heroin-related ED visit rates. Of the 3 data sources, ESSENCE-FL provided the timeliest data availability. Conclusions: These 3 data sources can be considered acceptable surveillance systems for monitoring heroin-related events in Orange County. The timely availability of data from ESSENCE-FL makes it the most useful source for obtaining near–real-time data about the heroin epidemic, potentially leading to improved identification of populations most in need of interventions to reduce morbidity and mortality.

Correctional research has just begun to explore the effects of variables and their differences over the course of a career within the field. This study examined several correctional staff outcomes and how they varied over three identified career stages (initial, establishment, and maintenance) at a state-government operated prison. Results indicated that job involvement, job satisfaction, affective commitment, moral commitment, and turnover intent were highest during the initial stage of employment, which is contrary to other occupations. Job stress and continuance commitment remained equal across all three career stages. Findings suggest that the effects on career stages are contextual and vary across different types of organizations. Furthermore, the strains and stresses of working in a correctional institution may not be cumulative but remain steady across a career.

There is little evidence about barriers to pain management or their relationships with pain outcomes of hospice patients with cancer. The purpose of the study was to determine the barriers reported by hospice patients with cancer and their caregivers and the relationships with demographic characteristics and the patients’ pain. In this cross-sectional study, we used selected baseline data from an ongoing randomized clinical trial of patient and lay caregiver dyads receiving home-level hospice care. Participants used an Internet-enabled tablet to complete the valid, reliable measures of pain intensity, pain management barriers (Barriers Questionnaire 13 items [BQ-13]), and demographic characteristics. The responses indicate that the 2 areas of highest concern (mean scores >3) to both patients and caregivers were “pain means disease progression” and “constipation.” Additionally, 3 other areas of highest concern (mean scores >3) to caregivers were “addiction” pain medicine causing “one to do embarrassing things” and “confusion.” The mean BQ-13 scores ranged from 0.2 to 4.9 and averaged 2.6 ± 0.9 for the patients and ranged from 0.5 to 4.7 and averaged 2.7 ± 0.9 for the caregivers. Mean barrier scores remain high and were not different between patients and their caregivers or significantly related to the patients’ pain intensity. However, there were differences in race, ethnic, and hospice setting in the barrier scores. Patients with Hispanic heritage reported higher barrier scores than non-Hispanic patients. Together, these findings not only support prior research findings but also contribute new insights about pain intensity and pain barriers that are relevant to hospices serving minorities with cancer.

The montane forests of south-eastern Nigeria are of immense conservation value due to their high levels of biodiversity and endemism. Yet despite increasing anthropogenic disturbance and forest fragmentation, little is known about the genetics of resident tree populations. We used a set of conserved chloroplast simple sequence repeat (SSR) primers to quantify and directly compare genetic diversity in three tree species: Cordia millenii, West African Cordia; Entandrophragma angolense, tiama mahogany; and Lovoa trichilioides, African walnut, within a single montane forest. Additionally, we assessed the diversity of West African Cordia between forests at a local and regional scale. Results indicate that for our focal loci, in all three species, there is a general lack of chloroplast genetic diversity. Our study is particularly relevant because it considers genetic diversity among multiple tree species simultaneously. This work represents the first study of its kind in the region, and will pioneer the way for future conservation genetic studies in montane Nigeria.

Objectives: Although outbreaks of restaurant-associated foodborne illness occur periodically and make the news, a restaurant may not be aware of the cost of an outbreak. We estimated this cost under varying circumstances. Methods: We developed a computational simulation model; scenarios varied outbreak size (5 to 250 people affected), pathogen (n = 15), type of dining establishment (fast food, fast casual, casual dining, and fine dining), lost revenue (ie, meals lost per illness), cost of lawsuits and legal fees, fines, and insurance premium increases. Results: We estimated that the cost of a single foodborne illness outbreak ranged from $3968 to $1.9 million for a fast-food restaurant, $6330 to $2.1 million for a fast-casual restaurant, $8030 to $2.2 million for a casual-dining restaurant, and $8273 to $2.6 million for a fine-dining restaurant, varying from a 5-person outbreak, with no lost revenue, lawsuits, legal fees, or fines, to a 250-person outbreak, with high lost revenue (100 meals lost per illness), and a high amount of lawsuits and legal fees ($1 656 569) and fines ($100 000). This cost amounts to 10% to 5790% of a restaurant’s annual marketing costs and 0.3% to 101% of annual profits and revenue. The biggest cost drivers were lawsuits and legal fees, outbreak size, and lost revenue. Pathogen type affected the cost by a maximum of $337 000, the difference between a Bacillus cereus outbreak (least costly) and a listeria outbreak (most costly). Conclusions: The cost of a single foodborne illness outbreak to a restaurant can be substantial and outweigh the typical costs of prevention and control measures. Our study can help decision makers determine investment and motivate research for infection-control measures in restaurant settings.

Recent literature has found that organizational commitment of correctional staff is highly influenced by the workplace and can either result in positive or negative behaviors. Most research, though, has examined predictors of only one type of commitment. This study looked at three types of commitment (continuance, moral, and affective) and their influence on the outcomes of correctional orientation, views of absenteeism, and turnover intent. The results indicate that the three dimensions of commitment varied in their impact on the organization outcomes and provide insight into the complex nature of the bonds that tie employees to this unique organization.

Antiretroviral therapy has decreased HIV-related mortality. However, the incidence of diabetes as a co-morbidity is increasing as HIV-positive patients age. The purpose of this study was to assess the correlation between markers of HIV-infection and diabetes and to determine the proportion of patients achieving an haemoglobin A1c (HbA1c) goal 10 viral load, HbA1c increased 0.67 units ( p = 0.0085). Only 38% of patients prescribed a protease inhibitor–based regimen vs. 56% of patients not on a protease inhibitor–based regimen achieved an HbA1c goal ( p = 0.1864). Additionally, patients on an insulin-based regimen and patients that were less adherent were less likely to be at HbA1c goal ( p = 0.018 and p = 0.0378, respectively). Patients with higher viral loads and patients that were less adherent to antiretroviral therapy were more likely to have a higher HbA1c demonstrating that poor adherence to antiretroviral therapy leads to poor control of both disease states.

With the increasing number of studies examining work outcomes among prison staff, it is surprising that little attention has been paid to corrections officers who hold supervisory positions. Using multivariate analysis of survey results from 2,302 corrections line officers and 369 supervisors employed in one Western prison system, this study examined the conditioning effect of supervisory status on an officer’s reported commitment to the organization. The results suggest that compared with line officers, supervisory officers experience significantly higher levels of commitment to the prison organization. Less variation was found in the manner and magnitude of the effects of individual-level variables (gender, race, age) and work environment variables (organizational support, hostile work environment, quality of supervision, coworker support) on organizational commitment for both groups. The findings provide insight into the importance of officers’ perceived sources of support and the need to encourage organizational commitment within an arguably difficult work environment.

Prior research on correctional staff turnover intent and turnover generally assumes that staff are impacted by the workplace in a similar manner regardless of career stage. This study examined whether correctional officers ( N = 2,621) with a Southwestern correctional agency differed in their level of turnover intent across different career stages, and whether the impact of work environment variables on turnover intent varied across career stages. Results indicated that turnover intent was lowest among staff with less than 1 year into their careers, and that the effects of work environment variables on turnover intent varied greatly across the 4 career stages. Commitment to the organization was the only work environment variable to be a significant predictor of intent to leave among four career stages, with a negative association in each of the four career groups.

The study purpose was to evaluate a computer-based questionnaire (SCKnowIQ) and CHOICES educational intervention using cognitive interviewing with childbearing-aged people with sickle cell disease (SCD) or trait (SCT). Ten control group participants completed the SCKnowIQ twice. Ten intervention group participants completed the SCKnowIQ before and after the CHOICES intervention. Most participants found the questionnaire items appropriate and responded to items as the investigators intended. Participants’ responses indicated that the information on SCD and SCT and reproductive options was understandable, balanced, important, and new to some. Internal consistency and test–retest reliability were adequate (.47 to .87) for 4 of the 6 scales, with significant within-group changes in knowledge scores for the intervention group but not for the control group. Findings show evidence for potential efficacy of the intervention, but proof of efficacy requires a larger randomized study.

In a time of restricted budgets, true recognition of staff as a resource calls for correctional institutions to be more prudent in developing an environment that promotes staff commitment. Although prior research has examined affective commitment, far fewer studies have modeled the relationship between critical workplace factors and continuance and normative commitment. This study uses three key organizational concepts (job stress, job involvement, and job satisfaction) to explore their differing impacts on the three types of organizational commitment (continuance, normative, and affective). The study found that key workplace and demographic variables had varying effects on each type of commitment. This supports and extends findings from prior correctional studies suggesting that organizational commitment is not only a multidimensional construct but also that the mechanisms responsible for the development of each type of commitment differ. With this in mind, correctional administrators should recognize the need for various strategies to increase different forms of commitment among correctional staff.

In this article we describe some of the challenges and constraints that students face when they engage in qualitative research interviews. We borrow extensively from Ron Pelias’ in-depth description of leaning in during everyday life encounters. Although he refers to other kinds of relationships, we believe that the similarities are too important to overlook when it comes to the qualitative research interview. We begin the discussion by identifying what we believe are the main challenges facing novice qualitative researchers. Issues of professional identities, objectivity, relational engagement, and inherited understandings of what counts as research are highlighted. This article will be useful for graduate students engaged in narrative, ethnographic, and auto-ethnographic methodologies as well as other inquiries that require deeply relational processes. Recommendations for the kinds of supervisory conversations that may be helpful are included.

The social order of a prison arises from the combined effects of the prison’s institutional capacity for control and the effectiveness of prison management. Prior research suggests that the criminogenic characteristics of the inmate population, the security level of the prison, and the prison environment are three structural characteristics of prisons that define each prison’s institutional capacity for control, as reflected in the aggregate-level measures of inmate misconduct, and prison environment is expected to moderate the effects of inmate population characteristics on inmate misconduct. This study of 50 state prisons for men provides support for the hypothesized direct effects of institutional capacity for control on the level of violent and nonviolent inmate misconduct and for the contextual effect of prison environment. The findings are discussed in terms of the management environment created among prisons by variations in the institutional capacity for control.

Introduction: Teen pregnancy in Hispanic youth is a poorly understood phenomenon with numerous and overlapping sociocultural influences. Hispanics have had the highest teen pregnancy rates in the United States since 1995 and pregnancy rates that have declined much more slowly when compared to every other ethnic group. Literature investigating long-term Hispanic youth of the United States and the factors influencing their decision-making processes and sexual behaviours is limited. Purpose: This study aimed to explore and describe attitudes and behaviours related to teen pregnancy and parenting in Hispanic female teens from long-term families in New Mexico, whose primary language was English and who have experienced pregnancy and motherhood in the 12 months prior to participation. Methods: This was a focused-ethnographic qualitative study conducted in areas of New Mexico with high rates of teen pregnancy and where the population is majority Hispanic with long-term residency. Data were collected in interviews with 10 adolescent mothers and 10 adults, and through participant observation. Data were analysed inductively through immersion and crystallisation. Results: Key findings of the study include chaos/instability characterising the homes of youth, low levels of communication related to reproductive issues, disappointment expressed by families and community in response to teen pregnancy and community goals for the future. Conclusions: The study results will aid in increasing the knowledge base related to long-term Hispanic youth and the many sociocultural factors affecting their sexual decisions and behaviours.