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Background: Cancer affects patients and their families, but few data are available on factors associated with diversity of family structures among patients with cancer. Family is a source of both support and responsibility that must be understood to support patients and their families. Methods: Pooled data (2004–2015) from the National Health Interview Study were used to compare characteristics of cancer survivors with and without minor children and differences by sex and race/ethnicity among survivors with minor children. Results: 13.9% of cancer survivors have minor children in the household, and this experience is more likely for women and people who identify as other than non‐Hispanic White. Conclusion: There are considerable differences by sex and race/ethnicity in the characteristics of cancer survivors with minor children. Clinicians should make consideration of family circumstances a routine part of their history. Doing so will help to identify potential sources of support and responsibility that may affect adherence. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate snack food‐group composition by weight status among United States adolescents. Methods: Cross‐sectional analysis of adolescent food‐group‐component intake from snacking occasions using two 24‐hour dietary recalls from the 2007 through 2018 National Health and Nutrition Examination Survey (NHANES; n = 5264; 12‐19 years) was conducted. ANCOVA models evaluated food intakes by BMI percentile (BMI%; normal weight [NW]: <85th BMI%; overweight [OW]: 85th‐95th BMI%; and obesity [OB]: ≥95th BMI%), adjusting for energy misreporting and key covariates. Results: Adolescents with OB consumed greater total daily energy from snacks (mean [SE]: NW = 424 [10] kcal; OW = 527 [16] kcal; OB = 603 [22] kcal; p < 0.001) than adolescents with OW and NW. Adolescents with OW or OB consumed higher amounts of refined grains, dairy, protein, oil, solid fat, and added sugar from snacks than adolescents with NW (p < 0.05‐0.001). Conclusions: Adolescents with OW or OB consume more calories and higher levels of overconsumed dietary components, i.e., added sugar, solid fats, and refined grains, from snacks than adolescents with NW. Age‐specific snacking recommendations to inform dietary guidance are needed to prevent excess intake of overconsumed nutrients and calories. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality predicts poor quality of life, poor self‐rated health, and chronic diseases and mental disorders among older adults. The Pittsburgh Sleep Quality Index (PSQI) is the most widely used self‐report measure of sleep quality in older adults. Objectives: This study aimed to assess internal reliability, face validity, content validity and internal consistency of the Slovenian version of the PSQI (PSQI‐SLO) for sleep quality in older adults. Methods: A cross‐sectional study was used to evaluate content and face validity as well as reliability (ɑ, ω and item‐total correlations). Residents of 13 nursing homes and community‐dwelling older adults from all regions of Slovenia were sampled. A total of 831 participants aged 65 years and older participated in the study between March and August 2019. Results: All items were successfully translated to Slovenian. A minor cultural adaptation was made to improve the clarity of the meaning of all items. None of the items had an item content validity index (I‐CVI) score lower than 0.50. Kappa indices were excellent for half of the items and good for the remainder. Internal consistency agreed with prior research (ɑ = 0.74). Intraclass correlation coefficient for global PSQI‐SLO was 0.62 (p < 0.001). The total score of PSQI‐SLO (8.09 ± 3.64 (95%, CI = 7.85–8.34)) was expected and comparable. Fifty‐eight and four tenths' per cent (95%, CI = 55%–62%) had at least one chronic disease and 40% (95%, CI = 37%–42%) lived in a nursing home. Conclusions: PSQI‐SLO showed adequate internal consistency and test–retest reliability, and adequate construct and criterion validity. The instrument can be important in assessing older adults' subjective sleep quality in nursing homes, home environment and clinical settings. [ABSTRACT FROM AUTHOR]

Aim: Topographic complexity is widely accepted as a key driver of biodiversity, but at the patch‐scale, complexity–biodiversity relationships may vary spatially and temporally according to the environmental stressors complexity mitigates, and the species richness and identity of potential colonists. Using a manipulative experiment, we assessed spatial variation in patch‐scale effects of complexity on intertidal biodiversity. Location: 27 sites within 14 estuaries/bays distributed globally. Time period: 2015–2017. Major taxa studied: Functional groups of algae, sessile and mobile invertebrates. Methods: Concrete tiles of differing complexity (flat; 2.5‐cm or 5‐cm complex) were affixed at low–high intertidal elevation on coastal defence structures, and the richness and abundance of the colonizing taxa were quantified after 12 months. Results: The patch‐scale effects of complexity varied spatially and among functional groups. Complexity had neutral to positive effects on total, invertebrate and algal taxa richness, and invertebrate abundances. However, effects on the abundance of algae ranged from positive to negative, depending on location and functional group. The tidal elevation at which tiles were placed accounted for some variation. The total and invertebrate richness were greater at low or mid than at high intertidal elevations. Latitude was also an important source of spatial variation, with the effects of complexity on total richness and mobile mollusc abundance greatest at lower latitudes, whilst the cover of sessile invertebrates and sessile molluscs responded most strongly to complexity at higher latitudes. Conclusions: After 12 months, patch‐scale relationships between biodiversity and habitat complexity were not universally positive. Instead, the relationship varied among functional groups and according to local abiotic and biotic conditions. This result challenges the assumption that effects of complexity on biodiversity are universally positive. The variable effect of complexity has ramifications for community and applied ecology, including eco‐engineering and restoration that seek to bolster biodiversity through the addition of complexity. [ABSTRACT FROM AUTHOR]

Objective: The primary purpose of this study was to examine associations of objectively measured sleep duration with weight changes in black and Hispanic mothers over the first postpartum year.Methods: Data were from 159 mothers (69% black, 32% Hispanic). Nocturnal sleep duration was assessed using wrist actigraphy at 6 weeks and 5 months post partum, examined as a continuous variable and in categories (< 7 vs. ≥ 7 hours/night, consistent with American Academy of Sleep Medicine recommendations). Body weights were abstracted from medical records in pregnancy and measured at 6 weeks, 5 months, and 12 months post partum. Outcomes included early postpartum (6 weeks to 5 months) and late postpartum (5 to 12 months) weight changes.Results: The majority of participants slept < 7 hours/night at 6 weeks (75%) and 5 months (63%) post partum. Early postpartum weight change did not differ by 6-week sleep duration category. By contrast, adjusted average late postpartum weight gain (SE) was 1.8 (0.7) kg higher in participants sleeping < 7 hours/night at 5 months post partum compared with those sleeping ≥ 7 hours/night (P = 0.02). Results did not show statistically significant associations of continuous measures of sleep duration, nor of measures of sleep quality, with postpartum weight changes.Conclusions: Sleeping < 7 hours/night was associated with late postpartum weight gain in minority mothers. [ABSTRACT FROM AUTHOR]

Objective: To characterize associations of snacking frequency with weight status among US children aged 1 to 5 years.Methods: Participants were children (n = 4,669) aged 1 to 5 years in the 2005 to 2014 National Health and Nutrition Examination Survey (NHANES). Snacking was assessed by two 24-hour dietary recalls using definitions that considered "snack" occasions as well as other foods/beverages consumed between meals. Overweight/obesity (OW/OB) was defined using percentile cutoffs: ≥ 97.7th weight-for-length (< 2 years) cutoff and the ≥ 85th BMI-for-age (≥ 2 years) cutoff. Linear/logistic regressions evaluated snacking based on daily occasions and relative to current recommendations (two to three snacks per day).Results: During 2005 to 2014, US children aged 1 to 5 years consumed, on average, two to three snacks daily. Children with normal weight in both age groups tended to snack less frequently than children with OW/OB when considering all foods/beverages eaten between meals (P < 0.01-0.12). Across most snacking definitions, children < 2 years who snacked more frequently than recommended had greater odds of having OW/OB (P < 0.01-0.12) and consumed greater daily snack energy than those who snacked within recommendations (all P < 0.01). Recommendations did not clearly delineate weight status among children aged 2 to 5 years.Conclusions: Snacking frequency and weight are positively associated among US children 1 to 5 years old, with most consistent associations seen among children < 2 years old and when considering all foods/beverages consumed between meals. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine the relationship between orthostatic changes in blood pressure (BP) and cognition, with consideration given to cardiovascular risk factors and lifestyle variables. The cross-sectional analysis included 961 community-dwelling participants of the Maine-Syracuse Longitudinal Study, for whom BP clinic measures (five sitting, five recumbent, and five standing) were obtained. Eighteen percent of participants had orthostatic hypotension (fall in systolic BP ≥20 mm Hg or diastolic BP ≥10 mm Hg upon standing) and 6% had orthostatic hypertension (rise in systolic BP ≥20 mm Hg). Orthostatic hypotension and hypertension defined using traditional criteria were unrelated to cognition with covariate adjustment. However, an examination of systolic and diastolic BP change independently revealed that participants with systolic orthostatic hypotension had poorer global cognition, verbal memory, and scanning and tracking scores than those with normal systolic BP change. The authors conclude that systolic orthostatic hypotension is significantly associated with reduced cognitive function. [ABSTRACT FROM AUTHOR]

Objective: Evidence is lacking regarding effective weight control treatments in pregnancy for ethnic minority women with obesity. This study evaluated whether a technology-based behavioral intervention could decrease the proportion of African American women with overweight or obesity who exceeded Institute of Medicine (IOM) guidelines for gestational weight gain.Methods: We conducted a two-arm pilot randomized clinical trial. Participants were 66 socioeconomically disadvantaged African American pregnant women (12.5 ± 3.7 weeks' gestation; 36% overweight, 64% obesity) recruited from two outpatient obstetric practices at Temple University between 2013 and 2014. We randomized participants to usual care (n = 33) or a behavioral intervention (n = 33) that promoted weight control in pregnancy. The intervention included: (1) empirically supported behavior change goals; (2) interactive self-monitoring text messages; (3) biweekly health coach calls; and (4) skills training and support through Facebook.Results: The intervention reduced the proportion of women who exceeded IOM guidelines compared to usual care (37% vs. 66%, P = 0.033). Intervention participants gained less weight during pregnancy (8.7 vs. 12.3 kg, adjusted mean difference: -3.1 kg, 95% CI: -6.2 to -0.1). No group differences in neonatal or obstetric outcomes were found.Conclusions: The intervention resulted in lower prevalence of excessive gestational weight gain. [ABSTRACT FROM AUTHOR]

Objective Determine the association of children's susceptibility to large food portion sizes with appetite regulation and obesity. Methods Normal-weight and obese non-Hispanic black children ( n = 100) aged 5-6 years were observed in four dinner conditions of varying portion size; portions of all foods (except milk) offered were: 100% (677 kcal), 150% (1015 kcal), 200% (1353 kcal), or 250% (1691 kcal) of those in the reference condition (100%). Condition order was randomly assigned to 2-4 children who ate together at each meal. Child height and weight were measured and caregiver reports of child appetite were obtained. Hierarchical growth curve models were used to estimate associations of meal energy intake with portion size condition, child weight status, and appetite regulation traits, controlling for demographics. Results Total energy intake increased across conditions of increasing food portion size ( P < 0.001). The effect of portion size condition on total energy intake varied with food responsiveness ( P = 0.05) and satiety responsiveness ( P < 0.05), but not weight status ( P = 0.682). Children with lower satiety responsiveness and greater food responsiveness showed greater increases in meal energy across conditions. Conclusions Children with poorer appetite regulation may be more vulnerable to obesogenic dietary environments offering large food portions than other children. [ABSTRACT FROM AUTHOR]

The authors examined the associations between acculturation, supervisors' multicultural competence, and clinicians' self-efficacy in a sample of 153 immigrant therapists currently practicing in the United States. Participants completed a demographic questionnaire and 3 additional questionnaires that examined their levels of acculturation, perceived supervisors' multicultural competence, and clinical self-efficacy. Results suggested that perceived prejudice, not level of acculturation, was significantly associated with foreign-born therapists' clinical self-efficacy. Perceived supervisors' multicultural competence was significantly associated with therapists' clinical self-efficacy. Recommendations for supervisors working with foreign-born therapists are provided. Los autores examinaron las asociaciones entre aculturación, competencia multicultural de los supervisores y autoeficacia de los profesionales clínicos en una muestra de 153 terapeutas inmigrantes actualmente en activo en los Estados Unidos. Los participantes completaron un cuestionario demográfico y tres cuestionarios adicionales que examinaron sus niveles de aculturación, la competencia multicultural percibida de sus supervisores y la autoeficacia clínica. Los resultados sugieren que los prejuicios percibidos, no el nivel de aculturación, están asociados de forma significativa con la autoeficacia clínica de los terapeutas nacidos en el extranjero. La competencia multicultural percibida de sus supervisores está asociada significativamente con la autoeficacia clínica de los terapeutas. Se proporcionan recomendaciones para supervisores que trabajan con terapeutas nacidos en el extranjero. [ABSTRACT FROM AUTHOR]

Centenarians represent a rare but rapidly growing segment of the oldest-old. This study presents item-level data from the Mini- Mental State Examination ( MMSE) in a cross-sectional, population-based sample of 244 centenarians and near-centenarians (aged 98-108, 16% men, 21% African-American, 38% community dwelling) from the Georgia Centenarian Study (2001-2008) according to age, education, sex, race, and residential status. Multiple- Indicator Multiple- Cause ( MIMIC) models were used to identify systematic domain-level differences in MMSE scores according to demographic characteristics in this age group. Indirect effects of age, educational attainment, race, and residential status were found on MMSE scores. Direct effects were limited to concentration for education and race and orientation for residential status. Mean levels of cognitive functioning in centenarians were low, with mean values below most commonly-used cutoffs. Overall scores on the MMSE differed as a function of age, education, race, and residential status, with differences in scale performance limited primarily to concentration and orientation and no evidence of interactions between centenarian characteristics. Adjusting for education was not sufficient to account for differences according to race, and adjusting for residential status was not sufficient to account for differences according to age. [ABSTRACT FROM AUTHOR]

Objectives To describe the prevalence of diabetes mellitus ( DM) in centenarians. Design Cross-sectional, population-based. Setting Forty-four counties in northern Georgia. Participants Two hundred forty-four centenarians (aged 98-108, 15.8% male, 20.5% African American, 38.0% community dwelling) from the Georgia Centenarian Study (2001-2009). Measurements Nonfasting blood samples assessed glycosylated hemoglobin ( HbA1c) and relevant clinical parameters. Demographic, diagnosis, and DM complication covariates were assessed. Results 12.5% of centenarians were known to have DM. DM was more prevalent in African Americans (27.7%) than whites (8.6%, P < .001). There were no differences between men (16.7%) and women (11.7%, P = .41) or between centenarians living in the community (10.2%) and in facilities (13.9%, P = .54). DM was more prevalent in overweight and obese (23.1%) than nonoverweight (7.1%, P = .002) centenarians. Anemia (78.6% vs 48.3%, P = .004) and hypertension (79.3% vs 58.6%, P = .04) were more prevalent in centenarians with DM than in those without, and centenarians with DM took more nonhypoglycemic medications (8.6 vs 7.0, P = .02). No centenarians with HbA1c of less than 6.5% had random serum glucose levels greater than 200 mg/dL. DM was not associated with 12-month all-cause mortality, visual impairment, amputations, cardiovascular disease, or neuropathy. Thirty-seven percent of centenarians reported onset before age 80 (survivors), 47% between age 80 and 97 (delayers), and 15% aged 98 and older (escapers). Conclusion Diabetes mellitus is a risk factor for cardiovascular disease and mortality but is seen in persons who live into very old age. Aside from higher rates of anemia and use of more medications, few clinical correlates of DM were observed in centenarians. [ABSTRACT FROM AUTHOR]

Since its inception, family therapy (FT) has been distinguished by its explicit theoretical and practical focus on families and relationships as systems, with an emphasis on second order rather than first order change. As a result of these conceptual underpinnings we suggest that FT needs to look for manifestations of change which differ from individually focused disciplines such as clinical psychology. Studies of second order change have most commonly appeared in the form of conceptual papers and doctoral dissertations. We begin by revisiting the conceptual underpinnings of second order change. Building on this framework, we develop these aspects of change within the framework of recent developments in the empirical study of change. Finally, we point towards some promising directions for further evaluative work of FT as well as ways to incorporate some of these principles into training of FT students. [ABSTRACT FROM AUTHOR]

The article focuses on the threats to Lord Howe Island Marine Park coral and rocky reef communities located in New South Wales. It mentions the threats such as coral bleaching and ocean acidification brought by the global warming that may affect endemic and near endemic fish species and human impact. It states that the lagoonal sites that possessed carnivorous species which contributes to elevation of density of the trophic group of species.

This study explores how partner's employment and preretirement decision-making structures affect retirement satisfaction, using pooled data from Waves 1 to 4 of the Health and Retirement Surveys. Based on resource theory, the analyses indicate that retired husbands are least satisfied if their wives remain employed and had more say in decisions prior to the husband's retirement. Retired wives are least satisfied if their husbands remain employed and had more say in decisions prior to the wife's retirement. These results suggest that retirement transitions undermine married retirees’ satisfaction if they enhance the other partner's influence in the relationship. More research should address linkages between work and family realms during transitions such as retirement and explore the negotiation processes surrounding such transitions. [ABSTRACT FROM AUTHOR]

A sample of parents (aged 50+) drawn from the 1988 and 1992 waves of the National Survey of Families and Households was used to examine two questions: How responsive is support from adult children in times of need? Is support from children greater for those who expected their children to provide help? Parents who experience one or more transitions in the time between survey waves are likely to receive help from their adult children over and above previous exchange patterns. Responsiveness on the part of children does not appear to be linked with parental expectations, however. Neither general value orientations about what children should do to support parents, nor expectations of help from one's own children in hypothetical situations are related to children's responsiveness to parental needs. Results are consistent with a contingent exchange perspective on intergenerational relationships. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which is concerned with research which investigated the association between anemia and physical function in Georgia centenarians.

Poor vitamin D status is associated with falls, fractures, other chronic conditions, and risk of nursing home placement, but little is known about vitamin D status in those 80 and older. Therefore, vitamin D status (serum 25-hydroxyvitamin D [25(OH)D]) was assessed in a population-based multi-ethnic sample of adults aged 80 to 89 (N = 80) and 98 and older (centenarians, N = 237) from Georgia (US). Unadjusted mean 25(OH)D concentrations were 75.1 nmol/L in octogenarians and 66.7 nmol/L in centenarians, which are less than the recommended 80 nmol/L. The prevalence of vitamin D insufficiency [25(OH)D < 50 nmol/L] was 22.5% in octogenarians and 36.7% in centenarians (p < 0.02). In logistic regression analyses, the risk of vitamin D insufficiency was increased by about 2 to 3 fold by being a centenarian vs. octogenarian, being black vs. white, not taking supplements with vitamin D, and having vitamin D status measured in spring vs. summer (p < 0.05), but was not associated with gender, dairy intake, or living in the community vs. a nursing home. Given the many consequences of poor vitamin D status, efforts are needed to ensure vitamin D adequacy in these elders. [ABSTRACT FROM AUTHOR]