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Objectives This study examines the influence that smokefree workplaces, restaurants and bars have on the adoption of smokefree rules in homes and cars, and whether there is an association with adopting smokefree rules in homes and cars. Methods Bivariate probit models were used to jointly estimate the likelihood of living in a smokefree home and having a smokefree car as a function of law coverage and other variables. Household data were obtained from the nationally representative Social Climate Survey of Tobacco Control 2001, 2002 and 2004-2009; clean indoor air law data were from the American Nonsmokers' Rights Foundation Tobacco Control Laws Database. Results ‘Full coverage’ and ‘partial coverage’ smokefree legislation is associated with an increased likelihood of having voluntary home and car smokefree rules compared with ‘no coverage’. The association between ‘full coverage’ and smokefree rule in homes and cars is 5% and 4%, respectively, and the association between ‘partial coverage’ and smokefree rules in homes and cars is 3% and 4%, respectively. There is a positive association between the adoption of smokefree rules in homes and cars. Conclusions Clean indoor air laws provide the additional benefit of encouraging voluntary adoption of smokefree rules in homes and cars. [ABSTRACT FROM AUTHOR]

Purpose: We examined positive behavioral resources and characteristics that might distinguish resilient personality prototypes among persons with chronic spinal cord injury/disorder (SCID). Positive psychology variables with clear linkages to existing psychological interventions were examined as potential mediators of the resilience–well-being relationship. Research Method and Design: A cross-sectional, self-report study was conducted. Two hundred and ninety-eight consenting members of the Paralyzed Veterans of America (268 male; 236 self-identified as white) provided useable survey data for analysis (including 161 veterans with tetraplegia, 107 with paraplegia, 30 with cauda equina). Cluster analysis of Big Five personality traits identified resilient and nonresilient personality profiles. Tests of mean differences between resilient and nonresilient participants on behavioral resources and characteristics were performed. Path models predicting well-being and health-related quality of life (HRQL) were conducted. Results: One hundred and sixty-three respondents had resilient personality profiles and 135 had nonresilient profiles. Resilient individuals reported significantly more optimal scores on every positive psychology variable, and greater well-being and HRQL than nonresilient respondents. Path models found the relationship of resilience to well-being was explained through its beneficial associations with psychological flexibility, use of personal strengths, meaning in life (MIL), and gratitude. Psychological flexibility also mediated the resilience–HRQL relationship. Cauda equina was significantly associated with higher pain interference and lower HRQL. Conclusions: Higher gratitude, MIL, use of personal strengths, and psychological flexibility appear to characterize resilience and well-being among persons with chronic SCID. Further studies are needed to understand the impact of pain interference on HRQL among individuals with cauda equina. Impact and Implications: The present study documents several positive behavioral resources and characteristics that typify resilience among persons with chronic spinal cord injury/disorder. The results should prompt rehabilitation psychologists to consider further study of the positive psychology variables examined in this paper, and the potential use of the existing interventions associated with each one. [ABSTRACT FROM AUTHOR]

Latina women are less likely to utilize cancer screening services than are non-Latina White women. The purpose of this study is to examine the relationship between preferred language (English vs. Spanish) and receipt of mammography and Pap-smear testing among US Latinas and non-Latinas. Cross-sectional analysis of the 2008 and 2010 Behavioral Risk Factor Surveillance System (BRFSS) surveys. While Latinas responding to the BRFSS in English or in Spanish had unadjusted lower odds of receiving mammography testing, in multivariable analysis Latinas responding-in-Spanish had 2.20 times the odds (OR = 2.20, 95 % CI, 1.90-2.55) of reporting mammography compared to non-Latinas. Similarly, Latinas responding-in- Spanish had lower unadjusted odds of receiving Pap-smear testing. However, Latinas responding-in-Spanish had 2.37 times the odds (OR = 2.37 CI, 2.04-2.75) of reporting having received Pap smear testing compared to non-Latinas in multivariate analysis. The results of this paper further confirm the 'reversed associations' among Latinas and mammography and Pap smear testing described in previous studies and suggest that in addition to insurance status, preferred language may be a key variable contributing to the reversal phenomenon observed among Latinas. [ABSTRACT FROM AUTHOR]

This paper examined the prevalence of depressive symptomotology among women of Mexican ancestry (N = 205), over the age of 18, of diverse incomes and nativity. We examined differences in rates of diagnosis by Spanish/English preference and the sensitivity and specificity of three common measures: the Patient Health Questionnaire (PHQ9), the Kessler Psychological Distress Scale (K-10), and depression questions from the Composite International Diagnostic Interview, Short Form (MDD CIDI-SF); PHQ9 was used as the 'gold standard' measure. Results indicated 18-32 % of participants met criteria for depression with higher rates found among Spanish preference participants. The K-10 had significantly higher sensitivity (0.81) but lower specificity (0.79) than the MDD CIDI-SF items (0.57 and 0.89, respectively). This study suggests that the K-10 and MDD CIDI-SF measures are complementary to each other for screening of depressive symptomatology. Implications for cultural and linguistic assessment of depression are further discussed. [ABSTRACT FROM AUTHOR]

Background This paper examines the prevalence, the symptom profile, and the drinking and sociodemographic predictors of current (past 12 months) DSM- IV alcohol abuse and dependence among Mexican Americans living along the U. S.- Mexico border and those living in metropolitan areas away from the border. Methods Respondents in the non-border areas (primarily Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288) of these areas, interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey ( HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results Although bivariate analyses revealed no overall differences between border and non-border locations, (negative) age trends were more pronounced on the border for male abuse and for dependence among both genders. Among females aged 18 to 29, border residence was linked to significantly higher rates of dependence. In multivariable analyses, the prevalence of male abuse declined more rapidly with age on the border than off the border. Other unique predictors of male abuse were Jewish/other religion and weekly volume of alcohol consumption. Being married or out of the workforce, attaining a higher education, having no religious preference, and weekly volume uniquely predicted female dependence. Age and weekly volume uniquely predicted male dependence. Conclusions The prevalence of alcohol use disorders among Mexican Americans on and off the U. S.- Mexico border largely mirrors previously documented patterns of alcohol consumption in these areas. For young Mexican American women in particular, border residence is linked to heightened vulnerability to alcohol dependence. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for 'hazardous use.' which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic 'orphans.' These respondents reported 1 or 2 indicators of alcohol dependence as present. Conclusions: The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic 'orphans' to better design interventions to address their problems. [ABSTRACT FROM AUTHOR]

Background: There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion: The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption. [ABSTRACT FROM AUTHOR]

Objective: In 2006, the Food and Drug Administration (FDA) approved the human papillomavirus (HPV) vaccine Gardasil® (Merck) for girls and women aged 9-26 years. Although the vaccine is ideally administered to 11 and 12 year olds, college-aged women may be uniquely at risk for HPV due to high rates of sexual activity and, thus, serve as an important catch-up population for the HPV vaccine. The purpose of this study is to examine factors associated with HPV vaccination status among college women. Methods: In fall 2008, a convenience sample of 256 undergraduate women enrolled in an introductory social science course at a large, public, urban university in the southeastern United States was surveyed. The 30-item paper-and-pencil questionnaire asked for demographic information, HPV knowledge, HPV vaccine beliefs, and HPV vaccination status. The overall survey response rate was 89.6%. Results: Most women were unmarried/single (91.7%), with a mean age of 18.9 years (range 17-42). Race/ethnicity status included 73.0% white, 17.5% Hispanic, and 7.7% black/African American. One hundred eleven (40.5%) women reported receiving the vaccine. Nonvaccinated women were less likely to have heard of the vaccine through a healthcare provider (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.04-0.35) or from a family member (OR 0.33, 95% CI 0.16-0.68) and more likely to consider a healthcare provider recommendation as being only somewhat important (OR 2.91, 95% CI 1.32-6.41) or not important at all (OR 5.61, 95% CI 0.44-71.87) vs. very important. Conclusions: Findings suggest that healthcare providers have an important role in encouraging HPV vaccination. Continuing education for providers who see preadolescent girls in conjunction with a parent or who treat women of college age may be a worthwhile endeavor. [ABSTRACT FROM AUTHOR]

Background: Pre-injury opioid use is common, but the effects of opioid-related polysubstance use on mortality and health resources utilization (HRU) have not been investigated yet. The objective of this study was to investigate the effects of opioid-related polysubstance use on mortality and HRU among patients in trauma centres in the US. Methods: We conducted a retrospective cross-sectional study using the US National Trauma Databank from the year 2017 to 2019. Patients (≥ 18 years of age) who tested positive for opioids were included. Patients were analysed based on the number of substances used (i.e., opioids only, two substances (opioids + 1 substance), and three or more than three substances (opioids + ≥ 2 substances)), and polysubstance by type (i.e., opioids only, opioids and alcohol, opioids and stimulants, opioids and benzodiazepine, and other combinations). Multivariate logistic regression was used to determine the association between polysubstance use, mortality and HRU (i.e., need for hospital admission, ICU, and mechanical ventilation). Results: Both polysubstance by number and type analyses showed that opioid-related polysubstance use was not significantly associated with mortality compared to opioids only. The odds of hospital admission were higher among the opioids and benzodiazepines group (OR 1.15, 95% CI 1.06–1.24, p < 0.01). The need for ICU was magnified using benzodiazepines and stimulants with opioids (OR 1.44, 95% CI 1.27–1.63, p < 0.01) when compared to the opioids only group. Conclusion: Opioid-related pre-injury polysubstance use was associated with higher HRU in trauma patients. The evidence can be used by policymakers and practitioners to improve patient outcomes in trauma centers. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) women are among the many victims killed by intimate partner homicide (IPH) each year, though the differences between different SGM groups (and how these groups compare to non-SGM IPH) have not been well established. The objective of this article was to identify practicable, correlated risk factors of IPH of SGM women that may have utility in prevention of future IPH among these populations in the U.S. Homicide data from the National Violent Death Reporting System spanning 2003 to 2017 were used to identify a profile of IPH specific to SGM women compared to women who were neither sexual nor gender minorities. Situational and individual characteristics significantly differentiated sexual minority (SM) women from non-SGM women victims of IPH, including substance abuse history (adjusted odds ratio [AOR] = 4.80 [2.42, 9.51]), having themselves used a weapon during the incident (AOR = 3.63 [1.44, 9.16]), and the type of weapon(s) used, such as firearms (AOR = 0.61 [0.40, 0.91]), with notably different differentiating characteristics for gender minority (GM) women (vs. non-SGM women) such as the likelihood that thevictim was known to have experienced interpersonal violence victimization in the previous month (AOR = 0.50 [0.07, 3.67]). Lesbian and bisexual women homicide victims were far more likely to have been killed via IPH than non-SGM women (AOR for Black SM women = 7.84 [3.65, 16.88], AOR for White SM women = 2.30 [1.03, 5.17]). There was no corresponding difference for GM women victims, whose likelihood of being killed by an intimate partner was similar to that of non-SGM women. Based on these findings, actionable public health recommendations--centered around evidence that neither "all women" nor "all LGBTQ people" are appropriate intimate partner violence prevention umbrellas--are proposed. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease-2019 (COVID-19) pandemic has caused myriad health, social, and economic stressors. To date, however, no known study has examined changes in mental health during the pandemic in the U.S. military veteran population. Methods: Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, a nationally representative, prospective cohort survey of 3078 veterans. Pre-to-peri-pandemic changes in psychiatric symptoms were evaluated, as well as pre-pandemic risk and protective factors and pandemic-related correlates of increased psychiatric distress. Results: The prevalence of generalized anxiety disorder (GAD) positive screens increased from pre- to peri-pandemic (7.1% to 9.4%; p < 0.001) and was driven by an increase among veterans aged 45–64 years (8.2% to 13.5%; p < 0.001), but the prevalence of major depressive disorder and posttraumatic stress disorder positive screens remained stable. Using a continuous measure of psychiatric distress, an estimated 13.2% of veterans reported a clinically meaningful pre-to-peri-pandemic increase in distress (mean = 1.1 standard deviation). Veterans with a larger pre-pandemic social network size and secure attachment style were less likely to experience increased distress, whereas veterans reporting more pre-pandemic loneliness were more likely to experience increased distress. Concerns about pandemic-related social losses, mental health COVID-19 effects, and housing stability during the pandemic were associated with increased distress, over-and-above pre-pandemic factors. Conclusions: Although most U.S. veterans showed resilience to mental health problems nearly 1 year into the pandemic, the prevalence of GAD positive screens increased, particularly among middle-aged veterans, and one of seven veterans experienced increased distress. Clinical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Objectives This study investigates whether the year of arrival to the United States (U.S.) and birthplace relate to postmigration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life. Methods We analyzed 19 years (2000–2019) of data from the American Community Survey Public Use Microdata Samples (weighted N = 393,501; ages ≥ 50 years). Cognitive difficulty was based on self-reported data, and weighted means, percentages, adjusted prevalence estimates, and adjusted odds ratio were calculated. Results Controlling only for demographics, foreign-born Arabs reported higher odds of cognitive difficulty compared to U.S.-born Arabs across all arrival cohorts (p <.001). After accounting for economic and integration factors, those who arrived between 1991 and 2000 had higher odds (odds ratio [OR] = 1.06, 95% confidence interval [CI] =1.00, 1.19, p <.01), while those who arrived after 2001 had lower odds (OR = 0.87, 95% CI = 0.78, 0.97, p <.001) of cognitive difficulty. Lacking English proficiency (OR = 1.90, 95% CI = 1.82, 1.98, p <.001) was related to higher odds, whereas not being a U.S. citizen was significantly associated with lower odds (OR = 0.89, 95% CI = 0.52, 0.94, p <.001) of cognitive difficulty. Yet, results varied by birthplace. Migrants born in Iraq consistently reported the highest odds of cognitive difficulty across all arrival cohorts. Discussion Migration history and birthplace may be important factors explaining cognitive disparities among the diverse group of Arab migrants and Arab Americans. Future research examining mechanisms underlying these associations and the impact of migration on cognitive health is needed to address cognitive disparities in migrants. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association between metabolic syndrome (MetS) and frailty, and determine whether co-existent MetS and frailty affect disability-free survival (DFS), assessed through a composite of death, dementia or physical disability. Design: Longitudinal study. Setting and Participants: Community-dwelling older adults from Australia and the United States (n=18,264) from "ASPirin in Reducing Events in the Elderly" (ASPREE) study. Measurements: MetS was defined according to American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (2018). A modified Fried phenotype and a deficit accumulation Frailty Index (FI) were used to assess frailty. Association between MetS and frailty was examined using multinomial logistic regression. Cox regression was used to analyze the association between MetS, frailty and DFS over a median follow-up of 4.7 years. Results: Among 18,264 participants, 49.9% met the criteria for MetS at baseline. Participants with Mets were more likely to be pre-frail [Relative Risk Ratio (RRR): 1.22; 95%Confidence Interval (CI): 1.14, 1.30)] or frail (RRR: 1.66; 95%CI: 1.32, 2.08) than those without MetS. MetS alone did not shorten DFS while pre-frailty or frailty alone did [Hazard Ratio (HR): 1.68; 95%CI: 1.45, 1.94; HR: 2.65; 95%CI:1.92, 3.66, respectively]. Co-existent MetS with pre-frailty/frailty did not change the risk of shortened DFS. Conclusions: MetS was associated with pre-frailty or frailty in community-dwelling older individuals. Pre-frailty or frailty increased the risk of reduced DFS but presence of MetS did not change this risk. Assessment of frailty may be more important than MetS in predicting survival free of dementia or physical disability. [ABSTRACT FROM AUTHOR]

Sexual minorities are at greater risk for mental health difficulties than their heterosexual peers, and bisexual and asexual individuals may be at particularly heightened risk. However, the majority of the literature has failed to examine nuanced differences within the sexual minority community. We examined depression, anxiety and happiness as indicators of mental health, and belonging and coping as general psychological processes in 2,424 female and male college students who identified as gay/lesbian, asexual, or bisexual. The findings revealed a significant main effect for sexual orientation such that bisexual individuals scored significantly higher on depression and lower on happiness than asexual and gay/lesbian individuals. Gay/lesbian and bisexual individuals scored significantly higher on anxiety and lower on coping than asexual individuals. Asexual individuals reported greater belonging than bisexual individuals, and gay/lesbian individuals scored in between those groups. The results also revealed a significant main effect for gender such that women had higher levels of depression and anxiety, and lower levels of happiness and coping than men. Finally, gender did not moderate the relationship between sexual orientation and the outcome variables. These findings highlight that the sexual minority community is not a monolithic group in terms of mental health or general psychological processes. [ABSTRACT FROM AUTHOR]

Objective Regulations that reduce nicotine and eliminate menthol in cigarettes have been proposed to the US Food and Drug Administration (FDA) as product alterations that could reduce smoking prevalence in the USA. This study sought to assess the public response to either action. Methods A mail survey of a representative sample of 1074 adults was conducted in two major metropolitan areas to determine the level of support for immediate, gradual or no reduction of menthol and nicotine in cigarettes. Results There was more support for reducing nicotine (79%) than for reducing or removing menthol (59.5%). Most smokers (59.2%; 95% CI 50.7 to 67.2) and 36% of non-smokers (95% CI 31.7 to 40.8) opposed eliminating menthol, but few smokers (23.8%) or nonsmokers (20.3%) were opposed to reducing nicotine. Logistic regression showed no significant effect of smoking status on support for reductions in nicotine, but that smokers were significantly less supportive than nonsmokers of FDA action on menthol (OR=0.32, 95% CI 0.21 to 0.49). A significant race by smoking status interaction showed that African-American smokers were more supportive of removing menthol than non-African-American smokers. Conclusions The greater smoker support for reductions in nicotine than menthol could be due to inaccurate beliefs about the disease risk associated with the two substances (ie, a belief that nicotine is more harmful than menthol), or to greater awareness of the sensory role that menthol plays in smokers' satisfaction. In any case, if FDA goes ahead with regulations to remove menthol, it will be important to develop strategies to reduce smoker resistance. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness of a 6-session (12-hour) empowerment self-defense classroom delivered curriculum (i.e., IMpower) among American Indian girls. Girls (N = 74) in one middle school and two high schools on an Indian Reservation in the Great Plains region of the United States received the intervention and completed a pre-test and a post-test six months following the final program session. The surveys administered assessed hypothesized intermediary (i.e., efficacy to resist a sexual assault, self-defense knowledge), primary (i.e., sexual violence victimization), and secondary (i.e., physical dating violence, sexual harassment) outcomes. Native American girls (N = 181) in five middle schools and three high schools in a nearby city where there was no sexual assault prevention occurring completed surveys assessing sexual violence, physical dating violence, and sexual harassment victimization approximately six months apart, thus serving as a comparison to girls in the treatment condition on primary and secondary outcomes. Girls exposed to the IMpower program reported significant increases over time in efficacy to resist a sexual assault and knowledge of effective resistance strategies. Furthermore, propensity score analyses suggested that girls who received the IMpower program reported significantly fewer types of sexual assault and sexual harassment at follow-up compared to girls in the control condition. However, no effect was found for physical dating violence. These data suggest that empowerment self-defense is a promising approach in preventing sexual assault and sexual harassment among American Indian girls. [ABSTRACT FROM AUTHOR]

Objective. To assess the prevalence of food allergy in children presenting to a multidisciplinary feeding program. Methods. A retrospective chart review was conducted from 302 patients. We recorded history of food reaction, family history of any atopic disease, radioallergosorbent testing, prematurity, birth weight, breastfeeding history, Z-scores, age, and gastrointestinal mucosal biopsy reports with eosinophilic infiltrate. Three categories of possible food allergy were stratified based on increasing evidence of allergy. Results. Possible food allergy was found for 18% (n = 54), likely food allergy for 6% (n = 18), and very likely food allergy for 16% (n = 47) for a total of 40% classified in a food allergy group. Having been breastfed correlated with likelihood of food allergy but tube-feeding dependence did not. Conclusion. This study revealed a higher proportion of children in a feeding program with food allergy compared to the general population, but larger prospective studies are needed to confirm the association. [ABSTRACT FROM AUTHOR]

Objective The Food and Drug Administration is considering regulation of menthol cigarettes. While persons with mental distress are known to smoke cigarettes at high rates, little is known about their use of menthol. The authors examined the association of psychological distress and menthol use in a national sample of adult smokers. Methods Data were from the 2008 and 2009 National Survey on Drug Use and Health. Past month smokers (N=24 157) were categorised for menthol or nonmenthol use. Psychological distress was categorised as none/mild, moderate or severe on the Kessler six-item scale. Results The prevalence of menthol use was higher among individuals with severe psychological distress, women, young adults, African-Americans, Native Hawaiians/Pacific Islanders, persons with fewer years of education and lower income, and the unmarried and uninsured. In a multivariate model controlling for sociodemographic factors, smoking intensity and time to first cigarette, smokers with severe (adjusted OR (AOR) 1.23, 95% CI 1.04 to 1.46, p=0.02) but not moderate (AOR 1.03, 95% CI 0.92 to 1.15, p=0.58) psychological distress were significantly more likely to smoke menthols compared with smokers with none/mild distress. Conclusion An elevated prevalence of menthol use was found among persons with severe psychological distress, suggesting another group that could potentially benefit from the regulation of menthol cigarettes. [ABSTRACT FROM AUTHOR]

This study adapted Andersen’s Health Belief Model to examine the predictors of mental health services utilization among Korean American (KA) immigrants. A cross-sectional survey was used to gather data on 363 KA immigrants 18 years and older residing in New York City. Predisposing factors included gender, age, marital status, education, length of stay in the US, and religion; the need factor was depression; and enabling factors included health insurance, English proficiency, income, and perceived need for help. Approximately 8.5 % of participants reported having utilized mental health services, while 23 % reported having depressive symptoms. Shorter duration of residence in the US, lower income, and the presence of perceived need for help were significantly related to use of mental health services. The perceived need for help mediated the relationship between depression and mental health service utilization. Failure to perceive the need for psychological help continues to be a major reason that KA immigrants do not use mental health services. [ABSTRACT FROM AUTHOR]

Background In the USA, tobacco marketing expenditure is increasingly concentrated at the point of sale (POS). Previous studies have demonstrated an association between exposure to tobacco POS advertising and increased smoking initiation, but limited evidence is available on adult smokers' decisions and behaviours. Methods An immediate post-cigarette purchase survey was administered to 301 cigarette purchasers outside of two grocery stores in Vermont to assess the prevalence of unplanned purchases and opinions about POS tobacco advertising and displays. Results In total, 11.3% of purchases were reported as unplanned. Certain groups were more likely to make unplanned purchases including: 18-24-year-olds (OR: 2.1, 95% CI 1.0 to 4.4), less than daily smokers (OR: 5.6, 95% CI 1.9 to 16.9), smokers who made 3+ quit attempts in the previous year (OR: 2.4, 95% CI 0.9 to 6.0), those who plan to quit in the next month (OR: 3.7, 95% CI 1.6 to 9.0), and those who agreed that tobacco POS advertising makes quitting smoking harder (OR: 2.3, 95% CI 1.1 to 4.8). Overall, 31.2% of participants agreed that tobacco POS advertising makes quitting smoking harder. Individuals who intended to quit within the next month, made 3+ quit attempts in the last year, or made an unplanned cigarette purchase were the most likely to agree. Conclusions Young adults and individuals making multiple quit attempts or planning to quit in the next month are more likely to make unplanned cigarette purchases. Reducing unplanned purchases prompted by tobacco POS advertising could improve the likelihood of successful cessation among smokers. [ABSTRACT FROM AUTHOR]

Objective: To examine the use of electronic medical records (EMRs) among US occupational medicine physicians (OMPs). Methods: An electronic- and paper-based survey was conducted among OMPs using an anonymous self- administered questionnaire. Results: The OMPs reported using an EMR for billing purposes only (14.6%), clinical purposes only (27.8%), or both (39.3%) with the total EMR use of 81.7%. About 60% were satisfied with their EMRs, and 64% to 66% believed that EMRs improve safety and quality of medical care. Among OMPs not using EMR, 17% reported that they were likely to adopt an EMR in the year after the survey, whereas 47% were very unlikely to do so. Conclusions: Occupational physicians' use of EMRs was relatively high. They also seemed to be satisfied with their EMRs and believed that EMRs improve both safety and quality of clinical care. [ABSTRACT FROM AUTHOR]

The protective effect of family meals on unhealthy weight gain and diet has been shown across multiple age groups; however, it is unknown whether a similar effect is present among diverse immigrant populations. In addition, little research has focused on factors associated with the frequency of evening family meals, such as feeding styles (how parents interact with their child around feeding). Therefore the goals of this paper are to explore the 1) association between the frequency of evening family meals and child weight status among new immigrant families, and 2) influence of immigrant mothers’ feeding styles on the frequency of evening family meals. Baseline self-reported socio-demographic information and measured heights and weights were collected for both mother and child (age range: 3-12 years) among 387 mother-child dyads enrolled in Live Well, a community-based, participatory-research, randomized controlled lifestyle intervention to prevent excessive weight gain in recent (<10 years in the U.S.) immigrant mothers and children. For children, height and weight measurements were transformed into BMI z-scores using age-and sex-specific CDC standards and categorized as overweight (85th-94th percentile) and obese (≥95th percentile); mothers’ BMI was calculated. Frequency of evening family meals, eating dinner in front of the TV, acculturation and responses to the Caregiver’s Feeding Styles Questionnaire (CFSQ) were also obtained from the mother. Children were categorized as “eating evening family meals regularly” if they had an evening family meal ≥5 times per week. Overall, 20% of children were overweight and 25% were obese. Less than half (40.9%) of families had regular evening family meals. In multivariate analyses, adjusting for covariates, children who were overweight/obese were significantly less likely to have ≥5 evening family meals/week compared with normal weight children (OR = 0.51, 95% CI 0.32-0.82) . Mothers who had a low demanding/high responsive or a low demanding/low responsive feeding style, were less likely to have ≥5 evening family meals/week compared to mothers with a high demanding/high responsive feeding style (OR = 0.41, 95% CI 0.18-0.0.96, OR = 0.33, 95% CI 0.13-0.87, respectively). Future interventions and programs that seek to help parents establish healthy household routines, such as family meals, may consider tailoring to specific maternal feeding styles. [ABSTRACT FROM AUTHOR]

AIM: To investigate the impact of newspaper use in a year of increased coverage of litigation against the tobacco industry on youths' beliefs about the health risks of ‘light’ cigarettes, and examine relations between inaccurate beliefs about ‘lights’, perceptions of risk and intentions to quit smoking. PARTICIPANTS: The data come from the 2004 National Annenberg Survey of Youth, a representative random digit dial telephone survey of youths aged 14–22 years in the USA (n=1501; current smokers, n=305; ‘lights’ smokers, n=112). DESIGN: All youths were asked about newspaper use and beliefs regarding ‘light’ cigarettes (riskiness, addictiveness, ease of quitting). Smokers reported on risk perceptions and quitting intentions. We also examined changes in newspaper coverage related to ‘lights’ from January 2001 to April 2004. RESULTS: Newspaper coverage related to ‘lights’ increased in the first months of 2003, and continued into 2004. Logistic regression analyses suggest that ‘lights’ smokers with lower levels of newspaper use were most likely to hold inaccurate beliefs about ‘lights’ (OR=5.93, 95% CI 1.48 to 23.77). Smokers of ‘lights’ with inaccurate beliefs were less likely to perceive their smoking as risky (OR=0.29, 95% CI 0.11 to 0.87), and smokers with inaccurate beliefs were less likely to have strong quitting intentions (OR=0.52, 95% CI 0.28 to 0.96). CONCLUSIONS: Inaccurate beliefs about the risks of ‘lights’ were negatively related to youth smokers' perceptions of risk and intentions to quit smoking. News coverage surrounding the tobacco industry's failure to disclose these risks might help reduce these inaccurate, and potentially dangerous, beliefs. [ABSTRACT FROM AUTHOR]

Aims: To describe beginning nursing student learning styles and to determine whether there are relationships between learning style and sociodemographic or educational background. We also aim to compare these data with the normative values of the 3.1 version of the Kolb learning style inventory and verify its reliability. Background/Literature: Learning style is related to the way in which an individual interacts with learning conditions, involving cognitive, affective, physical and environmental aspects. In nursing education, few studies have focused on knowing the learning styles of beginning nursing students, despite the need for students to develop critical thinking skills required of nurses. Design: Descriptive, cross‐sectional, correlational, multi‐site study. Method: The study took place at five universities in Brazil and one university in the United States. Data were collected from a sample of beginning nursing students (n = 176) in 2019, using the Portuguese and English 3.1 versions of Kolb's learning style inventory. Results: Most students' learning styles were classified as divergers (34.10%), while 28.41% were assimilators, 23.86% were accommodators and 13.63% were convergers. Kolb describes learning as a four‐stage cyclical process grounded in experience. The mean score of one learning stage, the concrete experience, showed those who attended public high schools compared with private high schools was higher (mean = 26.22; p =.0019), and there were different results between Brazilian state universities, Brazilian federal universities and the American university (p =.0149). Conclusion: The diverger style was the most common among beginning nursing students in Brazil and the United States. There was a significant relationship between learning style, the educational background of students, the type of institution they attend and their previous experience with some active learning methodologies. Relevance to clinical practice: Aligned with Kolb's experiential learning theory, nurse educators must be aware of student learning styles so they may use teaching strategies to meet their students' needs. [ABSTRACT FROM AUTHOR]

Transgender and nonbinary (TNB) individuals experience high rates of myriad types of victimization, including in health care settings. Many TNB people avoid medical visits for fear of mistreatment and, when they do visit a provider, report negative experiences (e.g., denial of services, misgendering, verbal abuse). These negative experiences are heightened for TNB individuals who have an intersecting marginalized identity (e.g., low socioeconomic status, disability). Using data from the 2015 United States Transgender Survey, the largest survey of TNB individuals in the United States to date, the present study examines differential experiences of victimization in health care settings by TNB identity and other demographics (i.e., race, age, class, educational level, disability). A series of multivariate logistic regressions were run to determine adjusted odds ratios (AORs) for TNB individuals recently (i.e., in the past year) experiencing four forms of victimization: (a) doctor/health care provider used harsh or abusive language; (b) doctor/health care provider was physically rough or abusive; (c) patient was verbally harassed in health care setting; and (d) patient experienced unwanted sexual contact in health care setting. Frequency of victimization varied by gender identity and type of victimization; the most prevalent form was verbal harassment by a doctor/provider (5.84%) and the least prevalent was unwanted sexual contact in a health care setting (1.20%). Although findings varied by form of violence, generally, regression models demonstrated elevated odds of experiencing some form of health care victimization for those who were transgender compared with genderqueer, biracial/multiracial compared with White, low income compared with higher income, and disabled compared to non-disabled. In addition, odds ratios for victimization increased with age and, for some forms, increased with low educational attainment. We discuss the need for increased mandatory trainings for providers to reduce discriminatory and violent behavior toward TNB patients, as well as intersectional research to better ascertain the extent and nuance of victimization within TNB health care. [ABSTRACT FROM AUTHOR]

Within correctional settings, incarcerated women have disproportionately high rates of experiencing staff-perpetrated sexual victimization. In addition, only a small proportion of incarcerated women formally report their victimization experiences to correctional staff and even fewer reports are fully investigated by internal investigators and found to be substantiated. Given the multiple steps in this process, incarcerated women face several possible justice gaps in receiving preventive and intervention-focused responses from correctional staff. Racial differences among incarcerated women's experiences of these steps have not been explored. This study used a structural intersectional framework to examine racial differences in these areas: incarcerated women's experiences of staff-perpetrated rape, reporting decisions, and correctional staff's investigation decisions. With a sample of 180 incarcerated women, this study included analysis of archival data (i.e., settlement claim forms and internal investigation files) from a class action lawsuit involving incarcerated women who had experienced staff sexual misconduct. Black women represented over half of the incarcerated women who experienced staff-perpetrated rape. There were no statistical differences between Black and White women with regard to the characteristics of their victimization experiences, and they had similar rates of reporting their victimization to institutional staff. However, significant differences were found between women with regard to prison staff's responses to their reports; Black women were less likely to have their reports investigated by staff and were more likely to have their investigated reports found to be unsubstantiated. A detailed analysis of 100 specific incidents showed similar findings. Thus, while justice gaps existed for all women, gaps in institutional responses were exacerbated for Black women. Centering incarcerated Black women's experiences is pivotal for guiding efforts to transform correctional settings, to prevent and address staff-perpetrated sexual victimization, and to build safety for incarcerated women. [ABSTRACT FROM AUTHOR]

The current study examined regional differences in body image perceptions and body mass index (BMI) among young African American women. Three hundred forty-one African American women, 18 to 40 years old, living in three regions of the United States were recruited. Pulver's Figure Rating scale was used to identify body image perceptions. Weight and height were measured for BMI calculation. Analysis of covariance was used to examine body image perception differences. The sample mean age was 27.8 years and mean BMI was 30.3 kg/m². Participants' body image perceptions were significantly smaller among participants living in the Northeast compared to the Southeast (mean difference = -0.65, 95% confidence interval [CI] [-1.18, -0.11], p = 0.018) and Midwest (mean difference = -0.64, 95% CI [-1.16, -0.12], p = 0.015). No significant differences in BMI were found among regions (F(8,318) = 1.17, p = 0.314). Clinical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore racial/ethnic differences in midlife women's cognitive symptoms among four major racial/ethnic groups in the United States and to determine multiple factors that influenced the women's cognitive symptoms. This was a secondary analysis of the data from two larger studies among 1,054 midlife women. The instruments included multiple questions on background characteristics and health and menopausal status, and the Cognitive Symptom Index for Midlife Women. The data were analyzed using multiple logistic and Poisson regression analyses. There existed significant racial/ethnic differences in the total numbers and total severity scores of cognitive symptoms (p < .01); non-Hispanic Asians had significantly lower total numbers and total severity scores compared with other racial/ethnic groups. Socioeconomic status and health and menopausal status were significant factors that influenced cognitive symptoms across racial/ethnic groups (p < .05). Further studies on racial/ethnic differences in cognitive symptoms are needed with diverse groups of midlife women. [ABSTRACT FROM AUTHOR]

Due to reliability problems, use of retrospective measurement to assess child sexual abuse has long concerned researchers. Possible psychosocial causes of these reliability issues—including problem avoidance—have not been thoroughly studied. We tested the reliability of retrospective child sexual abuse measurement in a nationally representative sample of 12,438 adults over two periods (2001–2002, 2007–2008), assessed sex differences in reliability, and examined whether reliability depends on problem avoidance tendencies. Nearly three-fourths of child sexual abuse cases in the former wave were not again reported, and two-thirds of child sexual abuse cases in the latter wave were not previously reported. Females were more likely to report CSA later if reported previously (OR = 5.11). Participants who reported child sexual abuse in the former wave but not the latter were more avoidant than consistent reporters (3.13 versus 2.77). Our findings suggest that females may report child sexual abuse more consistently. Furthermore, inconsistent reporting may indicate problem avoidance. Suggestions for researchers and practitioners are discussed. [ABSTRACT FROM AUTHOR]

Prevalence of self-injurious behavior (SIB) is as high as 50% among children with autism spectrum disorder (ASD). Identification of risk factors for the development of SIB is critical to early intervention and prevention. However, there is little empirical research utilizing a prospective design to identify early risk factors for SIB. The purpose of this study was to evaluate behavioral characteristics predicting SIB at age 2 years among 235 infants at high familial risk for ASD. Logistic regression results indicated that presence of SIB or proto-SIB and lower developmental functioning at age 12 months significantly predicted SIB at 24 months. A pattern of persistent SIB over this period was associated with a diagnosis of autism and poorer cognitive and adaptive outcomes. [ABSTRACT FROM AUTHOR]

There has been an increase in utilization of the Emergency Department (ED) in individuals with autism spectrum disorder (ASD) which may reflect a deficit of services (Green et al., Journal of the American Academy of Child and Adolescent Psychiatry 40(3):325-332, 2001; Gurney et al., Archives of Pediatric and Adolescent Medicine 160:825-830, 2006; Leichtman et al., American Journal of Orthopsyhciatry 72(2):227-235, 2001). The current study examined the rates of ED utilization between 2005 and 2013 in ASD youth 12- to 21-years-old. Adolescents with ASD accessed ED services four times as often as adolescents without ASD. Older adolescents and those living in rural areas showed a significant increase in ED visits over time. Post hoc analysis revealed increased ED utilization for females and behavioral health ED services over time. Better access to and greater understanding of services for adolescents with ASD is a critical need. [ABSTRACT FROM AUTHOR]

Aims To test whether exposure to party-related alcohol advertising is associated with drinking behavior in a national US sample of adolescents and young adults, independently of exposure to other alcohol advertising. Design Longitudinal telephone- and web-based surveys conducted in 2011 and 2013. Setting All regions of the United States, participants selected via mixed-mode random-digit-dial landline and cellphone frames. Participants A sample of 705 respondents who never had a whole drink of alcohol at baseline (mean age 16.9 years, 53.3% female) and a sample of 1036 who never had six or more drinks during one drinking occasion (mean age 17.4 years, 55.8% female). Measurements Outcome measures were onset of alcohol use and binge drinking during the study interval. Primary predictor was exposure to television alcohol advertising, operationalized as contact frequency and brand recall for 20 randomly selected alcohol advertisements. Independent post-hoc analyses classified all advertisements as 'party' or 'non-party' advertisements. Socio-demographics, sensation-seeking, alcohol expectancies and alcohol use of friends and family were assessed as covariates. Findings Onset rates for having the first whole drink of alcohol and for first binge drinking were 49.2% and 29.5%, respectively. On average, approximately half (median = 10.2) of the 20 alcohol advertisements in each individual survey were 'party' advertisements. If both types of exposures ('party' and 'non-party') were included in the regression model, only 'party' exposure remained a significant predictor of alcohol use onset [adjusted odds ratio (AOR) = 19.17; 95% confidence interval (CI) = 3.72-98.79] and binge drinking onset (AOR = 3.87; 95% CI = 1.07-13.99) after covariate control. Conclusions Adolescents and young adults in the United States appear to have higher rates of alcohol use and binge drinking onset if they have higher exposure to alcohol advertisements using a partying theme, independently of the amount of exposure to alcohol advertisements with non-party themes. [ABSTRACT FROM AUTHOR]

Aims and objectives The purposes of this study were to measure the prevalence of, and identify factors associated with, cervical cancer screening among a sample of lesbian, bisexual and queer women, and transgender men. Background Past research has found that lesbian, bisexual and queer women underuse cervical screening service. Because deficient screening remains the most significant risk factor for cervical cancer, it is essential to understand the differences between routine and nonroutine screeners. Design A convergent-parallel mixed methods design. Methods A convenience sample of 21- to 65-year-old lesbian and bisexual women and transgender men were recruited in the USA from August-December 2014. Quantitative data were collected via a 48-item Internet questionnaire ( N = 226), and qualitative data were collected through in-depth telephone interviews ( N = 20) and open-ended questions on the Internet questionnaire. Results Seventy-three per cent of the sample was routine cervical screeners. The results showed that a constellation of factors influence the use of cervical cancer screening among lesbian, bisexual and queer women. Some of those factors overlap with the general female population, whereas others are specific to the lesbian, bisexual or queer identity. Routine screeners reported feeling more welcome in the health care setting, while nonroutine screeners reported more discrimination related to their sexual orientation and gender expression. Routine screeners were also more likely to 'out' to their provider. The quantitative and qualitative factors were also compared and contrasted. Conclusions Many of the factors identified in this study to influence cervical cancer screening relate to the health care environment and to interactions between the patient and provider. Relevance to clinical practice Nurses should be involved with creating welcoming environments for lesbian, bisexual and queer women and their partners. Moreover, nurses play a large role in patient education and should promote self-care behaviours among lesbian women and transgender men. [ABSTRACT FROM AUTHOR]

Objectives: The current study examined the relationship between the 4 quadrants of the job strain model and incident diabetes in U.S. working adults 50 years and older. Methods: This study used longitudinal data from the 2006-2012 waves of the Health and Retirement Study (n = 1,396). Kaplan-Meier survival curves and Cox proportional hazard regression models were used to examine whether job strain significantly predicted diabetes incidence. Results: Participants in high strain and passive jobs had significantly higher risk of diabetes relative to those in low strain jobs. In the univariate survival curves, significantly higher risk of diabetes was observed in men working in passive jobs. After adjustment for relevant covariates, participants in high strain (hazard ratio [HR] = 1.73, 95% confidence interval [CI] = 1.09-2.75) and passive (HR = 1.66, 95% CI = 1.01-2.73) jobs had a significantly increased risk of diabetes. Among adults 65 years and older, high strain and passive jobs were associated with an approximately fourfold increased risk of incident diabetes. Discussion: High strain and passive occupations which represent low control over work are associated with increased risk of diabetes incidence among older workers. More research is required to better understand how psychosocial work factors impact health in aging workers. Further, research should continue to explore gender differences in effects of job strain on diabetes. [ABSTRACT FROM AUTHOR]

Objectives. To examine the association of school sociodemographic characteristics with tobacco outlet and fast-food restaurant availability near schools in a national study. Methods. Business lists and data from the National Center for Education Statistics were used to calculate the numbers of tobacco outlets and fast-food restaurants within 800 meters of public schools in 97 US counties. Results. More than 50% of schools with a majority of Hispanic students had both a fast-food restaurant and tobacco outlet nearby, compared with 21% of schools with a majority of White students. In adjusted models, each 10% increase in the number of low-income and Hispanic students enrolled in a school led to a 3% to 5% increase in the odds of the school having both a fast-food restaurant and a tobacco outlet nearby. Conclusions. Low-income and Hispanic students are disproportionately exposed to both tobacco outlets and fast-food restaurants near their schools. Easy access to tobacco products and fast food may influence youth smoking initiation and contribute to poor dietary intake. [ABSTRACT FROM AUTHOR]

Adherence to diabetic care guidelines among US immigrants remains low. This study assesses adherence to diabetic care guidelines by country-of-origin and language among a limited English-proficient (LEP) population. Timely completion of diabetic measures and acceptable levels of hemoglobin A1c (A1c), low density lipoprotein (LDL) cholesterol, and blood pressure (BP) were compared between LEP and English-proficient (EP) patients in this 2013 retrospective cohort study of adult diabetics. More LEP patients met BP targets (83 vs. 68 %, p < 0.0001) and obtained LDL targets (89 vs. 85 %, p = 0.0007); however, they had worse LDL control (57 vs. 62 %, p = 0.0011). Ethiopians and Somalians [adjusted OR (95 % CI) = 0.44 (0.30, 0.63)] were less likely than Latin Americans to meet BP goals. LEP patients outperformed EP peers on several diabetic outcomes measures with important variation between groups. These data highlight the success of a safety net hospital in improving diabetes management among diverse populations. [ABSTRACT FROM AUTHOR]

Background Children with autism spectrum disorder (ASD) experience a range of severity levels characterised as levels of support they need for everyday functioning. By this definition, greater levels of severity should warrant greater use of services and supports among children with ASD. In previous studies, Latino children with ASD in the USA have been shown to have lower access to diagnosis and treatment services than White children. However, none have examined service use in relation to severity. In this study, we examined whether there are ethnic disparities between Latino and White children with ASD in specialty autism-related services, and whether functional severity moderates the relationship between ethnicity and receipt of autism services. Methods We used data from the Survey of Pathways to Diagnosis and Services, a supplement to the National Survey of Children with Special Health Care Needs and analysed four specialty services commonly used by children with ASD, adjusting for demographic variables. Results We found that Latino children with ASD who had severe limitations received fewer specialty autism-related services than White children with similarly severe conditions. These disparities were evident despite the fact that the sample of Latino children in these data were more privileged than the general US Latino population. Conclusion Assertive policy initiatives are needed to address these disparities and ensure that these highly vulnerable children with severe functional limitations receive appropriate services and supports. [ABSTRACT FROM AUTHOR]

Background. The attainment of walking is a focus of physical therapy intervention in children with cerebral palsy (CP) and may affect their independence in mobility and participation in daily activities. However, knowledge of determinants of independent walking to guide physical therapists' decision making is lacking. Objective. The aim of this study was to identify child factors (postural control, reciprocal lower limb movement, functional strength, and motivation) and family factors (family support to child and support to family) that predict independent walking 1 year later in young children with CP at Gross Motor Function Classification System (GMFCS) levels II and III. Design. A secondary data analysis of an observational cohort study was performed. Methods. Participants were 80 children with CP, 2 through 6 years of age. Child factors were measured 1 year prior to the walking outcome. Parent-reported items representing family factors were collected 7 months after study onset. The predictive model was analyzed using backward stepwise logistic regression. Results. A measure of functional strength and dynamic postural control in a sit-to-stand activity was the only significant predictor of taking ≥3 steps independently. The positive likelihood ratio for predicting a "walker " was 3.26, and the negative likelihood ratio was 0.74. The model correctly identified a walker or "nonwalker " 75% of the time. Limitations. Prediction of walking ability was limited by the lack of specificity of child and family characteristics not prospectively selected and measurement of postural control, reciprocal lower limb movement, and functional strength 1 year prior to the walking outcome. Conclusions. The ability to transfer from sitting to standing and from standing to sitting predicted independent walking in young children with CP. Prospective longitudinal studies are recommended to determine indicators of readiness for independent walking. [ABSTRACT FROM AUTHOR]

We assessed associations of demographic, psychosocial, and substance use factors with seroadaptation strategies among 835 BMSM in four US cities. Seroadaptation strategies were practiced by 59.8 % of men, with 10.5 % practicing 100 % condom use, 26.5 % serosorting, 7.2 % condom serosorting, and 15.6 % seropositioning. In multivariable analyses, compared to men who used no seroadaptation strategies, serosorters were older, were less likely to be HIV infected, had fewer male sex partners, and had higher levels of social support and sexual self-efficacy. Condom serosorters had less psychological distress, were more likely to use methamphetamine, and had higher levels of sexual self-efficacy. Seropositioners were older, were less likely to be HIV infected, to have a main partner, and report alcohol/drug use with sex, while having higher levels of sexual self-efficacy. Seroadaptation practices among BMSM need to be considered to address perceived safer sex strategies and strengthen access to a broader reach of culturally-relevant prevention efforts. [ABSTRACT FROM AUTHOR]

This study investigated the differences in clinical symptoms between females and males with autism spectrum disorder (ASD) across three verbal ability groups (nonverbal, phrase and fluent speech), based on which Autism Diagnostic Observation Schedule module was administered to 5723 individuals in four research datasets. In the Simons Simplex Collection and Autism Treatment Network, females with ASD and phrase or fluent speech had lower cognitive, adaptive, and social abilities than males. In the Autism Genetics Resource Exchange and the Autism Consortium, females with phrase or fluent speech had similar or better adaptive and social abilities than males. Females who were nonverbal had similar cognitive, adaptive, and social abilities as males. Population-based longitudinal studies of verbally fluent females with ASD are needed. [ABSTRACT FROM AUTHOR]

Although misconceptions associated with ASD are apparent worldwide, they may differ across cultures. This study compares knowledge and stigma associated with ASD in a country with limited autism resources, Lebanon, and a country with substantial autism resources, the United States (US). College students in the US (N = 346) and Lebanon (N = 329) completed assessments of knowledge and stigma associated with ASD before and after an online ASD training. Although students in the US exhibited higher overall knowledge and lower stigma towards ASD, certain misconceptions were more apparent in the US than in Lebanon. Participation in the training was associated with decreased stigma and increased knowledge in both countries. Thus, online training may be useful for increasing understanding about ASD internationally. [ABSTRACT FROM AUTHOR]

Introduction. Vasopressors (epinephrine and vasopressin) are associated with return of spontaneous circulation (ROSC). Recent retrospective studies reported a greater likelihood of ROSC when vasopressors were administered within the first 10 minutes of arrest. However, it is unlikely that the relationship between ROSC and the timing of vasopressor administration is a binary function (i.e., ≤10 vs. >10 minutes). More likely, this relationship is a function of time measured on a continuum, with diminishing effectiveness even within the first 10 minutes of arrest, and potentially, some lingering benefit beyond 10 minutes. However, this relationship remains undefined. Objective. To develop a model describing the likelihood of ROSC as a function of the call receipt to vasopressor interval (CRTVI) measured on a continuum. Methods. We conducted a retrospective study of cardiac arrest using the North Carolina Prehospital Care Reporting System (PREMIS). Inclusionary criteria were all adult patients suffering a witnessed, nontraumatic arrest during January–June 2012. Chi-square and t-tests were used to analyze the relationships between ROSC and CRTVI; patient age, race, and gender; endotracheal intubation (ETI); automated external defibrillator (AED) use; presenting cardiac rhythm; and bystander cardiopulmonary resuscitation (CPR). A multivariate logistic regression model calculated the odds ratio (OR) of ROSC as a function of CRTVI while controlling for potential confounding variables. Results. Of the 1,122 patients meeting inclusion criteria, 542 (48.3%) experienced ROSC. ROSC was less likely with increasing CRTVI (OR = 0.96, p < 0.01). Compared to patients with shockable rhythms, patients with asystole (OR = 0.42, p < 0.01) and pulseless electrical activity (OR = 0.52, p < 0.01) were less likely to achieve ROSC. Males (OR = 0.64, p = 0.02) and patients receiving bystander CPR (OR = 0.42, p < 0.01) were less likely to attain ROSC, although emergency medical services response times were significantly longer among patients receiving bystander CPR. Race, age, ETI, and AED were not predictors of ROSC. Conclusions. We found that time to vasopressor administration is significantly associated with ROSC, and the odds of ROSC declines by 4% for every 1-minute delay between call receipt and vasopressor administration. These results support the notion of a time-dependent function of vasopressor effectiveness across the entire range of administration delays rather than just the first 10 minutes. Large, prospective studies are needed to determine the relationship between the timing of vasopressor administration and long-term outcomes. Keywords: Epinephrine, cardiac arrest, emergency medical services, paramedic, resuscitation, CPR [ABSTRACT FROM AUTHOR]

Background Few studies have assessed how well body mass index ( BMI), waist circumference ( WC), or waist to height ratio ( WtHR) perform in identifying cardio-metabolic risk among youth. Objective The objective of this study was to evaluate the utility of BMI and WC percentiles and WtHR to distinguish adolescents with and without cardio-metabolic risk. Methods A cross-sectional analysis of data from 6097 adolescents aged 10-13 years who participated in the HEALTHY study was conducted. Receiver operating characteristic curves determined the discriminatory ability of BMI and WC percentiles and WtHR. Results The discriminatory ability of BMI percentile was good (area under the curve [ AUC] ≥ 0.80) for elevated insulin and clustering of ≥3 risk factors, with optimal cut-points of 96 and 95, respectively. BMI percentile performed poor to fair ( AUC = 0.57-0.75) in identifying youth with the majority of individual risk factors examined (elevated glucose, total cholesterol, low-density lipoprotein, blood pressure, triglycerides and high-density lipoprotein). WC percentile and WtHR performed similarly to BMI percentile. Conclusions The current definition of obesity among US children performs well at identifying adolescents with elevated insulin and a clustering of ≥3 cardio-metabolic risk factors. Evidence does not support WC percentile or WtHR as superior screening tools compared with BMI percentile for identifying cardio-metabolic risk. [ABSTRACT FROM AUTHOR]

Workplace stress likely plays a role in health disparities; however, applying standard measures to studies of immigrants requires thoughtful consideration. The goal of this study was to determine the appropriateness of two measures of occupational stressors ('decision latitude' and 'job demands') for use with mostly immigrant Latino farm workers. Cross-sectional data from a pilot module containing a four-item measure of decision latitude and a two-item measure of job demands were obtained from a subsample (N = 409) of farm workers participating in the National Agricultural Workers Survey. Responses to items for both constructs were clustered toward the low end of the structured response-set. Percentages of responses of 'very often' and 'always' for each of the items were examined by educational attainment, birth country, dominant language spoken, task, and crop. Cronbach's α, when stratified by subgroups of workers, for the decision latitude items were (0.65-0.90), but were less robust for the job demands items (0.25-0.72). The four-item decision latitude scale can be applied to occupational stress research with immigrant farm workers, and potentially other immigrant Latino worker groups. The short job demands scale requires further investigation and evaluation before suggesting widespread use. [ABSTRACT FROM AUTHOR]

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Background Parenting stress has been consistently reported among parents of children with developmental disabilities. However, to date, no studies have investigated the impact of a molecular subtype of Angelman syndrome ( AS) on parent stress, despite distinct phenotypic differences among subtypes. Method Data for 124 families of children with three subtypes of AS: class I and II deletions ( n = 99), imprinting centre defects ( IC defects; n = 11) and paternal uniparental disomy ( UPD; n = 14) were drawn from the AS Rare Diseases Clinical Research Network ( RDCRN) database and collected from five research sites across the Unites States. The AS study at the RDCRN gathered health information to understand how the syndrome develops and how to treat it. Parents completed questionnaires on their perceived psychological stress, the severity of children's aberrant behaviour and children's sleep patterns. Children's adaptive functioning and developmental levels were clinically evaluated. Results Child-related stress reached clinical levels for 40% of parents of children with deletions, 100% for IC defects and 64.3% for UPD. Sleep difficulties were similar and elevated across subtypes. There were no differences between molecular subtypes for overall child and parent-related stress. However, results showed greater isolation and lack of perceived parenting skills for parents of children with UPD compared with deletions. Better overall cognition for children with deletions was significantly related to more child-related stress while their poorer adaptive functioning was associated with more child-related stress. For all three groups, the severity of children's inappropriate behaviour was positively related to different aspects of stress. Conclusions How parents react to stress depends, in part, on children's AS molecular subtype. Despite falling under the larger umbrella term of AS, it is important to acknowledge the unique aspects associated with children's molecular subtype. Identifying these factors can lead to tailored interventions that fit the particular needs of families of children with different AS subtypes. [ABSTRACT FROM AUTHOR]

Background Our goal was to assess the prevalence of 9 different types of precipitating circumstances among suicide decedents, and examine the association between circumstances and postmortem blood alcohol concentration ( BAC ≥ 0.08 g/dl) across U.S. ethnic groups. Methods Data come from the restricted 2003 to 2011 National Violent Death Reporting System, with postmortem information on 59,384 male and female suicide decedents for 17 U.S. states. Results Among men, precipitating circumstances statistically associated with a BAC ≥ 0.08 g/dl were physical health and job problems for Blacks, and experiencing a crisis, physical health problems, and intimate partner problem for Hispanics. Among women, the only precipitating circumstance associated with a BAC ≥ 0.08 g/dl was substance abuse problems other than alcohol for Blacks. The number of precipitating circumstances present before the suicide was negatively associated with a BAC ≥ 0.08 g/dl for Whites, Blacks, and Hispanics. Conclusions Selected precipitating circumstances were associated with a BAC ≥ 0.08 g/dl, and the strongest determinant of this level of alcohol intoxication prior to suicide among all ethnic groups was the presence of an alcohol problem. [ABSTRACT FROM AUTHOR]

Unintentional injuries are the leading cause of death among children in the United States. The use of recommended safety practices can reduce injuries. Children often learn behaviors from media exposure. Children's movies released in 1995-2007 infrequently depicted appropriate injury prevention practices. The aim of this study was to determine if injury prevention practices in children's movies have improved. The top grossing 25 G- and PG-rated movies in the United States per year for 2008-2012 were eligible for inclusion in the study. Movies or scenes were excluded if they were animated, not set in the present day, fantasy, documentary, or not in English. Injury prevention practices involving riding in a motor vehicle, walking, boating, bicycling, and four other activities were recorded for characters with speaking roles. Fifty-six (45 %) of the 125 movies met the inclusion criteria. A total of 603 person-scenes were examined involving 175 (29 %) children and 428 (71 %) adults. Thirty-eight person-scenes involved crashes or falls, resulting in four injuries and no deaths. Overall, 59 % (353/603) of person-scenes showed appropriate injury prevention practices. This included 313 (70 %) of 445 motor-vehicle passengers who were belted; 15 (30 %) of 50 pedestrians who used a crosswalk, 2 (7 %) of 30 boaters who wore personal flotation devices, and 8 (29 %) of 28 bicyclists who wore helmets. In comparison with previous studies, there were significant increases in usage of seat belts, crosswalks, personal flotation devices, and bicycle helmets. However, 41 % of person-scenes still showed unsafe practices and the consequences of those behaviors were infrequently depicted. [ABSTRACT FROM AUTHOR]

We examined racial/ethnic differences in cognitive disability and the contribution of sociodemographic factors to these differences. Using logistic regression, we measured the association between race/ethnicity and cognitive disability after adjustment for sociodemographic covariates, including agegroup, sex, education, nativity, region, marital status, and occupation among 2009 American Community Survey respondents (≥25 years). Effect modification was also explored. Cognitive disability was self-reported by 6 % of respondents. The proportion with cognitive disability was highest for Blacks and Native American/Pacific Islanders. Statistically significant effect modification was observed for all sociodemographic covariates, except sex. Although most sociodemographic modifiers revealed a more convoluted relationship between race/ethnicity and cognitive disability, the cognitive benefits of higher education, foreign born nativity, and top-tier occupations were observed among most racial/ethnic groups. The observed interplay between sociodemographics and race/ethnicity highlight a complex relationship between race/ethnicity and cognitive disability. Future research should examine mechanisms for this induced complexity. [ABSTRACT FROM AUTHOR]