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This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research articles meeting the inclusion criteria; the search results were uploaded into PICO Portal and assessed by two independent reviewers. Of the 488 initial search results, 50 articles were eligible for full-text review, and 38 were included in this review. Most studies were cross-sectional, conducted in the United States or Chile, and included children 5–18 years old. Overall, the majority of articles reported positive associations between physical activity or physical fitness and cognitive outcomes (n = 11/12; 91.7%), and physical activity or physical fitness and academic outcomes (n = 22/28; 78.6%). In sum, this review provided consistent evidence for higher amounts of physical activity and greater physical fitness to be associated with various positive cognitive and academic outcomes in a school-aged Latino population. This scoping review also elucidated a substantial gap in the research regarding study design, with a discernible lack of interventional efforts. Future studies should test physical activity interventional strategies to optimize cognitive and academic outcomes in school-aged Latino populations. [ABSTRACT FROM AUTHOR]

Background: In the United States, Black maternal mortality is 2–4 × higher than that of White maternal mortality, with differences also present in severe maternal morbidity and other measures. However, limited research has comprehensively studied multilevel social determinants of health, and their confounding and effect modification on obstetrical outcomes. Materials and Methods: We performed a retrospective multistate analysis of adult inpatient delivery hospitalizations (Florida, Kentucky, Maryland, New Jersey, New York, North Carolina, and Washington) between 2007 and 2020. Multilevel multivariable models were used to test the confounder-adjusted association for race/ethnicity and the binary outcomes (1) in-hospital mortality or maternal end-organ injury and (2) in-hospital mortality only. Stratified analyses were performed to test effect modification. Results: The confounder-adjusted odds ratio showed that Black (1.33, 95% confidence interval [CI]: 1.30–1.36) and Hispanic (1.14, 95% CI: 1.11–1.18) as compared with White patients were more likely to die in-hospital or experience maternal end-organ injury. For Black and Hispanic patients, stratified analysis showed that findings remained significant in almost all homogeneous strata. After statistical adjustment, Black as compared with White patients were more likely to die in-hospital (1.49, 95% CI: 1.21–1.82). Conclusions: Black and Hispanic patients had higher adjusted odds of in-patient mortality and end-organ damage after birth than White patients. Race and ethnicity serve as strong predictors of health care inequality, and differences in outcomes may reflect broader structural racism and individual implicit bias. Proposed solutions require immense and multifaceted active efforts to restructure how obstetrical care is provided on the societal, hospital, and patient level. [ABSTRACT FROM AUTHOR]

In a randomized clinical trial, we compare early neutralizing antibody responses after boosting with bivalent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines based on either BA.1 or BA.4/BA.5 Omicron spike protein combined with wild-type spike. Responses against SARS-CoV-2 variants exhibited the greatest reduction in titers against currently circulating Omicron subvariants for both bivalent vaccines. [ABSTRACT FROM AUTHOR]

The intrauterine device is one of the most effective forms of contraception. Use of the intrauterine device has increased in the United States over the last 2 decades. Two formulations are commercially available in the United States: the levonorgestrel-releasing intrauterine device and the copper intrauterine device. The levonorgestrel intrauterine device releases progestin, causing endometrial suppression and cervical mucus thickening, whereas the primary mechanism of action of the copper intrauterine device is to create a local inflammatory response to prevent fertilization. Whereas the protective effects of combined hormonal contraception against ovarian and endometrial cancer, and of tubal sterilization against ovarian cancer are generally accepted, less is known about the effects of modern intrauterine devices on the development of gynecologic malignancies. The best evidence for a protective effect of intrauterine device use against cancer incidence pertains to levonorgestrel intrauterine devices and endometrial cancer, although studies suggest that both copper intrauterine devices and levonorgestrel intrauterine devices reduce endometrial cancer risk. This is supported by the proposed dual mechanisms of action including both endometrial suppression and a local inflammatory response. Studies on the relationship between intrauterine device use and ovarian cancer risk show conflicting results, although most data suggest reduced risk of ovarian cancer in intrauterine device users. The proposed biological mechanisms of ovarian cancer reduction (foreign-body inflammatory response, increased pH, antiestrogenic effect, ovulation suppression) vary by type of intrauterine device. Whereas it has been well established that use of copper intrauterine devices confers a lower risk of cervical intraepithelial neoplasms, the effect of levonorgestrel intrauterine device use on cervical cancer remains unclear. Older studies have linked its use to a higher incidence of cervical dysplasia, but more recent literature has found a decrease in cervical cancer with intrauterine device use. Various mechanisms of protection are postulated, including device-related inflammatory response in the endocervical canal and prostaglandin-mediated immunosurveillance. Overall, the available evidence suggests that both levonorgestrel intrauterine devices and copper intrauterine devices reduce gynecologic cancer risk. Whereas there is support for the reduction of endometrial cancer risk with hormonal and copper intrauterine device use, and reduction of cervical cancer risk with copper intrauterine device use, evidence in support of risk reduction with levonorgestrel intrauterine device use for cervical and ovarian cancers is less consistent. [ABSTRACT FROM AUTHOR]

Early intervention programs are developed on the premise that parents or primary caregivers generalize treatment strategies within naturalistic environments. The diverse characteristics of children within early language intervention reinforce the urgency for services that consider the needs of each child within his or her broader social, cultural, and familial context. Furthermore, effective language interventions require the integration of many factors including cognitive, linguistic, and cultural influences. This article presents strategies for implementing collaborative, family-centered language intervention with Hispanic parents and their children with communication disabilities. General strategies include establishing a trusting relationship, valuing parents as experts of their children, creating mutually constructed goals, accommodating families' schedules and roles, individualizing intervention in the home language, and encouraging parental education and advocacy. The intent of this article is to guide understanding of communication disabilities among young Hispanic children and provide speech-language pathologists with information on implementing evidence-based practices. (Contains 2 tables.)

The "GeoLiteracy for English language learners" (ELLs) program is a curriculum that enhances reading and writing skills while teaching geography content for US students in kindergarten through eighth grades. The program includes 85 lesson plans that address all US national geography standards, a quarter of which address environmental issues. The program also includes methodology and materials aimed at meeting the academic needs of the growing population of ELLs in the United States. This article describes a study conducted in three US states that examined the effects of "GeoLiteracy for English Language Learners" on reading comprehension of third to eighth grade students. The findings reveal that reading comprehension achievement of students, especially ELLs, who used GeoLiteracy improved or maintained. Thus, offering geography education to ELLs not only promotes the discipline but also improves reading comprehension. This study uncovered a number of bureaucratic, political and philosophical issues related to the education of ELLs in the state of Arizona, which could mirror issues in other US states. (Contains 3 tables and 1 figure.)

The "sociocultural framework" highlights the contributions of children's cultural and linguistic contexts to early language and literacy development. To collaborate with parents in early intervention programs, including speech-language therapy, there must be a sincere commitment to the development of cultural competence. Hispanics are one of the largest and fastest growing minority groups within the United States. The goal of this study was to identify Mexican immigrant mothers' perceptions and beliefs about language development, their children's disabilities, and therapy activities. Additionally, it explored how these perceptions and beliefs inform culturally responsive speech-language therapy with families of Mexican descent.

This study examined the relationships among academic stress, valuing of education, self-esteem, and educational self-efficacy for first-semester, female undergraduates and the interaction of race/ethnicity with these variables. Conducted at a large, southwestern university, this study was part of a comprehensive examination of psychosocial factors related to academic persistence decisions of 876, first-year college undergraduates, 549 (62.7%) of whom were women. The women's mean age was 18.27 years (SD = 1.56). Self-reported race/ethnicity revealed that 377 (68.3%) were Euro-American, 25 (4.6%) Asian American, 77 (14%) Latino, 7 (1.3%) international, 12 (2.2%) African American, 19 (3.5%) Native American, and 32 (5.8%) were biracial. The majority of the women were from in state (n = 339, 61.7%), and most were either living with family (n = 160, 29.1%) or on campus (n = 329, 59.9%). Self-reported high school grade point average (GPA) was 3.49 (SD = .39). Participants were recruited through more than 50 sections of 100-level classes and through ethnic and racial minority student organizations. Students were told that participation was voluntary, that participation was not related to their class grade, and that their responses would be kept confidential. A lottery gift of $100, $50, or $25 was offered to encourage participation. Approximately 90% of 1st-year female undergraduates who were recruited chose to participate and completed the survey packet. In addition to the demographic variables, the five constructs examined were personal and family valuing of education, self-esteem, educational self-efficacy, and academic stress. Overall, the findings present an interesting pattern. Mothers' education, fathers' education, family income, and high school GPAs were positively related to educational self-efficacy. The findings suggest that educational self-efficacy, personal valuing of education, family valuing of education, academic stress, and self-esteem are important for college women, in general, and do not necessarily interact with race/ ethnicity. The results also have implications for counseling practice and future research. The findings suggest that self-beliefs are more influential in determining college women's levels of educational self-efficacy than is family valuing of education and are also related to less academic stress. Future research, both quantitative and qualitative, should reexamine and extend the issues raised in this study.

Background: Doulas have been instrumental in providing breastfeeding support to nursing mothers before and during the COVID-19 pandemic, as they can significantly impact a mother's ability to initiate and maintain breastfeeding. However, the COVID-19 pandemic, subsequent lockdowns, and social isolation created challenges for nursing mothers to access doulas' services, usually provided in person. In this study, we examined the role of doulas in providing breastfeeding support during the COVID-19 pandemic, exploring adaptation to COVID-19 guidelines and the challenges doulas face in providing breastfeeding support during the pandemic. Methods: A systematic review was conducted following the PRISMA guidelines. Thirteen scientific databases and twenty peer-reviewed journals were searched for journal articles published in English between January 2020 and March 2022 using key search terms (e.g., Doula, Breastfeeding, COVID-19). Studies evaluating the role of doulas in providing breastfeeding support during COVID-19, and the impact of COVID-19 Guidelines on doula services, were included. Two reviewers independently performed the risk of bias assessment and data extraction. Summative content analysis was used to analyze the data. Results: The majority of studies were conducted in developed nations. This systematic review includes eight articles, four qualitative, one survey, two mixed-methods studies, and one prospective research study. Seven of the eight studies were conducted in the United States, and the eighth was conducted in multiple countries. These studies have three main themes: (1) virtual breastfeeding support provided by doulas during the pandemic; (2) remote social support provided by doulas to breastfeeding mothers during the pandemic; and (3) barriers to doula service delivery due to COVID-19 restrictions, primarily the exclusion of doulas as essential workers. The eight studies showed that doulas found innovative ways to serve the needs of birthing and nursing mothers during the difficulties brought on by the pandemic. Conclusion: Doulas provided breastfeeding support during the COVID-19 pandemic by utilizing innovative service delivery methods while navigating changes in COVID-19 guidance. However, system-level integration of doulas' work and the acknowledgment of doulas as essential healthcare providers are needed to enhance doula service delivery capacity, especially during a pandemic, to help improve maternal health outcomes. [ABSTRACT FROM AUTHOR]

COVID‐19 has infected millions of patients and impacted healthcare workers worldwide. Personal Protective Equipment (PPE) is a key component of protecting frontline clinicians against infection. The benefits of PPE far outweigh the risks, nonetheless, many clinicians are exhibiting skin injury caused by PPE worn incorrectly. These skin injuries, ranging from lesions to open wounds are concerning because they increase the susceptibility of viral infection and transmission to other individuals. Early into the COVID‐19 pandemic (April 2020), the U. S. National Pressure Injury Advisory Panel (NPIAP) developed a series of position statements to improve wear‐ability of PPE and protect healthcare professionals and their patients as safe from harm as possible under the circumstances. The NPIAP positions, which were formed by conducting a systematic review of what was known at the time, include: (a) Prepare skin before and after wearing PPE with skin sealants, barrier creams and moisturisers; (b) Frequent PPE offloading to relieve pressure and shear applied to skin; (c) treat visible skin injuries immediately caused by PPE to minimise future infection; (d) non‐porous dressings may provide additional skin protection, but lack evidence; (e) health systems should take care to educate clinicians about placement and personal hygiene related to handling PPE. Throughout all of these practices, handwashing remains a top priority to handle PPE. These NPIAP positions provided early guidance to reduce the risk of skin injury caused by PPE based on available research regarding PPE injuries, a cautious application of evidence‐based recommendations on prevention of device‐related pressure injuries in patients and the expert opinion of the NPIAP Board of Directors. Clinicians who adhere to these recommendations reduce the prospects of skin damage and long‐term effects (e.g. scarring). These simple steps to minimise the risk of skin injury and reduce the risk of coronavirus infection from PPE can help. [ABSTRACT FROM AUTHOR]

Background: The CDC recently reported that firearm homicide rates in the United States increased in 2020, particularly among Black/African American individuals and men 25–44 years old. It is unclear whether firearm hospitalizations also increased, and more importantly, what impact the COVID-19 pandemic and COVID-related policies had. Using the North Carolina Trauma Registry, a statewide registry of trauma admissions to eighteen North Carolina hospitals, we calculated weekly GSW hospitalization rates from 1/2019 to 12/2020, overall and stratified by race-ethnicity, age, and sex. Interrupted time-series design and segmented linear regression were used to estimate changes in weekly hospitalization rates over time after (1) U.S. declaration of a public health emergency; (2) statewide Stay-at-Home order; (3) Stay-at-Home order lifted with restrictions (Phase 2: Safer-at-Home); and (4) further lifting of restrictions (Phase 2.5: Safer-at-Home). Non-GSW assault hospitalizations were used as a control to assess whether trends were observed across all assault hospitalizations or if effects were specific to gun violence. Findings: Overall, 47.3% (n = 3223) of assault hospitalizations were GSW. Among GSW hospitalizations, median age was 27 years old (interquartile range [IQR] 21–25), 86.2% were male, and 49.5% occurred after the U.S. declared a public health emergency. After the Stay-at-Home order was implemented, weekly GSW hospitalization rates began increasing substantially among Black/African American residents (weekly trend change = 0.775, 95% CI = 0.254 to 1.296), peaking at an average 15.6 hospitalizations per 1,000,000 residents. Weekly hospitalization rates declined after restrictions were lifted but remained elevated compared to pre-COVID levels in this group (average weekly rate 10.6 per 1,000,000 at the end of 2020 vs. 8.9 per 1,000,000 pre-pandemic). The Stay-at-Home order was also associated with increasing GSW hospitalization rates among males 25–44 years old (weekly trend change = 1.202, 95% CI = 0.631 to 1.773); rates also remained elevated among 25–44-year-old males after restrictions were lifted in 2020 (average weekly rate 10.1 vs. 7.9 per 1,000,000). Non-GSW hospitalization rates were relatively stable in 2020. Conclusions: The COVID-19 pandemic and statewide Stay-at-Home orders appeared to have placed Black/African American residents and men ages 25–44 at higher risk for GSW hospitalizations, exacerbating pre-existing disparities. Persistent gun violence disparities must be addressed. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) is a conversation about values, future treatment choices, and designation of a surrogate decision-maker, held in advance of a health crisis. ACP protocols are established by home health agencies (HHAs) to support the staff in talking about patients' future treatment choices, which can include opting against acute care use. In 2016, Medicare implemented an experimental incentive program called Home Health Value-Based Purchasing (HHVBP) in 9 regionally representative states. These agencies were required to compete on value, where reimbursement rates were tied to outcomes in a Total Performance Score (TPS). With home health's aim of avoiding unplanned acute care use, in-patient hospitalization was weighted the heaviest as a poor outcome, followed by emergency department (ED) use. The purpose of this quasi-interventional study was to determine the relationship between advance care planning protocols and ED use among HHAs in the U. S. by the status of participation HHVBP intervention group. The Advance Care Planning Protocol (ACPP) score was measured by scoring survey questions. Our findings show (1) ACPP score intensity was higher in states that participated in the HHVBP program; (2) high measurement reliability for the ACPP scores; (3) no significant relationship between ACPP and ED use overall; but (4) the relationship between ACPP intensity and ED use was equal-and-opposite for the HHVBP and non-HHVBP groups. These findings suggest that the HHVBP intervention altered the influence of ACPP intensity on ED use. Recommendations are made for the HHVBP program regarding ACP's role in goal-concordant care. [ABSTRACT FROM AUTHOR]

Objectives: Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods: Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results: For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P <.05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions: Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy. [ABSTRACT FROM AUTHOR]

To date, 110,000+ people in the United States have died from the COVID-19 pandemic. In this paper, the authors will discuss COVID-19 relative to Black people and their overrepresentation among those who are infected and died from the disease. Their dying, death, and grief experiences are explored through a cultural and spiritual lens. The physical distancing, social isolation, misinformation, and restrictive burials and cremations now elicited by this unprecedented pandemic have had diminished familial, cultural, emotional, and economic impacts on the Black community. Implications for public health and Black peoples' involvement in the political process are also addressed. [ABSTRACT FROM AUTHOR]

Dying, death, and grief are universal human experiences that are impacted by cultural values and beliefs. We provide service providers a context from which to consider the importance of spirituality and religiosity in the grief process and the variances in grief practices that exist within the Black community. This knowledge can serve as a catalyst for developing culturally appropriate interventions for Black people aimed at helping them to more effectively cope with grief and further enabling them to thrive rather than merely survive a sociopolitical US climate that is laden with grief producing experiences. [ABSTRACT FROM AUTHOR]

Advance care planning is a conversation about personal values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on advance care planning have taken place outside of home health among populations with HIV/AIDS, cancer, dementia, and end stage renal disease. The U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses, and hospitalization is a poor outcome. In 2016, Medicare implemented the Home Health Value-Based Purchasing Model, in which reimbursement rates for agencies in 9 regionally representative states were dependent on quantitative measures of quality performance. Part of the program was a process-level mandate requiring agencies to report on advance care planning. The aim of this study was to examine the relationship of home health advance care planning protocols with hospitalization rates. Descriptive and regression analyses were conducted on survey data of protocols and agency data of demographics and outcomes. Statistical significance was found in the positive correlation between advance care planning protocols and hospitalization. Recommendations are made for broadening the scope of evaluation of quality in home health to include goal-concordant care and transitions to appropriate services. [ABSTRACT FROM AUTHOR]

The avemge age of individuals in the United States and worldwide is steadily increasing, resulting in an increase in the number of older, terininally ill adults who may seek counseling for end-of-life decisions. Euthaimsia is one such end-of-life option that is emerging iii the United States. Physicicm-assisted dying, currently the only legal form of active euthanasia in eight states and the District of Columbia, is a relatively new and often misuitderstood eitd-oflife option. Although arguments continue about this issue, the American Mental Health Counselors Association has developed ethical codes to guide mental health counselors working with terminally ill clients making end-of-life decisions. The core moral and ethical principles of autonomy, betteficence, nonmaleficence, justice,/idelity, and veracity provide guidance/6r helping tenninally ill clients explore end-o/-life options that could include physician-assisted dying when it is a legally viable option. Additional recommendations are made for increasing intellectual and emotional competence regarding euthanasia. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective study used a cochlear implant registry to determine how performing speech recognition candidacy testing in quiet versus noise influenced patient selection, speech recognition, and self-report outcomes. Method: Database queries identified 1,611 cochlear implant recipients who were divided into three implant candidacy qualifying groups based on preoperative speech perception scores (≤ 40% correct) on the AzBio sentence test: quiet qualifying group, +10 dB SNR qualifying group, and +5 dB SNR qualifying group. These groups were evaluated for demographic and preoperative hearing characteristics. Repeated-measures analysis of variance was used to compare pre- and postoperative performance on the AzBio in quiet and noise with qualifying group as a between-subjects factor. For a subset of recipients, pre- to postoperative changes on the Speech, Spatial and Qualities of Hearing Scale were also evaluated. Results: Of the 1,611 patients identified as cochlear implant candidates, 63% of recipients qualified in quiet, 10% qualified in a +10 dB SNR, and 27% qualified in a +5 dB SNR. Postoperative speech perception scores in quiet and noise significantly improved for all qualifying groups. Across qualifying groups, the greatest speech perception improvements were observed when tested in the same qualifying listening condition. For a subset of patients, the total Speech, Spatial and Qualities of Hearing Scale ratings improved significantly as well. Conclusion: Patients who qualified for cochlear implantation in quiet or background noise test conditions showed significant improvement in speech perception and quality of life scores, especially when the qualifying noise condition was used to track performance. [ABSTRACT FROM AUTHOR]

On December 19, 2019, the Food and Drug Administration (FDA) approved rVSVΔG-ZEBOV-GP Ebola vaccine (ERVEBO, Merck) for the prevention of Ebola virus disease (EVD) caused by infection with Ebola virus, species Zaire ebolavirus, in adults aged ≥18 years. In February 2020, the Advisory Committee on Immunization Practices (ACIP) recommended preexposure vaccination with ERVEBO for adults aged ≥18 years in the United States who are at highest risk for potential occupational exposure to Ebola virus because they are responding to an outbreak of EVD, work as health care personnel at federally designated Ebola treatment centers in the United States, or work as laboratorians or other staff members at biosafety level 4 facilities in the United States (1). [ABSTRACT FROM AUTHOR]

Background Cochlear implant qualifying criteria for adult patients with public insurance policies are stricter than the labeled manufacturer criteria. It remains unclear whether insurance payer status affects expedient access to implants for adult patients who could derive benefit from the devices. Purpose This study examined whether insurance payer status affected access to cochlear implant services and longitudinal speech-perception outcomes in adult cochlear implant recipients. Research Design Retrospective cross-sectional study. Study Sample Sixty-eight data points were queried from the Health Insurance Portability and Accountability Act--Secure, Encrypted, Research Management and Evaluation Solution database which consists of 12,388 de-identified data points from adult and pediatric cochlear implant recipients. Data Analysis Linear mixed-effects models were used to determine whether insurance payer status affected expedient access to cochlear implants and whether payer status predicted longitudinal postoperative speech-perception scores in quiet and noise. Results Results from linear mixed-effects regression models indicated that insurance payer status was a significant predictor of behavioral speech-perception scores in quiet and in background noise, with patients with public insurance experiencing poorer outcomes. In addition, extended wait time to receive a cochlear implant was predicted to significantly decrease speech-perception outcomes for patients with public insurance. Conclusion This study documented patients covered by public health insurance wait longer to receive cochlear implants and experience poorer postoperative speechperception outcomes. These results have important clinical implications regarding the cochlear implant candidacy criteria and intervention protocols. [ABSTRACT FROM AUTHOR]

Background: Birth defects are established risk factors for childhood cancer. Nonetheless, cancer epidemiology in children with birth defects is not well characterized.Methods: Using data from population-based registries in 4 US states, this study compared children with cancer but no birth defects (n = 13,111) with children with cancer and 1 or more nonsyndromic birth defects (n = 1616). The objective was to evaluate cancer diagnostic characteristics, including tumor type, age at diagnosis, and stage at diagnosis.Results: Compared with the general population of children with cancer, children with birth defects were diagnosed with more embryonal tumors (26.6% vs 18.7%; q < 0.001), including neuroblastoma (12.5% vs 8.2%; q < 0.001) and hepatoblastoma (5.0% vs 1.3%; q < 0.001), but fewer hematologic malignancies, including acute lymphoblastic leukemia (12.4% vs 24.4%; q < 0.001). In age-stratified analyses, differences in tumor type were evident among children younger than 1 year and children 1 to 4 years old, but they were attenuated among children 5 years of age or older. The age at diagnosis was younger in children with birth defects for most cancers, including leukemia, lymphoma, astrocytoma, medulloblastoma, ependymoma, embryonal tumors, and germ cell tumors (all q < 0.05).Conclusions: The results indicate possible etiologic heterogeneity in children with birth defects, have implications for future surveillance efforts, and raise the possibility of differential cancer ascertainment in children with birth defects.Lay Summary: Scientific studies suggest that children with birth defects are at increased risk for cancer. However, these studies have not been able to determine whether important tumor characteristics, such as the type of tumor diagnosed, the age at which the tumor is diagnosed, and the degree to which the tumor has spread at the time of diagnosis, are different for children with birth defects and children without birth defects. This study attempts to answer these important questions. By doing so, it may help scientists and physicians to understand the causes of cancer in children with birth defects and diagnose cancer at earlier stages when it is more treatable. [ABSTRACT FROM AUTHOR]

Background: Implementation theories, models and frameworks offer guidance when implementing and sustaining healthcare evidence-based interventions. However, selection can be challenging given the myriad of potential options. We propose to inform a decision support tool to facilitate the appropriate selection of an implementation theory, model or framework in practice. To inform tool development, this study aimed to explore barriers and facilitators to identifying and selecting implementation theories, models and frameworks in research and practice, as well as end-user preferences for features and functions of the proposed tool.Methods: We used an interpretive descriptive approach to conduct semi-structured interviews with implementation researchers and practitioners in Canada, the United States and Australia. Audio recordings were transcribed verbatim. Data were inductively coded by a single investigator with a subset of 20% coded independently by a second investigator and analyzed using thematic analysis.Results: Twenty-four individuals participated in the study. Categories of barriers/facilitators, to inform tool development, included characteristics of the individual or team conducting implementation and characteristics of the implementation theory, model or framework. Major barriers to selection included inconsistent terminology, poor fit with the implementation context and limited knowledge about and training in existing theories, models and frameworks. Major facilitators to selection included the importance of clear and concise language and evidence that the theory, model or framework was applied in a relevant health setting or context. Participants were enthusiastic about the development of a decision support tool that is user-friendly, accessible and practical. Preferences for tool features included key questions about the implementation intervention or project (e.g., purpose, stage of implementation, intended target for change) and a comprehensive list of relevant theories, models and frameworks to choose from along with a glossary of terms and the contexts in which they were applied.Conclusions: An easy to use decision support tool that addresses key barriers to selecting an implementation theory, model or framework in practice may be beneficial to individuals who facilitate implementation practice activities. Findings on end-user preferences for tool features and functions will inform tool development and design through a user-centered approach. [ABSTRACT FROM AUTHOR]

Background: Early hospital readmission for patients with cirrhosis continues to challenge the healthcare system. Risk stratification may help tailor resources, but existing models were designed using small, single-institution cohorts or had modest performance.Aims: We leveraged a large clinical database from the Department of Veterans Affairs (VA) to design a readmission risk model for patients hospitalized with cirrhosis. Additionally, we analyzed potentially modifiable or unexplored readmission risk factors.Methods: A national VA retrospective cohort of patients with a history of cirrhosis hospitalized for any reason from January 1, 2006, to November 30, 2013, was developed from 123 centers. Using 174 candidate variables within demographics, laboratory results, vital signs, medications, diagnoses and procedures, and healthcare utilization, we built a 47-variable penalized logistic regression model with the outcome of all-cause 30-day readmission. We excluded patients who left against medical advice, transferred to a non-VA facility, or if the hospital length of stay was greater than 30 days. We evaluated calibration and discrimination across variable volume and compared the performance to recalibrated preexisting risk models for readmission.Results: We analyzed 67,749 patients and 179,298 index hospitalizations. The 30-day readmission rate was 23%. Ascites was the most common cirrhosis-related cause of index hospitalization and readmission. The AUC of the model was 0.670 compared to existing models (0.649, 0.566, 0.577). The Brier score of 0.165 showed good calibration.Conclusion: Our model achieved better discrimination and calibration compared to existing models, even after local recalibration. Assessment of calibration by variable parsimony revealed performance improvements for increasing variable inclusion well beyond those detectable for discrimination. [ABSTRACT FROM AUTHOR]

Background: This study examines relations between parent and youth physical activity (PA; days per week), sports participation, and overweight (BMI ≥ 85th percentile) among U.S. youth, and whether this relationship varies by immigrant generation and sex. Methods: Participants included 28,691 youth ages 10-17 years from the 2007 National Survey of Children's Health. Youth were grouped into first, second, and third or higher generation. Primary analyses include Chi-square and post hoc tests to assess mean differences, and adjusted logistic regressions to test associations between weight status and independent variables. Results: Each additional day youth participated in PA decreased their odds of overweight (OW) by 10% [OR: 0.90 (0.87-0.94)]; participation in sports significantly reduced their odds of OW by 17% [OR: 0.83 (0.71-0.98)]. First generation boys who participated in sports had 70% lower odds of OW [OR: 0.30 (0.11-0.83)] compared with first generation boys who did not participate in sports. For third generation girls, participation in sports reduced the odds of OW by 23% [OR: 0.77 (0.62-0.96)] compared with those who did not participate in sports. Conclusion: The protective influence of PA on youth's risk of OW varies by immigrant generation and sex. Parent PA was not related to youth's risk of OW. [ABSTRACT FROM AUTHOR]

Research on the effectiveness of clinical mock boards for future oral health professionals is conflicting and limited. Despite this, U.S. dental hygiene programs rely on clinical mock board experiences as essential components for preparing students for their clinical board examinations. Differences in programs' mock board characteristics may relate to board exam outcomes. The validity and reliability of mock boards can be questioned when deviations from exam criteria and procedures are made and grading mechanisms are not consistent. The aim of this study was to determine which mock board characteristics were critical in preparing students by exploring the relationships between programs' dental hygiene, local anesthesia, and restorative mock boards and their 2013-14 candidates' performance on the corresponding three Western Regional Examining Board (WREB) licensure exams. Of the 23 U.S. dental hygiene education programs in four states invited to participate, 15 agreed to do so, and 13 consented to have WREB provide their programs' test result data. The mock board coordinators provided data on characteristics of their programs' mock boards with an online questionnaire distributed in 2014. Scores calculated from the responses were compared to performance of the programs' candidates on the corresponding WREB exam. Of the 45 questionnaires (on three exams each x 15 programs), 33 were completed (73.3%). Significant relationships were found between candidates' WREB exam results and the mock boards' intensity scores, remediation, multiple experiences, and examiner calibration scores. The results of this study provide fundamental information about mock board characteristics that may assist educators in facilitating experiences to more effectively prepare students for these high-stakes exams. [ABSTRACT FROM AUTHOR]

Background Emergency medicine (EM) pharmacists are increasingly recognized as integral team members in the care of emergency department (ED) patients but there is variability in the scope of direct patient care services. Objectives The primary objective was to categorize direct patient care activities and drug therapy recommendations. The secondary objectives were to categorize recommendations based on drug class and to determine the proportion of recommendations associated with Institute for Safe Medication Practices (ISMP) high-alert medications. Methods This retrospective, single-center, chart review was conducted in an academic ED with 65,000 annual visits. EM pharmacists documented direct patient care activities in the electronic health record. Documented activities from 1/1/2015 through 3/31/2015 were abstracted electronically for analysis by a trained reviewer. Results There were 3567 interventions and direct patient care activities documented. The most common activities were facilitation of medication histories (n = 1300) and drug therapy recommendations (n = 1165). Of 1165 drug therapy recommendations, 986 were linked to a drug class such as antimicrobial agents (31.9%), cardiovascular agents (16.6%), and analgesic agents (13.2%) and 20% of these interventions were associated with ISMP high-alert medications. Conclusion EM pharmacists documented several types of direct patient care activities with the majority being drug therapy recommendations and medication histories. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate possible use for cone‐beam computed tomography (CBCT) guidance, this phantom study evaluated the contrast enhancement provided by Gadoxetate Disodium (Primovist® CAN/EU, or Eovist® USA, Bayer Healthcare, Leverkusen, Germany), a contrast agent that is taken up selectively by liver cells and is retained for up to an hour. Image quality from CBCT was benchmarked against helical fan‐beam computed tomography for two phantom geometries. Methods and Materials: Concentrations were diluted to 0.0125–0.1 mmol per kilogram of body weight (mmol/kg) corresponding to expected physiological concentrations in the liver. Kilovoltage CBCT imaging parameters of x‐ray tube potential, current, and filtration were investigated using clinically available options on a TrueBeam STx linear accelerator CBCT platform. Two phantoms were created, a cylindrical idealized imaging geometry and an ellipsoidal more realistic abdominal geometry. All parameters were optimized according to the contrast‐to‐noise ratio (CNR) image quality metric, as a function of concentration, following the Rose criterion for CNR. Results: Acceptable CNR was defined as greater than or equal to three, in accordance with the Rose criterion for CNR. These were found in a range of expected liver concentrations of 0.025–0.1 mmol/kg for a tube potential of 100 kVp, half‐fan bowtie filtration and tube currents giving exposures between 2025 and 5085 mAs. Linear correlations were found for all CNR as a function of concentration, in agreement with the literature. Conclusion: Based on this phantom study, with appropriate selection of imaging protocol, Gadoxetate Disodium may provide useful liver CBCT enhancement at physiologically achievable liver concentrations. [ABSTRACT FROM AUTHOR]

Introduction: Most successful trials of financial incentives for smoking cessation have offered large rewards contingent on outcomes. This study examines whether more modest incentives to encourage engagement, non-contingent on outcomes, also increase cessation; whether sending medications directly to participants boosts quitting; and whether these strategies are effective in Medicaid.Study Design: Three-group RCT of usual care (UC); nicotine patch (NP); and NP and financial incentive (NP+FI).Setting/participants: Medicaid beneficiaries calling the California Smokers' Helpline, 2012-2013 (N=3,816). Data were analyzed in 2017.Intervention: All participants enrolled in evidence-based, multisession telephone counseling. All received proof of enrollment with which they could obtain free quitting aids at their pharmacy. NP and NP+FI also received nicotine patches sent to their homes. NP+FI received up to $60 for completing counseling calls.Main Outcome Measures: Quit attempt rate, 7-day and 30-day abstinence at 2 and 7 months, and 6-month prolonged abstinence (primary outcome).Results: In both complete-case and intention-to-treat analyses, outcomes trended upward from UC to NP to NP+FI. Differences between NP and UC were generally nonsignificant. By contrast, the NP+FI group significantly outperformed the other groups on all measures. In intention-to-treat analysis, compared with UC, NP+FI was more likely to make a quit attempt (68.4% vs 54.3%, p<0.001); be abstinent for 7 days at 2 months (36.1% vs 25.5%, p<0.001) and 7 months (21.2% vs 16.1%, p=0.002); be abstinent for 30 days at 2 months (30.0% vs 18.9%, p<0.001) and 7 months (21.5% vs 16.7%, p=0.004); and achieve 6-month prolonged abstinence (13.2% vs 9.0%, p=0.001).Conclusions: Financial incentives increased treatment engagement and short- and long-term smoking cessation, despite being modest and non-contingent on outcomes. The study found that incentives can be effective in a Medicaid population, and can feasibly be integrated into existing quitline services.Trial Registration: The trial is registered at www.clinicaltrials.gov NCT01502306.Supplement Information: This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health. [ABSTRACT FROM AUTHOR]

In this article, we replicate and extend several elements of E. Foxman, P. Tansuhaj, and K. Ekstrom's 1989 study of adolescent influence, while providing an integrative model of teenager influence and a new scale of perceived relative influence. Further, we examine the effect of parental employment status on teens' influence, as well as gender-based differences in perceptions. Motivational aspects, including product importance and usage, provided the strongest and most consistent explanations of teenagers' perceived relative influence across stages and purchase situations. In addition, parental employment status positively influenced teens' perceived influence of durable family purchases. Mothers and daughters generally did not differ in their ratings of the daughters' perceived influence in the durable purchase decision-making process, while fathers' and sons' ratings did differ. [ABSTRACT FROM AUTHOR]

This article compares and contrasts two methods of measuring consumer values: the List of Values (LOV) and Values and Life Style (VALS). LOV apparently has some advantages: it is in the public domain and it relates more closely to consumer behavior. [ABSTRACT FROM AUTHOR]

Latinos, particularly Mexican immigrants, are the fastest-growing population in the United States but lag behind others in educational attainment. Parent involvement in their child's education has been linked to positive student academic outcomes, but few studies have focused specifically on Latino/a parents. To identify and promote culturally salient parent involvement approaches for Mexican immigrant parents, this qualitative strength-based study investigated motivations, actions, and culture of 11 Mexican immigrant parents of students who attended a selective college preparatory high school. The study found that a parent's effort to help their children succeed is not dependent on high levels of parent education or income. Rather, the home-based strategies, many of which are rooted in the Latino culture, and specific outreach by educators influenced parent involvement. [ABSTRACT FROM AUTHOR]

Recent high-profile killings of unarmed Black males underscore a stark reality in America: though Black men have the same constitutional rights as all other citizens of the United States, in practice their rights are often violated. The negative stereotype that all Black males are criminals has created an environment that perpetuates the killing of unarmed Black males by police officers as justifiable self-defense. In this article, critical race theory (CRT) provides a theoretical lens to examine and understand the persistent racism underlying the social inequities that have been thrust upon Black males in the United States of America. The authors conclude with implications and recommendations for social work education. [ABSTRACT FROM AUTHOR]

Aims To estimate the prevalence and predictors of failed biochemical verification of self-reported abstinence among participants enrolled in trials of hospital-initiated smoking cessation interventions. Design Comparison of characteristics between participants who verified and those who failed to verify self-reported abstinence. Settings Multi-site randomized clinical trials conducted between 2010 and 2014 in hospitals throughout the United States. Participants Recently hospitalized smokers who reported tobacco abstinence 6 months post-randomization and provided a saliva sample for verification purposes ( n = 822). Measurements Outcomes were salivary cotinine-verified smoking abstinence at 10 and 15 ng/ml cut-points. Predictors and correlates included participant demographics and tobacco use; hospital diagnoses and treatment; and study characteristics collected via surveys and electronic medical records. Findings Usable samples were returned by 69.8% of the 1178 eligible trial participants who reported 7-day point prevalence abstinence. The proportion of participants verified as quit was 57.8% [95% confidence interval (CI) = 54.4, 61.2; 10 ng/ml cut-off] or 60.6% (95% CI = 57.2, 63.9; 15 ng/ml). Factors associated independently with verification at 10 ng/ml were education beyond high school education [odds ratio (OR) = 1.51; 95% CI = 1.07, 2.11], continuous abstinence since hospitalization (OR = 2.82; 95% CI = 2.02, 3.94), mailed versus in-person sample (OR = 3.20; 95% CI = 1.96, 5.21) and race. African American participants were less likely to verify abstinence than white participants (OR = 0.64; 95% CI = 0.44, 0.93). Findings were similar for verification at 15 ng/ml. Verification rates did not differ by treatment group. Conclusions In the United States, high rates (40%) of recently hospitalized smokers enrolled in smoking cessation trials fail biochemical verification of their self-reported abstinence. [ABSTRACT FROM AUTHOR]

Background/Objectives U.S. adults and children are equally likely to have allergic contact dermatitis. Historically the narrow geographic location of data-reporting providers has quantitatively and qualitatively limited the pediatric contact dermatitis data. The Pediatric Contact Dermatitis Registry was used to evaluate self-identified pediatric patch test providers within the United States with regard to demographic characteristics, geographic location, and practice patterns. Methods A wide range of U.S. providers were invited to join the registry by completing a secure online 11-question registration survey. Results There were 252 respondents from 50 states and the District of Columbia; 28.6% were pediatric dermatologists and members of the Society for Pediatric Dermatology ( SPD), and 38% were members of the American Contact Dermatitis Society. The cumulative range of pediatric patch-test evaluations performed each year was 1,726 to 4,613 children. SPD members had a significantly greater likelihood of performing a commercially available patch test (odds ratio 7.14 [95% confidence interval 5.11, 9.97], p < .001) than those who were not SPD members. SPD members also had significantly lower odds of performing North American Contact Dermatitis Group standard tests than nonmembers. Conclusions The frequency of patch test evaluations in children is significantly underreported. This study provides insight into the practice patterns of various providers who are patch testing children and makes recommendations for evidence-based modifications regarding these practices. Limitations of the study include survey responder selection bias and small sample size. [ABSTRACT FROM AUTHOR]

Using the theoretical scaffold of the relative deprivation theory, we present a commentary that delineates: (a) the 4 stages of social movements (e.g., emergence, coalescence, bureaucratization, and decline) and (b) sociopolitical and ethno-generational leadership, networks, narratives and tactics of the Civil Rights Movement compared with the Black Lives Matter. We provide a commentary on the 2 social movements’ precipitating events during the emergence and coalescence stages. Also, the social-psychological pressures of mainstream social justice protest during the bureaucratization and decline stages are explored to highlight the emotional toil that threaten social movements and the lives of its leaders. [ABSTRACT FROM PUBLISHER]

With 87% of providers using electronic health records (EHRs) in the United States, EHRs have the potential to contribute to population health surveillance efforts. However, little is known about using EHR data outside syndromic surveillance and quality improvement. We created an EHR-based population health surveillance system called the New York City (NYC) Macroscope and assessed the validity of diabetes, hyperlipidemia, hypertension, smoking, obesity, depression, and influenza vaccination indicators. The NYC Macro-scope uses aggregate data from a network of outpatient practices. We compared 2013 NYC Macro-scope prevalence estimates with those from a population-based, in-person examination survey, the 2013-2014 NYC Health and Nutrition Examination Survey. NYC Macroscope diabetes, hypertension, smoking, and obesity prevalence indicators performed well, but depression and influenza vaccination estimates were substantially lower than were survey estimates. Ongoing validation will be important to monitor changes in validity over time as EHR networks mature and to assess new indicators. We discuss NYC's experience and how this project fits into the national context. Sharing lessons learned can help achieve the full potential of EHRs for population health surveillance [ABSTRACT FROM AUTHOR]

Research has identified differences in partisan communication styles, cognitive processing, values, and cultures. This article assesses if there are also differences in how Democrats and Republicans conceive of electoral participation. We submitted 1,730 open-ended responses from a 2016 survey prompt soliciting thoughts and feelings about voting to computerized content analysis. Findings show that Republicans employed more confident and less negative language than Democrats in their responses. Additionally, a close read of the Republican statements reveals how they expressed that their electoral participation matters. Our conclusion addresses how the traditional ideals often associated with the Grand Old Party may make them a more duty-based constituency valuing voting more than their less conservative peers. [ABSTRACT FROM AUTHOR]

Evidence-based practice standards are not yet well defined for assisting potential victims of human trafficking. Nonetheless, health care professionals are learning to be first responders in identifying, treating, and referring potential victims. As more public and private sector resources are used to train health care professionals about human trafficking, more evaluation and research are needed to develop an effective standard of care. Adopting a public health lens and using the "National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care" can guide critical decision making and actions. Through collaboration between researchers and policymakers, lessons learned in health care settings can inform future evidence-based standards of care so that all patients receive the services that they need. [ABSTRACT FROM AUTHOR]

Background and Aims Clinical trials on the impact and safety of reduced nicotine content cigarettes (RNCs) are ongoing, and an important methodological concern is participant compliance with smoking only RNCs. Our aims were to measure non-compliance biochemically with urine cotinine (COT) and total nicotine equivalents (TNEs), compare with self-reported non-compliance and identify associated covariates. Design Secondary analysis of a double-blind, parallel, randomized clinical trial. Setting Research centers from the United States, enrolling participants from June 2013 to July 2014. Participants Volunteer sample of 242 participants (55% Caucasian), average age of 41.2 years, smoking at least five cigarettes per day (CPD). Intervention Smoking very low nicotine cigarettes (VLNCs; 0.4 mg nicotine/g tobacco) for 6 weeks. Measurements The primary outcome was biochemically verified non-compliance, measured as thresholds of COT/CPD and TNE/CPD ratios, considering changes in nicotine content from conventional levels to VLNCs, and as an absolute threshold of week 6 TNEs. Self-reported non-compliance was measured via daily phone calls. Key predictors included age, sex, race, menthol preference, nicotine metabolite ratio, time to first cigarette, dependence, CPD, TNEs, tar level and cigarette evaluation. Findings Estimates of non-compliance with smoking the VLNCs exclusively include: the biochemical ratios (both 78%), the week 6 TNE threshold (76%) and self-report (39%). Of the key covariates, age, dependence and cigarette evaluations of satisfaction were significant; for age, younger participants more likely to be non-compliant [ P = 0.01; odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.96-0.99]. Dependence was associated significantly with self-reported non-compliance ( P = 0.01; OR = 1.28, 95% CI = 1.06-1.55). Cigarette evaluations of satisfaction were associated significantly with non-compliance ( P = 0.001; OR = 0.71, 95% CI = 0.61-0.82). Conclusions Among smokers volunteering to smoke only very low nicotine cigarettes for 6 weeks, non-compliance was common and biochemical assessments detected more cases of non-compliance than self-report. Despite high levels of non-compliance, smokers reduced their intake of nicotine by an average of 60%. [ABSTRACT FROM AUTHOR]

Background Varenicline is known to have greater efficacy than other pharmacotherapy for treating nicotine dependence and has gained popularity since its introduction in 2006. This study examines if adding varenicline to existing pharmacotherapies increased the population cessation rate. Methods Data are from two cross-sectional US Current Population Surveys--Tobacco Use Supplements (2003 and 2010-2011). Smokers and recent quitters 18 or older (N=34 869 in 2003, N=27 751 in 2010-2011) were asked if they had used varenicline, bupropion or nicotine replacement therapies (NRT) in their most recent quit attempt. The annual cessation rate, as well as the per cent of smokers who had quit for ≥3 months, was compared between surveys. Results Varenicline use increased from 0% in 2003 to 10.9% in 2010--2011, while use of bupropion decreased from 9.1% to 3.5%, and NRT from 24.5% to 22.4%. Use of any pharmacotherapy increased by 2.4 percentage points. Varenicline users stayed on cessation aids longer and were less likely to relapse than users of other pharmacotherapies in the first 3 months of a quit attempt, after which the difference was no longer significant. The change in annual cessation rate was negligible, from 4.5% in 2003 to 4.7% in 2010--2011 (p=0.36). Conclusions Addition of varenicline to the list of approved cessation aids has mainly led to displacement of other therapies. As a result, there was no meaningful change in population cessation rate despite a remarkable increase in varenicline use. The population impact of a new therapy is a function of more than efficacy or reach of the therapy. [ABSTRACT FROM AUTHOR]

A drug is a particular substance in physiology that exerts an effect when ingested or otherwise introduced into the body. Drugs may be administered in a variety of constitutions from capsules, injections, creams, and ointments to inhalants, liquids, and dermal patches. Administration is by way of different routes, namely, topical, parenteral, inhalation, and via injection routes such as subcutaneous, intramuscular, or intravenous. The purpose of this column is to direct the reader's attention to some of the more common drugs used in dermatology. The mechanism of action for the drug, the indications for its use, efficacy, dosing and administration, monitoring guidelines, adverse side effects, and any standard alternatives are discussed. In addition, this column contains pertinent patient education on the use of the medication. This article focuses on a common medication for plaque psoriasis, adalimumab. [ABSTRACT FROM AUTHOR]

Pediatric allergic contact dermatitis (ACD) has been increasingly recognized in the United States. Reported rates of positive patch tests in children referred for suspected ACD range between 27 and 95.6%. Many young children are becoming sensitized to contact allergens found in personal hygiene products. We reviewed five recent pediatric patch test studies to determine the top allergens associated with this source of ACD in children. The top ten allergens were neomycin, balsam of Peru, fragrance mix, lanolin, cocamidopropylbetaine, formaldehyde, corticosteroids, methylchlorisothiazolinone (MCI)/methylisothiazolinone (MI), propylene glycol, and benzalkonium chloride. We estimate that one third of children suffering from ACD could potentially benefit from a ‘pre-emptive avoidance strategy’ (P.E.A.S.) of the stated top 10 allergens. [ABSTRACT FROM AUTHOR]

Police shootings of young Black males that ultimately result in their death have become an all-too-common occurrence in this country. The deaths of Michael Brown and Eric Gardner have highlighted police relations with this population. Before viable solutions can be established, a number of areas need to be addressed that relate to the historical context in which police relations with this group exist that impact current relations between the police and young Black males, why their lives are seemingly given less value by society than those of their White counterparts, the role that spirituality and religiosity play that may help to make connections between them and the police, and the benefit of the Black church in fostering amicable police relations with young Black males. This article addresses these issues and concludes with recommendations for how the social work and human services professions, along with the Black church and police, can be responsive and proactive in addressing this social problem. [ABSTRACT FROM PUBLISHER]

Background: In order to develop effective physical activity interventions and to address the burden of obesity in Hispanic children, qualitative studies are needed to build descriptive theory and expand the state of the science. The purpose of this study is to describe physical activity perceptions, context, facilitators, and barriers from the perspective of Hispanic immigrant-origin children. Method: This in-depth, ethnographic study included 14, 6- to 11-year old, first- and second- generation Hispanic children recruited from an afterschool program in Southeastern Pennsylvania, USA. Methods included child observation, field notes, semi-structured interviews, and a Photo Voice activity. Transcripts and field notes were coded and analyzed using the constant comparison method to identify overarching themes and patterns in the data. Results: Data analysis yielded four overarching themes regarding children's perspectives on physical activity. Children engaged in a variety of physical activities and sedentary behaviors, which differed by physical (e.g., park, outside home, and afterschool programs) and social (e.g., parents, siblings, and friends) contexts. Children discussed specific benefits of physical activity. Children's negative attitudes toward physical activity were related to physical discomfort, low athletic competence, and safety concerns. Children perceived physical activity and play to be one in the same, and "fun" was identified as a primary driver of physical activity preferences. The facilitators and barriers to physical activity were related to specific parent/home, school, and neighborhood factors. Conclusion: Findings from this study suggest that an emphasis on fun and active play, while taking into account family and neighborhood context, may be a desirable intervention approach in Hispanic immigrant-origin children. This study lays the groundwork for future studies to further explore some of the themes identified here to better understand children's conceptualization of and experience with physical activity. Such research may inform the design of programs to increase physical activity or active play, and ultimately promote health and well-being, in this at-risk population. [ABSTRACT FROM AUTHOR]