Measuring the Cultural Competence of Latinx Domestic Violence Service Organizations

Domestic violence (DV) represents a significant public health concern in the United States, including among Latinx populations. Despite the negative consequences associated with experiencing DV, research has shown that Latinx DV survivors may be less likely than others to utilize important services. One potential barrier is cultural competence (CC) in the provision of services specific to Latinx survivors among DV organizations. Thus, a beneficial addition to the field of DV service provision for such survivors is a better understanding and measurement of CC for this unique population. The exploratory, cross-sectional study herein presents the development and evaluation of a novel instrument for measuring the CC of DV organizations. Exploratory factor analysis was used on a purposive sample of 76 organizations in North Carolina who completed a comprehensive survey on their characteristics, practices, norms, and values. Psychometric results found best support for a 29-item, 4-factor bifactor model with both a general CC factor as well as three sub-factors. The general scale was named “General Cultural Competence,” while the three sub-scales were named “Organizational Values and Procedures,” “Latinx Knowledge and Inclusion,” and “Latinx DV Knowledge.” The final measure also demonstrated convergent validity with key organizational characteristics. Overall, higher CC scores were associated with organizations having more DV services in Spanish, a higher percentage of staff attending CC training, a higher percentage of staff attending Latinx service provision training, and a medium or greater presence in the Latinx community, and a moderate or stronger relationship with the Latinx community. The development of this measure is particularly useful in addressing knowledge gaps regarding the measurement of CC for Latinx DV services. Implications have importance for both the measurement of organizational CC and the scope of the measure’s associations with organizational, provider, and client outcomes

Developing Evaluation Approaches for an Anti-Human Trafficking Housing Program

The increasing number of anti-trafficking organizations and funding for anti-trafficking services have greatly out-paced evaluative efforts resulting in critical knowledge gaps, which have been underscored by recent recommendations for the development of greater evaluation capacity in the anti-trafficking field. In response to these calls, this paper reports on the development and feasibility testing of an evaluation protocol to generate practice-based evidence for an anti-trafficking transitional housing program. Guided by formative evaluation and evaluability frameworks, our practitioner-researcher team had two aims: (1) develop an evaluation protocol, and (2) test the protocol with a feasibility trial. To the best of our knowledge, this is one of only a few reports concerning anti-trafficking housing program evaluations, particularly one with many foreign-national survivors as evaluation participants. In addition to presenting evaluation findings, the team herein documented decisions and strategies related to conceptualizing, designing, and conducting the evaluation to offer approaches for future evaluations

Understanding Intimate Partner Violence Service Delivery for Latinx Survivors in Rural Areas

Using a statewide survey, this exploratory, cross-sectional study examined 78 domestic violence (DV) service organizations? service delivery practices and perceived challenges to serving Latinx survivors in the context of rurality. Findings showed that DV organizations in rural areas perceived more challenges to delivering culturally appropriate services for Latinx survivors compared to those in other geographic settings even after accounting for client characteristics, service provision characteristics, and community resources. The study finding offers critical insights to ensure and enhance the provision of linguistically and culturally accessible services for rural Latinx survivors of intimate partner violence

Product attributes important to US adult consumers' use of electronic nicotine delivery systems: A discrete choice experiment

Objective To understand the importance of electronic nicotine delivery systems (ENDS) product attributes to adult consumers in the USA by age and gender. Design Cross-sectional survey with a discrete choice experiment (best-worst, case 2, scaling) of 19 choice tasks in which participants answered what would make them most want to use and least want to use an ENDS product. Setting and participants A national sample of adults (aged 18+ years) in the USA who had tried an ENDS product at least once. Measures We included 9 ENDS attributes with levels that varied across 19 choice tasks. We performed a multinomial logistic regression to obtain overall importance scores, attribute-level part-worth utilities and most important attribute. Results Of 660 participants, 81% were white, 51% women and 37% had at least a 4-year college degree with an average age of 42.0 years (SD ±19.4). The attributes had the following importance: harms of use 17.6%; general effects 14.1%; cessation aid 12.6%; purchase price 12.1%; monthly cost 12.0%; nicotine content 11.4%; flavour availability 8.4%; device design 7.2%; modifiability 4.6%. Harms of use was the most important attribute for all ages and genders (p<0.05); variation in other important attributes existed by age though not by gender. Conclusion This study identified the importance of nine ENDS attributes. Perceived harms of use of ENDS use appeared most important, and modifiability was least important. Variation by consumer group existed, which may allow for targeted interventions to modify ENDS use

Fine-structural distribution of MMP-2 and MMP-9 activities in the rat skeletal muscle upon training: a study by high-resolution in situ zymography

Matrix metalloproteinases (MMPs) are key regulators of extracellular matrix remodeling, but have also important intracellular targets. The purpose of this study was to examine the activity and subcellular localization of the gelatinases MMP-2 and MMP-9 in skeletal muscle of control and physically trained rats. In control hind limb muscle, the activity of the gelatinases was barely detectable. In contrast, after 5 days of intense exercise, in Soleus (Sol), but not Extensor digitorum longus (EDL) muscle, significant upregulation of gelatinolytic activity in myofibers was observed mainly in the nuclei, as assessed by high resolution in situ zymography. The nuclei of quiescent satellite cells did not contain the activity. Within the myonuclei, the gelatinolytic activity colocalized with an activated RNA Polymerase II. Also in Sol, but not in EDL, there were few foci of mononuclear cells with strongly positive cytoplasm, associated with apparent necrotic myofibers. These cells were identified as activated satellite cells/myoblasts. No extracellular gelatinase activity was observed. Gel zymography combined with subcellular fractionation revealed training-related upregulation of active MMP-2 in the nuclear fraction, and increase of active MMP-9 in the cytoplasmic fraction of Sol. Using RT-PCR, selective increase in MMP-9 mRNA was observed. We conclude that training activates nuclear MMP-2, and increases expression and activity of cytoplasmic MMP-9 in Sol, but not in EDL. Our results suggest that the gelatinases are involved in muscle adaptation to training, and that MMP-2 may play a novel role in myonuclear functions

As-Needed Prescribing and Administration of Psychotropic Medications in Assisted Living: A 7-State Study

Psychotropic medications administered on an as-needed basis, often designated as pro re nata (or PRN, hereafter as-needed), can alleviate acute symptoms and facilitate deprescribing, although as-needed use is associated with negative outcomes such as polypharmacy and drug interactions. The aim of this study was to examine the extent to which PRN psychotropic medications are prescribed and administered to assisted living (AL) residents, overall and in relation to resident- and community-level characteristics

Effects of concentric and eccentric contractions on phosphorylation of MAPKerk1/2 and MAPKp38 in isolated rat skeletal muscle

Exercise and contractions of isolated skeletal muscle induce phosphorylation of mitogen-activated protein kinases (MAPKs) by undefined mechanisms. The aim of the present study was to determine exercise-related triggering factors for the increased phosphorylation of MAPKs in isolated rat extensor digitorum longus (EDL) muscle.Concentric or eccentric contractions, or mild or severe passive stretches were used to discriminate between effects of metabolic/ionic and mechanical alterations on phosphorylation of two MAPKs: extracellular signal-regulated kinase 1 and 2 (MAPKerk1/2) and stress-activated protein kinase p38 (MAPKp38).Concentric contractions induced a 5-fold increase in MAPKerk1/2 phosphorylation. Application of the antioxidants N-acetylcysteine (20 mm) or dithiothreitol (5 mm) suppressed concentric contraction-induced increase in MAPKerk1/2 phosphorylation. Mild passive stretches of the muscle increased MAPKerk1/2 phosphorylation by 1.8-fold, whereas the combination of acidosis and passive stretches resulted in a 2.8-fold increase. Neither concentric contractions, nor mild stretches nor acidosis significantly affected phosphorylation of MAPKp38.High force applied upon muscle by means of either eccentric contractions or severe passive stretches resulted in 5.7- and 9.5-fold increases of phosphorylated MAPKerk1/2, respectively, whereas phosphorylation of MAPKp38 increased by 7.6- and 1.9-fold (not significant), respectively.We conclude that in isolated rat skeletal muscle an increase in phosphorylation of both MAPKerk1/2 and MAPKp38 is induced by mechanical alterations, whereas contraction-related metabolic/ionic changes (reactive oxygen species and acidosis) cause increased phosphorylation of MAPKerk1/2 only. Thus, contraction-induced phosphorylation can be explained by the combined action of increased production of reactive oxygen species, acidification and mechanical perturbations for MAPKerk1/2 and by high mechanical stress for MAPKp38

Dementia and COVID-19 Infection Control in Assisted Living in Seven States.

Assisted living (AL) is the largest residential long-term care provider in the United States, including for persons with Alzheimer\u27s disease and related dementias. Despite recognizing the challenge of infection control for persons with dementia, this study of 119 AL communities is the first to describe dementia-relevant COVID-19 infection control across different types of AL communities, and to discuss implications for the future