Examining linkages among sources of racial-ethnic discrimination and Latino adolescents' psychosocial and academic outcomes: are culturally-relevant factors protective?

Given adversity associated with racial-ethnic discrimination, Latino adolescents are at increased risk for academic disengagement, and internalizing and externalizing symptoms. However, cultural-ecological theoretical models (García Coll et al., 1996; Spencer, 1995) also described the importance of examining cultural values and culturally-relevant coping strategies that may protect against the negative effects of discrimination and promote youths' developmental competencies. As such, the goals of the present study are threefold: (a) to examine associations among familism values, religious coping, and academic motivation and internalizing and externalizing symptoms, (b) to examine the effects of school-based racial-ethnic discrimination by source (e.g., school adults versus peers) and foreigner-based discrimination on Latino adolescents' academic motivation, and internalizing and externalizing symptoms, and (b) to examine the moderating effects of familism values and religious coping in the association between multiple sources of discrimination and adolescents' academic and psychosocial outcomes. Participants included 133 Latino adolescents (Mage = 12.88; SD = .70; 51% girls); majority of youth are from Mexican-origin families (81%). Using Structural Equation Modeling (SEM), results indicated that religious coping and familism values were associated with higher levels of academic motivation. Peer discrimination was associated with higher internalizing and externalizing symptoms. The protective and exacerbating effects of youths' familism values and religious coping for internalizing and externalizing symptoms varied under conditions of peer, school-adult, and foreigner-based discrimination. Discussion will be focus on implications for creating promotive contexts for Latino youth

The role of parent-adolescent relationships in predicting Mexican American adolescents' coping strategies: examining variation across parent and adolescent gender

The primary aim of this paper was to examine associations between supportive-responsive maternal/paternal-adolescent relationships and adolescents' coping strategies and whether associations vary across adolescent gender. It was hypothesized that supportive-responsive parent-adolescent relationships (indicated by high support and knowledge and low psychological control) would predict higher levels of seeking family support, peer support, and seeking spirituality and lowered levels of anger coping and substance-use coping. Gender of parent and adolescent was considered to examine whether associations between supportive-responsive maternal/paternal and adolescent relationships would vary across boys and girls. Participants included 367 Mexican American adolescents (M age = 14.46, SD = .69; 58% female). Structural equation modeling (SEM) involving latent and manifest constructs and multigroup analyses was used to evaluate the study aims. Results generally supported the primary hypothesis in that supportive-responsive parent-adolescent relationships were associated positively with seeking support from family, peer support, and spirituality and associated negatively with anger and substance-use coping. However, some paths varied across adolescent gender indicating that the effect of parenting on adolescent coping strategies was gendered particularly for father-son adolescent relationships. These findings highlight the importance of proximal supportive and responsive relationships with mothers and fathers for boys' and girls' coping in Mexican American families

Latino Adolescent Educational Affiliation Profiles

Supporting postsecondary access for Latino adolescents is important due to the size of the population and mixed evidence of progress. In order to better understand the college-going and school belonging attitudes of Latinos, we used an exploratory latent profile analysis to identify the educational affiliation profiles present in a sample of Latino seventh- to 10th-grade students in the Southeastern United States. In addition, we investigated how proximal peer processes (support and discrimination) functioned to differentiate membership in the educational affiliation profiles. We found that a three-typology profile was the best fit to the data (low, moderate, and high educational affiliation), and that peer support was more likely to be associated with membership in the high profile (compared with low profile and moderate profile), while peer discrimination was more likely to be associated with membership in the moderate profile (as compared with the high profile). Implications for conceptualizing college readiness are offered. </jats:p

Kidney Function and Disability-Free Survival in Older Women.

ObjectivesTo examine the prospective association between kidney function and three outcomes: survival to age 85 with functional independence, survival to age 85 with disability, and death before age 85.DesignProspective study.SettingWomen's Health Initiative, conducted at 40 U.S. clinical centers.ParticipantsPostmenopausal women enrolled between 1993 and 1998 with baseline biomarker assessments who had the potential to reach age 85 before September 2013 (N = 7,178).MeasurementsKidney function was measured according to estimated glomerular filtration rate (eGFR) calculated from serum creatinine collected at baseline. Outcomes were survival to age 85 with functional independence, survival with disability, or death before age 85. Disability was defined as mobility or activity of daily living limitations measured by questionnaire.ResultseGFR was greater than 90 mL/min per 1.73 m2 in 22.7% of women, 60 to 89 mL/min per 1.73 m2 in 66.5%, 45 to 59 mL/min per 1.73 m2 in 8.7%, and less than 45 mL/min per 1.73 m2 in 2.0%. Median follow-up was 15 years. Of 4,953 survivors, 3,155 reported no physical disability at age 85. Two thousand two hundred twenty-five participants died before age 85. Women with an eGFR of 90 mL/min per 1.73 m2 or greater had 2.71 times greater odds of survival to age 85 with functional independence than of dying before 85 (95% confidence interval (CI) = 1.62-4.51) than those with an eGFR less than 45 mL/min per 1.73 m2 , women with an eGFR of 60 to 89 mL/min per 1.73 m2 had 3.04 times (95% CI = 1.85-5.00) greater odds, and women with an eGFR of 45 to 59 mL/min per 1.73 m2 had 2.22 times (95% CI = 1.31-3.76) greater odds. Similar, but slightly weaker odds were seen for survival to age 85 with disability. Better kidney function was not significantly associated with greater likelihood of survival to age 85 with independent function than of surviving with disability.ConclusionBetter kidney function was associated with greater likelihood of survival to age 85 with and without disability

When Discrimination Hurts: The Longitudinal Impact of Increases in Peer Discrimination on Anxiety and Depressive Symptoms in Mexican-origin Youth

Life course models of the impact of discrimination on health and mental health outcomes posit that the pernicious effects of discrimination may not be immediate, but instead may become apparent at later stages in development. This study tests whether peer discrimination changes at particular transition points (i.e., transition to middle and high school) predict subsequent internalizing symptoms in Mexican-origin youth. In a sample of 674 Mexican-origin youth (50% female), this study used a latent change score framework to model changes in peer discrimination across time and to test whether changes in peer discrimination at 7th and 9th grades predicted greater depressive and anxiety symptoms in 12th grade controlling for 5th grade symptoms. Irrespective of longitudinal changes, greater peer discrimination in 5th grade predicted greater depressive and anxiety symptoms in 12th grade. Further, significant increases in peer discrimination from 7th to 8th grade and in 9th to 10th grade uniquely predicted greater anxiety symptoms in 12th grade. These findings suggest that longitudinal research on peer discrimination needs to take into account unique periods of risk. Future research implications are discussed

Racial/Ethnic Disparities in Physical Function Before and After Total Knee Arthroplasty Among Women in the United States

Importance: Although racial/ethnic differences in functional outcomes after total knee arthroplasty (TKA) exist, whether such differences are associated with differences in presurgical physical function (PF) has not been thoroughly investigated. Objective: To examine trajectories of PF by race/ethnicity before and after TKA among older women. Design, Setting, and Participants: This cohort study was conducted among the prospective Women\u27s Health Initiative with linked Medicare claims data. A total of 10325 community-dwelling women throughout the United States with Medicare fee-for-service underwent primary TKA between October 1, 1993, and December 31, 2014, and were followed up through March 31, 2017. Exposures: Race/ethnicity comparisons between Hispanic or Latina women, non-Hispanic black or African American women, and non-Hispanic white women (hereafter referred to as Hispanic, black, and white women, respectively). Main Outcomes and Measures: Physical functioning scale scores and self-reported activity limitations with walking 1 block, walking several blocks, and climbing 1 flight of stairs were measured by the RAND 36-Item Health Survey during the decade before and after TKA, with a median of 9 PF measurements collected per participant over time. Results: In total, 9528 white women (mean [SD] age at surgery, 74.6 [5.5] years), 622 black women (mean [SD] age at surgery, 73.1 [5.3] years), and 175 Hispanic women (mean [SD] age at surgery, 73.1 [5.2] years) underwent TKA. During the decade prior to TKA, black women had lower PF scores than white women (mean difference, -5.8 [95% CI, -8.0 to -3.6]) and higher odds of experiencing difficulty walking a single block (5 years before TKA: odds ratio, 1.86 [95% CI, 1.57-2.21]), walking multiple blocks (odds ratio, 2.14 [95% CI, 1.83-2.50]), and climbing 1 flight of stairs (odds ratio, 1.81 [95% CI, 1.55-2.12]). After TKA, black women continued to have lower PF scores throughout the decade (mean difference 1 year after TKA, -7.8 [95% CI, -10.8 to -4.9]). After adjusting for preoperative PF scores, PF scores after TKA were attenuated (mean difference 1 year after TKA, -3.0 [95% CI, -5.3 to -0.7]), with no statistically significant differences in long-term follow-up. Hispanic women had similar PF scores to white women during the pre-TKA and post-TKA periods. Conclusions and Relevance: This study suggests that black women had significantly poorer PF than white women during the decades before and after TKA. Poorer PF after surgery was associated with poorer preoperative PF. Reducing disparities in post-TKA functional outcomes should target maintenance of function preoperatively in the early stages of arthritic disease and/or reduction of delays to receiving TKA once need arises