Variation in African American parents' use of early childhood physical discipline

Physical discipline is endorsed by a majority of adults in the U.S. including African American (AA) parents who have high rates of endorsement. Although many studies have examined physical discipline use among AA families, few have considered how early childhood physical discipline varies within the population. Individuals within a cultural group may differ in their engagement in cultural practices (Rogoff, 2003). Furthermore, AA families’ characteristics and their contexts, which are shaped by the interaction of social position, racism, and segregation (García Coll et al., 1996), likely influence how AA families physically discipline their young children. This study examined variation in early childhood physical discipline among AA families living in low-income communities and relations with demographic and contextual factors. Year 1 data from 310 AA parents living in three regionally distinct low-income communities were used from a sequential longitudinal intervention program study of the development and prevention of conduct disorder. Latent class analyses were conducted using parents’ responses on a measure, of the frequency of overall physical discipline, spanking, and hitting during prekindergarten and kindergarten. The associations between latent classes and six demographic and contextual factors were examined using the Bolck, Croon, and Hagenaars (BCH) method. The factors were: child gender (59% male); marital status (51% never married); parental education (66% high school graduates and beyond); income (mean = $16.66K, S.D. = 12.50), family stress, and perception of neighborhood safety. Measures included the Family Information Form, Life Changes, and the Neighborhood Questionnaire. After considering two to seven class solutions, five physical discipline classes or sub-groups were identified. Classes were defined by discipline frequency (‘Infrequent’, ‘Weekly’, ‘Monthly’, ‘Almost-Every-Day’ and ‘Weekly-All’) as well as by discipline type (only parents in the ‘Weekly-All’ class hit their children). Significant associations were found between class membership, and child gender, marital status, income, and perception of neighborhood safety. Girls were more likely to be physically disciplined infrequently, χ2(4, N = 310) = 11.88, p = .05. The ‘Weekly’ class had significantly fewer married parents than all classes except ‘Almost-Every-Day’, χ2(4, N = 310) = 21.56, p < .001. Parents in the ‘Almost-Every-Day’ class had a significantly lower income than parents in all other classes except “Weekly-All”, χ2(4, N = 310) = 10.88, p = .03. Finally, parents in the “Almost-Every-Day” class perceived their neighborhood as significantly less safe compared to those in all other classes except the ‘Weekly-All’ class, χ2(4, N = 310) = 14.13 p = .01. These findings suggest that AA families vary in physical discipline during early childhood; this variation may result in sub-groups with different demographic characteristics. Associations between frequent discipline classes and perceptions of neighborhood safety implies that some AA parents may use physical discipline to protect their children from being harmed if they believe their communities are unsafe. Future research should qualitatively examine how AA parents respond to unsafe neighborhoods in their parenting behaviors, including physical discipline

How does racial context matter?: Family preparation-for-bias messages and Black youths’ racial coping reported by Black youth

Black families and youth likely consider specific racial discriminatory situations in preparation‐for‐bias messages and racial coping responses. Our study investigated coping responses embedded in youth‐reported Black families’ preparation‐for‐bias messages and youths’ proactive coping responses to specific racially discriminatory situations—teachers’ negative expectations, store employees’ hyper‐monitoring and police harassment. Gender and racial discrimination experience differences were considered along with relations between messages and coping. Our investigation was guided by the integrated‐developmental, transactional/ecological, intersectionality, and Phenomenological Variant of Ecological Systems Theory theoretical frameworks. We conducted cluster analyses using data from 117 Black youth aged 13–14 to identify situation‐specific family messages and youth coping responses. Families’ messages and youths’ responses varied in content and frequency based on the specific discriminatory situation, which suggests consideration of context.Accepted manuscript2021-10-2

Substance Use Prevention Services in Juvenile Justice and Behavioral Health: Results from a National Survey

BACKGROUND: This study examined the national availability of substance use prevention (SUP) within juvenile justice (JJ) and their primary behavioral health (BH) providers, and the relationships between the availability of SUP and agency-level measures of organizational structure, staffing, and youth characteristics. A three-stage national probability sampling process was used to select participants for a national survey that included, among other facets of community supervision (CS) and BH practices, questions on agency characteristics, youth characteristics, whether the agency/provider directly provided SUP services, and whether the agency/provider directly provided substance use and/or mental health treatment. This paper focuses on SUP services along with agency/provider and youth characteristics related to providing SUP. RESULTS: The response rate for both CS agencies (n = 195) and BH providers (n = 271) was 96%. Complex samples logistic regression initially examined univariate associations of each variable and identified candidates for a final multivariate model. Overall, only one-third of CS and BH providers reported offering SUP services, with BH providers being significantly more likely than CS agencies to provide SUP services. In addition, likelihood of SUP was significantly lower among agencies where the substance use distribution of the caseload was below the median. Controlling for master\u27s level staff and the substance use distribution, CS agencies were about 67% less likely to offer SUP when compared to BH providers. CONCLUSIONS: Given the high rates of substance use among justice-involved youth and that substance use is an established risk for several negative behaviors, outcomes, and health conditions, these findings suggest that evidence-based prevention services should likely be expanded in justice settings, and perhaps included as part of CS programs, even when youth do not initially present with SU service needs

Use of the Palliative Performance Scale to estimate survival among home hospice patients with heart failure

AimsEstimating survival is challenging in the terminal phase of advanced heart failure. Patients, families, and health‐care organizations would benefit from more reliable prognostic tools. The Palliative Performance Scale Version 2 (PPSv2) is a reliable and validated tool used to measure functional performance; higher scores indicate higher functionality. It has been widely used to estimate survival in patients with cancer but rarely used in patients with heart failure. The aim of this study was to identify prognostic cut‐points of the PPSv2 for predicting survival among patients with heart failure receiving home hospice care.Methods and resultsThis retrospective cohort study included 1114 adult patients with a primary diagnosis of heart failure from a not‐for‐profit hospice agency between January 2013 and May 2017. The primary outcome was survival time. A Cox proportional‐hazards model and sensitivity analyses were used to examine the association between PPSv2 scores and survival time, controlling for demographic and clinical variables. Receiver operating characteristic curves were plotted to quantify the diagnostic performance of PPSv2 scores by survival time. Lower PPSv2 scores on admission to hospice were associated with decreased median (interquartile range, IQR) survival time [PPSv2 10 = 2 IQR: 1–5 days; PPSv2 20 = 3 IQR: 2–8 days] IQR: 55–207. The discrimination of the PPSv2 at baseline for predicting death was highest at 7 days [area under the curve (AUC) = 0.802], followed by an AUC of 0.774 at 14 days, an AUC of 0.736 at 30 days, and an AUC of 0.705 at 90 days.ConclusionsThe PPSv2 tool can be used by health‐care providers for prognostication of hospice‐enrolled patients with heart failure who are at high risk of near‐term death. It has the greatest utility in patients who have the most functional impairment.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148390/1/ehf212398_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148390/2/ehf212398.pd

Inbreeding shapes the evolution of marine invertebrates

Inbreeding is a potent evolutionary force shaping the distribution of genetic variation within and among populations of plants and animals. Yet, our understanding of the forces shaping the expression and evolution of nonrandom mating in general, and inbreeding in particular, remains remarkably incomplete. Most research on plant mating systems focuses on self-fertilization and its consequences for automatic selection, inbreeding depression, purging, and reproductive assurance, whereas studies of animal mating systems have often assumed that inbreeding is rare, and that natural selection favors traits that promote outbreeding. Given that many sessile and sedentary marine invertebrates and marine macroalgae share key life history features with seed plants (e.g., low mobility, modular construction, and the release of gametes into the environment), their mating systems may be similar. Here, we show that published estimates of inbreeding coefficients (FIS) for sessile and sedentary marine organisms are similar and at least as high as noted in terrestrial seed plants. We also found that variation in FIS within invertebrates is related to the potential to self-fertilize, disperse, and choose mates. The similarity of FIS for these organismal groups suggests that inbreeding could play a larger role in the evolution of sessile and sedentary marine organisms than is currently recognized. Specifically, associations between traits of marine invertebrates and FIS suggest that inbreeding could drive evolutionary transitions between hermaphroditism and separate sexes, direct development and multiphasic life cycles, and external and internal fertilization

The Recognizability and Localizability of Auditory Alarms: Setting Global Medical Device Standards.

Objective Four sets of eight audible alarms matching the functions specified in IEC 60601-1-8 were designed using known principles from auditory cognition with the intention that they would be more recognizable and localizable than those currently specified in the standard. Background The audible alarms associated with IEC 60601-1-8, a global medical device standard, are known to be difficult to learn and retain, and there have been many calls to update them. There are known principles of design and cognition that might form the basis of more readily recognizable alarms. There is also scope for improvement in the localizability of the existing alarms. Method Four alternative sets of alarms matched to the functions specified in IEC 60601-1-8 were tested for recognizability and localizability and compared with the alarms currently specified in the standard. Results With a single exception, all prototype sets of alarms outperformed the current IEC set on both recognizability and localizability. Within the prototype sets, auditory icons were the most easily recognized, but the other sets, using word rhythms and simple acoustic metaphors, were also more easily recognized than the current alarms. With the exception of one set, all prototype sets were also easier to localize. Conclusion Known auditory cognition and perception principles were successfully applied to an existing audible alarm problem. Application This work constitutes the first (benchmarking) phase of replacing the alarms currently specified in the standard. The design principles used for each set demonstrate the relative ease with which different alarm types can be recognized and localized

Coordination and resource-related difficulties encountered by Quebec's public health specialists and infectious diseases/medical microbiologists in the management of A (H1N1) - a mixed-method, exploratory survey

<p>Abstract</p> <p>Background</p> <p>In Quebec, the influenza A (H1N1) pandemic was managed using a top-down style that left many involved players with critical views and frustrations. We aimed to describe physicians' perceptions - infectious diseases specialists/medical microbiologists (IDMM) and public health/preventive medicine specialists (PHPMS) - in regards to issues encountered with the pandemics management at the physician level and highlight suggested improvements for future healthcare emergencies.</p> <p>Methods</p> <p>In April 2010, Quebec IDMM and PHPMS physicians were invited to anonymously complete a web-based learning needs assessment. The survey included both open-ended and multiple-choice questions. Descriptive statistics were used to report on the frequency distribution of multiple choice responses whereas thematic content analysis was used to analyse qualitative data generated from the survey and help understand respondents' experience and perceptions with the pandemics.</p> <p>Results</p> <p>Of the 102 respondents, 85.3% reported difficulties or frustrations in their practice during the pandemic. The thematic analysis revealed two core themes describing the problems experienced in the pandemic management: coordination and resource-related difficulties. Coordination issues included communication, clinical practice guidelines, decision-making, roles and responsibilities, epidemiological investigation, and public health expert advisory committees. Resources issues included laboratory resources, patient management, and vaccination process.</p> <p>Conclusion</p> <p>Together, the quantitative and qualitative data suggest a need for improved coordination, a better definition of roles and responsibilities, increased use of information technologies, merged communications, and transparency in the decisional process. Increased flexibility and less contradiction in clinical practice guidelines from different sources and increased laboratory/clinical capacity were felt critical to the proper management of infectious disease emergencies.</p

Tenofovir alafenamide versus tenofovir disoproxil fumarate, coformulated with elvitegravir, cobicistat, and emtricitabine, for initial treatment of HIV-1 infection: Two randomised, double-blind, phase 3, non-inferiority trials

none27siBackground Tenofovir disoproxil fumarate can cause renal and bone toxic effects related to high plasma tenofovir concentrations. Tenofovir alafenamide is a novel tenofovir prodrug with a 90% reduction in plasma tenofovir concentrations. Tenofovir alafenamide-containing regimens can have improved renal and bone safety compared with tenofovir disoproxil fumarate-containing regimens. Methods In these two controlled, double-blind phase 3 studies, we recruited treatment-naive HIV-infected patients with an estimated creatinine clearance of 50 mL per min or higher from 178 outpatient centres in 16 countries. Patients were randomly assigned (1:1) to receive once-daily oral tablets containing 150 mg elvitegravir, 150 mg cobicistat, 200 mg emtricitabine, and 10 mg tenofovir alafenamide (E/C/F/tenofovir alafenamide) or 300 mg tenofovir disoproxil fumarate (E/C/F/tenofovir disoproxil fumarate) with matching placebo. Randomisation was done by a computer-generated allocation sequence (block size 4) and was stratified by HIV-1 RNA, CD4 count, and region (USA or ex-USA). Investigators, patients, study staff, and those assessing outcomes were masked to treatment group. All participants who received one dose of study drug were included in the primary intention-to-treat efficacy and safety analyses. The main outcomes were the proportion of patients with plasma HIV-1 RNA less than 50 copies per mL at week 48 as defined by the the US Food and Drug Adminstration (FDA) snapshot algorithm (pre-specified non-inferiority margin of 12%) and pre-specified renal and bone endpoints at 48 weeks. These studies are registered with ClinicalTrials.gov, numbers NCT01780506 and NCT01797445. Findings We recruited patients from Jan 22, 2013, to Nov 4, 2013 (2175 screened and 1744 randomly assigned), and gave treatment to 1733 patients (866 given E/C/F/tenofovir alafenamide and 867 given E/C/F/tenofovir disoproxil fumarate). E/C/F/tenofovir alafenamide was non-inferior to E/C/F/tenofovir disoproxil fumarate, with 800 (92%) of 866 patients in the tenofovir alafenamide group and 784 (90%) of 867 patients in the tenofovir disoproxil fumarate group having plasma HIV-1 RNA less than 50 copies per mL (adjusted difference 2·0%, 95% CI -0·7 to 4·7). Patients given E/C/F/tenofovir alafenamide had significantly smaller mean serum creatinine increases than those given E/C/F/tenofovir disoproxil fumarate (0·08 vs 0·12 mg/dL; p<0·0001), significantly less proteinuria (median % change -3 vs 20; p<0·0001), and a significantly smaller decrease in bone mineral density at spine (mean % change -1·30 vs -2·86; p<0·0001) and hip (-0·66 vs -2·95; p<0·0001) at 48 weeks. Interpretation Through 48 weeks, more than 90% of patients given E/C/F/tenofovir alafenamide or E/C/F/tenofovir disoproxil fumarate had virological success. Renal and bone effects were significantly reduced in patients given E/C/F/tenofovir alafenamide. Although these studies do not have the power to assess clinical safety events such as renal failure and fractures, our data suggest that E/C/F/tenofovir alafenamide will have a favourable long-term renal and bone safety profile. Funding Gilead Sciences.openSax, Paul E; Wohl, David; Yin, Michael T.; Post, Frank; Dejesus, Edwin; Saag, Michael; Pozniak, Anton; Thompson, Melanie; Podzamczer, Daniel; Molina, Jean Michel; Oka, Shinichi; Koenig, Ellen; Trottier, Benoit; Andrade-Villanueva, Jaime; Crofoot, Gordon; Custodio, Joseph M.; Plummer, Andrew; Zhong, Lijie; Cao, Huyen; Martin, Hal; Callebaut, Christian; Cheng, Andrew K.; Fordyce, Marshall W.; Mccallister, Scott; for the GS-US-292-0104/0111 Study Team [...; Pierluigi Viale; ...]Sax, Paul E; Wohl, David; Yin, Michael T.; Post, Frank; Dejesus, Edwin; Saag, Michael; Pozniak, Anton; Thompson, Melanie; Podzamczer, Daniel; Molina, Jean Michel; Oka, Shinichi; Koenig, Ellen; Trottier, Benoit; Andrade-Villanueva, Jaime; Crofoot, Gordon; Custodio, Joseph M.; Plummer, Andrew; Zhong, Lijie; Cao, Huyen; Martin, Hal; Callebaut, Christian; Cheng, Andrew K.; Fordyce, Marshall W.; Mccallister, Scott; for the GS-US-292-0104/0111 Study Team [..; Pierluigi Viale; ..