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Introduction: Hispanic adolescents are at high risk of engaging in sexual risk-taking behaviors. Parent-child communication protects against such behaviors. Among Hispanic families, it is critical to explore how cultural characteristics influence mothers-daughter communication about sex. The purpose of this qualitative study was to understand how cultural values influence mothers' communication about sex with their early adolescent Hispanic daughters., Methodology: Twenty-one Hispanic mothers of seventh-grade daughters participated in this focus group study. Directed content analysis was used to analyze the data., Results: Four Hispanic cultural values ( familismo, machismo, marianismo , and respeto ) and how each value influences mother-daughter communication about sex were identified. While mothers want to protect their daughters, there are multiple cultural norms that made it challenging for them to have critical conversations., Discussion: The study informs researchers and clinicians how to facilitate parent-child conversations about sex and to equip parents to teach their children how to avoid engaging in sexual risk-taking behaviors.

We used the developmental systems model to deduce a definition of female early adolescent sexual desire. We evaluated a measure of this phenomenon with a secondary analysis of data from a randomized group sexual health intervention trial involving low-income, English-speaking, seventh grade Latinas enrolled in a Miami-Dade County public school ( n =  542). As part of this study, girls completed a four-item early adolescent sexual desire (EASD) measure. Study findings supported internal consistency (Cronbach's alpha = .81 to .82) and stability over a 1-month period ( r = .74). Developmental sensitivity was supported by a decline in stability over 12- ( r = .66) and 24-month periods ( r = .56). Validity was supported by correlations with puberty changes, sexual intentions, sexting, and sexual behavior, and hypothesized mean differences associated with dating and preference for shoes culturally associated with female sexual attractiveness ( p < .01). Research implications include validation work with other ethnic/racial groups and using the EASD as a starting point for a measurement continuum tracking development of sexual desire across adolescence and into adulthood. Directions for future research also include measuring the development of sexual desire in boys and transgendered youth across adolescence and into adulthood.

Purpose: U.S. Hispanic adolescents are at risk for negative health outcomes due to risk-taking behaviors involving sex, drugs, and alcohol. Mother-daughter communication can reduce these risk-taking behaviors and reinforce parents' expectations. The purpose of this study was to explore mothers' descriptions of their communication about risk-taking behaviors with their early adolescent Hispanic daughters., Design and Methods: This qualitative descriptive study involved focus groups with 21 Hispanic mothers of 7th grade (12-14 years old) girls. Conventional content analysis was conducted to identify the strategies they used during these conversations., Results: Strategies mothers used included warning, focusing on negative consequences, creating opportunities to express maternal expectations, and stressing the importance of positive influences. Communication was also influenced by daughters' physical development and social media., Conclusions: The mothers were concerned about their daughters' exposure to risk-taking behaviors but were unsure about how to talk to their daughters about how to avoid them, particularly regarding topics related to sex., Practice Implications: Our study results have implications on how to facilitate parent-child conversations about risk-taking behaviors and to equip mothers and parents to teach their children how to avoid engaging in these behaviors., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: Many low-income and middle-income countries (LMICs) struggle to provide the health services investment required for life-saving congenital heart disease (CHD) surgery. We explored associations between risk-adjusted CHD surgical mortality from 17 LMICs and global development indices to identify patterns that might inform investment strategies., Design: Retrospective analysis: country-specific standardised mortality ratios were graphed against global development indices reflective of wealth and healthcare investment. Spearman correlation coefficients were calculated., Setting and Participants: The International Quality Improvement Collaborative (IQIC) keeps a volunteer registry of outcomes of CHD surgery programmes in low-resource settings. Inclusion in the IQIC is voluntary enrolment by hospital sites. Patients in the registry underwent congenital heart surgery. Sites that actively participated in IQIC in 2013, 2014 or 2015 and passed a 10% data audit were asked for permission to share data for this study. 31 sites in 17 countries are included., Outcome Measures: In-hospital mortality: standardised mortality ratios were calculated. Risk adjustment for in-hospital mortality uses the Risk Adjustment for Congenital Heart Surgery method, a model including surgical risk category, age group, prematurity, presence of a major non-cardiac structural anomaly and multiple congenital heart procedures during admission., Results: The IQIC registry includes 24 917 congenital heart surgeries performed in children<18 years of age. The overall in-hospital mortality rate was 5.0%. Country-level congenital heart surgery standardised mortality ratios were negatively correlated with gross domestic product (GDP) per capita (r=-0.34, p=0.18), and health expenditure per capita (r=-0.23, p=0.37) and positively correlated with under-five mortality (r=0.60, p=0.01) and undernourishment (r=0.39, p=0.17). Countries with lower development had wider variation in mortality. GDP per capita is a driver of the association between some other measures and mortality., Conclusions: Results display a moderate relationship among wealth, healthcare investment and malnutrition, with significant variation, including superior results in many countries with low GDP per capita. These findings provide context and optimism for investment in CHD procedures in low-resource settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The objective of this study was to compare the effectiveness of the topical application of Aloe barbadensis Miller (juice and fresh gel) to skin wounds, in dogs and cats, with that of topically applied silver sulfadiazine cream. The sample included 16 patients with cutaneous wounds (13 dogs and three cats) that were divided into three groups. Aloe vera "juice" and "fresh gel" were applied for groups I and II, respectively, while silver sulfadiazine was applied for the control group III. In order to evaluate the healing of wounds, the following parameters were taken into consideration: the percentage of wound shrinkage, the healing time and the macroscopic appearance of the scarring process. The interpretation of the data relating to the percentage of wound shrinkage showed a faster rate for groups I and II compared to that of group III. However, the wound shrinkage rates between "juice" and "fresh gel" protocols were not significantly different. Aloe vera was more effective than silver sulfadiazine, in accelerating wound shrinkage, reducing healing time and decreasing the severity of the associated injuries., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: To explore the health education needs and learning preferences of female intimate partner violence (IPV) survivors in a social service agency located in South Florida, United States., Design and Sample: An exploratory two-phase sequential mixed-methods study was completed through semistructured interviews with social service providers (n = 10), followed by a survey with predominately female IPV survivors (n = 122, 98.4%)., Measures: Data obtained from interviews with social service providers were analyzed through conventional thematic content analysis. Data from interviews were used in developing a health survey completed by IPV survivors and analyzed utilizing descriptive statistics, chi-square tests and t tests., Results: Three themes emerged from interviews including multidimensional health needs, navigating barriers to health care, and self-improvement specific to survivors of intimate partner violence. Survey results indicated that depression and self-esteem were the health education needs of highest priority. Demographic characteristics, including age and language use, were significantly associated to preferred methods of learning, p < .05., Conclusions: IPV survivors present with various health education needs. Current study findings can inform public health nurses in developing interventions or health-based programs for female IPV survivors in social service agency settings., (© 2017 Wiley Periodicals, Inc.)

Motivation: Our overall goal is to develop machine-learning approaches based on genomics and other relevant accessible information for use in predicting how a patient will respond to a given proposed drug or treatment. Given the complexity of this problem, we begin by developing, testing and analyzing learning methods using data from simulated systems, which allows us access to a known ground truth. We examine the benefits of using prior system knowledge and investigate how learning accuracy depends on various system parameters as well as the amount of training data available., Results: The simulations are based on Boolean networks-directed graphs with 0/1 node states and logical node update rules-which are the simplest computational systems that can mimic the dynamic behavior of cellular systems. Boolean networks can be generated and simulated at scale, have complex yet cyclical dynamics and as such provide a useful framework for developing machine-learning algorithms for modular and hierarchical networks such as biological systems in general and cancer in particular. We demonstrate that utilizing prior knowledge (in the form of network connectivity information), without detailed state equations, greatly increases the power of machine-learning algorithms to predict network steady-state node values ('phenotypes') and perturbation responses ('drug effects')., Availability and Implementation: Links to codes and datasets here: https://gray.mgh.harvard.edu/people-directory/71-david-craft-phd., Contact: dcraft@broadinstitute.org., Supplementary Information: Supplementary data are available at Bioinformatics online., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com)

Purpose The purpose of this descriptive qualitative study was to explore cognitive, behavioral, and psychosocial challenges associated with having and/or parenting an adolescent with pediatric type 2 diabetes (T2D) from the perspectives of ethnic minority parents and adolescents. Methods Ethnic minority (79.2% non-Hispanic black, 29.6% Hispanic) adolescents (n = 14, 78.6% female, 14.7 ± 1.9 years) and their parents (n = 13, 100% female) participated in either individual family interviews or multifamily focus group sessions. Sessions were audio recorded, transcribed, and coded by a team of 4 raters. QSR NVivo 10 was used to perform a content analysis and to extract coded adolescent and parent responses. Results Six themes corresponding to 3 broad categories (cognitive, behavioral, and psychosocial challenges) emerged. Regarding cognitive challenges, families described difficulties learning about a new disease and managing youth knowledge deficits and/or superficial knowledge. In terms of behavioral challenges, parents and adolescents discussed ongoing difficulties with making and maintaining positive youth health behavior changes as well as with ensuring regimen adherence. Finally, managing youth emotions related to diabetes and navigating social relationships with peers and other family members around the disclosure of T2D were the primary psychosocial challenges to emerge. Conclusions Directions for future research include developing and evaluating brief family interventions and adolescent psychosocial screening measures. Recommendations for clinical practice include increasing family knowledge of T2D, enhancing parenting skills for managing youth behavior change, and conducting routine psychosocial screening during follow-up clinic visits.

Hispanic females in their late adolescence appear to be disproportionately affected by dating violence, yet the majority of victims never seek out formal services. The purpose of this study was to explore the dating violence and help-seeking experiences of Hispanic females in their late adolescence. Participants were recruited from a social service agency providing wrap-around services to individuals and families affected by abuse in South Florida. Eleven in-depth qualitative interviews were conducted with Hispanic female victims of dating violence in their late adolescence (18 to 24 years of age) in English or Spanish. A thematic analysis of transcripts identified four major themes: (a) conflict, culture, and context influences Hispanic couples; (b) missed opportunities to accessing help; (c) pivotal moments are needed to access formal services; and (d) family matters. Participants of this study believed that dating violence was more normative in Hispanic relationships than "American" relationships. Although participants had opportunities to seek formal services early in their relationships, formal services were only sought after pivotal moments. Families played an important role in supporting or further victimizing the participants. Findings from this study can be used to inform interventions addressing both informal and formal sources of support for Hispanic female victims of dating violence in their late adolescence.