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To investigate the effectiveness and safety of pembrolizumab and lenvatinib (PEMBRO+LEN) for recurrent endometrial cancer (EC) in a real-world setting.This multicenter retrospective cohort study included patients with recurrent EC who received PEMBRO+LEN between March 2020 and May 2021 at three tertiary hospitals in Korea. We summarized patient characteristics and evaluated the response rates, survival outcomes, and treatment-related adverse events (AEs).In total, 48 patients were included in the study. The median age of the patients was 62.5 (range, 42-78) years. The most common histologic subtype was endometrioid adenocarcinoma (43.8%), followed by serous adenocarcinoma (25.0%). Most patients (91.7%) had mismatch repair-proficient tumors. Patients received PEMBRO+LEN for a median of 4.5 cycles, during which the best objective response rate and disease control rate were 23.8% (95% CI, 11.9-38.1) and 76.2% (95% CI, 61.9-88.1), respectively. Overall, 56.2% of patients experienced LEN dose reduction once or more and 16.7% experienced LEN interruption. The most common treatment-related AEs were fatigue (18.8%), hypertension (16.7%), and hypothyroidism (14.6%). Total of 8 patients (16.7%) discontinued LEN during the treatment because of treatment-related AEs. Serum CA-125 level was the only prognostic factor for progression-free survival (adjusted hazard ratio, 4.41; 95% confidence interval, 1.19-16.36; p = 0.03).In our real-world study, Korean patients with recurrent EC who received PEMBRO+LEN showed lower treatment response rate and similar treatment discontinuation rate, compared to clinical trials.

Intimate partner violence (IPV) has been highlighted as one of the challenges to the effectiveness of the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs in rural areas in South Africa. This study aimed at assessing the prevalence of prenatal and postnatal physical as well as psychological IPV, and corresponding time-invariant and time-varying predictors, among HIV-positive women attending PMTCT services in rural South Africa. The Conflict Tactics Scale (CTS) was used to assess IPV at four time points prenatal and postnatal. This study highlighted high levels of physical and psychological IPV experienced by HIV-infected women during pregnancy and in the first year after childbirth. Time-invariant predictors and time-varying predictors of physical IPV and psychological IPV were individual, social, and behavioral factors. Multi-dimensional evidence-based interventions are needed to deal with the high levels of prenatal and postnatal physical as well as psychological IPV experienced by these women.

‘Mother-to-child transmission of HIV’ can occur during the period of pregnancy, childbirth, or breastfeeding. ‘Prevention of mother-to-child transmission of HIV’ (PMTCT) in Mpumalanga Province, South Africa, is especially vital as the prevalence of HIV is 28.2% in women aged 15–49. PMTCT interventions resulted in a drop of MTCT rates in Mpumalanga from ∼2% in 2015 to 1.3% in 2016. This randomised controlled trial in Mpumalanga examined the potential impact of a lay healthcare worker administered intervention, ‘Protect Your Family’, on maternal and infant adherence, and to assess the relative influence of male partner involvement on infant and maternal adherence. This cluster randomised controlled trial used a two-phase and two-condition (experimental or control) study design where participants (n = 1399) did assessments both during pregnancy and post-postpartum. Only women participated in Phase 1, and both female and male partners participated in Phase 2. Results indicated that male involvement was associated with self-reported maternal or infant antiretroviral therapy (ART) adherence, but the intervention was not associated with ART adherence. Self-reported adherence was associated with depression, age, and partner HIV status. The study results provide support for the involvement of men in the antenatal clinic setting during pregnancy. Results also support further research on the meaning and assessment of male involvement and clarification of the constructs underlying the concept in the sub-Saharan African context. Outcomes provide support for male involvement and treatment of depression as adjuncts to improve uptake of both maternal and infant medication as part of the PMTCT protocol.

Background and Objectives The present study investigated pain trajectories of husbands and wives over their mid-later years, the grouping of these trajectories, and differences in baseline biopsychosocial profiles and health and well-being outcomes in later years across the pain trajectory groups. Research Design and Methods Growth mixture modeling was used to identify latent classes of 244 husbands’ and wives’ physical pain trajectories over their mid-later years (1994–2015, average ages of 44–65 years). Analyses were conducted to identify how these pain trajectory classes were associated with respondents’ biopsychosocial profiles in 1994 and health and well-being in later years (2017 [>67 years]). Results The individual pain trajectories of husbands and wives were clustered into 3 heterogeneous groups with differing trajectory patterns. Nonnormative pain trajectory groups (with either a high pain level and/or persistent pain) were associated with adverse baseline biopsychosocial characteristics. These groups also experienced poorer health and well-being outcomes in later years (2017) compared to those with consistently low pain after controlling for lagged measures in 2015. Discussion and Implications The identification of pain trajectory groups and characteristics of group members provides a potentially useful prognostic tool for early preventive intervention efforts, treatment, and policy formation. Such interventions can promote and develop resiliency factors, thereby aiding in the redirection of middle-aged husbands’ and wives’ adverse pain trajectories.

This study investigates (1) conjoint latent classes of adolescent co-occurring developmental problems (obesity, depressive symptoms, and low educational attainment), (2) socioeconomic and genetic influences on these classes of adolescents' problem trajectories, and (3) physical health consequences of those latent classes. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health

This integrative review of research utilizing the National Longitudinal Study of Adolescent to Adult Health draws on previous research detailing pathways linking early socioeconomic adversity in childhood and adolescence (Wave 1 in 1995 and prior) to physical health outcomes in young adulthood (Wave 5 in 2015). Health outcomes considered included specific diseases, disease risk, and morbidity as prospectively measured by parent-reported and self-reported health outcomes as well as clinical biomarkers. A heuristic research framework was developed from the comprehensive review focused on 4 study designs and identifying total associations, physiological pathways, stress pathways, and resources pathways linking early socioeconomic adversity to physical health outcomes for young adults, as well as potential modifiers of these pathways. The appropriateness of different analytical strategies used in these research studies including approaches for analysis of change in health are discussed. Taken together, review findings suggest the merit of an integrated perspective taking a long view over early life course to explain cumulative physical health risk over the first half of the life course by assessing multiple pathways simultaneously. Looking forward, the review findings also emphasize the need for the investigation of the continuity and change in these pathways over the second half of the life course.

biBackground:/i/bStudies have shown that obesity (OB) has strong intergenerational linkages and tends to cluster in families, but there is a dearth of research examining the socioecological factors predictive of weight status concordance and discordance among parents and adolescents.biMethods:/i/bWe ran a stepwise multinomial logistic regression to assess for sociodemographic, individual-, and family-level predictors of four dyadic weight status groups using data from 1516 parent/adolescent dyads from the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. We categorized parent/adolescent dyads into one of four groups based on their BMI: (1) Healthy Weight Concordance (ii.e./i, both parent and adolescent in the normal weight range); (2) overweight (OW)/OB Concordance (ii.e./i, both parent and adolescent with OW or OB); (3) Discordance-Parent OW/OB (ii.e./i, parent with OW/OB and adolescent in the normal weight range); or (4) Discordance-Adolescent OW/OB (ii.e./i, adolescent with OW/OB and parent in the normal weight range).biResults:/i/bThere were 475 parent/adolescent dyads (31.3%) in the Healthy Weight Concordance group, 351 (23.2%) in the OW/OB Concordance group, 604 (39.8%) in the Discordance-Parent OW/OB group, and 86 (5.7%) in the Discordance-Adolescent OW/OB group. Being from a low socioeconomic family, identifying as a minority, and identifying as a male parent were associated with an OW/OB dyadic BMI. Higher levels of adolescent and parent emotional eating were significantly associated with parent/adolescent dyads being in the OW/OB Concordance group. Parent emotional eating was also associated with Discordance-Parent OW/OB. In contrast, parents' and adolescents' physical activity self-efficacy was associated with a Healthy Weight dyadic BMI vs. OW/OB Concordance or Discordance-Parent OW/OB.biConclusions:/i/bOur findings highlight the strength of OW/OB concordance in families, especially among lower socioeconomic and ethnic minority families and the significance of emotional eating and physical activity self-efficacy in contributing to BMI patterns among parents and adolescents.

The present study investigated an integrated life course model, drawn from the life course theoretical perspective, to elucidate youth’s additive, cascading, and cumulative life course processes stemming from early socioeconomic adversity and education polygenic score (education PGS) as well as potential interactions between them (GxE), which contribute to subsequent young adult socioeconomic outcomes. Additionally, the independent, varying associations among social and genetic predictors, life-stage specific educational outcomes (educational achievement in adolescence and educational attainment, in later stages), and young adult economic outcomes were examined. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. Early family socioeconomic adversity and individual education PGS were associated with life stage-specific educational outcomes through additive and cascading processes linked to young adults’ economic outcomes (personal earnings) through a cumulative process. A GxE moderation existed between individuals’ education PGS and early socioeconomic adversity at multiple life stages, explaining variation in adolescent educational outcomes. Both early socioeconomic adversity and education PGS were persistently associated with youth’s educational and economic outcomes throughout the early life course. In sum, the findings based on the integrated life course model showed how additive, cascading, and cumulative processes were related and conditioned one another, generating specific life course patterns and outcomes. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental characteristics.

Background: Previous literature has shown a negative relationship between parental stress and youth moderate to vigorous physical activity (MVPA). This study examined (1) the relationship between parental stress and adolescent MVPA, (2) the moderating role of family communication on this relationship, and (3) gender differences in these effects among overweight and obese Hispanic adolescents. Methods: Hispanic adolescents (N = 280, 52% female, 13.0 [0.8] y old, 44% obese, 12% severely obese) and their parents (88% female, 44.9 [6.5] y old) completed baseline measures for an efficacy trial. Adolescents self-reported MVPA in minutes per week for work, transportation, and recreation using a validated measure. Multiple regression analyses with interaction terms and multigroup methods were conducted. Results: There was a negative effect of parental stress on adolescent MVPA (β = −0.15, t = −2.018, P ≤ .05). This effect was moderated by family communication (β = 0.20, t = 2.471, P = .01), such that the association between parental stress and youth MVPA was stronger for adolescents with low levels of family communication. Furthermore, a multiple group model showed that the interaction was significant for boys (β = 0.27, t = 2.185, P = .03), but not for girls. Conclusions: Findings provide support that addressing parental stress and family communication may help facilitate MVPA among Hispanic boys, the most at-risk group for pediatric obesity.

Moving beyond personal responsibility-taking behaviors, this paper examines communicative (interpersonal talk and online message sharing) and civic (public policy support and intention to donate) b...

Curcuma zedoaria rhizome (Zingiberaceae) is a well-known traditional medicinal plant used in Ayurvedic and traditional Chinese medicine to treat various cancers. This study aimed to identify the cytotoxic components from C. zedoaria rhizomes that act against gastric cancer, which is the third leading cause of death from cancer worldwide because the MeOH extract of C. zedoaria rhizome was found to show a cytotoxic effect against gastric cancer AGS cells. Repeated column chromatography and semi-preparative HPLC purification were used to separate the components from the C. zedoaria MeOH extract. Two new sesquiterpenes, curcumenol-9,10-epoxide (1) and curcuzedoalide B (2), and 12 known related sesquiterpenes (3–14) were isolated from the C. zedoaria MeOH extract. The structures of new compounds were determined by 1D and 2D NMR spectroscopic experiments and HR-ESIMS, and quantum chemical ECD calculations. The cytotoxic effects of the isolated compounds were measured in human gastric cancer AGS cells using an MTT cell viability assay. Compounds 9, 10, and 12 exhibited cytotoxic effects against gastric cancer AGS cells, with IC50 values in the range of 212–392 μM. These findings provide further experimental scientific evidence to support the traditional use of C. zedoaria rhizomes for the treatment of cancer. Curcumenol (9), 4,8-dioxo-6β-methoxy-7α,11-epoxycarabrane (10), and zedoarofuran (12) were identified as the main cytotoxic components in C. zedoaria rhizomes.

OBJECTIVE General psychopathology (GPP), as reflected by dimensional symptoms of depression, anxiety, and hostility, has been shown to have a persistent influence on physical health problems. Yet, little is known about longitudinal changes in GPP and the long-term GPP- physical health process within married couples over their midlater years. This study examined the multilevel influence of GPP trajectories on husbands' and wives' physical health problems at the couple- and individual-levels over a period of 25 years. METHOD A sample of 257 husbands and wives in enduring marriages (Mean age = 40.85 and 38.81 years in 1990 for husbands and wives, respectively) in Iowa self-reported their GPP and physical health from 1990 to 2015. Latent growth curve modeling was used to investigate the influence of GPP trajectories (as higher-order latent constructs of depressive symptoms, anxiety, and hostility) during midlife (from 1990 to 2001) on physical health problems in later adulthood (2015) at both the individual- and couple-level. RESULTS Couple-level trajectories of GPP (husbands' and wives' shared trajectories of GPP) in midlife had long-term influences on couple-level health problems in later adulthood. After adjusting for this couple-level association, husbands' and wives' individual-specific GPP trajectories uniquely influenced their own health problems (actor effects), but no effects were found for their partners' health problems (partner effects). CONCLUSIONS This study demonstrates the multilevel, long-term associations between GPP and health problems for older adults in a couple context, emphasizing the value of considering both couple- and individual-level psychopathology when developing interventions targeting health outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Purpose The research literature shows that discrepancies in positive parenting between parent and adolescent represents maladaptive parent-adolescent relationships, which are in turn positively linked to later substance use in Hispanic youth. However, questions remain about for whom interventions work and by what mechanisms they work to prevent discrepancies in positive parenting. The current study investigated the moderating and mediating roles of positive parenting discrepancy trajectories on the association between condition effect (i.e., a family-based intervention vs. prevention as usual condition) and substance use among Hispanic youth. Methods Eigth grade Hispanic adolescents (mean age = 13.86) and their primary caregivers (mean age = 42.32) were randomly assigned to two conditions: Familias Unidas (n = 376) or prevention as usual (n = 370). Participants were assessed at baseline and at 6, 18, and 30 months postbaseline. Using structural equation modeling, moderated mediation analyses were conducted to test whether the relationship between condition and past 90-day substance use at 30 months was mediated by discrepancy trajectories in positive parenting and whether direct and indirect relationships between condition and substance use were moderated by positive parenting discrepancies at baseline. Results The results showed that, relative to prevention as usual, Familias Unidas reduced positive parenting discrepancies across time, when parent reports were higher than adolescent reports at baseline; this in turn, predicted substance use at 30 months postbaseline. Conclusions The findings provide important evidence supporting the need to collect multiple informant reports on positive parenting and examining the directionality of these reports among Hispanic families.

INTRODUCTION: The pervasive use of technology has raised concerns about its association with adolescent mental health, including internalizing symptoms. Existing studies have not always had consistent findings. Longitudinal research with diverse subgroups is needed. METHODS: This study examines the relationship between screen-based sedentary (SBS) behaviors and internalizing symptoms among 370 Hispanic adolescents living in Miami, Florida- United States, who were followed for 2 ½ years and assessed at baseline, 6, 18 and 30 months post-baseline between the years 2010 and 2014. Approximately 48% were girls, and 44% were foreign-born, most of these youth being from Cuba. Mean age at baseline was 13.4 years, while at the last time-point it was 15.9 years. RESULTS: Findings show that girls had higher internalizing symptoms and different patterns of screen use compared to boys, including higher phone, email, and text use. SBS behaviors and internalizing symptoms cooccurred at each time-point, and their trajectories were significantly related (r =0.45, p < .001). Cross-lagged panel analyses found that SBS behaviors were not associated with subsequent internalizing symptoms. Among girls, however, internalizing symptoms were associated with subsequent SBS behaviors during later adolescence, with internalizing symptoms at the 18-month assessment (almost 15 years old) associated with subsequent SBS behaviors at the 30-month assessment (almost 16 years old; β = 0.20, p < .01). CONCLUSIONS: Continued research and monitoring of internalizing symptoms and screen use among adolescents is important, especially among girls. This includes assessments that capture quantity, context, and content of screen time.

Despite the availability of efficacious and effective family-based interventions, such interventions are scarce for sexual minority adolescents, particularly among ethnic/racial minorities. Prior to creating an entirely new intervention, a prudent first step may be to determine if existing interventions are efficacious in reducing risk behaviors in sexual minority adolescents. This study assesses the relative efficacy of a general, family-based intervention (Familias Unidas) on improving substance and condom use outcomes among Hispanic adolescents with same gender sexual behaviors (HASGB). Data across five distinct trials of Familias Unidas were synthesized. HASGB were randomized either to an intervention (n = 94) or control condition (n = 100). Mediation analyses tested for intervention efficacy on past 90-day substance (cigarette/alcohol/illicit drug) use and condomless sex at last intercourse in HASGB participants and whether family functioning indicators-parent-adolescent communication, positive parenting, and parental monitoring of peers-mediated the effects. Post hoc analyses explored the moderating role of study target population based on prior risk. Familias Unidas did not impact substance use but significantly reduced condomless sex postintervention relative to the control condition. Hypothesized mediators did not explain this effect. Post hoc analyses indicated that the effect was significant in studies that recruited based on prior risk but not studies that recruited universal samples. Our results suggest that a general, family-based intervention may have positive effects on condom use in HASGB, particularly those with prior indicated risk. Identifying intervention components that drive this effect in addition to developing tailored content for HASGB is needed.

In this article, several dyadic analyses are applied to illustrate how they can be used to answer distinct research questions regarding associations between dyad members over time (longitudinal interdependence). This article focuses on how to conceptualize and empirically assess distinct dyadic processes, including time-sequential processes involving change in rank-order, parallel change processes involving intra-individual changes, dynamic dyadic processes involving both intra-individual changes and time-specific deviations (from intra-individual change), and accelerated dyadic processes involving acceleration of intra-individual change. These dyadic processes are depicted by four different dyadic models; a cross-lagged autoregressive model, a dyadic latent growth model (with and without structured residuals), and a dyadic latent change score model, respectively. These four longitudinal dyadic models are illustrated using a sample of 251 husbands and wives in enduring marriages. Each model focuses on a different dyadic process demonstrating distinct ways to empirically assess longitudinal interdependence; thus, when analyzing data, dyadic researchers must weigh the advantages and disadvantages of each and select the modeling approach that is most appropriate for the research question. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Parental exposure to adverse childhood experiences (ACEs) has been documented as a strong risk factor for subsequent externalizing behaviors in their youth. Although studies have investigated ACEs and their intergenerational association with youth externalizing behaviors, this association has not been investigated in Hispanic families. Additionally, substantial gaps in the literature exist explaining the mechanisms by which this association occurs. The purpose of this study was to examine whether parent-adolescent communication and parental depressive symptomatology explain the relationship between parent's ACE score and adolescent externalizing behaviors. This secondary data analysis utilized baseline data from an ongoing randomized controlled trial evaluating the relative effectiveness of an online parenting intervention for Hispanic adolescents. The sample consisted of 456 parents and their adolescents between the ages of 12-16. Using path modeling, parental depressive symptomatology and parent-adolescent communication were simultaneously examined as mechanisms that may explain the intergenerational relationship between parental exposure to ACEs and externalizing behaviors in Hispanic youth. Parental depressive symptomatology and parent-adolescent communication both significantly mediated the association between parental exposure to ACEs and adolescent externalizing behaviors. Understanding the mechanisms explaining the intergenerational association between parental exposure to ACEs and adolescent externalizing behaviors may aid future research examining problematic behaviors in Hispanic youth.La exposición de los padres a las experiencias adversas de la niñez se ha documentado como un factor de riesgo potenciador de comportamientos posteriores de exteriorización en sus hijos. Aunque existen estudios donde se han investigado las experiencias adversas de la niñez y su asociación intergeneracional con las conductas de exteriorización de los jóvenes, esta asociación no se ha investigado en familias hispanas. Además, existen vacíos considerables en la bibliografía sobre la explicación de los mecanismos por los cuales ocurre esta asociación. El propósito de este estudio es analizar si la comunicación entre padres y adolescentes y la sintomatología depresiva de los padres explican la relación entre el puntaje de las experiencias adversas de la niñez de los padres y las conductas de exteriorización de los adolescentes. En este análisis de datos secundarios se utilizaron datos basales de un ensayo controlado aleatorizado en curso que evalúa la eficacia relativa de una intervención virtual sobre la crianza para adolescentes hispanos. La muestra consistió en 456 padres y sus adolescentes de entre 12 y 16 años. Utilizando un modelo de pautas, se analizaron simultáneamente la sintomatología depresiva de los padres y la comunicación entre los padres y los adolescentes como mecanismos que pueden explicar la relación intergeneracional entre la exposición de los padres a experiencias adversas en la niñez y las conductas de exteriorización en los jóvenes hispanos. La sintomatología depresiva de los padres y la comunicación entre los padres y los adolescentes mediaron significativamente la asociación entre la exposición de los padres a experiencias adversas en la niñez y las conductas de exteriorización de los adolescentes. La comprensión de los mecanismos que explican la asociación intergeneracional entre la exposición de los padres a experiencias adversas en la niñez y las conductas de exteriorización de los adolescentes puede ayudar a investigaciones futuras que analicen las conductas problemáticas de los jóvenes hispanos.父母在童年期经历过逆境,他们的过往经历已被证明是青少年后期外化行为的一个强相关的风险因素。虽然有研究调查了ACE及其对下一代年轻孩子的外化行为的关系, 但这种关系尚未在西班牙裔家庭中进行调查过。此外, 文献中找不到这种关联发生的机制的阐释。本研究旨在探讨父母-青少年之间的沟通与父母抑郁症状是否能解释父母ACE得分与青少年外化行为之间的关系。间接的数据分析利用了一项持续进行的随机对照试验的基线数据, 该试验评估了对西班牙裔青少年其父母进行远程在线的干预的相对有效性。该样本由456名父母和他们12-16岁的青少年组成。本研究采用路径模型, 同时研究了父母抑郁症状和父母-青少年子女的沟通机制, 以解释西班牙裔青少年其父母有经历过逆境这种情况对下一代孩子的外化行为之间的代际关系。父母的抑郁症状和青少年子女与家长之间的沟通均显著地调和了父母在童年期间经历过逆境对下一代青少年外化行为的影响这两者之间的关系。父母在童年期经历过逆境, 这种情况会影响到其青少年子女的外化行为, 理解这种机制有可能有助于未来针对关于西班牙裔青少年的问题行为所作的相关研究。.

Crisis migration refers to displacement of large numbers of individuals and families from their home countries due to wars, dictatorial governments, and other critical hazards (e.g., hurricanes). Although crisis migration can adversely influence direct and indirect effects on the mental health of adults and their children collectively as families, there is a deficiency in theory that addresses family level processes in this crisis migration context. We propose the Family Crisis Migration Stress Framework, which consolidates what is known about the multiple factors affecting mental health outcomes of crisis migrants into one cohesive model. In our article, we synthesize relevant theories and models of disaster, migration, and family resilience in order to create a framework in which to organize the complex processes that occur within families as a result of migration and that affect the mental health of children. We include examples from various national settings to illustrate the tenets of our framework. Future policy and intervention for crisis migrant should focus on the family as a unit, instead of parents and children as individual entities.

This study examined the efficacy of a healthy lifestyle family-based intervention in reducing substance use and sexual risk behaviors compared with prevention as usual over 24 months in Hispanic adolescents. Participants were overweight/obese Hispanic adolescents (N = 280; M age 13.01; SD = .82) in the 7th/8th grade and their primary caregivers. Participants were randomized to either the healthy lifestyle family-based intervention or to the control condition (i.e., referral to community services offered for overweight and/or obese adolescents and their families). Outcomes included adolescent substance use and sexual risk behaviors among adolescents. Intervention effects were found for adolescent alcohol (b = - 0.37, 95% CI = [- 0.49, - 0.26]), marijuana (b = - 1.00, CI = [- 1.22, - 0.78]), and non-prescription drug use (b = - 3.77, CI = [- 6.49, - 1.05]) over 24 months. No significant intervention effects were found for adolescent sexual risk behaviors. Findings suggest that Familias Unidas for Health and Wellness reduces adolescent alcohol, marijuana, and non-prescription drug use across time. ClinicalTrials.gov Identifier: NCT03943628.

Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.

Objective To explore the moderation effect of parental social determinant factors—educational attainment, income, and nativity—on intervention effects of a family-based lifestyle intervention, Familias Unidas for Health and Wellness (FUHW). Design Longitudinal analysis across 6- and 24-months postbaseline of a randomized controlled trial. Participants Two-hundred and eighty primary caregivers. Analysis Moderation analysis was used to examine the interactive effects between intervention effects and social determinant factors. Main Outcome Measures Parental body mass index, added sugar intake, sugar-sweetened beverage intake, and fruits and vegetable intake. Results Findings indicated that FUHW effects on added sugar intake were moderated by educational attainment (P = 0.006), income (P = 0.023), and nativity (P = 0.024). In addition, FUHW effects on sugar-sweetened beverage intake were moderated by parent education (P = 0.042). Conclusions and Implications This study suggests that FUHW may be helpful in reducing added sugar and sugar-sweetened beverage intake for Hispanic parents who face social determinant factors—educational attainment, income, and foreign-born status—that may influence their dietary behaviors. By including demographic information in intervention development, effects may be enhanced by ensuring that considerations related to participants’ socioeconomic and cultural status are incorporated into intervention components and help reduce overweight and obesity.

The syndemic conditions of low education, childhood maltreatment, depression, HIV, alcohol and cocaine use, and obesity have been established as independent risk factors for cardiovascular risk, but research examining the association between syndemic conditions and cardiovascular risk in high-risk populations is lacking. A total of N = 503 participants underwent an ultrasound of the carotid artery to assess for atherosclerotic plaque. Participants, HIV-infected (n=202) and HIV-uninfected (n=301) with and without a history of cocaine use, were a mean age of 36.13 years (SD =9.51); 50% were male, and 62% were African-American. Each syndemic condition was associated with 8% greater odds of atherosclerotic plaque (OR = 1.08), 9% greater odds of systolic blood pressure (OR = 1.09), and 10% greater odds of diastolic blood pressure (OR = 1.10). Multilevel research, interventions, and public policy initiatives are needed to activate stakeholders at each level to maximize their impact at a community level among populations with high rates of syndemic conditions.

The study examined the mediating roles of risky health lifestyle and depressive symptoms in relation to childhood/adolescence adversity and young adult cardiometabolic risk with data from the National Longitudinal Study of Adolescent to Adult Health (n = 9421). Four classes of youth emerged from a latent class analysis with varying early adversity patterns: (a) both low disadvantaged SES and stressful experience (54.8%), (b) high disadvantaged SES and low stressful experience (31.0%), (c) low disadvantaged SES and high stressful experience (10.9%), and (d) both high disadvantaged SES and stressful experience (3.3%). Early adversity had multiple direct and indirect effects on CM risk for those experiencing SES-related adversities. Instead, early adversity generated mediational processes between adversity and CM risks through risky health lifestyle and depressive symptoms for those experiencing stressful experience. Implications for intervention when dealing with youths who have experienced multiple forms of early adversity are discussed.

Pinus koraiensis pinecones are considered an undesired waste by-product of the processing of seeds. However, recent studies of the potential anti-tumor effects of the pinecones have led to increasing interest in their chemical constituents. The present study examined the potential antiangiogenic effects of the constituents of pinecones and further characterized their underlying mechanisms of action. Chemical investigation of a water extract of P. koraiensis pinecones led to the isolation and identification of the eight main components including five diterpenoids (1-5), two monoterpenes (6,7) and a phenolic acid (8). The structure of the compounds was determined by spectroscopic analysis of NMR spectra and LC/MS analysis. Of the isolated compounds, 7α,15-dihydroxydehydroabietic acid (5) significantly inhibited the promotion of angiogenesis in human umbilical vein endothelial cells (HUVECs). Compound 5 inhibited angiogenesis through downregulation of the VEGF, p-Akt and p-ERK signaling pathways. These results provide experimental evidence of a novel biological activity of 7α,15-dihydroxydehydroabietic acid (5) as a potential antiangiogenic substance. This study also suggests that compound 5 could potentially be a useful adjuvant therapeutic substance for cancer prevention and treatment.

Background The minimal clinically important difference (MCID) is the threshold value for a change that would be considered meaningful by the patient. The purpose of this study was to determine the MCIDs for the Rowe score and the Western Ontario Shoulder Instability Index (WOSI) score after arthroscopic repair of anterior shoulder instability. Methods The study enrolled 198 patients who underwent an arthroscopic stabilization procedure for anterior shoulder instability. Patients were assigned to no change and minimal change groups by a 15-item questionnaire at the 1-year postoperative visit. The Rowe and WOSI scores were assessed preoperatively and at a 1-year postoperative follow-up. The MCID was calculated using an anchor-based method and a distribution-based method. Results There were 9 patients in the no change group and 26 patients in the minimal change group. The MCID for the Rowe score was 9.7 according to the anchor-based method. By the anchor-based method, the authors could not calculate MCID for the WOSI score because of insignificant difference of the mean score changes between the no change and minimal change groups. By the distribution-based method, MCIDs for the Rowe and the WOSI scores were 5.6 and 151.9 with the standard deviation–based estimate and 2.2 and 60.7 with the effect size–based estimate, respectively. Conclusions To assess the effectiveness of an arthroscopic stabilization procedure for anterior shoulder instability using the Rowe score, a difference of at least 9.7 in the score is clinically relevant. To compare clinical outcomes between different modalities, we should consider not only statistically significant differences but also the MCID.

Research has shown that family functioning has been positively associated with physical activity and dietary intake, both of which are obesity-related risk factors. The most widely practiced methodological approach to assessing this construct in empirical studies relies on either parent or adolescent report. Yet, discrepancy in parent and adolescent report of family functioning may provide a fuller understanding of the effects of this construct on obesity-related health outcomes. This is especially important among Hispanics, a population that suffers from disproportionately high rates of obesity and its health-related consequences. The purpose of this study was to examine whether, and to what extent, parent-adolescent discrepancies in family functioning are associated with physical activity, and fruit and vegetable and added sugar intake. We estimated discrepancy scores between parents and adolescents (n = 280 dyads) in family functioning. Then, using structural equation modeling, we tested the effect of family functioning discrepancy on adolescent reports of physical activity, fruits and vegetables intake, and added sugar intake. After controlling for adolescent's gender and BMI, family functioning discrepancy was significantly associated with reduced physical activity (β = -.14*, 95% CI ([-.26, -.05]) and fruits and vegetables intake (β = -.22*, 95% CI [-.38, -.09]) such that the larger the discrepancy between parent and youth reported family functioning, the fewer days of adolescent physical activity and the poorer the fruits and vegetables intake. Our findings provide insight for the role of the family in Hispanic adolescent health outcomes and rationale for capturing rich data to better understand that role. (PsycINFO Database Record

This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8–24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2%). Results indicate that at baseline, 48.7% of the women screened positive for depression (scores of ≥13 on the “Edinburgh Postnatal Depression Scale 10”), while postnatally (at 12 months) the prevalence was 35.6%. Mothers who did not have depression before or after were 205 (50.1%), those who had depression before and after were 58 (14.4%), those who had depression only before were 81 (20.1%), and those who had depression only after were 59 (14.6%). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.

Recent research suggests that psychosocial resources and life stressors are mediating pathways explaining socioeconomic variation in young adults' health risks. However, less research has examined both these pathways simultaneously and their genetic moderation. A nationally representative sample of 11,030 respondents with prospective data collected over 13 years from the National Study of Adolescent to Adult Health was examined. First, the association between early cumulative socioeconomic adversity and young adults' (ages 25–34) cardiometabolic disease risk, as measured by 10 biomarkers, through psychosocial resources (educational attainment) and life stressors (accelerated transition to adulthood) was examined. Second, moderation of these pathways by the serotonin transporter linked polymorphic region gene (5-HTTLPR) was examined. There was evidence for the association between early socioeconomic adversity and young adults' cardiometabolic disease risk directly and indirectly through educational attainment and accelerated transitions. These direct and mediating pathways were amplified by the 5-HTTLPR polymorphism. These findings elucidate how early adversity can have an enduring influence on young adults' cardiometabolic disease risk directly and indirectly through psychosocial resources and life stressors and their genetic moderation. This information suggests that effective intervention and prevention programs should focus on early adversity, youth educational attainment, and their transition to young adulthood.

Although previous studies have documented spousal resemblance in health attributes, questions remain regarding the longitudinal resemblance of spouses' body mass index (BMI) and the possible formation of couple-level BMI trajectory patterns. Consequentially, we know little about how the longitudinal resemblance of spouses' BMI may link couples' varying socioeconomic experiences to their physical health outcomes in later years. Thus, the present study using prospective data from a sample of 255 couples in enduring marriages over a period of 26 years (from 1991 to 2017) examined (a) the existence of couple-level BMI trajectory patterns in mid-later years, (b) their social stratification into heterogeneous groups of couples associated with family economic hardship (FEH), and (c) differential later-life health outcomes of these groups. The results provided evidence for groups of couples with distinct BMI trajectory patterns. These groups were associated with latent groups of FEH trajectories, suggesting a persistent association between couple BMI and FEH. Couple BMI trajectory patterns were consequential for physical health consequences in later years. Two features of couple BMI trajectory patterns, severity and synchrony, were utilized to explain these associations. Taken together, the results provided evidence for a couple-level FEH-BMI-health process over the life course and emphasize the impact of severity and synchrony in couples' BMI for their health problems in later adulthood. Findings are discussed as they relate to health policies and interventions focusing on the well-being of married couples in later life, particularly the need for couple-focused obesity-related interventions and policies that mitigate economic hardship given its long-lasting health impacts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

BackgroundThe Sub-Saharan Africa region still remains the epicentre of the global HIV/AIDS epidemic. With regards to new paediatric HIV infections, almost 90% of new HIV infections are among children (aged 0-14 years), largely through mother to child transmission. Male Partner Involvement in Prevention of Mother to Child Transmission programmes is now strongly advocated as being key in improving infant outcomes. This study describes the role of Male Partner Involvement on infant HIV infection and mortality survival in the first year among HIV-exposed infants born from HIV positive mothers.MethodsThis study was a two-phase, two condition (intervention or control) longitudinal study as part of a clinic-randomized Prevention of Mother to Child Transmission controlled trial. For Phase 1, female participants were recruited without their male partners. In Phase 2, both female and male participants were enrolled in the study as couples in order to encourage active Male Partner Involvement during pregnancy. Participants had two assessments prenatally (8-24 weeks and 32 weeks) and three assessments postnatally (6 weeks, 6 months, and 12 months).ResultsAbout 1424 women were eligible for recruitment into the study and 18 eligible women declined to participate. All women had a partner; 54% were unmarried, 26% were cohabiting, and 20% were married. Just over half (55%) of the women had been diagnosed with HIV during the current pregnancy. Phase 1 had significantly more HIV-infected infants than Phase 2 at 12-months postpartum (aOR = 4.55 [1.38, 15.07]). Increased depressive symptoms were associated with infant HIV infection at 12-months (aOR = 1.06 [1.01, 1.10]). Phase 1 also had a significantly greater proportion of dead and HIV-infected infants than Phase 2 at 12-months (aOR = 1.98 [1.33, 2.94]).ConclusionMale partner involvement in antenatal care is critical in ensuring infant survival and HIV infection among children born to HIV-positive mothers. This study highlights the high risk of ante-and-post natal depression and underscores the need of screening for depression during pregnancy.Trial registrationClinicalTrials.Gov; Trial Number NCT02085356.

Voluntary medical male circumcision has been shown to provide a 50%–70% reduction in the risk of HIV infection without contributing to behavioral disinhibition of safer sexual practices. This study examined the interim implementation and dissemination data of Spear and Shield 2, an HIV risk-reduction program in Zambia. The purpose of this interim review was to identify contextual challenges to implementation and implement midcourse corrections associated with sustainability of program delivery. Using a mixed-methods design, quantitative evaluations of organizational functioning, barriers to implementation, burnout, and organizational readiness, as well as qualitative data utilizing the Consolidated Framework for Implementation Research (CFIR), were examined to evaluate program implementation. Participants were 184 health care providers from 46 clinics in Zambia. Successful implementation was associated with better community and leader support, and employee readiness and motivation. Quantitative assessments were not related to implementation and provided a limited picture of implementation outcomes. Results suggest that the qualitative data underlying the CFIR constructs provided a nuanced, contextual assessment of implementation, and dissemination outcomes. The CFIR may be valuable in informing the implementation of evidence-based interventions in other parts of Zambia.

Background Stigma can exacerbate negative health outcomes in people living with HIV (PLWH). This longitudinal, cluster randomized controlled trial in rural Mpumalanga, South Africa, examined the interdependence of HIV-related stigma among pregnant couples living with HIV, and the potential impact of a lay health worker delivered intervention, Protect Your Family, on changes in stigma over time across couples, controlling for physical intimate partner violence (IPV), verbal IPV, gender, HIV knowledge, and months since HIV diagnosis. Using a form of the Actor-Partner Interdependence model, changes in stigma over time were also examined within each dyad of seroconcordant participants with HIV. Method Antenatal clinics were randomized to experimental or control conditions, and participants completed baseline antenatal and 12-month postpartum assessments. Both women and male partners participated in intervention sessions in gender concordant groups and couple or individual sessions. Results Multilevel models (N = 1475) revealed stigma was related to condition and verbal intimate partner violence, but not time. Using an Actor-Partner Interdependence cross-lagged path model to examine within dyad changes in stigma for seroconcordant couples (n = 201), intervention condition participants' stigma levels were not interdependent over time. Women's 12-month stigma was related to their partners' stigma at baseline in the control condition, but not in the intervention condition. Discussion Compared to women in the control condition, postpartum stigma among women in the intervention condition was not related to their male partners' stigma, suggesting that women's perception of stigma became uncoupled from that of their partners. The intervention may have promoted female empowerment to shape their own beliefs and attitudes towards what it means to be infected with HIV, and express their own agency in responding to how others treat them and they treat themselves.

Introduction Evidence on prospective bidirectional associations between e-cigarette and alcohol use among adolescents can inform prevention and policy but is largely absent from the literature. Methods Data were drawn from a prospective cohort of students attending 10 Los Angeles high schools (N = 3396; baseline mean age = 14.1, SD = 0.4). Students completed surveys every 6-months from 2013 to 2017; 8 total waves. Analyses were restricted to (a) individuals who were never users of alcohol (N = 2394) or (b) individuals who were never users of e-cigarettes (N = 2704) at baseline. Repeated-measures, generalized linear mixed models were used to estimate the adjusted odds of past 6-month alcohol and e-cigarette initiation, in separate models. Results Among alcohol never-users at baseline, 15.7 % (N = 375) initiated alcohol use over the study period. Compared to never-users of e-cigarettes, those who reported use of e-cigarettes had 3.5 times the odds of subsequently initiating alcohol use in the following wave (OR = 3.54; 95 % CI: 2.81, 4.47). Stronger associations were observed for males (OR = 4.94; 95 % CI: 3.78, 6.45) than for females (OR = 3.21; 95 % CI: 2.33, 4.41; pinteraction = 0.04). Among e-cigarette never-users at baseline, 26.3 % (N = 709) initiated e-cigarette use over the study period. Compared to never-users of alcohol, those who reported use of alcohol had 3.2 times the odds of subsequently initiating e-cigarette use in the following wave (OR = 3.23; 95 % CI: 2.68, 3.89). This association did not differ by gender. Conclusions E-cigarette and alcohol use can be markers to identify youth at risk for future alcohol and e-cigarette use, respectively. Research examining mechanisms underlying these associations is needed to infer causality.

Aims To assess the concurrent validity of the two-item NIAAA/American Academy of Pediatrics Brief Alcohol Use Screener, a developmentally sensitive assessment instrument, in a school-based sample of adolescents. Method The sample consisted of 756 adolescents (53% girls; Mage = 13.7 years; SD = 1.6 years) in the 6th (n = 192), 8th (n = 283), and the 10th (n = 281) grades from Miami-Dade County, FL and Prince George's County, MD. Adolescents completed the NIAAA/AAP Brief Alcohol Use Screener, which consists of two items asking about adolescents' alcohol use and about peers' alcohol use during the last year. Peer-Risk is categorized into 'No Peer-Risk' versus 'Heightened Concern'; Self-Risk is categorized into 'No-Risk,' 'Low-Risk,' 'Moderate-Risk' or 'High-Risk,' based on alcohol use patterns and age. Adolescents also completed measures of recent alcohol use and four previously validated screener instruments. Results Relative to the self-use 'No-Risk' category, adolescents classified into the 'Low-,' 'Moderate-' and 'High-Risk' categories reported progressively greater alcohol use and misuse during the last 90 days. Similar patterns were observed between the Peer-Risk categories. Combined, the two NIAAA/AAP screener items were positively related to recent alcohol use and outperformed the other screeners examined. Conclusions Results from the present study support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments. Short Summary The current results support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments, in a school-based sample of adolescents.

Background Research has documented heterogeneous developmental trajectories of specific symptoms, such as anxiety and depression, in late childhood and adolescence. Few studies, however, have examined the heterogeneity of general psychopathology (GPP) trajectories considering symptoms of anxiety, depression, and hostility in adolescence simultaneously. Identifying antecedents for distinct trajectory groups of GPP, and their respective consequences, may provide insight into the etiological underpinnings of social antecedents of different symptoms and inform the targets and timing of intervention. Methods European American target adolescents (N=444, 53% female) evaluated three domain specific symptoms (i.e., symptoms of anxiety, depression, and hostility) as well as psychosocial risks and social consequences over 10 years (from 1990 [Wave 2] to 2001 [Wave 13]). First- and second-order growth mixture models (SOGMMs) were used to identify trajectories of GPP and specific symptoms from mid-adolescence through young adulthood, as well as their predictors and consequences. Results A three-class model consisting of high and escalating (10.1%), high and decreasing (23.2%), and consistently low (66.7%) GPP emerged as the preferred solution. More predictors and outcomes were associated with membership in both the high and escalating and the high and declining classes of GPP compared to corresponding classes of the specific symptoms trajectories. Limitations Self-reported information regarding three symptoms may be a source of bias within the current study. Conclusion Our findings suggest that unified interventions and/or prevention efforts are needed to not only assess specific symptoms, but also to treat GPP in adolescence.

The long-term impact of Familias Unidas on suicidal behaviors among Hispanic 8th graders (N = 746) was examined along with parent-adolescent communication as a moderator of intervention effectiveness. At baseline, 9.2% (95% CI = 7.3%-11.6%) of adolescents reported suicide ideation and 5.7% (95% CI = 4.1%-7.7%) reported a past year suicide attempt. There were no significant intervention effects on suicidal behaviors; however, parent-adolescent communication was a moderator of suicide attempts in the past year, across the intervention (b = -.01, p = .01). Results suggest that Familias Unidas reduces suicidal behaviors among Hispanic adolescents with low levels of parent-adolescent communication despite no suicide-specific intervention content. Implications of these findings are discussed.

The current study examines how a personal health story on a blog can influence individuals' perceived social norms, adopting the notion that social norms are "group identity-based codes of conduct". For that, we tested the effects of story framing and personal experience on perceived similarity, which interacts with social media metrics in forming perceived social norms. In an online experiment, college students (

This study examined whether regulatory focus changes the effects of gain- and loss-framed narratives on promoting Human Papillomavirus (HPV) vaccination among young females in Singapore. We conducted a quasi-experiment in which participants reported their regulatory focus and then read either a gain- or loss-framed narrative about HPV vaccination. The results showed an overall advantage of a loss frame over a gain frame in producing transportation and self-referent emotions, which in turn led to increased vaccination intentions. This pattern was more pronounced among those high in prevention or promotion focus, with self-referent emotions being the primary mediator transferring the interactive effects onto vaccination intentions. This study contributes to the extant literature on narrative persuasion by addressing the specific mechanisms of the effect of framing employed in narratives.

Guided by construal level theory (CLT), this study investigates the interplay between two framing approaches that address outcomes of obesity-related policies. A randomized experiment (N = 299) was conducted with a 2 (gain- vs. loss-frame) X 2 (societal- vs. individual-frame) between-participants design. Consistent with CLT, frame combinations with consistent construal levels were more persuasive. Compared to a societal-loss frame, a societal-gain frame was perceived as a stronger argument, which in turn increased policy support. Participants were also more likely to engage in healthier diets and physical activity when messages highlighted societal-gain rather than societal-loss. This study offers important insights for combining multiple framing approaches in a persuasive message to improve policy support as well as individual health decisions. Accepted version

LC/MS-based phytochemical analysis of an EtOH extract of the roots of rice (Oryza sativa; Gramineae), which takes a crucial role in the stable crop population in Asia, resulted in the isolation of a new lignan, oryzativol C (1), as a minor component. The chemical structure of compound 1 was unambiguously confirmed using spectroscopic evidence (including 1D- and 2D-NMR data), HR-ESI-MS, and CD data analysis. Considering the traditional medicinal efficacy of O. sativa and its importance as a food crop, compound 1 was evaluated for effects on breast cancer cell lines (MDA-MB-231) and on glucose-stimulated insulin secretion in an INS-1 pancreatic β-cell line. Compound 1 showed mild cytotoxicity toward the MDA-MB-231. Furthermore, compound 1 stimulated insulin secretion in INS-1 pancreatic β-cells without inducing cytotoxicity. These results indicate that compound 1 is an active ingredient of O. sativa that offers health benefits including inhibition of breast cancer cell proliferation and hyperglycemia control.

South African guidelines for prevention-of-mother-to-child-transmission (PMTCT) of HIV emphasize exclusive breastfeeding (EBF). This study examined the impact of a PMTCT intervention and male involvement on EBF. In a two-phase cluster-randomized trial, rural South African community health centers were randomized to offer HIV-infected pregnant women PMTCT standard of care plus either: a behavioral PMTCT intervention, or a time-equivalent attention-control condition. Phase 1 women had non-participating male partners; Phase 2 women had participating partners. Pregnant women (n = 1398) were assessed on HIV stigma, disclosure of HIV status to partner, male involvement, and family planning knowledge. Feeding practices were assessed 6 weeks postpartum (56% retained). Reduced depressive symptomatology predicted EBF 6 weeks postpartum, adjusting for attrition (AOR = 0.954, p = 0.001). Neither male involvement in antenatal care, phase, HIV stigma, disclosure, nor family planning knowledge predicted EBF. Future studies and perinatal care should address depression, which has important implications for infant health.

This study examined participant attendance patterns and individual (e.g., income), family dynamics (e.g., communication), and cultural (i.e., Americanism, Hispanicism) predictors of these patterns among Hispanic families enrolled in a 12-week family-based intervention, Familias Unidas for Health and Wellness. Hispanic adolescents (n = 140, 49% female, 13.04 &plusmn, 0.87 years old, 36% overweight, 64% obese, 39% immigrants) and their parents (87% female, 42.09 &plusmn, 6.30 years old, BMI 30.99 &plusmn, 6.14 kg/m2, 90% immigrants) were randomized to the intervention condition. A repeated measures latent class analysis that included 12 binary variables (yes/no) of attendance identified three subgroups of attendance patterns: consistently high, moderate and decreasing, and consistently low. An ANOVA was then conducted to examine whether the identified attendance patterns differed by individual, family dynamics, and cultural characteristics at baseline. Parents in the consistently high attendance group had lower Americanism than those in either of the other attendance groups. Adolescents in the consistently high attendance group had lower Hispanicism than those in either of the other attendance groups. No other variables significantly discriminated between attendance groups. Sustained attendance in the Familias Unidas for Health and Wellness intervention may be driven by Hispanic parents&rsquo, desire to better understand their host culture, connect with other culturally similar parents, and reconnect adolescents with their heritage culture.

While substance use and sexual risk behaviors among Hispanic youth continue to be public health concerns, few evidence-based preventive interventions are developed for and implemented with Hispanic/Latino youth. The objective of this study was to evaluate the efficacy of eHealth Familias Unidas, an Internet adaptation of an evidence-based family intervention for Hispanics. A randomized controlled trial design (n = 230) was used to evaluate intervention effects on substance use and condomless sex among a sample of Hispanic eighth graders with behavioral problems. Participants were randomized to eHealth Familias Unidas (n = 113) or prevention as usual (n = 117) and assessed at baseline and 3 and 12 months post baseline. We trained mental health school personnel and community mental health professionals to recruit and deliver the Internet-based intervention with Hispanic families. It was hypothesized that, over time, eHealth Familias Unidas would be more efficacious than prevention as usual in reducing drug use (marijuana, cocaine, inhalants, and other drugs), prescription drug use, cigarette use, alcohol use, and condomless sex and that these changes would be mediated by family functioning. Significant intervention effects were found across time for drug use, prescription drug use, and cigarette use. While eHealth Familias Unidas positively affected family functioning, mediation effects were not found. This study demonstrated that family-based eHealth interventions can be efficacious among Hispanic populations when delivered in community settings.

Lespedeza cuneata (Dum. Cours.) G. Don. (Fabaceae), known as Chinese bushclover or sericea lespedeza, has been used in traditional medicine to treat diabetes, hematuria, and insomnia, and it has been reported that bioactive compounds from L. cuneata possess various pharmacological properties. However, there has been no study to determine the active compounds from L. cuneata with potential activity against ovarian cancer. This study aimed to isolate cytotoxic compounds from L. cuneata and identify the molecular mechanisms underlying the apoptosis pathway in ovarian cancer cells. Based on cytotoxic activity identified in the screening test, chemical investigation of the active fraction of L. cuneata led to the isolation of nine compounds including four lignanosides (1–4), three flavonoid glycosides (5–7), and two phenolics (8–9). Cytotoxicity and the molecular mechanism were examined by methyl thiazolyl tetrazolium (MTT) assay and Western blot analysis. Of the isolated compounds, (−)-9′-O-(α- l -rhamnopyranosyl)lyoniresinol (3) demonstrated the strongest effect in suppressing A2780 human ovarian carcinoma cell proliferation in a dose-dependent manner, with an IC50 value of 35.40 ± 2.78 μM. Control A2780 cells had normal morphology, whereas cell blebbing, shrinkage, and condensation were observed after treatment with compound 3. Western blotting analysis showed that compound 3 inhibited A2780 human ovarian cancer cell viability by activating caspase-8, caspase-3, and PARP, which contributed to apoptotic cell death. These results suggest that (−)-9′-O-(α- l -rhamnopyranosyl)lyoniresinol (3) has potent anticancer activities against A2780 human ovarian carcinoma cells through the extrinsic apoptotic pathway. Therefore, (−)-9′-O-(α- l -rhamnopyranosyl)lyoniresinol is an excellent candidate for the development of novel chemotherapeutics.

BackgroundWe evaluate the impact of clinic-based PMTCT community support by trained lay health workers in addition to standard clinical care on PMTCT infant outcomes.MethodsIn a cluster randomized controlled trial, twelve community health centers (CHCs) in Mpumalanga Province, South Africa, were randomized to have pregnant women living with HIV receive either: a standard care (SC) condition plus time-equivalent attention-control on disease prevention (SC; 6 CHCs; n = 357), or an enhanced intervention (EI) condition of SC PMTCT plus the “Protect Your Family” intervention (EI; 6 CHCs; n = 342). HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions and those in the EI, four antenatal and two postnatal PMTCT plus “Protect Your Family” sessions led by trained lay health workers. Maternal PMTCT and HIV knowledge were assessed. Infant HIV status at 6 weeks postnatal was drawn from clinic PCR records; at 12 months, HIV status was assessed by study administered DNA PCR. Maternal adherence was assessed by dried blood spot at 32 weeks, and infant adherence was assessed by maternal report at 6 weeks. The impact of the EI was ascertained on primary outcomes (infant HIV status at 6 weeks and 12 months and ART adherence for mothers and infants), and secondary outcomes (HIV and PMTCT knowledge and HIV transmission related behaviours). A series of logistic regression and latent growth curve models were developed to test the impact of the intervention on study outcomes.ResultsIn all, 699 women living with HIV were recruited during pregnancy (8–24 weeks), and assessments were completed at baseline, at 32 weeks pregnant (61.7%), and at 6 weeks (47.6%), 6 months (50.6%) and 12 months (59.5%) postnatally. Infants were tested for HIV at 6 weeks and 12 months, 73.5% living infants were tested at 6 weeks and 56.7% at 12 months. There were no significant differences between SC and EI on infant HIV status at 6 weeks and at 12 months, and no differences in maternal adherence at 32 weeks, reported infant adherence at 6 weeks, or PMTCT and HIV knowledge by study condition over time.ConclusionThe enhanced intervention administered by trained lay health workers did not have any salutary impact on HIV infant status, ART adherence, HIV and PMTCT knowledge.Trial registrationclinicaltrials.gov: number NCT02085356

Ethnopharmacological relevance Curcuma zedoaria Roscoe (Zingiberaceae), also known as white turmeric or zedoaria, has been used in Ayurveda and traditional Chinese medicine to treat various cancers, and it possesses several sesquiterpenoid compounds. Objective This study aimed to evaluate the therapeutic effects of a methanolic (MeOH) extract of C. zedoaria rhizomes, as well as its active constituents, against gastric cancer, which is a frequently diagnosed cancer in South Korea. Materials and methods Repeated column chromatography, together with semi-preparative HPLC purification, was used to separate the bioactive constituents from the C. zedoaria MeOH extract. The cytotoxic effects of the C. zedoaria MeOH extract and its active compounds were measured in human gastric cancer AGS cells. Expression of proteins related to apoptosis was evaluated using Western blotting analysis. Results The MeOH extract of C. zedoaria rhizomes exerted a cytotoxic effect on AGS cells (IC50: 96.60 ± 4.87 μg/mL). Based on the bioactivity-guided fractionation for antiproliferative activity, a chemical investigation of the MeOH extract led to the isolation of five sesquiterpenes including isoprocurcumenol (1), germacrone (2), curzerenone (3), curcumenol (4), and curcuzedoalide (5). Among these, curcuzedoalide demonstrated the strongest effect in suppressing gastric cancer cell proliferation in a dose-dependent manner with an IC50 value of 125.11±2.77 μM. Western blotting analysis showed that curcuzedoalide inhibited AGS human gastric cancer cell viability by activating caspase-8, caspase-9, caspase-3, and PARP, which contributed to apoptotic cell death in AGS human gastric cancer cells. Conclusion These data indicate that curcuzedoalide contributed to the cytotoxicity of C. zedoaria by activating the cleavage of caspases and PARP, which are representative markers for apoptosis. Therefore, curcuzedoalide is a positive candidate for the development of novel chemotherapeutics.

Although research has established the impact of early stress, including stressful life contexts, and early resources, such as educational attainment, on various adolescent health outcomes, previous research has not adequately investigated "integrative models" incorporating both stress and resource mediational pathways to explain how early socioeconomic adversity impacts physical health outcomes, particularly in early life stages. Data on early childhood/adolescent stress and socioeconomic resources as well as biomarkers indicating physical health status in young adulthood were collected from 11,798 respondents (54 % female) over a 13-year period from youth participating in the National Study of Adolescent Health (Add Health). Physical health risk in young adulthood was measured using a composite index of nine regulatory biomarkers of cardiovascular and metabolic systems. Heterogeneity in stress and socioeconomic resource pathways was assessed using latent class analysis to identify clusters, or classes, of stress and socioeconomic resource trajectories. The influence of early socioeconomic adversity on young adults' physical health risk, as measured by biomarkers, was estimated, and the role of stress and socioeconomic resource trajectory classes as linking mechanisms was assessed. There was evidence for the influence of early socioeconomic adversity on young adults' physical health risk directly and indirectly through stress and socioeconomic resource trajectory classes over the early life course. These findings suggest that health models should be broadened to incorporate both stress and resource experiences simultaneously. Furthermore, these findings have prevention and intervention implications, including the importance of early socioeconomic adversity and key intervention points for "turning" the trajectories of at-risk youth.

Purpose The present study investigated the psychophysiological inter- and intra-individual processes that mediate the linkage between childhood and/or adolescent socioeconomic adversities and adult health outcomes. Specifically, the proposed model examined the roles of youth depressive symptoms and body mass index (BMI) trajectories as mediators that explain the link between early adversity and young adults' general health and physical illnesses after controlling for gender, race or ethnicity, and earlier general health reports. Methods Using a nationally representative sample of 12,424 from National Longitudinal Study of Adolescent Health (Add Health), this study used growth curve modeling to consider both the severity (initial level) and the change over time (deterioration or elevation) as psychophysiological mediators, thereby acknowledging multiple facets of depressive symptoms and BMI trajectories as psychophysiological mediators of early adversity to adult health. Results Results provide evidence for (1) the influence of early childhood and early adolescent cumulative socioeconomic adversity on both the initial levels and changes over time of depressive symptoms and BMI and (2) the independent influences depressive symptoms and BMI trajectories on the general health and the physical illnesses of young adults. Conclusions These findings contribute valuable knowledge to existing research by elucidating how early adversity exerts an enduring long-term influence on physical health problems in young adulthood; furthermore, this information suggests that effective intervention and prevention programs should incorporate multiple facets (severity and change over time) of multiple mechanisms (psychological and physiological).

Objectives. To evaluate the effectiveness of an evidence-based, parent-centered intervention, Familias Unidas, delivered by nonresearch personnel, in preventing substance use (alcohol, illicit drugs) and sex without a condom among Hispanic adolescents. Methods. A randomized controlled trial (n = 746) evaluated the effectiveness of Familias Unidas among Hispanic eighth graders (age range = 12–16 years), relative to prevention as usual, within a public school system. School personnel, including social workers and mental health counselors, were trained to deliver the evidence-based intervention. Participant recruitment, intervention delivery, and follow-up ran from September 2010 through June 2014 in Miami–Dade County, Florida. Results. Familias Unidas was effective in preventing drug use from increasing and prevented greater increases in sex without a condom 30 months after baseline, relative to prevention as usual. Familias Unidas also had a positive impact on family functioning and parental monitoring of peers at 6 months after baseline. Conclusions. This study demonstrated the effectiveness of a parent-centered preventive intervention program in preventing risky behaviors among Hispanic youths. Findings highlight the feasibility of training nonresearch personnel on effectively delivering a manualized intervention in a real-world setting.

This study examines how current smokers respond differently to gain-loss-framed antismoking narratives depending on their stages of change to quit smoking. An experiment (N = 461) was conducted with a 2 (narrative perspective: first person vs. third person) × 2 (framing: gain vs. loss) factorial design having smoker's stage of change (precontemplation vs. contemplation/preparation) as a moderator. We observed differential framing effects depending on smoker's current stages of change only when they were exposed to first-person narratives. For precontemplators, a loss-framed (vs. a gain-framed) first-person narrative induced greater quit intentions and stage progression. Conversely, among contemplators and preparers, a gain-framed (vs. a loss-framed) first-person narrative led to greater quit intentions and stage progression. These interactive patterns were partly mediated by self-referencing and perceived similarity. This study proposes an alternative mechanism to explain the conditional framing effect by stages of change and highlights the importance of tailoring messages to smoker's psychosocial characteristics and needs. Accepted version