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Latinx immigrants endure stressors throughout the immigration process that detrimentally impact their health and wellbeing. Yet, they also face substantial barriers to accessing and utilizing services. These barriers might be heightened under the Trump administration, which has implemented policies facilitating increased immigration enforcement and punitive immigration practices. This study utilizes data collected from providers who serve Latinx immigrants in the border state of Texas to better understand current immigrant service utilization behaviors. Individual interviews and focus groups were conducted shortly after the last presidential election to inquire about recruitment, retention, program completion, and resources to address key client risk factors. Applying grounded theory analysis strategies, interviews, and focus group recordings were coded for key themes. Data demonstrated central concerns held by providers serving immigrants, and especially those who are undocumented or in mixed-status families. Concerns were related to the following three themes: (1) undocumented immigrant stressors, (2) limited resources for undocumented immigrants, and (3) service utilization barriers. Lack of services for undocumented immigrants and fear related to service utilization were prominent subthemes. These findings extend our knowledge of stressors and barriers of access and utilization for immigrants during this time period of increased immigration enforcement which have valuable implications for practice and future research. Providers can take concrete actions to educate immigrants, regardless of documentation status, on how their clients' identities will be protected. In addition, intentional trust-building strategies are essential to help overcome fear of utilizing services. Future research should ascertain perspectives of immigrant families, as this study drew perspectives only from providers.

Objective: To analyze the risk of megestrol, a glucocorticoid and progesterone receptor agonist used to enhance appetite, on the development of a new psychiatric diagnosis., Design and Participants: Deidentified data of megestrol (n = 706) and propensity score-matched comparison (age, gender, and body mass index) patients (n = 2,118) from January 1, 2001 to June 30, 2018 were obtained from the UT Southwestern patient database. Data were analyzed using a series of conditional binary logistic regressions controlling for comorbidities, pre-existing psychiatric disorders, and number of patient encounters., Setting: A large academic medical center database of megestrol-treated patients and matched comparison patients was used., Measurements and Results: The regression model showed that megestrol was significantly associated with developing a new psychiatric diagnosis (B = 1.28, Wald χ 21  = 83.12, odds ratio [OR] = 3.60, p <0.001). In subgroup analyses, development of cognitive (B = 2.42, Wald χ 21  = 16.09, OR = 11.30, p <0.001), mood (B = 1.31, Wald χ 21  = 40.38, OR = 3.70, p <0.001), and anxiety (B = 1.72, Wald χ 21  = 45.28, OR = 5.60, p <0.001) disorders were also associated with megestrol use., Conclusions: Patients taking megestrol were significantly more likely to develop a new psychiatric diagnosis than comparison patients. Highest risks were associated with the development of cognitive diagnoses. The findings suggest that megestrol, like other glucocorticoid agonists, is associated with an increased risk of developing a psychiatric disorder. This risk should be considered when determining the risk-to-benefit ratio of megestrol use in patients., (Published by Elsevier Inc.)

Background: Adverse childhood experiences (ACEs) are known risk factors for negative health and behavioral outcomes, including caregiving. Foster parents are key to supporting foster children, yet there is limited research on their ACE history and how it might relate to their foster children's behavior., Objective: This study addressed three research questions: (1) What are ACE totals in this sample of foster parents and how do they compare with the original CDC-Kaiser study? (2) Does foster parents' ACE exposure relate to foster child behavior? (3) Is the relation between foster parents' ACEs and children's challenging behaviors different based on the specific ACE?, Participants & Setting: Participants were 89 foster parents (age M = 43.3 years) and 50 of their foster children (age M = 10 years) in central Texas. Children have been in their current placements for an average of 11 months (range 1 month to 4.7 years)., Methods: Foster parents completed demographics, the ACE Questionnaire (Felitti et al., 1998) and the Strengths and Difficulties Questionnaire (Goodman, 1997)., Results: Results showed over 40 % of foster parents in this sample reported 2+ ACEs and 20 % reported 4+ ACEs. Foster parents' total ACEs related to foster children's emotional problems (β = .27, p = .02), conduct problems (β = .28, p = .01), and hyperactivity-inattention (β = .25, p = .03). Certain ACEs related more strongly to child outcomes than others., Conclusions: Foster parents may have a higher ACE exposure than the general population. Foster parents' ACEs were associated with foster children's challenging behaviors. Future research should investigate the mechanism of this connection., (Copyright © 2020 Elsevier Ltd. All rights reserved.)