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We propose a new paradigm with three historical stages for an optimal parenting style (i.e., indulgent parenting style), which extends the traditional paradigm of only two stages (i.e., authoritarian and authoritative parenting styles). The three stages concur, at the same time, in different environments, context, and cultures. We studied the third stage for optimal parent-child relationships through the offspring's personal and social well-being, with four adolescent samples from 11 to 19 years old (52.2% girls) from Spain ( n = 689), the United States ( n = 488), Germany ( n = 606), and Brazil ( n = 672). The offspring's personal well-being was measured through self-esteem (academic, social, emotional, family, and physical), while social well-being was measured with the internalization of self-transcendence (universalism and benevolence) and conservation values (security, conformity, and tradition). The parent-child parenting style was measured through parental warmth and strictness, and the adolescents' parents were classified into one of four groups (indulgent, authoritarian, authoritative, and neglectful). Remarkably, the greatest personal well-being was found for adolescents raised with higher parental warmth and lower parental strictness (i.e., indulgent), and the greatest social well-being was found for adolescents raised with higher parental warmth (i.e., indulgent and authoritative; p < 0.05 for all countries). Consistently, poorer personal well-being and social well-being were associated with less parental warmth (i.e., authoritarian and neglectful). Findings suggest that the parent-child relationships analyzed have a common pattern associated with personal and social well-being that coincide with a proposed third stage.

The Gender, Race, and Clinical Experience (GRACE) study was designed to assess sex-based differences in darunavir/ ritonavir-based therapy and to enroll a female population representative of the racial demographics of women with human immunodeficiency virus (HIV)/AIDS in the United States. Here, we report week 48 results, stratified by race. GRACE was a multicenter, open-label, phase 3b study. Patients received 600 mg of darunavir and 100 mg of ritonavir twice daily plus an investigator-selected optimized background regimen. Virologic response (HIV-1 RNA < 50 copies/ mL) and safety were assessed over 48 weeks. Post hoc multivariate analyses were performed to investigate factors associated with response. Of 429 patients enrolled, 61.5% were black, 22.4% were Hispanic, and 15.2% were white. Black patients had more advanced disease at baseline, and more black patients discontinued (32.6%) than Hispanic (24%) or white (26.2%) patients. In the intent-to-treat population, similar response rates were seen in Hispanic (61.5%) and white patients (60.0%); lower response rates were observed in black patients (48.5%). Similar trends were observed in the nonvirologic failure censored population. The multivariate analysis revealed that being of a nonblack race was significantly associated with improved response (P = .009). Overall, darunavir/ritonavir-based therapy was well tolerated, regardless of race. Diarrhea, nausea, and rash were the most commonly reported grade 2 to 4 adverse events (at least possibly related to darunavir/ritonavir). Darunavir/ritonavir treatment is safe and effective in treatment-experienced patients, irrespective of sex or race. Despite the controlled trial environment, more black patients discontinued and experienced virologic failure than Hispanic or white patients.