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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.

Conflictual marital and parental relationships mutually reinforce each other generating family-level stress. The cumulative experiences of stressful family conflictual circumstances (a family-level construct of family conflictual circumstances (FCC), based on marital and parental conflictual behaviors) affect a couple’s well-being. The present study, utilizing longitudinal data of 370 couples in enduring marriages and a person-centered approach, examined: a) the existence of heterogeneous groups of couples with FCC trajectory patterns, b) whether individual and contextual factors are associated with FCC trajectory patterns, and c) differential later-life health and relational consequences of these groups. We identified four heterogeneous groups of couples with distinct FCC trajectory patterns in the early middle years (from 1990 to 1994; approximately age 40 for both husbands and wives). Personal (neurotic vulnerability) and contextual factors (family financial hardship) influenced the development of the FCC trajectories, and FCC trajectory patterns were consequential for spouses’ later mental, physical, and relational health (2001). Two features of the longitudinal synchrony in FCC trajectory patterns (severity and synchrony) were utilized to explain the differential impacts of the trajectory patterns on spouses’ later health and relational outcomes.

Because sequential patterns of multiple transition events (i.e., college graduation, full-time employment, marriage, and parenthood) are associated with turning points in depressive symptom trajectories during young adulthood, the present study used a sample of 446 White adolescents (52.3% females; 15.58 years old, on average) over 18 years (1992 to 2010) to (a) identify distinct

OBJECTIVE: The present study was designed to examine distinct co-occurrence patterns of acculturation and perceived context of reception between weekdays and weekends among Hispanic college students in Miami and their influences on psychosocial maladaptation. METHODS: We conducted a 12-day diary study with a sample of first- and second-generation Hispanic college students in Miami (n = 864). Depressive symptoms and physically aggressive behaviors were assessed on Days 1 and 12, and acculturation components and perceived negative context of reception were measured using single items on Days 2–11. We examined the overlap between weekday and weekend patterns of acculturation and negative context of reception, as well as links of this overlap with depressive symptoms and with physically aggressive behaviors. RESULTS: Overall, six distinct co-occurrence patterns of acculturation and perceived contexts of reception emerged from the analysis. Four of these appeared to represent stable co-occurrence patterns regardless of weekdays and weekends and two indicated changing co-occurrence patterns between weekdays and weekends. Students in patterns of the Moderate Biculturalism–High Negative Context of Reception regardless of weekdays and weekends reported high depressive symptoms and physically aggressive behaviors. Also, for the two changing co-occurrence patterns, students in patterns of the Changes in both Acculturation and Negative Context of Reception between weekdays and weekends reported high scores on both depressive symptoms and physical aggressive behaviors. CONCLUSION: Both stable and changing patterns in acculturation and context of reception co-occurrences between weekdays and weekends predicted psychosocial maladaptation.

We aimed to identify subgroups of Hispanic/Latino (H/L) cancer survivors with distinct health behavior patterns and their associated sociodemographic, medical, and psychosocial characteristics.Baseline data were used from a randomized clinical trial evaluating the efficacy of an enhanced patient navigation intervention in H/L cancer survivors. Participants (n = 278) completed the Lifestyle Behavior Scale and validated questionnaires on health-related quality of life (HRQOL), supportive care needs, distress, and satisfaction with cancer care. Latent class analysis was used to determine the latent classes and associated characteristics.Three latent classes emerged: class 1 (survivors who increased health behaviors [e.g., exercising and eating healthy] since diagnosis); class 2 (no changes in health behaviors since diagnosis); and class 3 (a "mixed class," with a higher or lower engagement across various health behaviors since diagnosis). Participants in class 1 were significantly more educated and less likely to be foreign born. Participants in class 2 were significantly older and more likely to have prostate cancer. H/L cancer survivors in class 3 had a significantly lower income, were less educated, and reported greater unmet supportive care needs, more distress, and poorer HRQOL.Survivors who report engaging in health behaviors less frequently since diagnosis may be experiencing psychosocial challenges and health disparities.Hispanic/Latino cancer survivors may benefit from screening for social determinants of health and mental health needs, prompt referral to supportive care services, community resources, and public services, and participating in culturally informed psychosocial interventions to address their unique needs.

The present study used a sample of 9,100 youth from The National Longitudinal Study of Adolescent to Adult Health to identify how early socioeconomic adversity and BMI-related genetics combine to influence youth BMI and academic achievement/failure across successive life stages (i.e., adolescence, emerging adulthood, young adulthood), resulting in adverse economic outcomes in young adulthood. The results indicate that early socioeconomic adversity and BMI-related genetics initiate additive, cascading, and cumulative processes through BMI and academic achievement leading to economic hardship after accounting for relevant demographic and contextual variables, including race/ethnicity. Importantly, the BMI-related polygenic score revealed a moderate genetic influence on youth BMI and academic achievement at each life stage. The findings highlight the need to inform longitudinal health and obesity research with molecular genetic information.

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.

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.

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.

The present study was designed to examine acculturation trajectories of first-generation, Latino immigrant youth and their parents in an emerging immigrant context. We also examined whether acculturation trajectories differed between families with youth who migrated at different stages of development and who have spent differential amounts of time in the United States (US). A community sample of 217 immigrant families in western Oregon was purposely sampled according to youths’ age at arrival and time in US residency (TR) and assessed three times over a 3-year period. Families were stratified into three TR groups: TR1 = 2–4 years spent in the US; TR2 = 6–8 years spent in the US; and TR3 = 10–12 years. Parents and youth in each TR group completed measures assessing their acculturation to US American and Latino culture. Results from multiple-group latent growth models showed that acculturation trajectories differed for both youth and parents depending on the TR group. Moreover, both youth and their parents within each TR group differed in their acculturation trajectories. Overall, although youth slowly gravitated toward biculturalism over time, their parents remained relatively separated such that they reported high endorsement of their heritage culture and low endorsement of US culture over time. Findings are discussed in terms of prior research and theory.

‘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 article introduces and demonstrates the use of an integrated life course systems perspective to advance the study of the aging processes of couples in enduring relationships. This objective is accomplished by bridging the life course and systems perspectives to conceptualize the couple as a functioning system and to locate couple dynamics within a longitudinal life course context in order to identify multilevel relational mechanisms that explain partners' aging outcomes in their broader socioeconomic and longitudinal context. Informed by this integrated theoretical perspective, testable hypotheses related to aging processes are derived, and analytical methodologies that can advance the research on couple aging processes are demonstrated. Identifying these relationship-health processes and contextual considerations provides insight into leverage points for the development and implementation of prevention and intervention efforts to facilitate positive aging outcomes. Directions for further theoretical and analytical advances in the area of couple aging are discussed.

The primary aim of this study was to examine the association between perceived discrimination and posttraumatic stress disorder (PTSD) outcomes among recently arrived Venezuelan parents in Florida and Colombia. The secondary aim was to determine whether, given the existence of an association between perceived discrimination and PTSD, this association may have been moderated by gender or by country of relocation. This is the first study to examine perceived discrimination and PTSD in Venezuelan migrants.In October 2017, 647 Venezuelan migrant parents (62% female, average age 33) participated in an online survey in the United States (primarily Florida) and Colombia (Bogotá). The survey was cross-sectional and assessed mental health outcomes, perceived discrimination, and participant demographics.There was a significant positive association between discrimination and PTSD outcomes when controlling for age, college completion, marital status, and recency of arrival (β = .25,Perceived discrimination is an important factor when considering mental health outcomes among Venezuelans in the United States and in Colombia. Further, our findings suggest the presence of gender differences in the relationship between discrimination and PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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

Drug use and depression co-occur and disproportionately affect Latinx sexual minority youth relative to their heterosexual Latinx peers. However, heterogeneity in co-occurring patterns of drug use and depressive symptoms is unknown. The objective of the current study was to identify patterns of drug use and depressive symptom trajectories and examine how these patterns varied between Latinx sexual minority youth and Latinx non-sexual minority youth. Latent class trajectory analysis identified distinct patterns of drug use and depressive symptom trajectories among 231 Latinx adolescents (Latinx sexual minority youth: n = 46, 21.4%; Latinx non-sexual minority youth: n = 169, 78.6%). After identifying class mean trajectories, we examined differences in mean trajectories across groups. A 3-class model was selected as the optimal class trajectory model for both groups, yet classes and trajectories differed. There were differences in initial levels of depression and drug use trajectories between both groups, as well as differences in patterns of drug use trajectories between both groups in two of the three classes. Given the variation in trajectory patterns, there is a need for practitioners to consider the unique needs of both groups to inform the development of preventive interventions for these two populations.

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.