A latent growth curve analysis of precursor cognitive abilities and academic achievement.

BACKGROUND: Language-based cognitive fitness describes the ability to carry out cognitive tasks with vigour and alertness, to learn, and to adapt. AIMS: The purpose of this research was to test the efficacy of a brain fitness training programme to better understand the role played by three precursor abilities for language-based cognitive development-verbal reasoning, visual synthesis, and active analysis-and their impact on academic achievement. SAMPLE: The sample included 92 children from a private school designed to deliver a prescriptive educational model for the spectrum of challenged, average, and gifted students. METHOD: Students completed cognitive tests at entry to the program and at the end of each academic year. Students completed daily brain-based exercises. Associative latent variable growth curve modelling using Mplus was used to test growth in all variables. Bayesian estimation analysis was used for missing data imputation. Age and baseline cognitive ability were included as covariates. RESULTS: Model fit was excellent, χ2 (104) = 115.98, p = .20, (χ2 /df) = 1.11, CFI = 0.98, TLI = 0.98, RMSEA = 0.04, SRMR = 0.05. Students who started with the lowest ability levels initially grew faster than those students with higher initial two-wave performance levels consistent with a closing of an ability gap. This had a lagged effect on achievement that accelerated in growth after the first 2 years. CONCLUSIONS: Results provide evidence for the importance of interventions that focus on strengthening precursor cognitive abilities directly involved with language and mathematics achievement.

Situational judgment tests as measures of 21st century skills: evidence across Europe and Latin America / Los tests de juicio situacional como medida de las habilidades para el siglo XXI: evidencia en toda Europa y América Latina

Over the years, various governmental, employment, and academic organizations have identified a list of skills to successfully master the challenges of the 21st century. So far, an adequate assessment of these skills across countries has remained challenging. Limitations inherent in the use of self-reports (e.g., lack of self-insight, socially desirable responding, response style bias, reference group bias, etc.) have spurred on the search for methods that could complement or even substitute self-report inventories. Situational judgment tests (SJTs) have been proposed as one of the complements/alternatives to the traditional self-report inventories. SJTs are low-fidelity simulations that confront participants with multiple domain-relevant situations and request to choose from a set of predefined responses. Our objectives are twofold: (a) outlining how a combined emic-etic approach can be used for developing SJT items that can be used across geographical regions and (b) investigating whether SJT scores can be compared across regions. Our data come from Laureate International Universities (N = 5,790) and comprise test-takers from Europe and Latin America who completed five different SJTs that were developed in line with a combined emic-etic approach. Results showed evidence for metric measurement invariance across participants from Europe and Latin America for all five SJTs. Implications for the use of SJTs as measures of 21st century skills are discussed

A lo largo de los años, varias organizaciones gubernamentales de empleo y académicas han identificado una lista de habilidades para superar con éxito los desafíos del siglo XXI. Hasta ahora, una evaluación adecuada de estas habilidades en los países ha continuado siendo un reto. Las limitaciones inherentes al uso de autoinformes (p. ej., falta de autoconocimiento, respuestas socialmente deseables, sesgo en el estilo de respuesta, sesgo del grupo de referencia, etc.) han estimulado la búsqueda de métodos que puedan complementar o incluso sustituir inventarios de autoinforme. Los tests de juicio situacional (TJS) se han propuesto como uno de los complementos/alternativas a los inventarios tradicionales de autoinforme. Los TJS son simulaciones de baja fidelidad que enfrentan a los participantes con múltiples situaciones de dominio relevantes y solicitan elegir entre un conjunto de respuestas predefinidas. Tenemos un doble objetivo: (a) explicar cómo se puede utilizar un enfoque emic-etic combinado para desarrollar ítems de TJS que se puedan emplear en todas las regiones geográficas y (b) investigar si las puntuaciones de los TJS se pueden comparar entre regiones. Nuestros datos provienen de las Laureate International Universities (N = 5,790) y están compuestos por examinandos de Europa y América Latina que cumplimentaron cinco TJS diferentes que se desarrollaron de acuerdo a un enfoque emic-ethic. Los resultados mostraron la existencia de invarianza en la medición en los participantes de Europa y América Latina para los cinco TJS. Se discuten las implicaciones para el uso de TJS como medida para detectar habilidades en el siglo XXI

Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses.

AIM: The purpose of these studies was to determine the reliability and validity of the 24 item Perspectives on Caring for Older Patients (PCOP) scale and further develop the scale as a useful tool for measuring nurses' perspectives toward caring for older patients. BACKGROUND: Ageism has long been an issue in the U.S. as well as globally and is reflected in the attitudes of nurses caring for older patients. Most research in this area utilizes scales that measure attitudes toward older adults or aging in general which is different from how nurses feel about caring for older patients. METHODS: Instrument development studies using the PCOP scale were conducted involving two independent samples for exploratory and confirmatory analyses. Study 1 included nurses and nursing students from six hospitals in the U.S. while Study 2 included students in a baccalaureate nursing program. Exploratory factor analysis was conducted in Study 1, and confirmatory factor analysis using structural equation modeling was performed in Study 2. A test of structural invariance was used to confirm stability of factor structure across samples. RESULTS: Exploratory factor analysis using split samples (Study 1) resulted in a PCOP scale with 12 items, and structural equation modeling confirmed a 9-item factor structure. The test for invariance also showed an excellent fit to the data. CONCLUSIONS: The revised nine-item PCOP scale is a reliable and valid tool for use in measuring nurses' perspectives toward caring for older patients in the U.S. and internationally.

Measuring the Pros and Cons of What It Means to Be a Black Man: Development and Validation of the Black Men's Experiences Scale (BMES).

Although extensive research documents that Black people in the U.S. frequently experience social discrimination, most of this research aggregates these experiences primarily or exclusively by race. Consequently, empirical gaps exist about the psychosocial costs and benefits of Black men's experiences at the intersection of race and gender. Informed by intersectionality, a theoretical framework that highlights how multiple social identities intersect to reflect interlocking social-structural inequality, this study addresses these gaps with the qualitative development and quantitative test of the Black Men's Experiences Scale (BMES). The BMES assesses Black men's negative experiences with overt discrimination and microaggressions, as well their positive evaluations of what it means to be Black men. First, we conducted focus groups and individual interviews with Black men to develop the BMES. Next, we tested the BMES with 578 predominantly low-income urban Black men between the ages of 18 and 44. Exploratory factor analysis suggested a 12-item, 3-factor solution that explained 63.7% of the variance. We labeled the subscales: Overt Discrimination, Microaggressions, and Positives: Black Men. Confirmatory factor analysis supported the three-factor solution. As hypothesized, the BMES's subscales correlated with measures of racial discrimination, depression, resilience, and social class at the neighborhood-level. Preliminary evidence suggests that the BMES is a reliable and valid measure of Black men's experiences at the intersection of race and gender.

A model for HIV disclosure of a parent's and/or a child's illness.

HIV prevalence in Kenya remains steady at 5.6% for adults 15 years and older, and 0.9% among children aged below 14 years. Parents and children are known to practice unprotected sex, which has implications for continued HIV spread within the country. Additionally, due to increased accessibility of antiretroviral therapy, more HIV-positive persons are living longer. Therefore, the need for HIV disclosure of a parent's and/or a child's HIV status within the country will continue for years to come. We conducted a qualitative phenomenological study to understand the entire process of disclosure from the time of initial HIV diagnosis of an index person within an HIV-affected family, to the time of full disclosure of a parent's and/or a child's HIV status to one or more HIV-positive, negative, or untested children within these households. Participants were purposively selected and included 16 HIV-positive parents, seven HIV-positive children, six healthcare professionals (physician, clinical officer, psychologist, registered nurse, social worker, and a peer educator), and five HIV-negative children. All participants underwent an in-depth individualized semistructured interview that was digitally recorded. Interviews were transcribed and analyzed in NVivo 8 using the modified Van Kaam method. Six themes emerged from the data indicating that factors such as HIV testing, living with HIV, evolution of disclosure, questions, emotions, benefits, and consequences of disclosure interact with each other and either impede or facilitate the HIV disclosure process. Kenya currently does not have guidelines for HIV disclosure of a parent's and/or a child's HIV status. HIV disclosure is a process that may result in poor outcomes in both parents and children. Therefore, understanding how these factors affect the disclosure process is key to achieving optimal disclosure outcomes in both parents and children. To this end, we propose an HIV disclosure model incorporating these six themes that is geared at helping healthcare professionals provide routine, clinic-based, targeted, disclosure-related counseling/advice and services to HIV-positive parents and their HIV-positive, HIV-negative, and untested children during the HIV disclosure process. The model should help improve HIV disclosure levels within HIV-affected households. Future researchers should test the utility and viability of our HIV disclosure model in different settings and cultures.

Sexual scripts and sexual risk behaviors among Black heterosexual men: development of the Sexual Scripts Scale.

Sexual scripts are widely shared gender and culture-specific guides for sexual behavior with important implications for HIV prevention. Although several qualitative studies document how sexual scripts may influence sexual risk behaviors, quantitative investigations of sexual scripts in the context of sexual risk are rare. This mixed methods study involved the qualitative development and quantitative testing of the Sexual Scripts Scale (SSS). Study 1 included qualitative semi-structured interviews with 30 Black heterosexual men about sexual experiences with main and casual sex partners to develop the SSS. Study 2 included a quantitative test of the SSS with 526 predominantly low-income Black heterosexual men. A factor analysis of the SSS resulted in a 34-item, seven-factor solution that explained 68% of the variance. The subscales and coefficient alphas were: Romantic Intimacy Scripts (α = .86), Condom Scripts (α = .82), Alcohol Scripts (α = .83), Sexual Initiation Scripts (α = .79), Media Sexual Socialization Scripts (α = .84), Marijuana Scripts (α = .85), and Sexual Experimentation Scripts (α = .84). Among men who reported a main partner (n = 401), higher Alcohol Scripts, Media Sexual Socialization Scripts, and Marijuana Scripts scores, and lower Condom Scripts scores were related to more sexual risk behavior. Among men who reported at least one casual partner (n = 238), higher Romantic Intimacy Scripts, Sexual Initiation Scripts, and Media Sexual Socialization Scripts, and lower Condom Scripts scores were related to higher sexual risk. The SSS may have considerable utility for future research on Black heterosexual men's HIV risk.

HIV-positive parents, HIV-positive children, and HIV-negative children's perspectives on disclosure of a parent's and child's illness in Kenya.

HIV disclosure from parent to child is complex and challenging to HIV-positive parents and healthcare professionals. The purpose of the study was to understand the lived experiences of HIV-positive parents and their children during the disclosure process in Kenya. Sixteen HIV-positive parents, seven HIV-positive children, and five HIV-negative children completed semistructured, in-depth interviews. Data were analyzed using the Van Kaam method; NVivo 8 software was used to assist data analysis. We present data on the process of disclosure based on how participants recommended full disclosure be approached to HIV-positive and negative children. Participants recommended disclosure as a process starting at five years with full disclosure delivered at 10 years when the child was capable of understanding the illness, or by 14 years when the child was mature enough to receive the news if full disclosure had not been conducted earlier. Important considerations at the time of full disclosure included the parent's and/or child's health statuses, number of infected family members' illnesses to be disclosed to the child, child's maturity and understanding level, and the person best suited to deliver full disclosure to the child. The results also revealed it was important to address important life events such as taking a national school examination during disclosure planning and delivery. Recommendations are made for inclusion into HIV disclosure guidelines, manuals, and programs in resource-poor nations with high HIV prevalence.

Neighborhood context and Black heterosexual men's sexual HIV risk behaviors.

The effects of neighborhood context on sexual risk behavior are understudied, particularly for Black heterosexual men who do not inject drugs or report heavy drug use. Evidence of a generalized HIV epidemic (>1 %) among Black heterosexuals in low-income urban U.S. communities underscores the importance of examining the effects of neighborhood context on Black heterosexual men's sexual risk, however. We used structural equation modeling to test the pathways between neighborhood context (neighborhood disorder, personal violence, neighborhood threats), depression, substance use, and sexual risk behavior. Participants were 526 self-identified Black heterosexual men, ages 18-45, recruited via randomized venue-based probability sampling in Philadelphia, PA. Analyses of model fit statistics from Mplus indicated statistically significant direct pathways between neighborhood context, depression, substance use, and sexual risk behavior. The total indirect effect of neighborhood context on sexual risk behavior through substance use was also significant. The study's results highlight a need for more research on neighborhood context and sexual HIV risk, and for multilevel interventions to address the effects of negative neighborhood context on Black heterosexual men's sexual HIV risk.

Racial discrimination and posttraumatic stress symptoms as pathways to sexual HIV risk behaviors among urban Black heterosexual men.

In light of evidence that racial discrimination and posttraumatic stress symptoms (PTSS) are neither rare nor extraordinary for many Black urban men, we examined the relationship between everyday racial discrimination and sexual HIV risk behaviors in a predominantly low-income sample of 526 urban Black heterosexually identified men; 64% of whom were unemployed and 55% of whom reported a history of incarceration. We tested the hypothesis that PTSS would mediate the relationship between everyday racial discrimination and sexual risk. Participants in the predominantly low-income urban sample ranged in age from 18 to 45 (M = 28.80, SD = 7.57). Three multiple regression models were used to test the study's mediational model. As hypothesized, PTSS mediated the relationship between everyday racial discrimination and sexual risk behaviors. Most participants (97%) reported experiences with everyday racial discrimination. Results empirically support the notion of racial discrimination-based traumatic stress as a pathway to Black heterosexual men's increased sexual risk behaviors. Results also highlighted key demographic differences with older men reporting fewer PTSS and sexual risk behaviors compared with younger men. Incarceration was related to both PTSS and sexual risk, underscoring the role that incarceration may play in Black heterosexual men's adverse health outcomes. Our study highlights the need for more qualitative and quantitative research to understand the nature of PTSS in Black heterosexual men and mechanisms such as substance use that may link traumatic experiences and sexual risk. Future research could also assess experiences with childhood sexual abuse, violence, and incarceration to gain a more in-depth understanding of the sources of traumatic stress in Black heterosexual men's lives. We advocate for the development of community-based individual and structural-level interventions to help Black heterosexual men in urban areas develop effective strategies to cope with racial discrimination-based traumatic stress to reduce sexual HIV risk behaviors in Black communities.

Racial discrimination, social support, and sexual HIV risk among Black heterosexual men.

Numerous studies document the adverse impact of racial discrimination on African Americans' health outcomes, but few have focused on HIV risk. We examined the relationship between racial discrimination and sexual risk in a sample of 526 Black heterosexual men and tested the hypothesis that social support would moderate this relationship. Participants in the predominantly low-income urban sample ranged in age from 18 to 45. High social support had a buffering impact on the relationship between racial discrimination and sexual risk. Among men reporting high racial discrimination, those with more social support reported less sexual risk than men with low social support. Men who reported high racial discrimination and low social support reported more sexual risk than men in any of the other groups. The study highlights social support as an important but understudied protective factor that may reduce sexual risk for Black heterosexual men who report high levels of racial discrimination.

Alcohol and folate intake and breast cancer risk in the WHI Observational Study.

BACKGROUND: Alcohol increases breast cancer risk. Epidemiological studies suggest folate may modify this relationship. OBJECTIVE: To examine the relationship among breast cancer, alcohol and folate in the Women's Health Initiative-Observational Study (WHI-OS). METHODS: 88,530 postmenopausal women 50-79 years completed baseline questionnaires between October 1993 and December 1998, which addressed alcohol and folate intake and breast cancer risk factors. Cox proportional hazards analysis examined the relationship between self-reported baseline alcohol and folate intake and incident breast cancer. RESULTS: 1,783 breast cancer cases occurred over 5 years. Alcohol was associated with increased risk of breast cancer (RR = 1.005, 95%CI 1.001-1.009). Risk increased with consumption of alcohol (up to 5 g/d, adjusted HR = 1.10, 95%CI 0.96-1.32; >5-15 g/d HR = 1.14, 95%CI 0.99-1.31; and >15 g/d HR = 1.13 95%CI 0.96-1.32). We found no significant interaction between alcohol and folate in our adjusted model. CONCLUSIONS: We found no evidence for folate attenuating alcohol's effect on breast cancer risk in postmenopausal women. Our results may be due to misclassification of folate intake or the relatively short follow-up period.

The complexities of outness: psychosocial predictors of coming out to others among Black lesbian and bisexual women.

This mixed method study investigated the psychosocial predictors of coming out among a predominantly middle-class sample of Black lesbian and bisexual women (LBW; N = 95) between the ages of 18 and 68. Results demonstrated that demographic variables (i.e., age, age of coming out, income), social support, and ranking one's LBW identity greater than one's Black identity significantly predicted being "out and talking about" one's sexual identity to others. Findings from semistructured interviews with a subsample (n = 19) of Black LBWs about experiences of coming out and being out demonstrated two key themes: (a) although coming out is important, decisions to do so are often collective, shaped by familial, community, and religious concerns, rather than an individualistic need to be out; and (b) the experience of coming and being out is contextualized through the intersection of race, gender, and sexual identities, rather than separate identities as Black and LBW.

Assessing fat-related dietary behaviors among black women: reliability and validity of a new Food Habits Questionnaire.

OBJECTIVE: To describe the development of the SisterTalk Food Habits Questionnaire (STFHQ). DESIGN: Formative research was conducted to adapt previous tools for the study's target population. A pilot tool (168 questions) was tested. The new 94-question tool was then used for evaluation of the SisterTalk project. Lastly, a 4-week reliability calibration study of the revised STFHQ was conducted in comparison with a food frequency questionnaire (FFQ). ANALYSIS: Reliability was assessed using test-retest correlations. Validity was assessed by correlations between STFHQ scores with FFQ calculated calories, total fat (g) and percentage of calories from fat. Three scoring methods (ie, introductory, product, and detail) were calculated along with inclusion or exclusion of dining out questions and alternate methods of scoring for food items not consumed. RESULTS: Reliability (correlation) was 0.87. Inclusion of dining out questions and imputation of zero for food items never consumed were more highly associated with fat intake than other scoring methods. The introductory score was most highly correlated with fat (g), whereas the product and detail scoring methods correlated highest with percentage of calories from fat. Responsiveness to the SisterTalk intervention was highest with the detail score. CONCLUSIONS AND IMPLICATIONS: The STFHQ is a reliable and valid tool that may be useful for evaluating dietary change for black women.

Cost-effectiveness of minimal contact education strategies for cholesterol change.

OBJECTIVES: To compare the effectiveness and cost effectiveness of minimal contact nutrition interventions that varied in intensity on lowering total blood cholesterol (BC) levels. DESIGN: A randomized trial in which public, work, religious, and medical sites were randomly assigned to one of six minimal-contact nutrition interventions for lowering total BC. SETTING: 36 public, work, religious, and medical sites in southern New England (total sites = 144). PARTICIPANTS: The number of eligible participants at baseline was 10,144, which included 1425 Hispanics, who were over-recruited for this study. INTERVENTION: One of six brief interventions was provided to participants: 1) feedback tip sheet only; 2) tip sheet plus Rate Your Plate (RYP); 3) tip sheet, RYP, plus Let's Eat Kit (LEK); 4) all written materials plus CD audio intervention (AUD); 5) all written materials plus counseling from a trained lay person (LAY-C); and 6) all written materials plus counseling by a nutritionist (NUT-C). The educational materials were adapted to be culturally and linguistically appropriate for a Hispanic audience, and the counselors for the Hispanic participants were bilingual. MEASURES: Total blood cholesterol levels were measured using fingerstick methods at baseline, 3 months, and 12 months after the intervention. RESULTS: Blood cholesterol (BC) was significantly reduced from baseline to 12-month follow-up among most experimental groups. Only LAY-C and NUT-C conditions demonstrated significant BC reductions at three months. The BC change in the NUT-C group was statistically different from the feedback only condition at three months only. At three-month followup, BC was reduced 1.6% for the total sample, 2.8% for participants with borderline-high BC levels, and 3.4% for participants with high BC. Generally, the two conditions receiving counseling resulted in the largest percentage changes in BC levels. When examining BC change data by ethnicity, Hispanic participants in the audio condition achieved the largest overall 12-month change (4%). Generally, total costs increased as the intensity of the experimental condition increased. When comparing 3-month and 12-month cost effectiveness, LAY-C and NUT-C were approximately the same, whereas LEK and AUD conditions tended to become more expensive than the other interventions. CONCLUSIONS: Brief nutrition counseling is an effective component of BC reduction programs. Culturally tailoring programs can result in substantial reductions in BC among Hispanic participants. Overall, even the most expensive intervention was fairly inexpensive compared to other, more intensive clinical interventions.

Challenges in measuring concurrency, agency and intentionality in polydrug research.

Polydrug use is of particular interest to researchers concerned with the drug use of youth and young adults because it is associated with progression to regular and addictive drug use. New research shows that polydrug use appears to be taking new forms as youth use multiple drugs concurrently in the same setting, sometimes to achieve specific desired effects. Existing approaches to measuring polydrug use are confusing and inconsistent. This paper calls for new ways of measuring polydrug use that capture concurrency in context to obtain more accurate assessments of drug mixing and its potential physical and social effects.

Relationship of treatment delay with surgical defect size from keratinocyte carcinoma (basal cell carcinoma and squamous cell carcinoma of the skin).

Larger keratinocyte carcinoma (KC) lesions are associated with higher morbidity. This study examined the association of potentially modifiable characteristics, including treatment delay, with KC defect size after Mohs micrographic surgery (MMS). A stratified random sample of patients treated for KC with MMS were selected for telephone interview. Two hundred and nineteen interviews were completed (refusal rate 24%). Regression models were used to examine the predictors to defect size and delay. Anatomic site, age, histology, and gender predicted defect size (R(2) = 0.39) and were used as control variables. Self-reported delay between initial physician examination and MMS predicted defect size (p = 0.0004), with greater than 1 y delay being associated with a doubling of defect size (adjusted odds ratio (OR) 2.0; 95% confidence interval (CI) 1.3-3.1). Delays of this duration were associated with initial examination by a primary provider (unadjusted OR 3.9; 95% CI 1.7-8.8), misdiagnosis (unadjusted OR 6.8; 95% CI 2.5-18.7), being treated without biopsy (unadjusted OR 23.3; 95% CI 6.5-83.7), and multiple surgical removals (unadjusted OR 6.2; 95% CI 2.5-15.5). All but provider specialty were independent predictors of delay. Attention to processes of care delivery for KC may have a greater impact on morbidity than efforts are earlier detection by the public.

Rising and surviving: a conceptual model of active coping among Black lesbians.

This study tested a conceptual model of active coping among a predominantly middle-class sample (N = 92) of Black lesbians (ages 18 to 68) attending a Black lesbian retreat. F. B. Tyler's (1978) active coping dimension of psychosocial competence and L. P. Anderson, C. L. Eaddy, and E. A. Williams's (1990) psychosocial competence model for Black Americans emphasizing the role of individual and environmental factors provided the theoretical framework for the study. A theoretical model was developed to examine whether internal (self-esteem, race and lesbian identification) and external (social support, perceived available lesbian, gay, bisexual, and transgendered resources) factors predicted active coping. Results confirmed that the model of internal and external factors was a statistically significant predictor of active coping.

Does the DRD2-Taq1 A polymorphism influence treatment response to bupropion hydrochloride for reduction of the nicotine withdrawal syndrome?

Bupropion hydrochloride is effective in promoting long-term abstinence from smoking and may reduce risk for relapse through attenuation of withdrawal symptoms and craving. Bupropion is a weak dopamine reuptake inhibitor, and individual genetic variation in the dopamine D2 receptor has been associated with nicotine dependence in case-control studies. Thirty smokers were randomly assigned to bupropion or placebo and interviewed using the Minnesota Nicotine Withdrawal Scale on two occasions: prior to starting medication and after 14 days on bupropion or placebo. The individual symptoms of craving, irritability, and anxiety were significantly reduced in the bupropion group, whereas no withdrawal symptoms were diminished in the placebo group. Within the bupropion group, subgroup analyses with stratification by genotype demonstrated that craving, irritability, and anxiety were significantly attenuated only among subjects with DRD2-Taq1 A2/A2 genotypes. In the DRD2-Taq1 A1/A1 and A1/A2 groups, no significant reduction was seen in any individual symptom of the nicotine withdrawal syndrome. These data suggest that bupropion attenuates specific symptoms of the nicotine withdrawal syndrome and that this effect may be modified by genotype for the dopamine D2 receptor.