Exploratory factor and confirmatory analyses of the polycystic ovary syndrome health-related quality of life questionnaire (PCOSQ-50).

BACKGROUND: A condition-specific instrument is necessary to measure the health-related quality of life among those with polycystic ovary syndrome (PCOS), the most common chronic endocrinopathy among women. The first instrument was developed in 1988, followed by several revisions. However, further recommendations from all versions include additional application and measurement among different cultural populations of women with PCOS and psychometric testing based on use among larger samples of women with PCOS. Thus, the purpose of this study was to explore the factor structure of the Polycystic Ovary Syndrome Questionnaire (PCOSQ-50) using an international cross-sectional survey data from women with PCOS aged 18-42 years. METHODS: Using data from the largest known international cross-sectional study of women with PCOS aged 18-42 years (n = 935) to date, exploratory factor and confirmatory analyses were conducted for the PCOSQ-50, followed by factor labeling using a thematic analysis approach. RESULTS: Respondents were 31.0 ± 5.8 years of age, mostly White (72%), well-educated (56% had a college degree), married (69%), and employed full-time (65%). Three-quarters (74%) of the sample had one or more chronic conditions in addition to PCOS. Approximately 20% of the respondents originated from countries such as the United Kingdom, Australia, South Africa, etc. The PCOSQ-50 demonstrated good reliability but may be best described using a 7-factor model. The 7-factor model revealed goodness-of-fit. Thematic analysis suggested the following labels of those seven factors: hirsutism, fertility, isolation/trepidation, sexual function, self-esteem, emotional, and obesity. CONCLUSION: More research is needed to adapt the current PCOSQ-50, as well as to create an age-appropriate PCOS-specific HRQoL instrument for peri-postmenopausal women with PCOS.

Exploratory factor analysis of shared trauma in psychiatric-mental health nurses using the Shared Trauma Professional Posttraumatic Growth Inventory (STPPG).

INTRODUCTION: The Shared Trauma Professional Post Traumatic Growth Inventory (STPPG) was developed by Tosone et al. (2014) to help understand shared trauma (ST) in social workers. ST occurs when the healthcare professional and client both experience the same collective traumatic event. This inventory has been adapted for use with mental health nurses. A cross-sectional study of N = 552 mental health nurses was completed in the spring of 2023 to assess the feasibility of using the STPPG to explore shared trauma in mental health nurses. METHODS: An exploratory factor analysis was run for the STPPG using squared multiple correlations with the maximum likelihood method. RESULTS: The alpha coefficient ranged from 0.82 to 0.89 for 2-factors and 0.73 to 0.89 for 3-factors. The results indicated that all correlations were significant among the total scales and subscales. All correlations were positive, ranging from 0.81 to 0.95 for two factors and 0.58 to 0.89 for three factors. CONCLUSION: The STPPG has confirmed a two-factor analysis for mental health nurses. The STPPG is a valid inventory to measure ST in mental health nurses and will allow the concept to be further studied.

PCOS health-related quality-of-life and depressive symptoms across the lifespan: Comparative study.

The purpose of this cross-sectional study was to compare health-related quality of life (HRQoL) and depressive symptoms among peri-postmenopausal women with polycystic ovary syndrome (PCOS) aged ≥43 years relative to premenopausal women with PCOS aged 18-42 years. An online survey link comprising questionnaires about demographics, HRQoL, and depressive symptoms was posted onto two PCOS-specific Facebook groups. Respondents (n = 1,042) were separated into two age cohorts: women with PCOS aged 18-42 years (n = 935) and women with PCOS aged ≥43 years (n = 107). Data from the online survey were analyzed using descriptive statistics, Pearson correlations, and multiple regression via SAS. Results were interpreted through the lens of life course theory. All demographic variables, except for the number of comorbidities, significantly differed between groups. HRQoL among older women with PCOS was significantly better as compared to those aged 18-42 years. Results indicated significant positive linear associations between the HRQoL psychosocial/emotional subscale and other HRQoL subscales and a significant negative association with age. The fertility and sexual function HRQoL subscales were not significantly associated with the psychosocial/emotional subscale among women aged ≥43 years. Women in both groups had moderate depressive symptoms. Study findings demonstrate the need to tailor PCOS management to women's life stage. This knowledge can inform future research about peri-postmenopausal women with PCOS and age-appropriate and patient-centered healthcare, including requisite clinical screenings (e.g., depressive symptoms) and lifestyle counseling across the lifespan.

Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease: Development of a Situation-Specific Theory for African American Emerging Adults.

BACKGROUND: Emerging adulthood (18-25 years old) is a distinct developmental period in which multiple life transitions pose barriers to engaging in healthy lifestyle behaviors that reduce cardiovascular disease risk. There is limited theory-based research on African American emerging adults. OBJECTIVE: This article introduces a synthesized empirically testable situation-specific theory for cardiovascular disease prevention in African American emerging adults. METHODOLOGY: Im and Meleis' integrative approach was used to develop the situation-specific theory. RESULTS: Unlocking Population-Specific Treatments to Render Equitable Approach and Management in Cardiovascular Disease is a situation-specific theory developed based on theoretical and empirical evidence and theorists' research and clinical practice experiences. DISCUSSION: African American emerging adults have multifaceted factors that influence health behaviors and healthcare needs. Unlocking Population-Specific Treatments to Render Equitable Approaches and Management in Cardiovascular Disease has the potential to inform theory-guided clinical practice and nursing research. Recommendations for integration in nursing practice, research, and policy advocacy are presented. Further critique and testing of the theory are required.

Substance use disorders among African-American men in the rural south: A scoping review.

African American (AA) men in the rural South may be at high risk for experiencing adverse health outcomes from substance use (SU). We conducted a scoping review to explore the research on SU among rural AA men in the rural South of the United States (US). Ten articles addressed the following thematic areas pertaining to SU: factors associated with SU (n = 6), associations between substance use and health outcomes (n = 2), and the influence of impulsivity on SU (n = 2). Additional research on SU among AA men in the rural South is needed, particularly pertaining to treatment-related considerations.

Pivoting Nursing Research and Scholarship During the COVID-19 Pandemic.

BACKGROUND: The global COVID-19 pandemic has brought numerous challenges for conducting the human subjects research needed to advance science and improve health. OBJECTIVES: The purpose of this article is to discuss how a college of nursing at a large public university in the southeast United States has responded to the challenges of conducting research during the novel COVID-19 pandemic. METHODS: Seven faculty researchers at the University of South Carolina College of Nursing share their experiences in overcoming the unique challenges of conducting research because of the COVID-19 pandemic. Strategies to overcome the challenges posed by COVID-19 are presented within the context of the research process, career implications, communication, and maintaining morale. RESULTS: Fears of COVID-19 and social distancing measures have hindered participant recruitment, enrollment, and involvement in ongoing studies. Increasing virtual technology use and enhancing safety precautions have assisted researchers to overcome barriers. Scholarly writing has increased for some faculty members whose studies have been stalled by the pandemic, yet others have seen a decline because of additional personal responsibilities. The careers of faculty members across all ranks have been uniquely affected by the pandemic. With most faculty working remotely, enhanced communication strategies at the university and college have supported the research enterprise. Morale has been adversely affected, but a variety of personal and collegial efforts have helped faculty cope and preserve a sense of normalcy during this devastating pandemic. DISCUSSION: Faculty and their ability to conduct the research needed to inform clinical and public health practice have been adversely affected by the COVID-19 pandemic. Despite the challenges of conducting research during this unprecedented crisis, faculty and institutions are taking novel steps to ensure the continuity of scientific progress for improving the health and well-being of patients and populations.

Examining Use of Dual Point Temperature Display in Servo-Control With Early Preterm Infants.

BACKGROUND: Previously, we recorded periods of time with foot higher than abdominal temperatures in association with infection in preterm infants. Monitoring dual temperatures may be an important tool to assess infant instability. Currently, incubators cannot measure and display dual temperatures in servo-control mode. PURPOSE: To examine the usability of GE Healthcare's Giraffe OmniBed with research software to measure, display, and record dual temperatures, and their differences while in servo-control. In addition, nurses' perceptions of the use and display of dual temperatures and differences were evaluated. METHODS: A multiple-case, mixed-methods design. Abdominal and foot temperatures were measured, displayed, and stored for 28 days for 14 preterm infants. Nurses were surveyed for satisfaction and preferences with the dual temperature display. Nurses noted abnormal temperature differences and infant condition in bedside journals. RESULTS: Study infants were 26 to 31 weeks of gestational age and 670 to 1410 g. Abdominal, foot, and the abdominal-foot temperature difference was measured, recorded, and downloaded successfully in all infants over all days. Nurses liked using dual temperature display with the abdominal-foot temperature difference. Surveys indicated preferences for larger displays and alarms for abnormal values. Thermal instability, stimulation, and thermistor detachment were associated with abnormal thermal gradients. Two exemplar cases are presented. IMPLICATIONS FOR PRACTICE: Monitoring dual temperatures adds information to the clinical assessment. IMPLICATIONS FOR RESEARCH: Studies are needed to examine relationships between abnormal thermal gradients and infections, infant stability, and nursing care along with the underlying physiologic mechanisms. Studies are needed for wireless dual temperature monitoring.

Students Experience Mass Casualty Nursing From the Patient Perspective in a Simulated Mass Casualty Exercise.

ABSTRACT: Life-saving response to mass casualty incidents (MCIs) requires education and training. Participation in an MCI full-scale exercise provided nursing students with a rare opportunity to experience a simulated disaster from the patient perspective to better understand the unique issues involved in mass casualty response. This innovative teaching approach enabled students to undergo triage and decontamination as victims of a chemical MCI and participate in a research study. We describe student feedback on this learning experience and the implications of incorporating a full-scale MCI for providing a patient perspective into nursing curricula.

Are decision aids leading to shared prostate cancer screening decisions among African-American men?: iDecide.

PURPOSE: African-Americans have prostate cancer mortality rates that are double their White counterparts. To reduce prostate cancer disparities, it is suggested that men engage in shared decision making about prostate cancer screening with their healthcare provider after learning about the benefits and harms of these screenings. While researchers have developed decision aids to support African-American's screening decisions, there is some uncertainty whether these aids lead to shared decision making. The goal of the current study was to investigate the efficacy of iDecide, a computerized decision aid, for promoting African-American men's engagement in shared decision making. METHODS: Six months after their use of iDecide, a prostate cancer screening decision aid, 76 participants were surveyed to determine whether they spoke with a provider about screening, what this conversation entailed, and if shared decision making occurred. RESULTS: While iDecide is an effective tool for enhancing African-American's intention to engage in shared decision making, there is no evidence this aid increased their likelihood of discussing prostate cancer with a provider or participation in shared decision making. CONCLUSION: Future research should employ stronger research designs and assess the various contexts that can affect the relationship between decision-aid use and shared decision making among African-Americans.

Development and initial psychometric evaluation of the computer-based prostate Cancer screening decision aid acceptance scale for African-American men.

BACKGROUND: To reliably evaluate the acceptance and use of computer-based prostate cancer decision aids (CBDAs) for African-American men, culturally relevant measures are needed. This study describes the development and initial psychometric evaluation of the 24-item Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale among 357 African-American men. METHODS: Exploratory factor analysis (EFA) with maximum likelihood estimation and polychoric correlations followed by Promax and Varimax rotations. RESULTS: EFA yielded three factors: Technology Use Expectancy and Intention (16 items), Technology Use Anxiety (5 items), and Technology Use Self-Efficacy (3 items) with good to excellent internal consistency reliability at .95, .90, and .85, respectively. The standardized root mean square residual (0.035) indicated the factor structure explained most of the correlations. CONCLUSIONS: Findings suggest the three-factor, 24-item Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale has utility in determining the acceptance and use of CBDAs among African-American men at risk for prostate cancer. Future research is needed to confirm this factor structure among socio-demographically diverse African-Americans.

Comparing behavioral health models for reducing risky drinking among older male veterans.

BACKGROUND: Screening older veterans in Veterans Affairs Medical Center (VAMC) primary care clinics for risky drinking facilitates early identification and referral to treatment. OBJECTIVE: This study compared two behavioral health models, integrated care (a standardized brief alcohol intervention co-located in primary care clinics) and enhanced referral care (referral to specialty mental health or substance abuse clinics), for reducing risky drinking among older male VAMC primary care patients. VAMC variation was also examined. METHOD: A secondary analysis of longitudinal data from the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study, a multisite randomized controlled trial, was conducted with a sample of older male veterans (n = 438) who screened positive for risky drinking and were randomly assigned to integrated or enhanced referral care at five VAMCs. RESULTS: Generalized estimating equations revealed no differences in either behavioral health model for reducing risky drinking at a 6-month follow-up (AOR: 1.46; 95% CI: 0.42-5.07). Older veterans seen at a VAMC providing geriatric primary care and geriatric evaluation and management teams had lower odds of risky drinking (AOR: 0.24; 95% CI: 0.07-0.81) than those seen at a VAMC without geriatric primary care services. CONCLUSIONS: Both integrated and enhanced referral care reduced risky drinking among older male veterans. However, VAMCs providing integrated behavioral health and geriatric specialty care may be more effective in reducing risky drinking than those without these services. Integrating behavioral health into geriatric primary care may be an effective public health approach for reducing risky drinking among older veterans.

Validating Signs and Symptoms From An Actual Mass Casualty Incident to Characterize An Irritant Gas Syndrome Agent (IGSA) Exposure: A First Step in The Development of a Novel IGSA Triage Algorithm.

CONTRIBUTION TO EMERGENCY NURSING PRACTICE: • Chemical exposures daily pose a significant threat to life. Rapid assessment by first responders/emergency nurses is required to reduce death and disability. Currently, no informatics tools for Irritant Gas Syndrome Agents (IGSA) exposures exist to process victims efficiently, continuously monitor for latent signs/symptoms, or make triage recommendations. • This study uses actual patient data from a chemical incident to characterize and validate signs/symptoms of an IGSA Syndrome. Validating signs/symptoms is the first step in developing new emergency department informatics tools with the potential to revolutionize the process by which emergency nurses manage triage victims of chemical incidents. ABSTRACTINTRODUCTION: Chemical exposures can pose a significant threat to life. Rapid assessment by first responders/emergency nurses is required to reduce death and disability. Currently, no informatics tools for irritant gas syndrome agents (IGSA) exposures exist to process victims efficiently, continuously monitor for latent signs/symptoms, or make triage recommendations. This study describes the first step in developing ED informatics tools for chemical incidents: validation of signs/symptoms that characterize an IGSA syndrome. METHODS: Data abstracted from 146 patients treated for chlorine exposure in one emergency department during a 2005 train derailment and 152 patients not exposed to chlorine (a comparison group) were mapped to 93 possible signs/symptoms within 2 tools (WISER and CHEMM-IST) designed to assist emergency responders/emergency nurses with managing hazardous material exposures. Inferential statistics (χ2/Fisher's exact test) and diagnostics tests were used to examine mapped signs/symptoms of persons who were and were not exposed to chlorine. RESULTS: Three clusters of signs/symptoms are statistically associated with an IGSA syndrome (P < .01): respiratory (shortness of breath, wheezing, coughing, and choking); chest discomfort (tightness, pain, and burning), and eye, nose and/or throat (pain, irritation, and burning). The syndrome requires the presence of signs/symptoms from at least 2 of these clusters. The latency period must also be considered for exposed/potentially exposed persons. DISCUSSION: This study uses actual patient data from a chemical incident to characterize and validate signs/symptoms of an IGSA syndrome. Validating signs/symptoms is the first step in developing new ED informatics tools with the potential to revolutionize the process by which emergency nurses manage triage victims of chemical incidents.

The Impact of STORY on Depression and Fatigue in African-American Women with Breast Cancer.

The intervention Sisters Tell Others and Revive Yourself (STORY) is a teleconference intervention for African-American women with breast cancer that was studied with a randomized, non-blinded, intention-to-treat trial between 2006 and 2010 in the southeastern United States. This secondary data analysis research measured the impact of STORY on depression and fatigue in African-American women (N = 168) with breast cancer. The were no significant differences in depression or fatigue found between the intervention and control groups based on the Wilcoxon signed-rank test. Further research is needed to develop effective interventions aimed at decreasing depression and fatigue in African-American women with breast cancer.

Psychometric validation of Emotional Reaction Instrument-English to measure American children's emotional responses to hospitalisation.

AIMS AND OBJECTIVES: The aim of this study was to test the initial psychometric properties of the Emotional Reactions Instrument-English with hospitalised American children, ages 7-12 years, in the USA. BACKGROUND: Children's negative emotional responses have been a subject of concern for paediatric clinicians and researchers, especially because negative emotional responses following or during hospitalisation are associated with adverse patient outcomes. Existing self-report paediatric instruments have a number of limitations including lack of clinical feasibility and psychometric evidence. DESIGN: A survey and psychometric approach was used to test initial reliability and validity of the Emotional Reactions Instrument-ENGLISH. METHODS: Two hundred hospitalised American children, 7-12 years of age, who were admitted to a Children's Hospital in the USA were recruited for this study. The children were administered the Emotional Reactions Instrument-English, the Facial Affective Scale, and a demographic form. RESULTS: Internal consistency was supported by a Cronbach's alpha of 0·83 for the total scale. Alpha coefficients for subscales ranged from 0·59-0·82. Construct validity was tested with exploratory factor analysis. Through principal component analysis, four factors were identified that explained 64% of the variance. Concurrent validity was supported by most items in the Emotional Reactions Instrument-English being significantly correlated with the Facial Affective Scale (r = 0·18-0·59). The instrument can be administered to hospitalised children in 5-10 minutes. CONCLUSIONS: The results of this exploratory study provide initial support for the psychometric adequacy of the Emotional Reactions Instrument-English with hospitalised American children ages 7-12 years. Further testing of the Emotional Reactions Instrument-English is required to validate the subscales and evaluate the instrument's use with children of different ages, race and ethnicity. RELEVANCE TO CLINICAL PRACTICE: This study introduces a new, clinically feasible instrument to measure children's diverse emotional responses to hospitalisation.

Social networking policies in nursing education.

Social networking use has increased exponentially in the past few years. A literature review related to social networking and nursing revealed a research gap between nursing practice and education. Although there was information available on the appropriate use of social networking sites, there was limited research on the use of social networking policies within nursing education. The purpose of this study was to identify current use of social media by faculty and students and a need for policies within nursing education at one institution. A survey was developed and administered to nursing students (n = 273) and nursing faculty (n = 33). Inferential statistics included χ², Fisher exact test, t test, and General Linear Model. Cronbach's α was used to assess internal consistency of social media scales. The χ² result indicates that there were associations with the group and several social media items. t Test results indicate significant differences between student and faculty for average of policies are good (P = .0127), policies and discipline (P = .0315), and policy at the study school (P = .0013). General Linear Model analyses revealed significant differences for "friend" a patient with a bond, unprofessional posts, policy, and nursing with class level. Results showed that students and faculty supported the development of a social networking policy.

A validation study of 5 triage systems using data from the 2005 Graniteville, South Carolina, chlorine spill.

INTRODUCTION: Lack of outcomes-based research results in uncertainty about the effectiveness of any of the current triage systems in determining priority of care during actual chemical disasters. The purpose of this study was to determine whether the level of injury severity extrapolated from 5 triage systems correlated with actual injury severity outcomes of victims exposed to a chlorine disaster. METHODS: Using secondary data analysis, data for 631 victims were merged, de-identified, and analyzed. Using logic models from the triage systems, the actual injury severity was compared with the extrapolated injury severity classifications. RESULTS: Analysis showed weak to modest correlations between the extrapolated injury severity triage outcome classifications and the actual injury severity outcomes (Spearman correlation range 0.38 to 0.71, P < .0001). There was slight to fair agreement between the extrapolated injury severity triage outcome classifications and the actual injury severity outcomes (weighted κ = - 0.23 to 0.42). DISCUSSION: The extrapolated injury severity triage outcome categories from the 5 triage systems did not agree with the actual injury severity categories. Oxygen saturation measured by pulse oximetry provides early indications and is very predictive of outcome severity in incidents involving irritant chemical exposures such as chlorine, and should be a part of a mass casualty protocol for any irritant chemical incident. Additional research is needed to identify the most sensitive clinical measures for triaging victims of toxic inhalation disasters.

Racial and gender differences in relapse potential and treatment acceptance among rural residents in a substance use disorder treatment program.

PURPOSE: To examine racial and gender differences in treatment acceptance and relapse potential among rural residents admitted to a substance use disorder (SUD) treatment program. METHODS: A cross-sectional study using data collected from a sample of 1850 rural residents admitted to a South Carolina state-run SUD treatment center between the years of 2018 and 2020. Chi-square and t-tests were used to compare treatment acceptance and relapse potential by race and gender. Multivariate logistic regression analyses was conducted to further examine the relationship of race and gender with treatment acceptance and relapse potential after adjusting for potential confounding variables. FINDINGS: Approximately 50% of participants were classified as being accepting of their treatment and committed to changing their substance use, and there were no racial or gender differences in the bivariate and multivariate analyses. Approximately 25% of participants were classified as having low/no potential risk for relapsing, and there were no racial or gender differences in the bivariate analysis. However, the adjusted odds ratio of relapsing risk were lower among White compared to Black adults [AOR = 0.49 with 95% CI (0.31-0.77)]. CONCLUSION: This study suggests there are no gender or racial differences in treatment acceptance for SUD but that Black adults are at greater risk of relapsing relative to White adults. Additional research is needed to identify factors that increase Black adults' risk for relapse to inform interventions that can improve SUD treatment outcomes in this population.

A pilot study describing physical activity in persons with schizophrenia spectrum disorders (SSDS) after an exercise program.

Despite the well known mental and physical health benefits of exercise, persons with schizophrenia spectrum disorders remain sedentary. While the exercise barriers (i.e., lack of motivation, poor concentration, sedative effects of medication, poverty, and lack of access to exercise education/programs) of persons with SSDs are numerous, lack of motivation is considered foremost among them. Exercise interventions have been shown to improve exercise behavior, but there is a need for longitudinal documentation of physical activity after interventions conclude. This pilot study describes the physical activity level of 22 persons with SSDs 14 to 34 (mean 22) months after the conclusion of an exercise intervention provided in a randomized controlled trial (RCT). Eighteen months after the RCT, 22 participants wore pedometers daily for one week without altering their activity. Experimental participants walked more steps and covered more distance on average than control participants on six of the seven days. This pilot study is among the first to document the physical activity level of persons with SSDs after exercise intervention. While our findings confirm the low activity level of persons with SSDs reported by others, experimental participants demonstrated higher activity levels than controls on most days. Future studies should increase the sample size and recruit participants from multiple sites to enhance power and generalizability.

Developing Family Nurse Practitioner Student Competencies: A Two-Part Mental Health-Focused Telehealth Education Activity.

Telehealth is becoming a vital option for increasing access to health care. Family Nurse Practitioners (FNPs) are often the primary providers for rural and disadvantaged populations. They may be the first to encounter patients experiencing depression and other psychiatric problems. This article describes a two-part simulated telehealth education initiative to build FNP student competencies in the use of telehealth technology to interview clients with depressive symptoms. In Part 1, students completed didactic modules that introduced them to telehealth concepts. In Part 2, they participated in a simulated telehealth encounter with a standardized patient experiencing depression. Preparation included a review of care of patients with depression and focused content on telehealth etiquette. After the encounter, they received feedback from the standardized patient, debriefed with faculty, and documented their simulated telehealth visit. The activity was evaluated through post-education surveys and a one-time focus group. Students were overwhelmingly positive regarding the relevance of the educational activity to their graduate preparation and future practice. Many shared suggestions for refinement of the activity. Integration into the current curriculum and use of existing resources increased the feasibility, cost-effectiveness, and potential for long-term sustainability of the educational initiative.

Neonatal Autonomic Regulation as a Predictor of Autism Spectrum Disorder in Very Preterm Infants.

Infants born preterm are at a significantly higher likelihood of having autism spectrum disorder (ASD). Preterm birth and ASD are both associated with neurological differences, notably autonomic nervous system (ANS) dysfunction, pointing to preterm ANS dysfunction as a potential pathway to ASD, particularly in VPT infants. In this study, a subset of very preterm (VPT) infants enrolled in a large, multisite clinical trial were enrolled in this study at birth (N=20). Continuous measures of minute-by-minute thermal gradients, defined by the difference between central and peripheral temperatures, and hour-by-hour abnormal heart rate characteristics (HRCs) were collected from birth-28 days (>40,000 samples/infant). Following NICU discharge, standardized measures of cognition, language, and motor skills were collected at adjusted ages 6, 9, and 12 months. At 12 months, assessments of social communication and early ASD symptoms were administered. Results suggest significant ASD concerns for half of the sample by 12 months of age. Neonatal abnormal HRCs were strongly associated with 12-month ASD symptoms (r=0.81, p<.01), as was birth gestational age (GA), birth weight (BW), and abnormal negative thermal gradients. ANS measures collected in the first month of neonatal life, more than a year prior to the ASD evaluation, were surprisingly strong predictors of ASD. This study highlights complementary ANS measures that describe how ANS dysfunction, likely resulting from an imbalance between the parasympathetic and sympathetic systems, may impact very early regulatory processes for neonates who later develop ASD. This finding offers a promising avenue for researching ANS-related etiological mechanisms and biomarkers of ASD.