Stronger together than apart: The role of social support in adopting a healthy plant-based eating pattern.

The influence of the social environment on health behaviors is well documented. In recent years, there is mounting evidence of the health benefits of a plant-based eating pattern, yet little is known about how the social environment impacts the adoption of a plant-based eating pattern, specifically. In this convergent parallel mixed-methods study, we analyzed quantitative survey data and qualitative focus group data to assess how social support impacted participants of a lifestyle medicine intervention focused on the adoption of a plant-predominant eating pattern. Regression analysis of survey data showed a positive association between positive social support and healthy plant-based eating, while no association was found between negative social support and healthy plant-based eating. Focus groups yielded further insights into how positive aspects of social relationships with family and friends facilitated the adoption of plant-predominant eating among participants. Qualitative findings also showed the ways in which negative social support hindered progress to adopt a plant-predominant eating pattern including not eating the same foods as participants, being judgmental about new dietary behaviors, and encouraging participants to eat non-plant-based foods. Taken together, social support appears to be an important factor for individuals adopting a plant-predominant eating pattern. Future research is needed to explore mechanisms to enhance positive social support while mitigating negative aspects of social relationships for individuals participating in similar lifestyle medicine interventions that emphasize on plant-predominant eating.

Identification of Social Determinants of Education Among Pharmacy Students: Results From a Single-Institution Survey.

OBJECTIVE: To identify social determinants of education (SDOE) among pharmacy students enrolled in the entry-level Doctor of Pharmacy program at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. METHODS: An original 28-item survey was developed and disseminated to first through fourth year students enrolled in the entry-level Doctor of Pharmacy program at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences during the spring 2023 semester. The survey evaluated student demographics, educational performance, and SDOE in 6 categories: physical health, psychosocial health, economic stability, self-motivation, social environment/community, and physical environment/community. RESULTS: A total of 133 students responded to the survey. Over half of the respondents acknowledged difficulties completing errands or self-care tasks owing to their physical, mental, or emotional health. Over half of respondents also reported concerns about covering expenses at the end of the month. Respondents also reported eating less because of financial restraints (20.0%), worrying about housing (22.9%), feeling unsafe in their neighborhood (29.0%), and feeling lonely or isolated (63.4%). In the secondary analysis, the respondents who had concerns with covering expenses, affording food, or losing housing had significantly lower academic performance. CONCLUSION: This study identified several SDOE among pharmacy students at our institution, suggesting that students at even the highest levels of education may be subject to disparities. The identification of SDOE provides insight into barriers that are potentially hidden but are highly likely to impact student engagement and success. Efforts toward reducing disparities and promoting equitable opportunities for students are necessary to ensure continued growth and diversification of the pharmacy profession.

Healthcare professionals' perspectives on the challenges with managing polycystic ovary syndrome: A systematic review and meta-synthesis.

OBJECTIVE: To provide an overview of healthcare professionals' experience of PCOS management and identify the relevant facilitators and barriers. METHODS: A systematic search was conducted in MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane CENTRAL database from the earliest available date to April 2023. Qualitative and mixed methods studies that described healthcare professionals' experiences of PCOS management were included. RESULTS: A total of 74 findings were extracted from the 8 included studies, which were categorized into facilitators and barriers. The barriers were meta-aggregated into four themes: the weakness of clinical evidence; women's low adherence to PCOS management; various obstacles that healthcare professionals face, and the influence of social environment and culture. The facilitators were meta-aggregated into three themes: chronic disease healthcare plan, communication techniques and healthcare professionals' ability and awareness. CONCLUSION: The findings of this study have the potential to improve the care provided to women with PCOS. However, it is important for national health professionals and policy markers to consider the cultural context of their own country when implementing these findings. PRACTICAL IMPLICATIONS: This study illustrated several challenges in managing the heterogeneous condition of PCOS and provide insights for the development of medical policies and future research directions.

Associations between healthy lifestyle and mortality across different social environments: a study among adults with frailty from the UK Biobank.

BACKGROUND: Among people living with frailty, adherence to a healthy lifestyle may be a low-cost and effective strategy to decrease frailty-induced health risks across different social environments. METHODS: We included 15 594 frail participants at baseline from the UK Biobank study. We used four lifestyle factors to create a composite healthy lifestyle score and 17 social factors to construct a polysocial score. We classified the lifestyle score into two levels (unhealthy and healthy) and the polysocial score into three levels (low, intermediate and high). We used Cox regression to determine the association of each lifestyle factor and lifestyle score with all-cause mortality, respectively. We also examined the associations across polysocial score categories. We evaluated the joint association of the lifestyle score and the categorical polysocial score with all-cause mortality. RESULTS: During up to 14.41 follow-up years, we documented 3098 all-cause deaths. After multivariable adjustment, we found a significant association between not smoking and adequate physical activity with all-cause mortality across polysocial score categories, respectively. We also found a significant association between a healthy diet and all-cause mortality among frail participants living in an intermediate social environment. A healthy lifestyle was associated with a lower all-cause mortality risk across polysocial score categories, especially among those with a low polysocial score. CONCLUSIONS: Adherence to a healthy lifestyle, particularly not smoking, adequate physical activity and a healthy diet, may provide a feasible solution to decreasing mortality risk among frail adults across different social environments, especially for those in the socially disadvantaged group.

[Knowledge of the patient's bio-psycho-social context as a predictive tool for outcomes in palliative care.] / La conoscenza del contesto bio-psico-sociale del paziente come strumento predittivo di outcome in cure palliative.

INTRODUCTION: The General Practitioner (GP), thanks to his knowledge of the patient's bio-psycho-social context, has a fundamental role in the definition of a personalized care planning (Pcp). The HexCom model can be a valid tool for standardizing the level of complexity of the patient in palliative care and for evidentiate critical care issues. METHODS: The GP participants retrospectively assessed, using HexCom model, the complexity of the biopsycho-social context of 53 patients taken care by the Palliative Care Unit and who died in the years 2019-2021. For each patient, age, sex, treating doctor, main diagnosis, data and place of death (home/hospice/hospital) were collected. RESULTS: Subjects who died in hospital or hospice had similar HexCom complexity scores, higher than those who died at home (p=0.04). The HexCom score was inversely related to the subject's age (p=0.01). The ROC curve suggested a cut-off for HexCom equal to 209, whereby subjects with HexCom ≥209 would be associated with death in hospital/hospice while subjects with HexCom <209 would be associated with death at home. CONCLUSION: The present study confirms the importance of evaluating the complexity of a patient in palliative care and proposes the use of the HexCom model for the evaluation of the biopsycho-social context, a predictor of the outcome of a patient in palliative care. KEY WORDS: bio-psycho-social, complexity, GP, HexCom, palliative care, Pcp.

Environmental sustainability, the forgotten aspect that makes nursing invisible

Scientific publications in research journals have adeptly investigated into topics of considerable interest, rendering nursing care more intricate in the face of increasingly thorough investigations into numerous phenomena. This ongoing exploration contributes significantly to the body of knowledge disseminated within the scientific community. Nevertheless, the advent of the global era has presented nursing with novel challenges that persist from the dawn of history parallel to a lingering shadow obscuring the true essence of the profession. An example is environmental nursing, often overlooked from the lens of social sustainability­a neglect that researchers, as minority groups in a relentless struggle, have sidelined. These challenges align with the dynamic demands imposed by society and the mandates of state and/or governmental parliaments.

Medidas de proteção contra a COVID-19: impactos comunicativos, sociais e emocionais em usuários de aparelhos de amplificação sonora individual / Protective measures against COVID-19: communicative, social and emotional impacts on hearing aids users

RESUMO Objetivo investigar os impactos comunicativos, sociais e emocionais gerados pela adoção de medidas protetivas contra a COVID-19 e associá-los ao grau da perda auditiva e ao tempo de uso dos aparelhos de amplificação sonora individual. Métodos estudo transversal e quantitativo, com 72 indivíduos, divididos em adultos e idosos, com perda auditiva bilateral, de grau até moderadamente severo, protetizados antes da pandemia em um programa público de saúde auditiva e que mantiveram uso efetivo dos dispositivos. Os sujeitos foram convidados a participar do estudo enquanto aguardavam consulta. Os prontuários foram acessados, a fim de coletar informações sobre o perfil audiológico e adaptação/uso dos aparelhos de amplificação sonora individual. Em sala silenciosa, foi aplicado, oralmente, protocolo contendo questões objetivas e os dados foram tabulados e submetidos aos testes estatísticos Igualdade de Duas Proporções e Qui-Quadrado. Resultados nos dois grupos, um número significativo de usuários teve a comunicação impactada pelo uso de máscaras e pelo distanciamento físico, predominando, entre os adultos, a dificuldade com as tecnologias digitais (celulares/computadores), enquanto nas videochamadas, os prejuízos comunicativos foram mais experenciados pelos idosos. Os empecilhos comunicativos e sociais existiram, independentemente do perfil audiológico e do tempo de uso dos dispositivos. Quando questionados se deixaram de se comunicar e se as medidas afetaram a sua vida social, as respostas ficaram divididas entre "sim/às vezes" e "não". Quanto ao impacto emocional das medidas protetivas, constatou-se maior repercussão entre os adultos. Conclusão as medidas protetivas afetaram a comunicação dos usuários de aparelhos de amplificação sonora individual, porém, não desencorajaram as trocas comunicativas e as interações sociais de, aproximadamente, metade da amostra, sendo o impacto emocional mais evidente nos adultos. Tais dificuldades não estiveram relacionadas ao perfil audiológico e uso diário dos dispositivos.

ABSTRACT Purpose to investigate the communicative, social, and emotional impacts generated by adopting protective measures against COVID-19 and associate them with the degree of hearing loss and the time of use of hearing aids. Methods cross-sectional quantitative study, with 72 individuals, divided into adults and older adults, with bilateral hearing loss up to moderately severe degree, users of hearing aids fitted before the pandemic in a public hearing health program who had maintained effective use of the devices. The participants were invited to participate in the study while waiting for an appointment and signed the consent form. After that, medical records were accessed to collect information about audiological profiles and the fitting/use of hearing aids. Afterward, a protocol with objective questions was orally applied in a silent room. Data were tabulated and subjected to Equality of Two Proportions and Chi-Square statistical tests. Results in both groups, a significant number of users had communication impacted by the use of masks and by social distancing, with difficulty with digital technologies (cell phones/computers) predominating among adults, while older adults more commonly experienced communicative impairments during video calls. The communicative impediment existed regardless of the audiological profile and device use time. When asked if they stopped communicating and if the measures affected their social life, the sample was divided between "yes/sometimes" and "no". As for the emotional impact of protective measures, there was a greater impact among adults. Conclusion protective measures affected the communication of hearing aids users but did not discourage communicative exchanges and social interactions for approximately half of the sample, with the emotional impact being more evident in adults. Such difficulties were not related to the audiological profile and daily use of the devices.

Factors associated with drug use in prison: A systematic review of quantitative and qualitative evidence.

BACKGROUND: About a third of people use drugs during their incarceration, which is associated with multiple adverse health and criminal justice outcomes. Many studies have examined factors associated with in-prison drug use, but this evidence has not yet been systematically reviewed. We aimed to systematically review and synthesise the evidence on factors related to drug use in prison. METHODS: Three databases (PubMed, PsycINFO and Embase) were systematically searched as well as grey literature, for quantitative, qualitative and mixed-methods studies examining factors related to drug use inside prison. We excluded studies that did not explicitly measure in prison drug use or only measured alcohol and/or tobacco use. Study quality was assessed using the Newcastle Ottawa Scale (NOS) for quantitative studies and Critical Appraisal Skills Programme (CASP) for qualitative studies. The review was prospectively registered on PROSPERO (CRD42021295898). RESULTS: Fifty-four studies met the inclusion criteria, reporting data on 26,399 people in prison. Most studies were of low or moderate-quality, and all used self-report to assess drug use. In quantitative studies, studies found that previous criminal justice involvement, poor prison conditions, pre-prison drug use and psychiatric diagnosis were positively associated with drug use in prison. In qualitative studies, reasons for drug use were closely linked to the prison environment lacking purposeful activity and the social context of the prison whereby drug use was seen as acceptable, necessary for cohesion and pressurised. CONCLUSION: In the first systematic review of factors associated with drug use in prison, key modifiable risk factors identified from quantitative and qualitative studies were psychiatric morbidity and poor prison conditions. Non-modifiable factors included previous drug use and criminal history linked to substance use. Our findings indicate an opportunity to intervene and improve the prison environment to reduce drug use and associated adverse outcomes.

Why women continue to smoke during pregnancy: a qualitative study among smoking pregnant women.

Smoking during pregnancy is a serious public health concern due to its adverse consequences on fetal development and pregnant women's health. For the success of smoking cessation interventions, it is essential to determine why pregnant women continue smoking. The objective of this study is to determine the beliefs, attitudes, and barriers to quitting smoking during pregnancy. We adopted a qualitative research design. The participants consisted of 22 pregnant women who smoke, selected by purposive sampling. We collected data through semi-structured interviews and analyzed it using thematic analysis. We identified six themes namely "Reasons for starting to smoke: family and social environment," "Intention to quit smoking and related factors," "Smoking and emotional well-being," "Smoking and stressful life experiences," "Protective thoughts: reducing smoking to safeguard their babies," and "Belief in a healthy pregnancy and inadequate risk perception." Women expressed the desire to protect their fetus from the harm of smoking. However, they continued to smoke due to a lack of knowledge, inadequate risk perception, psychological difficulties, and lack of motivation. Health professionals should be aware of the difficulties experienced by pregnant women who smoke and should support them in quitting smoking.

Neighborhood Factors, Individual Stressors, and Cardiovascular Health Among Black and White Adults in the US: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

Importance: Chronic stress has been posited to contribute to racial disparities in cardiovascular health. Investigation of whether neighborhood- and individual-level stressors mediate this disparity is needed. Objective: To examine whether racial differences in ideal cardiovascular health (ICH) are attenuated by experiences with neighborhood- and individual-level stressors within a racially and geographically diverse population sample. Design, Setting, and Participants: This cross-sectional study examined data from 7720 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study who completed the second in-home visit (2013-2016). The REGARDS study is a population-based, longitudinal study of 30 239 non-Hispanic Black and non-Hispanic White adults aged 45 years or older at baseline (2003-2007). Data for the present study were analyzed from June to July 2021 and in March 2022. Exposures: Neighborhood physical environment (eg, excessive noise, violence; scored from 7-28, with higher scores indicating more problems), neighborhood safety (scored as very safe, safe, or not safe), neighborhood social cohesion (eg, shared values; scored from 5-25, with higher scores indicating higher cohesion), perceived stress (eg, coping; scored from 0-16, with higher scores indicating greater perceived stress), and the experience of discrimination (yes or no). Main Outcomes and Measures: Ideal cardiovascular health (ICH), measured as a composite of 4 health behaviors (cigarette smoking, diet, physical activity, body mass index) and 3 health factors (blood pressure, cholesterol, and glucose levels). Results: The sample included 7720 participants (mean [SD] age, 71.9 [8.3] years; 4390 women [56.9%]; 2074 Black participants [26.9%]; and 5646 White participants [73.1%]). Black participants compared with White participants reported higher perceived stress (mean [SD] score, 3.2 [2.8] vs 2.8 [2.7]) and more often reported discrimination (77.0% vs 24.0%). Black participants also reported poorer neighborhood physical environment (mean [SD] score, 11.2 [3.8] vs 9.8 [2.9]) and social cohesion (mean [SD] score, 15.5 [2.0] vs 15.7 [1.9]) and more often reported their neighborhoods were unsafe (54.7% vs 24.3%). The odds of having a high total ICH score (ie, closer to ideal) were lower for Black adults compared with White adults, both overall (adjusted odds ratio [AOR], 0.53; 95% CI, 0.45-0.61) and by gender (men: AOR, 0.73 [95% CI, 0.57-0.93]; women: AOR, 0.45 [95% CI, 0.37-0.54]). In mediation analyses, the racial disparity in total ICH score was attenuated by neighborhood physical environment (5.14%), neighborhood safety (6.27%), neighborhood social cohesion (1.41%), and discrimination (11.01%). In stratified analyses, the factors that most attenuated the racial disparity in total ICH scores were neighborhood safety among men (12.32%) and discrimination among women (14.37%). Perceived stress did not attenuate the racial disparity in total ICH scores. Conclusions and Relevance: In this cross-sectional study of Black and White US adults aged 45 years and older, neighborhood-level factors, including safety and physical and social environments, and individual-level factors, including discrimination, attenuated racial disparities in cardiovascular health. Interventional approaches to improve ICH that separately target neighborhood context and discrimination by gender and race are warranted.

Influence of group size on shelter choice in Blaptica dubia cockroaches.

Individuals in social groups can gain benefits from being in those groups, including an increased ability to find food and avoid predators. We tested for potential group benefits in shelter choice in the Argentinian wood roach, Blaptica dubia. Roaches were tested in arenas with two shelters available in which one shelter was significantly darker than the other. Female and male roaches, housed separately, were tested as solitary individuals, or in same-sex groups of 5, 10, or 15. The roaches were tested under two light regimes (lights on vs. lights off) and two shelter distances (shelters near vs. shelters far) to provide variation in shelter search conditions. Solitary individuals chose the darker shelter at chance levels, but the roaches in groups chose the darker shelter significantly more often than chance. Furthermore, the two largest groups chose the darker shelter more often than the group of five roaches. We detected effects related to light variation that indicated roaches were more likely to be under either shelter in the lights-on conditions, and more likely to be out in the arena and under no shelter in the lights-off condition. Shelter distances had negligible effects on shelter choice and sex had no effect. Taken together, our results indicate individuals can make more optimal choices regarding shelter darkness if they are in a group, and that decision-making related to shelter is sensitive to variation in social context. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Youth mental health and nicotine vape use: The moderating role of rural-urban/suburban school environments.

OBJECTIVE: To understand and compare the association between nicotine vape use and mental health among youth in rural and urban/suburban areas. METHODS: This cross-sectional study included 146,489 high school students from the 2019-2020 California Student Tobacco Survey. Descriptive statistics were estimated with frequencies and percentages. Separate bivariate associations between each covariate/predictor variable and mental health were examined using linear regression. Multivariate linear regression models were used to examine the association between nicotine vape use and mental health for youth attending school in rural versus suburban/urban communities. RESULTS: Findings showed that vaping nicotine was associated with poorer overall mental health (b = -0.307, SE = 0.019, p < 0.001), and that this association differed based on rural versus urban/suburban school environments (b = -0.135, SE = 0.046, p = 0.004). Specifically, the relationship between vaping and poor mental health was stronger for youth attending school in rural areas (b = -0.443, SE = 0.042, p < 0.001) than in urban/suburban localities (b = -0.307, SE = 0.019, p < 0.001). CONCLUSIONS: Although differences in mental health were not shown based on rural versus urban/suburban school environments alone, findings showed that the relationship between nicotine vape use and mental health was stronger for youth attending high school in rural areas. Additional research is needed to understand the underlying social and environmental mechanisms that exacerbate this relationship. Future interventions might consider how to support and improve the mental health of rural nicotine vapers to better achieve health equity across different school environments.

Exploring pain among young people who have completed treatment for acute lymphoblastic leukemia: experiences of youth and caregivers.

PURPOSE: Acute lymphoblastic leukemia (ALL) is the most common cancer diagnosed among individuals <14 years of age. The disease and its treatments are associated with negative side effects, including pain, which is both prevalent and distressing. Little is known about pain experiences in this population, which has slowed efforts to identify strategies to mitigate and cope with this adverse effect. This study sought to explore youth's and their caregiver's experiences with, and perspectives of, pain in the context of pediatric cancer treatment. METHODS: Youth and one of their caregivers were recruited through (omitted for peer review). Following completion of a demographic survey, youth and one of their caregivers were interviewed separately using a semi-structured, one-on-one interview guide. Demographic information was analyzed with descriptive statistics, and interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS: Youth (n = 19; Mage = 15.3 years) and caregiver (n = 19; Mage = 45.4 years) perspectives informed 4 themes: (1) my pain experience is nuanced, multidimensional, and is changing over time; (2) the cancer experience has changed the way I experience and respond to pain; (3) I used strategies to manage pain, and not all of them worked; and (4) my pain experience was influenced by people around me. CONCLUSIONS: Findings extend prior work, suggesting that pain is common, distressing, multidimensional, and influenced by social context. Results highlight the number of ways in which youth and their caregivers attempt to manage their pain and factors influencing pain experiences. Greater efforts are needed to address pain during cancer treatment and survivorship.

Natural Language Processing Methods to Empirically Explore Social Contexts and Needs in Cancer Patient Notes.

PURPOSE: There is an unmet need to empirically explore and understand drivers of cancer disparities, particularly social determinants of health. We explored natural language processing methods to automatically and empirically extract clinical documentation of social contexts and needs that may underlie disparities. METHODS: This was a retrospective analysis of 230,325 clinical notes from 5,285 patients treated with radiotherapy from 2007 to 2019. We compared linguistic features among White versus non-White, low-income insurance versus other insurance, and male versus female patients' notes. Log odds ratios with an informative Dirichlet prior were calculated to compare words over-represented in each group. A variational autoencoder topic model was applied, and topic probability was compared between groups. The presence of machine-learnable bias was explored by developing statistical and neural demographic group classifiers. RESULTS: Terms associated with varied social contexts and needs were identified for all demographic group comparisons. For example, notes of non-White and low-income insurance patients were over-represented with terms associated with housing and transportation, whereas notes of White and other insurance patients were over-represented with terms related to physical activity. Topic models identified a social history topic, and topic probability varied significantly between the demographic group comparisons. Classification models performed poorly at classifying notes of non-White and low-income insurance patients (F1 of 0.30 and 0.23, respectively). CONCLUSION: Exploration of linguistic differences in clinical notes between patients of different race/ethnicity, insurance status, and sex identified social contexts and needs in patients with cancer and revealed high-level differences in notes. Future work is needed to validate whether these findings may play a role in cancer disparities.

In what settings and social contexts do young adults vape or smoke cannabis? Findings from a web-based diary pilot study.

BACKGROUND: Vaping is an increasingly common mode of cannabis use among young adults. Despite potential to inform targeted prevention, settings and social contexts where young adults vape and/or smoke cannabis have rarely been investigated. We addressed this question in a diverse young adult sample. METHODS: Data were collected weekly in a web-based daily diary format for six weeks. The analytic sample consisted of the 108 participants (of the 119 enrolled) who used cannabis during the assessment period (mean age = 22.06; 23.78% college students; 65.74% female; 5.56% Asian, 22.22% Black, 16.67% Latinx, 2.78% Multi-racial or Other and 52.77% White). Cannabis use was queried separately for vaping and smoking; respondents reported all settings (14 options) and social contexts (7 options) where they used. RESULTS: For both vaping and smoking cannabis, the most common settings were home (vaping: 56.97%, smoking: 68.72% [significantly lower for vaping]), friend's home (vaping: 22.49%, smoking: 21.49%), and car (vaping: 18.80%, smoking: 12.99%). The most common social contexts were with friends (vaping: 55.96%, smoking: 50.61%), with significant other (vaping: 25.19%, smoking: 28.53%), and alone (vaping: 25.92%, smoking: 22.62%). Compared to non-students, college students reported vaping on a significantly higher proportion (27.88% vs. 16.50%) of cannabis use days. CONCLUSIONS: Very similar patterns in settings and social contexts were observed for vaping as smoking and in prevalence of vaping and smoking cannabis across demographic groups. The few notable exceptions have implications for vaping related public health measures: targeting reducing vaping outside the home, particularly in cars, and implementing prevention programming on college campuses.

Associations Between Social Context and Mood During Alcohol Consumption in Young Adult Smokers.

OBJECTIVE: Differences in the subjective effects of alcohol in different social contexts have been well documented, but little research examines affect during drinking in real-world social contexts. This study examined differences by social context in negative affect and positive affect during alcohol consumption. We hypothesized that negative affect and positive affect with drinking would vary as a function of social context (alone or with others). METHOD: A total of 257 young adults (M age = 21.3, 53.3% female) who were enrolled in a longitudinal, observational study assessing risk for smoking completed 7 days of ecological momentary assessment assessing alcohol use, affect, and social context at two time points of the study. Mixed-effects location scale analyses examined effects of being alone versus with others on positive affect and negative affect after drinking and compared with nondrinking times. RESULTS: Positive affect was higher when drinking with others versus alone, and negative affect was higher when drinking alone versus with others. Both negative affect and positive affect variability were higher when participants were drinking alone compared to with others, and negative affect variability was higher at low amounts of alcohol but decreased with increased drinking. CONCLUSIONS: These findings demonstrate that solitary drinking is less consistently reinforcing because of greater and more variable negative affect, as well as more variable positive affect. When drinking with others, increased and less variable positive affect suggests that social drinking may be particularly reinforcing in young adulthood.

Role of neighborhood context in ovarian cancer survival disparities: current research and future directions.

Ovarian cancer is the fifth leading cause of cancer-associated mortality among US women with survival disparities seen across race, ethnicity, and socioeconomic status, even after accounting for histology, stage, treatment, and other clinical factors. Neighborhood context can play an important role in ovarian cancer survival, and, to the extent to which minority racial and ethnic groups and populations of lower socioeconomic status are more likely to be segregated into neighborhoods with lower quality social, built, and physical environment, these contextual factors may be a critical component of ovarian cancer survival disparities. Understanding factors associated with ovarian cancer outcome disparities will allow clinicians to identify patients at risk for worse outcomes and point to measures, such as social support programs or transportation aid, that can help to ameliorate such disparities. However, research on the impact of neighborhood contextual factors in ovarian cancer survival and in disparities in ovarian cancer survival is limited. This commentary focuses on the following neighborhood contextual domains: structural and institutional context, social context, physical context represented by environmental exposures, built environment, rurality, and healthcare access. The research conducted to date is presented and clinical implications and recommendations for future interventions and studies to address disparities in ovarian cancer outcomes are proposed.

Allostasis and metastasis: The yin and yang of childhood self-regulation.

Most research has studied self-regulation by presenting experimenter-controlled test stimuli and measuring change between baseline and stimulus. In the real world, however, stressors do not flash on and off in a predetermined sequence, and there is no experimenter controlling things. Rather, the real world is continuous and stressful events can occur through self-sustaining interactive chain reactions. Self-regulation is an active process through which we adaptively select which aspects of the social environment we attend to from one moment to the next. Here, we describe this dynamic interactive process by contrasting two mechanisms that underpin it: the "yin" and "yang" of self-regulation. The first mechanism is allostasis, the dynamical principle underlying self-regulation, through which we compensate for change to maintain homeostasis. This involves upregulating in some situations and downregulating in others. The second mechanism is metastasis, the dynamical principle underling dysregulation. Through metastasis, small initial perturbations can become progressively amplified over time. We contrast these processes at the individual level (i.e., examining moment-to-moment change in one child, considered independently) and also at the inter-personal level (i.e., examining change across a dyad, such as a parent-child dyad). Finally, we discuss practical implications of this approach in improving the self-regulation of emotion and cognition, in typical development and psychopathology.

Resiliency Among Women's Health Initiative Women Aged 80 and Older by Race, Ethnicity, and Neighborhood Socioeconomic Status.

OBJECTIVES: A comprehensive examination of resilience by race, ethnicity, and neighborhood socioeconomic status (NSES) among women aged ≥80 is needed, given the aging of the U.S. population, increasing longevity, and growing racial and ethnic diversity. METHODS: Participants were women aged ≥80 enrolled in the Women's Health Initiative. Resilience was assessed with a modified version of the Brief Resilience Scale. Descriptive statistics and multiple linear regression examined the association of demographic, health, and psychosocial variables with resilience by race, ethnicity, and NSES. RESULTS: Participants (n = 29,367, median age = 84.3) were White (91.4%), Black (3.7%), Hispanic (1.9%), and Asian (1.7%) women. There were no significant differences by race and ethnicity on mean resiliency scores (p = .06). Significant differences by NSES were observed regarding mean resiliency scores between those with low NSES (3.94 ± 0.83, out of 5) and high NSES (4.00 ± 0.81). Older age, higher education, higher self-rated health, lower stress, and living alone were significant positive correlates of resilience in the sample. Social support was correlated with resilience among White, Black, and Asian women, but not for Hispanic women. Depression was a significant correlate of lower resilience, except among Asian women. Living alone, smoking, and spirituality were significantly associated with higher resilience among women with moderate NSES. DISCUSSION: Multiple factors were associated with resilience among women aged ≥80 in the Women's Health Initiative. Despite some differing correlates of resilience by race, ethnicity, and NSES, there were many similarities. These results may aid in the design of resilience interventions for the growing, increasingly diverse population of older women.