A systematic review and meta-analysis of psychosocial interventions for immigrant and limited English proficient cancer patients.

OBJECTIVE: Immigrants, particularly those who are less acculturated and limited English proficient (LEP), often lack access to culturally and linguistically appropriate psychosocial care in cancer survivorship. We sought to determine what psychosocial interventions are available for immigrant and/or LEP cancer patients and to assess treatment and patient factors that may correlate with better psychosocial outcomes for this population. METHODS: We conducted a systematic review and meta-analysis of studies published through August 2022 of interventions conducted with immigrant and/or LEP cancer patients aimed at improving psychosocial outcomes (i.e., quality of life, depression, cancer-related distress, and anxiety). Using Covidence, a software program for systematic review management, four independent raters screened 16,123 records with a systematic process for reconciling disagreement, yielding 48 articles (45 studies) for systematic review and 21 studies for meta-analysis. RESULTS: Most studies were conducted with Spanish-speaking patients with breast cancer. Study participants (N = 5400) were primarily middle-aged (mean = 53 years old), female (90.0%), and Hispanic (67.0%). The weighted average effect size (g) across studies was 0.14 (95% CI 0.03-0.26) for quality of life (18 studies), 0.04 (95% CI -0.08 to 0.17) for depression (8 studies), 0.14 (95% CI -0.03 to 0.31) for cancer-related distress (6 studies), and 0.03 (95% CI -0.11 to 0.16) for anxiety (5 studies). CONCLUSION: The interventions under review had small but beneficial effects on psychosocial outcomes for immigrant and LEP cancer patients. Notably, effect sizes were smaller than those found in previous meta-analyses of psychosocial interventions conducted in majority U.S.-born, non-Hispanic White, English-speaking cancer patient samples. More research is needed to identify key components and adaptations of interventions that benefit immigrant and LEP cancer patients to strengthen their effects for this growing yet underserved population.

Cultural adaptation process of cancer-related interventions: A step-by-step guide.

INTRODUCTION: To contribute to the reduction and elimination of cancer-related local and global health disparities, interventions must be culturally adapted to reach diverse cultural groups and demonstrate success in improving clinical and psychosocial outcomes. We provide step-by-step information on the conceptual and methodological challenges involved in culturally adapting interventions and provide guidelines, suggestions, tools, and concrete steps for implementing the process. METHODS: This article provides information, guidelines, suggestions, tools, and concrete steps, based on three rigorous models of cultural adaptations, for implementing this process, followed with examples from the field, to illustrate the conceptual and methodological challenges involved in culturally adapting interventions. CONCLUSION: Our systematic step-by-step approach recommends (1) the guidance of well-established research models; (2) use of multiple data sources and input from various stakeholders (i.e., from patients and providers); (3) qualitative and quantitative data usage and integration; (4) a steering committee with multiple perspectives, stakeholders assessments, and qualitative analyses; (5) consensus meetings; and (6) diverse representation on the steering committee and/or research team.

The Association of Untreated Mental Health Problems with Alcohol and Tobacco use Among New York City Taxi Drivers.

OBJECTIVES: Mental disorders and substance use disorders are highly comorbid. The "self-medication hypothesis" posits that individuals may use substances such as tobacco and alcohol to cope with symptoms associated with untreated mental health problems. The present study examined the association between having a currently untreated mental health condition and tobacco and alcohol use among male taxi drivers in NYC, a population at risk for poor mental and physical health outcomes. METHODS: The sample included 1105 male, ethnoracially diverse, primarily foreign-born NYC taxi drivers participating in a health fair program. This secondary cross-sectional analysis utilized logistic regression modeling to examine whether endorsement of a currently untreated mental health problem (i.e., depression, anxiety, or posttraumatic stress disorder) was associated with alcohol and/or tobacco use, controlling for potential confounders. RESULTS: 8.5% of drivers reported having mental health problems; among these, only 0.5% reported receiving treatment. Untreated mental health problems were associated with an increased risk of current tobacco/alcohol use after controlling for age, educational attainment, nativity, and pain history: drivers with untreated mental health problems had 1.9x the odds of reporting current tobacco use [95% CI: 1.10-3.19] and 1.6x the odds of reporting current alcohol use [95% CI: 1.01-2.46] than those without untreated mental health problems. CONCLUSIONS: Few drivers with mental health problems receive treatment. In line with the self-medication hypothesis, drivers with untreated mental health problems demonstrated significantly increased risk of tobacco and alcohol use. Efforts to encourage timely screening and treatment of mental health problems among taxi drivers are warranted.

Social determinants and health-related quality of life in a sample of diverse, low socioeconomic status cancer patients.

OBJECTIVES: In the United States, medically underserved populations, such as ethnoracially underrepresented groups, the limited English proficient (LEP), and the unemployed, may be vulnerable to poor functioning in cancer survivorship. The present study examined whether race/ethnicity, LEP status, and unemployment status were associated with poor health-related quality of life (HRQL) in four domains (physical, social, emotional, and functional well-being (FWB)) in a diverse, low socioeconomic status (SES) sample of cancer patients. METHODS: The sample included 1592 ethnoracially diverse, low SES, primarily foreign-born adult oncology patients participating in an enhanced patient navigation program in 11 New York City hospital-based cancer clinics. This secondary cross-sectional analysis of program intake data examined bivariate associations between sociodemographic and clinical factors and poor HRQL (Functional Assessment of Cancer Therapy-General scores ≤70). Factors found to be related to poor HRQL (at p < 0.05) were entered into logistic regressions with overall HRQL and the four HRQL subscales as outcomes. The Benjamini-Hochberg Procedure controlled for potentially inflated type-I error rate due to multiple comparisons. RESULTS: All three predictor variables (race/ethnicity, LEP status, and unemployment status) were significantly associated with increased odds of reporting poor FWB. Specifically, non-Hispanic White and Hispanic cancer patients had 2.7 and 1.5 times the odds of reporting poor FWB than non-Hispanic Black patients. The unemployed had 1.4 times the odds of reporting poor FWB than their employed or retired counterparts. Limited EP patients had 1.4 times the odds of reporting poor FWB than EP participants. Non-Hispanic Black patients evidenced significantly lower odds of reporting poor HRQL across all subscale domains compared with other ethnoracial groups. CONCLUSIONS: LEP and unemployed individuals were more likely to report poor FWB, which may indicate that the most marginalized cancer patients face significant barriers to adequate functioning. Interventions that promote functional abilities (i.e., activities of daily living, self-care, and work retention) and policies and programs that reduce systemic inequality and address social determinants of health may aid in improving HRQL for these underserved groups in survivorship. Non-Hispanic Black cancer patients were less likely than other groups to report poor physical, social, emotional, and FWB. Identifying protective factors in this group may aid in efforts to improve HRQL for all patients.

Developing a Culturally Responsive Lifestyle Intervention for Overweight/Obese U.S. Mexicans.

INTRODUCTION: Hispanics are the largest minority group in the United States, constituting 18 % of the population. Mexicans are the largest Hispanic subgroup and are at disproportionate risk for overweight/obesity. Lifestyle interventions targeting dietary change and physical activity have resulted in significant weight loss in several large randomized clinical trials in the general population, but few studies have tailored interventions to Mexican Americans. We conducted a community needs assessment from 2018 to 2020 in accordance with Domenech-Rodriguez and Wieling's Cultural Adaptation Process (CAP) model to inform the development of SANOS (SAlud y Nutrición para todOS) (Health and Nutrition for All), a culturally-tailored, community-based diet and lifestyle education and counseling program that addresses overweight/obesity among U.S. Mexicans. METHODS: Five Spanish-language focus groups were conducted until thematic saturation with 31 overweight/obese Mexicans in New York City about their knowledge, priorities, and preferences regarding diet, exercise, and evidence-based strategies for behavioral change. A grounded theory approach was used to analyze the data. RESULTS: Five themes were identified: (1) A strong desire for tangible information related to diet and health, (2) Family as a primary motivator for behavior change, (3) Desire for group-based motivation and accountability to sustain intervention participation, (4) Belief in short-term goal setting to prevent loss of motivation, and (5) Time and workplace-related barriers to intervention adoption. CONCLUSIONS: Ecological factors such as the effect of acculturation on diet, family members' role in behavior change, and socioenvironmental barriers to healthy dietary practices and physical activity should be considered when adapting evidence-based treatments for Mexican Americans.

A Pilot Group-Based Lifestyle Intervention to Promote Weight Loss Among Mexican Immigrants.

Mexican Americans are at increased risk for obesity upon immigration to the U.S., increasing their risk for diabetes, cardiovascular disease, and cancer. Our pilot individual lifestyle intervention culturally tailored for Mexican Americans, COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), showed promising results. This paper presents outcomes from the group-based version of COMIDA. 129 overweight/obese Mexican Americans were enrolled in 'Group COMIDA'. Participants' weight (primary outcome), dietary intake and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Seventeen percent of participants experienced 5% weight loss at follow-up. Post-intervention, participants consumed more fruit and vegetables and fewer sweets and fried foods. A group-based, culturally adapted lifestyle intervention may be a more cost-effective approach than individual interventions to improve dietary behavior among underserved populations, though additional modifications may be considered to increase the intervention's effectiveness in promoting significant weight loss.

Healthcare Professionals' Perspectives on Adapting a Community Health Worker Model to Facilitate Lung Cancer Screening for Chinese For-Hire Vehicle Drivers.

Chinese immigrant for-hire vehicle (FHV) drivers who smoke or smoked are at high risk for lung cancer due to the combined impact of tobacco use and air pollution exposure yet underutilize lung cancer screening (LCS). Community Health Worker (CHW) programs have been effective at improving cancer screening rates. This study describes a community needs assessment to inform the adaptation of an existing CHW intervention to facilitate LCS among Chinese FHV drivers. Interviews were conducted until saturation with 13 Chinese-serving health professionals to determine the community's needs, priorities, and preferences. Transcripts were qualitatively analyzed using Atlas.ti. Seven frequently occurring themes were identified: knowledge of guidelines/access to LCS, acceptability of CHW program, CHW role in screening process, qualities of an ideal CHW, barriers to LCS, challenges to implementing a CHW program, and adaptations to CHW program. The adapted CHW intervention should include culturally tailored health education to increase LCS knowledge for patients and providers.

Primary Care Providers' Knowledge, Attitudes, Beliefs, and Practice Related to Lung Cancer Screening in Five High-Risk Communities in New York City.

Racial/ethnic minorities face stark inequalities in lung cancer incidence, treatment, survival, and mortality compared with US born non-Hispanic Whites. Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is effective at reducing lung cancer mortality in high-risk current and former smokers and is recommended by the US Preventive Services Task Force (USPSTF). This study sought to assess primary care providers' (PCPs') knowledge, attitudes, beliefs, and practice related to LCS and the recent USPSTF guidelines in five high-risk immigrant communities in New York City. We surveyed 83 eligible PCPs between December 2016 and January 2018 through surveys sent by mail, email, and fax, administered by phone or in person. The survey included questions about providers' clinical practice, knowledge, attitudes, and beliefs related to LCS and the USPSTF guidelines. Information about patient demographics, PCPs' training background, and practice type were also collected. Sixty-seven percent of respondents reported that they did not have established guidelines for LCS at their practice, and 52% expressed that "vague" screening criteria influenced their referral processes for LCS. Barriers to LCS with LDCT included concerns that LDCT is not covered by insurance, patients' fears of screening results, and patients' concerns regarding radiation exposure. Targeted educational interventions for both PCPs and patients may increase access to recommended LCS, especially for populations at disproportionate risk for lung cancer.

A Case Study in Academic-Community Partnerships: A Community-Based Nutrition Education Program for Mexican Immigrants.

Hispanics are the largest U.S. immigrant group and Mexican Americans are the largest U.S. Hispanic population. Hispanics, particularly Mexican Americans, are among the highest risk groups for obesity, placing them at increased risk for cardiovascular disease and certain types of cancer. Obesity lifestyle interventions incorporating Motivational Interviewing techniques and specific adaptations for the population of interest can have a significant impact on reducing health risks. This paper presents a community-engaged, culturally-sensitive nutrition and dietary counseling intervention conducted between 2016 and 2018 at the Consulate General of Mexico in New York City and reports preliminary findings regarding participant satisfaction and self-reported changes in eating and exercise habits. In addition, it describes the community and academic partners' roles and processes in program development, discusses strengths and challenges posed by a multi-sector partnership and describes adaptations made using the Behavioral Model for Vulnerable Populations to increase the program's sustainability and potential for scalability.

Patient perspectives on adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population.

The Chinese immigrant community faces multiple obstacles to effective cancer support and psychosocial care post diagnosis. Meaning-centered psychotherapy (MCP) is an empirically based treatment (EBT) that has been found to significantly reduce psychological distress while increasing spiritual well-being and a sense of meaning and purpose in life in patients with advanced cancer. However, it has not yet been adapted for Chinese immigrants who have unique linguistic and cultural needs. This study presents a community needs assessment to inform the cultural adaptation of MCP for Chinese patients with advanced cancer using Bernal et al.'s ecological validity model and the cultural adaptation process model of Domenech-Rodriquez and Weiling. Interviews were conducted until saturation with 12 Chinese immigrants with advanced cancer to determine the community's needs and preferences regarding the MCP intervention. Transcripts were translated and analyzed using Atlas.ti and six frequently occurring themes were identified: Coping; End of Life; Family; Culture, Religion, and Language; Immigration; and Specific Adaptations to MCP. Sociocultural values, beliefs, and practices such as filial piety and the use of Traditional Chinese Medicine (TCM) should be considered when adapting EBTs for Chinese immigrant cancer patients.

Ethnic variation in whether dissociation mediates the relation between traumatic life events and attenuated positive psychotic symptoms.

The present study sought to determine whether dissociative experiences mediated the relationship between traumatic life events and attenuated positive psychotic symptoms in a non-treatment-seeking sample of racial and ethnic minority young adults. Participants (n = 549) completed a self-report inventory for psychosis risk (i.e., the Prodromal Questionnaire; R. L. Loewy, C. E. Bearden, J. K. Johnson, A. Raine, & T. D. Cannon, 2005), from which a total number of attenuated positive psychotic symptoms was assessed. Participants also completed a checklist of potentially traumatic life events and a traumatic dissociation scale. Hierarchical linear regression models and bootstrapping results indicated that dissociation mediated the relationship between traumatic life events and attenuated positive psychotic symptoms. Stratified analyses of Black, Asian, and Hispanic subgroups revealed that full mediation was only evident in the Black subgroup of young adults. Partial mediation was found among the Hispanic group, and no mediation occurred in the Asian subgroup. For the latter, traumatic life events were not significantly associated with dissociative experiences. A dissociative response style may be particularly relevant to trauma-exposed Black young adults exhibiting subclinical psychotic experiences and less so for Asian young adults. Trauma-induced dissociative experiences should be assessed further in clinical high-risk studies, especially among Black traumatized youth.

Racial microaggressions and major discriminatory events explain ethnoracial differences in psychotic experiences.

Few empirical studies have examined whether exposure to major racial discrimination explains ethnoracial disparities in psychosis outcomes and none to our knowledge have done so in the U.S. or have examined the role of other forms of racism such as racial microaggressions. The present study examined ethnoracial differences in self-reported psychotic experiences (PE) among 955 college students in an urban environment in the Northeastern U.S., and the degree to which major experiences of racial discrimination and racial microaggressions explains ethnoracial differences in PE. Mean scores on self-report inventories of PE and distressing PE (i.e., Prodromal Questionnaire (PQ)), major experiences of racial discrimination (EOD), and racial and ethnic microaggressions (REMS) were compared across 4 ethnoracial groups (White, Black, Asian, and Latina/o). Results from parallel mediation linear regression models adjusted for immigrant status, age, gender, and family poverty using the Hayes PROCESS application indicated ethnoracial differences in PE were explained independently by both forms of racism. Specifically, Black young people reported higher mean levels of PE, and distressing PE than both White and Latina/o people and the difference in PE between Black and White and Black and Latino/a young people was significantly explained by both greater exposure to racial microaggressions and major racial discriminatory experiences among Black people. This study re-emphasizes the explanatory role of racism, in its multiple forms, for psychosis risk among Black young populations in the US. Anti-racism interventions at both structural and interpersonal levels are necessary components of public health efforts to improve mental health in Black populations.

An Innovative Approach to Promote Weight Loss Among Mexican Immigrants: A Pilot Study.

Mexican Americans are among the highest risk groups for obesity and its associated health consequences, including diabetes, heart disease, and cancer. 154 overweight/obese Mexican Americans recruited from the Mexican Consulate in New York City were enrolled in COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), a 12-week Spanish-language lifestyle intervention that included a dietary counseling session, weight-loss resources, and thrice-weekly text messages. Participants' weight (primary outcome); dietary intake, physical activity, and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Of the 109 who completed follow-up, 28% lost ≥ 5% of their baseline body weight. Post-intervention, participants consumed more fruit and less soda, sweet pastries, fried foods and red meat; increased physical activity; and evidenced greater nutrition knowledge. A community-based lifestyle intervention with automated components such as text messaging may be a scalable, cost-effective approach to address overweight/obesity among underserved populations.

Refinement of a Meaning-Centered Counseling Program for Chinese Patients with Advanced Cancer: Integrating Cultural Adaptation and Implementation Science Approaches.

Background: This mixed methods study identified needed refinements to a telehealth-delivered cultural and linguistic adaptation of Meaning-Centered Psychotherapy for Chinese patients with advanced cancer (MCP-Ch) to enhance acceptability, comprehensibility, and implementation of the intervention in usual care settings, guided by the Ecological Validity Model (EVM) and the Practical, Robust Implementation and Sustainability Model (PRISM). Methods: 15 purposively sampled mental health professionals who work with Chinese cancer patients completed surveys providing Likert-scale ratings on acceptability and comprehensibility of MCP-Ch content (guided by the EVM) and pre-implementation factors (guided by PRISM), followed by semi-structured interviews. Survey data were descriptively summarized and linked to qualitative interview data. Three analysts independently coded the transcripts according to EVM and PRISM domains; discrepancies were resolved through discussion and consensus. Results: Quantitative findings showed high appropriateness and relevance of MCP-Ch across five EVM domains of Language, Metaphors/Stories, Goals, Content, and Concepts. Qualitative analysis yielded 23 inductive codes under the seven EVM domains: (1) Language (3 subcodes), (2) Persons (2 subcodes), (3) Metaphors/Stories (2 subcodes), (4) Methods (8 subcodes), (5) Content (2 subcodes), (6) Goals (4 subcodes), and (7) Concepts (2 subcodes). Themes based on PRISM included (1) Intervention characteristics (organizational perspective, 7 subcodes; and patient perspective, 6 subcodes) (2) External environment (2 subcodes), (3) Implementation and sustainability infrastructure (4 subcodes), and (4) Recipients (organizational characteristics, 5 subcodes; and patient characteristics, 4 subcodes). Conclusion: Recommendations for next steps include increasing the MCP-Ch protocol's flexibility and adaptability to allow interventionists to flexibly tailor MCP-Ch material to meet patients' individual needs, simplifying content to improve comprehension and acceptability, providing additional training to Chinese-serving providers to increase adoption and sustainability, and considering interpreter-assisted delivery to increase access. Findings yielded important information to maximize cultural relevance as well as the implementation and sustainability potential of MCP-Ch in real-world settings.

Institutional Ethnoracial Discrimination and Microaggressions among a Diverse Sample of Undergraduates at a Minority-Serving University: A Gendered Racism Approach.

Purpose: Ethnoracial minorities report a variety of discriminatory experiences due to systemic racism. Yet, few studies have examined whether gender and race/ethnicity interact to predict institutional discrimination and racial microaggressions through an intersectional approach. Design/methodology/approach: A predominantly female (60%), ethnoracial minority (20.8% Black, 31.6% Asian, 30.8% Latina/o, 8.2% White, 6.6% Middle Eastern) sample of 895 undergraduates attending a minority-serving public university in an urban setting completed self-report measures of sociodemographic characteristics, experiences of racial microaggressions, and institutional discrimination. Findings: Significant (p<.05) gender × race/ethnicity interaction effects were found in several institutional discrimination domains: Males reported more police/court discrimination overall, but gender differences in police/court discrimination were less pronounced for non-Black vs. Black students. While males tended to report more institutional discrimination than females, the reverse was true for the Middle Eastern group: Middle Eastern females reported institutional discrimination in more domains and more discrimination getting hired than their male counterparts. There was a significant race/ethnicity × gender interaction effect for environmental microaggressions: White males reported more environmental microaggressions than White females, but gender differences were not found in the overall sample. Originality: This study is the first to our knowledge to assess the interactive effects of gender and ethnicity on the type of microaggressions experienced in a diverse sample that includes individuals of Middle Eastern descent. The authors highlight the range of discriminatory events that ethnoracially minoritized undergraduates experience, even at a minority-serving institution.

Chinese Livery Drivers' Perspectives on Adapting a Community Health Worker Intervention to Facilitate Lung Cancer Screening.

Chinese immigrant livery drivers with a smoking history are at high risk for lung cancer. A culturally adapted community health worker (CHW) program may be an effective approach to increase lung cancer screening (LCS) uptake in this underserved group. Five focus groups were conducted with 39 Chinese immigrant male livery drivers with a smoking history in New York City to assess their needs, priorities, and preferences regarding the proposed intervention. Transcripts were qualitatively analyzed using Atlas. ti. Focus group participants were uncertain about whether smoking was associated with cancer, unfamiliar with LCS, and reported numerous barriers to LCS uptake. Most believed a CHW program to facilitate LCS would be acceptable and feasible, if tailored to meet their needs. Our results have implications for improving access to early detection of lung cancer and preventive care (e.g., culturally appropriate smoking cessation and health education programs) for Chinese livery drivers.

Latent class analysis of racial microaggressions and institution-specific racial discrimination at a U.S. minority-serving university: Implications for mental health and coping.

Research has demonstrated that ethnoracially minoritized college students face negative mental health outcomes associated with racism. However, little is known about the intersections between microaggressions and institution-specific racial discrimination, their relationship with psychological distress, and the role of coping in this relationship. An ethnoracially diverse sample of 915 young adults attending an urban minority-serving institution (MSI) completed self-report measures on sociodemographics, microaggressions and institution-specific racial discrimination, coping, anxiety and depression, and perceived stress. Latent class analysis (LCA) determined the number and nature of classes for both forms of racism. Hierarchical linear regressions assessed the association between the LCA classes and anxiety/depression and examined the moderating role of coping in said association. The LCA revealed two classes: "exoticization and environmental microaggressions" (EM), whose members reported experiencing these two types of microaggressions, and "institution-specific racial discrimination and microaggressions" (IRM), whose members reported both institution-specific racial discrimination and microaggressions in multiple domains. Belonging to the IRM group was associated with depression but not anxiety after adjusting for perceived stress. Black students and those reporting lower family income were more likely to belong to the IRM group. Coping moderated the relation between IRM group membership and depression, which was weaker for those who reported active coping in response to racism. College students from MSIs who experience both institution-specific racial discrimination and microaggressions may be at greater risk for depression than those who experience exoticization and environmental microaggressions alone. Active coping may ameliorate depression risk. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychotic experiences among Black college students in the United States: The role of socioeconomic factors and discrimination.

BACKGROUND: Psychosis is more prevalent among Black individuals compared with White individuals. However, it is unknown whether this disparity exists among college populations in the United States, and if so, what factors contribute to the disparity. METHODS: We analyzed data from Black and White young adult students using the Health Minds Study (2020-2021), which is a survey administered at 140 colleges in the U.S. Using mediation analysis, we examined the extent to which the relation between race and psychotic experiences was mediated by socioeconomic factors (past and current financial distress, food insecurity, parental education) and discrimination. RESULTS: Approximately 38 % of Black students and 30 % of White students reported lifetime psychotic experiences. Including all socioeconomic factors together in the same model accounted for just over half (50.2 %) the association between race and psychotic experiences. We then conducted additional analyses examining discrimination, all the socioeconomic factors plus discrimination accounted for 81.5 % of the association between race and psychotic experiences. When disentangling the mediators, food insecurity and discrimination accounted for the largest percentages of the association. The effects of past financial distress and parental education were modified by race. CONCLUSION: Black college students were more likely to report lifetime psychotic experiences than their White counterparts. Moreover, socioeconomic factors and discrimination made significant contributions to this racial difference.

Quiescent Mineralisation for Free-standing Mineral Microfilms with a Hybrid Structure.

HYPOTHESIS: The air-solution interface of supersaturated calcium hydrogen carbonate (Ca(HCO3)2) represents the highest saturation state due to evaporation/CO2-degassing, where calcite crystals are expected to nucleate and grow along the interface. Hence, it should be possible to form a free-standing mineral-only calcium carbonate (CaCO3) microfilm at the air-solution interface of Ca(HCO3)2. The air-solution interface of phosphate buffered saline (PBS) could represent a phase boundary to introduce a hybrid microstructure of CaCO3 and carbonate-rich dicalcium hydroxide phosphate (carbonate-rich hydroxylapatite). EXPERIMENTS: Supersaturated Ca(HCO3)2 was prepared at high pressure and heated to form CaCO3 microfilms, which were converted to bone-like microfilms at the air-solution interface of PBS by dissolution-recrystallisation. The microfilms were characterised by scanning electron microscopy, 3D confocal microscopy, atomic force microscopy, Fourier transform infrared spectroscopy, laser Raman microspectroscopy, and X-ray photoelectron spectroscopy. An in situ X-ray diffraction (XRD) system that simulates the aforementioned interfacial techniques was developed to elucidate the microfilms formation mechanisms. FINDINGS: The CaCO3 and bone-like microfilms were free-standing, contiguous, and crystalline. The bone-like microfilms exhibited a hybrid structure consisting of a surface layer of remnant calcite and a carbonate-rich hydroxylapatite core of plates. The present work shows that the air-solution interface can be used to introduce hybrid microstructures to mineral microfilms.

Changes in perceived neighborhood ethnic density among racial and ethnic minorities over time and psychotic-like experiences.

BACKGROUND: Research primarily conducted in Europe find high neighborhood ethnic density (i.e., proportion of own ethnic group) lessens risk of psychotic symptoms among racial and ethnic minorities; however, most studies measure ethnic density through crude demarcations in geographic data only at illness onset which may miss meaningful variation from the perspective of residents. The present study is the first in the U.S. to examine whether changes in perceived ethnic density from childhood are associated with psychotic-like experiences (PLE). METHODS: A Northeastern U.S. urban undergraduate sample of 1330 racial and ethnic minorities completed a self-report inventory of PLE, the Prodromal Questionnaire, and indicated their racial and ethnic neighborhood composition before and after age 12. One way analyses of covariance (ANCOVA) adjusted for age, family poverty, racial and ethnic group, immigrant status, and lifetime cannabis use, compared PLE across ethnic density categories and change. RESULTS: Racial and ethnic minorities who grew up in a neighborhood (before age 12) predominantly inhabited by a different group of color (e.g., being Black in a predominantly Asian neighborhood) endorsed significantly more PLE than those who grew up in racially concordant, mixed, or predominantly White neighborhoods. In addition, those reporting a change in perceived neighborhood ethnic density after age 12 endorsed significantly more PLE than those reporting no change. CONCLUSION: Racial dynamics among people of color in urban neighborhood U.S. contexts may create psychological challenges in the social environment. The developmental timing of demographic changes in neighborhoods may influence stress processes that enhance risk for PLE.