Rural Children's Well-Being in the Context of the COVID-19 Pandemic: Perspectives from Children in the Midwestern United States.

Children in rural areas are more likely to experience a variety of risk factors that increase their vulnerability to physical and mental health disparities. Bronfenbrenner's ecological model (1986) was used as a framework for understanding rural children's perceptions and well-being within multiple interactive contexts during the COVID-19 pandemic. This phenomenological study was designed to explore rural children's perceptions of their well-being and the impact of the COVID-19 pandemic on their contexts and well-being. This sub-study of the Children's Understandings of Well-Being project followed the standard qualitative interview protocol with additional prompts related to the pandemic. Rural children (age 8 to 18, N = 72) from the Midwestern United States participated from March 2020 to November 2021 via teleconferencing. Phenomenological analyses of transcripts focused on the essence of children's understanding of well-being and their perception of the impact of the pandemic on their contexts and well-being. Each transcript was coded by author 1 and verified by author 2, and discrepancies were identified, discussed, and resolved. The third author served as an external auditor to enhance trustworthiness. First-cycle coding focused on children's specific references to well-being experiences during COVID-19. Second-cycle selective coding focused on specific well-being experiences and contexts that were impacted by COVID-19. These codes were used to develop two broad themes, "Well This Kinda Stinks, But We Just Adapt" and "Safety Means Something Different to Me Now." The meaning of themes and subthemes are explored, with implications for researchers, practitioners, and policymakers.

Multilevel Analysis of Child and Adolescent Subjective Well-Being Across 14 Countries: Child- and Country-Level Predictors.

This study tests an ecological, relationship-based model of children's subjective well-being with 9- to 14-year-old children (n = 25,906) from 14 countries across Africa, Asia, Europe, North America, and South America. Children completed the Children's Worlds survey, a self-report measure of contextual and well-being indicators. Multilevel modeling was used to predict children's well-being (life satisfaction and self-image) at two levels, child (age, gender, home context, family relationships, peer relationships, school context, teacher relationships, and neighborhood quality), and country (gross domestic product and income inequality). Findings indicated that intercepts varied significantly across countries. The majority of variance in children's well-being was attributed to child-level rather than country-level factors. Country-level factors did not strongly predict well-being but marginally improved model fit.

A Comparison of Risk and Protective Factors Related to Depressive Symptoms among American Indian and Caucasian Older Adults.

Despite efforts to reduce health disparities, many American Indian and Alaska Native (AI/AN) populations, including older adults, experience elevated levels of depression and associated suicide. Although adverse childhood experiences (ACEs) and social support are well-documented risk and protective factors for depression in the general population, little is known about AI/AN populations, especially older adults. The purpose of this study was to examine factors related to depression among a sample of AI older adults in the Midwest. Data were collected using a self-administered survey completed by 479 AI and Caucasian respondents over the age of 50. The survey included standardized measures such as the Geriatric Depression Scale-Short Form, ACE Questionnaire, and Multidimensional Scale of Perceived Social Support. Hierarchical multivariate regression analyses were conducted to evaluate the main hypotheses of the study. Results indicate that two dimensions of ACEs (childhood neglect and household dysfunction) were positively associated with depressive symptoms; social support was negatively associated with depressive symptoms. Perceived health and living alone were also significant predictors of depressive symptoms. ACEs may play a significant role in depression among AI/AN populations across the life course and into old age. Social support offers a promising mechanism to bolster resilience among AI/AN older adults.

Depression Literacy Among American Indian Older Adults.

Older American Indians experience high rates of depression and other psychological disorders, yet little research exist on the depression literacy of this group. Depression literacy is fundamental for individuals seeking help for depression in a timely and appropriate manner. In the present study the authors examine levels and predictors of knowledge of depression symptoms in a sample of rural older American Indians (N = 227) living in the Midwestern United States. Data from self-administered questionnaires indicate limited knowledge of depression and negative attitudes toward seeking help for mental health problems. Additional findings and implications for social work practice and policy are discussed.

Paraneoplastic leukocytoclastic vasculitis as an initial presentation of malignant pleural mesothelioma: a case report.

INTRODUCTION: Vasculitis has been associated with malignancies, more commonly hematological rather than solid malignancies. Due to the rarity of these conditions and the lack of a temporal association, the relationship between vasculitis and malignancy remains unclear. Paraneoplastic vasculitis as a phenomenon of lung cancer has been described in the literature. To the best of our knowledge, this is the first case report of leukocytoclastic vasculitis being an initial presentation of malignant pleural mesothelioma. CASE PRESENTATION: We report the case of an 84-year old Greek man who presented to our facility with an erythematous, pruritic and purpuric rash affecting his limbs. This was biopsy-proven to be leukocytoclastic vasculitis and treated conservatively with topical corticosteroids as well as oral prednisolone, with good results. Six months later, he was diagnosed as having malignant pleural mesothelioma. As he remained asymptomatic from his malignancy, no systemic chemotherapy was instituted. He had a recurrence of biopsy-proven leukocytoclastic vasculitis two months after he was diagnosed as having mesothelioma, which again settled with conservative measures. CONCLUSIONS: It is important to remain vigilant with regard to the association between leukocytoclastic vasculitis and malignancies. A diagnosis of vasculitis requires a search for malignancies as well as other possible etiologies. This is particularly of relevance when the vasculitis becomes chronic, recurrent or treatment is no longer effective. Should our patient have experienced refractory vasculitis, we would have instituted systemic chemotherapy to treat the underlying malignancy.

Family transitions during the adolescent transition: implications for parenting.

This study explored how family transitions affect parenting practices in a sample of 7,000 ethnically diverse students in 9th, 10th, or 11th grade over a period of 2 years. Adolescent perceptions of parental control and parental responsiveness were assessed in three groups: (1) adolescents moving into mother-custody households following a marital separation or divorce, (2) adolescents from stable never-divorced households, and (3) adolescents from stable mother-custody households. The study examined pre- and posttransition data to determine whether adolescents in newly formed single-parent families experienced a larger drop in parental control and responsiveness than did adolescents in stable nondivorced and stable mother-custody households. Adolescents from all family types reported significant declines in behavioral control, but not parental responsiveness. However, the lack of family-type differences contrasts sharply with findings from the childhood-divorce literature. Findings suggest that adolescent individuation may overshadow family-type differences during middle adolescence. As expected, boys reported lower parental control than did girls. Ethnic differences revealed that European American adolescents reported the highest levels of parental responsiveness, and African American adolescents reported the highest levels of parental control. Contextual and individual pathways in adolescence are discussed.