Serious psychological distress, sex, and falls among the elderly.

Serious psychological distress and falls are two major public health problems among the elderly. This study aims to test the hypothesis that although serious psychological distress can increase the risks of falls among the elderly, it tends to affect elderly women more than elderly men. Data of this study are from the 2011 California Health Survey Interviews (CHIS). We extracted a sample of 13,153 respondents aged 65 and older for this study, including 8,087 females and 5,066 males. We tested both unadjusted and adjusted interaction effects using bivariate and multivariate logistic regression analysis. Elderly women with serious psychological distress had the greatest likelihood of falls as compared to men with serious psychological distress and men and women without serious psychological distress. With respect to the covariates, limitations of physical activity and poor self-rated health status, Asian race, and older age were more likely to be associated with falls. This study provides further information on sex disparities of falls among the elderly such that serious psychological distress has a greater impact on falls for elderly women than elderly men. Thus, the findings of our studies suggest that mental health services and intervention can be useful to prevent falls for elderly women.

Health behaviors and demographic factors of chronic health conditions among elderly veteran men.

As male veterans age, there are unique opportunities for health-related prevention efforts to be introduced throughout the life cycle to ameliorate the effects of chronic health conditions such as cardiovascular disease, asthma, arthritis, and diabetes. This study analyzed data from the Behavioral Risk Factor Surveillance System (2012) with a sample of 27,187 male veterans aged 65-84 years and 4,079 male veterans over 85 years of age. The study examined associations between behaviors, demographics, and five chronic health conditions with variables that included marital status, health insurance coverage, alcohol consumption, smoking history, and income levels. These associations varied between the two age groups, suggesting the need for intervention with veterans across their lifespans. Public health social workers could help veterans modify their health behaviors to prevent the occurrence or worsening of chronic health conditions over time and across the aging process.

The association between unemployment status and physical health among veterans and civilians in the United States.

This study analyzed data from the 2012 Behavioral Risk Factor Surveillance System to examine the association between unemployment status and physical health among a sample of 170,924 civilians and 12,129 veterans (aged 18-50 years). Multivariate regression analysis was used to test the interaction effect between employment status and veteran/civilian status on physical health. Veterans who were unemployed long term (longer than 27 weeks) reported a significantly greater number of days with poor physical health than civilians who experienced long-term unemployment. Timely prevention and intervention efforts to integrate veterans into the workforce could lead to substantially improved physical health outcomes. Public health policies and programs that are funded to assist veterans in securing and maintaining gainful employment can have lasting implications for their overall improved health and physical well-being.

Association of BRCA1/2 defects with genomic scores predictive of DNA damage repair deficiency among breast cancer subtypes.

INTRODUCTION: Homologous recombination (HR) DNA repair is of clinical relevance in breast cancer. Three DNA-based homologous recombination deficiency (HRD) scores (HRD-loss of heterozygosity score (LOH), HRD-telomeric allelic imbalance score (TAI), and HRD-large-scale state transition score (LST)) have been developed that are highly correlated with defects in BRCA1/2, and are associated with response to platinum therapy in triple negative breast and ovarian cancer. This study examines the frequency of BRCA1/2 defects among different breast cancer subtypes, and the ability of the HRD scores to identify breast tumors with defects in the homologous recombination DNA repair pathway. METHODS: 215 breast tumors representing all ER/HER2 subtypes were obtained from commercial vendors. Next-generation sequencing based assays were used to generate genome wide SNP profiles, BRCA1/2 mutation screening, and BRCA1 promoter methylation data. RESULTS: BRCA1/2 deleterious mutations were observed in all breast cancer subtypes. BRCA1 promoter methylation was observed almost exclusively in triple negative breast cancer. BRCA1/2 deficient tumors were identified with BRCA1/2 mutations, or BRCA1 promoter methylation, and loss of the second allele of the affected gene. All three HRD scores were highly associated with BRCA1/2 deficiency (HRD-LOH: P = 1.3 × 10(-17); HRD-TAI: P = 1.5 × 10(-19); HRD-LST: P = 3.5 × 10(-18)). A combined score (HRD-mean) was calculated using the arithmetic mean of the three scores. In multivariable analyses the HRD-mean score captured significant BRCA1/2 deficiency information not captured by the three individual scores, or by clinical variables (P values for HRD-Mean adjusted for HRD-LOH: P = 1.4 × 10(-8); HRD-TAI: P = 2.9 × 10(-7); HRD-LST: P = 2.8 × 10(-8); clinical variables: P = 1.2 × 10(-16)). CONCLUSIONS: The HRD scores showed strong correlation with BRCA1/2 deficiency regardless of breast cancer subtype. The frequency of elevated scores suggests that a significant proportion of all breast tumor subtypes may carry defects in the homologous recombination DNA repair pathway. The HRD scores can be combined to produce a more robust predictor of HRD. The combination of a robust score, and the FFPE compatible assay described in this study, may facilitate use of agents targeting homologous recombination DNA repair in the clinical setting.

The association of self-rated health and lifestyle behaviors among foreign-born Chinese, Korean, and Vietnamese Americans.

PURPOSE: This study employed the 2009 California Health Interview Survey to examine the association of self-rated heath status and lifestyle behavior variables such as smoking at least 100 cigarettes or more in an entire lifetime, alcohol consumption, and physical activity level among foreign-born Chinese, Korean, and Vietnamese Americans aged 18 and older. METHODS: The total study sample consisted of 3,023 foreign-born adult Chinese (n = 812), Korean (n = 857), and Vietnamese (n = 1,354) Americans. Logistic regression via Stata 12 was employed. Odds ratios (OR) along with confidence intervals (CI) were reported in the results. RESULTS: Results revealed that smoking at least 100 cigarettes or more in an entire lifetime had a negative association with good health status (OR = 0.74, 95 % CI = 0.59, 0.94), while alcohol consumption had a positive association with good health status (OR = 1.20, 95 % CI = 1.00, 1.44). Moderate physical activity (OR = 1.26, 95 % CI = 1.05, 1.50) and vigorous physical activity (OR = 1.68, 95 % CI = 1.31, 2.15) had a similar positive association with good self-rated health status. The results also revealed that the predicted probability of self-rated health status based on ethnicity and lifestyle variables was more favorable for foreign-born Chinese Americans than their Korean and Vietnamese American counterparts. CONCLUSIONS: This study's results corroborated the findings reported in previous research on the association of lifestyle behaviors and health status. Regardless of racial or ethnic backgrounds, good lifestyles have an important role in the prevention of poor health status. However, health education and lifestyle intervention programs should take cultural differences among racial and ethnic populations into consideration.

Direct and mediated associations between religious coping, spirituality, and youth violence in El Salvador.

OBJECTIVE: To examine the direct and mediated relationships between religious coping, spirituality, social developmental factors, and violence among high-risk and gang-involved youth in a high-crime, Latin American country. METHODS: Using a community sample of 290 high-risk and gang-involved youth in San Salvador, El Salvador, structural equation modeling was employed to examine the relationships between religious coping, spirituality, social developmental factors (e.g., antisocial bond and antisocial beliefs), and violence. RESULTS: Religious coping (ß = - 0.14, P < 0.05) and spirituality (ß = - 0.20, P < 0.01) were both significantly associated with antisocial bond. Antisocial bond, in turn, was directly associated with violence (ß = 0.70, P < 0.001) and was associated with antisocial beliefs (ß = 0.54, P < 0.001); however, the path from antisocial beliefs to violence was not statistically significant. No direct paths were identified from religiosity and spirituality to violence. The goodness-of-fit statistics (root mean square error of approximation, 0.034; comparative fit index, 0.974; and Tucker-Lewis index, 0.966) suggest that the final model had acceptable fit. CONCLUSIONS: This study is among the first to shed light on the relationship between religiosity, spirituality, and youth violence in the Latin American context. Elevated levels of religious coping and spirituality are associated with less antisocial bonding, which, in turn, is associated with lower levels of violent behavior among high-risk and gang-involved Salvadoran youth. Study findings suggest that religious coping and spirituality are indirectly protective for youth violence among this high-risk population.

Measurement equivalence of seven selected items of posttraumatic growth between black and white adult survivors of Hurricane Katrina.

This study examined the equivalence or comparability of the measurement properties of seven selected items measuring posttraumatic growth among self-identified Black (n = 270) and White (n = 707) adult survivors of Hurricane Katrina, using data from the Baseline Survey of the Hurricane Katrina Community Advisory Group Study. Internal consistency reliability was equally good for both groups (Cronbach's alphas = .79), as were correlations between individual scale items and their respective overall scale. Confirmatory factor analysis of a congeneric measurement model of seven selected items of posttraumatic growth showed adequate measures of fit for both groups. The results showed only small variation in magnitude of factor loadings and measurement errors between the two samples. Tests of measurement invariance showed mixed results, but overall indicated that factor loading, error variance, and factor variance were similar between the two samples. These seven selected items can be useful for future large-scale surveys of posttraumatic growth.

No patients left behind: a systematic review of the cultural equivalence of distress screening instruments.

Despite the widespread use of distress screening instruments in cancer care, the reliability and validity of these instruments for a diverse population of cancer patients have not been well established. This is a systematic review of the conceptual and statistical equivalence of screening instruments of 148 psycho-oncology studies that included distress screening instruments. The findings indicate that screening measures of distress have comparable reliability, sensitivity, and specificity for White, Latino, and Asian samples. However, it is unclear if equivalent psychometrics are found among minority ethnic groups (e.g., African American) and immigrants within countries. Given the ethnic diversity among cancer patients and the lack of representation of this diversity in the current research, it is critical that researchers begin to include cancer patients of minority ethnic/racial groups in their samples so that health care providers can screen for distress with cultural sensitivity.

Reliability and validity of a bilingual measure of religiosity in English and Vietnamese: preliminary results from a pilot study.

This study reports preliminary psychometric findings for a seven-item religiosity scale in a community-based sample of Vietnamese Americans ages 18 to 83 years (N = 119; 58% women, 42% men). A bilingual survey was distributed to Vietnamese who were evacuated during Hurricane Katrina and had returned after the disaster. Internal consistency, factorial structure validity, and criterion validity were evaluated on the scale items. The bilingual scale had good internal consistency. While exploratory and confirmatory factor analysis results provided support for a two-factor structure which captured Religious Involvement and Religious Coping, a one-factor model had slightly better fit. Individuals who scored high on the religiosity scale reported a significantly lower score on their stressful experiences during the hurricane, providing evidence of criterion validity.

Associations of Sociodemographic Factors With Health-Related Social Networks Among Premigration Filipinos.

Social networks provide health information that is useful to prevent illness, promote health, and facilitate treatment for health problems. One understudied facet is which people in social networks provide health information. The present article fills a critical gap in the empirical literature by identifying which social networks are reported based on a premigrant's sociodemographic status that operate as their source of health information. Data were analyzed from the Health of the Philippine Emigrants Study (HoPES) (n = 829) migrant sample. Findings indicated having high English proficiency and educational attainment reduces the likelihood of reporting no one in their network as a source of health information. Those who reported family/relatives are less likely to be younger, and those who reported friends are also less likely to be living-in with a partner. This article informs social work researchers and practitioners in implementing interventions among premigration immigrants to help increase and broaden their social networks.

The role of racial/ethnic identity in the association between racial discrimination and psychiatric disorders: A buffer or exacerbator?

The present study tests whether and how racial/ethnic identity moderates the psychological burden associated with racial discrimination. The theoretical concept of identity-relevant stressors suggests that racial discrimination will be associated with stronger psychological burden for people who put more values on their racial/ethnic backgrounds (i.e., racial/ethnic identity as an exacerbator). Conversely, racial/ethnic identity may be a protective resource to buffer any negative mental health consequences of racial discrimination (i.e., racial/ethnic identity as a buffer). We adjudicate these two competing hypotheses, while also examining whether the moderating effect of racial/ethnic identity varies by race/ethnicity or nativity. The data are from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Our findings reveal a race/ethnicity-dependent pattern: High racial/ethnic identity functions as an exacerbator for Whites, American Indians/Alaska Natives, and Latinxs, but moderate racial/ethnic identity functions as a buffer for Asians and Blacks in handling racial discrimination. In addition, the moderating effect of racial/ethnic identity is more pronounced among the U.S.-born than the foreign-born. The present study contributes to the knowledge base by showing that racial/ethnic identity does not universally protect-nor does it universally exacerbate-the psychiatric burden of racial discrimination. Rather, whether it mitigates or intensifies the mental burden of racial discrimination depends on its level and race/ethnicity.

Nonlinear relationship between length of residence and depression in a community-based sample of Vietnamese Americans.

BACKGROUND: Length of residence has been viewed as an indicator of acculturation among immigrants and refugees in their host society. This study aims to test an inverted U relationship between length of residence and depression in a community-based sample of Vietnamese Americans. METHODS: Data were collected from a community-based survey of adult Vietnamese Americans living in an East Coast metropolitan area consisting of 349 respondents aged 18 and older. However, due to missing data, the actual sample in our regression analysis using listwise deletion method is 311. Among the participants, 52.1% are female (n = 182), and 47.9% are male (n = 167). The age of the respondents ranges from 18 to 73 years with the average age being 38.76 (SD = 13.76). The average number of years that the participants lived within the United States was 7.01 years (SD = 5.22). RESULTS: Findings from a polynomial regression analysis support the hypothesis that depression levels tend to be high during the first decade of initial resettlement. However, after approximately 12.5 years, depression levels decrease. CONCLUSION: As revealed by the data and community experts, immigrants/ refugees tend to suffer from higher levels of psychological problems during their first decade of resettlement. It takes more than a decade for a non-English-speaking immigrant or refugee to adjust psychologically into his/her host society.

Comparison of utilization of dental care services among Chinese- and Russian-speaking immigrant elders.

OBJECTIVE: The purpose of the study was to identify factors predictive of use of dental services among Chinese- and Russian-speaking immigrant elders. METHODS: The data for this analysis were collected from the 1997 survey "Assessing public health and health care needs of Russian-speaking elderly immigrants." A similar survey was replicated among Chinese-speaking elderly immigrants in 2000. Community-based samples of 300 Russian elders and 177 Chinese elders were recruited for the study. RESULTS: Chinese elders used dental care services at lower rates than Russian elders. Education, length of stay in the U.S., social support, and smoking behavior were significant predictors for the use of dental services among Chinese. However, among Russian elders, age, income, and denture use predicted utilization of dental services. CONCLUSIONS: Although Chinese- and Russian-speaking elders have similar immigrant experiences and share the same geographic location and urban setting, the two groups have different patterns of dental service use. These differences may be due to differences in socio-demographic characteristics, values, attitudes and knowledge of oral health and dental care, and unique cultural backgrounds.

Type 2 diabetes among Asian Americans: Prevalence and prevention.

Type 2 diabetes mellitus (T2DM) is a growing problem among Asian Americans. Based on the Centers for Disease Control, the age-adjusted prevalence of T2DM for Asian Americans is 9%, placing them at "moderate risk". However differential patterns of disease burden emerge when examining disaggregated data across Asian American ethnic groups; with Filipino, Pacific Islander, Japanese, and South Asian groups consistently described as having the highest prevalence of T2DM. Disentangling and strengthening prevalence data is vital for on-going prevention efforts. The strongest evidence currently available to guide the prevention of T2DM in the United States comes from a large multicenter randomized clinical control trial called the Diabetes Prevention Program, which targets individual lifestyle behavior changes. It has been translated and adopted for some Asian American groups, and shows promise. However stronger study designs and attention to several key methodological considerations will improve the science. Increased attention has also been directed toward population level downstream prevention efforts. Building an infrastructure that includes both individual and population approaches is needed to prevent T2DM among Asian American populations, and is essential for reducing health disparities.

A measure of English acculturation stress and its relationships with psychological and physical health status in a sample of elderly Russian immigrants.

This study aims to evaluate the factor structure and criterion validity of the English Language Acculturation Stress (ELAS) scale in a community-based sample of elderly Russian immigrants. The sample consists of 300 Russian immigrants with an equal number of females and males, from 59 to 93 years of age (Mean = 73.26, SD = 7.271). The majority of the respondents were married (72%) at the time the interviews were conducted. On average, the respondents have lived in the U.S. for about 7 years (SD = 3.00). We performed both exploratory and confirmatory factor analyses to ascertain the factor structure or conceptual dimensions of the 11-item ELAS scale. The findings revealed that this 11-item scale encompasses three dimensions: Basic English skills, survival English skills, and social involvement English skills. Correlation analyses of the scale with depression, physical health status, and length of residence suggest that the ELAS has good criterion validity and potential as a screening instrument of language acculturation stress for elderly Russian immigrants. Implications for research and practice are discussed.

Direct and mediated associations between religious coping, spirituality, and youth violence in El Salvador / Asociaciones directas y mediadas entre el afrontamiento religioso, la espiritualidad y la violencia juvenil en El Salvador

OBJECTIVE: To examine the direct and mediated relationships between religious coping, spirituality, social developmental factors, and violence among high-risk and gang-involved youth in a high-crime, Latin American country. METHODS: Using a community sample of 290 high-risk and gang-involved youth in San Salvador, El Salvador, structural equation modeling was employed to examine the relationships between religious coping, spirituality, social developmental factors (e.g., antisocial bond and antisocial beliefs), and violence. RESULTS: Religious coping (β = - 0.14, P < 0.05) and spirituality (β = - 0.20, P < 0.01) were both significantly associated with antisocial bond. Antisocial bond, in turn, was directly associated with violence (β = 0.70, P < 0.001) and was associated with antisocial beliefs (β = 0.54, P < 0.001); however, the path from antisocial beliefs to violence was not statistically significant. No direct paths were identified from religiosity and spirituality to violence. The goodness-of-fit statistics (root mean square error of approximation, 0.034; comparative fit index, 0.974; and Tucker-Lewis index, 0.966) suggest that the final model had acceptable fit. CONCLUSIONS: This study is among the first to shed light on the relationship between religiosity, spirituality, and youth violence in the Latin American context. Elevated levels of religious coping and spirituality are associated with less antisocial bonding, which, in turn, is associated with lower levels of violent behavior among high-risk and gang-involved Salvadoran youth. Study findings suggest that religious coping and spirituality are indirectly protective for youth violence among this high-risk population.

OBJETIVO: Analizar las relaciones directas y mediadas entre el afrontamiento religioso, la espiritualidad, los factores de desarrollo social, y la violencia en jóvenes de alto riesgo y pertenecientes a pandillas de un país latinoamericano con una alta incidencia de criminalidad. MÉTODOS: Se seleccionó una muestra de la comunidad de 290 jóvenes de alto riesgo y pertenecientes a pandillas de San Salvador (El Salvador). Mediante el modelado de ecuaciones estructurales se analizaron las relaciones entre el afrontamiento religioso, la espiritualidad, los factores de desarrollo social (por ejemplo, el vínculo antisocial y las creencias antisociales), y la violencia. RESULTADOS: El afrontamiento religioso (β = - 0,14, P < 0,05) y la espiritualidad (β = - 0,20, P < 0,01) se asociaron ambos significativamente con el vínculo antisocial. El vínculo antisocial, a su vez, se asoció directamente con la violencia (β = 0,70, P < 0,001) y también se asoció con las creencias antisociales (β = 0,54, P < 0,001); sin embargo, la vía de las creencias antisociales a la violencia no fue estadísticamente significativa. No se identificaron vías directas de la religiosidad y la espiritualidad a la violencia. La prueba estadística de bondad de ajuste (error de aproximación cuadrático medio, 0,034; índice de ajuste comparativo, 0,974; índice de Tucker-Lewis, 0,966) indica que el modelo final mostraba un ajuste aceptable. CONCLUSIONES: Este estudio es uno de los primeros en clarificar la relación entre la religiosidad, la espiritualidad y la violencia juvenil en el entorno latinoamericano. Los niveles elevados de afrontamiento religioso y espiritualidad se asocian con vínculos menos antisociales que, a su vez, se asocian con menores niveles de comportamiento violento entre los jóvenes salvadoreños de alto riesgo y pertenecientes a pandillas. Los resultados de este estudio indican que el afrontamiento religioso y la espiritualidad son protectores indirectos de la violencia juvenil en esta población de alto riesgo.

Use of senior centers as a moderator of stress related distress among Latino elders.

Little is known about the moderating effects of community services on psychological distress among Latino elders. This study explores the use of senior centers as an intervention strategy to moderate the harmful impact of stress on psychological distress. The study was conducted using data from the 1988 National Survey of Hispanic Elderly People (N=2,299). To examine the direct and moderating effects of the use of senior centers on the relationship between stress and psychological distress we applied multiple regression analysis to an initial model, a direct effect model, and a moderating model. The results indicated that, under stressful life situations, respondents who used senior centers experienced lower levels of psychological distress than those who did not. Implications of the findings for senior centers and for further research are discussed.

Health care and social service use among Chinese immigrant elders.

We explored patterns and reasons for health and social service use among Chinese immigrant elders. Interviews were conducted with 27 Chinese immigrant elders, 11 adult care giving children, and 12 health and social service providers. Content analysis of these data indicated that participants across groups agreed that Chinese elders under-utilize services because of problems related to language, transportation, cost, long waits for appointments, and because of cultural norms/values related to need for care, preference for self-over professional care, fear, and distrust of western biomedicine, and the obligation to refrain from using formal services. These problems are complicated by geographical dispersion and dialect differences in the local Chinese immigrant community.