Cysteamine-mediated blockade of the glycine cleavage system modulates epithelial cell inflammatory and innate immune responses to viral infection.

Transient blockade of glycine decarboxylase (GLDC) can restrict de novo pyrimidine synthesis, which is a well-described strategy for enhancing the host interferon response to viral infection and a target pathway for some licenced anti-inflammatory therapies. The aminothiol, cysteamine, is produced endogenously during the metabolism of coenzyme A, and is currently being investigated in a clinical trial as an intervention in community acquired pneumonia resulting from viral (influenza and SARS-CoV-2) and bacterial respiratory infection. Cysteamine is known to inhibit both bacterial and the eukaryotic host glycine cleavage systems via competitive inhibition of GLDC at concentrations, lower than those required for direct antimicrobial or antiviral activity. Here, we demonstrate for the first time that therapeutically achievable concentrations of cysteamine can inhibit glycine utilisation by epithelial cells and improve cell-mediated responses to infection with respiratory viruses, including human coronavirus 229E and Influenza A. Cysteamine reduces interleukin-6 (IL-6) and increases the interferon-λ (IFN-λ) response to viral challenge and in response to liposomal polyinosinic:polycytidylic acid (poly I:C) simulant of RNA viral infection.

The reporting quality of randomized controlled trials and experimental animal studies for urethroplasty.

OBJECTIVES: To assess the reporting quality of randomized controlled trials and experimental animal studies examining urethroplasty in reconstructive urological surgery literature. METHODS: We performed a comprehensive literature search to identify all urethroplasty-related RCTs examining humans as well as animal models. We used the Consolidated Standards of Reporting Trials (CONSORT) and the Animals in Research: Reporting in vivo Experiments (ARRIVE) guidelines to assess reporting quality. Two reviewers performed data abstraction independently and in duplicate. We then generated descriptive statistics including CONSORT (0-25) and ARRIVE (0-20) summary scores using the median and interquartile range. RESULTS: Twenty studies were ultimately included; 14 randomized controlled trials and 6 experimental animal studies. All studies were two-armed, parallel group studies. Median sample sizes (and interquartile range) of the human and animal studies were 48.5 (31.8-53.8) and 18 (15.3-27.5), respectively. The median CONSORT and ARRIVE scores were 10.0 (8.75-12.63) and 7.97 (6.79-8.64), respectively. Human randomized controlled trials did not consistently report the method of allocation concealment (6/14; 42.9%), blinding (2/14; 14.3%), or discuss the generalizability of the results (6/14; 42.9%). Animal studies infrequently reported why a given animal model was used (1/6; 16.7%), how they were allocated to groups (0/6; 0%) or what the experimental primary and secondary outcomes were (0/6; 0%). CONCLUSIONS: Urethroplasty literature is marked by a paucity of both randomized controlled trials and experimental design animal studies. The existing studies are inconsistently reported and are therefore of uncertain methodological quality.

Effective Demand for In-Line Chlorination Bundled with Rental Housing in Dhaka, Bangladesh.

Delivering safe water in cities of lower- and middle-income countries remains elusive even where there is a piped supply. Passive, in-line chlorination upstream of the point of water collection reduces child diarrhea without the behavior change required for point-of-use water treatment products or manual chlorine dispensers. We conducted a price experiment to measure effective demand (willingness and ability to pay) for an in-line chlorination service using tablet chlorinators among 196 landlords of rental housing properties in Dhaka, Bangladesh. We offered a 12-month subscription using Becker-DeGroot-Marschak auctions with real money payments. The service consistently delivered chlorinated water and satisfied tenants. Landlords' effective demand for in-line chlorination was similar to or greater than that for point-of-use treatment products and manual chlorine dispensers previously documented among Dhaka households. Over the service period, landlords renting to low-income households had lower effective demand than those renting to middle-income households despite similar initial rates of payment across both groups. Making in-line chlorination financially viable for the lowest-income consumers would likely require service cost reductions, subsidies, or both. Our findings suggest that even revealed preference experiments may overestimate the effective demand needed to sustain water supply improvements, especially in low-income populations, if they only measure demand once.

The reporting quality of studies of diagnostic accuracy in the urologic literature.

INTRODUCTION: High-quality evidence regarding questions of diagnostic accuracy relies on transparent reporting of study results. The quality of reporting for such studies in the urologic literature is unknown. METHODS: In accordance with an a priori protocol, we systematically searched for all articles on diagnostic accuracy studies published in four major urologic journals in 2015. Using the 2015 STAndards for Reporting Diagnostic accuracy studies (STARD) checklist, two of us independently abstracted data. For each article, we calculated STARD summary scores (scale of 0-30, with higher scores reflecting higher-quality reporting). We compared scores by journal, topic, and sample size. RESULTS: We screened 819 references of which 61 met inclusion criteria. Nearly two-thirds of studies (39/61%; 63.9%) addressed prostate cancer diagnosis or staging; less than one in ten (6/61%; 9.8%) was conducted in non-oncological disease settings. The major focus for the investigation of new index tests lay in imaging modalities (33/61%; 54.1%); over half of these imaging studies addressed magnetic resonance imaging (18/61%; 29.5%). The average STARD score was 18.9 ± 2.4 (range 12-24). Six criteria had poor reporting compliance and were met by less than 20% of studies. We found no association between reporting quality and topic, journal or study size. CONCLUSIONS: The reporting quality of studies of diagnostic accuracy appears modest and independent of topic, journal or study size. There is an urgent need for greater awareness for the reporting quality of these studies among readers, editors, and investigators to raise evidentiary standards on issues of diagnosis.

Alternative Reservoir and Balloon Placement in Complex Patients Undergoing Urologic Prostheses.

PURPOSE OF REVIEW: To evaluate contemporary rationale and techniques for ectopic reservoir/balloon placement in complex urologic prosthetics patients. RECENT FINDINGS: Recent studies have demonstrated that ectopic reservoir placement is safe and durable when compared to traditional space of Retzius placement. Complex patients exist on a spectrum from those with a previously violated retropubic space, to those with bilaterally obscured external inguinal rings and/or multiple prior prosthetic reservoirs. Ectopic placement has become more commonplace and accepted as a viable alternative strategy over the past 7 years. Concerns relating to reservoir palpability and long-term outcomes have been allayed. The risk of deep pelvic complications appears to be negligible after both placement or removal of ectopic reservoirs when performed by experienced implanters even in the most complex patient. Ectopic placement of prosthetic balloons and reservoirs offers unique advantages and has become commonplace in contemporary prosthetic urology practice.

NP108, an Antimicrobial Polymer with Activity against Methicillin- and Mupirocin-Resistant Staphylococcus aureus.

Staphylococcus aureus is a clinically significant human pathogen that causes infectious diseases ranging from skin and soft tissue infections (SSTI) and health care-associated infections (HAI) to potentially fatal bacteremia and endocarditis. Nasal carriage of S. aureus, especially for persistent carriage, is associated with an increased risk of subsequent infection, particularly nosocomial and surgical site infections (SSI), usually via autoinfection. NP108 is a cationic antimicrobial polymer composed of generally recognized as safe (GRAS) amino acid building blocks. NP108 is broad spectrum and rapidly bactericidal (3-log kill in ≤3 h), killing bacteria by membrane disruption and cell lysis. NP108, contrary to many antibiotics, shows equally effective antimicrobial activity against a variety of S. aureus (MIC100 = 8 to 500 mg/liter) and S. epidermidis (MIC100 = 4 to 8 mg/liter) isolates, whether exponentially growing or in stationary phase. NP108 is antimicrobially active under nutrient-limiting conditions similar to those found in the anterior nares (MIC100 = 8 mg/liter) and kills antibiotic-resilient small colony variants (MIC100 = 32 mg/liter) and S. aureus biofilms (prevention, MIC100 = 1 to 4 mg/liter; eradication, MIC100 ≥ 31.25 mg/liter). NP108 is active against isolates of S. aureus resistant to the current standard-of-care decolonization agent, mupirocin, with no significant increase in the MIC100 NP108 is water soluble and has been formulated into compatible aqueous gel vehicles for human use in which antimicrobial efficacy is retained (2.0% [wt/vol]). NP108 is a potential nonantibiotic antimicrobial alternative to antibiotics for the nasal decolonization of S. aureus, with clear advantages in its mechanism of action over the existing gold standard, mupirocin.

Design of a cluster-randomized minority recruitment trial: RECRUIT.

BACKGROUND: Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to increase minority recruitment focus on minority communities and emphasize common diseases such as hypertension. Scant literature focuses on minority recruitment to trials of less common conditions, often conducted in specialty clinics and dependent on physician referrals. We identified trust/mistrust of specialist physician investigators and institutions conducting medical research and consequent participant reluctance to participate in clinical trials as key-shared barriers across racial/ethnic groups. We developed a trust-based continuous quality improvement intervention to build trust between specialist physician investigators and community minority-serving physicians and ultimately potential trial participants. To avoid the inherent biases of non-randomized studies, we evaluated the intervention in the national Randomized Recruitment Intervention Trial (RECRUIT). This report presents the design of RECRUIT. Specialty clinic follow-up continues through April 2017. METHODS: We hypothesized that specialist physician investigators and coordinators trained in the trust-based continuous quality improvement intervention would enroll a greater proportion of minority participants in their specialty clinics than specialist physician investigators in control specialty clinics. Specialty clinic was the unit of randomization. Using continuous quality improvement, the specialist physician investigators and coordinators tailored recruitment approaches to their specialty clinic characteristics and populations. Primary analyses were adjusted for clustering by specialty clinic within parent trial and matching covariates. RESULTS: RECRUIT was implemented in four multi-site clinical trials (parent trials) supported by three National Institutes of Health institutes and included 50 associated specialty clinics from these parent trials. Using current data, we have 88% power or greater to detect a 0.15 or greater difference from the currently observed control proportion adjusting for clustering. We detected no differences in baseline matching criteria between intervention and control specialty clinics (all p values > 0.17). CONCLUSION: RECRUIT was the first multi-site randomized control trial to examine the effectiveness of a trust-based continuous quality improvement intervention to increase minority recruitment into clinical trials. RECRUIT's innovations included its focus on building trust between specialist investigators and minority-serving physicians, the use of continuous quality improvement to tailor the intervention to each specialty clinic's specific racial/ethnic populations and barriers to minority recruitment, and the use of specialty clinics from more than one parent multi-site trial to increase generalizability. The effectiveness of the RECRUIT intervention will be determined after the completion of trial data collection and planned analyses.

Psychometrics of a Child Report Measure of Maternal Support following Disclosure of Sexual Abuse.

The study examined a new child report measure of maternal support following child sexual abuse. One hundred and forty-six mother-child dyads presenting for a forensic evaluation completed assessments including standardized measures of adjustment. Child participants also responded to 32 items considered for inclusion in a new measure, the Maternal Support Questionnaire-Child Report (MSQ-CR). Exploratory factor analysis of the Maternal Support Questionnaire-Child Report resulted in a three factor, 20-item solution: Emotional Support (9 items), Skeptical Preoccupation (5 items), and Protection/Retaliation (6 items). Each factor demonstrated adequate internal consistency. Construct and concurrent validity of the new measure were supported in comparison to other trauma-specific measures. The Maternal Support Questionnaire-Child Report demonstrated sound psychometric properties. Future research is needed to determine whether the Maternal Support Questionnaire-Child Report provides a more sensitive approximation of maternal support following disclosure of sexual abuse, relative to measures of global parent-child relations and to contextualize discrepancies between mother and child ratings of maternal support.

Providing Clinical Psychology Training and Trauma-Focused Treatment via Telehealth During COVID-19.

To slow the spread of COVID-19 many mental health providers transitioned to telehealth delivery of trauma-focused treatment for maltreated children. However, these providers faced myriad challenges, including equitable access to equipment and technical demands of telehealth software. Training clinics overseeing pre-doctoral clinical psychology interns experienced the added challenge of providing quality supervision and training via telehealth. This study involves a retrospective application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to describe the innovative adaptation to a telehealth service delivery model in a training clinic providing evidence-based trauma-focused treatment to children and their families. Mixed methods data from clinic records and intern evaluations indicate that compared to pre-COVID (February 2019 - February 2020), during early COVID (April 2020 - April 2021) more patients accessed clinic services, interns reported fewer hours of individual supervision, and interns reported greater satisfaction with their training experiences. Implications for ongoing provision of telehealth services are discussed.

Longitudinal predictors of children's self-blame appraisals among military families reported for family violence.

BACKGROUND: Although children's self-blame appraisals are recognized as important sequelae of child victimization that contribute to subsequent adjustment problems, little is known about the factors that predict their development and longitudinal course. OBJECTIVE: The current study examines the stability and longitudinal predictors of children's self-blame appraisals among a sample of children reported for family violence. PARTICIPANTS AND SETTING: Children (N = 195; 63 % female) aged 7 to 17 years (Mage = 12.17) were recruited as part of a longitudinal assessment of families referred to the United States Navy's Family Advocacy Program due to allegations of child physical abuse, sexual abuse, or intimate partner violence. METHODS: Children completed assessments on self-blame at 3 time points (baseline, 9-12 months, and 18-24 months) and baseline measures of their victimization experience, caregiver-child conflict, and depression. RESULTS: In univariate analyses, victimization that involved injury (r = 0.29, p < .001), the number of perpetrators (r = 0.23, p = .001), the number of victimization types (r = 0.32, p < .001), caregiver-child conflict (r = 0.36, p < .001), and depression (r = 0.39, p < .001) were each positively associated with baseline self-blame. When examined in a single longitudinal multilevel model, results indicated only caregiver-child conflict (b = 0.08, p = .007) and baseline depression (b = 0.06, p = .013) predicted increases in self-blame. CONCLUSION: Findings suggest clinicians and researchers may consider assessment of victimization characteristics, caregiver-child relationships, and depression symptoms to identify children most at risk for developing self-blame appraisals.

Patterns of multiple victimization among maltreated children in Navy families.

The current study examined the cumulative risk associated with children's exposure to multiple types of parent-inflicted victimization. The sample was comprised of 195 children who were 7 to 17 years old (64.1% female and 48.2% non-White) at the time of referral to the United States Navy's Family Advocacy Program due to allegations of sexual abuse, physical abuse, or parental intimate partner violence. We conducted an exploratory latent class analysis to identify distinct subgroups of children based on lifetime victimization. We hypothesized that at least 2 classes or subgroups would be identified, with 1 characterized by greater victimization and poorer outcomes. Results indicated that 3 classes of children best fit the data: (a) high victimization across all 3 categories, (b) high rates of physical abuse and witnessing intimate partner violence, and (c) high rates of physical abuse only. Findings indicated that the high victimization class was at greatest risk for alcohol and substance use, delinquent behavior, and meeting criteria for posttraumatic stress disorder (PTSD) and/or depression 1 year later (odds ratio = 4.53). These findings highlight the serious mental health needs of a small but significantly high-risk portion of multiply victimized children entering the child welfare system.

Longitudinal Predictors of Mother- and Child-Report of Maternal Support Following Child Sexual Abuse.

Maternal support is theorized as a critical predictor of children's recovery from sexual abuse. However, following disclosure, several factors may cause maternal support to fluctuate over time. This study examined the effects of hypothesized risk factors, mother's relationship to the perpetrator and maternal psychological distress, as well as protective factors, maternal belief of disclosure, lower levels of child blame, and mother-child relationship quality, as predictors of change in maternal support over a 9 month period. Mothers (Mage = 38.42, SD = 8.99) and their children (Mage = 11.57, SD = 2.69; 85% female), recruited from a child advocacy center following sexual abuse disclosure, completed measures of maternal support. Mothers reported on their relationship to the perpetrator, psychological distress, belief of disclosure, child blame, and mother-child relationship quality. On average, mother- and child-reports of maternal support were stable across time. Belief of disclosure and child blame predicted mother- and child-report of maternal support. Psychological distress and mother-child relationship quality predicted change in mother-report, but not child-report of maternal support. Researchers and clinicians should consider potential fluctuations in maternal support in assessment and intervention following child sexual abuse.

Inter- and intra-rater reliability of handpump functionality field tests.

Sustaining the functionality of drinking water supplies in low- and middle-income countries is a longstanding challenge. Growing awareness of this problem has motivated increased attention to validly and reliably measuring water point functionality, including among handpumps, which serve approximately 9 % of the global population. Yet the most widely used indicator of functionality, whether a water point provides water, has limited validity, reliability, and utility. We tested the inter-rater (agreement among measurements taken by different people) and intra-rater (agreement among repeated measurements taken by the same person) reliability of three handpump functionality field tests in Uganda: pump capacity, 10-minute leakage rate, and flowrate. One person equipped with a stopwatch and a 20-liter container can complete the tests for one handpump in 15 min. The same three to four raters each conducted the tests three times on 28 handpumps. Different sets of four to five raters each conducted the tests once on 32 handpumps. Intraclass correlation coefficients were estimated to indicate inter- and intra-rater reliability. Ten-minute leakage rate had the highest inter-rater reliability, followed by pump capacity. Flowrate, which is commonly measured manually as part of handpump functionality assessments, had poor inter-rater reliability. Indicators derived from all three tests had high intra-rater reliability. Drawing on our inter-rater reliability results, we propose a fully quantitative procedure and validate an ordinal scale of physical handpump functionality based on the 10-minute leakage rate and pump capacity tests. This measurement procedure can be usefully incorporated into service delivery monitoring and research to enhance the objectivity, utility, and comparability of global handpump functionality data. Future studies can test the reliability of these indicators in other contexts and their value for predicting handpump breakdown.

Using the 5C model to understand COVID-19 vaccine hesitancy across a National and South Carolina sample.

Vaccine hesitancy is a serious threat to global health; however, significant COVID-19 vaccine hesitancy exists throughout the United States. The 5C model, which postulates five person-level determinants for vaccine hesitancy - confidence, complacency, constraints, risk calculation, and collective responsibility - provides one theoretical way of understanding COVID-19 vaccine hesitancy. The present study examined the effects of these 5C drivers of vaccine behavior on early vaccine adoption and vaccine intentions above and beyond theoretically salient demographic characteristics and compared these associations across a National sample (n = 1634) and a statewide sample from South Carolina (n = 784) - a state with documented low levels of COVID-19 vaccination uptake. This study used quantitative and qualitative data collected in October 2020 to January 2021 from the MFour-Mobile Research Panel, a large, representative non-probability sample of adult smartphone users. Overall, the South Carolina sample reported lower COVID-19 vaccine intentions and higher levels of 5C barriers to vaccine uptake compared to the National sample. Findings further indicated that both demographic characteristics (race) and certain drivers of vaccine behavior (confidence and collective responsibility) are associated with vaccine trust and intentions across samples above and beyond other variables. Qualitative data indicated that COVID-19 vaccine hesitancy was driven by fears about the quick vaccine development, limited research, and potential side effects. Although there are some limitations to the cross-sectional survey data, the present study offers valuable insight into factors associated with early COVID-19 vaccine hesitancy across the United States.

A randomized recruitment intervention trial in Parkinson's disease to increase participant diversity: early stopping for lack of efficacy.

BACKGROUND: Failure to include participants of diverse race and ethnicity (i.e. those other than European Caucasian, non-Hispanic) in clinical trials impedes the safe development of new therapies given the potential for racial/ethnicity-related variations in treatment response. Increasing diversity is problematic for low prevalence diseases, where most community-based approaches do not reach those with the disease. PURPOSE: Increase racial/ethnic diversity of participants in a Parkinson's disease therapeutic trial. METHODS: We incorporated a randomized Ancillary Trial into the multisite National Institute of Neurologic Disorders and Stroke Exploratory Trials in Parkinson's Disease Long-Term Study 1. Movement disorders clinics already participating in long-term trial 1 were eligible and were the unit of randomization and analysis. At least 14% of adult residents over age 55 and living within 30 miles of the eligible site were from a diverse population, or there was a near-by zip code with a highly diverse population. Eligible sites also agreed to be randomized. The intervention was designed to increase community physicians' trust in long-term trial 1 investigators and address recruitment barriers in diverse populations. Primary outcomes included percentage of participants from diverse racial/ethnic groups enrolled in long-term trial 1, and qualitative findings from key informant interviews of the Ancillary Trial investigators and coordinators at the end of the trial. RESULTS: The Ancillary Trial stopped early for lack of efficacy, conditional power less than 1%. The 17 intervention sites had 12.6% diverse participants compared to 15.6% in 15 control clinics; odds ratio 0.82 (95% confidence interval = 0.32-2.16). In key informant interviews, high enrollers of diverse participants reported more use of existing physician relationships, untargeted community outreach, and extensive efforts to overcome participants' barriers. Low enrollers reported more use of patients in their practices and placed more responsibility for low enrollment on prospective participants. LIMITATIONS: The Ancillary Trial included only those with Parkinson's disease. Whether our findings generalize to trials in other low prevalence diseases is unknown. CONCLUSIONS: Increasing diversity in Parkinson's disease clinical trials requires new paradigms for trial investigator and coordinator interactions with community physicians and prospective trial participants.

Commercial naphthenic acids and the organic fraction of oil sands process water induce different effects on pro-inflammatory gene expression and macrophage phagocytosis in mice.

Naphthenic acids (NAs) are believed to be the major toxic component of oil sands process water (OSPW). Different OSPW preparations have distinct NA compositions, and additional organics, that differ from the commercial NAs (C-NAs) often used for toxicology studies. To evaluate whether C-NAs are an adequate model to study OSPW toxicity in complex organisms, we compared the effects of C-NAs and the extractable organic fraction of OSPW (OSPW-OF) on mice immune mechanisms. Mice were orally exposed to different C-NA doses, or OSPW-OF at the same NA dose, for up to 8 weeks, and the expression of pro-inflammatory genes in different organs was determined using quantitative PCR. C-NAs and OSPW-OF altered the expression of pro-inflammatory genes, inducing either expression down-regulation or up-regulation, depending on the organ examined and time after exposure. The time at which gene expression alterations occurred, and the specific sets of genes whose expression was altered, were very different between animals exposed to C-NAs or to OSPW-OF. We evaluated the ability of mouse peritoneal macrophages to phagocytose yeast cell wall, as a measure of the ability of mice to mount a central function of the innate immune response. Phagocytosis was significantly reduced in animals exposed to C-NAs, but enhanced in mice exposed to OSPW-OF. Our results indicate that studies using C-NAs may not necessarily reflect the possible effects induced in animals by process water from tailing ponds.

Longitudinal examination of PTSD symptoms and problematic alcohol use as risk factors for adolescent victimization.

The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD symptoms and subsequent victimization. Participants included a national longitudinal sample of adolescents (N = 3,604) who were ages 12 to 17 at the initial assessment: 50% were male, and 67% were White, 16% African American, and 12% Hispanic. Cohort-sequential latent growth curve modeling was used to examine associations among the study variables. Baseline PTSD symptoms significantly predicted age-related increases in interpersonal victimization, even after accounting for the effects of earlier victimization experiences. In addition, alcohol problems emerged as a partial mediator of this relation, such that one fourth to one third of the effect of PTSD symptoms on future victimization was attributable to the impact of PTSD symptoms on alcohol problems (which, in turn, predicted additional victimization risk). Collectively, the full model accounted for more than half of the variance in age-related increases in interpersonal victimization among youth. Results indicate that PTSD symptoms serve as a risk factor for subsequent victimization among adolescents, over and above the risk conferred by prior victimization. This increased risk occurred both independently and through the impact of PTSD symptoms on problematic alcohol use. Based on these findings, it is hypothesized that the likelihood of repeated victimization among youth might be reduced through early detection and treatment of these clinical problems.

Measurement invariance of caregiver support following sexual abuse across age, relationship, and English-Spanish language.

BACKGROUND: The Maternal Self-report Support Questionnaire (MSSQ) is among the most rigorously evaluated measures of caregiver support following child sexual abuse, but there is a paucity of data on the factor structure and variance of the MSSQ across diverse groups of caregivers and their children. OBJECTIVE: The present study examined the factor structure and measurement invariance of the MSSQ across 386 non-offending caregivers following a disclosure of child sexual abuse. PARTICIPANTS AND SETTING: Data were collected from non-offending caregivers at two Child Advocacy Centers (n = 277; n = 109) in the United States. METHODS: Caregivers completed the MSSQ and assessments of child age, caregiver-child relationship, and caregiver preferred language. RESULTS: Confirmatory factor analyses replicated the original two-factor structure, with the emotional support and blame/doubt subscales emerging as distinct factors. Multigroup confirmatory factor analyses showed measurement invariance across child age and caregiver-child relationship (mother vs. another caregiver). Evidence of partial invariance was found for caregiver preferred language. Comparisons of scores indicated caregiver support varied by child age and caregiver preferred language. CONCLUSIONS: Overall, findings suggest the MSSQ can be used to measure caregiver support across caregivers with children of different ages and both mothers and non-mothers, but caution should be practiced in interpreting mean-level differences between English- and Spanish-speaking caregivers.

Adolescent distress in traumatic stress research: data from the National Survey of Adolescents-Replication.

Small numbers of adults report distress in response to traumatic stress surveys. Less is known about adolescent research participants. We examined distress in response to a survey on traumatic stress using data from the National Survey of Adolescents-Replication, a nationally representative sample of 3,614 youth aged 12-17 years. Although 204 (5.7%) adolescents found some questions distressing, only 8 (0.2%) remained upset at the end of the interview, and 2 (<0.1%) wished to speak to a counselor. Adolescents reporting traumatic experiences or mental health problems were significantly more likely to report distress compared to those not endorsing such problems. Significantly more girls (7.5%) reported distress than boys (3.9%). Findings suggest that survey questions about trauma pose minimal risk to adolescents.