Far from a monolith: a typology of externalizing behavior among African American youth

Purpose

Previous studies have examined externalizing behaviors among African American youth using variable-centered approaches that study aggression and delinquency separately. However, aggression and delinquency often operate together in shaping adolescent behavior. For this reason, person-centered approaches are essential for identifying subgroups of African American youth using multiple indicators of aggression and delinquency to model the behavioral heterogeneity within this population. We examined the relationship between interpersonal, school, and parenting factors and externalizing behaviors among African American youth.

Method

Drawing from the National Survey on Drug Use and Health 2015–2018, we conducted latent class analysis based on 5 externalizing behavior indicator variables (i.e., serious fight, attack to harm, stealing, drug selling, handgun carrying) using a sample of 7,236 African American adolescents, aged 12–17.

Results

We identified a three class solution: Class #1—No Involvement (74.4%), characterized by very low levels of involvement in all of the externalizing behaviors examined; Class #2—Serious fight (23.3%), which is characterized by near-universal involvement in a serious fight, far lower levels of attack to harm, and negligible levels of stealing, drug selling, and handgun caring; and Class #3—Multidimensional externalizing (2.3%), characterized by very high levels of involvement in all of the externalizing variables examined.

Conclusion

Most African American youth are not involved in externalizing behaviors. It is vital to support both the large majority of African-American youth who are abstaining from externalizing behaviors and to develop/implement programs to address the contextual and interpersonal needs of youth at elevated risk for consequences related to externalizing.

     

Synergistic Effects of Pr6O11 and Co3O4 on Electrical and Microstructure Features of ZnO-BaTiO3 Varistor Ceramics

This paper investigated the effects of Pr₆O₁₁ and Co₃O₄ on the electrical properties of ZnO-BaTiO₃ varistor ceramics. The Pr₆O₁₁ doping has a notable influence on the characteristics of the nonlinear coefficient, varistor voltage, and leakage current where the values varied from 2.29 to 2.69, 12.36 to 68.36 V/mm and 599.33 to 548.16 µA/cm², respectively. The nonlinear varistor coefficient of 5.50 to 7.15 and the varistor voltage of 7.38 to 8.10 V/mm was also influenced by the use of Co₃O₄ as a dopant. When the amount of Co₃O₄ was above 0.5 wt.%, the leakage current increased from 202.41 to 302.71 μA/cm². The varistor ceramics with 1.5 wt.% Pr₆O₁₁ shows good nonlinear electrical performance at higher breakdown voltage and reduced the leakage current of the ceramic materials. Besides, the varistor sample that was doped with 0.5 wt.% Co₃O₄ was able to enhance the nonlinear electrical properties at low breakdown voltage with a smaller value of leakage current.     

Stakeholders’ Perceptions Regarding the Use of Patient Photographs Integrated with Medical Imaging Studies

Integrating digital facial photographs of pediatric patients as identifiers (ID) with medical imaging (integrated photographic IDs) may increase the detection of mislabeled studies. The purpose of this study was to determine how different stakeholders would receive this novel technology. Parents or guardians of patients in a children’s hospital outpatient radiology department, radiology faculty and residents, and radiology technologists and nurses were asked to complete a survey. The perception about the anticipated use of integrated photographic ID in different clinical scenarios was investigated, and its predictors were determined using logistic regression analysis. Four hundred ninety-eight parents responded (response rate 83 %); 96 and 97 % supported the use of integrated photographic ID, if it improves the radiologist’s imaging interpretation or decreases the rate of mislabeled errors, respectively. Thirty-eight percent were worried that photographic IDs would impact patients’ privacy. Ninety-four percent believed that they should be asked for their consent prior to obtaining their child’s photograph. Seventy-eight radiologists responded (response rate 39 %); 63 and 59 % believed that the use of integrated photographic ID would result in improvement in accurate interpretation of images and identification of mislabeled patient errors, respectively. Forty-nine percent of radiologists had concern that integrated photographic ID would increase interpretation time. Fifty technologists and nurses responded (response rate 59 %); 71 and 73 % supported the technology if it resulted in more acute interpretation of images and identification of mislabeled patients, respectively. A majority of stakeholders support integrated photographic ID in order to improve safety. A majority of parents believe that consent should be obtained.     

Structure-function properties of the apoE-dependent COX-2 pathway in vascular smooth muscle cells

Apolipoprotein (apoE) E is a multifunctional protein that plays a critical role in atherogenesis, in part by regulating the intimal proliferation of vascular smooth muscle cells. Recently, a novel cyclooxygenase (COX)-2 pathway was shown to contribute to the anti-proliferative action of human apoE3 in vascular smooth muscle cells (VSMC). Here, we provide insight into the structure-function properties by which apoE mediates these effects. ApoE3 is most effective in promoting COX-2 expression as a lipid-free protein and is less active after lipidation. Alterations in the stability of the helix bundle N-terminal domain of apoE that contains the binding site for the low density lipoprotein (LDL) receptor and heparin do not affect the up-regulation of the COX-2 pathway. In addition, the apoE2, 3, and 4 isoforms are all capable of up-regulating the COX-2 pathway. Finally, the effect of apoE on COX-2 was found to be independent of expression on the VSMC surface of the LDL receptor and heparan sulfate proteoglycans (HSPG). In summary, our data indicates that apoE, particularly in the lipid-free state, can up-regulate COX-2 in murine vascular smooth muscle cells apparently independently of binding to the LDLR, LRP or HSPG.     

Nasogastric feeding practices: a survey using clinical scenarios

BackgroundBolus nasogastric tube feeding is common. Unsafe practices such as failure to confirm tube placement can result in death. It is vital to ensure that nurses are adopting safe practices.ObjectiveTo evaluate nurses’ practices on bolus nasogastric feeding relating to verification of tube placement, management of gastric residual volume, and response to complications during feeding.DesignCross-sectional, self-administered survey using clinical scenarios.Setting and participantsAll nurses who worked in the general wards in a tertiary hospital in August 2008.MethodsWe developed six clinical scenarios to describe common clinical situations in nurses’ daily practices. Participants were instructed to choose the responses that best reflected their practices, and to return the completed questionnaires to the study member present.ResultsThe survey participation rate was 99.5% (1203 nurses). Seventy-six percent would choose two or more methods to verify placement when they were in doubt. Percentage of hydrogen (pH) testing was the most common first method of checking tube placement. The second and third self-reported methods were auscultation and the bubble test. Few chose radiography to confirm tube placement. When the aspirate was pH 7, and in the presence of positive auscultation, most participants would take further steps to confirm placement. There were variations in the nurses’ responses on managing the gastric residual volume, with 78.1% indicating that they would return the aspirate. Most nurses lacked the knowledge to effectively manage patients’ distress during tube feeding.ConclusionsThe findings showed that the majority of participants reported that they would exercise due caution by taking additional measures to check tube placement when in doubt. The practice gaps identified in the study highlighted a need to realign our care to best practices. Following the study, we revised the institution's guideline, reinforced specific safety precautions on nasogastric feeding, and incorporated clinical scenarios in our training.     

Perceptions of colorectal cancer among three ethnic subgroups of US blacks: a qualitative study

Colorectal cancer (CRC) is currently associated with one of the highest burdens of morbidity and mortality among American men and women. Racial/ethnic disparities are well documented and the subject of intense research and intervention. Our understanding of disparities related to awareness and perceptions about causes, risk factors, and screening for CRC among subgroups of blacks in the United States is limited. This may be in part because grouping US-born blacks and foreign-born blacks as one homogeneous group obscures possible within-group differences. This study aimed to explore the cultural perceptions of CRC among 3 ethnic subgroups of blacks: African Americans (US born), foreign-born blacks from English-speaking Caribbean countries, and Haitian-born blacks. The study was informed by a community-based participatory research approach, using a cross-sectional mixed qualitative and quantitative methods design. A total of 62 individuals from the 3 ethnic subgroups participated in semistructured, in-depth qualitative and structured quantitative interviews. Qualitative findings revealed no stark differences among the 3 ethnic subgroups in their overall perceptions of cancer as well as their attitudes related to barriers, motivation, and resources for CRC screening. However, there were subtle differences in perceptions of curability, preventive practices, and preferred sources of information among the three ethnic subgroups of US blacks. The study has important implications for the design of educational materials and targeted interventions for diverse groups of US blacks.     

Discussion of First-Degree Relatives’ Colorectal Cancer Risk: Survivors’ Perspectives

Although screening reduces colorectal cancer (CRC) incidence and mortality, screening rates are low, particularly among CRC patients’ first-degree relatives (FDRs). Little is known about discussion of family members’ risk of CRC among patients and their health care providers or with their FDRs. The purpose of this research, guided by the Protection Motivation Theory, was to assess patients’ patterns of disclosure of CRC diagnosis to adult siblings and/or children and discussion of familial risk by healthcare providers. A cross-sectional sample of patients who received care at a comprehensive cancer center was recruited to complete telephone-based interviews related to disclosure of CRC diagnosis to FDRs, recall of physician counseling about familial risk, and patients’ perception of CRC risk to FDRs. Sixty-nine patients completed the interview. Most participants (n = 67, 97%) had informed their adult children or siblings of their CRC diagnosis to keep their family informed of their health status (n = 15, 22%) and to encourage FDRs to screen for CRC (n = 14, 20%). More than half of the participants’ physicians (n = 38, 55%) discussed FDRs’ risk of developing CRC with the patient. However, a substantial proportion of patients reported no physician discussion of this risk (n = 28, 41%). Data from this study may guide the development of interventions to facilitate physician discussion and counseling of CRC patients about their FDRs’ risk for CRC. However, future studies should explore whether FDRs are likely to be screened after becoming aware of their family member’s diagnosis of CRC.