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Kearney Duelund posted an update 6 hours, 44 minutes ago
This Treatment Development Report describes the need for evidence-based psychosocial trauma-focused treatment for people living with comorbid posttraumatic stress disorder (PTSD) and HIV. Individuals with HIV have higher rates of exposure to traumatic events and PTSD than the general public, and they also experience additional consequences of PTSD on the management of their chronic disease (e.g., established link between PTSD symptoms and lack of adherence to antiretroviral therapy [ART]). We used the empirically-supported ADAPT-ITT approach to consider the initial steps in adapting evidence-based Cognitive Processing Therapy (CPT) for individuals with PTSD and HIV. This paper reviews a case example that involved various clinical issues that may arise when providing trauma-focused treatment for people living with HIV including HIV-stigma, disease management, and the need for making multicultural adaptations to psychotherapy. This case example illustrates how trauma-focused treatment may benefit from enhancement to address additional barriers that may arise over the course of PTSD treatment in this population. Feasibility of engaging and delivering a “full dose” of evidence-based PTSD treatment among individuals living with HIV is discussed. GC7 While evidence-based treatments can reduce PTSD symptom severity, issues related to chronic disease coping and HIV-related stigma management could be integrated to augment the efficacy of treatment for individuals with HIV. Adaptive intervention research targeting PTSD in persons living with HIV warrants further attention, especially given the association between PTSD and adherence to ART.In this letter, we propose a novel conjugate gradient (CG) adaptive filtering algorithm for online estimation of system responses that admit sparsity. Specifically, the Sparsity-promoting Conjugate Gradient (SCG) algorithm is developed based on iterative reweighting methods popular in the sparse signal recovery area. We propose an affine scaling transformation strategy within the reweighting framework, leading to an algorithm that allows the usage of a zero sparsity regularization coefficient. This enables SCG to leverage the sparsity of the system response if it already exists, while not compromising the optimization process. Simulation results show that SCG demonstrates improved convergence and steady-state properties over existing methods.Little research has focused on the positive adjustment of emerging adult adoptees (Palacios & Brodzinsky, 2010). Given the developmental context of emerging adulthood (Arnett, 2000), it is important to select an indicator of adjustment that reflects the associated ambiguity. The present study aims to provide empirical support for the construct of relational competence, or competence in one’s closest relationship regardless of relationship type (i.e., romantic vs. nonromantic) among emerging adult adoptees. Participants included 162 adoptees who had been adopted before the age of one in the United States through private domestic adoption in to same-race families. Relational competence was measured by adapting a measure of romantic competence in emerging adulthood (Shulman, Davila, & Shachar-Shapira, 2011). Indicators of relational competence were coded from interviews in which participants discussed their self-identified closest relationship (White, Speisman, Jackson, Bartis & Costos, 1986). Confirmatory factor analyses showed that the proposed model of relational competence was a good fit to the data and was invariant across relationship type and gender. No differences in relational competence scores were found by relationship type or by gender (all p’s >. 552). Relational competence was positively associated with adaptive functioning (β = .325, p = .006) and negatively associated with internalizing (β = -.246, p = .035) and externalizing behavior (β = -.347, p = .003).Asian Americans are the fastest growing racial/ethnic minority group in the United States and have unique, heterogenous health status and outcomes across a range of conditions between disaggregated Asian subgroups. Despite the rapid growth of this group, clinical and epidemiologic research lags considerably in adequately and appropriately representing Asian Americans. Too often, Asian American participants and populations are inappropriately aggregated into a single race category in research, masking important differences between ethnic subgroups. In this commentary, actionable recommendations are provided to investigators in order to enhance inclusion and representation of Asian Americans in a broad scope of research programs. Incorporating these recommendations in research planning and conduct will support health and promote health equity for these populations.Although gentrification is occurring at increasing rates across the United States, our understanding of what this means for public health is limited. While positive changes, such as increases in property values and reduced crime rates occur, negative consequences, such as residential displacement, also ensue. Individuals living through gentrification experience major changes in social and environmental conditions often in short periods of time, which can result in disrupted social networks and stress, both associated with decrements in health. As neighborhoods across the United States undergo revitalization, understanding health effects of gentrification, positive and negative, is paramount. We posit that gentrification may be beneficial in some aspects of health and detrimental in others. To address current challenges in the gentrification-health literature, we recommend future research 1) examine the gentrification processes and stages; 2) integrate built, natural, and social environment metrics; and 3) assess mediating and moderating associations. As gentrification expands across the United States, research conducted in this area is poised for timely contributions to equitable development and urban planning policies.
To describe the demographic, legal, and clinical characteristics of a cross-section of incarcerated homeless individuals with the highest utilization of Los Angeles (LA) County public services in order to increase opportunities for focused jail diversion.
The “5% list” (N=5,905 in February 2018), LA County’s list of homeless individuals with the highest 5% utilization of public services, was cross-matched with the total jail population to obtain a sample of 333 homeless high-utilizing individuals. This sample was compared with the overall jail population (N=17,121) from publicly available aggregate data by Chi-square testing.
84% of the high-utilizing sample were male, 38% Black, 37% Hispanic, 21% White. 67% were prescribed psychiatric medication. Compared with the overall jail population, the sample was significantly older, with a greater proportion of Black and White persons, and a lesser proportion of Hispanic individuals relative to the overall jail population. A significantly greater proportion of high-utilizing individuals faced misdemeanor charges.