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Purpose: In this study, we explored experiences and feelings of safety in public facilities in relation to psychological well-being among transgender and gender nonconforming (TGNC) youth in the Midwest in the summer of 2016, in the context of ongoing legislative proposals and regulations regarding school and public bathroom use in the United States.Methods: We used a mixed-method approach, with (1) a self-administered, paper-and-pencil survey of 120 TGNC youth, focusing on differences of self-esteem, resilience, quality of life (QoL), perceived stigma, feelings of safety, and experiences of public facility use and (2) two focus group interviews (n=9) in which TGNC youth discussed individual perceptions, attitudes, and experiences of bathroom use outside participants' homes. The samples consisted predominantly of individuals assigned female at birth and currently of trans-masculine identity.Results: TGNC youth in our sample who reported that they had felt unsafe in bathrooms due to appearance or gender identity had significantly lower levels of resilience (mean(felt safe)=125.7 vs. mean(felt unsafe)=116.1; p=0.03, Cohen's d=0.44) and QoL (mean(felt safe)=59.1 vs. mean(felt unsafe)=51.9; p=0.04, Cohen's d=0.39), compared to those who felt safe. Meanwhile, feeling unsafe in bathrooms was associated with a greater level of perceived LGBT stigma (mean(felt safe)=2.3 vs. mean(felt unsafe)=2.6; p=0.03, Cohen's d=0.41) and problematic anxiety in the past year (χ2 (1)=4.06; p=0.04). Individuals in the focus groups provided specific examples of their experiences of and concerns about locker room or bathroom use in public facilities, and on the impact of school bathroom-related policies and legislation on them.Conclusion: Perceptions of safety related to bathroom use are related to psychological well-being among TGNC youth. Our predominantly trans-masculine youth sample indicated that choice of bathroom and locker room use is important and that antiharassment policies need to support students' use of their choice of bathrooms. This is particularly important information given debate of so-called bathroom bills, which attempt to restrict public bathroom use for TGNC youth, creating less choice and more stress and fear among these individuals.

Malnutrition–sarcopenia syndrome (MSS) might put older adults at higher risk for disability, frailty, and mortality. This study examined the prevalence and association of the self-management-process factors (i.e., self-efficacy and aging expectations) and behaviors (protein and caloric intake and sedentary and physical-activity behaviors) to MSS among older adults living in continuing care retirement communities (CCRCs). Using a cross-sectional correlational design, data of 96 CCRC residents (82.4 ± 7.4 years) were analyzed. Muscle mass, strength, function, nutritional status, sedentary time, physical activity levels, protein and caloric intake, self-efficacy for physical activity, aging expectations, and physical and mental health-related quality of life were measured. Results show that 36 (37.5%) had sarcopenia, 21 (21.9%) had malnutrition risk, 13 (13.4%) had malnutrition, and 12 (12.5%) had MSS. We also found that high time spent in sedentary behaviors (OR = 1.041; 95% CI: 1.011–1.071) was associated with higher odds of having MSS and high expectations regarding aging (OR = 0.896; 95% CI: 0.806–0.997) was associated with less likelihood of having MSS. Findings suggest that CCRC residents should be screened for MSS. Self-management interventions that consider the self-management-process factors are needed to prevent MSS and mitigate its negative outcomes among CRCC residents.

Abstract Some municipalities are promoting lead-filtering point-of-use (POU) systems to minimize the risk of lead exposure through drinking water, often targeting use at racial minorities and low-income households. However, links among social inequality markers and adoption of these systems are not well understood. Survey data on adoption and use of POU systems were collected from a U.S. Mechanical Turk (MTurk) sample (N = 2,867) in March 2018. We use logistic regression to assess the association of race/ethnicity, socioeconomic status (SES), and lead-filtering POU adoption. We also examined key health behaviors related to POU systems. We found that race and SES are indirectly predictive of lead-filtering POU adoption through the propensity of some respondents to report a residence with a lead service line and levels of concern and knowledge about lead exposure. In addition, individuals with similar levels of concern about lead in water have lower odds of adopting a POU system if they have lower, rather than higher, incomes. Among POU adopters, while confidence in correct use of these devices was relatively high, the frequency of filtered water use for cooking was lower than drinking frequency. Overall, these findings inform health policies aimed at mitigating risk of lead exposure through water.

Poor muscle function is a major source of disability among older adults and leads to negative health outcomes including falls and fractures, exacerbating healthcare cost. This study was undertaken to understand: a) the characteristics of muscle function; and b) the relationship of self-management process variables (expectations regarding aging, goal congruence, and self-efficacy for physical activity) and physical activity self-management behavior to muscle function in a sample of older adults (N = 65) 75-93 years of age living in Continuing Care Retirement Communities. Using a descriptive correlational design, muscle function was measured with the Short Physical Performance Battery (SPPB) test and physical activity level with ActiGraph GT3X. Questionnaires included Expectations Regarding Aging and goal congruence scales and Physical Activity Assessment Inventory to assess self-efficacy. Pain was assessed by the PROMIS Pain Intensity 3a. Most participants (77%) performed poorly on the SPPB test. Controlling for pain, expectations regarding aging, goal congruence, self-efficacy and physical activity explained 46% of the variance in SPPB score. The model demonstrated that self-efficacy and light-intensity physical activity significantly explained 24.6 % of the variance in SPPB score; suggesting that low self-efficacy and decreased levels of light-intensity physical activity were significant predictors of low SPPB score. The findings demonstrate the need for more research documenting the underlying processes and risk factors for reduced muscle function. The potential benefits of this approach provide a basis for designing interventions to improve muscle function and delay the transfer to more restrictive living environments.