This study examined the effects of slowing down presentation of facial expressions and their corresponding vocal sounds on facial expression recognition and facial and/or vocal imitation in children with autism. Twelve autistic children and twenty-four normal control children were presented with emotional and non-emotional facial expressions on CD-Rom, under audio or silent conditions, and under dynamic visual conditions (slowly, very slowly, at normal speed) plus a static control. Overall, children with autism showed lower performance in expression recognition and more induced facial-vocal imitation than controls. In the autistic group, facial expression recognition and induced facial-vocal imitation were significantly enhanced in slow conditions. Findings may give new perspectives for understanding and intervention for verbal and emotional perceptive and communicative impairments in autistic populations.

Background: Boxing programs designed specifically for people with Parkinson's disease (PD) can be beneficial in improving the physical, mental, and functional health of persons with PD. Purpose: This study examined the effect of a boxing program, Rock Steady Boxing (RSB), on the health of people with PD from both the boxers' and their caregivers' perspectives as well as evaluated balance, quality of life (QoL), and depressive symptoms after 12 weeks of RSB. Methods: A mixed methods, one-group experimental design with focus groups were embedded within an intervention study. Six boxers completed baseline and 12-week postassessments. Results: The majority of boxers maintained or improved scores for balance, QoL, and reduced depressive symptoms. Findings indicate physical and mental benefits of RSB among persons with PD and this was further validated by qualitative data from boxers and caregivers, along with quantitative data of boxers. Caregivers and boxers reported that boxers' ability to perform activities of daily living (ADLs) improved and is supported by quantitative improvements in the Parkinson's disease Questionnaire-39 ADL subscale. All boxers reported reduced stigma, and caregivers and boxers valued the opportunity to work out in an environment free of stigma, a finding not previously reported. Conclusions: It is important for nurse practitioners to recognize exercise benefits for people with PD and recommend the program to patients and include caregivers in their overall assessment of health and wellness. Implications for practice: Nurse practitioners and other health practitioners may consider recommending a boxing program, such as RSB, for their PD patients as a sole or supplemental exercise program.

Date Presented 04/06/19 Adults with autism experience significant health disparities, including higher rates of chronic disease, less access to health services, and younger mortality rates. In this research project, we used qualitative methods to interview adults with autism, their caregivers, and their healthcare providers to develop an understanding of why these health disparities occur and to guide future intervention work. Primary Author and Speaker: Jaclyn Schwartz Contributing Authors: Jeanette Alam, Elena Cotayo, Sofia Espinosa, Dominique Grossman, Patricia Herdocia, Veronica Hernandez, Berline Lherisson, Karen Lopez, Jennifer Mejia, Cati Rodriguez, Melissa Rodriguez, Jessica Torres

Introduction: Hispanic/Latino lung cancer patients typically present at a more advanced stage and are less likely to undergo surgical resection. Prior studies have identified multiple barriers for seeking diagnostic work-up though few studies have focused on difficulties encountered in navigating the health care system. Our study aim was to identify obstacles experienced by Hispanic/Latino patients in accessing timely lung cancer care, as well as the strategies employed to overcome these obstacles. Methods: We conducted semi-structured individual interviews with Hispanic/Latino patients diagnosed with lung cancer to explore their comfort with health care professionals, perceptions about barriers to care, and the process by which they made treatment-related decisions. We analyzed the data through thematic text analysis. Four coders independently summarized the data for conceptual themes focusing on challenges overcome in accessing care, and solutions to address these barriers. The coders then met to reach consensus on overall themes describing perceived difficulties in access to care and strategies used to surmount such barriers. Results: Participants were 24 Stage I-IV Hispanic/Latino lung cancer patients (79% female, ages 20-87, M=63 years), treated at a tertiary cancer center, equally divided as primary English and Spanish speakers. As expected, they reported experiencing multiple patient-, provider-, and health care system-level barriers to cancer care. Patient-level barriers included difficulties understanding providers' recommendations, comprehending medical jargon, lack of knowledge about lung cancer treatment options, emotional distress, and being overwhelmed which led to denial of diagnosis and confusion about treatment options. Provider-level barriers included providers overlooking symptoms, and lack of detailed explanation about lung cancer symptoms, disease course, and treatment options. Health care system level-barriers included fragmentation with lack of continuity of care, variable primary care provider (PCP)-patient relationships, use of numerous primary care facilities resulting in gaps in medical history and current health status, disagreement among providers about optimal treatment, and PCPs' referrals to multiple specialists, all leading to delayed diagnosis and access to treatment. Strategies devised to address barriers to care included: using family members as patient advocates and cultural brokers to help patients access providers, navigate the health care system, schedule appointments, determine the best treatment course, and translate physician discussions; and being assertive to pursue more responsive providers and specialized cancer treating facilities, seeking second opinions, asking providers to clarify treatment options and explain medical jargon, independently researching effective treatments, and finding creative solutions to finance care. Surprisingly, ability to pay for care was rarely perceived as being an obstacle for accessing cancer care. No significant differences were found between primary Spanish and English-speaking participants regarding barriers to care and solution strategies. Conclusions: Hispanic/Latino lung cancer patients identified successful strategies in overcoming barriers to accessing specialized cancer care. Future studies on improving the cultural competence and communication skills of the healthcare workforce, involving family caregivers, and patient navigation are warranted. Citation Format: William Alago, Elyse Shuk, Ana-Motta Moss, George Brandon, Abraham Aragones, Idalid Franco, Roberto Valentin, Mutiat A. Akinsemoyin, Melissa Rodriguez, Hector Velez, Tyler Barretto, Uriel Castaneda, Jamie Ostroff. Hispanic/Latino lung cancer patients overcoming barriers for accessing cancer care: A qualitative study. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C47. doi:10.1158/1538-7755.DISP13-C47

Purpose Adults with autism spectrum disorder (ASD) experience significant health-care disparities across physical and mental health domains resulting in poorer health and quality of life. Poor transitions to adult care negatively impact the health of adults with ASD. Current research focuses on personal factors in research samples that lack diversity. The purpose of this study is to examine the lived health-care experiences of geographically and ethnically diverse young adults with ASD in adult care settings in the USA to understand provider and system-level factors affecting their health. Design/methodology/approach Nine caregivers of young adults with ASD participated in key informant interviews describing their experiences in navigating the health-care system. Data were analyzed using a grounded theory approach. Findings The data indicated that limited quantity of services, poor quality of services, and high cost of services had a negative effect on the health of adults with ASD. Issues cascaded to become more complex. Practical implications Practical implications for payors, providers, persons with ASD and their families are discussed in this paper. Originality/value To the best of the authors’ knowledge, this study answers the call to better understand system-level factors affecting the health of geographically and ethnically diverse people with ASD.