Medicine and Health Sciences Commons^™

Korelasi Antara Kadar Matriks Metalloproteinase 9, Laju Endap Darah, Faktor Reumatoid, Dan Lama Sakit Dengan Gambaran Radiologis Pada Pasien Artritis Reumatoid, Giri Aji, Sumariyono Sumariyono, Kahar Kusumawidjaja, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

Pendahuluan. Artritis Reumatoid (AR) merupakan penyakit autoimun dengan etiologi yang belum jelas, gejala utama dari AR adalah keradangan pada sendi yang ditandai dengan sinovitis simetris dan erosi tulang, walaupun perjalanan penyakit AR sulit diduga dengan sifat kronik-remisi-eksaserbasi namun secara umum hasil akhir dari AR adalah deformitas sendi. Penelitian terakhir pada AR menunjukkan adanya overekspresi dari sejumlah enzim matrix metallopeoteinases (MMPs) yang mempunyai kemampuan degradasi komponen kolagen dam matriks ekstraseluler tulang rawan Beberapa penelitian menemukan keterlibatan MMP-2, MMP-9, MMP-1 ,MMP-8 dan MMP-3 pada penyakit AR. Penelitian di Taiwan oleh Chang Yh menunjukkan peningkatan kadar aktivitas MMP-9 pada pasien AR di …

Gambaran Endoskopi Saluran Cerna Bagian Atas Pada Pasien Dispepsia Usia Lanjut Di Rumah Sakit Cipto Mangunkusumo, Hendra Agustian, Dadang Makmun, Czeresna H. Soejono

Jurnal Penyakit Dalam Indonesia

Pendahuluan. Salah satu masalah kesehatan yang sering terjadi pada pasien usia lanjut adalah gangguan saluran cerna bagian atas. Pada pasien usia lanjut dapat terjadi perubahan di lambung akibat proses penuaan antara lain perubahan integritas mukosa (berkurangnya kadar prostaglandin mukosa, integritas vaskuler menurun, dan penurunan aktivitas anti radikal bebas). Tindakan endoskopi merupakan tindakan yang relatif aman pada usia lanjut untuk menegakkan diagnosis saluran cerna bagian atas. Pemeriksaan endoskopi lebih awal sangat penting dilakukan untuk dapat mencegah penyulit yang mungkin terjadi akibat penyakit pada saluran cerna. Penelitian ini bertujuan untuk mengetahui karakteristik pasien dispepsia usia lanjut yang telah dilakukan pemeriksaan endoskopi saluran …

Probabilitas Temuan Kanker Kolorektal Pada Pasien Simtomatik Berdasarkan Unsur-Unsur Asia Pacific Colorectal Screening (Apcs), Muhammad Yamin Lubis, Murdani Abdullah, Irsan Hasan, Suhendro Suwarto

Jurnal Penyakit Dalam Indonesia

Pendahuluan. Kanker Kolorektal (KKR) masih menjadi masalah besar di dunia pada umumnya dan di Indonesia pada khususnya. Kolonoskopi dapat melihat lesi di kolon tetapi biayanya mahal bila dilakukan pada semua pasien asimtomatik. Memakai komponen unsur-unsur Asia Pacific Colorectal Screening (APCS) dapat memprediksi KKR pada pasien simtomatik sehingga kolonoskopi hanya merupakan modalitas untuk menstratifikasi KKR. Penelitian ini bertujuan untuk mengetahui probabilitas kanker kolorektal menggunakan unsur-unsur APCS pada penderita simtomatik.

Metode. Penelitian kasus-kontrol retrospektif dilakukan di RS Cipto Mangunkusumo Jakarta, sejak bulan Februari 2014 hingga Mei 2014. Data dikumpulkan dari catatan rekam medis pasien di RSCM. Kelompok kasus adalah subjek …

Diagnosis Dan Tata Laksana Paroksismal Nokturnal Hemoglobinuria, Laurentius A. Pramono, Birry Karim, Marha Iskandar, Asnawi Yanto

Jurnal Penyakit Dalam Indonesia

Paroksismal nokturnal hemoglobinuria (PNH) merupakan kelainan darah yang sangat jarang. Penegakan diagnosis PNH cukup panjang, mulai darianamnesis, pemeriksaan fisik, serta pemeriksaan laboratorium (darah dan urin) dimulai dari yang sederhana sampai lanjutan. Penyelidikan ini tidak saja memerlukan perencanaan klinis yang matang, melainkan juga waktu dan tenaga yang banyak, serta biaya yang mahal. Selain itu, sampai saat ini, pilihan pengobatan untuk PNH masih sangat terbatas, dengan keberhasilan yang belum memuaskan sepenuhnya. Berikut kami laporkan sebuah kasus PNH pada seorang perempuan 18 tahun.

Peran Procalcitonin Sebagai Penanda Inflamasi Sistemik Pada Sepsis, Dana Dharaniyadewi, Khie Chen Lie, Suhendro Suwarto

Jurnal Penyakit Dalam Indonesia

Terapi antibiotika awal dan tepat merupakan faktor yang penting untuk kesintasan pasien sehingga diperlukan pemeriksaan yang cepat dan akurat untuk deteksi adanya bakteri di sirkulasi. PCT merupakan biomarker yang paling sering dipelajari dan rutin digunakan dalam praktik klinik dan rekomendasi saat ini di beberapa negara. Kadar PCT serum meningkat pada sepsis. Kadar PCT normal di bawah 0,5 ng/mL dan kadar PCT > 2 ng/mL memiliki risiko tinggi untuk sepsis. PCT lebih unggul daripada CRP untuk diagnosis dan prognosis sepsis pada pasien kritis tetapi penggunaannya harus tetap diiringi dengan penilaian secara klinis. Hal ini terutama penting pada awal infeksi atau pasien dengan …

Kelengkapan Resume Medis Dan Kesesuaian Penulisan Diagnosis Berdasarkan Icd-10 Sebelum Dan Sesudah Jkn Di Rsu Bahteramas, Fera Retno Mangentang

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Medical resume is the summary of the whole medical treatment and care provided by medical doctor to patient. Completeness of medical resume is the reflection of the quality of medical record and serives provided by hospital. Diagnostic must be completely written in accordance with ICD-10. This research used mix method, with cross sectional quantitative method to find out the relation between the characteristic of medical doctor with the completeness of the medical resume and compliance with the diagnostic guidelines based on ICD-10. Result of the research proved that there is a relation between the characteristic of medical doctor with the …

Analisis Konsep Lean Thinking Pelayanan Laboratorium Pada Pasien Ugd Rs Masmitra Bekasi, Relia Sari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Thesis describes the improvement of quality and laboratory services at. Masmitra Hospital through Lean method which aims to create value by reducing errors and waiting time. This study is a qualitative analytical research method by observation, interviews and data analysis to analyze the flow process of laboratory services for ER patients. The results showed that laboratory services at Masmitra Hospital still found delays which is prooven on the Current State Value Stream Map where 39% of the activities are non-value - added and 7 types of waste as well as through the aplication of Lean Tools has created improvement ideas …

Unraveling The Mysteries Of The Mitochondria In Huntington's Disease – And Getting Fast, Clear, And Useful Results From Research Studies, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

2014-2015 Department Of Biomedical Sciences Scholarly Activity Report, Quillen College Of Medicine, East Tennessee State University

Quillen College of Medicine Scholarly Activity Reports

No abstract provided.

Onset Time And Durability Of Huntingtin Suppression In Rhesus Putamen After Direct Infusion Of Antihuntingtin Sirna, Richard Grondin, Pei Ge, Qingmin Chen, Jessica E. Sutherland, Zhiming Zhang, Don M. Gash, David K. Stiles, Gregory R. Stewart, Dinah W. Y. Sah, William F. Kaemmerer

Neuroscience Faculty Publications

One possible treatment for Huntington's disease involves direct infusion of a small, interfering RNA (siRNA) designed to reduce huntingtin expression into brain tissue from a chronically implanted programmable pump. Here, we studied the suppression of huntingtin mRNA achievable with short infusion times, and investigated how long suppression may persist after infusion ceases. Rhesus monkeys received 3 days of infusion of Magnevist into the putamen to confirm catheter patency and fluid distribution. After a 1-week washout period, monkeys received radiolabeled siRNA targeting huntingtin. After 1 or 3 days of siRNA delivery, monkeys were either terminated, or their pumps were shut off …

Patients Recording Clinical Encounters: A Path To Empowerment? Assessment By Mixed Methods, Glyn Elwyn, Paul James Barr, Stuart W. Grande

Dartmouth Scholarship

Objective: To examine the motivations of patients recording clinical encounters, covertly or otherwise, and why some do not wish to record encounters. Design: Mixed-methods analysis of survey data and nested semistructured interviews. Setting: Survey to UK audience, using social media and radio broadcast. Participants: 168 survey respondents, of whom 161 were 18 years of age or older (130 completions). Of the 56 participants who agreed to be contacted, we included data from 17 interviews.

A Structural And Functional Comparison Between Infectious And Non-Infectious Autocatalytic Recombinant Prp Conformers, Geoffrey P. Noble, Daphne W. Wang, Daniel J. Walsh, Justin R. Barone, Michael B. Miller, Koren A. Nishina, Sheng Li, Surachai Supattapone

Dartmouth Scholarship

Infectious prions contain a self-propagating, misfolded conformer of the prion protein termed PrPSc. A critical prediction of the protein-only hypothesis is that autocatalytic PrPSc molecules should be infectious. However, some autocatalytic recombinant PrPSc molecules have low or undetectable levels of specific infectivity in bioassays, and the essential determinants of recombinant prion infectivity remain obscure. To identify structural and functional features specifically associated with infectivity, we compared the properties of two autocatalytic recombinant PrP conformers derived from the same original template, which differ by >105-fold in specific infectivity for wild-type mice. Structurally, hydrogen/deuterium exchange mass spectrometry (DXMS) studies revealed that solvent …

Faktor-Faktor Yang Mempengaruhi Keberhasilan Terapi Antibiotik Empirik Pada Pasien Sepsis Berat Dan Syok Sepsis Di Bangsal Rawat Inap Penyakit Dalam Rumah Sakit Cipto Mangunkusumo, Sudirman Katu, Suhendro Suwarto, Herdiman T. Pohan, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

Pendahuluan. Salah satu faktor utama yang berperan pada keberhasilan terapi pada pasien sepsis berat dan syok sepsis adalah penggunaan antibiotika empirik yang adekuat. Penelitian ini ditujukan untuk mengetahui faktor utama apa yang paling berpengaruh terhadap keberhasilan pengobatan antibiotika empirik pada pasien sepsis berat dan syok sepsis.

Metode. Studi kohort retrospektif dengan subjek dari data rekam medik (RM) pasien yang telah di rawat inap di ruang ICU dan perawatan Penyakit dalam RSCM Jakarta antara bulan Januari 2011 - Juni 2012. Kriteria inklusi adalah semua data RM pasien dewasa dengan sepsis, sepsis berat dan syok sepsis yang di rawat di …

Treatment For Inclusion Body Myositis, Michael R. Rose, Katherine Jones, Kevin Leong, Maggie C. Walter, James Miller, Marinos Dalakas, Ruth Brassington, Robert Griggs

Department of Neurology Faculty Papers

Background Inclusion body myositis (IBM) is a late-onset inflammatory muscle disease (myopathy) associated with progressive proximal and distal limb muscle atrophy and weakness. Treatment options have attempted to target inflammatory and atrophic features of this condition (for example with immunosuppressive and immunomodulating drugs, anabolic steroids, and antioxidant treatments), although as yet there is no known effective treatment for reversing or minimising the progression of inclusion body myositis. In this review we have considered the benefits, adverse effects, and costs of treatment in targeting cardinal effects of the condition, namely muscle atrophy, weakness, and functional impairment. Objectives To assess the effects …

Mobas: Identification Of Disease-Associated Protein Subnetworks Using Modularity-Based Scoring, Marzieh Ayati, Sinan Erten, Mark R. Chance, Mehmet Koyutürk

Faculty Scholarship

Network-based analyses are commonly used as powerful tools to interpret the findings of genome-wide association studies (GWAS) in a functional context. In particular, identification of disease-associated functional modules, i.e., highly connected protein-protein interaction (PPI) subnetworks with high aggregate disease association, are shown to be promising in uncovering the functional relationships among genes and proteins associated with diseases. An important issue in this regard is the scoring of subnetworks by integrating two quantities: disease association of individual gene products and network connectivity among proteins. Current scoring schemes either disregard the level of connectivity and focus on the aggregate disease association of …

Novel Cross Talk Between Igf-Ir And Ddr1 Regulates Igf-Ir Trafficking, Signaling And Biological Responses., Roberta Malaguarnera, Maria Luisa Nicolosi, Antonella Sacco, Alaide Morcavallo, Veronica Vella, Concetta Voci, Michela Spatuzza, Shi-Qiong Xu, Renato V Iozzo, Riccardo Vigneri, Andrea Morrione, Antonino Belfiore

Kimmel Cancer Center Faculty Papers

The insulin-like growth factor-I receptor (IGF-IR), plays a key role in regulating mammalian development and growth, and is frequently deregulated in cancer contributing to tumor initiation and progression. Discoidin domain receptor 1 (DDR1), a collagen receptor tyrosine-kinase, is as well frequently overexpressed in cancer and implicated in cancer progression. Thus, we investigated whether a functional cross-talk between the IGF-IR and DDR1 exists and plays any role in cancer progression.Using human breast cancer cells we found that DDR1 constitutively associated with the IGF-IR. However, this interaction was enhanced by IGF-I stimulation, which promoted rapid DDR1 tyrosine-phosphorylation and co-internalization with the IGF-IR. …

Public Health, Universal Health Coverage, And Sustainable Development Goals: Can They Coexist?, Harald Schmidt, Lawrence O. Gostin, Ezekiel Emanuel

Georgetown Law Faculty Publications and Other Works

In her 2012 reconfirmation speech as WHO Director-General, Dr. Margaret Chan asserted: "universal coverage is the single most powerful concept that public health has to offer. It is our ticket to greater efficiency and better quality. It is our savior from the crushing weight of chronic noncommunicable diseases that now engulf the globe ". The UN General Assembly is currently considering proposals for Sustainable Development Goals (SDGs), succeeding the Millennium Development Goals. SDGs, focusing on health, specifically includes universal health coverage (UHC) among its targets. Unquestionably, UHC is timely and fundamentally important. However, its promotion also entails substantial risks. A …

Tooth Retrospective Dosimetry Using Electron Paramagnetic Resonance: Influence Of Irradiated Dental Composites, Céline M. Desmet, Andrej Djurkin, Ana Maria Dos Santos-Goncalvez, Ruhong Dong, Maciej M. Kmiec, Kyo Kobayashi, Kevin Rychert, Sébastien Beun, Julian G. Leprince, Gaëtane Leloup, Philippe Levêque, Bernard Gallez

Dartmouth Scholarship

In the aftermath of a major radiological accident, the medical management of overexposed individuals will rely on the determination of the dose of ionizing radiations absorbed by the victims. Because people in the general population do not possess conventional dosimeters, after the fact dose reconstruction methods are needed. Free radicals are induced by radiations in the tooth enamel of victims, in direct proportion to dose, and can be quantified using Electron Paramagnetic Resonance (EPR) spectrometry, a technique that was demonstrated to be very appropriate for mass triage. The presence of dimethacrylate based restorations on teeth can interfere with the dosimetric …

Analisis Biaya Satuan Dan Kualitas Hidup Penderita Gagal Ginjal Kronik Yang Menggunakan Tindakan Hemodialisis Di Rumah Sakit Tebet Tahun 2015, Anggun Nabila

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The research aims to describe unit cost of hemodialysis and quality of life of Chronic Kidney Disease patients who use hemodialysis as a therapy at Tebet Hospital in 2015. Unit cost is calculated based on hospital perspective. Developing questioner of quality of life of Chronic Kidney Disease (CKD) patients (Dialysis Health Related Quality of Life) and clinical pathway of hemodialysis. Dialysis Health Related Quality of Life has 13 dimensions (sense of taste, sleep disorders, mobility, fatigue, anxiety, emotional, pain, self-care, daily activities (working, shopping, study, travelling, etc), communication, social interaction, being isolated, the burdens of others), measuring utility and time …

Selective Impact Of Cdk4/6 Suppression On Patient-Derived Models Of Pancreatic Cancer., Agnieszka K Witkiewicz, Nicholas A Borja, Jorge Franco, Jonathan Brody, Md, Charles Yeo, John Mansour, Michael A Choti, Peter Mccue, Erik S Knudsen

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Pancreatic ductal adenocarcinoma (PDA) harbors an exceedingly poor prognosis, and is generally considered a therapy-recalcitrant disease due to poor response to conventional chemotherapy coupled with non-actionable genetic drivers (e.g. KRAS mutations). However, PDA frequently loses p16ink4a, thereby leading to deregulation of CDK4/6. Surprisingly, in established cell models and xenografts, CDK4/6 inhibition has a modest effect on proliferation and resistance develops rapidly. To determine if such weak response was an intrinsic feature of PDA, we developed primary tumor explants that maintain the tumor environment and recapitulate feuture of primary PDA. The CDK4/6 inhibitor PD-0332991 was highly efficient at suppressing proliferation in …

Pengaruh Kepemimpinan Manajemen Rumah Sakit Dalam Iklim Keselamatan Pasien Di Rumah Sakit Sentra Medika Cibinong Tahun 2013, Regina Angelia Suwignjo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Transformational leadership as one of leadership style become the most important factor to build a patient safety culture in hospital environment and ensure the program will run succesfully to promote patient safety hospital services. The transformational leadership style indicator is intellectual stimulation, inspirational motivation, idealized influence, and individual consideration. Indicator of patient safety climate is management commitment, employee empowerment, reporting system, reward system and organizational identity. The aim of the study was to obtain every leadership factor that affect patient safety climate and which one is the most prominent leadership factor that influenced the patient safety climate in Sentra Medika …

Analisis Sistem Penyelenggaraan Rekam Medis Di Instalasi Rekam Medis Rs “X” Tangerang Periode April-Mei 2015, Novita Nuraini

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aims to analyze the medical records implementation system (input, process, output, feedback and control) in the "X" Hospital Tangerang period from April to May 2015. This research is a mixed method. The data collected by observation, interview, documentation. Results: The medical record system implementation was not running optimally so this is due to produce output completeness of medical record file is only 55.2%, while the timeliness of the provision of medical record file is only 31%. This relates to the control and the process does not complete the analysis of the file. Suggestion: Hospital activate Control Committee of …

Analisis Implementasi Kebijakan Dokter Spesialis Jaga On Site Di Instalasi Gawat Darurat Rumah Sakit Dr. Mohammad Hoesin Palembang, Kms Anhar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Since the introduction of the National Health Insurance Program January 1, 2014 has been an increase in patients visit to hospital-government hospitals. Emergency Department (ED) Hospital is a unit leader in the provision of hospital services. The increasing amount of patients visit especially in dr. Moh. Hoesin Palembang (RSMH) raises complex issues which experienced by other hospitals both at world, national and regional. Although the problems in the ED is complex they still expected to provide a certifiable quality service in accordance with the Decree of the Minister of Health no. 856 in 2009 about ED service standards. The problems …

Analisis Budaya Organisasi Dan Budaya Keselamatan Pasien Sebagai Langkah Pengembangan Keselamatan Pasien Di Rsia Budi Kemuliaan Tahun 2014, Afrisya Iriviranty

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Establishing patient safety culture is the first step in patient safety improvement.Therefore we need an assessment of patient safety culture in hospitals. Patient safety culture is part of the organizational culture, so that the study of organizational culture needed to be a guidance in developing patient safety. The aims of this study is to determine the patient safety culture among clinical staff in RSIA Budi Kemuliaan and identify organizational culture profiles. This study is descriptive with qualitative interpretation and analysis. It was found that teamwork within the unit is the strongest dimension of patient safety culture. While staffing and non-punitive …

Obstetrician-Gynecologists’ Knowledge Of Health Disparities And Barriers Among American Indian/Alaska Native Women In Washington State, Katherine M. Jones, Greta B. Raglan, Sophia M. Lannon, Jay Schulkin

Journal of Health Disparities Research and Practice

Background: Health disparities between American Indian/Alaska Native (AI/AN) women and other races/ethnicities have long been noted. Obstetricians-Gynecologists (Ob-Gyn) play a significant role in well-woman care and are often the first and most frequent point of medical contact for women, particularly among minority and low-income women.

Objective: This study aimed to assess Ob-Gyns’ knowledge, beliefs, and practices related to health disparities among AI/AN women.

Method: A self-administered questionnaire, consisting of questions about knowledge, beliefs, and practices of health disparities among AI/AN women, was mailed to 722 members of The American College of Obstetricians and Gynecologists (ACOG) practicing in the state of …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Journal of Health Disparities Research and Practice

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Factors Influencing Hpv Vaccine Use Among Racially Diverse Female College Students, Timmerie F. Cohen, Jeffrey Legg

Journal of Health Disparities Research and Practice

Abstract

Objective. This study describes Human Papillomavirus (HPV) vaccination rates and possible factors influencing vaccination utilization rates in a diverse population of college women 18-26 years old.

Methods. The National College Health Assessment survey provided a large diverse sample size (N=67,762) in which to perform descriptive and binary logistic regression analysis. Demographic characteristics were analyzed as potential barriers to HPV vaccination. Additionally, lack of certain health behaviors were explored as potential barriers to HPV vaccination.

Results. In this study, White/non-Hispanic women had a higher HPV vaccination rate when compared to minority women. Binary regression analysis demonstrated that minority …

Modeling Bmi, Dietary Habits, And Physical Activity Among Ethnically Diverse Urban College Students, Hollie Jones, Nicholas Freudenberg, Lorraine Mongiello

Journal of Health Disparities Research and Practice

Objectives The objective of this research study was to examine the relationship between BMI, physical activity, dietary habits, and student demographic factors (age, ethnicity, income, immigration, and sex). Given the association between overweight and obesity and the inequitable burden of chronic health conditions among ethnic minority populations, a deeper understanding of the socioeconomic, gender, age, and racial/ethnic variation in BMI, physical activity, and dietary habits is needed. The shifting demographics of urban college populations make urban college campuses an important setting for addressing the lifetime health needs of ethnically diverse urban populations.

Methods In this cross-sectional non-experimental study, we used …

Addressing Disparities In Access To Information For Hispanic Families Of Children With Special Health Care Needs, Suzanne M. Bronheim, Sandra Soto, Bruno J. Anthony

Journal of Health Disparities Research and Practice

Objectives: Utilizing a diffusion of innovation (DOI) framework, the study seeks to increase access to information for Hispanic families of children with special health care needs (SHCN) by increasing their use of Family-to-family Centers (F2Fs) in their states. Methods: Focus groups were implemented of both English-speaking and Spanish-speaking Hispanic families in two states with a confirming Delphi procedure exploring factors within DOI framework related to using F2Fs and the nature of current family communication networks. Results: Families seeking information at key change points turn to formal sources, although Spanish-speaking families, noted that due to language barriers, they also turned to …

Personal, Family, And Peer Correlates Of General And Sport Physical Activity Among African American, Latino, And White Girls, Susan C. Duncan, Lisa A. Strycker, Nigel R. Chaumeton

Journal of Health Disparities Research and Practice

This study examined associations between personal, family, and peer variables on objectively measured physical activity (PA), and sports participation, of African American, Latino, and white girls. Specific variables included barriers efficacy, parent PA, parent support of PA, the home exercise environment, friends’ PA, and friends’ support of PA. The sample comprised 372 girls (mean age = 12.03 years; SD = 1.81; n = 128 African American, n = 120 Latino, and n = 124 white). Data were analyzed using multiple-sample structural equation models (by ethnicity), controlling for age, household income, body mass index, and physical development. Girls’ moderate to vigorous …