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Purpose: Sexuality education is essential for children and adolescents to make better choices regarding their sexual well‐being. Parents, teachers, and healthcare providers are not always comfortable talking to school‐age children about sex, making sexuality education a concept of interest to be explored. The purpose of this paper is to explain the concept of sexuality education in school‐aged children and adolescents. Design and Methods: This paper uses Walker and Avant's concept analysis to help clarify its meaning. The sexuality education concept is explored in this article in the views of educating school systems K‐12 with three types of sexuality education (abstinence‐only, abstinence‐plus, and comprehensive sexuality education). Literature from 1990 to 2023 was retrieved using PubMed, Google Scholar, and CINAHL. Results: A model case is used to demonstrate the importance of sexuality education. A borderline case and a related case are proposed to explain other uses of the concept. Defining attributes, antecedents, consequences, and empirical referents are explored. Antecedents of sexuality education are grouped into three categories: resources, political environment, and social beliefs. Practice Implications: A conceptual understanding of sexuality education can foster nurses' confidence in talking to their patients about this topic and encourage nurses to advocate for comprehensive sexuality education nationwide. [ABSTRACT FROM AUTHOR]

Background: In the US, over 50% of suicide deaths are by firearm injury. Studies have found that limiting access to firearms, including storing them temporarily outside of the home or locking and unloading them securely at home, helps prevent suicide. Family members and other loved ones are in a unique position to encourage secure firearm storage. This paper describes the development of a workshop to empower loved ones of individuals at risk for suicide to discuss secure firearm storage in New York State. Methods: Using a multistakeholder engagement framework, we partnered with New York State county-level suicide prevention coalitions, local firearms experts, and other stakeholders to develop a 90-min workshop addressing secure firearm storage for suicide prevention. Pilot workshops were co-facilitated by a suicide prevention coalition member and a local firearms expert. Feedback gathered via surveys from workshop attendees and interviews with workshop co-facilitators were used to revise workshop content and inform dissemination. Following pilot workshops, a 1-day training event was held for potential future facilitators, and survey data were collected to assess trainee experiences and interest in facilitating future workshops. Data analysis included rapid qualitative analysis of interviews and statistical analysis of survey responses about acceptability of workshop. Results: Four pilot workshops included a total of 23 attendees. Pilot workshop attendees endorsed willingness and confidence to discuss secure firearm storage with a family member or loved one. The training event included 42 attendees, of which 26 indicated interest in facilitating a workshop within the next year. Co-facilitators agreed on several key themes, including the importance of having a "trusted messenger" deliver the firearms portion of the workshop, keeping the conversation focused on firearm safety for suicide prevention, and developing interventions that reflect firearm owning community's culture. Conclusions: Consistent with a public health approach to suicide prevention, this study leveraged a multistakeholder engagement framework to develop a community-based workshop empowering loved ones of individuals at risk for suicide to discuss secure firearm storage. The workshop will be disseminated across New York State. We noted positive and collaborative relationships across stakeholder groups, and willingness to facilitate the workshop among both suicide prevention and firearm stakeholders. [ABSTRACT FROM AUTHOR]

Background: The Hearing Voices Approach, a community-based peer-led support group model, is generating interest as a novel way to engage with psychosis. Hearing Voices (HV) groups are run by peers, 'experts-by-experience', and emphasize group ownership and community-building rather than adherence to a therapist-led, predetermined structure. Diverse beliefs about experiences are respected and viewed as potentially meaningful. Groups work within each individual's explanatory framework to reframe understandings. Aims: This paper describes the effects of participation in Veteran Voices and Visions (VVV) groups, an adaptation of the HV approach, co-led by clinicians and Veteran peer support specialists, adapted for Veterans who have experienced psychosis and receive care at the VA, a large public health system in the United States. Method: This mixed methods pilot study has a convergent parallel design, integrating quantitative and qualitative data from participants in pre-intervention and post-intervention assessments. Results: Over 16 weeks, quantitative analysis showed a statistically significant reduction in distress, due to auditory hallucinations, as measured by the Psychotic Symptom Rating Scales (PSYRATS). The Beliefs about Voices Questionnaire- Revised (BAVQ-R) results showed a reduction in malevolence and omnipotence and an increase in benevolence related to auditory hallucinations, but no change in resistance. Engagement showed a trend-level reduction. Qualitative data from midpoint (Week 8) and endpoint (Week 16) interviews revealed several perceived benefits from groups: 1) normalization and camaraderie, 2) increased hope and confidence, 3) self-understanding and reframing of experiences, and 4) building relationships outside of groups. Overall, VVV groups reduced distress due to voices, negative beliefs about voices, and perceived power of voices. Conclusions: Study findings contribute to a growing body of literature indicating HV groups support those who have experienced psychosis by reducing social isolation and fostering community, which may facilitate social integration. Overall, our findings highlight the potential benefits of adapting HV groups to health systems. [ABSTRACT FROM AUTHOR]

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has uncovered public health vulnerabilities worldwide, particularly in the hard-hit USA. US public health professionals, regardless of role, may need to exercise leadership in both planned and unexpected situations. This model of practice outside of traditional roles, known as Public Health 3.0, requires adaptive leadership – a systems approach to making progress on complex challenges. Educational programs should improve students' adaptive leadership competency to prepare them for the public health workforce. This paper aims to provide an educational framework for implementing adaptive leadership instruction for undergraduate students. Design/methodology/approach: This paper used experiential and traditional instructional strategies and adaptive leadership competencies to develop a semester-length leadership course for undergraduate students in health, nursing, social science, business and education. Adaptive leadership principles were learned and practiced, preparing students for systemic challenges through the lens of Public Health 3.0. Competencies were assessed pre- and post-semester. Findings: Of 248 students, 72% were health professions majors. Students reported pre-post scores on 29 measures of competency, interest, learning and behavioral change. Quantitative evaluations identified statistically significant improvement in all domains. Additional quantitative feedback indicated improvement on the three Kirkpatrick levels of evaluation assessed (reaction, learning and behavior). Originality/value: Tiered evaluation methods indicated that this leadership course enhanced participants' self-reported adaptive leadership learning and competency, as well as intention and ability to translate learning into practice. A broad spectrum of competency development is needed for students entering practice in the Public Health 3.0 era, particularly related to pandemic response. [ABSTRACT FROM AUTHOR]

Background and Objectives Evidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training in Assisted Living Residences (STAR)-VA, an intervention to manage DBD in VA nursing home settings, or Community Living Centers (CLCs). This paper summarizes multiyear formative evaluation results including challenges, adaptations, and lessons learned to support sustained integration into usual care across CLCs nationwide. Research Design and Methods STAR was selected as an evidence-based practice for DBD, adapted for and piloted in VA (STAR-VA), and implemented through a train-the-trainer program from 2013 to 2018. Training and consultation were provided to 92 CLC teams. Evaluation before and after training and consultation included descriptive statistics of measures of clinical impact and survey feedback from site teams regarding self-confidence, engagement, resource quality, and content analysis of implementation facilitators and challenges. Results STAR-VA training and consultation increased staff confidence and resulted in significant decreases in DBD, depression, anxiety, and agitation for Veterans engaged in the intervention. Implementation outcomes demonstrated feasibility and identified facilitators and barriers. Key findings were interpreted using implementation frameworks and informed subsequent modifications to sustain implementation. Discussion and Implications STAR-VA successfully prepared teams to manage DBD and resulted in improved outcomes. Lessons learned include importance of behavioral health–nursing partnerships, continuous engagement, iterative feedback and adaptations, and sustainment planning. Evaluation of sustainment factors has informed selection of implementation strategies to address sustainment barriers. Lessons learned have implications for integrating team-based practices into system-level practice. [ABSTRACT FROM AUTHOR]

Background: Providing students with worked out problem solutions is a beneficial instructional technique in STEM disciplines, and studying examples that have been worked out incorrectly may be especially helpful for reducing misconceptions in students with low prior content knowledge. However, past results are inconclusive and the effects of incorrect worked examples alone or in combination with correct examples remains unclear. Objectives: We aim to address whether studying incorrect examples alone or in combination with correct examples can support the reduction of students' fraction misconceptions, operationalized as errors made with high confidence. Methods: After incorrectly solving a sampling problem, 130 students in 4th through 11th grade in the U.S. were randomly assigned to a condition in an online problem set focused on fraction equivalence. Students studied either single‐type worked examples (i.e., correct or incorrect; n = 49) or combination‐type worked examples (correct and incorrect; n = 41) or engaged in a problem‐solving control (n = 50). Results: Studying a combination of correct and incorrect worked examples was as effective as the problem‐solving control with feedback at improving fraction equivalence knowledge and reducing the rate of high‐confidence errors. Students in both the combination condition and the problem‐solving with feedback condition outperformed those who studied either correct or incorrect worked examples alone. Conclusions: Results support the inclusion of a combination of correct and incorrect worked examples when teaching students with low prior content knowledge. Studying a combination of example types within an online tutor helps to reduce misconceptions about fractions, a topic students commonly struggle with. A problem‐solving task with corrective feedback worked equally well. Lay Description: What is already known about this topic: Studying worked examples of mathematical solutions improves student learning.Incorrect examples, either alone or in combination with correct examples, are particularly effective for improving learning for students with low prior knowledge in the target content.Comparing correct and incorrect examples is also effective at improving problem‐solving but this effect may be specific to those with high prior knowledge.Still unknown are the impacts of these different combinations of examples on misconceptions in particular. What this paper adds: We show that studying a combination of correct and incorrect examples reduces math misconceptions.Problem‐solving with corrective feedback within an online tutor also has this effect. Implications for practice and/or policy: Using a combination of example types will help reduce students' misconceptions about fractions. [ABSTRACT FROM AUTHOR]

Introduction: The National Maternal and Child Health Workforce Development Center provides training, coaching, and consultation to Title V programs. The flagship experience is the Cohort program, a 6-8-month leadership development program where Title V programs convene a multisector team to address a pre-selected state/jurisdictional challenge related to health systems transformation. The overall objective of this paper is to demonstrate the impact of skills developed via the Cohort program on state/jurisdictional capacities to address complex challenges. Methods: Qualitative, post-Cohort evaluation data were analyzed using inductive and deductive coding and the "Sort and Sift, Think and Shift" method. Themes and supporting text were summarized using episode profiles for each team and subsequently organized using the EvaluLEAD methodology for identifying and documenting impact. Results: Teams brought an array of challenges related to health systems transformation and 94% of teams reported achieving progress on their challenge six-months after the Cohort program. Teams described how the Cohort program improved workforce skills in strategic thinking, systems thinking, adaptive leadership, and communication. Teams also reported the Cohort program contributed to stronger partnerships, improved sustainability of their project, produced mindset shifts, and increased confidence. The Cohort program has also led to improved population health outcomes. Discussion: Through working with the Center, Title V leaders and their teams achieved episodic, developmental, and transformative results through application of Center tools and skills to complex challenges. Investment in the MCH workforce through skill development is critical for achieving transformative results and solving "wicked" public health problems. [ABSTRACT FROM AUTHOR]

The International Rescue Committee's Life Skills Tailored Package for Early Marriage focuses on engaged, married, and divorced Syrian refugee girls aged 13–18 living in Lebanon. This paper details findings from a qualitative program evaluation. In-depth interviews (IDIs) and focus group discussions (FGDs) explored participants' viewpoints about program components. IDIs engaged program staff and adolescent girls. FGDs included adolescent girls, husbands/fathers, and mothers/mothers-in-law. Data were audio-recorded, transcribed, and assessed using inductive content analysis. Three themes emerged: (1) engaging influencers with discretion facilitated girls' participation, (2) reaching out to vulnerable girls required foresight and flexibility, and (3) participation fostered development of personal resources and adaptive capacities among adolescent girls, who described improvements in self-confidence for decision-making/time management, reproductive health knowledge, emotional regulation/understanding of healthy relationships, and self-protection. Efforts to improve psychosocial and reproductive health of refugee adolescent girls experiencing child marriage should integrate lessons learned through this program. [ABSTRACT FROM AUTHOR]

Previous research has demonstrated that becoming vaccinated with the Coronavirus vaccine may lower mental distress. However, it remains uncertain whether this relationship holds amid concerns of vaccine side effects and doubts of the vaccine's protective capabilities. We presented three studies that showed how vaccine confidence negatively influences the relationship between vaccine uptake and mental distress. Using two‐way fixed effects regression models, Study 1 analyzes longitudinal survey of respondents from Los Angeles County in the US, while Study 2 uses the same analytical strategy but generalises findings by analysing longitudinal data of participants across all 50 US states. Main results of both studies show that (i) vaccination uptake is linked with reduced mental distress among individuals with high vaccine confidence (ii) vaccine uptake has no effect on mental distress among individuals with low vaccine confidence. Lastly, Study 3 applies multilevel analysis to a large‐scale pseudo‐panel study of 15 developed countries. Results for the third study corroborate finding (i) but not (ii) in that the multinational study finds that vaccine uptake is actually associated with higher mental distress among individuals with low vaccine confidence. In sum, our paper shows that the palliative effect of vaccination on mental health only exists when vaccine confidence is high. Results are mixed on whether vaccination affects mental distress when individual vaccine confidence is low. [ABSTRACT FROM AUTHOR]

Background: The sudden growth in online instruction due to COVID‐19 restrictions has given renewed urgency to questions about remote learning that have remained unresolved. Web‐based assessment software provides instructors an array of options for varying testing parameters, but the pedagogical impacts of some of these variations has yet to be examined. Objectives: The current study examines whether question order affects student performance on online college math assessments. Drawing on the literature of testing and math anxiety, we hypothesized that difficult questions near the beginning of an assessment would have a destructive effect on student confidence, which would in turn have a deleterious effect on their performance. Methods: We employed an observational 'big data' methodology, analysing 23,468 final exams completed by students in 10 different courses over eight semesters at a Math Emporium in a large technical university in the eastern United States. Students were freshmen and sophomores enrolled in non‐engineering math courses. We regressed the final score on the difficulty level of the first and second questions, controlling for several other factors. Results and Conclusions: We found that several factors—day of the week, amount of time before the deadline, number of minutes spent on the exam—have more of an impact on score than question order. This pattern was consistent across sexes. Takeaways: Our findings contradict some previous studies, which have found that difficult early questions degrade student performance, and that this affect is more pronounced in females. This work enriches our understanding of how students respond to online assessment. Lay Description: What is already known about this topic: Previous studies have had mixed results about the effect of question difficulty ordering on student performance.Furthermore, few studies have examined this issue for computer assessments. What this paper adds: We employ a novel methodology with a uniquely large data set.Our findings indicate that difficulty ordering has no effect on student performance. Implications for practice: Math instructors can use the random ordering feature of computer assessment generating tools because question order does not affect performance. [ABSTRACT FROM AUTHOR]

The article focuses on survey of several economists at top universities of the U.. to answer whether women at the top of their careers are less confident than men and why. It mentions measurement of confidence by the propensity to provide extreme judgments, and the self-reported confidence level; and also mentions how women are as confident as men when answering questions related to their primary field but less confident when asked a question outside of their primary field.

Background: Cultural competency is often promoted as a strategy to address health inequities; however, there is little evidence linking cultural competency with improved patient outcomes. This article describes the characteristics of recent educational interventions designed to improve cultural competency in healthcare workers for First Nations peoples of Australia, New Zealand, Canada and the USA. Methods: In total, 13 electronic databases and 14 websites for the period from January 2015 to May 2021 were searched. Information on the characteristics and methodological quality of included studies was extracted using standardised assessment tools. Results: Thirteen published evaluations were identified; 10 for Australian Aboriginal and Torres Strait Islander peoples. The main positive outcomes reported were improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. The methodological quality of evaluations and the reporting of methodological criteria were moderate. Conclusions: Cultural competency education programs can improve knowledge, attitudes and confidence of healthcare workers to improve the health of First Nations peoples. Providing culturally safe health care should be routine practice, particularly in places where there are concentrations of First Nations peoples, yet there is relatively little research in this area. There remains limited evidence of the effectiveness of cultural education programs alone on community or patient outcomes. Cultural competency is often promoted as a strategy to address health inequities, although evidence linking cultural competency to patient outcomes is scarce. We conducted a narrative review of the recent literature on cultural education programs and found 13 published evaluations, mainly reporting improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. Although cultural education has a positive short-term impact, none of the studies included measured improved patient health outcomes. [ABSTRACT FROM AUTHOR]

Mental health is one of the most pervasive health concerns in the refugee population due to the combined effects of traumatic experiences prior to migration and post-migration stressors related to resettlement. The objectives of this systematic search were to synthesize evidence on the effectiveness and identify gaps of mental health interventions on mental health outcomes for refugees resettled in the United States. This review search identified a combination of quasi-experimental (7 studies) and qualitative research studies (5 studies). Twelve papers, published between 2003-2017, evaluating twelve different interventions, were selected for review. Studies were conducted in a variety of refugee populations: Africans (8), Southeast Asians (2), Bhutanese (1), and multicultural (1). Interventions included groups/workshops (10) and individual counseling (2). The results from the mental health interventions showed increases in health confidence, health seeking behaviors, consistency with treatment course, English proficiency, quality of life, and level of enculturation. Results also showed decreases in depression and psychological distress. Also identified from this review were different methods for interventions including linguistic and ethnically-matched facilitators versus non-matched facilitators, as well as group interventions versus non-group interventions. These differences were identified in the review and discovered to be areas for further research as these items were not often addressed in the literature. [ABSTRACT FROM AUTHOR]

High annual turnover rates that plague child welfare agencies are costly and disrupt services. Numerous studies have focused on aspects of the workplace and the characteristics of child welfare workers that may be associated with leaving. Fewer studies have explored the types of worker supports that agencies can offer to encourage retention. This two-study paper utilized data from public child welfare caseworkers to examine predictors of self-reported intent to stay and its association with actually staying at the agency. Results of Study 1 indicated that that self-reported intent to stay was a key predictor of staying (as was number of years on the job). Results of Study 2 indicated that self-efficacy, peer support, supervision, and organizational supports were key predictors of intent to stay. Newer workers differed somewhat from more experienced workers, providing an opportunity for reflection on how agencies can best support staff during different phases of their career. [ABSTRACT FROM AUTHOR]

As the U.S. population becomes more racially diverse, physicians need to have cultural skills for optimal health outcomes; however, the literature is sparse for cultural skill application of medical trainees. This paper focuses on Family Medicine residents' perceptions of racial anxiety and their preparedness to manage cross-racial interactions. Of the 24 respondents, the majority were female. The ethnicities of respondents were 16 non-Hispanic White, five African American, and three Native American. Most participants demonstrated good general knowledge and/or self-efficacy on racial anxiety, but produced lower scores in workplace skills and actions related to racial anxiety. Thus, physician training programs should incorporate more skill development around racial anxiety. More research is needed to examine how medical schools approach multicultural education as a method of disrupting health disparities to reflect trends of social accountability and social justice. [ABSTRACT FROM AUTHOR]

Background: Nearly half of all college students do not engage in the recommended amount of physical activity which may contribute to chronic diseases such as obesity. Purpose: To investigate college students' use and perceptions of wearable fitness trackers (WFTs) and the impact on confidence and motivation for increasing physical activity. Reasons for non-use were also explored. Methods: 356 College students completed a 25 -item paper survey. Results: 22.5% reported using a WFT. Most wore their WFT either "every day without fail" or "most days" and half wore their WFT "all day and while sleeping". Analyses were significant for those reporting a high increase in physical activity and or a high increase in number of steps as being more likely to report a high motivation for physical activity. Discussion: Two reasons for use of WFT were weight loss and to track sleep. A common reason for non-use of WFT was cost. WFTs may help to increase motivation to engage in physical activity. Translation to Health Education Practice: When considering the use of WFTs, Health Educators would do well to identify affordable WFTs for use in interventions and be mindful of the barriers related to discontinuation of use. [ABSTRACT FROM AUTHOR]

Introduction. Applying computerized simulation education tool for learning in medical domains is widely used in many countries. This review is aimed at systematically investigating the computerized simulation tools developed to educate physiotherapy students and determine the effectiveness of these interventions. Methods. A comprehensive search was conducted in Medline (through PubMed) and Scopus databases from inception to Sept. 10, 2022. The studies that examined the effectiveness of computerized simulation-based interventions were included. Results. Sixteen studies were included in this systematic review. All included examinations were ranked "good" or "low risk of bias" based on the criteria utilized in the Joanna Briggs Institute (JBI) scale and the Effective Public Health Practice Project (EPHPP) tool. Most of the articles (43%) were conducted in the USA and 25% in Australia. In 43% of the total studies, the study population was only physiotherapy students, and in 12.5% of them, the scope of education was related to practical skills training. Three of the 16 reviewed articles presented positive qualitative results; thirteen quantitative investigations also declared statistically positive effects. Positive effects have been seen in areas such as improving professional and behavioral abilities, improving knowledge and self-confidence, and reducing stress. The sample size of the studies ranged from eight to 162 participants. The limited sample sizes in groups, lack of interaction, and short follow-up duration were the most consistent limitations evident within the included studies. Conclusion. Computerized simulation education approaches can help to improve physiotherapy students' skills and knowledge. They also have great potential to reduce learning costs and increase the quality of education. [ABSTRACT FROM AUTHOR]

Accessible summary In the Western world, many people who have mental health problems experience poor physical health. Research suggests that those with mental illness often have difficulties in accessing health care services, reporting that when they do, their physical health needs are often overlooked., Nurses are expected to deliver safe and effective care that meets the needs of service users. In order to help mental health nurses address physical health care needs, changes to nurse education, supported by government policy, have been made in the United Kingdom. Despite these changes, mental health nurses still feel less confident and prepared to address physical health needs of service users. However, this same problem is also reported by nurses throughout Europe and in other Western countries, who have undergone different training and education programmes., This paper discusses important factors affecting the mental health nurses' ability to deliver physical care and how they impact on confidence and competence., The paper concludes by highlighting the role of the mental health nurse being key in addressing the physical health needs of those in their care, and how this will only be realized when education and practice provide sufficient opportunity for them to develop and maintain their knowledge and skills., Abstract In the Western world, there is increasing concern regarding the ability of health care professionals to meet the physical health care needs of those diagnosed with mental illness. This discussion paper seeks to explore some of the issues facing mental health nurses in delivering care to those who have both mental and physical illness. Criticism of the National Health Service for failing to meet the physical health needs of people with serious mental illness has generated a number of political strategies aimed at addressing inequalities between mental and physical health care, a consequence being a change in pre-registration nurse education. It is envisaged that such changes will enable all nurses to deliver safe, effective care to service users, with adult and mental health nurses being more adept at meeting both the mental and physical health needs of those in their care. The impact of three key areas identified within the literature will be considered: the impact of co-existing physical and mental illness; the role of mental health nurses and perceptions of service users re physical health care; and education, training and learning from others in the Western world. In conclusion, the complexities of delivering such care will be addressed. [ABSTRACT FROM AUTHOR]

Little is known about how athletic trainers (ATs) learn clinical documentation, but previous studies have identified that ATs have a need for more educational resources specific to documentation. To obtain ATs' perspectives on learning clinical documentation. Qualitative study. Web-based audio interviews. Twenty-nine ATs who completed 2 different continuing education (CE) clinical documentation modules. Participants averaged 36.2 ± 9.0 years of age and included 16 women and 13 men representing 21 US states and 8 clinical practice settings. Participants were recruited from a group of ATs who completed 1 of 2 web-based CE clinical documentation modules. Within 3 weeks of completing the educational modules, participants were interviewed regarding their perceptions of how they learn clinical documentation, including their experiences completing the modules. Using the Consensual Qualitative Research approach, 3 researchers and 1 internal auditor inductively analyzed the data during 5 rounds of consensus coding. Trustworthiness measures included multianalyst triangulation, data source triangulation, and peer review. Two themes emerged from the data, including (1) mechanisms of learning documentation and (2) benefits of the educational modules. Athletic trainers primarily learn documentation through professional education and workforce training, but training appears to be inconsistent. Participants perceived that both educational modules were effective at increasing their knowledge and confidence related to learning documentation. The CE modules incited a growth mindset and intention to change behavior. Athletic trainers are satisfied with web-based CE learning experiences specific to clinical documentation and may benefit from more CE offered in these formats. Educators are encouraged to integrate clinical documentation principles throughout the curriculum during both didactic and clinical education. Workforce training is also valuable for improving knowledge and skills related to clinical documentation, and employers should onboard and support ATs as they start new positions. [ABSTRACT FROM AUTHOR]

Aims: (1) To identify, evaluate and summarize evidence about the objectives and characteristics of mentoring programmes for specialized nurses (SNs) or nurse navigators (NNs) and advanced practice nurses (APNs) and (2) to identify the effectiveness of these programmes. Design: A systematic review based on PRISMA guidelines. Data Sources: From November 2022 until 7 December 2022, four databases were searched: PubMed, EMBASE, CINAHL and The Cochrane Library. Review Methods: Study selection was performed independently by two researchers. Disagreements were discussed until consensus was reached. Data extraction was undertaken for included studies. Data synthesis was conducted using narrative analysis. Quality appraisal was performed using the Critical Appraisal Skill Programme (CASP) and Mixed Methods Appraisal Tool (MMAT). Results: Twelve articles were included, all of which focused on mentoring programmes for APNs. Different forms of mentorship (e.g. (in)formal mentorship, work shadowing, workshops) were reported. Studies reported positive outcomes on job retention (n = 5), job satisfaction (n = 6), skills improvement (n = 7), satisfaction with the programme (n = 7) and confidence improvement (n = 4) among participants of mentoring programmes. Conclusion: There is a lack of uniformity and consistency in various elements of mentoring programmes. Further research is needed to develop mentoring programmes for both APNs and SNs/NNs in a systematic and theoretically underpinned manner. It is necessary to establish a thorough evaluation methodology, preferably using a mixed methods design that includes both a qualitative process evaluation and a comprehensive outcome evaluation using validated questionnaires, taking into account the NN/APN, the interprofessional team and organizational level. Impact: The synthesis of evidence may be useful to organizations developing and implementing mentoring programmes for both SN/NN and APN. The development of a mentoring programme for nursing experts should be considered a complex intervention that requires theoretical frameworks and contextual considerations. No Patient or Public Contribution: Not applicable, as no patients or public were involved. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic of 2020 was one of the rare events that shocked almost every world government simultaneously, thus creating an unusual opportunity to understand how political institutions shape policy decisions. There have been many analyses of what governments did. We focus instead on what they could do, focusing on the institutional politics of agency – how institutions empower rather than how they constrain, and how they affect public policy decisions. We examine public health measures in the first wave (March-September 2020) in Brazil, India, and the U.S. to understand how the interplay of institutions in a complex federal context shaped COVID-19 policy-responses. We find similar patterns of concentrated federal executive agency with limited constraints. In each case, when federal leadership failed public health policy responses, federated, subnational states were left to compensate for these inefficiencies without necessary resources. [ABSTRACT FROM AUTHOR]

Background: Foster parents experience multiple challenges; however, managing problematic child behaviors can be especially difficult. Given the ecological nature of challenges associated with fostering, it is imperative that researchers identify means for combatting foster parent stress and factors that may contribute to placement disruption. Objective: The purpose of this paper is to examine the importance of social support for foster parents, in regards to confidence and satisfaction, as well as perceived challenges with fostering. Additionally, social support was evaluated as a moderator between reported child behaviors and foster parents' confidence and satisfaction with fostering. Method: This study included 155 licensed foster caregivers across the United States. Participants completed standardized measures (i.e., child behaviors, satisfaction and challenges as a foster parent, social support) through an online survey after being recruited via social media. Variables were analyzed through simple and hierarchal linear regressions. Results: Findings indicate that social support significantly predicted confidence and satisfaction as a foster parent; intensity of child behaviors is negatively associated with confidence as a foster parent and positively associated with an overall perception of challenges related to fostering; and social support moderates the relationship between perceived problem with child behaviors and perceived challenging aspects of fostering. Conclusion: This study indicates social support may be a protective factor for foster parents in regards to child behaviors and challenges associated with fostering. Social support is linked to variables that directly influence placement stability. [ABSTRACT FROM AUTHOR]

This paper analyzes the results of an 18 month study of a variety of participants involved in written reflection on their learning, both in classes at two universities in the Southern US or in voluntary focus groups. The purpose of the study was to analyze the effects of including autobiographical tools in written reflection. Participants used three tools from the genre of autobiography as they reflected on their learning inside either course content, internship experiences, experiential learning, or goal-setting. Over 500 samples were gathered, offering a large data set for analysis of what kinds of best practice produce quality reflective writing. Through analysis of the data and student surveys and interviews, results show increased attention to critical thinking and metacognition; expressed flexibility, adaptability, and ability to handle ambiguity; and value in connection to others/empathy-building as a result of incorporating autobiographical tools in reflective prompts. The study indicated that reflections using the same autobiographical tool over the course of several sessions seemed to produce deeper levels of reflection and more engagement with the autobiographical tool. Of the three autobiographical tools used in the study, the tool that seemed most helpful to participants was reflection as storytelling that revealed aspects of the self. [ABSTRACT FROM AUTHOR]

This paper studies, theoretically and empirically, the role of overconfidence in political behavior. Our model of overconfidence in beliefs predicts that overconfidence leads to ideological extremeness, increased voter turnout, and stronger partisan identification. The model also makes nuanced predictions about the patterns of ideology in society. These predictions are tested using unique data that measure the overconfidence and standard political characteristics of a nationwide sample of over 3,000 adults. Our numerous predictions find strong support in these data. In particular, we document that overconfidence is a substantively and statistically important predictor of ideological extremeness, voter turnout, and partisan identification. (JEL C83, D03, D72, D83) [ABSTRACT FROM AUTHOR]

A substantial literature claims that the strong increase in inequality over the last decade in Western industrial countries such as the United States (US) would lead to increasing tensions between different socio-economic groups which might in turn hamper economic growth. The population’s fading hopes regarding the outlook on the future seem to confirm this. This paper qualifies this interpretation using survey data collected by the Pew Research Center for the People covering 1999-2014. Over the first decade, the decline in hope cannot be traced back to the rising inequality. However, recent data from 2014 suggest that inequality is now a major driver of a lower than ever level of hope. Hence inequality is a recent factor, not the driver of the long-term decline in hope. [ABSTRACT FROM AUTHOR]

Objective As part of the National MCH Workforce Development Center, an innovative internship program placed MCH undergraduate and graduate students in summer practica in state Title V agencies. Graduate student mentoring of undergraduates and leadership and professional development training and support are key features of the program. The objective of this paper is to report on the results of the evaluation of the MCH Paired Practica Program in its pilot years, 2014–2016. Methods Students completed pre and post internship questionnaires which included closed as well as open-ended questions. In addition, the Title V state health agency preceptors completed a questionnaire at the end of each summer. Results Over the 3-year pilot project, a total of 17 teams participated. Students were from 6 of the 13 graduate Centers of Excellence in MCH programs in Schools of Public Health and two undergraduate MCH Pipeline Programs. There were 11 participating states. After the practicum experience, there was a significant increase in students’ confidence in a number of measures related to working in complex, dynamic environments and in their ability to contribute to improvements in MCH population health. Students reported having more confidence in their ability to function effectively as an informal/formal MCH leader (p = 0.02), more confidence in their ability to contribute to improvements in MCH population health (p = 0.04), and being more prepared to enter the workforce after the practicum experience (p = 0.07), although there was no significant change in students’ (n = 22) interest in seeking a job in a Title V agency or a community based organization with a MCH focus. Nearly 60% of the students did state at the posttest that they would likely seek additional education in MCH. Overall, the Title V preceptors (n = 14) were very positive about the program although in some instances there was less confidence in the knowledge and skills of the undergraduate students. Conclusion The MCH Paired Practica Program is a unique effort to go beyond the academic training of undergraduate and graduate MCH students to provide them with direct exposure to the field, as well as leadership, mentorship, and professional development training. While some challenges emerged related to differences in skills between undergraduates and graduate MCH students, participating students demonstrated clear improvements in their leadership skills including increased confidence in their ability to take initiative, provide opinions and feedback, to function informally or formally as leaders, and to contribute to improvements in MCH population health. [ABSTRACT FROM AUTHOR]

The widespread need to address both science, technology, engineering, and math (STEM) education and STEM workforce development is persistent. Underscored by the Next Generation Science Standards, demand is high for P-12 engineering-centered curricula. TeachEngineering is a free, standards-aligned NSF-funded digital library of more than 1,500 hands-on, design-rich K-12 engineering lessons and activities. Beyond anonymous site-user counts, the impact of the TeachEngineering collection and outreach initiatives on the education of children and their teachers was previously unknown. Thus, the project team wrestled with the question of how to meaningfully ascertain classroom impacts of the digital engineering education library and--more broadly--how to ascertain the impacts of teacher-focused P-12 engineering education initiatives. In this paper, the authors approach the classroom impact question through probing self-reported differentials in: (1) teachers' confidence in teaching engineering concepts, and (2) changes in their teaching practices as a result of exposure to (and experiences with) K-12 engineering education resources and outreach opportunities. In 2016, four quantitative and qualitative surveys were implemented to probe the impact of the TeachEngineering digital library and outreach on four populations of K-12 teachers' confidence and practices, including the frequency with which they integrate engineering into their precollege classrooms. Survey results document the teacher experience and perception of using hands-on K-12 engineering curricular materials in the classroom and help create a data-driven understanding of where to best invest future resources. The results suggest that the TeachEngineering curricular resources and outreach initiatives help teachers build confidence in their use of engineering curriculum and pedagogy in K-12 classrooms, impact their teaching practices, and increase their likelihood of teaching engineering in the classroom in the future. [ABSTRACT FROM AUTHOR]

Many transgender individuals face inequities, discrimination, and sometimes even a lack of transgender-specific knowledge in health care settings. Educational curricula can address such disparities and help future health professionals to become more knowledgeable, confident, and well-prepared for addressing the needs of transgender individuals. This systematic review aims to summarize current training interventions about care of transgender individuals for health and allied health students, and to analyse the effects of the respective intervention. A total of six databases (Pubmed, MEDLINE, Scopus, Web of Science, Embase and SciSearch) were screened for original articles published between 2017 and June 2021. Search terms and eligibility criteria were pre-specified, and after a structured selection process 21 studies were included into further analysis. Extracted data contained information on general study properties, population, design, program format and outcomes of interest. A narrative synthesis was used to summarize detected results. Study quality was assessed for each individual study. A self-developed 18-item checklist combining criteria of two prior published tools was used to assess overall quality of quantitative studies. For qualitative studies a 10-item checklist by Kmet et al. [HTA Initiat, 2004] was applied. Eligible studies were designed for multiple health or allied health profession students, and varied widely regarding program format, duration, content, and assessed outcomes. Almost all (N = 19) interventions indicated improvements in knowledge, attitude, confidence and comfort levels or practical skills concerning care for transgender clients. Major limitations included the lack of long-term data, validated assessment tools, control groups and comparative studies. Training interventions contribute to prepare future health professionals to deliver competent and sensitive care and which may improve the prospective experienced health care reality of transgender individuals. However, currently there is no common consensus about best practice of education. Additionally, little is known about whether detected effects of training interventions translate into noticeable improvements for transgender clients. Further studies are warranted to assess the direct impact of specific interventions in the light of the respective target populations. [ABSTRACT FROM AUTHOR]

Teachers set the tone for their classrooms, but what teacher beliefs shape students' sense of belonging? We investigate how teachers' mindsets—or their beliefs about learning and school—relate to adolescents' individual and collective reports of classroom belonging. Our pre-registered analyses include a multilevel design of how 1,200 US middle school students (ages 11–13; 50% female; 49% low income; 40% White, 30% Latinx, 13% Black, 9% Asian) and their teachers responded to surveys on educational mindsets. We find teachers' growth mindset and confidence in teaching positively relate to students' math class belonging—explaining between 30 and 40% of belonging among classes. Our data suggest a teacher's own sense of school belonging is unrelated to the belonging students feel in class, suggesting teachers' broad feelings of belonging may not influence students' specific classroom feelings of belonging as anticipated. These findings reinforce the notion that what teachers think and believe influence how students feel when in class. [ABSTRACT FROM AUTHOR]

Objective: No fatigue‐specific programs exist for people with systemic sclerosis (SSc) despite the burden of fatigue and negative impact on daily activities. This study used a convergent parallel mixed methods design to evaluate the impact of an adapted virtual intervention, Fatigue and Activity Management Education in Systemic Sclerosis (FAME‐iSS), in the United States. Methods: Eighteen people with SSc participated in three separate six‐week FAME‐iSS programs. Participants completed the modified Fatigue Impact Scale (m‐FIS), the Self‐Efficacy for Performing Energy Conservation Strategies Assessment (SEPESCA), the Patient‐Reported Outcomes Measurement Information System (PROMIS) Self‐Efficacy for Managing Symptoms, and the Hospital Anxiety and Depression Scale (HADS) before, immediately after, and three months post intervention. Data were analyzed using descriptive and nonparametric inferential statistics. Participants' perceptions of the program and their use of fatigue management strategies were qualitatively analyzed using content analysis. Results: Eighty‐nine percent of participants were women with a mean ± SD age of 52.0 ± 11.6 years and a mean ± SD disease duration of 13.7 ± 14.5 years, and more than 70% had a college degree. Significant improvements were observed for self‐efficacy on the PROMIS Self‐Efficacy for Managing Symptoms (P = 0.002) and SEPESCA (P = 0.016) immediately post intervention, which continued to significantly improve up to the three‐month follow‐up (P = 0.006 and 0.035, respectively). Significant improvements were also observed for the m‐FIS between baseline and the three‐month follow‐up (P = 0.029). Participants reported a deeper understanding of fatigue and that they liked sharing strategies and experiences with each other along with the facilitator, citing that "there was a power in our group because we had a common condition." Conclusion: FAME‐iSS resulted in improvements in the impact of fatigue and self‐efficacy for managing symptoms and performing energy conservation strategies. Feedback was positive, and the virtual format allowed for greater accessibility and sharing of strategies. [ABSTRACT FROM AUTHOR]

During COVID-19, SM media was relied upon for health-related information-seeking and activity support. This study uses the social cognitive theory (SCT) and a representative dataset of the population in the US to explore the factors influencing patients' perceptions of SM for health-related activities. As per SCT, consolidated factors comprised personal factors (sociodemographic, health perception, self-efficacy) and environmental factors (social isolation, purpose in life). Multivariate logistic regression analysis was conducted. Among the 6252 respondents, 95.15% rarely use SM to share personal health-related information, and 90.44% rarely use it to share general health-related information. Older individuals and Whites are less likely to consider SM for healthcare decisions. Education levels influence SM's perceived reliability. Those with positive health perceptions find SM more suitable for healthcare discussions. Socially-isolated individuals are less likely to use SM for healthcare. Those with a strong sense of purpose are less inclined to trust it for health decisions and may question its accuracy. SM-based interventions should address sociodemographic differences. Our findings contribute to the literature by SCT relevance validation in identifying the antecedents of SM use in healthcare. Our results also help to understand the challenges to its adoption. This can help enhance SM-based communication strategies and interventions. [ABSTRACT FROM AUTHOR]

The most recent internationally widespread disease outbreak occurred during the flu season of 2009 and 2010. On April 2009, the first cases of influenza A (H1N1) (Popularly called, Swine Flu) were confirmed in the USA and UK following a novel virus that was first identified in Mexico. As the virus spread rapidly, the risk of morbidity and mortality increased in several countries. In this paper, we rely on the social cognitive theory of risk to assess the willingness of the US public to comply with vaccination and reduce the risk of sickness and death from the flu. We conduct a secondary data analysis of the Pew Research for the People and Press October 2009 and investigate the factors associated with willingness to take the swine flu vaccine (n = 1000). The findings indicate that the decision to take the swine flu vaccination was highly polarized across partisan lines. Controlling for education, income and demographic factors, the likelihood of taking the vaccine was associated with party identification. Individuals that identified themselves as Democrats were more likely to be willing to take the swine vaccine than individuals that identify themselves as Republicans and Independents. Confidence in the ability of the government to deal with the swine flu crisis seems to explain party identification differences in the willingness to take the vaccine. The implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Young Latina women (YLW) in the US and in Alabama are disproportionately affected by sexual health disparities. Our community based participatory research (CBPR) study's purpose was to examine YLW's perceptions and experiences of sexual healthcare access (SHCA) toward developing community-driven, multilevel intervention strategies. We conducted 20 semi-structured qualitative interviews with YLW between 15 and 19 years old and who had been in the US for 5 or more years. We content-analyzed the data guided by the Socioecological Model of Sexual Health (SEMSH). We began analyses by coding independently, built consensus on the codes, then finished coding transcripts independently. Sixty-five percent of participants were US-born and 60% had health insurance. Participants identified barriers/facilitators to SHCA including discrimination in clinical settings and embarrassment/stigma about SHCA. Our study is the first in AL to use CBPR to work with YLW. Interventions should consider the multi-level and intersectional nature of SHCA challenges. [ABSTRACT FROM AUTHOR]

Objective In this study, we used human factors (HF) methods and principles to design a clinical decision support (CDS) that provides cognitive support to the pulmonary embolism (PE) diagnostic decision-making process in the emergency department. We hypothesised that the application of HF methods and principles will produce a more usable CDS that improves PE diagnostic decision-making, in particular decision about appropriate clinical pathway. Materials and methods We conducted a scenario-based simulation study to compare a HF-based CDS (the so-called CDS for PE diagnosis (PE-Dx CDS)) with a web-based CDS (MDCalc); 32 emergency physicians performed various tasks using both CDS. PE-Dx integrated HF design principles such as automating information acquisition and analysis, and minimising workload. We assessed all three dimensions of usability using both objective and subjective measures: effectiveness (eg, appropriate decision regarding the PE diagnostic pathway), efficiency (eg, time spent, perceived workload) and satisfaction (perceived usability of CDS). Results Emergency physicians made more appropriate diagnostic decisions (94% with PE-Dx; 84% with web-based CDS; p<0.01) and performed experimental tasks faster with the PE-Dx CDS (on average 96 s per scenario with PE-Dx; 117 s with web-based CDS; p<0.001). They also reported lower workload (p<0.001) and higher satisfaction (p<0.001) with PE-Dx. Conclusions This simulation study shows that HF methods and principles can improve usability of CDS and diagnostic decision-making. Aspects of the HF-based CDS that provided cognitive support to emergency physicians and improved diagnostic performance included automation of information acquisition (eg, auto-populating risk scoring algorithms), minimisation of workload and support of decision selection (eg, recommending a clinical pathway). These HF design principles can be applied to the design of other CDS technologies to improve diagnostic safety. [ABSTRACT FROM AUTHOR]

Summary: Although Latinx families comprise the largest growing population in the United States, research has not examined how the lack of social inclusion (e.g., multidimensional term comprising economic, political, and cultural dimensions, among others) influences the lives of low-income Latina mothers. Social inclusion, which is a term born as a counterpart to social exclusion, has been overlooked as an alternative construct that allows the development of personal agency. Contrary to social exclusion paradigms which often focus on deficits, social inclusion focuses on recognizing inherit strengths among vulnerable families. The first purpose of this research is to explore social inclusion (a strength perspective) as a much-needed alternative to social exclusion (deficit view). The second is to describe the experiences of low social inclusion among low-income urban Latina mothers via two interviews, a focus group, recollection of artifacts from participants, and reflective journaling, which were documented within a context of a feminist action research intervention. Participants consisted of 12 low-income Latina mothers (N = 12) who participated in a financial literacy intervention. Findings: Via thematic analysis, findings confirmed two new dimensions of low social inclusion not found in traditional literature: low language and technological inclusion. Applications: Recommendations for social work practitioners and future research include developing culturally relevant interventions among minoritized communities and families, for instance, by promoting bilingual curricula and implementing technology in current interventions, which can have significant positive effects on the social inclusion of vulnerable communities. [ABSTRACT FROM AUTHOR]

Among the challenges faced by work-integrated learning (WIL) educators, recruiting, selecting, and retaining outside organizations as 'clients' or 'community partners' to work with students looms large. The gap between classroom needs and professional practice often leads to a tangle of unrealistic expectations. These challenges grow even more acute given that faculty often lack the experience, skill, time, and resources critical for fostering partnerships with organizations. To gain a clearer sense of the challenges involved, this article considers the body of literature on one course taught at U.S. universities: the public relations campaigns, with a specific focus on clients. The intention is twofold: first, it aims to identify opportunities for future research on the course to fill gaps in best practices for faculty working with client organizations; and second, to show how these course-specific issues echo, and potentially expand upon, challenges WIL professionals grapple with regardless of what they teach. [ABSTRACT FROM AUTHOR]

This study presents findings on the indicators of educational displacement as an early risk factor for radicalization in school settings in the U.S. We collected and analyzed data from 301 students living in 43 U.S. states to inform the creation of Reimagine Resilience, an innovative violence prevention training program for educators and educational staff developed at Teachers College, Columbia University, and to measure early indications of educational displacement as a risk factor for radicalization. The study shows that poor teacher-student relations and multiple experiences of biased speech and behavior are significant early predictors of the students' educational displacement. Educational displacement, in this study, is measured as a lack of social belonging in schools. [ABSTRACT FROM AUTHOR]

Introduction: An estimated 38 million people are living with human immunodeficiency virus (HIV) worldwide. Pharmacists are well positioned to provide care to patients with HIV, but gaps in HIV education among pharmacists exist. Recognizing the need to educate and prepare future pharmacists, a 2-credit advanced HIV elective course was created for Doctor of Pharmacy students at Washington State University College of Pharmacy and Pharmaceutical Sciences in the United States, and Masters of Clinical Pharmacy students from University of Western Cape School of Pharmacy in South Africa. Methods: Course topics included diagnosis and treatment of HIV in children and adults, management of common comorbidities, pre-exposure prophylaxis, pharmacogenetic applications, and antiretroviral drug-drug interactions. Course effectiveness was evaluated using student examination results. Student perceptions were evaluated using pre- and post-course self-assessments involving abilities, confidence, and attitudes toward caring for people living with HIV. Results: Student pharmacists demonstrated competency in HIV knowledge, demonstrated skills in application to clinical-based scenarios, and reported significantly improved confidence and abilities as well as positive changes in attitudes toward people with HIV. Conclusion: This course contributed to student learning across different student cohorts in an institutional program in the United States including successful execution of distance learning and clinical application for students at a program in South Africa. [ABSTRACT FROM AUTHOR]

Franklin Delano Roosevelt is arguably one of the greatest of American Presidents. His encounter with the polio that crippled him at an early age and its transformative impact upon him are here discussed with particular reference to his relationship with his physician, Dr. George Draper. This transformation liberated energy in Roosevelt to lead and to show empathy for others in ways that both challenged the political and social status quo in the USA as well as helped save the world from the threat of Fascism in World War II. This essay seeks to demonstrate how an investigation of the life and struggles of this famous patient is one avenue for relating the study of the humanities to medical education. An earlier version of this paper was presented as the Heberden Lecture in the History of Medicine at the New York Academy of Medicine in 2012. [ABSTRACT FROM AUTHOR]

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This article investigates the contribution of sentiment shocks to US fluctuations in a Structural VAR setup with restrictions at various frequencies. Sentiments shocks are identified as shocks orthogonal to fundamentals that account for most of the variance of confidence.We obtain that, contrary to news shocks on total factor productivity, sentiment shocks explain little of quantities and prices. Sentiments shocks mostly appear as an idiosyncratic component of confidence. These results are robust to various perturbations. [ABSTRACT FROM AUTHOR]

Background: Foster youth endure traumatic adversities, which can lead to obstacles when transitioning to young adulthood and pursuing postsecondary education. This vulnerable population is required to navigate independent living while also managing stress that commonly arises from postsecondary education. Method: A pre test, post test pilot design was employed to determine the potential impact and feasibility of an evidenced-based multi-factorial stress management program in reducing foster youth's perceived stress during postsecondary education. Participants (n = 3) received one, 90-min individual occupational therapy session weekly over 6 weeks. Author-generated stress management surveys along with the Perceived Stress Scale were administered pre and post intervention. Results: Outcomes reveal this cost-effective program may be feasible in decreasing foster youth's perceived stress. All participants' individual Perceived Stress Scale scores decreased over the course of the intervention. Two out of three participants demonstrated a decrease in perceived academic stress while one participant's perceived academic stress remained the same from pre to post intervention. Conclusion: Considerations for future programs include flexibility in scheduling, addressing time management challenges with this population, and integration of trauma-informed care principles. [ABSTRACT FROM AUTHOR]

Background: Indo-US Masters in Emergency Medicine (MEM) certification courses are rigorous three-year emergency medicine (EM) training courses that operate as a partnership between affiliate hospitals or universities in the United States with established EM training programs and local partner sites in India. Throughout their 15 years of operation, these global training partnerships have contributed to the EM workforce in India. Our objective in this study was to describe Indo-US MEM program graduates, their work environments, and their contribution to the growth of academic EM and to the coronavirus disease 2019 (COVID-19) response. Methods: An electronic survey was created by US and Indian MEM course stakeholders and distributed to 714 US-affiliated MEM program graduates. The survey questions investigated where graduates were working, their work environments and involvement in teaching and research, and their involvement in the COVID-19 response. We consolidated the results into three domains: work environment and clinical contribution; academic contribution; and contribution to the COVID-19 response. Results: The survey response rate was 46.9% (335 responses). Most graduates reported working within India (210, 62.7%) and in an emergency department (ED) setting (304, 91.0%). The most common reason for practicing outside of India was difficulty with formal MEM certificate recognition within India (97, 79.5%). Over half of graduates reported dedicating over 25% of their work hours to teaching others about EM (223, 66.6%), about half reported presenting research projects at conferences on the regional, national, or international level (168, 50.5%), and almost all graduates were engaged in treating COVID-19 patients during the pandemic (333, 99.4%). Most graduates agreed or strongly agreed that they were satisfied with their overall MEM training (296, 88.4%) and confident in their ability to practice EM (306, 91.6%). Conclusion: Indo-US MEM graduates have made a notable contribution to EM in India through clinical service delivery, teaching, and research, even more essential in the context of the COVID-19 pandemic. The roles of these graduates should be acknowledged and can contribute further to expandEM specialty and systems development across India. [ABSTRACT FROM AUTHOR]

Purpose: This study examined public school (PS) speech-language pathologists’ (SLPs’) perceived confidence in managing pediatric feeding disorders (PFDs). Perceived confidence is a rater’s self-reported assurance level to manage PFDs. The study then looked for relationships between personal and professional factors that might account for perceived confidence. Geographic location as well as administrative supports and resources were also examined. Method: Participants were PS SLPs from across the United States who were recruited via American Speech-Language-Hearing Association Special Interest Groups. This study measured perceived confidence with a 5-point Likert-type scale for 17 roles and responsibilities in PFD management. Pearson and Spearman correlations were used to identify relationships with personal and professional characteristics. Results: PS SLPs perceived themselves as having low confidence in managing PFDs. Personal and professional characteristics account for low perceived confidence (e.g., number of graduate courses, clinical experience with swallowing and feeding in early intervention or medical settings, managing swallowing and feeding currently, having more administrative support). Conclusions: This study provided a more representative sample (i.e., geographic regions) of PS SLPs. Perceived confidence in PFD management is linked to factors that can be modified through personal and professional changes. [ABSTRACT FROM AUTHOR]

Our study measured parental confidence and intention/uptake of two adolescent vaccines (HPV and COVID-19), focusing on differences among community types including urban, suburban, and rural. Although social media provides a way for misinformation to spread, it remains a viable forum for countering misinformation and engaging parents with positive vaccine information across community types. Yet, little is understood about differences in social media use and vaccine attitudes and behaviors for parents living in rural, suburban and urban areas. We sought to determine how to better reach parents living in different community types with targeted social media channels and messaging. In August 2021, we used a cross-sectional survey programmed in Qualtrics to collect data from 452 parents of children ages 9 to 14 living in different community types across the United States. Participants came from a survey panel maintained by CloudResearch. Survey questions asked about demographics, political affiliation, community type, social media use, health and vaccine information sources, and attitudes and behaviors regarding the HPV and COVID-19 vaccines. Our sample of parents (n = 452) most frequently used Facebook (76%), followed by YouTube (55%), and Instagram (43%). When comparing social media use by community type, parents used the top platforms at similar rates. Social media use was associated with vaccine confidence and intention/uptake in unadjusted models but not in adjusted models. Further, there were no significant differences in HPV vaccine confidence or intention/uptake by community type (i.e., rural, suburban, urban). For the COVID-19 vaccine, parents in rural communities were less likely to have vaccine confidence and intention/uptake in the unadjusted model. For both HPV and COVID-19 vaccines, political affiliation was the only common factor associated with both vaccine confidence and intention/uptake. Parents who identified as Democrat compared to Republican had greater confidence in the vaccines and had higher odds of vaccine intention/uptake for their children. Although rurality has been associated with vaccine confidence in the past we did not find that in our study. Instead, political affiliation appeared to explain most of the variation in vaccine confidence and intention/uptake, suggesting that more research is needed to identify best practices for using social media to reach parents with different political beliefs. [ABSTRACT FROM AUTHOR]

In the United States, established adulthood (ages 30–45) often represents the most intense and demanding years of adult life. During this time, most individuals settle into adult roles and responsibilities, negotiating the intersecting demands of work and family obligations. While discrete topics relevant to this period have been investigated by developmental scientists, the subjective experience of established adulthood as a whole remains largely overlooked. In the present study, we aim to provide the foundation for a more comprehensive and integrated understanding of established adulthood by interviewing participants (n = 127) aged 30–45 from across the United States about the nature of their current lived experience. In general, participants described the Experience of Established Adulthood as a time of establishing their adulthood, stability, changes in priorities, and shifting perceptions of time. They also noted a number of Responsibilities and Commitments, describing an increase in obligations, and feeling a "career and care crunch. Participants also reported experiencing Evolution, noting that they continued to grow and learn, explore their beliefs and values, and make course corrections as needed. Finally, participants described Actualization in terms of gained wisdom, self-understanding, self- confidence, and life satisfaction. Taken together, our results suggest that established adults in the USA face challenges and opportunities distinct from those faced during emerging adulthood or midlife. [ABSTRACT FROM AUTHOR]

The current study replicated Wang and Singer's ([2021]. A cross-cultural study of self-defining memories in Chinese and American college students. Frontiers in Psychology, 11. ) finding that Chinese college students from the People's Republic of China (PRC) recalled more self-defining memories (SDMs) focused on high school academic stress than their American counterparts. Seventy-eight American students from a private 4-year liberal arts college and 96 Chinese students from 13 different Chinese universities recalled two SDMs and rated them for affect, recall frequency, and importance. Once again, Chinese college students were more likely than American students to recall academic stress SDMs, but also expressed more redemptive themes in these memories. Overall, Chinese students rated their SDMs as more positive than the Americans, while the American sample tended to recall their negative memories more frequently. Contrasting the SDMs, American students self-reported higher levels of stress about their high school workload and less academic self-confidence. Regressions linked more negative affect in American SDMs to these work load and self-confidence concerns. Chinese students' SDM negative affect was most strongly predicted by perceived academic stress linked to parental and teachers' expectations. The discussion highlights the potential influence of Confucian values in the Chinese students' responses to past academic stress and their internalisation of academic stress memories in their narrative identity. [ABSTRACT FROM AUTHOR]

Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narratively. We included 24 meta-analyses on mental health and climate events (n = 13), pollution (n = 11), and green spaces (n = 2) (two meta-analyses provided data on two categories). The quality was suboptimal. According to AMSTAR-2, the overall confidence in the results was high for none of the studies, for three it was moderate, and for the other studies the confidence was low to critically low. The meta-analyses on climate events suggested an increased prevalence of symptoms of post-traumatic stress, depression, and anxiety associated with the exposure to various types of climate events, although the effect sizes differed considerably across study and not all were significant. The meta-analyses on pollution suggested that there may be a small but significant association between PM2.5, PM10, NO2, SO2, CO and mental health, especially depression and suicide, as well as autism spectrum disorders after exposure during pregnancy, but the resulting effect sizes varied considerably. Serious methodological flaws make it difficult to draw credible conclusions. We found reasonable evidence for an association between climate events and mental health and some evidence for an association between pollution and mental disorders. More high-quality research is needed to verify these associations. [ABSTRACT FROM AUTHOR]

Objectives. To report insurance-based discrimination rates for nonelderly adults with private, public, or no insurance between 2011 and 2019, a period marked by passage and implementation of the Affordable Care Act (ACA) and threats to it. Methods. We used 2011–2019 data from the biennial Minnesota Health Access Survey. Each year, about 4000 adults aged 18 to 64 years report experiences with insurance-based discrimination. Using logistic regressions, we examined associations between insurance-based discrimination and (1) sociodemographic factors and (2) indicators of access. Results. Insurance-based discrimination was stable over time and consistently related to insurance type: approximately 4% for adults with private insurance compared with adults with public insurance (21%) and no insurance (27%). Insurance-based discrimination persistently interfered with confidence in getting needed care and forgoing care. Conclusions. Policy changes from 2011 to 2019 affected access to health insurance, but high rates of insurance-based discrimination among adults with public insurance or no insurance were impervious to such changes. Public Health Implications. Stable rates of insurance-based discrimination during a time of increased access to health insurance via the ACA suggest deeper structural roots of health care inequities. We recommend several policy and system solutions. (Am J Public Health. 2023;113(2):213–223. https://doi.org/10.2105/AJPH.2022.307126) [ABSTRACT FROM AUTHOR]