Search

Background: The complexity of communication presents challenges for clinical assessment, outcome measurement and intervention for people with acquired brain injury. For the purposes of assessment or treatment, this complexity is usually managed by isolating specific linguistic functions or speech acts from the interactional context. Separating linguistic functions from their interactional context can lead to discourse being viewed as a static entity comprised of discrete features, rather than as a dynamic process of co‐constructing meaning. The ecological validity of discourse assessments which rely on the deconstruction of linguistic functions is unclear. Previous studies have reported assessment tasks that preserve some of the dialogic features of communication, but as yet, these tasks have not been identified as a distinct genre of assessment. We suggest the term 'co‐constructed communication' to describe tasks which are specifically designed to capture the dynamic, jointly produced nature of communication within a replicable assessment task. Aims: To identify and summarize how co‐constructed communication has been assessed with individuals with non‐progressive acquired communication disability regarding task design, measures and psychometric robustness. Methods: A scoping review methodology was used to identity relevant studies. Systematic database searches were conducted on studies published before July 2021. Studies in the yield were assessed against eligibility criteria, with 37 studies identified as eligible for inclusion. Main contribution: This is the first time that co‐constructed communication has been defined as a genre of discourse assessment for stroke and traumatic brain injury populations. Co‐constructed communication has been assessed for 144 individuals with aphasia and 111 with cognitive–communication disability. Five categories of co‐constructed communication tasks were identified, ranging in complexity. Variability exists in how these assessment tasks are labelled and measured. Assessment measures require further psychometric profiling, specifically regarding test–retest reliability and validity. Conclusions: Co‐constructed communication is a discourse genre which offers researchers and clinicians a replicable method to assess language and communication in an experimentally rigorous way, within an ecologically valid context, bridging the gap between experimental and ecological assessment approaches. What this paper adds: What is already known on this subject: Standardized assessments of language skills and monologue offer reliable, replicable ways to measure language. However, isolating language from an interactional context fundamentally changes the behaviour under study. This raises questions about the ecological validity of the measures we routinely use to determine diagnoses, guide treatment planning and measure the success of treatment. What this study adds to the existing knowledge: This review highlights studies that conceptualize, and often quantify, interaction by combining experimental rigour and aspects of everyday dialogue. This is the first time this genre of discourse assessment has been identified. We propose the term 'co‐constructed communication' to describe this genre and provide an operational definition for the term. What are the practical and clinical implications of this study?: Co‐constructed communication assessment tasks require refinement, particularly regarding aspects of psychometric robustness. In the future, these tasks offer pragmatic, meaningful ways to capture the effect and impact of aphasia and cognitive–communication disability within interaction. [ABSTRACT FROM AUTHOR]

Background and aim: In Uruguay, residents age 18 and older seeking legal cannabis must register with the government and choose one of three supply mechanisms: self‐cultivation, non‐profit cannabis clubs or pharmacies. This is the first paper to measure the association between type of legal cannabis supply mechanism and traffic crashes involving injuries. Design Ecological study using ordinary least squares regression to examine how department‐level variation in registrations (overall and by type) is associated with traffic crashes involving injuries. Setting: Uruguay. Cases 532 department‐quarters. Measurements Quarterly cannabis registration counts at the department level and incident‐level traffic crash data were obtained from government agencies. The analyses controlled for department‐level economic and demographic characteristics and, as a robustness check, we included traffic violations involving alcohol for departments reporting this information. Department‐level data on crashes, registrations and alcohol violations were denominated by the number of residents ages 18 and older. Findings From 2013 to 2019, the average number of registrations at the department‐quarter level per 10 000 residents age 18 and older for self‐cultivation, club membership and pharmacy purchasing were 17.7 (SD = 16.8), 3.6 (SD = 8.6), and 25.1 (SD = 50.4), respectively. In our multivariate regression analyses, we did not find a statistically significant association between the total number of registrations and traffic crashes with injuries (β = −0.007; P = 0.398; 95% CI = −0.023, 0.01). Analyses focused on the specific supply mechanisms found a consistent, positive and statistically significant association between the number of individuals registered as self‐cultivators and the number of traffic crashes with injuries (β = 0.194; P = 0.008; 95% CI = 0.058, 0.329). Associations for other supply mechanisms were inconsistent across the various model specifications. Conclusions: In Uruguay, the number of people allowed to self‐cultivate cannabis is positively associated with traffic crashes involving injuries. Individual‐level analyses are needed to assess better the factors underlying this association. [ABSTRACT FROM AUTHOR]

The potential of artificial intelligence (AI) to shape research and education is a highly topical issue. The recent release of ChatGPT (Chat Generative Pre‐trained Transformer) by OpenAI on November 30, 2022 has opened up new possibilities for the use of chatbot services in ecological research and education. In this perspective article, we address associated contemporary topics including the use of chatbot services in ecology education and academic writing, the application of AI in ecology, the potential environmental impact, and ethical considerations of using such services. Several logistical, ethical and environmental factors were identified that should be considered in the context of ecological research. We argue that ChatGPT can help reduce the workload of researchers, generate new insights and ideas, and serve as a personal instructor and assistant for students. While we show how AI chatbots have the potential to be useful assets for ecologists, several challenges arose. AI in ecological research includes the limited ability of AI algorithms to capture complexity and nuance, the dependence of AI models on data quality, and ethical concerns about the use of AI in research. The construction and operation of such services also have potential environmental impacts but may also provide environmental benefits in comparison with other conventional approaches, all of which should be evaluated. Despite these limitations and challenges, we consider that the use of AI can be a valuable tool in ecological research and could enhance the speed and efficiency of research by automating certain tasks (e.g. data collection and management) and analyzing large amounts of data. However, we emphasize the importance of taking a responsible, sustainable and transparent approach to using chatbot services and AI in ecological research and education, while remaining mindful of the potential impact on the environment, society, and ethical concerns. [ABSTRACT FROM AUTHOR]

Adolescent stress is complex and impairing. Novel measures are needed to understand stress variability within individuals over time from a physiological as well as a subjective perspective. To test the feasibility of combining ecological momentary assessment (EMA) and wearable biosensors to assess adolescent stress, using an idiographic approach with experience sampling methods. A small sample (n = 23) of predominantly African American, economically disadvantaged adolescents were asked to complete EMA surveys four times per day and wear an armband measuring Heart rate (HR) and skin response for a 2‐week period. Descriptive analyses examined number of hours of armband wear, percentage of viable data, and percentage of surveys completed by gender and race. Associations between biosensor data and EMA reports within and across individuals were also examined using hierarchical linear regression. EMA survey completion was good (81%) as was adherence to biosensor protocols, although technological difficulties interfered with collection of HR variability for youth with darker skin tones. Youth reported stressful events in 12.79% of EMA surveys, although 43% reported no negative mood experiences. Convergent validity was supported for detecting between‐person (EMA) and within‐person (EMA and biosensors) variability in stress across time, although associations across youth were highly variable. Results suggest value for biobehavioral methods in understanding day‐to‐day stress in adolescents but highlight variability in stress experiences as well as technological limitations, especially for youth of colour. [ABSTRACT FROM AUTHOR]

Objective: Momentary worsening (i.e., greater than one's average levels) of state body dissatisfaction (BD) has been implicated as a proximal risk factor for eating disorder (ED) behaviors in binge‐spectrum EDs. Yet, research exploring the prospective association between noneating activities in daily life (e.g., chores, self‐care/coping) and momentary state BD remains limited. Understanding the momentary link between engagement in noneating activities and state BD, and pathways through which engagement in said activities influences momentary state BD is critical to informing treatments. The current ecological momentary assessment (EMA) study examined whether (1) engagement in noneating activities at Time 1 prospectively predicted momentary state BD at Time 2 and (2) reward drawn from noneating activities at Time 1 mediates the prospective association between engagement in noneating activities at Time 1 and momentary state BD at Time 2. Method: Sixty‐six adults with transdiagnostic binge eating completed an EMA protocol over 7–14 days. Participants received six EMA signals per day (total EMA observations = 4038). Multilevel modeling was used to examine the research questions. Results: Engagement in an indoor hobby, outdoor recreation, socializing, and self‐care/coping strategies prospectively predicted momentary state BD improvements, while using TV/social media and cooking prospectively predicted momentary state BD worsening. Reward drawn from engagement in these noneating activities mediated the associations. Discussion: If replicated, these findings suggest that increasing the frequency of certain noneating activities and enhancing their rewarding aspects to improve state BD and decrease ED behavior risk during treatment may be worthy of further exploration. Public Significance: Momentary worsening of state body dissatisfaction (BD) is a risk factor for eating disorder behaviors in individuals with binge eating. This study found that engaging in certain noneating activities (e.g., socializing) prospectively predicted momentary improvements in state BD, while other noneating activities (e.g., cooking) predicted momentary worsening of state BD. Reward drawn from activities mediated these relations. To improve state BD, treatments should target the frequency of, and reward obtained from these noneating activities. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the relationship between the distance and travel time from each municipality to the nearest delivery facilities in the other municipalities and the frequency of out‐of‐facility deliveries in Hokkaido. Methods: Vital statistics from 2016 to 2020 were used. For municipalities without delivery facilities, the distance and travel time from the town office of each municipality to the nearest delivery facility was measured using Google maps. Negative binomial regression with an offset term was used to calculate the relative risks (RRs) and 95% confidence intervals (CIs) of out‐of‐facility delivery for distance (<30, 30–59, ≥60 km), and travel time by car (<30, 30–59, and ≥60 min) from the town office to the nearest delivery facility compared with the presence of delivery facilities. Results: The overall rate of out‐of‐facility deliveries in Hokkaido was 2.1‰; in municipalities with delivery facilities, 1.8‰, and in municipalities without delivery facilities, 3.1‰. The adjusted RRs (95% CIs) for out‐of‐facility deliveries were significantly higher in municipalities with less than 30 km and travel time of less than 30 min to delivery facilities, 2.63 (1.34–5.17) and 2.76 (1.36–5.58), respectively, compared to municipalities with delivery facilities. However, the adjusted RR of out‐of‐facility delivery for municipalities ≥30 km was higher, although the difference was not significant. Conclusions: Even in municipalities with a distance to delivery facilities of less than 30 km or travel time of less than 30 min, we should keep in mind the occurrence of out‐of‐facility deliveries. [ABSTRACT FROM AUTHOR]

The transition from adolescence to adulthood is difficult for individuals with autism spectrum disorder (ASD) and their families because they must learn to navigate the complex adult disability service delivery system. For Latinx (vs. White) families of youth with ASD, this period is especially difficult because of the systemic barriers (e.g., language and cultural differences) they face when accessing services. To support Latinx families, effective and culturally responsive supports (e.g. culturally tailored programs) are critical. To this end, the purpose of this study is to describe the cultural adaptation of a transition planning program (i.e., ASSIST) for Latinx families of youth with ASD. First, we culturally adapted the curriculum using the Ecological Validity Framework (Bernal et al., 1995) and the Cultural Sensitivity (CS) model (Resnicow et al., 1999). Then, we presented the culturally adapted curriculum to eight Mexican–American caregivers of youth with ASD. Specifically, we conducted three individual interviews with each participant (N = 24 interviews altogether) to examine their perceptions of the six sessions of the culturally adapted curriculum. Based on their feedback, changes were made to the curriculum. Overall, participants reported positive perceptions of the culturally adapted curriculum, but suggested the following recommendations: include information related to mixed‐status families, add information about guardianship, and use the translation technique of borrowing for specific terms. Based on the findings, implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this ecological study was to analyze the relationship of social restriction measures and people's interest in searching toothache‐related information on the Internet. Materials and Methods: The following indicators Stringency Index (SI), Years Lived with Disability (YLDs) for untreated caries in permanent teeth, Google market share, Internet penetration, and relative search volume (RSV) for the Topic "Toothache" in Google Trends were determined for 21 countries with available data, from April 2018 to May 2020. Statistical analysis was performed using Mann–Whitney U test, t‐Student test, Pearson's Chi‐square test, and Spearman and Pearson's cross‐correlation tests (α = 0.05). Results: Relative search volume values increased significantly after restriction measures in all countries, except for Japan. Higher RSV values were found among 11 countries that presented a cross‐correlation between RSV and SI with r≥│0.6│. The most common queries were linked to the treatment and self‐resolution of toothache, with a sudden increase of searches that combined the symptom with COVID‐19. Conclusions: The interests in toothache‐related digital information were associated with social restriction measures. These results allow the identification of dental demands of distinct populations, contributing to the planning of specific public health policies during and after the pandemic period. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to describe the quantity and cost of in‐person and telehealth dietetics services reimbursed under Australia's Medicare Benefits Scheme, before and during the coronavirus pandemic. Methods: Publicly available Medicare Benefits Scheme dietetics service activity data were extracted from an online database, between January 2019 and June 2021. For allied health telehealth items, it was assumed that between 10% and 20% of all consults were dietetic related. Results: Dietetics service claims reimbursed through the Medicare Benefits Scheme averaged 115 thousand per quarter in 2019. In quarter 2 of 2020, service delivery dropped by 25% compared to quarter 1 of 2020 and 32% compared to 2019. This drop recovered in quarters 3 and 4, with dietetic consultations claimed through the Medicare Benefits Scheme remaining relatively comparable to 2019 data. Dietetics services cost AUD 5,868,021 in quarter 1 2019 and AUD 5,742,632 in quarter 1 2020. Since the introduction of allied health telehealth items, the number of consultations claimed per quarter has accounted for between 17.7% (quarter 2 2020) and 4.5% (quarter 2 2021) of all consultations per quarter. Conclusions: The provision and costs of dietetics services in Australia have remained relatively constant compared to 2019 data, indicating telehealth was being used for substitutive rather than additive care, apart from an initial reduction of 25% between March and June 2020. The introduction of telehealth items for dietitians has been modest, peaking at 17.7% and now consistently averaging 5% of total dietetics services. The permanent implementation of telehealth items is unlikely to cause significant increases in cost or access and will assist Australians to eat better to support improved chronic disease outcomes. [ABSTRACT FROM AUTHOR]

Providing an enabling nurturing care environment for early childhood development (ECD) that cuts across the five domains of the Nurturing Care Framework (i.e., good health, adequate nutrition, opportunities for early learning, security and safety and responsive caregiving) has become a global priority. Brazil is home to approximately 18.5 million children under 5 years of age, of which 13% are at risk of poor development due to socio‐economic inequalities. We explored whether the Early Childhood Friendly Municipal Index (IMAPI) can detect inequities in nurturing care ECD environments across the 5570 Brazilian municipalities. We examined the validity of the IMAPI scores and conducted descriptive analyses for assessing sociodemographic inequities by nurturing care domains and between and within regions. The strong correlations between school achievement (positive) and socially vulnerable children (negative) confirmed the IMAPI as a multidimensional nurturing care indicator. Low IMAPI scores were more frequent in the North (72.7%) and Northeast (63.3%) regions and in small (47.7%) and medium (43.3%) size municipalities. Conversely, high IMAPI scores were more frequent in the more prosperous South (52.9%) and Southeast (41.2%) regions and in metropolitan areas (41.2%). The security and safety domain had the lowest mean differences (MDs) among Brazilian regions (MD = 5) and population size (MD = 3). Between‐region analyses confirmed inequities between the North/Northeast and South/Southeast. The biggest within‐region inequity gaps were found in the Northeast (from −22 to 15) and the North (−21 to 19). The IMAPI distinguished the nurturing care ECD environments across Brazilian municipalities and can inform equitable and intersectoral multilevel decision making. [ABSTRACT FROM AUTHOR]

Objective: To identify changes in the dental service provision to people with disabilities (PD) in the Dental Specialties Centers (acronym CEO in Portuguese‐Centro de Especialidades Odontológicas) between the first and second cycles of the Program for the Improvement of Access and Quality of CEO and analyse factors associated with any changes. Methods: This nationwide ecological time series study adopted the CEO as the analysis unit. The 827 CEO who participated in the two program's cycles (2014 and 2018) were included. Data on the structure and the work process were considered to identify features of providing services to PD in both cycles. Latent transition analysis (LTA) was performed to identify latent status (LS) with similar features and model the transition between LS over time. Models with five variables and with two to five LS were tested, considered best conceptual interpretability and best model fit parameters: human resources structure (dentist working exclusively with PD) and work process that identified guarantee of PD treatment at the CEO, the CEO's interface with primary care, and the interface with tertiary care. Spatial analysis was performed to identify spatial patterns of LS in the Brazilian territory with choropleth maps. A multinomial logistic regression model was performed to identify factors associated with changes in the provision of CEO (improved, remained or worsened). Findings: The best‐fit model identified four LS: 'Better', 'Medium better', 'Medium worse' and 'Worse'. CEO remained in the LS 'Better' (94%), LS 'Medium' (5.3%) and LS 'Worse' (78.4%). It is noteworthy that the highest proportion of CEO, in both cycles, was in the LS 'Better', featured by the CEO, characterized by all the CEO guaranteeing treatment to users with PD, high proportions of professionals working exclusively with PD, and most CEO articulated with primary care and with tertiary care. However, there is a decrease in the number of postgraduate professionals specializing in this service profile (1.3%). The higher the population growth, the greater the likelihood of the CEO achieving 'improved' in the LS. Moreover, the higher the number of goals, the lower the likelihood of the CEO getting 'worse' in the LS. Conclusion: Advances in dental service provision were observed, with more significant transitions to the 'Better' class, with improvements mainly in the interface with primary and tertiary care. Disability will be an even more significant concern as the population ages. Initiatives that can remove barriers and empower PD are potent in the provision of oral health services. [ABSTRACT FROM AUTHOR]

Summary: Purpose: The consumption of sugar‐sweetened beverages (SSBs) is associated with weight gain in both children and adults. In addition to environmental factors, such as food availability, psychological variables, including mood states, also impact intake. In the current study, we focus on momentary associations between feelings of loneliness and craving for SSBs among adolescents and explore the moderating role of family functioning. Loneliness has been associated with a wide range of health outcomes, but to date, few studies have examined its association with cravings for SSBs. Methods: Using an ecological‐momentary assessment design, data were collected on 158 (males = 68, mean age = 15.13 ± 2.27 years) participants. Multilevel mixed‐effects models were used to examine the relations between the main and interactive effects of loneliness and family functioning on cravings for SSBs, independent of other negative emotions. Results: Results suggest that loneliness in adolescents was associated with a small increase in craving for SSBs. Importantly, the relationship held after controlling for negative emotions, suggesting the unique role of loneliness. However, positive family functioning did not mitigate the relations between loneliness and craving for SSBs. Conclusions: Loneliness uniquely contributes to cravings for SSBs. At the same time, family functioning did not buffer the influence of loneliness on cravings for SSBs among adolescents. [ABSTRACT FROM AUTHOR]