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Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

The degree to which disability benefit programs provide an adequate standard of living to those with work-limiting disabilities has long been overlooked in social policy research. This paper presents a framework for assessing disability-related decommodification and then applies that framework to an analysis of the Social Security Disability (SSD) programs in the United States. The paper draws on survey data from the Health and Retirement Study linked to administrative records from the Social Security Administration, and further compares the U.S. estimates to those from 27 other countries. The results indicate that more than 50 percent of older adults of working-age with work-disabilities in the U.S. do not receive SSD benefits, though rates of benefit receipt are higher than the average across other high-income countries. Those that receive SSD benefits, moreover, experience greater difficulty achieving an adequate standard of living, as measured by an index of financial security, than those with similar characteristics in the U.S. who do not receive disability benefits. The paper thus provides a framework for future policy research on benefit adequacy, while evaluating the availability and generosity of disability benefits in the U.S. [ABSTRACT FROM AUTHOR]

Accessible SummaryWhat is known on the subjectHealth professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness.For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide.Little research has investigated multi‐national comparisons of nursing students' attitudes towards mental illness.What this paper adds to existing knowledgeThis study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness.Cultural perspectives may explain some of these differences.What are the implications for practiceRegardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness. Introduction: Stigmatizing attitudes perpetuated by nursing professionals are a pervasive problem for people experiencing mental health issues. This global issue has detrimental consequences; inhibiting one's life chances and help‐seeking behaviours. To date, few studies have compared nursing students' attitudes towards mental illness from a multi‐national perspective. Aim: To compare undergraduate nursing students' attitudes towards mental illness across six countries: Australia, India, Jordan, Saudi Arabia, Taiwan and USA. Method: In a cross‐sectional design, data were collected from undergraduate nursing students (N = 426) using the Social Distance Scale. A one‐way analysis of variance was used to compare differences between countries. Results: Nursing students' attitudes to mental illness differed between countries. Social Distance Scores were highest amongst nursing students from Jordan and Saudi Arabia. Students from Taiwan and India possessed moderate stigma scores. Social Distance Scores from the USA and Australia were lowest. Discussion: Clear differences in stigmatizing attitudes emerged between countries; these are discussed in relation to possible cultural influences. Implications for Practice: It is suggested that educating nurses, combined with direct contact with people with lived experiences of mental illness, can reduce stigmatizing attitudes regardless of country, location or educational institution. [ABSTRACT FROM AUTHOR]

Background: The proliferation of instruments that define instrument-specific metrics impedes progress in comparative assessment across populations. This paper explores a method to extract a common metric from related but different instruments and transform the original measurements into scores with a standard unit of measurement. Methods: Existing data from four assessment instruments of child development, collected from three different samples of children, were used to create "equate clusters" of items that measure the same behaviour in (slightly) different ways. A probability model was formulated to identify best items and groups to serve as anchors linking the instruments, assuming that items in an anchoring or "active" equate cluster are psychometrically equivalent. Quantification and inspection of item characteristic curves were used to resolve which equate clusters should be active. We simulated the impact of various analytic choices. Results: Simulation confirmed the feasibility of creating a common metric from data collected with different instruments from respondent samples with different abilities. The method performed as expected in an application in early childhood development. Conclusions: The use of equate clusters is an intuitive and flexible way to establish a common metric across instruments and facilitates the transformation of measurements obtained to a standardized scale. Standardizing instrument scores to a common metric allows for population-level comparisons on a global scale. [ABSTRACT FROM AUTHOR]

This paper presents the results of thirty-seven interviews of senior library leaders at American Association of University (AAU) institutions conducted in Spring 2023. The author replicated a 2016 study from portal , revealing an increased focus on strategic plan-based decision-making along with new priorities of open scholarship and diversity, equity, and inclusion (DEI). The COVID-19 pandemic had a drastic impact on staffing and budgets, requiring academic library leaders to balance internal operations and external collaboration. A younger, more diverse AAU library leadership population achieves success through strong advocacy to campus leadership and the inclusive leadership practices outlined in this paper. [ABSTRACT FROM AUTHOR]

Existing research suggests that prior victimizations during a person's lifetime, particularly childhood traumas and maltreatment, are risk factors for abuse and revictimization in adulthood, although longitudinal evidence is sparse. Using data from a 30-year ongoing longitudinal study of the long-term consequences of childhood maltreatment, this paper describes the extent to which childhood maltreatment predicts subsequent victimization and partner violence victimization at two time points in adulthood. Data were obtained from a prospective cohort design study in which children with court-substantiated cases of maltreatment (ages 0–11 years) and demographically matched controls were followed into adulthood and interviewed over several waves. Childhood maltreatment was assessed through juvenile and adult court records from 1967 to 1971 in a midwestern county area in the United States. Victimization experiences were assessed from 2000 to 2002 (M age = 39.5 years) and 2009 to 2010 (M age = 47.5) and included two types based on information from the lifetime trauma and victimization history instrument and questions about past year partner violence victimization. Individuals with histories of childhood maltreatment were more likely to report physical and sexual assaults and kidnapping and stalking victimization than controls through age 39.5. In contrast, the two groups did not differ at the later assessment at age 47.5, except maltreated individuals reported greater risk for sexual assault/abuse than controls. For intimate partner violence victimization at age 39.5, maltreated and control groups differed only in terms of victimization involving injury. Later in adulthood, more individuals with histories of childhood maltreatment reported partner physical violence victimization compared to controls. Although these longitudinal findings showed a general decline in victimization experiences over the two time points, these results demonstrate that childhood maltreatment increases risk for subsequent revictimization in middle adulthood, specifically for sexual assault/abuse and intimate partner physical violence victimization. These findings have implications for prevention and intervention efforts targeting maltreated children. [ABSTRACT FROM AUTHOR]

Objective: This paper reports on the initial outcomes of a new mHealth intervention to reduce diabetes distress (DD) in families of school-age children living with type 1 diabetes (T1D) entitled, 'Remedy to Diabetes Distress' (R2D2). Methods: We randomized 34 families (mean child age = 10 ± 1.4 years; 53% male, 85% White, mean HbA1c = 7.24 ± 0.71%) to one of three delivery arms differing only by number of telehealth visits over a 10-week period: zero visits = self-guided (SG), three visits = enhanced self-guided (ESG), or eight visits = video visits (VV). All families had 24 × 7 access to digital treatment materials for 10 weeks. We examined the feasibility and acceptability of R2D2. We used the Problem Areas in Diabetes-Child (PPAIDC and PAIDC, parent and child, respectively) to examine treatment effects by time and delivery arm. We performed sensitivity analyses to characterize families who responded to R2D2. Results: It was feasible for families to access R2D2 mHealth content independently, though attendance at telehealth visits was variable. Parents and children reported high satisfaction scores. There were significant pre-post reductions in PPAIDC (p = 0.026) and PAIDC (p = 0.026) scores but no differences by delivery arm. There were no differences in child age, sex, race, or pre-treatment HbA1c for responders versus non-responders, though families who responded reported higher PPAID-C scores pre-treatment (p = 0.01) and tended to report shorter diabetes duration (p = 0.08). Conclusions: Initial results support the acceptability and treatment effects of R2D2 regardless of the frequency of adjunctive virtual visits. Characterizing responders may help to identify families who could benefit from R2D2 in the future. [ABSTRACT FROM AUTHOR]

Background: Assessment tools that assess pragmatic skills in adults with a mild‐severe traumatic brain injury (TBI) are hard to access, not person‐centred and have a high risk of clinician bias. The Pragmatics Profile is an informant report tool that was originally designed to assess pragmatic skills in people with a developmental disability. Aims: The aim of this study was to seek consensus from a panel of experts and create a version of the Pragmatics Profile for the TBI population. Methods and Procedures: A three‐round modified Delphi methodology panel of 13 experts were invited to comment anonymously on the suitability of each question from the Pragmatics Profile modified for those with TBI until ≥ 80% agreement was reached. Outcomes and Results: The Pragmatics Profile (TBI) included 66 questions that achieved consensus after three rounds of the Delphi panel. Qualitative analysis illuminated themes relating to adults with TBI and the need to include contextual factors. Conclusions and Implications: The outcome of this project was a revised version of the Pragmatics Profile which is suitable for adults with a mild‐severe TBI, informed by experts and freely available online. Future research exploring the tool's utility and acceptability is the next step in its evaluation. WHAT THIS PAPER ADDS: What is already known on this subject: Assessment of the everyday functional use of language is challenging but vital. This is particularly true for those who have traumatic brain injury (TBI) where the communication outcomes can be highly variable and may include difficulties with conversational turn‐taking, topic maintenance and reading social cues.There are limited tools available to clinicians and those tend to be rating scales or checklists which have a high risk of clinician bias.Available tools have a limited ability to capture the individual's personal social communication goals. What this paper adds to existing knowledge: This study created an online Pragmatics Profile (PP) for TBI based on experts' opinions.This paper details the themes that emerged during the process of revising the PP for those with TBI. What are the potential or actual clinical implications of this work?: The PP‐TBI adds to the toolkit for speech and language therapists working with people with TBI. It meets recent recommendations in the literature to create an interview‐based tool.The versatility of an online tool combined with revised input from a panel of experts increases the likelihood that clinicians will utilise this tool.Given the long‐term use of the original PP by clinicians for almost 30 years and a focus on personalised care, the format and approach are also likely to be acceptable to clinicians. [ABSTRACT FROM AUTHOR]

The purpose of this research is to focus on the most practised Artificial Food Colourants (AFCs) creating a demand in the consumer food market and neglecting food safety by the stakeholders, as these AFCs have been proven to be harmful to human health. The problem question that has been addressed here is whether the labeling policy and the consumer awareness of AFC are in tandem with; how the Indian judiciary fared in delivering their judgements towards the prevalence of non-permitted AFCs in the Indian food market to tell them as successful for the healthier consumer food industry. The main objective is to examine the consumers's awareness on AFC on the International Numbering System for Food Additives (INS) and their mentioning on the label of food products along with the regulatory measures for approvals of AFCs in Europe, USA and India for comparison. It is revealed that consumers' awareness of INS is not very significant; FSSAI permits only eight AFCs for consumption, nevertheless, other non-permitted AFCs were also found to be used and the Indian government has acted responsibly on various occasions by entering the manufacturing premises to inspect the food, collect samples for testing the adulteration by submitting to the food analyst, thereby curbing such activities and grabbing such offenders to the court. The concept of food safety dimensions in consensus with AFC practices, the health and legal issues associated with AFC consumption, the Indian Government's policies and the response of the judiciary related to food colourants safety are discussed in this paper. A doctrinal research method is followed by analysing the legal literature such as the regulatory provisions, government policies and noteworthy cases from the Indian judiciary and drawing support from empirical research evidencing the poor knowledge of consumers on AFCs being added in the food. Therefore, a serious policy awareness among consumers with respect to AFCs, being responsible and taking ownership towards one's own health and their family members by taking steps in questioning the consumer forum, avoiding purchase of such packed food which does not adhere to the labeling standards and being consumer friendly. Stringent regulations in labeling standards of packaged food in the USA and Europe due to the import nature of their products are the need of the hour. [ABSTRACT FROM AUTHOR]

Background: The U.S. Boards of Nursing (BONs) collect annual report data from their nursing programs as part of their approval process. This paper highlights the 2020 and 2021 annual report data on the effect of coronavirus disease 2019 (COVID-19) on all nursing programs in 17 BONs in 2020 and 19 in 2021. Method: Nursing programs answered 16 questions on the effect of COVID-19 on their programs. Because BONs require annual report data, all programs in the participating states answered the questions, which included 798 programs in 2020 and 929 in 2021. Results: Major disruptions in nursing education occurred during the pandemic. Clinical experiences and didactic classes were greatly affected, though alternative strategies were used. Student and faculty attrition rates were particularly high in 2021. Conclusion: The authors call for a national forum where nurse leaders analyze what happened and make recommendations for future crisis events. [J Nurs Educ. 2024;63(5):312–319.] [ABSTRACT FROM AUTHOR]

The paper presents a comparative mixed methods study of the accessibility and usability for disabled people of four video conferencing tools, Zoom, MS Teams, Google Meet and Skype. Useable responses were obtained from 81 disabled people with diverse characteristics, mainly in the UK, though some groups had low representation. None of the tools was considered fully accessible and useable. Zoom was both the most commonly used and the most frequently preferred (56.1%) tool, with MS Teams second in usage and a trailing second in preferences (15.9%). It was considered to have better captioning, but otherwise to generally be a poor second to Zoom. Skype was the most commonly used before lockdown, but was considered dated and its limited use was mainly social, whereas the other tools were also used in work and education. The results were used to draw up separate lists of recommendations for developers and meeting organisers and hosts, as the study also identified actions for organisers and hosts to improve meeting accessibility. Developer recommendations include several easy to set customisation and user friendly interface features, involving disabled people and specific accessibility features, including compatibility with assistive technology, keyboard shortcuts for all functions and automatically-on high quality captions. [ABSTRACT FROM AUTHOR]

The Baylor Religion Survey (Wave 6; 2021) contains the most comprehensive set of prayer questions of any national survey of the USA; it also contains multiple indicators of mental health and well-being, specifically measures of happiness, depression, anxiety, sense of control, mattering, and dignity. This paper provides a complete overview of how various dimensions of prayer correlate with these different aspects of well-being. While many of these relationships will require more intensive investigation, our synopsis provides confirmation of past expectations using new data. Overall, we find that prayer is related to mental well-being in both positive and negative ways. Specifically, we find that praying with others and positive emotions felt during prayer are correlated with greater overall mental health and more positive self-concepts. However, we also find that petitionary prayer topics, belief that God is impersonal, and negative emotions felt during prayer coincide with higher levels of depression, anxiety, and a lack of control. Generally, these conclusions hold after controlling for basic demographics, religious tradition, and church attendance, which confirms that mental well-being is related to the practice of prayer in both beneficial and detrimental ways. [ABSTRACT FROM AUTHOR]

Background: The voices virtual on‐screen characters use has been shown to impact learning and perception outcomes. Recent replication research on these voices showed that synthetic voices were not a detriment if produced by a high‐quality engine with clear articulation. The current manuscript examines previous accent research that utilized now outdated engines, to determine if the impact of accents still holds with high‐quality engines and voice actors. Objectives: To investigate the impact on learning and perceptions with pedagogical agents speaking in accented voices, synthetic voices, and the interaction between the two using modern voice engines. Methods: This study is a between‐subjects two (accent) by two (type) factorial design to determine the impact the voice accent, voice type, and the interaction have on learning retention, learning transfer, mental effort efficiency, and perception measures. 197 participants were recruited from the online Amazon's Mechanical Turk with qualifications of 18 years of age, "normal or corrected‐to‐normal hearing", and located with the continental United States of America. Results and Conclusions: There were no significant differences between the accented conditions or interaction effects, deviating from previous research that showed impact of accents on learning. The synthetic condition had significantly lower knowledge retention, knowledge transfer, mental effort efficiency, and perception measures than the human professional. These findings demonstrate the importance of considering voice quality when designing pedagogical agents. Previous research showed synthetic voices perform as well as the average voice, and this research continues the narrative of voice quality by showing professional recordings outperform modern synthetic engines. Lay Description: What is currently known about this topic: Accents and synthetic voices can impact learning from virtual humans. What does this paper add: Shows professional human voices outperform modern synthetics, a quality effect. Implications for practice/or policy: Creators of educational materials should aim for professional voice actors. [ABSTRACT FROM AUTHOR]

Currently, schools in the United States are highly diversified and integrated. In other words, the integration of students representing multiple identities and positionalities existing in the same educational spaces is much more common. The purpose of this study was to examine elementary school principals' perspectives on inclusive education. Grounded in social constructionism, the research design was a descriptive case study positioned using qualitative methodology. The primary data sources were semi‐structured one‐on‐one Zoom interviews with four elementary school principals from the Midwestern region of the United States; and researchers' reflexive notes in order to understand how principals understand and deploy inclusion within their respective schools. Based on thematic analysis, in this paper, we constructed the following interrelated themes: (a) building discourses around inclusion from prior educational experiences; (b) culturally responsive leadership as a practice to inclusion; (c) collective feelings of safety, comfort and harmony and (d) the negotiation of privilege. These themes highlighted that the conceptualization and implementation of inclusion heavily prioritize the perspectives of professionals within schools rather than those of the individuals being included. [ABSTRACT FROM AUTHOR]

Background: The use of electronic intake forms within the electronic health record (EHR) is an emerging method for routinely collecting patient-reported outcomes (PRO). However, few studies have evaluated experiences/perspectives toward electronic forms among outpatients receiving care within Integrative Health and Medicine (IHM) clinics. The study purpose was to understand patients' perspectives of electronic intake and PRO forms in the outpatient IHM setting. Methods: Electronic intake (e.g., treatment expectations, medical history, chief complaints, prior experience with integrative modalities) and PRO forms (i.e., Patient Reported Outcome Measurement Information System [PROMIS]-29, Perceived Stress Scale 4, Oswestry Disability Index) were designed in collaboration with clinic leadership and the Information Technology team. Semi-structured interviews were used to gather perspectives of the functionality and acceptability of the forms among outpatients receiving care at the IHM center. Interviews were coded to describe themes regarding perceptions and suggestions for improvement. Results: Qualitative interviews were completed with 10 participants (median age 51 years, 70% female, 30% Black/African American). Participants considered electronic intake and PRO forms as relevant to their health concerns, valuable for conveying important health information to providers, and easy to navigate. Suggested changes to the intake form included adding relevant open-ended questions, save and print functions, and examples and definitions to prompt responses. Conclusion: Participants felt the electronic format was a feasible and acceptable method of collecting patient information and PROs. Future goals are to implement the revised forms in a common EHR to patients receiving care at multiple IHM clinics across the United States. [ABSTRACT FROM AUTHOR]

Emerging research supports that some former collegiate athletes (FCAs) can become physically inactive after retiring from sport, which can exacerbate unfavorable changes in long-term health. While researchers have addressed transitional difficulties FCAs may experience after retiring, little empirical evidence exists on how to promote healthy post-sport physical activity (PA) levels for those who are insufficiently active. Because of FCAs' past sports training, considering their opinions for effective PA program components may be beneficial in early stages of behavioral intervention development. As such, 17 insufficiently active former National Collegiate Athletic Association Division I athletes engaged in semi-structured interviews exploring their post-sport PA experiences and perceptions of effective program characteristics. Using Consensual Qualitative Research procedures, five domains were constructed. Three domains were discussed in a previous article; this paper overviews the remaining two, which describe participants' opinions of what would effectively promote PA in their population: (a) a desire for an 'athletics-lite' atmosphere in an FCA-targeted intervention, and (b) using technology to positively engage former athletes in their PA transition. While participants believed an athletics-based program where they are provided feedback and individualized workouts would be effective in maintaining PA, this may indicate underdeveloped autonomy in some FCAs regarding PA maintenance post-sport. Initially utilizing college sports personnel in a program may aid FCAs at risk of inactivity in transferring skills used in sport to independent PA maintenance after retiring. Further, the introduction and use of technology may help facilitate self-monitoring of progress, social support, and individualization when external resources are unavailable. Lay summary: Seventeen, inactive former college athletes (FCAs) were interviewed to understand enablers for promoting physical activity (PA) in their population. Utilizing sport/exercise personnel to help FCAs become more autonomous in their behavior and promoting self-monitoring through technology may help those in this population who struggle to maintain PA post-sport. IMPLICATIONS FOR PRACTICE: On-campus programs should consider involving athletics personnel (e.g., coaches, athletic trainers, certified mental performance consultants) and, pending available resources, outside experts (e.g., exercise physiologists) to deliver techniques, strategies, and education to explicitly support retiring student-athletes in maintaining PA after retirement. The perceived need for an athletics atmosphere, such as a coach-figure and teammates to be competitive with, may indicate underdeveloped autonomy for maintaining PA in insufficiently active FCAs. While athletics personnel may be useful in early promotion of PA, programs should strive to help them build more self-determined forms of motivation and be self-sufficient in maintaining PA post-sport. Programs may consider promoting the maintenance of PA to students-athletes via the use of wearable devices, PA applications, and online resources to promote self-monitoring of behavior, facilitate social support, and provide education on healthy PA practices. [ABSTRACT FROM AUTHOR]

Unplanned or unwanted pregnancies and births are linked to adverse maternal outcomes, but the extent to which such relationships hold for all racial/ethnic groups remains unknown. In this paper, I use large-scale data to estimate unadjusted and inverse propensity weighted associations between a five-level measure of pregnancy intention and six indicators of maternal well-being among separate samples of white, Black, and Hispanic mothers. I find substantial racial/ethnic variation. White and Hispanic mothers who reported that their pregnancies were mistimed, unwanted, or that they were unsure how they felt were significantly more likely to experience adverse outcomes than same-race/ethnicity mothers who reported that their pregnancy was intended, but the pattern was much more tenuous for Black mothers. After adjusting for potential confounding variables, relationships between pregnancy intentions and adverse outcomes remain substantial only for white and Hispanic mothers. Significance: What is already known on this subject?: Recent research has found links between unplanned or unwanted pregnancies and adverse maternal outcomes, but the extent to which the relationship varies by race/ethnicity is unknown. What this study adds?: This study estimates unadjusted and inverse propensity weighted associations between a 5-level measure of pregnancy intention and six indicators of maternal well-being among separate samples of white, Black, and Hispanic mothers. Both unadjusted and inverse propensity weighted relationships are considerably stronger among Hispanic and white mothers than among Black mothers. Possible causes of these differences are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand the developmental experiences that unfold in youth development contexts, and why they matter for character development. Drawing on pre- and post-program data provided by 846 adolescents (47% female, 63% youth of color), this paper empirically investigated the role of three developmental experiences―developmental relationships, critical reflection, and intrinsic program engagement―in promoting civic, moral, intellectual, and performance character strengths in a conservation context in the United States. Results provide robust evidence of the pervasive power of all three developmental experiences, and especially youth-adult developmental relationships and critical reflection, in promoting key elements of character. Specific suggestions are described for organizational action to invest strategically and systematically in these program features to support young people's character development. [ABSTRACT FROM AUTHOR]

Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions. [ABSTRACT FROM AUTHOR]

Financial exploitation (FE) is one of the most common reports to Adult Protective Services (APS) and the cases are often complex. Consequently, APS caseworkers report FE investigations to be among the most difficult while simultaneously reporting low confidence in productive outcomes for these investigations. This necessitates finding ways to support APS FE investigations. This paper describes the structure, process, and formative findings of a collaboration between forensic accounting examiners and APS workers to investigate complex cases of FE. Among the 77 FE cases completed, forensic examiners reviewed multiple years of financial records which included over 101,000 transactions, totaling over $213,000,000.00 in finances, and identified over $8,000,000 in questionable activity. Scores on the 8-item Client Satisfaction Questionnaire were high indicating high program satisfaction by APS workers, subject matter experts, and forensic examiners. These findings support the feasibility and acceptability of forensic accounting and APS collaborations to investigate complex cases of FE. [ABSTRACT FROM AUTHOR]

INTRODUCTION Despite the existence of numerous studies highlighting the adverse effects of smoking on kidney function, the investigation of the correlation between serum cotinine and chronic kidney disease (CKD) remains inconclusive due to insufficient evidence. Consequently, the primary objective of this study was to ascertain the association between serum cotinine levels and CKD. METHODS This study analyzed data from 10900 Americans participating in the National Health and Nutrition Examination Survey between 2005 and 2016. The independent variable under investigation was log serum cotinine, while the dependent variable was the presence of CKD. To investigate the potential linear and non-linear correlations between serum cotinine and CKD, logistic regression models and generalized additive models (GAM) were employed. Furthermore, stratified analyses and interaction tests were conducted to evaluate potential disparities in the relationship between serum cotinine and CKD, based on sex. RESULTS The median age in the study participants was 49.28 ± 17.96 years, and the median log serum cotinine (ng/mL) was -0.54 ± 1.68. The prevalence of CKD was found to be 17.04%. Multifactorial regression analysis did not show a statistically significant association between log serum cotinine and CKD (OR=1.02; 95% CI: 0.98--1.06, p=0.4387). A statistically significant non-linear association between log serum cotinine and CKD was also not observed in the GAM analysis (p nonlinear value=0.091). Subgroup analyses revealed sex differences in the association between log serum cotinine and CKD. Briefly, males had a positive association between log serum cotinine and incident CKD (OR=1.08; 95% CI: 1.02--1.15, p=0.0049). In females, there was a U-shaped association between log serum cotinine and CKD, with an optimal inflection point for log serum cotinine of -0.30 (serum cotinine=0.5 ng/mL). CONCLUSIONS Cross-sectional analyses of NHANES data showed gender differences in the association between serum cotinine and the development of CKD. [ABSTRACT FROM AUTHOR]

This paper aimed to explore BDSM involvement and its effects on mental health. The study had four objectives: (1) quantify frequencies of BDSM self-labels, (2) describe patterns of BDSM involvement subtypes (i.e. fantasy, behaviour, and identity), (3) compare BDSM-related involvement among two samples: members of the National Coalition for Sexual Freedom (NCSF) and a non-NCSF sample of adults interested in or practicing BDSM, and (4) understand whether BDSM identity specialty interest group membership is associated with enhanced health (i.e. coping). Data were drawn from archival survey data on sexuality and health. Participants (N = 1036) completed BDSM identity and behaviour measures. The most common BDSM identities were 'dominant' and 'submissive'. NCSF members adopted BDSM identity labels more frequently compared to general adult BDSM practitioners. Dominant and submissive fantasy and behaviour varied by gender, sexual orientation, and relationship status. For example, cisgender men reported elevated patterns of dominant and lowered submissive BDSM involvement. Compared to non-NCSF members, NCSF members reported higher dominant and submissive fantasies and behaviours, and better mental health and emotion regulation. Finally, submissive fantasy involvement displayed statistically significant, but weak, positive associations with psychological health. Potential implications for public health practice, theory development, and future research are discussed. [ABSTRACT FROM AUTHOR]

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases: PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs. [ABSTRACT FROM AUTHOR]

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. [ABSTRACT FROM AUTHOR]

Purpose: Research suggests immigrants are at a greater risk of mental health disorders compared to native-born populations. Thus, the current study investigated factors associated with professional mental help-seeking intention among American immigrants. Method: A cross-sectional study was conducted with 207 first-generation Iranian Americans, and data were collected using survey questionnaires. Results: Younger Iranians living in western states in the United States and those with positive attitudes toward professional mental health services had greater intention to seek these services. Unexpectedly, those with better mental health literacy (MHL) held more mental health stigma (MHS). Conclusion: Findings elucidated valuable insights into the complex dynamics among sociodemographic factors, acculturation, MHL, MHS, attitudes, and intentions toward professional mental health help-seeking. We also highlighted the intricate relationship between MHL and MHS, suggesting that strategies to improve MHL may not necessarily mitigate MHS within this community. Therefore, integrating anti-stigma, contact-based approaches to MHL programs could effectively reduce stigma while facilitating mental health help-seeking. [Journal of Psychosocial Nursing and Mental Health Services, 62(12), 37–48.] [ABSTRACT FROM AUTHOR]

Research on pornography use and sexual coercion has provided some evidence that there is an association between these two behaviors. One area in this body of research where there is a need for improvement is the operationalization of pornography use. In particular, a need for researchers to capture all relevant aspects of pornography use that are associated with sexual coercion. These aspects include frequency of use, type of pornography used, investment in use, sexual scripts adopted from pornography, compulsive use, and first exposure. The current study aims to examine which of these aspects of pornography use are significantly associated with sexual coercion. A sample of 365 college males was surveyed on their pornography use, engagement in sexually coercive behaviors, and other relevant variables. Results show that sexual scripts and investment in pornography use are significantly related to self-reported sexual coercion. These findings indicate that the frequency with which someone views pornography may not be driving the relationship between pornography use and sexual coercion and that an individual's monetary investment in their pornography use habit, as well as their adoption of sexual scripts from pornography, may be what is driving this relationship. In addition, these findings have implications for the aspects of pornography use that researchers should focus on when examining the relationship between pornography use and sexual coercion. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated the potential link between serum klotho levels and cognitive function in patients with non-alcoholic fatty liver disease (NAFLD). Materials and Methods: Utilizing NHANES data from 2011 to 2014, the research included 356 eligible participants. NAFLD was identified with the United States Fatty Liver Index (US-FLI), and cognition was measured by various tests including the Animal Fluency Test (AFT), Digit Symbol Substitution Test (DSST), Immediate Recall Test (IRT), and Delayed Recall Test (DRT). Weighted logistic regression and restricted cubic splines were employed to analyze the relationship between klotho levels and cognitive scores. Results: A significant nonlinear association was observed between klotho levels and the performance in DSST and Delayed Recall Test (DRT). After controlling for confounding factors, the study found a positive association between higher serum klotho levels and improved cognitive performance in both AFT and DSST. However, there was no significant relationship between klotho levels and the IRT or DRT, regardless of whether the natural logarithm or quartile was considered. Discussion: The findings suggest that a higher serum klotho level may be positively correlated with better cognitive performance in NAFLD patients. [ABSTRACT FROM AUTHOR]

Background: The inclusion of family therapy in residential treatment centers (RTCs) has increased over time. However, there is little data on whether empirically-supported family therapies (ESFTs) are being adopted and if they contribute to treatment effectiveness. This study aimed to test whether Attachment-Based Family Therapy (ABFT), an ESFT integrated into a large residential psychiatric system, would improve perceived attachment insecurity (anxiety and avoidance) and contribute to decreases in depression for adolescents. Method: ABFT was integrated into the clinical program of a large, residential psychiatric system. All family therapists were trained to a level of certification. Improvement was measured by changes in adolescent's perceived attachment to caregivers and reduction in depressive symptoms. The sample included 4786 patients. Attachment insecurity and depressive symptoms were measured at intake, week 3, and week 5. A random-intercept, cross-lagged panel model was used to examine the relationships between attachment and depression over time. Results: The results generally supported hypotheses. Attachment insecurity and depressive symptoms improved over the five weeks of treatment. Improvements in attachment avoidance preceded improvements in depressive symptoms within subjects, over time. Simultaneously, improvements in depressive symptoms preceded those in both dimensions of attachment. Thus, improvement in perceived attachment was associated with a reduction in depressive symptoms. Conclusion: RTCs that can generate improvements in attachment insecurity and depressive symptoms, via ABFT or other ESFTs, might improve treatment outcomes, and ideally, adolescents' successful transition back home to families. More research is needed to disentangle the contribution of ABFT and other treatment elements in a multimodal, residential treatment program. The study supports the call for increased incorporation of families into the RTC treatment process. [ABSTRACT FROM AUTHOR]

Background: Bowel urgency, the sudden and immediate need to have a bowel movement, is common in patients with ulcerative colitis (UC) and Crohn's disease (CD). While its impact in UC is well established, less is known about its importance in CD. Further, what level of bowel urgency control patients with UC or CD would consider to be acceptable or in remission has not been established. This qualitative study aimed to understand perceptions of bowel urgency and remission in these patients. Methods: Semi-structured combined concept elicitation and cognitive interviews were conducted to explore how adults with moderate-to-severe UC or CD and current or recent bowel urgency think about the concept of bowel urgency and its remission. The Urgency Numeric Rating Scale (UNRS) was used to examine different levels of bowel urgency severity and to investigate what level of bowel urgency patients would consider as representing remission. Results: Forty adults (n = 19 UC, n = 21 CD) recruited from six US sites completed the study. Sociodemographic and clinical characteristics were similar in both groups. Both groups reported impacts of bowel urgency on physical, social, professional, and emotional aspects of their lives. Most participants (n = 15 UC, n = 18 CD) reported having experienced one or more incidents of urgency-related fecal incontinence. Most participants considered remission to be a state with a normal or reduced number of bowel movements and no or less frequent bowel urgency, and they noted that remission would increase their ability to engage in daily activities without fear of fecal incontinence. Participants were able to map different levels of severity of bowel urgency to UNRS score ranges (scale: 0–10), and they indicated that a mean UNRS score of 5 (UC) or 4 (CD) would be the highest point on the NRS at which they would still consider their bowel urgency to be in remission. Conclusions: Bowel urgency is an important issue for patients with either moderate-to-severe UC or CD, and its remission would improve their lives. Further, these patients may still consider bowel urgency to be in remission even at UNRS scores as high as 4 or 5. Plain English summary: Bowel urgency is the sudden need to rush to the bathroom to have a bowel movement, which is common in people with ulcerative colitis and Crohn's disease. We interviewed adults with moderate or severe ulcerative colitis or Crohn's disease to better understand their experiences. They said that bowel urgency often made them feel anxious, depressed, or embarrassed and interfered with their social lives, work, and chores. Most felt that they would be in "remission" if the bowel urgency stopped or happened less often. They added that this would help them feel more relaxed and be more active. Interestingly, they would consider even a moderate amount of bowel urgency as being in "remission." This information can help healthcare providers better understand the toll that bowel urgency takes on patients with ulcerative colitis or Crohn's disease and better manage their treatment. [ABSTRACT FROM AUTHOR]

Background: Alterations in the bacteria, such as the periodontal bacteria, might be considered potential risk factors for nonalcoholic fatty liver disease (NAFLD). Most studies analyzing this association have focused mainly on a specific periodontal bacteria (Porphyromonas gingivalis) and have involved relatively small study populations (tens or hundreds of individuals). To address this gap, a sizable, nationally representative adult population was utilized to investigate the association between the incidence of NAFLD and high serum IgG antibodies for 19 periodontal bacteria. Methods: To explore this association, data from the Third National Health and Nutrition Examination Survey (NHANES III)—which provides a cross-sectional representation of the noninstitutionalized U.S. population, encompassing 33,994 individuals—were analyzed. Participants aged 40 years and above with data on NAFLD—determined by the gold standard of ultrasound examination (USON)—as well as comprehensive records of serum IgG antibodies against periodontal bacteria, were included, resulting in a final analysis subset of 6,330 individuals. Results: Using a cluster analysis based on the Socransky classification scheme for oral microorganisms, antibody titers for the 19 bacteria were grouped into four clusters—Red-Green, Orange-Blue, Yellow-Orange, and Orange-Red. When these clusters, as well as individual antibody relationships with NAFLD, were examined, the adjusted odds ratios (ORs) ranged from 0.958 [95% confidence interval (CI): 0.916, 1.003] to 1.021 [95% CI: 0.987, 1.055]. This indicated that no statistically significant associations were found (P > 0.05), underscoring the absence of a meaningful link. Conclusions: In summary, it was discovered that there is currently no evidence to correlate serum antibodies to periodontal pathogens with NAFLD in the nationally representative NHANES III. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background/Objectives: Test efficacy of the social emotional learning (SEL)-based Mighty Girls program, a program culturally tailored for English-speaking Hispanic/Latino girls in seventh grade comprised of classroom sessions and a virtual reality computer game. We hypothesized that the curriculum would decrease risky sexual behaviors in a program that can be used as part of a comprehensive sex education curriculum or as a stand-alone program. Methods: A randomized group trial was conducted in which 22 low-income, predominately Hispanic schools within the Miami-Dade County Public School System were randomly assigned to intervention (consented n = 335) and control (consented n = 217) conditions. All study activities occurred after school. Primary outcome measures were resistance self-efficacy, acceptance of dating violence, sexual intentions, and sexual behavior. Assessments occurred at baseline, immediately post-intervention, 3-, 12-, and 24-months post-intervention. Changes in outcomes from baseline to 24 months were modeled using multi-level models to account for nesting of students within schools with full information maximum likelihood to account for missing data and baseline school attendance and enrollment in free and reduced lunch as covariates. Analyses are also controlled for multiple testing. Results: The program had a significant effect on reducing acceptance of dating violence at 24 months post-intervention (estimate = −0.083, p ≤ 0.05), but no effect on resistance self-efficacy, sexual intentions, or sexual behavior (p ≥ 0.58). Conclusion: Study findings demonstrate that a social emotional learning (SEL) curriculum can impact sexual behaviors such as susceptibility to dating violence. Low baseline levels for sexual intentions and behaviors as well as a high baseline of efficacy may have impacted findings for the other outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Ineffective communication between health care professionals is one of the leading causes of medical errors and can result in adverse events and patient harm. Improving the effectiveness of communication in health care is a worldwide necessity. Objective: The aim of this project was to promote evidence-based practices regarding general communication principles among the nursing staff in one unit of a children's hospital in the southern United States. Methods: The project used JBI's Evidence Implementation Framework, together with two JBI audit tools (Practical Application of Clinical Evidence System and Getting Research into Practice). A baseline audit was conducted, followed by the implementation of targeted strategies. The project was completed with a follow-up audit to determine changes in practice. Results: Baseline data revealed 61% adherence with four audit criteria for effective communication in health care. Barriers included a lack of education of nursing staff regarding communication skills and less than optimal use of a structured communication tool. Targeted strategies to address the barriers included providing an educational module on communication to nursing staff and moving the structured communication tool to a more convenient location to increase its use. The post-implementation data revealed 81% adherence with the four audit criteria, a 20% increase from baseline results. Conclusions: Optimizing communication and monitoring the use of a structured communication tool has the potential to decrease the risk of medical errors among health care providers. [ABSTRACT FROM AUTHOR]

Aims: We investigate the relationship between narrative macrostructure, current language exposure, and microstructure in second-grade Spanish-English bilingual children in the United States. Macrostructure knowledge has been claimed to be shared across languages in multilingual individuals. We examine the role of current language exposure and microstructure on macrostructure and how individual children organize their stories in English and Spanish. We use socio-cultural theory to investigate differences in the macrostructural elements children choose to include in their stories by language. Methodology: Using existing data, we used a two-sample t-test to compare average macrostructure and microstructure performance in English and Spanish in addition to performance on subcomponents of macrostructure. A correlational analysis was used to compare narrative performance in both languages. We used regression analysis to investigate to what extent current language exposure and microstructure influenced the macrostructure of 62 Spanish-English bilingual second graders' stories. Results: Children used more words and a greater variety of words in Spanish compared to English. However, they demonstrated comparable use of overall macrostructure across languages, in addition to variation in what macrostructure subcomponents they use by language of story elicitation. No statistically significant relationship was found between current language exposure and macrostructure, except for Spanish story structure. Correlational analysis revealed a significant relationship between macrostructure performance in English and Spanish. A significant relationship was found within languages between micro-structure and macrostructure and across languages between Spanish micro-structure and English internal state terms. Discussion: Findings are consistent with extant literature that claims macro-structure is shared across languages. Children require lexical diversity across languages to express their ideas organized within macrostructural elements. Although bilingual children tell comparably complex stories, they may be making culturally and linguistically specific decisions about what macrostructure components to include in their stories. [ABSTRACT FROM AUTHOR]

Aim: To examine the psychometric properties of a short form version of the Numinous Motivation Inventory (NMI) for use with healthcare providers in measuring their existential engagement with life and to assess its relationship with spiritual coping and emotional dysphoria. Design: Correlational and psychometric study. Method: Data were collected from June to December 2022. Participants included 102 physicians, recruited from across the United States. Qualtrics was utilized to collect data, and they were evaluated with the NMI short form, Spiritual Coping Questionnaire and Depression, Anxiety, and Stress scale (DASS‐21). Results: Obtained fit statistics from structural equation modelling analysis indicated close fit of the NMI short form with the original model. Multiple regression analyses demonstrated the value of the NMI as a predictor of negative affect independent of spiritual coping. The NMI did not interact with Spiritual Coping, which was independent of negative affect. Conclusions: The Numinous represents an important aspect of physicians' coping. The constructs can be utilized in training and clinical settings as a valuable and easy‐to‐use metric for promoting and assessing wellness. The implications of these findings and the value of the NMI were discussed. Impact: An understanding of existential drivers can equip one to cope with the stressors of healthcare. The NMI short form has the capability to explore an individual's existential drivers through the understanding of three domains. Reporting Method: Adhered to proper EQUATOR guidelines (GRRAS). Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Complex motor stereotypies are rhythmic, repetitive, fixed, and non-goal directed movements (e.g., bilateral flapping/waving movements of the hands/arms). Movements typically begin in early childhood and can occur in otherwise normally developing ("primary") or autistic ("secondary") children. Stereotypies persist, occur multiple times a day, have prolonged durations, can be socially stigmatizing, and may lead to bullying and isolation. Prior behavioral treatment studies have focused on older children (ages 6–12) and report modest reductions in stereotypy (i.e., between 14% and 33%). The current study involves the functional assessment and treatment of five children with Primary Complex Motor Stereotypy using a modified awareness training procedure, differential reinforcement of other behavior, and schedule thinning in a nonconcurrent multiple baseline design. Results suggest a 99% reduction of motor stereotypy from baseline across all participants. [ABSTRACT FROM AUTHOR]

Background: Evidence on long COVID symptom clustering patterns among patients with COVID-19 is limited. We summarized long COVID symptoms in clusters defined by number of symptoms co-occurring together, and we assessed Health-Related Quality of Life (HQRoL), Work Productivity and Activity Impairment (WPAI) outcomes across these clusters over time. We assessed associations between the clusters and BNT162b2 vaccination status. Methods: A prospective longitudinal patient-reported outcomes (PRO) study recruited laboratory-confirmed symptomatic COVID-19 patients seeking testing from a national retail pharmacy. Long COVID-19 symptoms were self-reported by participants at 4-week, 3-month and 6-month surveys. Patient classes identified via latent class analysis (LCA) with long COVID-19 symptoms were simplified into clusters based on number of symptoms. HRQoL and WPAI outcomes were collected using EQ-ED-5L and WPAI: GH questionnaires. Mixed models for repeated measures analyses were conducted to examine associations between exposure groups and outcomes. Results: The study included 328 participants that were segmented into three groups of long COVID-19 symptoms based on LCA and then simplified by the number of symptoms (Cluster 1 low, <2; Cluster 2 moderate, 2–6; and Cluster 3 high, >6 symptoms). The number of long COVID-19 symptoms was negatively associated with HRQoL and WPAI, whereby participants with high symptom burden (>6 symptoms) had the lowest HRQoL and WPAI scores assessed by absenteeism, presenteeism, work productivity loss, activity impairment, and hours worked metrics. Compared with those unvaccinated and not up-to-date with COVID-19 vaccination, subjects boosted with BNT162b2 consistently reported less symptom burden during the follow-up, regardless of their symptom-based cluster. Conclusion: Three distinct patient clusters based on frequency of long COVID symptoms experienced different HRQoL and WPAI outcomes over 6 months. The cluster with more concomitant symptoms experienced greater burden than the others. Participants up-to-date with BNT162b2 reported lower symptom burden across all clusters and timeframes. Clinical trial registration: Clinicaltrials.gov NCT05160636. [ABSTRACT FROM AUTHOR]

Background: Obesity is a growing epidemic with non-surgical/non-pharmacological interventions having only nominal and transient effects on excess weight. Those persistent shortcomings are associated with minimal understandings of impacts of treatment-associated changes in psychological variables and their relationships. Women of lower incomes have high rates of obesity and might have increased difficulties accessing evidence-based programs. Methods: Women with obesity of lower- to lower-middle incomes participated in 6-month community-based treatments in the United States emphasizing either self-regulatory skills development (behavioral methods group: n = 63) or typical education in exercise and healthy dietary practices (education group: n = 48). Results: There were significant 6-month improvements in self-regulation, self-efficacy, mood, physical activity/exercise, dietary behaviors, and weight in both groups. All improvements were significantly greater in the behavioral group. Based on the incorporation of multiple behavioral theories, separate multiple regression models were fit for prediction of the weight-loss behavior changes. Stepwise entry of changes in self-regulation, self-efficacy, and mood each significantly contributed to the explained variance in physical activity/exercise change. Change in self-efficacy was most relevant in the prediction of change in dietary behaviors. Change in physical activity/exercise was significantly related to change in dietary behaviors; however, a regression analysis indicated that only physical activity/exercise change was a significant independent contributor to the overall accounted-for variance in lost weight. Conclusion: By incorporating key tenets of social cognitive theory, self-efficacy theory, self-regulation theory, coaction theory, and the mood-behavior model in an additive manner, suggestions and emphases for addressing psychological variables for improved weight-loss behaviors within scalable obesity treatments were advanced. [ABSTRACT FROM AUTHOR]

Background: Medication non-adherence is a common issue in chronic illness. The World Health Organization has recognized a need for a valid and reliable method of measuring adherence to understand and mitigate non-adherence. This study aimed to psychometrically evaluate the English version of the Adelphi Adherence Questionnaire (ADAQ©), a questionnaire designed to assess patient-reported medication adherence across multiple therapy areas, in patients with Osteoarthritis (OA). Methodology: Data from the Adelphi OA Disease Specific Programme™, a survey of physicians and their consulting adult patients with OA conducted in the United States, November 2020 to March 2021, was used to assess the psychometric properties of the ADAQ. Patients completed the ADAQ, Adherence to Refills and Medication Scale (ARMS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and EQ-5D-3L. The measurement model of the 13-item ADAQ was assessed and refined using latent variable modelling (Multiple Indicator Multiple Cause, confirmatory and exploratory factor analyses, item response theory, Mokken scaling, and bifactor analyses). Correlational analyses (Spearman's rank and polyserial as appropriate) with ARMS, WOMAC, and EQ-5D-3L scores assessed construct validity. Anchor- and distribution-based analyses were performed to estimate between-group clinically important differences (CID). Results: Overall, 723 patients were included in this analysis (54.5% female, 69.0% aged ≥ 60). Latent variable modelling indicated a unidimensional reflective model was appropriate, with a bifactor model confirming an 11-item essentially unidimensional score. Items 12 and 13 were excluded from scoring as they measured a different concept. The ADAQ had high internal reliability with omega hierarchical and Cronbach's alpha coefficients of 0.89 and 0.97, respectively. Convergent validity was supported by moderate correlations with items of the ARMS, and physician-reported adherence and compliance. Mean differences in ADAQ score between high and low adherence groups yielded CID estimates between 0.49 and 1.05 points, with a correlation-weighted average of 0.81 points. Conclusion: This scoring model showed strong construct validity and internal consistency reliability when assessing medication adherence in OA. Future work should focus on confirming validity across a range of disease areas. [ABSTRACT FROM AUTHOR]

The bullying of nurses by patients, doctors, and employees is common in the healthcare industry. Nurses who are bullied are more likely to experience burnout, and nurses who experience burnout are more likely to intend to quit. However, few studies investigate how leadership can mitigate workplace incivility and nurse bullying as a way to improve nurse retention. A cross‐sectional study was conducted using a sample of 216 nurses recruited from various regions across the United States from different specialties. A moderated mediation model using path analysis was used to examine the relationships between bullying, burnout, and ethical leadership in predicting intentions to stay. Bullying significantly and positively related to burnout (β = 0.22, p = 0.02), and burnout significantly and negatively related to intent to stay (β = −0.18,p = 0.01). Perceived ethical leadership predicted intentions to stay (β = 0.62, p = 0.00), and ethical leadership moderated the effect of bullying on burnout (β = 0.20, p = 0.03). The results of our study also suggest that nurses are less likely to quit when ethical leadership is present, and ethical leadership weakens the effect of bullying on burnout. [ABSTRACT FROM AUTHOR]

Objective Conventional total knee arthroplasty (TKA) rehabilitation has little impact on sedentary lifestyles that have negative long-term health consequences. The purpose of this trial was to determine the effect of telehealth-based physical activity behavior change intervention on physical activity and functional outcomes following TKA. Methods This study was a 2-arm, parallel randomized controlled superiority trial at a regional Veterans Affairs medical center. The participants were 92 US military veterans (mean age = 65.7 [SD =7.8] y) undergoing unilateral TKA. The Physical Activity Behavior Change (PABC) intervention included telehealth-based self-management training (10 30-minute sessions) delivered over 12 weeks. The control intervention included telehealth-based health education sessions that matched PABC frequency and duration. Both groups participated in standardized conventional outpatient rehabilitation. Physical activity, measured as average daily step count, was the primary outcome. Secondary outcomes were Life-Space Assessment questionnaire, 30-Second Chair-Stand test, Timed "Up & Go" Test, 6-Minute Walk Test, Western Ontario and McMaster Universities Osteoarthritis Index, and Veterans RAND 12-Item Health Survey. The Self Efficacy for Exercise scale and daily time spent in different postures (sitting/lying, standing, stepping) were exploratory variables. Outcomes were measured at baseline (before surgery), mid-intervention (8 weeks after surgery), after the intervention (14 weeks after surgery; primary endpoint), and follow-up (38 weeks after surgery). Results The PABC group had an estimated 931 (95% CI = 42–1819) more daily steps than the control group from baseline to 14 weeks, though a between-group effect was not sustained at 38 weeks. There were no group differences in secondary outcomes. Participants included only military veterans using Veterans Health Administration services. The intervention targeted self-management and did not include peer support. Conclusion The PABC intervention improved physical activity for veterans recovering from unilateral TKA at 14 weeks after surgery, though the effect was not sustained at 38 weeks. Physical function improved with rehabilitation but was not different between groups, indicating that physical function was not a primary driver of physical activity behavior. Impact Conventional TKA rehabilitation has a negligible effect on free-living physical activity, which is relevant to long-term health outcomes. This trial identified telehealth physical activity self-management as effective in addressing activity behaviors, separate from conventional rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Gaslighting, a form of psychological abuse, has received increasing attention in recent years. The current research provides reliability and validity evidence for a new 11-item measure of exposure to gaslighting by a romantic partner: The Gaslighting Relationship Exposure Inventory (GREI). Two studies were conducted with Israeli (N = 509) and American (N = 395) community samples. Participants were involved in a romantic relationship and completed an online questionnaire that included measures of intimate partner violence (IPV) victimization, depression, and relationship satisfaction. In both studies, the GREI items loaded onto a single factor of relationship gaslighting exposure. The scale demonstrated metric gender invariance and was reliable in both men and women. Relationship gaslighting exposure was strongly linked with psychological abuse victimization and weakly linked with other forms of IPV victimization, thus showing strong convergent and discriminant validity. Moreover, relationship gaslighting exposure was associated with greater depression and lower relationship quality, above and beyond other forms of IPV victimization. The results support the reliability and validity of the GREI in both men and women, as well as its utility for the study of gaslighting exposure within relationships. The current research highlights that gaslighting is a distinct form of psychological abuse with unique implications for personal and relational well-being. [ABSTRACT FROM AUTHOR]

Purpose: Situated within the conservation of resources theory, this study sought to understand how resources such as self-efficacy, job satisfaction, caseload size, and geographic location influence the number of data sources used by school-based speech-language pathologists (SLPs) to determine eligibility. Method: Using a cross-sectional descriptive design, 665 school-based SLPs from the United States reported professional demographics, workload, and assessment/eligibility characteristics, as well as levels of job satisfaction and self-efficacy. Multiple regression was used to examine the effects of self-efficacy, job satisfaction, caseload size, and geographic location on the number of data sources used in eligibility decision making and to examine the effects of caseload size and job satisfaction resources on SLP self-efficacy. Results: SLPs, on average, reported using 7.98 data sources to support eligibility determinations. Standardized tests, conversation samples, and review of records were most used, and literacy assessments were used least. Results of multiple regression models indicate that SLPs with higher self-efficacy scores reported using significantly more data sources and that SLPs with higher job satisfaction indicated significantly higher self-efficacy. Conclusions: This study affirms self-efficacy as a strong resource for school-based SLPs and that it is, in fact, related to the number of data sources used in eligibility decisions. Limited literacy assessment was reported, despite the SLP's critical role in an educational setting. Job satisfaction as a predictor of self-efficacy and self-efficacy, in turn, as a predictor of data sources underscore the need for SLPs to advocate for work conditions that support their work. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the experiences of families of children with developmental language disorder (DLD) during COVID-19 educational disruptions is essential for designing responsive supports during pandemic recovery efforts and beyond. This qualitative study describes the experiences of families of first-and second-grade children with DLD during the pandemic as compared to the experiences of families of typically developing (TD) peers. Method: A conventional content analysis approach was used to analyze caregivers' written responses to open-ended questions regarding their perceptions of COVID-19 educational disruptions. Responses were analyzed separately by group: caregivers of children with DLD (n = 23) and caregivers of TD children (n = 22). Results: Four categories of caregiver responses were generated for each group: impacts on children, remote learning challenges, impacts on caregivers, and protective factors. For both groups, concerns about the child's well-being and literacy learning were most prevalent and prevailed over concerns about oral language. Most caregivers in each group described negative impacts of educational disruptions on their cdhildren. As compared to caregivers of TD children, caregivers of children with DLD reported higher rates of remote learning challenges and more negative impacts on literacy learning, speech and/or language, and education in general. DLD caregivers also shared fewer positive comments and remarks related to protective factors. Conclusions: Results indicate that families of children with DLD may have experienced more challenges during COVID-19 educational disruptions as compared to families of TD peers. Thus, responsive research and supports for these families is essential. [ABSTRACT FROM AUTHOR]

This study explores the complex nature of female genital mutilation/cutting (FGM/C) by juxtaposing the mental and sexual health of women who had undergone FGM/C as part of initiation/membership into a traditional women's society (TWS) with those who were also cut but not initiated into a TWS. While considerable differences emerged between TWS members and nonmembers, there was no evidence that TWS membership was protective against the physical and psychological trauma typically ascribed to FGM/C. In fact, the pattern of results would tend to suggest the opposite. Possible explanations for and implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The Senior Community Service Employment Program (SCSEP) is a U.S.-based job-training program that serves unemployed workers aged 55 and older with incomes at or below 125% of the federal poverty level. While federal funds are set aside to serve Asian workers in SCSEP, little is known about their characteristics and experiences. In response, this pilot study aimed to document the health, well-being, and experiences of older Asian SCSEP participants in Massachusetts through the completion of a survey. Respondents (N = 39) ranged in age from 58 to 73 and identified as either Chinese (72%) or Vietnamese (28%). All were immigrants, and almost all spoke a language other than English at home. Most reported "good" health as well as financial difficulties. They also stated that their supervisors in their placements were supportive. On average, respondents noted moderate interest in searching for a paid job after exiting SCSEP, although more reported interest in searching for a volunteer role. Key to the success of this study was a robust collaboration with a local human services organization with strong ties to the Chinese and Vietnamese communities. The findings highlight the importance of this growing group of older workers. [ABSTRACT FROM AUTHOR]

Simple Summary: This research identifies the critical metabolic syndrome components that lead to a higher risk of developing colorectal cancer. This is a crucial step in creating colon cancer screening guidelines based on the presence of some specific MetS components or combinations of components. This pivotal insight could inform future CRC screening strategies. Finally, our findings could fill the knowledge gaps in current research areas relevant to metabolic syndrome and colorectal cancer. Background/Objectives: Dysfunctions of metabolic syndrome (MetS) have been identified as a significant risk factor for colorectal cancer (CRC). However, current colon cancer guidelines do not classify patients with MetS as high risk, thereby leaving these individuals vulnerable. Consequently, we explored the relationship between MetS, its individual components, and the development of CRC in a cohort of patients with MetS to assess the necessity for CRC screening in these individuals. Methods: This study included patients ages 18 and older that received a service from the Marshall-Health (MH) practice plan, Cabell-Huntington Hospital (CHH), MU/JCESOM's Edwards Comprehensive Cancer Center (ECCC), or the University of Kentucky HealthCare (UKHC) system between 2010 and 2018. We implemented log-binomial regression models to assess the individual and collective effects of MetS components after adjusting other CRC risk factors. Results: Given that CRC prevalence increases in the older population (aged 65 years and above), and that multiple components of MetS are observed within the same population, we analyzed the concurrent impact of all MetS components on CRC. Log-binomial regression models were implemented to assess the risk of CRC due to MetS components after adjusting other risk factors. Conclusions: We identified specific components that markedly increased CRC risk, suggesting that individuals with these components should be prioritized for early screening. These findings could significantly influence early CRC screening protocols, with the ultimate aim to reduce mortality associated with the disease. [ABSTRACT FROM AUTHOR]

Providing video recordings of lecture material may enhance student flexibility, but does it alter attendance or influence their grade? This project assessed the extent and purpose of video usage by students and evaluated their impact on course performance within first-year basic science courses in a chiropractic curriculum. All first-year students enrolled at a chiropractic college based in the United States were invited to complete a retrospective survey regarding video usage, attendance, and study behaviors for basic science courses they were enrolled during the previous term. Grades were third-party obtained for each consenting student. Statistical analysis included descriptive statistics and independent t tests for each course. Effect size using Cohen's d was calculated for all statistically significant courses (p <.05). Overall, 260 students completed the questionnaire assessing 18 courses in total. The perceived helpfulness of video recordings was associated with heavier usage, primarily to study for exams. Shorter summary videos were preferred by 78% of students over full lecture recordings. Use of videos to replace lectures increased from 21.9% to 53.2% in first through third trimester, respectively. Video use in Neuroanatomy I, Neuroanatomy II, Gross Anatomy II, Organ Histology, and Endocrinology were associated with lower exam scores and overall grades (p <.05), yielding moderate to large effect sizes. Videos were used < 1 hour per week, primarily to study for exams. When used as a study tool, video use decreased course performance. Rewatching videos to prepare for exams may be mistaken for mastery of material. [ABSTRACT FROM AUTHOR]

Purpose: Patient experience is fundamental to Patient-Centered Care (PCC). Although prior bibliometric research studies have focused on various aspects of PCC, a comprehensive analysis of PREM articles is required to understand its impact on the clinical practices. This study aims to analyze the top 100 most-cited PREM articles to examine the critical studies and related trends. Methods: The 100 most cited articles on PREM were gathered from the Web of Science using a combination keyword search approach. The following information was extracted: study design, sample size, topic, number of citations, authorship, country, year of publication, journal title, and dimensions included in these PREM instruments. The VOSviewer software was used to generate graphical bibliometric networks. Results: The citation count of the top 100 PREM articles varied from 20 to 775 citations. 21 articles had received a minimum of 100 citations. All the articles were in English, and out of these 45% were from the USA. The cross-sectional study (69%) was the most common study design, and the impact of treatment (44%) was the most frequent topic. The common PREM instruments used were customized PREM questionnaires (16%) and HCAHPS (10%). Conclusion: This bibliometric research showed that the area of PREM is far from being saturated. The authors have attempted to provide an overview of global PREM research. Future research should focus on studies from underdeveloped and developing countries to develop condition–specific PREM tools. Longitudinal researches among special populations and studies in day-care and outpatient settings are recommended in future. [ABSTRACT FROM AUTHOR]