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The article discusses the author's opinions on how long law school exam answers, court briefs, and other legal compositions should be as of May 2014, focusing on various legal scholarship standards in terms of law-review articles and footnotes. The attitudes of American law professors are mentioned, along with the concept that good ideas do not have to be explained by long answers and multiple pages of text. Readability and the value of short papers are also examined.

This is a report of a study that examined the social and academic climates of two American law schools, concluding that the environment in which legal education takes place is not conducive to significant socialization. The diminution after 7 months of law school of the expectations of first-year students to work as professionals after graduation in attaining justice and establishing social reforms was due largely to rational cognitive processes, inasmuch as there were no significant changes in basic motives and attitudes. The study supports adult socialization theory that holds that adult individual rationality is a powerful inhibitor of attempts to bring about fundamental affective changes. [ABSTRACT FROM AUTHOR]

A traditionally salient topic of empirical investigation in the sociology of religion, this paper seeks to offer a recent investigation into the intergenerational transmission of religion and the parental forms of religious engagement that predict adult engagement with religion. The study of this paper explores the intergenerational transmission of religion, focusing on the parental forms of religious identity and engagement that influence religious identity, beliefs, and practices in adulthood. By analyzing the 2018 GSS dataset in the United States with multiple regression analyses, I found strong parental and childhood influences on adult religiosity, religious service attendance, and belief in God. Indeed, this engagement often mirrors parental engagement for these variables. However, while paternal religious identity often predicts these religious variables, I found that the religious identity and engagement of parents generally do not predict religious identity in adulthood. Ultimately, while these results generally show strong predictive mechanisms of intergenerational transmission, they also illustrate that these relationships are variably dependent on the form of parental and adult religious engagement, and which parent participates or is associated with that engagement. [ABSTRACT FROM AUTHOR]

INTRODUCTION The FDA's 'The Real Cost' tobacco prevention campaign aimed to counter tobacco marketing efforts directed toward children and youths. Our objectives were to explore the associations between exposure to the FDA's campaign and cigarette risk perception among the US adolescent population, and between exposure and cigarette smoking curiosity among adolescents who never smoked cigarettes. METHODS We analyzed 3 cycles of National Youth Tobacco Survey (NYTS 2018-2020, n=53738). Multivariable logistic regression models were fitted to measure the relationship between campaign exposure and cigarettes risk perception (among all), as well as the relationship between campaign exposure and cigarette curiosity (among cigarette never smokers). RESULTS Majority of youths have reported exposure to the campaign 63% between 2018-2020. The odds of youths perceiving cigarettes as risky were 1.6 times higher among exposed compared to those not exposed (adjusted odds ratio, AOR=1.60; 95% CI: 1.43-1.79). There were some racial disparities in risk perceptions among Hispanics and Non-Hispanic Blacks across exposure groups. Exposure was associated with higher cigarettes curiosity odds among Hispanic youths who never smoked (AOR=1.26; 95% CI: 1.10-1.44) compared to their Non-Hispanic White peers. CONCLUSIONS The FDA's 'The Real Cost' campaign had exposure levels deemed essential for population-level perceptions change. Exposure was associated with youths having higher risk perceptions about the negative health outcomes related to cigarette smoking. However, students that never smoked were more curious about smoking with campaign exposure. Therefore, future health communication plans should consider both the potential benefits and possible unintended consequences prior to launching such campaigns. [ABSTRACT FROM AUTHOR]

In this paper, we provide a theoretical and empirical framework that allows us to synthesize and assess the burgeoning literature on CEO overconfidence. We also provide novel empirical evidence that overconfidence matters for corporate investment decisions in a framework that explicitly addresses the endogeneity of firms' financing constraints. [ABSTRACT FROM AUTHOR]

Background: While research on trans People of Color's experiences has been increasing in recent years, this intersectional work has often not included a focus on the specificities of multiracial and multiethnic trans experiences. Aims: This study explores shifts in racial identity by multiracial/multiethnic trans people as they transition gender and the ways Whiteness and nationalist ideology shape their racialized gender experiences. Methods: This paper is based on six in-depth, semi-structured interviewswith self-identifiedmultiracial, multiethnic, andmulti-heritage trans people in the USA. Data collection centered participants' experiences of self-identification and interactionswith others (e.g., family, acquaintances, and strangers). Results: As participants transitioned gender and were acknowledged by others in their gender identity, shifts in their embodiment were used by others to ascribe a new racialized gender. This often resulted in participants reflecting on their sense of self and racialized gender identities in new ways. Discussion: Multiracial and multiethnic transgender people's experiences in transitioning race confirm the importance of intersectional analysis, reveal the intersectional fluidity of social categories, explicate how social understandings of one category (e.g., race) influence another category (e.g., gender), demonstrate that the meanings associated with racialized gender are based in relations of power, and show that, in transgender studies particularly, we must attend to the ways that the concept of transition implicates not only gender, but also other categories such as race and nationality. [ABSTRACT FROM AUTHOR]

Abortion continues to be a highly contentious issue in the United States, with few signs of abatement. The god of this paper is to specify how variable positions about abortion across religious traditions have led to differential shifts in attitudes among their members. Based on culturally relevant events, position papers, and other religious media, the guiding hypotheses propose that Evangelicals have become increasingly opposed to abortion for elective reasons; yet changes in attitudes regarding abortion for traumatic reasons are due primarily to cohort shifts. Data from the cumulative General Social Surveys (1972–2002) are used to test the hypotheses. The first hypothesis is supported: Opposition to elective abortions among Evangelicals has increased relative to other religious traditions. However, contrary to the second hypothesis, they have also become more opposed to abortion for traumatic reasons. This increasing opposition is most prominent among Evangelicals born in the last 40 years or so. Implications for understanding Evangelical distinctiveness and the cultural context of abortion attitudes are discussed. [ABSTRACT FROM AUTHOR]

The article provides information about a symposium on "Aggression Across Species," held in July 2002 at the 32nd Annual Meeting of the Behavior Genetics Association in Keystone, Colorado. Presentations varied from the genetic analysis of aggression in fruit flies to aggression in mice and men and the result is this collection of papers, which cover five different species, including zebrafish, dog, rat, mouse, and humans, and various tools for the genetic analysis of aggression. The papers in this issue have in common the objective of exploring the genetic influences on aggressive behavior. Different vertebrate species exhibit aggressive behavior with some common features, and by taking advantage of the experimental opportunities that each offers we can gain insights into the largely common underlying biology and biochemistry.

This paper tests whether effects of individual characteristics on redistributive preferences are constant across ideological subgroups. Using data from the U.S. General Social Surveys, we estimate ordered probit models for a full pooled sample, and liberal, moderate, and conservative subsamples. Wide cleavages in redistributive attitudes between liberals and conservatives, and between Democrats and Republicans are observed. Substantial gaps between Democrats and Republicans persist within ideological subgroups. Attitudinal differences across social classes exist for conservatives and moderates, but not liberals. Among moderates and conservatives, blacks are more likely than whites to support government redistribution. No black-white gap is observed among liberals. Though conservative women are more likely than conservative men to support major government involvement in redistribution, no gender gap emerges for liberals or moderates. Full sample results suggest that education has no discernible impact on redistributive attitudes, but subsample results strongly suggest that a college degree reinforces ideological effects. [ABSTRACT FROM AUTHOR]

INTRODUCTION E-cigarette use among youth and young adults remains of public health concern. Pod-based e-cigarettes, including JUUL, significantly changed the e-cigarette landscape in the US. Using an online survey, we explored the socio-behavioral correlates, predisposing factors, and addictive behaviors, among young adult pod-mod users within a University in Maryland, USA. METHODS In total, 112 eligible college students aged 18--24 years, recruited from a University in Maryland, who reported using pod-mods were included in this study. Participants were categorized into current/non-current users based on past- 30-day use. Descriptive statistics were used to analyze participants' responses. RESULTS The mean age of the survey participants was 20.5 ± 1.2 years, 56.3% were female, 48.2% White, and 40.2% reported past-30-day (current) use of pod-mods. The mean age of first experimentation with pod-mods was 17.8 ± 1.4 years, while the mean age of regular use was 18.5 ± 1.4 years, with the majority (67.9%) citing social influence as the reason for initiation. Of the current users, 62.2% owned their own devices, and 82.2% predominantly used JUUL and menthol flavor (37.8%). A significant proportion of current users (73.3%) reported buying pods in person, 45.5% of whom were aged <21 years. Among all participants, 67% had had a past serious quit attempt. Among them, 89.3% neither used nicotine replacement therapy nor prescription medications. Finally, current use (adjusted odds ratio, AOR=4.52; 95% CI: 1.76--11.64), JUUL use (AOR=2.56; 95% CI: 1.08-6.03), and menthol flavor (AOR=6.52; 95% CI: 1.38-30.89) were associated with reduced nicotine autonomy, a measure of addiction. CONCLUSIONS Our findings provide specific data to inform the development of public health interventions targeted at college youth, including the need for more robust cessation support for pod-mod users. [ABSTRACT FROM AUTHOR]

With recent educational demands placed on academic accountability, it is difficult for many people to determine or acknowledge where or how focusing on social and emotional learning (SEL) can be beneficial. In this paper we focus on principals' beliefs and attitudes about social and emotional learning. Principals influence implementation through their school priorities, vision, expectations, and emphases. We used grounded theory techniques and semistructured interviews with K-8th grade principals of public schools located in a state in the southeastern United States. When describing principals' beliefs and attitudes, late majority adopters held neutral attitudes and weak beliefs regarding SEL. In addition, a lack of understanding of the SEL concept became evident as principals did not express a clear understanding of SEL. Comprehensive training at the administrative and policy level is needed. Principals should implement targeted staff training providing key strategies for intentionally integrating SEL skills into their current curriculum. [ABSTRACT FROM AUTHOR]

This paper examines the changing nature of attitudes toward and reports of sexual harassment using data for 1978-94 drawn from the U.S. Merit Systems Protection Board (USMSPB) of the U.S. federal government. The authors find that although unwanted sexual behavior reported by federal government employees changed only slightly in overall incidence over the period, its pattern changed noticeably. Unwanted sexual attention by supervisors, for example, declined in incidence; crude and offensive behavior by co-workers increased; and the likelihood that harassment would occur only once (rather than repeatedly) increased. Employees' attitudes toward sexual harassment changed markedly, with a dramatically increased willingness to define unwanted sexual behavior as sexual harassment. This trend appears to have been due not to changes in employees' demographic, human capital, and job characteristics, but rather to structural changes in their views of what constitutes sexual harassment. [ABSTRACT FROM AUTHOR]

Research on COVID-19 vaccine hesitancy and misinformation endorsement among Spanish-speaking Americans is limited. This cross-sectional study used a Spanish-language survey from May–August 2021 among 483 Spanish speakers living in the US and Puerto Rico. We applied multivariable Poisson regression with robust error variances to assess the association between independent variables and binary outcomes for vaccine acceptance versus hesitance, as well as misinformation endorsement. Vaccine acceptance was associated with COVID-19 risk perception score (PR = 1.7 high vs. low perceived risk), opinion of government transparency (PR = 2.2 very transparent vs. not transparent), and trust in vaccine information (PR = 1.8 high vs. low). There was also an interaction between time spent on social media and social media as a main source of COVID-19 information (p = 0.0484). Misinformation endorsement was associated with opinion about government transparency (PR = 0.5 moderately vs. not transparent), trust in vaccine information (PR = 0.5 high vs. low trust), social media impact on vaccine confidence (PR = 2.1 decreased vs. increased confidence), distrust vaccines (PR = 1.9 distrust vs. trust), using vaccine information from Facebook (PR = 1.4 yes vs. no), and time spent on social media by those using social media as main source of COVID-19 vaccine information (p = 0.0120). Vaccine acceptance in respondents with high misinformation endorsement scores was 0.7 times those with low scores. These findings highlight the importance of effective information dissemination, the positive role of social media, and government transparency in boosting vaccine uptake among Spanish speakers in the US. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States of America (USA). Cervical cancer is the most common HPV-related cancer, which leads to approximately 4000 deaths yearly in women. Despite the nationwide availability of the HPV vaccine, the coverage and series-completion rates have been historically low due to multiple barriers. Previous systematic literature reviews emphasize global quantitative studies regarding parents of pediatric populations. This study aimed to evaluate qualitative studies conducted in the USA to characterize the facilitators and barriers to HPV uptake among eligible women. Four databases, including PubMed/MEDLINE, Embase, Scopus, and the Cumulative Index for Nursing and Allied Health Literature (CINAHL), were utilized to search the literature for comprehensive qualitative studies from 2014 to 2023 with pre-selected inclusion criteria. This review was conducted in compliance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After detailed full-text extraction, 26 studies met the inclusion criteria, and two authors extracted the data. Three themes emerged from the data: (1) facilitators perceived by women to uptake the HPV vaccine, (2) barriers perceived by women to uptake the HPV vaccine, and (3) barriers and facilitators perceived by women to uptake the HPV vaccine. These themes highlighted different barriers and facilitators to HPV vaccines uptake, such as the lack of healthcare provider recommendation, cost, and safety concerns as barriers to receiving the vaccine. To change the norms towards HPV vaccine hesitancy, the healthcare team has a important opportunity to impart the knowledge and skills known to elicit behavior change. [ABSTRACT FROM AUTHOR]

Background: Improving care coordination is a key priority for many healthcare systems. However, initiatives to improve care coordination are complex to implement and have produced mixed results. A better understanding of how to craft and support implementation of effective care coordination strategies is needed.Objective: To identify and understand the challenges and factors encountered by Patient-Aligned Care Team (PACT) staff in performing care coordination tasks in outpatient clinics in the Veterans Health Administration (VA).Design: Qualitative study using semi-structured formative evaluation interviews.Participants: Fourteen interviews with 18 clinical frontline managers and staff from 12 clinic sites across five VA health systems.Interventions: This paper reports on baseline data collected for the Coordination Toolkit and Coaching (CTAC) project. CTAC aims to improve patients' experience of care coordination within VA primary care and between PACT and other outpatient and community settings.Approach: We conducted pre-implementation telephone interviews with frontline managers and staff, primarily nurse managers.Key Results: PACT staff described challenges in aligning care coordination priorities across different levels of the VA system, including staff, patients, and leadership. Additionally, PACT staff noted challenges coordinating care both within and outside the VA, and identified resource barriers impeding their care coordination efforts. To address these challenges, staff made several recommendations for improvement, including (1) contingency staffing to address staff burnout; (2) additional PACT training for new staff; (3) clarification of care coordination roles and responsibilities; and (4) and care coordination initiatives that align both with centrally initiated care coordination programs and frontline needs.Conclusion: In the VA and similarly complex healthcare systems, our findings suggest the need for care coordination strategies that are buttressed by a system-level vision for care coordination, backed up by clear roles and responsibilities for information exchange between primary care staff and other settings, and multidimensional accountability metrics that encompass patient-, staff-, and system-level goals. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite facing significant uncertainty about their lifespans and health care costs, most retirees do not buy annuities or long-term care insurance. In this paper, I find that retirees’ saving and insurance choices are highly inconsistent with standard life-cycle models in which people care only about their own consumption but match well models in which bequests are luxury goods. Bequest motives tend to reduce the value of insurance by reducing the opportunity cost of precautionary saving. The results suggest that bequest motives significantly increase saving and significantly decrease purchases of long-term care insurance and annuities. (JEL D14, D15, D64, G22, H55, J26) [ABSTRACT FROM AUTHOR]

A technological trend influencing society is the provision and adoption of digital books. Digital books are used in education in the form of electronic textbooks (e-textbooks). The research question examined in this manuscript is which students' characteristics and attitudes influence their adoption or non-adoption of e-textbooks? The study explores these characteristics and attitudes of students who have made the decision to become either an e-textbook user or nonuser. The empirical analysis is conducted using 1191 student responses to a questionnaire distributed in a mid-sized university in the western United States. Among these 1191 responses, 530 of the students had used an e-textbook and 661 had not used an e-textbook. The e-textbook user and nonuser groups are studied in three different ways. The first is by examining the counts and percentages for five respondent characteristics. The second way is through statistical tests (i.e., t-tests and multiple analysis of variance) on these characteristics across the groups. The results from these analyses did not identify any meaningful differences in characteristics across the user and nonuser groups. The third way was a content analysis performed on an open-ended question (i.e., What factors influenced you on whether to use an e-textbook?) on the questionnaire. The student e-textbook attitudes discovered from the content analysis showed that for e-textbook users, the cost or price of an e-textbook had a significant influence on e-textbook adoption. Two other attitudes influencing e-textbook users' adoption were usability, both positive and negative. The key attitude of nonusers regarding e-textbook adoption is negative e-textbook usability. [ABSTRACT FROM AUTHOR]

Background and Objectives: Education of health care clinicians on racial and ethnic disparities has primarily focused on emphasizing statistics and cultural competency, with minimal attention to racism. Learning about racism and unconscious processes provides skills that reduce bias when interacting with minority patients. This paper describes the responses to a relationship-based workshop and toolkit highlighting issues that medical educators should address when teaching about racism in the context of pernicious health disparities.Methods: A multiracial, interdisciplinary team identified essential elements of teaching about racism. A 1.5-hour faculty development workshop consisted of a didactic presentation, a 3-minute video vignette depicting racial and gender microaggression within a hospital setting, small group discussion, large group debrief, and presentation of a toolkit.Results: One hundred twenty diverse participants attended the workshop at the 2016 Society of Teachers of Family Medicine Annual Spring Conference. Qualitative information from small group facilitators and large group discussions identified some participants' emotional reactions to the video including dismay, anger, fear, and shame. A pre/postsurvey (N=72) revealed significant changes in attitude and knowledge regarding issues of racism and in participants' personal commitment to address them.Discussion: Results suggest that this workshop changed knowledge and attitudes about racism and health inequities. Findings also suggest this workshop improved confidence in teaching learners to reduce racism in patient care. The authors recommend that curricula continue to be developed and disseminated nationally to equip faculty with the skills and teaching resources to effectively incorporate the discussion of racism into the education of health professionals. [ABSTRACT FROM AUTHOR]

This paper examines why overconfident CEOs issue more debt than equity within US Real Estate Investment Trusts (REITs) and the value implications of this debt preference. Consistent with a demand-side story, the paper finds that overconfident CEOs choose to issue more debt than equity than their non-overconfident counterparts. The findings also rule out the supply-side story that overconfident CEOs are screened out of the equity market. CEO preference for debt is associated with a decline in shareholder wealth. Specifically, using an event study, the paper finds that overconfident CEOs suffer an approximately $67 million loss associated with debt issues in market capitalization. Further analysis suggests that the loss stems from the higher default risk induced by overconfident REIT CEOs' debt preference. The demand-side explanation remains robust even after considering several CEO demographics, estimation methods, and the following five possible alternative drivers of the main results: (1) insider information; (2) risk tolerance; (3) past performance; (4) dividends; and (5) board pressure. [ABSTRACT FROM AUTHOR]

Consumer price sensitivity is important to marketing theory and practice because of its impact on profitability. This paper presents a model containing four important antecedents of price sensitivity. Previous studies show that enduring product involvement, consumer innovativeness, perceived brand parity, and attitudinal brand loyalty separately influence price sensitivity. This paper presents a model showing how these four antecedents interact. The model fits data from two separate samples of U.S. consumers (n = 156 and 305) and accounts for a substantial proportion of the variance in price sensitivity. Price sensitivity is positively related to perceived brand parity and negatively related to involvement, innovativeness, and loyalty. Innovativeness, brand parity, and brand loyalty appear to mediate the influence of involvement on price sensitivity, thereby partially explaining the psychological linkages between these distinct concepts. [ABSTRACT FROM AUTHOR]

Racial-ethnic minorities receive lower quality and intensity of health care compared with whites across a wide range of preventive, diagnostic, and therapeutic services and disease entities. These disparities in health care contribute to continuing racial-ethnic disparities in the burden of illness and death. Several national medical organizations and the Institute of Medicine have issued position papers and recommendations for the elimination of health care disparities. However, physicians in practice are often at a loss for how to translate these principles and recommendations into specific interventions in their own clinical practices. This paper serves as a blueprint for translating principles for the elimination of racial-ethnic disparities in health care into specific actions that are relevant for individual clinical practices. We describe what is known about reducing racial-ethnic disparities in clinical practice and make recommendations for how clinician leaders can apply this evidence to transform their own practices. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this paper was to describe primary care prescribers' perspectives on electronic prescribing drug alerts at the point of prescribing.Design: We used a mixed-method study which included clinician surveys (web-based and paper) and focus groups with prescribers and staff.Participants: Prescribers (n = 157) working in one of 64 practices using 1 of 6 e-prescribing technologies in 6 US states completed the quantitative survey and 276 prescribers and staff participated in focus groups.Measurements: The study measures self-reported frequency of overriding of drug alerts; open-ended responses to: "What do you think of the drug alerts your software generates for you?"Results: More than 40% of prescribers indicated they override drug-drug interactions most of the time or always (range by e-prescribing system, 25% to 50%). Participants indicated that the software and the interaction alerts were beneficial to patient safety and valued seeing drug-drug interactions for medications prescribed by others. However, they noted that alerts are too sensitive and often unnecessary. Participant suggestions included: (1) run drug alerts on an active medication list and (2) allow prescribers to set the threshold for severity of alerts.Conclusions: Primary care prescribers recognize the patient safety value of drug prescribing alerts embedded within electronic prescribing software. Improvements to increase specificity and reduce alert overload are needed. [ABSTRACT FROM AUTHOR]

Health sciences librarianship has historically benefited from avoiding critical conversations around the role of race in the profession, reflected through a select few number of articles on the topic. The purpose of this study was to add to this body of literature and apply a critical librarianship framework on the early scholarly record of health sciences librarianship and the legacy of integration within the Medical Library Association (MLA). Three Southern medical works and the integration views of Mary Louise Marshall, the longest-serving president of MLA from 1941 to 1946, were thematically and textually analyzed to redress the profession's long-standing legacy with Whiteness and Black, Indigenous, and People of Color (BIPOC) representation. In reframing the historic past of MLA both through Marshall's works and her views, the goal is to acknowledge ways in which the profession has impeded progress and present steps to remedy appropriate outreach for the future. [ABSTRACT FROM AUTHOR]

Background: Medical schools have a major impact on future doctors' ethics and their attitudes towards cooperation with the pharmaceutical industry. From childhood, medical students who are related to a physician are exposed to the characteristics of a medical career and learn its professional ethics not only in school but also in the family setting. The present paper sought to answer the research question: 'How does growing up with a physician influence medical students' perceptions of conflicts of interest in their relationships with industry?'Methods: An anonymous questionnaire was completed by 451 medical students from four Philadelphia medical schools and 554 medical students from Warsaw Medical University during 2013. Medical schools in these two cities were chosen because they are both university cities with similar population sizes. Students who had and who did not have a family member working as a physician were compared using chi-square analysis. Data were analysed for each country separately.Results: For both the US and Poland, there were statistically significant differences (p < .05) between medical students with a physician as a family member and other students with respect to views regarding relationship with the pharmaceutical industry. In both groups, this difference occurred for three important dimensions: students' relationship with the pharmaceutical industry; students' views on physicians' rights to cooperate with the pharmaceutical industry; trust in the pharmaceutical industry. In the US, students related to a doctor were characterized by more restrictive opinions on all three dimensions than other students (e.g., 27.8% of the former students vs. 31.4% of the latter students thought doctors had unrestricted rights to cooperate with the industry). However, the contrary was observed in Poland: students with a physician in the family had less strict views than their colleagues (e.g., 56.8% of the former vs. 39.7% of the latter thought that doctors should have unrestricted rights of cooperation).Conclusions: In Poland, a former communist country, physicians transmit a more liberal approach towards collaboration with the pharmaceutical industry to their student relatives than those in the US. [ABSTRACT FROM AUTHOR]

Background: The most pervasive form of female genital mutilation/cutting--infibulation--involves the almost complete closure of the vaginal orifice by cutting and closing the labia to create a skin seal. A small opening remains for the passage of urine and menstrual blood. This physical closure has to be re-opened--defibulated--later in life. When they marry, a partial opening is made to enable sexual intercourse. The husband commonly uses his penis to create this opening. In some settings, a circumciser or traditional midwife opens the infibulated scar with a knife or razor blade. Later, during childbirth, a further opening is necessary to make room for the child's passage. In Norway, public health services provide surgical defibulation, which is less risky and painful than traditional forms of defibulation. This paper explores the perceptions and experiences of surgical defibulation among migrants in Norway and investigates whether surgical defibulation is an accepted medicalization of a traditional procedure or instead challenges the cultural underpinnings of infibulation. Methods: Data derived from in-depth interviews with 36 women and men of Somali and Sudanese origin and with 30 service providers, as well as participant observations in various settings from 2014-15, were thematically analyzed. Results: The study findings indicate that, despite negative attitudes towards infibulation, its cultural meaning in relation to virility and sexual pleasure constitutes a barrier to the acceptance of medicalized defibulation. Conclusions: As sexual concerns regarding virility and male sexual pleasure constitute a barrier to the uptake of medicalized defibulation, health care providers need to address sexual concerns when discussing treatment for complications in infibulated women. Furthermore, campaigns and counselling against this practice also need to tackle these sexual concerns. [ABSTRACT FROM AUTHOR]

The increasingly criticized "two Buddhisms" dichotomy in scholarly and popular literature bifurcates American Buddhism into two separate groups: white converts who are focused on meditation, and Asian immigrants who engage in devotional practices. This paper builds on critiques of the "two Buddhisms" model by demonstrating the importance of attending to generation as a factor of analysis when studying American Buddhists. Specifically, this study analyzes the diverse practices and nuanced beliefs of twenty-six young adult Asian American Buddhists from a diverse range of ethnic and sectarian backgrounds. In their open-minded attitudes toward a wide range of Buddhist practices and multivalent interpretations of various Buddhist beliefs, these young adults challenge simplistic representations of Asian American Buddhists and present an inclusive vision of Buddhism that embraces nuance, ambiguity, and change. [ABSTRACT FROM AUTHOR]

This paper reports five studies examining audit team members' willingness to raise audit issues. The first study is a survey of interacting audit teams that provides evidence that team members are more willing to speak up when they view their leader as team-oriented (i.e., emphasizing team success as opposed to the leader's own personal advancement). Experiments 1-3 provide converging evidence that audit seniors are more willing to speak up to a team-oriented leader and about issues that are aligned with that leader's concerns. Experiment 4 provides evidence that the effect of team-oriented leadership on willingness to speak up is mediated by team members' commitment to the team leader and, to a lesser extent, by their identification with their team, but not by concerns about the immediate or eventual repercussions of speaking up. Together, these studies provide evidence that auditors' willingness to raise audit issues is affected by what the auditor has to say and how they think their message will be received, potentially affecting audit effectiveness and audit efficiency. [ABSTRACT FROM AUTHOR]

The United States and the Canadian province of Ontario have enacted endangered species laws that regulate private land. The rationale for this is that the vast majority of endangered species in the two countries rely on private lands for survival. However, from a landowner perspective the law is deemed unfair. This paper presents analysis from 141 interviews with landowners in three U.S. states and Ontario. In recognition of distributive justice claims, both the U.S. government and the Ontario government have enacted programs aimed at increasing financial incentives for participation and compliance with the law. However, the law is still perceived as unfair. The central argument of this paper is that future amendments and new policies for endangered species should confront two other forms of environmental justice: procedural justice and justice-as-recognition. Landowners in both countries expressed not only concerns about compensation, but also a deep desire to be included in the protection and recovery process, as well as to be recognized by government and society as good stewards of the land. The paper concludes by stating that future policy amendments need to address justice-as-recognition if endangered species conservation on private lands is to be considered fair by landowners. [ABSTRACT FROM AUTHOR]

Purpose: To create an instrument to assess attitudes toward lesbian, gay, and bisexual (LGB) patients among random samples of athletic trainers in the United States. Methods: This was a cross-sectional study using semi-structured interviews, paper-based questionnaires, and an electronic questionnaire. Development included three phases: (1) exploratory interviews and questionnaire responses, (2) construct validity and item reduction, and (3) criterion validity. Results: Six athletic trainers completed semi-structured interviews to develop themes regarding LGB patients. Additionally, 39 students in professional and post-professional athletic training programs answered questionnaires designed to elicit statements regarding LGB patients. For item reduction, 3,000 athletic trainers were emailed a questionnaire (response rate = 17%). For validation, another sample of 3,000 athletic trainers was sent the instruments (response rate = 13%). Athletic trainer emails were obtained from the National Athletic Trainers' Association. The resultant instrument was the 15-item Attitudes Toward Lesbian, Gay, and Bisexual Patients (ATLGBP) (α =.830). There were significant correlations between the ATLGBP and subscales of the Lesbian, Gay, Bisexual–Knowledge and Attitude Scale for Heterosexuals (hate: r =.464; civil rights: r = −.683; religion: r =.532; internal: r = −.612; knowledge: r = −.430; P <.001). Conclusions: The ATLGBP assesses affective, cognitive, and behavioral expressions of LGB attitudes in settings common to clinicians. The ability to assess attitudes toward LGB patients enables clinicians to identify areas on which to focus training and education. [Athletic Training & Sports Health Care. 2021;13(4):e146–e152.] [ABSTRACT FROM AUTHOR]

Objectives: The objective of this paper was to determine the extent to which dry needling is instructed in entry-level education programs for physical therapists. Methods: Program directors from 226 entry-level education programs recognized by the Commission on Accreditation in Physical Therapy Education were recruited via e-mail to participate in an anonymous 35-item electronic survey during the 2017-2018 academic year. The survey evaluated dry needling curricula, faculty qualifications, attitudes and experience, and programs' future plans for teaching dry needling. Results: A total of 75 programs responded to the survey (response rate = 33.1%). Forty (53.3%) had integrated dry needling theory and psychomotor training into their programs and 8 (10.6%) planned to include such content in their curriculum in the future. Of the 40 respondents, 28 indicated that dry needling education was integrated into a required course, 4 indicated that dry needling was an elective course, and 8 did not specify how dry needling education was integrated. Faculty teaching dry needling appear to be well qualified, with the majority having 5-10 years of experience using dry needling in clinical practice. The primary reason for programs not teaching dry needling is that it was not considered an entry-level skill. Discussion: There appeared to be variability in how dry needling was integrated into the curricula, as well as in the depth and breadth of instruction. Our research may serve as a baseline for faculty to assess existing dry needling curricula and as a guide for developing curricula in new or existing physical therapy programs. [ABSTRACT FROM AUTHOR]

This paper examines determinants of timing of marriage for young women by modeling the transition from the single to the married state by age. This approach, combined with a large longitudinal data set, allows us to disaggregate the analysis into fine age groupings and to include situational and attitudinal factors in our model. We find that those characteristics of a young woman's parental family that reflect the availability of parental resources tend to decrease the chances of a marriage during the early teens. Chances of marrying appear to decrease with increases in the availability and attractiveness of alternatives to the wife role and in the costs of assuming it. We discuss these results from the perspective of the societal and parental normative pressures which affect timing of marriage for young women. [ABSTRACT FROM AUTHOR]

While births may be dichotomous, fertility intentions are not inherently so. Intentions are predictions about the future and, as such, are couched in considerable uncertainty. Ignoring this uncertainty hides much of what could be learned from data on fertility intentions. This paper presents a model which allows analysis of the full range of intentions. This paper presents a model which allows analysis of the full range of intentions. After selecting a sample of women in the later stage of childbearing (e.g., those who intend fewer than two additional children) from the 1965 and 1970 National Fertility Studies, it is shown that: (1) substantial portions of women at this stage of the reproductive life cycle were indeed uncertain of their parity-specific intention; (2) this certainty, like more firm intentions, varies by age and parity as the model predicts; and (3) there were significant shifts in the level of certainty between 1965 and 1970. Specifically, while intentions for third, fourth, and fifth births declined, more women "didn't know" if they intended to have another child or not. Among those not intending another child, more seemed uncertain of this intention in 1970 than did comparable women in 1965. In contrast, those intending another child seemed more certain. These changes in intention and uncertainty indicate that the observed decline in intended parity was tentative. Post-1970 evidence suggests that this tentative decline has become an equivocal one. [ABSTRACT FROM AUTHOR]

This paper explores the role of size of place residential preference in the evolution of the intention to move out of the present community using data from the March 1974 NORC Amalgam Survey. People who prefer to live in a community having different size or location characteristics than their present residence are five times more likely to intend to move than those who have attained their preferred type of residence. Within these two groups, however, the particular configuration of current and preferred residence has no significant effect on the likelihood of intending to move. This finding justifies the creation of a simple dichotomous variable, preference status, contrasting these two groups. Community satisfaction and preference status are highly interrelated and each has an independent effect on intentions to move. Moreover, the effect of preference status on mobility intentions is somewhat larger than that for community satisfaction, indicating that residential preference plays a significant role in the decision-making process regarding migration. [ABSTRACT FROM AUTHOR]

This paper uses data from five sample surveys taken between 1964 and 1974 to investigate recent change in U.S. women's sex-role attitudes. It employs several statistical techniques to insure comparability among samples before making inferences about attitude change. The results of the analysis suggest there has been considerable movement toward more egalitarian role definitions in the past decade, with such change occurring equally among higher and lower status women. The analysis also finds evidence that women's attitudes about their rights in the labor market are becoming more strongly related to their attitudes about their roles in the home and shows that educational attainment and employment are among the most important individual- level predictors of attitudes at a given point in time. Little evidence is found for the unique influence of the women's movement on change in women's sex-role attitudes, but the sizable changes in these attitudes since 1964 may help explain the rise of the movement. [ABSTRACT FROM AUTHOR]

Increasingly, social scientists are paying attention to the manner in which religious values and contexts affect political behavior. This paper, based on a Catholic sample from three NORC General Social Surveys (1977, 1978, 1980) examines effects of marital context on sociopolitical attitudes that are consistent with Catholic social teachings. These data do not support the hypothesis that homogamous Catholics ` sociopolitical positions are more consistent with church teaching on justice and peace issues. Further, identification with the church, as measured in the GSS, displays an anomalous pattern between justice and peace issues. The slight tendency for heterogamous Catholics to exhibit greater consistency with church teaching on justice and peace issues was interpreted in terms of differences in learning prescriptive and proscriptive ethics. [ABSTRACT FROM AUTHOR]

Introduction: Access to medication assisted treatment (MAT) for opioid use disorder (OUD) in the United States is a significant challenge for many individuals attempting to recover and improve their lives. Access to treatment is especially challenging in rural areas characterized by lack of programs, few prescribers, and transportation barriers. This study aims to better understand the roles that transportation, Medicaid-funded non-emergency medical transportation (NEMT), and telehealth play in facilitating access to MAT in West Virginia (WV). Methods: We developed this survey using an exploratory sequential mixed methods approach following a review of current peer-reviewed literature plus information gained from 3 semi-structured interviews and follow-up discussions with 5 individuals with lived experience in MAT. Survey results from 225 individuals provided rich context on the influence of transportation in enrolling and remaining in treatment, use of NEMT, and experiences using telehealth. Data were collected from February through August 2021. Results: We found that transportation is a significant factor in entering into and remaining in treatment, with 170 (75.9%) respondents agreeing or strongly agreeing that having transportation was a factor in deciding to go into a MAT program, and 176 (71.1%) agreeing or strongly agreeing that having transportation helps them stay in treatment. NEMT was used by one-quarter (n = 52, 25.7%) of respondents. Only 13 (27.1%) noted that they were picked up on time and only 14 (29.2%) noted that it got them to their appointment on time. Two thirds of respondents (n = 134, 66.3%) had participated in MAT services via telehealth video or telephone visits. More preferred in-person visits to telehealth visits but a substantial number either preferred telehealth or reported no preference. However, 18 (13.6%) reported various challenges in using telehealth. Conclusions: This study confirms that transportation plays a significant role in many people's decisions to enter and remain in treatment for OUD in WV. Additionally, for those who rely on NEMT, services can be unreliable. Finally, findings demonstrate the need for individualized care and options for accessing treatment for OUD in both in-person and telehealth-based modalities. Programs and payers should examine all possible options to ensure access to care and recovery. [ABSTRACT FROM AUTHOR]

Background: Adaptive designs have been increasingly used in the pharmaceutical and device industries, but adoption within the academic setting has been less widespread - particularly for confirmatory phase trials. We sought to understand perceptions about understanding, acceptability, and scientific validity of adaptive clinical trials (ACTs).Methods: We used a convergent mixed methods design using survey and mini-focus group data collection procedures to elucidate attitudes and opinions among "trial community" stakeholders regarding understanding, acceptability, efficiency, scientific validity, and speed of discovery with adaptive designs. Data were collected about various aspects of ACTs using self-administered surveys (paper or Web-based) with visual analog scales (VASs) with free text responses and with mini-focus groups of key stakeholders. Participants were recruited as part of an ongoing NIH/FDA-funded research project exploring the incorporation of ACTs into an existing NIH network that focuses on confirmatory phase clinical trials in neurological emergencies. "Trial community" representatives, namely, clinical investigators, biostatisticians, NIH officials, and FDA scientists involved in the planning of four clinical trials, were eligible to participate. In addition, recent and current members of a clinical trial-oriented NIH study section were also eligible.Results: A total of 76 stakeholders completed the survey (out of 91 who were offered it, response rate 84 %). While the VAS attitudinal data showed substantial variability across respondents about acceptability and understanding of ACTs by various constituencies, respondents perceived clinicians to be less likely to understand ACTs and that ACTs probably would increase the efficiency of discovery. Textual and focus group responses emerged into several themes that enhanced understanding of VAS attitudinal data including the following: acceptability of adaptive designs depends on constituency and situation; there is variable understanding of ACTs (limited among clinicians, perceived to be higher at FDA); views about the potential for efficiency depend on the situation and implementation. Participants also frequently mentioned a need for greater education within the academic community. Finally, the empiric, non-quantitative selection of treatments for phase III trials based on limited phase II trials was highlighted as an opportunity for improvement and a potential explanation for the high number of neutral confirmatory trials.Conclusions: These data show considerable variations in attitudes and beliefs about ACTs among trial community representatives. For adaptive trials to be fully considered when appropriate and for the research enterprise to realize the full potential of adaptive designs will likely require extensive experience and trust building within the trial community. [ABSTRACT FROM AUTHOR]

When does Congress repeal laws enacted by prior generations? Although the substantial body of work on policy creation provides tentative explanations, we believe repeals represent an alternative way of examining the effects of congressional organization on legislative behavior. In this paper, we develop hypotheses based on both the conditional nature of party power and the location of pivot points, and test these hypotheses with a new data set of repeals from 1877 to 2012. We find that the largest effects on Congress’s capacity to repeal legislation are variation in the majority’s positive agenda control and shifts in the gridlock interval. We also find that when the majority claims control of both chambers after a long stretch in the minority, there is an increased likelihood of repeal beyond what is predicted by conditional party government alone. Because the partisan factors in our model have the largest substantive effects, and because repeals do not occur automatically in productive Congresses, we characterize repeals as long-term contests between two great “teams” over the location of the status quo. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders (SUDs) in the United States cause many preventable deaths each year. Finding effective ways to manage SUDs is vital to improving outcomes for individuals seeking treatment. This has increased interest in using e-health technologies in behavioral healthcare settings. This research is part of a larger study evaluating the efficacy of the NIATx coaching intervention for implementing RISE Iowa, an e-health patient recovery app, in SUD treatment organizations and seeks to examine clinician perspectives of the barriers and facilitators to its implementation. Method: Semi-structured qualitative interviews were conducted with 13 clinicians from 9 different intervention sites involved in the study. Results: Major barriers to implementing e-health technology include inability to access the technology, lack of time for both patients and clinicians, and a perceived lack of patient motivation to make changes. Facilitators to implementation include collaboration with other staff using e-health technology and integrating technology use into typical workflows. Conclusions: Implementation of e-health technology in SUD treatment will require integrating the technology into clinical workflows and improving patient access to the technology. [ABSTRACT FROM AUTHOR]

Background: Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East. Methods: A systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care. Results: The database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East. Conclusions: This systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to contribute to assertiveness research and assess the differences in assertiveness as it relates to gender, national culture, and ethnicity. Design/methodology/approach -- The data for the study are from 231 undergraduate students majoring in business at one of four academic institutions: three in the USA and one in the Republic of Vietnam. Students completed the 30-item Rathus Assertiveness Schedule. Findings -- This research suggests that individuals who are alike in level of education and status demonstrate similar levels of assertiveness, regardless of gender, national culture, or ethnicity. However, differences were seen as the data show white American males to be the most assertive, with African American females next. White females ranked third, followed by Vietnamese females, concluding with Vietnamese males. Research limitations/implications -- Although the sample size is small, the intent of this research was never to have the subjects represent the general population in terms of the variables used. Instead, the authors attempted to control for gender, culture, and ethnicity variables by using a sample of college students who were similar in relation to education and social status. Future research could more fully research the findings from this study which suggest that African American women are more assertive than all other groups with the exception of white males. Originality/value -- This study also gives credence to the suggestion that the global manager, in order to become more effective, needs to fully understand employee differences as represented by gender, national culture, and ethnicity. [ABSTRACT FROM AUTHOR]

Wildland fire affects both public and private resources throughout the United States. A century of fire suppression has contributed to changing ecological conditions and accumulated fuel loads. Managers have used a variety of approaches to address these conditions and reduce the likelihood of wildland fires that may result in adverse ecological impacts and threaten communities. Public acceptance is a critical component of developing and implementing successful management programs. This study examines the factors that influence citizen support for agency fuel reduction treatments over time-particularly prescribed fire and mechanical vegetation removal. This paper presents findings from a longitudinal study examining resident beliefs and attitudes regarding fire management and fuels treatments in seven states: Arizona, Colorado, Oregon, Utah, Michigan, Minnesota, and Wisconsin. The study was implemented in two phases over a 6-year period using mail surveys to residents of communities adjacent to federal lands in each location. Questions replicated measures from the original project as well as some new items to allow a more in-depth analysis of key concepts. The study design enables comparisons over time as well as between locations. We also assess the factors that influence acceptance of both prescribed fire and mechanical vegetation removal. Findings demonstrate a relative stability of attitudes toward fuels management approaches over time and suggest that this acceptance is strongly influenced by confidence in resource managers and beliefs that the treatments would result in positive outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This paper investigates consumer attitudes and behavioural intentions related to direct-to-consumer advertising (DTCA) as influenced by the health locus of control and selfefficacy of the consumer. This study examines how consumers' health locus of control and selfefficacy influence their attitude toward a pharmaceutical advertisement and their subsequent intention to obtain a medical prescription. Design/methodology/approach: Using ordinary least squares and Chronbach's alpha, this study measures the attitude towards advertisement and side effects of drugs in advertising. 128 responses of individuals who are in good health comprised the sample size. Findings: The results indicate that attitude toward the advertisement for both benefits and side effects of the DTCA for a specific prescription drug was a determinant in the intentions to seek medical advice. Results also show a strong correlation between HLOC and attitude toward the ad in both benefits and side effects; however, self-efficacy was not significantly correlated to attitude toward the advertisement. Practical/social implications: Pharmaceutical advertisers can adjust and alter ads based on attitudes towards drug side effects. Further research can be done via focus groups and surveys to find what words or alterations may have a positive effect on these attitudes. Originality: This research is unique in that there are no prior studies that examine consumer attitudes toward drug side effects using the General Self Efficacy Scale. [ABSTRACT FROM AUTHOR]

The present paper examines the link between language and cultural identity by exploring the language-related attitudes, policies and ideologies as reflected in the written records of the U.S. Federal Congress from 1789 until roughly the end of the “Second War of Independence” in 1815. The results are compared and contrasted with the findings of a previous study which examined the founding documents of the United States from a similar perspective. The most salient language policy development of the post-1789 period is the overall shift from the symbolic, general language-related remarks towards the formulation of more substantive and general policies. [ABSTRACT FROM AUTHOR]