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While ChatGPT has recently become very popular, AI has a long history and philosophy. This paper intends to explore the promises and pitfalls of the Generative Pre-trained Transformer (GPT) AI and potentially future technologies by adopting a speculative methodology. Speculative future narratives with a specific focus on educational contexts are provided in an attempt to identify emerging themes and discuss their implications for education in the 21st century. Affordances of (using) AI in Education (AIEd) and possible adverse effects are identified and discussed which emerge from the narratives. It is argued that now is the best of times to define human vs AI contribution to education because AI can accomplish more and more educational activities that used to be the prerogative of human educators. Therefore, it is imperative to rethink the respective roles of technology and human educators in education with a future-oriented mindset.

This research investigated how the bug tracker database of the Virtual Learning Environment (VLE) Moodle is developed as an application of crowd work. The bug tracker is used by software developers, who write and maintain Moodle's code, but also by a wider public world of ordinary Moodle users who can report bugs. Despite many studies of the phenomenon of open source bug fixing and software building, much remains to be answered. Specifically, we sought to analyse the implications of this massively distributed collaborative development process for education and educational technology. The research examined the ways educators interface and contribute to the development of the VLE Moodle at the granular level of bug fixing as an example of a global crowdsourced activity. In this study, twenty community participants were interviewed, from fringe members, to key actors, including lead developers from the Open University, Moodle HQ and Moodle founder Martin Dougiamas. We uncovered rich stories of practices of community members. We found that projects are complex interplays of many actors assuming different roles and identities, and that brokers, or "kindly souls", play a key role in activities such as filing reports on behalf of others, or inducting new members.

While many studies investigate student leadership development in educational contexts or curriculum-based programs, little is known about the efficacy of leadership development programs that emerge in municipalities. This mixed methods case study explored the leadership development of participants in three nine-month youth leadership programs at a municipal-based prevention, treatment, and outreach center in the United States. Qualitative focus groups and quantitative surveys using the Student Leadership Practices Inventory (SLPI) were used to collect data at the beginning and end of the three programs along with a post-program evaluative survey. Findings from the qualitative and quantitative analyses are first presented individually and then expressed using a joint display table to visually represent the integrated results. Findings showed that the programs positively influenced participants' perceptions, characteristics, and behaviors as youth leaders in their communities. Participants not only indicated improvements in their leadership practices according to the SLPI from pre- to post-program, but also demonstrated more complex understandings of leadership and what it means to be a leader in one's community. These findings are useful for individuals and organizations planning student leadership development programs and should inform future research in the field.

This study examined the development of empathic care across three generations in a sample of 184 adolescents in the United States (99 female, 85 male; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other groups), followed from their family of origin at age 13 into their parenting years (through their mid‐30s). Mothers' empathic support toward adolescents at age 13 predicted teens' empathy for close friends across adolescence (13–19 years). Participants' empathic support for friends in late adolescence predicted more supportive parenting behavior in adulthood, which in turn was associated with their children's empathy at age 3–8 years. Results suggest that individuals "pay forward" the empathic care they receive from parents, and that skills developed in adolescent friendships may inform later parenting. [ABSTRACT FROM AUTHOR]

This article presents findings from our 2018 survey of over 331 institutions about the factors that impact Women's, Gender, and Sexuality programs and challenge their survival. Across the United States, significant changes have affected not just the stability of WGS programs, but their very existence. WGS academic programs are experiencing extreme precarity based on several factors: reductions in state funding for education; the rise of political conservatism/authoritarianism globally, and increased mistrust of liberal arts locally. These external factors have caused WGS Programs to be redefined, merged with other programs, or cut altogether. The onset of the pandemic intensified all these factors exponentially and is exacerbated by the interdisciplinarity of the field, the reliance on personality in leadership, and the lack of resources. We hope this article, in conversation with the brief data that NWSA gathered in 2020, will illuminate the challenges and pose some solutions. [ABSTRACT FROM AUTHOR]

Growing evidence has revealed the crucial role of motor simulation and spatial perspective-taking in action language. However, there is still a lack of understanding of how motor and spatial processes interact when there are multiple actors involved, and if embodied processes are consistent across different cultures. To address this gap, we examined the interaction between motor simulation and spatial perspective-taking in action-sentences comprehension, along with the consistency of embodied processes across cultures. We collected data from Italian and US English speakers using an online sentence-picture verification task. The participants completed four conditions: two congruent (i.e., the participant is the agent in the sentence and the photo; the agent is someone else interacting with the participant in both the sentence and the picture) and two incongruent (i.e., the agents of the sentence and the picture do not match). The results show that when the perspective of the picture matched that described in the sentence-processing reaction times (RTs) were faster than in the incongruent conditions. In the congruent conditions where the agent is someone else, RTs were slower compared to the condition where the participant is the agent. This has been interpreted as claiming that motor simulation and perspective-taking are independent processes interacting during sentence comprehension (e.g., motor simulation is always run in the role of the agent, but we can adopt multiple perspectives depending on the pronouns and the contextual cues). Furthermore, Bayesian analysis provided evidence that embodied processing of action language entwines a common mechanism, suggesting cross-cultural consistency of embodied processes. [ABSTRACT FROM AUTHOR]

This scoping review explores the professional literature in allied healthcare to determine which self-assessments of mentor skills are the most valid and reliable for use in occupational therapy doctoral capstone programs. The aims of this scoping review include mapping evidence related to mentor assessments in healthcare, exploring implications for occupational therapy doctoral mentor training programs, and identifying common characteristics of mentor self-assessments for occupational therapy programs to consider when developing capstone mentoring resources. Researchers applied and reported via PRISMA Extension for Scoping Reviews (PRISMA-ScR). A librarian and authors formulated keywords and database selections to search PubMed/MEDLINE/PMC, and Embase were searched from across healthcare professions for training outcomes, mentor self-assessment, mentor attributes, and use of researcher-developed assessments. The search was limited to English publications from the last 20 years. Data were extracted for quantitative information regarding study characteristics and qualitative information about mentoring skills. A total of 852 results were delivered across all databases. Nineteen papers met the final eligibility criteria and were included in the data extraction. Populations were included from several healthcare professions, including 11 nursing, four healthcare researchers, one pharmacy, one midwifery, one medicine, and one medical dietetics. Countries included the United States (n = 7), Finland (n = 5), United Kingdom (n = 4), Japan (n = 1), South Africa (n = 1) and Canada (n = 1). The authors identified four valid self-assessment tools, demonstrating III and IV levels of evidence, that may be implemented by occupational therapy programs as they develop resources for mentor programs. Occupational therapy programs can use the mentor attributes found in this scoping review to create their own mentor assessment measures or may choose to use a validated tool. The authors recommend additional research in mentor education and mentor skill acquisition. [ABSTRACT FROM AUTHOR]

Objective: To identify the predictors of nonmedical ADHD medication use by college students. Participants: A total of 843 undergraduates attending one public or one private university in southeastern United States. Method: Students completed a Web-based survey inquiring about ADHD medication use during the first semester freshman of their year and a second time during the second semester of their sophomore year. Results: A total of 45 participants (5.3%) reported the onset of nonmedical ADHD use between the two survey administrations. The majority of these students were high substance users as freshman. Attention difficulties also predicted the onset of nonmedical use, especially in the absence of excessive substance use. Compared with other nonmedical users of ADHD medication, those reporting attention difficulties had lower GPAs, greater academic concerns, and higher levels of depressive symptoms. Conclusion: Attention difficulties contribute to the onset of nonmedical ADHD medication use in a significant minority of nonmedical users. These students may begin using ADHD medication to address attention problems they experience as undermining their academic success. (Contains 4 tables.)

The arts are often seen as peripheral to the "real business" of school and schooling. While this has been the case for some time now, the increasing pressures of high-stakes testing and ever-more draconian public funding schemes (particularly in the wake of 9/11) have created something of a "perfect storm" for those working in the arts. Arts proponents today live and operate within a culture of scarcity, having to justify their increasingly marginalized vocations while competing for continually shrinking resources. The result is an often deep-bodied sense of vulnerability, one which saturates the social field (both micro and macro) of arts education in ways not often publicly acknowledged. In this article, I explore this notion of "vulnerability" as a framework for understanding qualitative data which emerged from a three-year arts and education project I conducted in a large, northeast city in the USA beginning in 2003. In so doing, I look to open up a broader discussion about the oft-ignored intersection(s) between the material and aesthetic in arts and education--a discussion which is sober about the future of such work in times of economic scarcity and conservative retrenchment. (Contains 1 note.)

Group achievements and social change are rooted in self-efficacy. This concept has important implications for career development in a changing environment. Associations that represent professionals involved with physical rehabilitation in the United States have identified activities that they feel are essential for the survival of the rehabilitation professions. The purpose of this study was to describe how confident rehabilitation professionals are to perform these activities. Results showed that most rehabilitation professionals did not feel totally confident to perform these activities. These results suggest that rehabilitation professionals may not be optimally prepared to adapt to the changing health care environment and suggest methods to facilitate professional development of these professionals. (Contains 2 tables.)

This exploratory quantitative study assessed 149 behaviors, characteristics, and techniques considered indicative of expertise to determine what social scientists in Agricultural Communications, Education, Extension, and Leadership (ACEEL) disciplines value. A total of 731 social scientists from 25 land-grant universities across the United States surveyed in the fall of 2018 served as the population for this study. Using Principal Component Analysis (PCA), 10 constructs describing expertise were identified. A list of the 10 constructs was presented to faculty representing the ACEEL disciplines who helped determine what the constructs collectively measured, resulting in a label for each construct. The behaviors, characteristics, and techniques of the highest scoring constructs were used to create a rubric to assist social scientists in the systematic and intentional selection and description of the qualifications and expertise of individuals asked to serve as coders (Content Analysis), expert panelists (the Delphi method), and any contributor to social science studies in ACEEL disciplines. Use of the rubric would improve the overall consistency and transparency in how qualifications of expertise are reported in academic publications. [ABSTRACT FROM AUTHOR]

The methods and procedures within United States naval aviation to certify an aircraft safe for flight are well established. However, these methods and procedures are based on clearing a system that is operated or monitored by a human. A fully autonomous system will not have a human in or on the loop and will therefore require a new method for certifying it safe for flight. This paper details how to use run time assurance as the framework for a safety of flight certification of autonomous behavior within United States naval aviation. We present an aerial refueling task with run time assurance as use case for the framework for certification. Within the use case we then give more details on the mechanics of using RTA to enable autonomous functionality within naval aviation. [ABSTRACT FROM AUTHOR]

The doctoral capstone coordinator (DCC) position is a required faculty position in U.S. entry-level OTD programs, but there is limited information about this role. This descriptive study aimed to explore the demographics of DCCs; their required workload, tasks, and responsibilities; and the supports available to DCCs. The researchers administered an online survey and analyzed the data using descriptive statistics and content analysis. The results revealed much variability in DCCs' experiences, workloads, and responsibilities across OTD programs. Of the DCCs survey, 74.0% previously held leadership positions in academia or clinical practice before taking the role, and 60.5% of the DCCs worked overtime for at least half of the previous year. Approximately half of the DCCs spent different percentages of time on teaching, research, service, and clinical responsibilities than expected by their universities. Common capstone tasks completed only by the DCC involved educating others about the capstone process, developing and evaluating the capstone processes, and teaching capstone courses. Tasks commonly completed with support include ensuring student completion of preparatory requirements, securing placements and affiliation agreements, and advising students. The responses varied regarding the individuals involved with mentoring and student assessment responsibilities. Overall, 67.7% of the DCCs were slightly to extremely satisfied with their existing workload. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is among the top 10 most common cancers in both men and women with an estimated 75 000 cases each year in the US. Over the last decade, the therapeutic landscape for patients with metastatic RCC has significantly evolved, with immunotherapy emerging as the new front-line therapy. Despite significant improvement in toxicity profile and survival outcomes, key concerns such as patient selection, treatment sequencing, and intrinsic and acquired resistance remain unresolved. Emerging options such as antibody-based therapeutics (eg, anti-CD70, anti-CA9, and anti-ENPP3) are being explored in clinical trials for patients with cancer resistant or refractory to current immunotherapies. Despite positive results for hematological cancers, breast cancer, and more recently bladder cancer, most antibody-based therapies failed to improve the outcomes in patients with advanced RCC. This underscores the need to understand the underlying causes of failed responses to this treatment class, which will ultimately support the rational design of more effective and tolerable treatments. In this review, we summarize the evolving landscape of RCC therapeutics and describe recent clinical trials with emerging antibody-based therapeutics. We also describe the challenges that need to be overcome for the successful creation of therapeutic antibodies for treating RCC. [ABSTRACT FROM AUTHOR]

In previous studies, investigators have reported increased risks of specific cancers associated with exposure to metalworking fluids (MWFs). In this report we broadly examine the incidence of 14 types of cancer, with a focus on digestive, respiratory, and hormonal cancers, in the United Auto Workers–General Motors (UAW-GM) cohort, a cohort of workers exposed to MWFs (1973–2015). The cohort included 39,132 workers followed for cancer incidence. Cox models yielded estimates of adjusted hazard ratios, with categorical variables for lagged cumulative exposure to 3 types of MWF (straight, soluble, and synthetic). We fitted penalized splines to examine the shape of the exposure-response relationships. There were 7,809 incident cancer cases of interest. Oil-based straight and soluble MWFs were each modestly associated with all cancers combined. Exposure-response patterns were consistent with prior reports from this cohort, and results for splined exposures generally reflected their categorically modeled counterparts. We found significantly increased incidence of stomach and kidney cancer with higher levels of straight MWF exposure and increased rectal and prostate cancer with increasing water-based synthetic MWF exposure. Only non-Hodgkin lymphoma and prostate cancer were associated with soluble MWF. All results for colon and lung cancers were null. Our results provide updated evidence for associations between MWF exposure and incidence of several types of cancer. [ABSTRACT FROM AUTHOR]

Objectives: As part of the COVID‐19 and Epilepsy (COV‐E) global study, we aimed to understand the impact of COVID‐19 on the medical care and well‐being of people with epilepsy (PWE) in the United States, based on their perspectives and those of their caregivers. Methods: Separate surveys designed for PWE and their caregivers were circulated from April 2020 to July 2021; modifications in March 2021 included a question about COVID‐19 vaccination status. Results: We received 788 responses, 71% from PWE (n = 559) and 29% (n = 229) from caregivers of persons with epilepsy. A third (n = 308) of respondents reported a change in their health or in the health of the person they care for. Twenty‐seven percent (n = 210) reported issues related to worsening mental health. Of respondents taking ASMs (n = 769), 10% (n = 78) reported difficulty taking medications on time, mostly due to stress causing forgetfulness. Less than half of respondents received counseling on mental health and stress. Less than half of the PWE reported having discussions with their healthcare providers about sleep, ASMs, and potential side effects, while a larger proportion of caregivers (81%) reported having had discussions with their healthcare providers on the same topics. More PWE and caregivers reported that COVID‐19‐related measures caused adverse impact on their health in the post‐vaccine period than during the pre‐vaccine period, citing mental health issues as the primary reason. Significance: Our findings indicate that the impact of the COVID‐19 pandemic in the US on PWE is multifaceted. Apart from the increased risk of poor COVID‐19 outcomes, the pandemic has also had negative effects on mental health and self‐management. Healthcare providers must be vigilant for increased emotional distress in PWE during the pandemic and consider the importance of effective counseling to diminish risks related to exacerbated treatment gaps. [ABSTRACT FROM AUTHOR]

One approach to address both the environmental and scarcity issues that occur with phosphorus (P) losses from human systems is to improve understanding of the P demands of bio‐based products. Most P demand in the United States is driven by production of crops for animal feed and mineral P feed supplements for animals. In this research, we used the Commodity‐Specific Net Anthropogenic Phosphorus and Nitrogen Inputs (CSNAPNI) model to (1) assess the contributions of individual feed products such as corn, soy, and mineral P supplements to the embodied P of animal products and (2) estimate net anthropogenic phosphorus inputs (NAPIs) for the contiguous United States for two animal P‐intake scenarios. Results show that P supplements may contribute up to 30% of embodied P in pork and dairy products, up to 60% in chicken, and up to 75% in turkey. Other major contributors to animal product‐embodied P are grains, which are responsible for around 60% of embodied P in pork and dairy products, at least 30% in chicken, and at least 20% in turkey products. Results also show that animal P intake is such a significant driver of anthropogenic phosphorus that a reduction of animal P intake by 25% could reduce NAPI to the contiguous United States by 30%. Considering promising research on methods to improve digestibility of both mineral P supplements and grain P in animal diets, these results are encouraging. [ABSTRACT FROM AUTHOR]

Faith-based organizations (FBOs) can play an important role in improving health outcomes. Lay community health advisors (CHAs) are integral to these efforts. This paper assesses the sustainability of a CHA training program for congregants in African-American and Latino FBOs and subsequent implementation of educational workshops. The program is unique in that a health care chaplain in an academic medical center was central to the program's development and implementation. Forty-eight CHAs in 11 FBOs were trained to teach workshops on cardiovascular health, mental health, diabetes, and smoking cessation. Two thousand four hundred and forty-four participants attended 70 workshops. This program has the potential to be a model to educate individuals and to address health inequities in underserved communities. Health care chaplains in other medical centers may use this as a model for enhancing community engagement and education. [ABSTRACT FROM AUTHOR]

Although air pollution is an important risk factor for stroke, few studies have considered the impact of workplace exposure to particulate matter (PM). We examined implications of exposure to PM composed of metalworking fluids (MWFs) for stroke mortality in the United Autoworkers–General Motors cohort. Cox proportional hazards models with age as the timescale were used to estimate the association of cumulative straight, soluble, and synthetic MWF exposure with stroke mortality, controlling for sex, race, plant, calendar year, and hire year. Among 38,553 autoworkers followed during 1941–1995, we identified 114 ischemic stroke deaths and 113 hemorrhagic stroke deaths. Overall stroke mortality risk was increased among workers in the middle exposure category for straight MWF (hazard ratio (HR) = 1.31, 95% confidence interval (CI): 0.87, 1.98) and workers in the highest exposure category for synthetic MWF (HR = 1.94, 95% CI: 1.13, 3.16) compared with workers who had no direct exposure. Ischemic stroke mortality risk was increased among workers in the highest exposure categories for straight MWF (HR = 1.45, 95% CI: 0.83, 2.52) and synthetic MWF (HR = 2.39, 95% CI: 1.39, 4.50). We observed no clear relationship between MWF exposure and hemorrhagic stroke mortality. Our results support a potentially important role for occupational PM exposures in stroke mortality and indicate the need for further studies of PM exposure and stroke in varied occupational settings. [ABSTRACT FROM AUTHOR]

This study examined an intervention designed to improve sense of belongingness for new students at a medium-sized, four-year, public university in the Eastern United States. A randomized controlled trial was used to assess the impact of The Connection Project, a novel, 9-session intervention in a sample of 128 first-year students (77 treatment, 48 waitlist control). Given the onset of COVID-19, students received a hybrid in-person/online intervention. At post-intervention, the intervention group reported a significantly higher sense of school belongingness, after accounting for baseline levels, than control group students. Post-hoc analyses of moderation by demographic variables indicate that the intervention functioned similarly for students from a variety of backgrounds in this sample. These results are interpreted as suggesting the potential value of this intervention to promote a sense of community and connection among new students in college, whether delivered in-person or online. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of telemedicine use during the coronavirus disease 2019 (COVID‐19) pandemic on rheumatology trainees. Methods: A voluntary, anonymous, web‐based survey was administered in English, Spanish, or French from August 19 to October 5, 2020. Adult and pediatric rheumatology trainees were invited to participate via social media and email. Using multiple‐choice questions and Likert scales, the survey assessed prior and current telemedicine use, impact on training, and supervision after COVID‐19 prompted rapid telemedicine implementation. Results: Surveys were received from 302 trainees from 33 countries, with 83% in adult rheumatology training programs. Reported telemedicine use increased from 13% before the pandemic to 82% during the pandemic. United States trainees predominantly used video visits, whereas outside the United States telemedicine was predominantly audio only. Most (65%) evaluated new patients using telemedicine. More respondents were comfortable using telemedicine for follow‐up patients (69%) than for new patients (25%). Only 39% of respondents reported receiving telemedicine‐focused training, including instruction on software, clinical skills, and billing, whereas more than half of United States trainees (59%) had training. Postconsultation verbal discussion was the most frequent form of supervision; 24% reported no supervision. Trainees found that telemedicine negatively impacted supervision (50%) and the quality of clinical teaching received (70%), with only 9% reporting a positive impact. Conclusions: Despite widespread uptake of telemedicine, a low proportion of trainees received telemedicine training, and many lacked comfort in evaluating patients, particularly new patients. Inadequate supervision and clinical teaching were areas of concern. If telemedicine remains in widespread use, ensuring appropriate trainee supervision and teaching should be prioritized. [ABSTRACT FROM AUTHOR]

Purpose: The effects of the COVID-19 pandemic were felt acutely by resettled refugee communities around the world. Adjusting to life in a new country typically presents a host of challenges that must be met by newly resettled refugees, and these challenges were no doubt compounded by the pandemic. The purpose of this study is to explore the lived experiences of resettled Rohingyan refugees living in the USA during the COVID-19 pandemic. Design/methodology/approach: This study uses a grounded theory approach to derive meaning from qualitative interviews conducted with 21 Rohingyan refugees. This study embodied an emic design by involving the community in the development, conduction and interpretation of the data, rooting itself in the recognition of Rohingyan expertise and understanding. Findings: The data yielded three major themes: financial instability, disruptions in access to health care and mental health distress. In addition, two minor themes were established: disruptions to everyday life and impacts on religious practices. Originality/value: Little is known about the resettlement experiences of the Rohingyan people, who are arguably some of the most marginalized among refugees. With no written language shared among Rohingyans, communication barriers exacerbate an already challenging resettlement trajectory. The insights provided through this study are key to understanding the unique needs and strengths of Rohingyan refugees and will be valuable in shaping interventions to support their successful resettlement. [ABSTRACT FROM AUTHOR]

Significant advances have been made in interventions to maintain communication and personhood for individuals with neurodegenerative conditions. One innovation is Message Banking, a clinical approach first developed at Boston Children's Hospital (BCH). This paper outlines the Message Banking process as implemented at BCH, which includes the option of "Double Dipping," where banked messages are mined to develop personalized synthesized voices. More than a decade of experience has led to the evolution of six core principles underpinning the BCH process, resulting in a structured introduction of the associated concepts and practices with people with amyotrophic lateral sclerosis (ALS) and their families. These principles highlight the importance of assigning ownership and control of the process to individuals with ALS and their families, ensuring that as a tool it is empowering and offers hope. Changes have been driven by feedback from individuals who have participated in the BCH process over many years. The success of the process has recently been extended through partnerships that allow the recorded messages to be used to develop individual personalized synthetic voices to complement banked messages. While the process of banking messages is technically relatively simple, the full value of the process should be underpinned by the values and principles outlined in this tutorial. [ABSTRACT FROM AUTHOR]

Background Antibiotic stewardship in the pretravel care of older adults is important to effectively treat infections while minimizing harm from side effects and unnecessary antibiotic use. The objective of this study was to compare the characteristics, risk behaviors, infectious diseases, and antibiotic use between older (≥60 years) and younger (18–59 years) travelers. Methods TravMil is a prospective, observational cohort of United States (US) Department of Defense beneficiaries traveling outside the continental US for ≤6.5 months. For this analysis, we included adults enrolled pretravel between January 2010 and August 2018 and excluded active duty personnel on deployment. Pre and post-travel surveys captured trip characteristics, exposures, illnesses, and antibiotic use. Results A total of 1742 travelers were analyzed: 747 (42.9%) were aged ≥60 years and 995 (57.1%) were aged 18–59 years. Older travelers were less likely to engage in high-risk dietary behaviors and experience travelers' diarrhea than younger travelers (18.2% vs 22.9%; P  < .05). Influenza-like illness (12.5%) and febrile illness (3.4%) occurred less frequently in the older cohort. Antibiotic use for self-treatment was common in both age groups (25.7% vs 26.7%) and often inappropriate, for example, for treatment of occasional loose stool or mild travelers' diarrhea (67.0% [67/100] in older adults vs 57.6% [83/144] in younger adults; P  < .05), and influenza-like illness (63.4% [64/101] vs 58.6% [68/116], respectively; P  < .05). Conclusions Older travelers were less likely to engage in high-risk behaviors and experience travelers' diarrhea, and both age groups experienced mild, self-limited infections. Inappropriate use of antibiotics was common, suggesting that antimicrobial stewardship should be emphasized at pretravel counseling with international travelers. [ABSTRACT FROM AUTHOR]

What is known and objective: Current evidence‐based guidelines for the treatment of acute low back pain (ALBP) recommend the use of opioid medications only after failure of nonpharmacological therapy, non‐steroidal anti‐inflammatory drugs and skeletal muscle relaxants and after thorough evaluation of risks and benefits. Despite this recommendation and the state of the opioid epidemic in the United States (US), opioids remain a common drug of choice for ALBP in the emergency department (ED). The purpose of this study was to quantify the prevalence and identify predictors of opioid prescribing for acute lower back pain (ALBP) in emergency departments (EDs) in the United States. Methods: This was a national, cross‐sectional study of the National Hospital Ambulatory Care Survey from 2013‐2016. ED visits for patients aged ≥18 years treated for ALBP were included. Patients presenting with specified reasons that an opioid may be indicated were excluded. The primary endpoint was frequency of opioids prescribed. A multivariate logistic regression model identified patient‐ and provider‐level predictors of opioid use. Results and discussion: This analysis included 2260 visits for ALBP. Opioids were prescribed in 32.3% of visits. Positive predictors of opioid prescribing were pain score of 7‐10 (OR 1.85; 95% CI 1.26‐2.70), and patients seen in the Southern (OR 2.53; 95% CI 1.47‐4.36) or Western US (OR 2.10; 95% CI 1.19‐3.70). Opioids were prescribed less often to patients who received a NSAID or acetaminophen (OR 0.38; 95% CI 0.28‐0.52 and OR 0.03; 95% CI 0.01‐0.10, respectively). What is new and conclusion: Opioid prescribing rates for ALBP remain high and the predictors identified demonstrate that this prescribing pattern is not uniformly distributed across the patient and provider characteristics studied. [ABSTRACT FROM AUTHOR]

While outcomes for neonates with congenital heart disease have improved, it is apparent that substantial variability exists among centers with regard to the multidisciplinary approach to care for this medically fragile patient population. We endeavored to understand the landscape of neonatal cardiac care in the United States. A survey was distributed to physicians who provide neonatal cardiac care in the United States regarding (1) collaborative efforts in care of neonates with congenital heart disease (CHD); (2) access to neonatal cardiac training; and (3) barriers to the implementation of protocols for neonatal cardiac care. Responses were collected from 10/2018 to 6/2019. We received responses from 172 of 608 physicians (28% response rate) from 89 centers. When compared to responses received from physicians at low-volume centers (< 300 annual bypass cases), those at high-volume centers reported more involvement from the neurodevelopmental teams (58% vs. 29%; P = 0.012) and a standardized transition to outpatient care (68% vs. 52%; P = 0.038). While a majority of cardiothoracic surgery and anesthesiology respondents reported multidisciplinary involvement, less than half of cardiology and neonatology supported this statement. The most commonly reported obstacles to multidisciplinary engagement were culture (61.6%) and logistics (47.1%). Having a standardized neonatal cardiac curriculum for neonatal fellows was positively associated with the perception that multidisciplinary collaboration was "always" in place (53% vs. 40%; P = 0.09). There is considerable variation among centers in regard to personnel involved in neonatal cardiac care, related education, and perceived multidisciplinary collaboration among team members. The survey findings suggest the need to establish concrete standards for neonatal cardiac surgical programs, with ongoing quality improvement processes. [ABSTRACT FROM AUTHOR]

Objective: Racial/ethnic minorities experience more severe outcomes of coronavirus disease 2019 (COVID‐19) in the general US population. This study was undertaken to examine the association between race/ethnicity and COVID‐19 hospitalization, ventilation status, and mortality in people with rheumatic disease. Methods: US patients with rheumatic disease and COVID‐19 were entered into the COVID‐19 Global Rheumatology Alliance physician registry between March 24, 2020 and August 26, 2020 were included. Race/ethnicity was defined as White, African American, Latinx, Asian, or other/mixed race. Outcome measures included hospitalization, requirement for ventilatory support, and death. Multivariable regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for age, sex, smoking status, rheumatic disease diagnosis, comorbidities, medication use prior to infection, and rheumatic disease activity. Results: A total of 1,324 patients were included, of whom 36% were hospitalized and 6% died; 26% of hospitalized patients required mechanical ventilation. In multivariable models, African American patients (OR 2.74 [95% CI 1.90–3.95]), Latinx patients (OR 1.71 [95% CI 1.18–2.49]), and Asian patients (OR 2.69 [95% CI 1.16–6.24]) had higher odds of hospitalization compared to White patients. Latinx patients also had 3‐fold increased odds of requiring ventilatory support (OR 3.25 [95% CI 1.75–6.05]). No differences in mortality based on race/ethnicity were found, though power to detect associations may have been limited. Conclusion: Similar to findings in the general US population, racial/ethnic minorities with rheumatic disease and COVID‐19 had increased odds of hospitalization and ventilatory support. These results illustrate significant health disparities related to COVID‐19 in people with rheumatic diseases. The rheumatology community should proactively address the needs of patients currently experiencing inequitable health outcomes during the pandemic. [ABSTRACT FROM AUTHOR]

This study assessed self-perception as a long-term predictor of relative changes in problems related to alcohol and marijuana use in early adulthood. Self-report questionnaires were completed by a community sample of 124 individuals in the Southeastern United States who were followed longitudinally from age 19 to 27. More problems due to substance use at age 27 were predicted by participants' negative perceptions of their social acceptance, romantic appeal, and self-worth. Predictions remained after accounting for potential confounds including gender, income, and baseline substance use problems at age 19. Social avoidance and distress in new situations at age 19 mediated the relationship between self-perception and relative changes in substance use problems, such that increases in substance use problems from age 19 to 27 were potentially explainable by the linkage of negative self-perceptions to social avoidance and distress in new situations. [ABSTRACT FROM AUTHOR]

Purpose of study: The purpose of this qualitative research study is to describe COVID-19 survivors understanding and experiences of compassionate care during their hospitalization Design of study: A qualitative exploratory design was utilized to discern participant's perceptions of compassion. Methods: A purposive sample of adult survivors of COVID-19 hospitalization was obtained through announcements on the social media platform Facebook. Criteria for study enrollment in included individuals over the age of eighteen who had been hospitalized as a result of complications from COVID-19. A semi structured interview was utilized to explore participant's experiences of compassionate care practices by health care workers. Thematic analysis, a method for identifying, analyzing and reporting patterns (themes) within data was utilized until saturation was reached. Findings: An analysis of findings revealed four themes: Compassion without fear; Compassion with confidence; Compassion through physical presence; Compassion through listening. These themes were repeated throughout all interviews. Conclusions. The COVID-19 survivors in this study provided profound examples of the compassionate care they experienced during their hospitalization. The study participants shared stories of being on the receiving end of compassionate practices which helped them to feel connection at a time when they were most isolated and vulnerable. [ABSTRACT FROM AUTHOR]

The objective of this study was to reveal how the national economic recession has affected the nature and extent of support for tenure track librarians at Association of Research Libraries (ARL) member institutions. The authors surveyed 43 ARL Deans and University Librarians to discover the criteria for achieving tenure and the current institutional support for tenure-related activities. All of the responding libraries reported experiencing at least moderate reductions in their overall budgets, with the majority indicating increased workloads for faculty and reductions to monetary support for professional development. Despite this adversity, the survey indicated that the expectations for achieving tenure for librarians in the areas of research and service have not changed. [ABSTRACT FROM AUTHOR]

The Internet's relatively unfettered transmission of information risks exposing individuals to extremist content. Using online survey data (N = 768) of American youth and young adults, we examine factors that bring individuals into contact with online material advocating violence. Combining aspects of social structure-social learning theory with insights from routine activity theory, we find that exposure to violence-advocating materials is positively correlated with online behaviors, including the use of social media platforms and the virtual spaces individuals frequent. Target antagonism is also correlated with exposure to violence-advocating materials, but guardianship and online and offline associations are not. Finally, feelings of dissatisfaction with major social institutions and economic disengagement are associated with exposure to violent materials online. [ABSTRACT FROM AUTHOR]

Two seemingly associated demographic trends have generated considerable interest: income stagnation and rising premature mortality from suicides, drug poisoning, and alcoholic liver disease among US non-Hispanic Whites with low education. Economists interpret these population-level trends to indicate that despair induced by financial stressors is a shared pathway to these causes of death. Although we now have the catchy term "deaths of despair," we have yet to study its central empirical claim: that conceptually defined and empirically assessed "despair" is indeed a common pathway to several causes of death. At the level of the person, despair consists of cognitive, emotional, behavioral, and biological domains. Despair can also permeate social relationships, networks, institutions, and communities. Extant longitudinal data sets feature repeated measures of despair—before, during, and after the Great Recession—offering resources to test the role that despair induced by economic decline plays in premature morbidity and mortality. Such tests must also focus on protective factors that could shield individuals. Deaths of despair is more than a phrase; it constitutes a hypothesis that deserves conceptual mapping and empirical study with longitudinal, multilevel data. [ABSTRACT FROM AUTHOR]

What factors are related to online targeting of hate material based to sexual orientation? This study addresses that question, utilizing a sample of 968 Internet users aged 15-36. Employing a logistic regression analysis, we find that social network usage, online antagonism, informal online social control, and a lack of online anonymity increase the likelihood of being targeted. Moreover, individuals living in the southern region of the United States are nearly three times as likely to be targeted by hate related to sexual orientation, whereas those living in rural areas are more than twice as likely to face such targeting. [ABSTRACT FROM AUTHOR]

Context: Widespread digital retouching of advertising imagery in the fashion, beauty, and other consumer industries promotes unrealistic beauty standards that have harmful effects on public health. In particular, exposure to misleading beauty imagery is linked with greater body dissatisfaction, worse mood, poorer self-esteem, and increased risk for disordered eating behaviors. Moreover, given the social, psychological, medical, and economic burden of eating disorders, there is an urgent need to address environmental risk factors and to scale up prevention efforts by increasing the regulation of digitally altered advertising imagery.Methods: This manuscript summarizes the health research literature linking digital retouching of advertising to increased risk of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction in consumers, followed by a review of global policy initiatives designed to regulate digital retouching to reduce health harms to consumers. Next, we turn to the US legal context, reporting on findings generated through legal research via Westlaw and LexisNexis, congressional records, federal agency websites, law review articles, and Supreme Court opinions, in addition to consulting legal experts on both tax law and the First Amendment, to evaluate the viability of various policy initiatives proposed to strengthen regulation on digital retouching in the United States.Findings: Influencing advertising practices via tax incentives combined with corporate social responsibility initiatives may be the most constitutionally feasible options for the US legal context to reduce the use of digitally alternated images of models' bodies in advertising.Conclusions: Policy and corporate initiatives to curtail use of digitally altered images found to be harmful to mental and behavioral health of consumers could reduce the burden of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction and thereby improve population health in the United States. [ABSTRACT FROM AUTHOR]

The population of English learners (ELs) continues to grow in schools across the United States and around the world. In this article, we share one urban university's collaborative approach to building educational capacity for cultural and linguistic diversity through professional development efforts that brought together stakeholders from classrooms, schools, communities, and districts. This grant-funded project aimed to build educator expertise to effectively support and positively influence students' language development and disciplinary learning. Grounded in sociocultural theory, we used an apprenticeship framework of teacher development, strategically planning and implementing collaborative capacity building efforts to foster learning across individual, interpersonal, and institutional planes. In this paper, we share the results of professional development efforts across three years of this project, drawing from observation, interview, and focus group data. Findings indicate that classroom-, school-, and district-level educators developed knowledge of discipline-specific language development, pedagogical skills for effective EL teaching and learning, and leadership abilities to positively shape institutional responses to their culturally and linguistically diverse student populations. Implications focus on fostering teacher professionalism through bottom-up development of EL-specific expertise and expanded opportunities for leadership. [ABSTRACT FROM AUTHOR]

This article provides information on taxation of executive compensation in the U.S. The primary objective of any cost-effective executive compensation plan is to develop a pay scale that is commensurate with the level of responsibility and degree of success of the employee. Further, if an employer is to be competitive with other employers in hiring and retaining executive talent, the compensation formula must be flexible enough to accommodate use of tax-deferral techniques, provide for taxation of some portion of an executive's wealth accretion from his labors at the long-term capital gain rate, or some other favorable rate, permit exclusion from taxable income of certain economic benefits received by the executive as a result of the employment relationship, and provide a satisfactory degree of job security. The area of executive compensation will be a continuously evolving one as long as companies continue to compete for top executive talent. There is a trend toward greater use of multiple option plans and compensation plans based on performance. Innovative techniques such as junior stock plans should gain widespread use in anticipation of the projected favorable stock market performance throughout the 1980s.

Questionnaire data from eighty-seven middle-management personnel in a bank planning a merger with a larger bank were analyzed. Attitudes toward the merger tended to be unfavorable, although they ranged from very favorable to very unfavorable. Favorable attitudes were related to older age, lack of previous success in the organization, high morale, and high F-scale scores (authoritarianism). Unfavorable attitudes toward the merger seemed to be principally associated with: younger age, a pattern of success in the organization, low current morale, and low authoritarianism. [ABSTRACT FROM AUTHOR]

Aims: To describe the Great Smoky Mountains Study (GSMS).Methods: GSMS is a longitudinal study of child psychiatric disorders that began in 1992 to look at need for mental health services in a rural area of the USA. Over 20 years it has expanded its range to include developmental epidemiology more generally, not only the development of psychiatric and substance abuse problems but also their correlates and predictors: family and environmental risk, physical development including puberty, stress and stress-related hormones, trauma, the impact of poverty, genetic markers, and epigenetics. Now that participants are in their 30s the focus has shifted to adult outcomes of childhood psychopathology and risk, and early physical, cognitive, and psychological markers of aging.Results: This paper describes the results from over 11,000 interviews, examples of the study's contributions to science and policy, and plans for the future.Conclusions: Longitudinal studies can provide insights that aid in policy planning. [ABSTRACT FROM AUTHOR]

Past research links childhood exposure to intimate partner violence (IPV) to Post-Traumatic Stress Disorder (PTSD), with preliminary evidence that white children may be more traumatized by IPV exposure than African American children. Despite this, few studies have explored the moderating effect of race/ethnicity on children's IPV exposure and subsequent trauma symptoms. Using a diverse sample of children in the U.S. child welfare system (n = 713) with high prevalence of IPV exposure, this study employs subpopulation analysis with multivariate regression to explore whether race/ethnicity moderates the relationship between IPV exposure and trauma symptoms, and whether differential predictors of trauma exist for white, African American, and Hispanic children exposed to IPV. Race/ethnicity moderates the relationship between childhood exposure to IPV and trauma, with Hispanic children exhibiting fewer trauma symptoms than white children as IPV exposure becomes more frequent. Differential predictors of trauma also emerged by child race/ethnicity. Caregiver's depression predicted white and African American children's trauma, while neighborhood quality predicted Hispanic children's trauma. This study suggests that race/ethnicity correlates with different risk factors for child welfare-supervised children and, as such, should be considered when designing and implementing interventions for this population. [ABSTRACT FROM AUTHOR]

Diesel exhaust is a suggested risk factor for ischemic heart disease (IHD), but evidence from cohorts using quantitative exposure metrics is limited. We examined the impact of respirable elemental carbon (REC), a key surrogate for diesel exhaust, and respirable dust (RD) on IHD mortality, using data from the Diesel Exhaust in Miners Study in the United States. Using data from a cohort of male workers followed from 1948–1968 until 1997, we fitted Cox proportional hazards models to estimate hazard ratios for IHD mortality for cumulative and average intensity of exposure to REC and RD. Segmented linear regression models allowed for nonmonotonicity. Hazard ratios for cumulative and average REC exposure declined relative to the lowest exposure category before increasing to 0.79 and 1.25, respectively, in the highest category. Relative to the category containing the segmented regression change points, hazard ratios for the highest category were 1.69 and 1.54 for cumulative and average REC exposure, respectively. Hazard ratios for RD exposure increased across the full exposure range to 1.33 and 2.69 for cumulative and average RD exposure, respectively. Tests for trend were statistically significant for cumulative REC exposure (above the change point) and for average RD exposure. Our findings suggest excess risk of IHD mortality in relation to increased exposure to REC and RD. [ABSTRACT FROM AUTHOR]

Older adults with multiple chronic conditions (MCCs) receive care that is fragmented and burdensome, lacks evidence, and most importantly is not focused on what matters most to them. An implementation feasibility study of Patient Priorities Care (PPC), a new approach to care that is based on health outcome goals and healthcare preferences, was conducted. This study took place at 1 primary care and 1 cardiology practice in Connecticut and involved 9 primary care providers (PCPs), 5 cardiologists, and 119 older adults with MCCs. PPC was implemented using methods based on a practice change framework and continuous plan‐do‐study‐act (PDSA) cycles. Core elements included leadership support, clinical champions, priorities facilitators, training, electronic health record (EHR) support, workflow development and continuous modification, and collaborative learning. PPC processes for clinic workflow and decision‐making were developed, and clinicians were trained. After 10 months, 119 older adults enrolled and had priorities identified; 92 (77%) returned to their PCP after priorities identification. In 56 (46%) of these visits, clinicians documented patient priorities discussions. Workflow challenges identified and solved included patient enrollment lags, EHR documentation of priorities discussions, and interprofessional communication. Time for clinicians to provide PPC remains a challenge, as does decision‐making, including clinicians' perceptions that they are already doing so; clinicians' concerns about guidelines, metrics, and unrealistic priorities; and differences between PCPs and patients and between PCPs and cardiologists about treatment decisions. PDSA cycles and continuing collaborative learning with national experts and peers are taking place to address workflow and clinical decision‐making challenges. Translating disease‐based to priorities‐aligned decision‐making appears challenging but feasible to implement in a clinical setting. See related editorial by William B. Applegate et al. [ABSTRACT FROM AUTHOR]

Objective: To describe the history, key features, recent enhancements, and common applications of the Dietary Supplement Label Database (DSLD).Background and History: Although many Americans use dietary supplements, databases of dietary supplements sold in the United States have not been widely available. The DSLD, an easily accessible public-use database was created in 2008 to provide information on dietary supplement composition for use by researchers and consumers.Rationale: Accessing current information easily and quickly is crucial for documenting exposures to dietary supplements because they contain nutrients and other bioactive ingredients that may have beneficial or adverse effects on human health. This manuscript details recent developments with the DSLD to achieve this goal and provides examples of how the DSLD has been used.Recent Developments: With periodic updates to track changes in product composition and capture new products entering the market, the DSLD currently contains more than 71,000 dietary supplement labels. Following usability testing with consumer and researcher user groups completed in 2016, improvements to the DSLD interface were made. As of 2017, both a desktop and mobile device version are now available. Since its inception in 2008, the use of the DSLD has included research, exposure monitoring, and other purposes by users in the public and private sectors.Future Directions: Further refinement of the user interface and search features to facilitate ease of use for stakeholders is planned.Conclusions: The DSLD can be used to track changes in product composition and capture new products entering the market. With over 71,000 DS labels it is a unique resource that policymakers, researchers, clinicians, and consumers may find valuable for multiple applications. [ABSTRACT FROM AUTHOR]

Launched in 2008, the Dietary Supplement Label Database (DSLD) permits the search of any term that appears anywhere on product labels. Since then, the database's search and download features have been periodically improved to enhance use for researchers and consumers. In this review, we describe how to customize searches and identify products and ingredients of interest to users in the DSLD, and provide the limitations of working with information derived from dietary supplement product labels. This article describes how data derived from information printed on product labels are entered and organized in the DSLD. Among the challenges are determining the chemical forms, types of extract, and amounts of dietary ingredients, especially when these are components of proprietary blends. The FDA announced new dietary supplement labeling regulations in May 2016. The 2017 DSLD has been updated to reflect them. These new regulations and examples cited in this article refer to this redesigned version of the DSLD. Search selection characteristics such as for product type and intended user group are as described in FDA guidance and regulations for dietary supplements. For this reason, some age groups (such as teens and seniors) and marketing recommendations for use (e.g., weight loss, performance, and other disease- or condition-specific claims) are not included in the search selections. The DSLD user interface features will be revised periodically to reflect regulatory and technologic developments to enhance user experience. A comprehensive database derived from analytically verified data on composition would be preferable to label data, but is not feasible for technical, logistic, and financial reasons. Therefore, a database derived from information printed on product labels is the only practical option at present for researchers, clinicians, and consumers interested in the composition of these products. [ABSTRACT FROM AUTHOR]

Medical librarians lack professional development opportunities in the critical appraisal of biomedical evidence. An update to our professional development opportunities could support our efforts to teach critical appraisal of biomedical evidence during evidence-based medicine or information literacy instruction. If we enhance our understanding of latent influences on evidence quality--such as changes to Food and Drug Administration regulations, predatory or deceptive publishing practices, and clinical trial study designs--we can improve our value to medical education and hospital systems. [ABSTRACT FROM AUTHOR]