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Preparing students enrolled in healthcare programs for industry is paramount. While providing administrative and clinical education is essential, students must understand the health literacy levels of the population they serve and work diligently to ensure the population understands and comprehends the health information. Adults with low or limited health literacy levels need help understanding health information and making informed decisions. Research shows that improvements in health literacy result in decreased ER visits, medication errors, increased patient satisfaction, and better health outcomes. Health literacy is an issue throughout the world. This reflection seeks to provide a narrative comparing health literacy concerns in the United States and Spain. The objective is to shed light on the need for all colleges and universities to teach students about health literacy and how to determine patients' health literacy levels. Increasing students' understanding can improve the comprehension and awareness of patients and the population that they serve, thus leading to more appropriate health decisions and outcomes.

School gardens must overcome a range of challenges to be successful but are often lauded for fostering hands-on education and real-world learning. This thematic literature review synthesises 22 journal articles and two book chapters, extending on previous reviews by amassing their themes into one singular reference point for scholars, while simultaneously exploring ways to overcome the challenges associated with school gardens. Findings highlight that academic enhancement, environmental connection, and enhanced wellbeing (both physical and emotional) are the main benefits of school gardens, while the main barriers are time, funding, maintenance, and curriculum integration. Strategies for overcoming the challenges of garden spaces in educational contexts are identified which will be valuable to scholars and others seeking to establish and maintain gardens in schools.

This article reflects on some influential theories, concepts and institutions that have shaped the nature and substance of international development since the mid-20th century. In particular, theories of modernisation and dependency are deployed to reflect on the ways in which the International Financial Institutions, such as, the World Bank and the Asian Development Bank have adopted a 'Washington Consensus' concerning the social and economic development of 'developing' nations. 'Soft power' national agencies, such as, the British Council and USAID are brought into consideration, especially, for their interests and influences over matters of learning for development. The multi-national Commonwealth of Learning's particular contribution to learning for development is discussed with suggestions made for developing member nations' capacities to produce new local knowledge and to bring their existing local knowledge to the fore to share as part of a (Lockean) 'commonwealth of learning'.

Homework problems are frequently encountered, especially among youth with ADHD. The Homework Problems Checklist (HPC) is a parent-rated questionnaire to assess homework problems that was studied with children but not extensively with teens. We assessed the psychometric properties of the HPC with teens with and without ADHD. Firstly, the factor structures from previous studies were fitted on a large representative Dutch teen community sample (N = 991; 10-18 years), and one Dutch (N = 118; 12-16 years) and two American (N = 348; 10-14 years, N = 180; 13-17 years) samples with teens diagnosed with ADHD. Secondly, homework problems of the community sample and the samples of teens with ADHD were compared. Thirdly, the effects of age and sex on homework problems were tested. The results indicated that 1) a two-factor (1. Completion and 2. Management) model fitted the data adequately. Coefficients of congruence confirmed equal factor structures in the samples. 2) The samples with teens with ADHD had more homework problems than the community sample, and among those teens with ADHD the US samples had more homework problems than the Dutch sample. 3) In the community sample, older teens showed fewer homework completion problems than younger teens. Moreover, homework management problems decreased with age in females but not in males. Sex- and age effects for teens with ADHD were minimal. Raw and percentile scores of the community sample are provided. In sum, the HPC can be used to establish the severity and nature of homework problems in teens. In teens without ADHD, particularly females, homework problems decrease with age, but for teens with ADHD, homework problems persist during adolescence.

Childhood disadvantage is associated with psychological distress throughout the lifespan. Poor children are alleged to give up more often than their more privileged peers when facing challenges. Yet little research has examined the role of task persistence in poverty and mental health. We test whether poverty-related deficits in persistence contribute to the well-documented link between childhood disadvantage and mental health. We used growth curve modeling to analyze three waves (ages 9, 13, and 17) of data assessing the trajectories of persistence on challenging tasks and mental health. Childhood poverty is the proportion of time participants lived in poverty from birth to age 9. We found that individuals experiencing more poverty in early childhood demonstrate less persistence and deteriorated mental health from ages 9 to 17. As expected, task persistence accounts for a portion of the robust childhood poverty--worsening mental health association. Clinical research on childhood disadvantage is in the early stages of unpacking underlying reasons why childhood poverty is bad for psychological well-being throughout life, revealing potential points of intervention.

Student borrowing is a major higher education public policy issue, with students in both England and the United States increasingly relying on loans to finance postsecondary education. Our paper examines prospective higher education students' attitudes towards debt in England and the United States. It exploits a unique dataset which allows us to compare students' responses to similar surveys conducted in both countries during the same time period. Our study is the first of its kind to explore how students' borrowing attitudes differ across the two countries. It confirms widespread loan aversion among prospective higher education students in both countries. But students in the United States are more debt averse than their peers in England. These debt averse attitudes also predict lower intentions to pursue higher education, potentially exacerbating existing inequalities in access. We consider how these attitudes to borrowing are likely shaped by each country's distinctive student loan system. We conclude that the design of loans matters. England's income-contingent loan repayments, in contrast to North America's mortgage style repayments, make borrowing less risky and reduce the impact of loan aversion on participation decisions, while borrowing is more common, and the system less complicated, in England. Thus, there are lessons for other countries considering introducing student loans or reforming their provision. We contribute to the extant literature on the determinants of, and socioeconomic differences in, higher education participation and the overlooked role of student debt aversion.

Introduction: This paper describes the findings of a study of 1517 public library Websites in Australia, Canada, and the United States over a period of four years. These Websites are referred to as 'electronic branches' of the libraries, thereby extending the definition of physical library branches into the digital realm. The purpose of the research was to investigate the accessibility of public library Websites, the available online resources and whether library staff are available to respond to users' questions and concerns regarding the Website. Method: A quantitative study was conducted, using a spreadsheet protocol to determine if 18 criteria were present on the Websites. General comments about the Websites were also recorded and included in the analysis. Analysis: The quantitative data analysis for the 1517 Websites was done using Excel spreadsheets through formula manipulations. Descriptive statistics are used to report the findings. Results: The data revealed that the Websites of Canadian and USA libraries include more of the criteria than the Australian libraries. Overall many similarities were found between the accessibility of the Websites of the different countries. Conclusion: The study provides exemplars of an electronic branch of a public library and the services it can offer to its community members. These examples can be used to model ideal electronic branch libraries for library staff to improve their Websites.

Researchers studying college student activism have learned much about those students' motivations, tactics, and educational outcomes. Less is known about the relationships between activists and key institutional agents. For student activists with minoritized identities, institutional agents sometimes establish and maintain barriers between their institutions' espoused and enacted values of equity and justice. In this article, we used data from a national narrative inquiry study of minoritized student activists to understand how activists and agents worked in supportive and adversarial relationships with each other. Specifically, we focus on participants' perspectives to name the ways institutional agents created barriers against and provided support for students' activism. We share implications for practice for those seeking to forge stronger relationships with student activists grounded in support and a commitment to equity. This article offers researchers who seek to understand the more significant institutional dynamics of student activism a window into some of the critical interpersonal relationships that drive and foreclose change on college campuses.

Statistics is one of the important branches of mathematics taught in schools, colleges and universities. It is also an important tool in public policy discussions. This paper focuses on the use of statistics in the latter context, rather than its use in adult mathematics education research. I review the key characteristics of the statistical approach to constructing public knowledge, and give a very brief history of key points in its development. I discuss how what I call the "overt crisis of statistics," the apparent disenchantment of large sections of the public with the "expert" statistical methods, outputs and pronouncements, leads to dilemmas both for citizens and for democratic governments. Recently "Big Data" and data analytics seem to many to offer new solutions to problems resulting from the essential lack of certainty surrounding efforts to understand society, and from the need to make quick decisions in a rapidly changing world. These approaches have potential, but also limitations. This leads me to consider a second, "covert" crisis of statistics, resulting from a struggle between proponents of freely available public information and public argument, and those aiming to profit from the appropriation and sequestering of information for private ends. I finish by considering what can be done by ourselves, as citizens, as adult mathematics teachers, and as researchers.

Introduction. Data, information and knowledge together constitute a vital business asset for every organization that enables every business activity, every business process and every business decision. The global legal industry is facing unprecedented change, which inevitably creates challenges for individual law firms. These global changes affect law firms' business as well as information environments. Method. Qualitative interview-based empirical research was conducted with partners and practice managers in law firms in Australia, South Africa and the United States of America, to investigate the changes in the legal industry, the challenges subsequently faced by law firms, and how these challenges are being addressed. Analysis. The interview transcripts were thematically analysed, supported by the NVivo10 qualitative analysis software. Results. The legal sector, one of the most data, information and knowledge intensive industries, is currently undergoing unprecedented change resulting in numerous challenges for law firms that are creating increased pressure to be more effective and efficient. Conclusion. The findings show that significant improvement to law firms' business performance can be driven by overcoming barriers to information asset management such as lack of executive awareness, justification, business governance, leadership and management, as well as ineffective tools. This paper recommends the steps that law firms can take to overcome these barriers.

Teaching and learning research in higher education, often referred to as the Scholarship of Teaching and Learning (SoTL), is still relatively novel in many academic contexts compared to the mainstay of disciplinary research. One indication of this is the challenges those who engage in SoTL report in terms of how this work is valued or considered credible amongst disciplinary colleagues and in the face of institutional policies and practices. This paper moves beyond the literature that describes these specific challenges to investigate how 23 experienced SoTL researchers from five different countries understood the notion of credibility in relationship to their SoTL research and how they went about developing credibility for their work. Semistructured interviews were facilitated and analyzed using inductive analysis. Findings indicate that notions of credibility encompassed putting SoTL research into action and building capacity and community around research findings, as well as gaining external validation through traditional indicators such as publishing. SoTL researchers reported a variety of strategies and approaches they were using, both formal and informal, to develop credibility for their work. The direct focus of this paper on "credibility" of SoTL work as perceived by experienced SoTL researchers, and how they go about developing credibility, is a distinct contribution to the discussions about the valuing of SoTL work.

We investigate the relationship between China and the United States' trade with sub-Saharan Africa (SSA) and the region's economic growth (EG). The research analyzes trade dynamics, distinguishing between the effects of exports and imports, while highlighting the significant role of institutional quality (IQ) in shaping EG within the context of China–US trade with Africa. Despite increasing trade with China and the US, SSA's growth has lagged, prompting exploration into the specific trade forms contributing to EG and the role of IQ. Using data from 30 SSA countries from 2002-2020, we employed AMG and IV-2SLS estimations for our analysis. The study reveals that IQ complements Chinese and US trade to promote EG. Importantly, Chinese and US imports from Africa consistently boost growth, with the impact of exports diminishing. Chinese trade proves influential in countries with strong institutions but lacks impact in those with weaker institutions at higher levels of IQ. In contrast, US trade benefits growth in both strong and weak institutional contexts. These findings are instrumental for policymakers, offering insights into the specific trade activities that drive growth in SSA. Additionally, we emphasize the pivotal role of robust institutions in ensuring the positive impact of trade on growth. [ABSTRACT FROM AUTHOR]

Aims Continued low mortality from coronary heart disease in Japan, despite deleterious changes in traditional risk factors, remains unexplained. Since aortic calcification (AC) was an early predictor of cardiovascular mortality, we compared the progression and incidence of AC between Japanese in Japan, white Americans, and third-generation Japanese Americans in the ERA JUMP cohort. We examined whether higher blood levels of marine-derived n-3 fatty acids (FAs) in Japanese than in Americans accounted for the difference. Methods and results Men (n = 700) aged 40–49 years (252 Japanese in Japan, 238 white, and 210 Japanese Americans) were examined at baseline and 4–7 years later. AC was evaluated from the aortic arch to the iliac bifurcation with computed tomography and quantified by the Agatston method. Robust linear regression and linear mixed models were used to compare the progression of AC. Multivariable logistic regression models were fitted to compare the incidence of AC (AC ≥ 50 at follow-up) among those with baseline AC < 50. Japanese in Japan had a significantly slower progression of AC than white and Japanese Americans after adjusting for age, baseline AC, follow-up time, and traditional risk factors. White Americans had a significantly higher incidence of AC than Japanese in Japan [OR = 4.61 (95% CI, 1.27–16.82)]. Additional adjustment for blood levels of n-3 FAs accounted for the difference in AC incidence but not progression. Conclusion Japanese in Japan had a significantly slower progression and lower incidence of AC than white Americans. High levels of marine-derived n-3 FAs in Japanese in Japan partly accounted for the difference in incidence. [ABSTRACT FROM AUTHOR]

Background Human parechovirus (HPeV) infection can result in severe disease in infants, including sepsis, seizures, brain injury, and death. In 2022, a resurgence of HPeV was noted in young infants. The spectrum of illness and outcomes remain to be fully described. Methods A multistate retrospective cohort study was conducted to evaluate hospitalizations and outcomes of infants aged ≤6 months admitted in 2022 with laboratory-confirmed HPeV infection. Infants with severe disease were defined as having clinical seizures, or abnormalities on magnetic resonance imaging or electroencephalogram during admission. Infants with severe versus nonsevere disease were compared using descriptive statistics. Results A total of 124 U.S. infants were identified with HPeV in 11 states. Cases of HPeV peaked in May and presented at a median of 25.8 days of life (0–194 d) with fever, fussiness, and poor feeding. Bacterial and other viral co-infections were rare. Thirty-three (27%) of infants had severe neurologic disease, were more likely to present at an earlier age (13.9 vs 30 days of life, P <.01), have preterm gestation (12% vs 1%, P =.02), and present with respiratory symptoms (26% vs 8%, P =.01) or apnea (41% vs 1%, P <.001). Subcortical white matter cytoxic cerebral edema was common in severe cases. Two infants with HPeV died during admission with severe neurologic HPeV disease; no infant with mild HPeV disease died. Conclusions This is the largest, geographically diverse U.S. study to describe the 2022 HPeV outbreak among infants. Longitudinal follow up of infants is needed to define predictors and outcomes of severe HPeV disease. [ABSTRACT FROM AUTHOR]

Our goal was to determine the prevalence of anxiety and depression in a sample of U.S. military veterans with type 2 diabetes and elevated diabetes distress (DD). Cross-sectional analyses were conducted. The association between DD and anxiety and depression was assessed with logistic regression. Almost 80% of persons with elevated DD had clinically significant anxiety or depression symptoms. The odds of depression and anxiety increased with DD severity. Given the large overlap of depression and anxiety with elevated DD, we recommend providers screen for all three conditions and, if positive, connect to resources for diabetes self-management and/or clinical treatment. [ABSTRACT FROM AUTHOR]

Introduction: Exposure to unfavorable environmental conditions during pregnancy, such as extreme heat and air pollution, has been linked to increased risk of stillbirth, defined as fetal mortality at or after 20 weeks' gestation, however no studies have examined its association with social vulnerability. We examined associations between county-level stillbirth rates, environmental risk factors for stillbirth, and social vulnerability in the United States. Methods: This ecologic study linked county-level data from three nationwide datasets on stillbirths (National Vital Statistics System), environmental conditions (North American Land Data Assimilation System and Environmental Protection Agency), and social vulnerability (Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index). Poisson and negative binomial models were fit to the variables and produced rate ratios to estimate associations among stillbirth rates, environmental risk factors, and social vulnerability. Results: Social vulnerability was positively associated withn stillbirth rates, annual average number of extreme heat days, and ambient concentration of particulate matter ≤ 2.5 μm in diameter (PM2.5). The average number of days that ozone and PM2.5 each exceeded regulatory standards were not associated with stillbirth rates or social vulnerability. A positive association between average annual PM2.5 concentration and stillbirth rates was detected; no other significant associations between environmental risk factors and stillbirth rates were observed. Discussion: We found evidence of associations between social vulnerability and stillbirth rates, and between social vulnerability and environmental risk factors for stillbirth at the county level. Further research could inform understanding of how social vulnerability impacts the relationship between environmental exposures and stillbirth risk. Significance: We are not aware of any nationwide studies in the United States that have assessed the relationship between stillbirth rates and social vulnerability. Our findings contribute to the understanding of the complex interplay between social vulnerability, environmental exposures, and adverse birth outcomes. The results of our study have important implications for public health interventions and policy decisions aimed at reducing stillbirth rates in communities with higher social vulnerability. [ABSTRACT FROM AUTHOR]

While there is great potential for unbiased next-generation sequencing (NGS) approaches—eg, whole transcriptome sequencing (WTS)—for exploration, discovery, and clinical application in the realm of oncology, there are limitations that should be considered when relying on these methodologies for clinical decision making. When using WTS for the detection of clinically relevant gene fusions in tumor specimens, a key consideration is whether a limited coverage depth (approximately 30-50X) is sufficient for detecting these events, especially in samples with low tumor purity. We demonstrate the reduced sensitivity of both a commercial WTS assay for the detection of clinically relevant fusions in analytical validation control samples and of a research use only (RUO) WTS assay for the detection of clinically relevant fusions in real-world clinical samples compared to RNA comprehensive genomic profiling (CGP). Notably, the RUO WTS assay would not have reported 30% (6/20) of fusions detected using RNA CGP assays in fusion-positive tumor samples, highlighting a potential disadvantage of broader sequencing. [ABSTRACT FROM AUTHOR]

Evidence shows that parenting interventions are an effective method of reducing caregiver-perpetrated child maltreatment. The recent COVID-19 pandemic has changed the provision of parenting interventions worldwide, with many interventions adapting to continue providing services during the crisis. This global systematic review examined how parenting interventions targeting child maltreatment and its risk and protective factors were adapted during the COVID-19 pandemic. We searched for studies published between 2020 and 2022 and identified 31 eligible studies. The data on the rationale, process, feasibility, acceptability, and impacts of adaptations were narratively synthesized in accordance with the Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions. Results showed that most adaptations were proactive and focused on delivery methods, predominantly digitalization. While feasibility and acceptability were generally observed, the impacts of adapted programs were inconclusive. Inadequate reporting, especially regarding rationale, fidelity, facilitator capacity building, stakeholder involvement, and decision-making processes, was noted. The review recommends enhanced planning, documentation, and reporting of program adaptations using established guidelines, as well as process and impact evaluations. [ABSTRACT FROM AUTHOR]

Many researchers believe that the modern university is in a state of crisis like never before. One of the main reasons cited for this decline is that the modern university has a closer resemblance to a transnational corporation than to a traditional scholarly institution (Lewis, 2005). This paper attempts to define the term "university" from a classical perspective and to describe the gradual incorporation of vocational pursuits into its scope. Focusing on modern North American university models, it asks whether business schools, in particular, should be operating within academia. An alternative is discussed, which focuses on the vocational attributes of business rather than theoretical knowledge. I draw on secondary sources as well as my own personal experience as a student and researcher to make suggestions on how interdepartmental tension developed and how it can be reduced. The paper finds that the business school does have a place in the modern university; however, the classical representation of the university must be abandoned for it to be fully embraced.

Exercise training (EX) and weight loss (WL) improve lower extremity physical function (LEPF) in older overweight women; however, effects on rate of torque development (RTD) are unknown. This study aimed to determine the effects of WL + EX or WL alone on RTD, and relatedly LEPF, in overweight older women. Leg strength was assessed using isokinetic dynamometry, and RTD was calculated (RTD200 = RTD at 200 ms, RTDPeak = peak RTD, T2P = time to 1st peak). LEPF was determined via clinical functional tasks. Women (n = 44, 69.1 ± 3.6 years, 30.6 ± 4.3 kg/m2) completed a 6-month trial in EX + WL or WL groups with similar weight loss (−9.8 ± 4.2%, p >.95). EX + WL had greater improvements in (a) most LEPF tasks (p <.001) and (b) RTD200, compared with WL (36% vs. −16%, p =.031); no other RTD parameters differed. Changes in RTD parameters and LEPF were not related (all p >.05). RTD is responsive to EX but is not associated with LEPF in older women. [ABSTRACT FROM AUTHOR]

Xylazine, a veterinary sedative, has emerged as a concerning element in the landscape of substance use in the United States. This integrative review synthesizes evidence from a systematic examination of 14 selected studies conducted between 2008 and 2023. The primary objective is to comprehensively understand the epidemiology and prevalence of xylazine use, particularly its involvement in drug-related deaths, regional variations, national impact, co-occurrence with opioids, and challenges associated with detection and intervention. The results underscore stark regional disparities in xylazine prevalence. West Virginia and Miami-Dade County have experienced alarming surges in xylazine-involved drug-related deaths. Nationally, its influence extends beyond regional boundaries, predominantly affecting white males in the Northeast. The co-occurrence of xylazine with opioids, especially fentanyl and heroin, significantly amplifies the risks of fatal overdoses. Detecting xylazine presents formidable challenges due to its frequent presence alongside other substances, necessitating enhanced surveillance and more effective detection methods. User perspectives emerge as pivotal, emphasizing the importance of user-informed harm reduction strategies. In conclusion, this review has significant policy implications. Tailored, region-specific strategies are imperative to address the diverse prevalence of xylazine use. A nationwide response is indispensable, prioritizing harm reduction initiatives, enhanced detection methods, and active user engagement. The multifaceted nature of the xylazine issue requires comprehensive approaches to mitigate its profound risks effectively. Policymakers are urged to consider regional disparities and the co-occurrence of xylazine with opioids when crafting targeted interventions. Immediate, user-informed harm reduction is vital to address the evolving landscape of xylazine use in the United States. [ABSTRACT FROM AUTHOR]

Pornography often depicts traditional gender norms and aggression paired with sexual behaviour. Among adolescents, exposure to pornography is related to unhealthy beliefs about gender, sex and relationships. Critical thinking about media may reduce the internalisation of unhealthy messages in pornography. However, there is a dearth of research examining how critical media attitudes are protective of youth in early adolescence. Using a US sample of ninth- and tenth-grade students (n = 558; Mage = 14; 53% female), this study examines how the relationship between frequency of pornography use and acceptance of traditional gender norms, dating violence and rape myths may be moderated by critical media attitudes. More frequent pornography use was related to greater acceptance of rape myths and gender norms, but only for adolescents who were less sceptical about media messages. For adolescents who were sceptical of media messages about sex, there was no relationship between pornography use and their acceptance of rape myths and gender norms. This study provides preliminary evidence of the protective influence that critical media attitudes may have on adolescents' sexual and relationship health. In an increasingly digital world, it is critical to provide early media literacy education as part of sexuality education to promote adolescents' health. [ABSTRACT FROM AUTHOR]

This study evaluates the efficacy of Media Aware, a comprehensive sex education program with a media literacy education approach, for improving sexual health cognitions among 1139 U.S. community college students (ages 18–19) from 23 campuses. Students were randomized to condition (intervention or delayed-intervention control) and completed pretest and posttest questionnaires. Several main effects of the intervention were found at posttest, including reduced perceived realism of media messages, positive attitudes about risky sex, and descriptive normative beliefs about unprotected and risky sexual activity, and increased self-efficacy to use dental dams. Gender and pretest levels moderated some intervention effects. Women in the intervention group reported less identification with media messages compared to women in the control group. Students in the intervention group who reported lower pretest levels of self-efficacy to use dental dams and to refuse unprotected sex had higher posttest levels on those outcomes as compared with the control group. Students in the intervention group who reported higher pretest levels of normative beliefs about risky sexual activity had lower posttest levels on those outcomes as compared with the control group. Results suggest that Media Aware is a promising method to improve the sexual health of young adults attending community college. [ABSTRACT FROM AUTHOR]

Although untreated periodontitis increases the risk of developing diabetic complications, people with diabetes are less likely to use dental services. The authors estimated the prevalence of reporting delayed needed oral health care due to cost and associated risk indicators by diabetes status. The authors analyzed data for 43,291 adults who participated in the 2018 and 2019 Medical Expenditure Panel Surveys. The authors used t tests to compare crude estimates of delayed oral health care by diabetes status. Adjusted estimates were obtained from logistic regression models that controlled for sociodemographic, medical and dental insurance, health status, and geographic variables. Multivariable logistic regression models were run separately for adults with and without diabetes to identify factors that were associated with delayed oral health care. After controlling for covariates, the difference in delayed oral health care prevalence between adults with diabetes (18%) and without diabetes (16%) remained significant. Lack of medical insurance and fair or poor self-rated health status were the highest predictors of delayed oral health care among those with diabetes. Despite guidelines, factors other than biology and perceived need may impede access to oral health care for people with diabetes. For uninsured adults, policies should prioritize enhancing access to regular ambulatory care and promoting awareness about the importance of preventing and treating dental conditions. In addition, addressing the medical and psychosocial aspects of diabetes in affected patients could affect positively their overall sense of well-being and self-rated health status, potentially encouraging greater use of oral health care services. [ABSTRACT FROM AUTHOR]

In 2014, Dr. Elda Ramirez, alongside Dr. Arlo Weltge and Dr. Kyle Kincaid, founded the American Academy of Emergency Nurse Practitioners (AAENP) to support nurse practitioners working in emergency care. With initial support from 39 dedicated individuals, AAENP was incorporated in Texas and received pro bono management from an association management company. Over the years, AAENP has focused on defining the emergency nurse practitioner (ENP) role, developing a board certification examination, and creating standardized curricula for ENP programs. Strong collaborations with organizations such as the American Association of Nurse Practitioners (AANP) and the American College of Emergency Physicians (ACEP) have been pivotal. AAENP has grown significantly, now boasting over 1100 members, and has produced numerous evidence-based position statements and publications. This article highlights AAENP's achievements, and the challenges faced in its formative years, showcasing its commitment to advancing the ENP profession and ensuring quality care in emergency settings. [ABSTRACT FROM AUTHOR]

Data from the National Immunization Survey-Child (NIS-Child) were analyzed to estimate coverage with childhood vaccines recommended by the Advisory Committee on Immunization Practices among U.S. children by age 24 months. Coverage with nearly all vaccines was lower among children born in 2020 and 2021 than it was among those born in 2018 and 2019, with declines ranging from 1.3 to 7.8 percentage points. Analyses of NIS-Child data for earlier birth cohorts have not revealed such widespread declines in routine childhood vaccination coverage. Coverage among children born during 2020–2021 varied by race and ethnicity, health insurance status, poverty status, urbanicity, and jurisdiction. Compared with non-Hispanic White children, coverage with four of the 17 vaccine measures was lower among non-Hispanic Black or African American children as well as Hispanic or Latino (Hispanic) and non-Hispanic American Indian or Alaska Native children. Coverage was also generally lower among those covered by Medicaid or other nonprivate insurance, uninsured children, children living below the federal poverty level, and children living in rural areas. Coverage varied widely by jurisdiction, especially coverage with ≥2 doses of influenza vaccine. Children born during 2020–2021 were born during or after the period of major disruption of primary care from the COVID-19 pandemic. Providers should review children’s histories and recommend needed vaccinations during every clinical encounter. Addressing financial barriers, access issues, vaccine hesitancy, and vaccine-related misinformation can also help to increase coverage, reduce disparities, and protect all children from vaccine-preventable diseases. Strategies that have been found effective include implementation of standing orders and reminder and recall systems, strong physician recommendations to vaccinate, and use of immunization information systems to identify areas of lower coverage that could benefit from targeted interventions to increase immunization rates. [ABSTRACT FROM AUTHOR]

PURPOSE: Evaluation by a gynecologic oncologist (GO) is associated with improved clinical outcomes for patients with gynecologic cancers, yet little is known about health care factors that influence patients' referrals to GO. METHODS: Medical records of 50 consecutive new patients seen in GO clinics at each of six referral centers across the United States were reviewed. Patient and disease characteristics were collected along with referral indication, evaluation and referral dates, diagnostic procedures, provider specialties, and zone improvement plan (ZIP) code of up to three referring providers per patient. The primary outcome was interval between first evaluation and referral. Univariate associations were evaluated with Chi-square and Wilcoxon rank-sum tests and multivariable associations with negative binomial regression models. Secondary outcome was prolonged time to GO referral, defined as greater than the 75th percentile. Logistic regression was used for multivariable modeling. RESULTS: Three hundred patient records were analyzed. The median time from first health care encounter to referral was 15 days (IQR, 5-43). The mean distance from residence to GO was 39.8 miles (standard deviation, 53.8). Seventy-one percent of GO referrals were initiated by obstetrician-gynecologists, 9% by family physicians, and 6% internists. Presentation-to-referral interval was 76% shorter for patients evaluated by an emergency medicine clinician (exp(Beta), 0.24; 95% CI, 0.11 to 0.53; P <.001). Public insurance was associated with 1.47 times longer time to referral compared with private insurance (exp(Beta), 1.47; 95% CI, 1.05 to 2.04; P =.001). Residents of nonmetropolitan ZIP codes were less likely to have prolonged time to referral (odds ratio [OR], 0.288; P =.017). Distance from residence to GO (per 10 miles) increased the likelihood of prolonged time to referral (OR, 1.10; P =.010). CONCLUSION: Interventions are needed to improve recognition and referral of patients for gynecologic oncology evaluation. Community outreach and engagement with obstetrician-gynecologists should be prioritized to improve times to referral. Referral delays for patients living farthest away from GYN oncologists are an independent factor in treatment delay. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work is to examine suicide intent disclosures to identify patterns to support an improved understanding of the impetus for suicidal behavior in late life, which may offer insight useful in aiding prevention efforts. Methods: Using restricted access data from the National Violent Death Reporting System for years 2016–2018, we conducted qualitative content analysis of included narrative descriptions of 2,969 cases in which the decedent was aged 65 years or older and disclosed their intent to die by suicide. Results: The majority of suicide intent disclosures were direct statements of intent to die by suicide (37.19%), followed by a smaller proportion of indirect (implied) statements (25.29%). When response of disclosure recipient was described, such disclosures were frequently dismissed as insincere. Uncontrolled or chronic pain was cited by 11.62% of decedents as the rationale for suicide. Conclusion: Findings from this work suggest the content of suicide intent disclosures may vary considerably but demonstrate consistent patterns. Dismissal of such disclosures is a common response, likely due to inability to assess sincerity. Given the high rate of lethality among suicide attempts in late life, any intent disclosures should be critically evaluated. [ABSTRACT FROM AUTHOR]

Purpose: Individuals with aphasia identify discourse-level communication (i.e., language in use) as a high priority for treatment. The central premise of most aphasia treatments is that restoring language at the phoneme, word, and/or sentence level will generalize to discourse. However, treatment-related changes in discourse-level communication are modest, are poorly understood, and vary greatly among individuals with aphasia. In response, this study consisted of a multilevel discourse analysis of archival, monologic discourse outcomes across two high-intensity Semantic Feature Analysis (SFA) clinical trials. Aim 1 evaluated changes in theoretically motivated discourse outcomes representing lexical-semantic processing, lexical diversity, grammatical complexity, and discourse informativeness. Aim 2 explored the potential moderating role of nonlanguage cognitive factors (semantic memory, divided attention, and executive function) on discourse outcomes. Method: This study was a retrospective analysis of archival monologic discourse outcomes after intensive SFA for n = 60 (Aim 1) and a subset n = 44 (Aim 2). Outcome measures included lexical-semantic processing (% semantic errors), lexical diversity (moving average type-token ratio), grammatical complexity (mean utterance length), and discourse informativeness (% correct information units). Bayesian generalized mixed-effects models were used to examine changes across four study time points: enrollment, entry, exit, and 1-month follow-up. Results: The present study found no evidence for meaningful or statistically reliable improvements in monologue discourse performance after SFA when measured using standard, general-topic discourse stimuli. There was weak and inconsistent evidence that nonlanguage cognitive factors may play a role in moderating treatment response. Conclusions: These findings indicate a clear need to pair theoretically informed treatments designed to facilitate generalization to discourse with intentional measurement paradigms designed to capture it. Furthermore, there is a clear need to examine how established treatments, restorative or compensatory, can better facilitate generalization to discourse-level communication. These priorities are critical for meaningfully improving everyday communication and reducing the profound communication and psychosocial consequences of aphasia. [ABSTRACT FROM AUTHOR]

Purpose: While limited resources can make high‐quality, comprehensive, coordinated cancer care provision challenging in rural settings, rural cancer patients often rely on local hospitals for care. To develop resources and strategies to support high‐quality local cancer care, it is critical to understand the current experiences of rural cancer care physicians, including perceived strengths and challenges of providing cancer care in rural areas. Methods: Semi‐structured interviews were conducted with 13 cancer providers associated with all 12 non‐metropolitan/rural Iowa hospitals that diagnose or treat >100 cancer patients annually. Iterative thematic analysis was conducted to develop domains. Findings: Participants identified geographic proximity and sense of community as strengths of local care. They described decision‐making processes and challenges related to referring patients to larger centers for complex procedures, including a lack of dedicated navigators to facilitate and track transfers between institutions and occasional lack of respect from academic physicians. Participants reported a desire for strengthening collaborations with larger urban/academic cancer centers, including access to educational opportunities, shared resources and strategies to collect and monitor data on quality, and clinical trials. Conclusions: Rural cancer care providers are dedicated to providing high‐quality care close to home for their patients and would welcome opportunities to increase collaboration with larger centers to improve coordination and comprehensiveness of care, collect and monitor data on quality of care, and access continuing education opportunities. Further research is needed to develop implementation approaches that will extend resources, services, and expertise to rural providers to facilitate high‐quality cancer care for all cancer patients. [ABSTRACT FROM AUTHOR]

Distracted driving is a leading cause of motor vehicle crashes, and cell phone use is a major source of in-vehicle distraction. Many states in the United States have enacted cell phone use laws to regulate drivers' cell phone use behavior to enhance traffic safety. Numerous studies have examined the effects of such laws on drivers' cell phone use behavior based on self-reported and roadside observational data. However, little was known about who actually violated the laws at the enforcement level. This study sought to uncover the demographic characteristics of drivers cited for cell phone use while driving and whether these characteristics changed over time since the enactment of cell phone laws. We acquired useable traffic citation data for 7 states in the United States from 2010 to 2020 and performed descriptive and regression analyses. Male drivers were cited more for cell phone use while driving. Handheld and texting bans were associated with a greater proportion of cited drivers aged 40 and above, compared to texting-only bans. Trends in the citations issued based on drivers' age group following the enactment of different cell phone laws were also uncovered. The proportion of citations issued to drivers aged 60 and above increased over time but the temporal trend remained insignificant when population effect was considered. This study examined the demographic characteristics of drivers cited for cell phone use while driving in selected states with texting-only bans or handheld and texting bans. The results reveal policy-based differences in trends in the proportion of citations issued to drivers in different age groups. [ABSTRACT FROM AUTHOR]

EIn this article, the author presents a little-known but detailed history of Black women's tradition of study abroad. Specifically, she situates Dr. Anna Julia Cooper within the landscape of historic African American students who studied in Japan, Germany, Jamaica, England, Italy, Haiti, India, West Africa, and Thailand, in addition to France. The story of Cooper's intellectual production is especially intriguing because at a time when Black women were just beginning to pursue doctorates in the United States, Anna Cooper chose to earn her Ph.D. from the Sorbonne in Paris. The author demonstrates that Cooper's research agenda and institutional choice reflected a popular trend of Black academics to construct their scholarly identities with an international foundation. The author presents Cooper's education and shows how her research traversed national and international space in fascinating ways. Next, the author moves outward to show how international foci can be found in many African American women's research interests. This analysis reveals that a significant number of Black scholars have studied abroad in a range of geographic locations, and Paris was especially popular given the relative freedom Black Americans experienced there. In addition, readers receive a sample of how contemporary students with a wide range of disciplinary interests can engage and apply this history. The author ends by observing Cooper's significance as an American woman academic and outline implications for Black women's thought on research in the global Ivory Tower. (Contains 38 notes.)

Harold O. Rugg was one of a small group of leaders of the Progressive Education Movement centered at Teachers College, Columbia University, and a leader among the Social Frontier group that emerged in the 1930s to argue that schools should play a stronger role in helping to reconstruct the society. He was the author of an innovative and best selling series of social studies textbooks which ultimately came under attack from "patriotic" and business groups in the prelude to the United States involvement in World War II. The story of his rise and fall encapsulates a significant and central story in the history of American education. The Rugg story reveals a great deal about the direction of schooling in American life, the many alternative roads not taken, and possibilities for the future. This article focuses primarily on the examination and discussion of Rugg's social studies ideas. Revisiting Rugg's vision will underline several of the main themes of his work and highlight the fact that Rugg was instrumental, a seminal thinker in the world of social studies theory and practice. A full understanding requires a brief examination of the origins of his ideas, his developing theory, his critique of the standard practices in schools, the key principles and explicit rationale under-girding his social science program, and the controversy he inspired. (Contains 89 notes.)

Media-related commercial marketing aimed at promoting the purchase of products and services by children, and by adults for children, is ubiquitous and has been associated with negative health consequences such as poor nutrition and physical inactivity. But, as Douglas Evans points out, not all marketing in the electronic media is confined to the sale of products. Increasingly savvy social marketers have begun to make extensive use of the same techniques and strategies used by commercial marketers to promote healthful behaviors and to counter some of the negative effects of conventional media marketing to children and adolescents. Evans points out that social marketing campaigns have been effective in helping to prevent and control tobacco use, increase physical activity, improve nutrition, and promote condom use, as well as other positive health behaviors. He reviews the evidence from a number of major recent campaigns and programming in the United States and overseas and describes the evaluation and research methods used to determine their effectiveness. He begins his review of the field of social marketing by describing how it uses many of the strategies practiced so successfully in commercial marketing. He notes the recent development of public health brands and the use of branding as a health promotion strategy. He then goes on to show how social marketing can promote healthful behavior, how it can counter media messages about unhealthful behavior, and how it can encourage discussions between parents and children. Evans concludes by noting some potential future applications to promote healthful media use by children and adolescents and to mitigate the effects of exposure to commercial marketing. These include adapting lessons learned from previous successful campaigns, such as delivering branded messages that promote healthful alternative behaviors. Evans also outlines a message strategy to promote "smart media use" to parents, children, and adolescents and suggests a brand based on personal interaction as a desirable alternative to "virtual interaction." (Contains 2 tables and 72 endnotes.)

Introduction: The Vaccines for Children (VFC) program was established in 1994 to provide recommended vaccines at no cost to eligible children and help ensure that all U.S. children are protected from life-threatening vaccine-preventable diseases. Methods: CDC analyzed data from the 2012–2022 National Immunization Survey-Child (NIS-Child) to assess trends in vaccination coverage with ≥1 dose of measles, mumps, and rubella vaccine (MMR), 2–3 doses of rotavirus vaccine, and a combined 7-vaccine series, by VFC program eligibility status, and to examine differences in coverage among VFC-eligible children by sociodemographic characteristics. VFC eligibility was defined as meeting at least one of the following criteria: 1) American Indian or Alaska Native; 2) insured by Medicaid, Indian Health Service (IHS), or uninsured; or 3) ever received at least one vaccination at an IHS-operated center, Tribal health center, or urban Indian health care facility. Results: Overall, approximately 52.2% of U.S. children were VFC eligible. Among VFC-eligible children born during 2011–2020, coverage by age 24 months was stable for ≥1 MMR dose (88.0%–89.9%) and the combined 7-vaccine series (61.4%–65.3%). Rotavirus vaccination coverage by age 8 months was 64.8%–71.1%, increasing by an average of 0.7 percentage points annually. Among all children born in 2020, coverage was 3.8 (≥1 MMR dose), 11.5 (2–3 doses of rotavirus vaccine), and 13.8 (combined 7-vaccine series) percentage points lower among VFC-eligible than among non–VFC-eligible children. Conclusions and implications for public health practice: Although the VFC program has played a vital role in increasing and maintaining high levels of childhood vaccination coverage for 30 years, gaps remain. Enhanced efforts must ensure that parents and guardians of VFC-eligible children are aware of, have confidence in, and are able to obtain all recommended vaccines for their children. [ABSTRACT FROM AUTHOR]

Based on safety and efficacy data, vaccinations are the best defense to protect persons and communities from serious vaccine-preventable diseases. The Advisory Committee on Immunization Practices recommends routine vaccination of adolescents aged 11–12 years with three vaccines including tetanus, diphtheria, and acellular pertussis vaccine; quadrivalent meningococcal conjugate vaccine; and human papillomavirus vaccine. CDC analyzed data from the 2023 National Immunization Survey-Teen for 16,658 adolescents aged 13–17 years (born during January 2005–December 2010) to assess vaccination coverage in 2023, recent trends in coverage by birth year, and trends in coverage by eligibility for the Vaccines for Children (VFC) program and birth year. In 2023, coverage with all routine vaccines recommended for adolescents was similar to coverage in 2022. Vaccination coverage among VFC-eligible adolescents was generally stable during the COVID-19 pandemic, except for a decrease in the percentage of VFC-eligible adolescents who were up to date with HPV vaccination by age 13 years among those born in 2010 compared with those born in 2007. Whereas coverage differences were found between VFC-eligible and non–VFC-eligible adolescents before the COVID-19 pandemic, coverage was similar among the most recent birth years in the survey. Providers should make strong recommendations for all routine vaccines and review adolescent vaccination records to verify if adolescents are up to date with all recommended vaccines. [ABSTRACT FROM AUTHOR]

Background Desirability of outcome ranking (DOOR) is an innovative approach to clinical trial design and analysis that uses an ordinal ranking system to incorporate the overall risks and benefits of a therapeutic intervention into a single measurement. Here we derived and evaluated a disease-specific DOOR endpoint for registrational trials for hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP). Methods Through comprehensive examination of data from nearly 4000 participants enrolled in six registrational trials for HABP/VABP submitted to the Food and Drug Administration (FDA) between 2005 and 2022, we derived and applied a HABP/VABP specific endpoint. We estimated the probability that a participant assigned to the study treatment arm would have a more favorable overall DOOR or component outcome than a participant assigned to comparator. Results DOOR distributions between treatment arms were similar in all trials. DOOR probability estimates ranged from 48.3% to 52.9% and were not statistically different. There were no significant differences between treatment arms in the component analyses. Although infectious complications and serious adverse events occurred more frequently in ventilated participants compared to non-ventilated participants, the types of events were similar. Conclusions Through a data-driven approach, we constructed and applied a potential DOOR endpoint for HABP/VABP trials. The inclusion of syndrome-specific events may help to better delineate and evaluate participant experiences and outcomes in future HABP/VABP trials and could help inform data collection and trial design. [ABSTRACT FROM AUTHOR]

Background: Nurses have a critical role to play in achieving the United Nations' 17 Sustainable Development Goals (SDGs). While Goal 3 (good health and well-being) is of particular importance to nursing, every SDG contributes to the advancement of universal health and well-being. Yet many nurses are unfamiliar with the SDGs and how they relate to everyday nursing practices. Purpose: The purpose of this study was to examine RNs' knowledge of and attitudes toward the SDGs. Methods: This study used a descriptive correlational cross-sectional design. A convenience sample of RNs from multiple countries completed an anonymous online survey that included eight demographic items and 25 items exploring participants' knowledge of and attitudes toward the SDGs. Descriptive, parametric, and nonparametric statistics were used to analyze the data. Results: The majority of nurses in this study perceived themselves as lacking knowledge of the SDGs. Most wanted to know more, including how they could take action to help achieve the goals. Overall, participants agreed that the SDGs are relevant to nursing practice and that nurses are integral to their advancement. Participants who were younger than age 50, those living in the United States, and those who practiced primarily in a clinical or community setting were more likely than others to self-report lower SDG knowledge scores. Conclusions: The study findings contribute to our collective understanding of RNs' knowledge and attitudes regarding the SDGs. They can assist nurse educators and leaders worldwide in developing targeted strategies to better inform nurses and prepare them for actions that will advance these goals. Increasing nurses' knowledge of the SDGs, especially as these goals relate to daily clinical practice, may lead to greater nursing engagement and impact. [ABSTRACT FROM AUTHOR]

Multiple‐baseline‐across‐word‐sets designs were used to determine whether a computer‐based intervention would enhance accurate word signing with four participants. Each participant was a hearing college student with reading disorders. Learning trials included 3 s to observe printed words on the screen and a video model performing the sign twice (i.e., simultaneous prompting), 3 s to make the sign, 3 s to observe the same clip, and 3 s to make the sign again. For each participant and word set, no words were accurately signed during baseline. After the intervention, all four participants increased their accurate word signing across all three word sets, providing 12 demonstrations of experimental control. For each participant, accurate word signing was maintained. Application of efficient, technology‐based, simultaneous prompting interventions for enhancing American Sign Language learning and future research designed to investigate causal mechanisms and optimize intervention effects are discussed. [ABSTRACT FROM AUTHOR]

Unintended pregnancies, which occur in almost half (45%) of all pregnancies in the United States, are associated with adverse health and social outcomes for the infant and the mother. The risk of unintended pregnancies is significantly reduced when women use long-acting reversible contraceptives (LARCs), namely intrauterine devices and implants. Although LARCs are highly acceptable to women at risk of unintended pregnancies, barriers to accessing LARCs hinder its uptake. These barriers are greater among racial and socioeconomic lines and persist within and across the intrapersonal, interpersonal, institutional, and policy levels. A synthesis of these barriers is unavailable in the current literature but would be beneficial to health care providers of reproductive-aged women, clinical managers, and policymakers seeking to provide equitable reproductive health care services. The aim of this narrative review was to aggregate these complex and overlapping barriers into a concise document that examines: (a) patient, provider, clinic, and policy factors associated with LARC access among populations at risk of unintended pregnancy and (b) the clinical implications of mitigating these barriers to provide equitable reproductive health care services. This review outlines numerous barriers to LARC uptake across multiple levels and demonstrates that LARC uptake is possible when the woman is informed of her contraceptive choices and when financial and clinical barriers are minimized. Equitable reproductive health care services entail unbiased counseling, a full range of contraceptive options, and patient autonomy in contraceptive choice. [ABSTRACT FROM AUTHOR]