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Qualitative research is important to advance health equity as it offers nuanced insights into structural determinants of health inequities, amplifies the voices of communities directly affected by health inequities, and informs community-based interventions. The scale and frequency of public health crises have accelerated in recent years (e.g., pandemic, environmental disasters, climate change). The field of public health research and practice would benefit from timely and time-sensitive qualitative inquiries for which a practical approach to qualitative data analysis (QDA) is needed. One useful QDA approach stemming from sociology is flexible coding. We discuss our practical experience with a team-based approach using flexible coding for qualitative data analysis in public health, illustrating how this process can be applied to address multiple research questions simultaneously or asynchronously. We share lessons from this case study, while acknowledging that flexible coding has broader applicability across disciplines. Flexible coding provides an approachable step-by-step process that enables collaboration among coders of varying levels of experience to analyze large datasets. It also serves as a valuable training tool for novice coders, something urgently needed in public health. The structuring enabled through flexible coding allows for prioritizing urgent research questions, while preparing large datasets to be revisited many times, facilitating secondary analysis. We further discuss the benefit of flexible coding for increasing the reliability of results through active engagement with the data and the production of multiple analytical outputs. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to measure trajectories of craving for methamphetamine during the course of pharmacotherapy trials for methamphetamine use disorder. Design, setting and participants: Craving trajectories were identified using Group‐Based Trajectory Modeling. The association of craving trajectories with drug use trajectories was examined using a dual trajectory model. Association of craving trajectories with other health and social outcomes was also examined. The study used pooled data from five randomized controlled pharmacotherapy trials for methamphetamine use disorder. A total of 866 adults with methamphetamine use disorder participated in randomized controlled pharmacotherapy trials. Measurement: Craving was assessed weekly using the Brief Substance Craving Scale. Drug use was assessed using urine toxicology. Alcohol‐ and drug‐related problems, as well as psychiatric, medical, legal, employment and relationship problems, were measured using the Addiction Severity Index. Findings: A three‐trajectory model with high, medium and low craving trajectories was selected as the most parsimonious model. Craving trajectories were associated with methamphetamine use trajectories in the course of trial; 88.4% of those in the high craving trajectory group had a consistently high frequency of methamphetamine use compared with 18.7% of those in the low craving group. High craving was also associated with less improvement in most other outcomes and higher rate of dropout from treatment. In turn, low craving was associated with a rapidly decreasing frequency of methamphetamine use, greater improvement in most other outcomes and a lower rate of dropout. Participants on modafinil daily and ondansetron 1 mg twice daily were less likely to be in the high craving group compared with those on placebo. Conclusions: Trajectories of methamphetamine craving in the course of clinical trials for methamphetamine use disorder appear to be both highly variable and strongly associated with greater frequency of drug use, other drug‐related outcomes and dropout from trials. Two medications, modafinil daily and ondansetron at a dose of 1 mg two times daily, appear to be associated with greater reduction in craving in the course of treatment compared with placebo. A decrease in methamphetamine craving shows promise as an early indicator of recovery from methamphetamine use disorder. [ABSTRACT FROM AUTHOR]

The intellectually gifted have been found to have higher levels of many prosocial dispositions, but there is limited evidence of increased prosocial behavior. The present research used existing and original datasets to examine relations between intellectual giftedness and prosocial behavior and dispositions. In Study 1, those identified as intellectually gifted engaged in more political and helping behaviors than those not identified as intellectually gifted. In Study 2, gifted-identified undergraduate students reported more prosocial behavior (e.g., volunteering and giving) than nonidentified students; however, there were no clear differences in dispositions (e.g., personality and motivation) between gifted-identified and nonidentified students. Implications of these consistent linkages between intellectual giftedness and engaging in prosocial behavior for future research and practical applications are discussed. [ABSTRACT FROM AUTHOR]

\nSummaryAdolescents’ physical activity (PA) and sports participation declined due to the COVID-19 pandemic. This study aimed to determine the critical socio-ecological factors for PA and sports participation using a machine learning approach. We did a cross-sectional secondary data analysis utilising the 2021 National Survey of Children’s Health (NSCH) dataset (N=16,166; 49.0% female). We applied an interpretable machine learning approach (e.g. decision tree-based models) that examined the critical factors associated with PA and sports participation. The factors related to the intrapersonal, interpersonal, organisational, and community levels of the socio-ecological model. Out of the 25 factors examined, our findings unveiled the 11 critical factors associated with PA and the 10 critical factors associated with sports participation. Factors at the intrapersonal levels (e.g. age, screen time, and race) held greater importance to PA than those at the other three levels. While interpersonal factors (e.g. parent participation in children’s events/activities, family’s highest educational level, and family income level) were most important for sports participation. This study identified that the common critical factors of physical activity and sports participation during the COVID-19 pandemic mainly relied on intrapersonal and interpersonal levels. Unique factors were discussed.In this study, we identified 11 critical factors for PA, with the top five being age, neighbourhood amenities, screen time, missed school days, and family income level. Additionally, we identified 10 critical factors for sports participation, with the top five factors being parent participation in a child’s events/activities, family’s highest educational level, family income level, screen time, and school engagement. These findings emphasise the shared significance of intrapersonal and interpersonal factors as common determinants of both PA and sports participation. Notably, PA appears to be primarily influenced by intrapersonal factors (e.g. age, screen time, and race), reflecting its more internally driven nature. In contrast, sports participation appears to be more externally driven, primarily shaped by interpersonal factors (e.g. parent participation in the child’s events/activities, family’s highest educational level, and family income level). This distinction underscores the need for educators and policymakers to carefully consider these common and unique factors when devising promotion strategies during the COVID-19 pandemic. By recognising these distinctions, interventions can be better tailored to encourage both PA and sports participation among adolescents. [ABSTRACT FROM AUTHOR]

Background: Hypertensive patients with high-risk comorbidities require medications for each condition, leading to greater burden. The number of chronic conditions can affect patients' concurrent medication adherence. Objective: We aimed to compare the characteristics of groups based on their concurrent medication adherence and investigate the association between the number of high-risk comorbidities and concurrent medication adherence for patients with hypertension and high-risk comorbidities. Methods: A secondary data analysis was performed with the 2018 Korea Health Panel Survey, including 2230 patients with hypertension and at least 1 high-risk comorbidity who were prescribed medications for at least 2 conditions. Using medication adherence for each condition, we identified 3 concurrent medication adherence groups: adherent, suboptimal, and nonadherent groups. Multinominal logistic regression was used to determine the association between the number of high-risk comorbidities and the concurrent medication adherence groups. Results: Adherent, suboptimal, and nonadherent groups included 85%, 11%, and 4% of the patients, respectively. Whereas having more high-risk comorbidities was associated with belonging to the suboptimal group compared with the adherent group (adjusted odds ratio, 1.46), having fewer high-risk comorbidities was associated with belonging to the nonadherent group compared with the adherent group (adjusted odds ratio, 0.52). Conclusions: We identified 3 groups based on their concurrent medication adherence. Our results indicated that the relationship of the number of high-risk comorbidities with the concurrent medication adherence group was inconsistent. [ABSTRACT FROM AUTHOR]

As part of a research project on the lived and everyday temporal experiences of British people in the Covid-19 pandemic, a Mass Observation directive was commissioned that asked volunteers about their changing rhythms, feelings, and imagined futures. The responses were rich and raw. Some of these reflections, however, expressed a risk of harm that raised ethical issues that were not anticipated beforehand. These issues were complicated by the interstitial character of the data, being not primary and not quite secondary. This Sociology in Action paper reflects on one diary that expressed risk of harm to think through the slipperiness of the data as well as the ethical responsibility researchers have towards the well-being of participants and that of their own. I suggest a proactive ethical framework for such interstitial data that includes an ethics of care towards the participants and stimulates ethical reflexivity that prepares the researcher for potential emotional ties and investments. [ABSTRACT FROM AUTHOR]

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

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

Children and young people's mental health services have been under increasing pressure following COVID-19. Understanding, for which channels help is sought from, will highlight services needing support. This study aims to explore the professional services that parents of children, and young people get help from when they have a concern for the child's/their mental health. Secondary analysis of data is taken from Mental Health of Children and Young People in England Survey, 2017. 7608 reports of mental health-related contact with professional services from parents of 5–16 year-olds and self-reports from young people aged 17–19 were available. Service contact was reported by Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnosis, age, gender and ethnicity. Less than two-thirds of children and young people with a DSM-V diagnosis (63.5% (95% CI 58.6–68.1) aged 5–10, and 64.0% (95% CI 59.4–68.4) aged 11–16) reported contact with any professional services. The figure was lower for those aged 17–19; 50.1% (95% CI 42.8–58.2), p = 0.005. Children and young people aged 5–16 from Black (11.7%; 95% CI 2.4–41.4), Asian (55.1%; 95% CI 34.7–73.9) and Mixed (46.0%; 95% CI 32.4–60.3) ethnic groups reported less contact with professional services compared to those from the White group (66.9%; 95% CI 63.5–70.2). Patterns of service access during the three main educational stages aid with understanding service need during childhood. These lower levels of reported service access for young people aged 17–19 with a DSM-V diagnosis and those in ethnic minority groups demand further investigation. [ABSTRACT FROM AUTHOR]

Despite reliable evidence of adverse drug effects, the substantially increased prescription rates of proton pump inhibitors (PPIs) remain at a high level. This study analyzed the appropriateness of PPI prescriptions among residents of nursing homes in three regions of Germany. Baseline data of a cluster-randomized controlled trial were used to determine the prevalence of PPI prescriptions, the validity of indications, and the adequacy of the prescribed dosages according to 1. their drug approvals and 2. valid recommendation guidelines. Regression analyses were conducted to assess associated factors. A total of 437 residents in 37 nursing homes were included (mean age 83 ± 9.2 years, 72% women). The PPI prescription prevalence was 44% (n = 193). In 52/193 (27%) there was no adequate indication, and in 54 (39%) of 138 indicated PPI prescriptions it was overdosed. Yet, in only less than one-third (28%) of "adequate" prescriptions, the indication was according to the PPI approvals, whereas the majority (72%) were off-label indications in line with valid guideline recommendations. Non-indicated PPI prescription was associated with the total number of prescribed drugs (OR 1.32; 95% CI 1.18–1.62; p = 0.013). There were no associations with age, level of care dependency, cognitive impairment, prescription of psychotropic drugs, number of chronic diseases, number of physicians' consultations, or study region. To conclude, in 55%, the high prescription prevalence among residents was either not indicated or overdosed. In total, only 20% (39/193) of cases of PPI use complied with the approved indications. There is a need for quality control of 1. PPI administration in German nursing homes, and 2. of guideline recommendations expanding the off-label PPI use by 72% within the indication scale, predominantly from wide prescription for low-dose ASA. [ABSTRACT FROM AUTHOR]

Students with mental health needs, behavioral support needs, and/or emotional disturbance can engage in internalizing behaviors, externalizing behaviors, or both. Preservice and induction phase elementary general education teachers are reported to have limited education in providing evidence-based behavior management strategies, especially for students who engage in internalizing and/or externalizing behaviors. There is little understanding as to the differences in elementary general education teachers' knowledge, application, and self-efficacy in applying evidence-based behavior management strategies between preservice teachers, first-year teachers, second-year teachers, and third-year teachers. The purpose of this preliminary secondary data analysis was to examine differences in U.S. elementary general education teacher knowledge, application, and self-efficacy in evidence-based behavior management strategies from preservice to induction phase teaching. Results indicated third-year teachers had significantly less behavior management knowledge than preservice teachers. All other results were nonsignificant; however, there were practical differences when comparing the four groups on the knowledge and application measures. Implications for findings indicate the need for induction programs to focus on evidence-based behavior management strategies to support the development of behavior management for induction phase elementary education teachers as they progress through their first 3 years of teaching. [ABSTRACT FROM AUTHOR]

Background: Research on temporomandibular disorder (TMD) responsiveness is scarce and limited regarding patients' representativeness. Objective(s): This study aimed to estimate minimum clinically important difference (MCID) and substantial clinical benefit (SCB) among a large and diverse patient population regarding sex and age. Methods: In this study, 162 patients participated from five hospitals. MCID and SCB in pain, functional disability and quality of life were examined with anchor‐based methods. Patients' global impression of change was used as the anchor. Area under the curve (AUC) values were determined for testing accuracy. Changes from baseline and coefficient of variation by responsiveness status were calculated to explain the results of accuracy. Results: SCB was estimated to be 2.18 for the numeric rating scale (NRS) for pain (AUC: 0.80 [95% CI: 0.72–0.88]) in all patients and 2.50 in women (AUC: 0.81 [95% CI: 0.71–0.89]). The estimated SCB of NRS for discomfort (1.50) and Jaw Functional Limitation Scale for mastication (1.35) had wide CIs for AUCs. Likewise, the estimated MCIDs of NRS for pain (0.80) and NRS for discomfort (1.50) had wide CIs for AUCs. Among non‐responders who did not achieve the MCID of NRS for pain, the coefficient of variation was very high for all outcomes other than the NRS for pain. Conclusion: This study investigated the responsiveness of patients with TMD using a large and diverse patient sample. SCB in pain decrease can be used to assess the responsiveness of patients with TMD. Composite outcomes should be developed to estimate MCID. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the level of cardiopulmonary resuscitation (CPR) training among Korean older adults in a community and the factors associated with CPR training. Methods: A total of 51,939 elders were selected and analyzed using the 2022 Community Health Survey. The collected data were analysed using the Rao-Scott test and logistic regression via the SAS 9.4 program. Results: A total of 7.3% of older adults received CPR training. Factors influencing CPR training were age (odds ratio [OR]=4.76, 95% confidence interval [CI]=2.55~8.90), level of education (OR=2.43, 95% CI=1.77~3.33), region (OR=1.16, 95% CI=1.05~1.27), working (OR=3.68, 95% CI=3.33~4.07), and subjective health status (OR=1.57, 95% CI=1.37~1.79). Conclusion: Based on the results of this study, there is a need to explore various ways to improve CPR training for community older adults who are vulnerable to emergency situations. [ABSTRACT FROM AUTHOR]

Inequity in education is a worldwide concern and there is a growing need to investigate educational achievement inequality in a nuanced and contextual manner. This study aims to elucidate the growing educational achievement inequality within Pakistan by addressing two key questions: What can be revealed about the influence of family socioeconomic condition and household characteristics on children's disparate educational achievement in Pakistan? And what role do private schools and paid tuition play in exacerbating disparity in learning outcomes? In this study, we applied the concept of Equity in Education, particularly the impartiality approach, to consider disadvantaged conditions among children. We have analyzed the Annual Status of Education Report (ASER) Pakistan household-based survey data (N = 247,978) conducted in 2021. Our analysis involved both descriptive and logistic regression techniques. Students' achievement in the local language, arithmetic, and English language served as a dependent variable, while household factors remained a predictable variable. The results revealed that family socioeconomic factors including parents' education and income, household facilities, and school types have a significant influence on children's learning achievement and contribute to educational inequality. This study provides further insights for researchers and policymakers to better understand and address educational inequality in its specific context. [ABSTRACT FROM AUTHOR]

This brief analyzes 4-year graduation rates among students ever classified as English learners (ever-ELs) and those never classified as English learners (never-ELs) at the intersections of gender, race/ethnicity, and neighborhood income. We follow two cohorts of New York City students who entered ninth grade in 2013–2014 and 2014–2015 (N = 127,931). We find substantial variations in 4-year graduation among these subgroups, with differential predicted probabilities depending on the student's ever-EL status, race/ethnicity, and neighborhood income. These findings reveal important intersectional disparities in this diverse group of ELs—nuances that are lost when analyzing across a single social dimension and that push us to adopt an intersectional lens in quantitative research on ELs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Vulnerable older adults living with Alzheimers disease or Alzheimers disease and related dementia (AD/ADRD) and chronic pain generally receive fewer pain medications than individuals without AD/ADRD, especially in nursing homes. Little is known about pain management in older adults with AD/ADRD in the community. The aim of the study was to examine opioid prescribing patterns in individuals with chronic pain by levels of cognitive ability in ambulatory care. METHODS: We used the Medical Expenditure Panel Survey (MEPS), years 2002-2017, and identified three levels of cognitive impairment: no cognitive impairment (NCI), individuals reporting cognitive impairment (CI) without an AD/ADRD diagnosis, and individuals with a diagnosis of AD/ADRD. We examined any receipt of an opioid prescription and the number of opioid prescriptions using a logistic and negative binomial regression adjusting for sociodemographic and health characteristics and stratifying by three types of chronic pain (any chronic pain, severe chronic pain, and chronic pain identified through ICD 9/10 chronic pain diagnoses). RESULTS: Among people with any chronic pain, adjusted odds of receiving an opioid for people with CI (OR 1.41, 95% confidence interval 1.31-1.52) and AD/ADRD (OR 1.23, 95% confidence interval 1.04-1.45) were higher compared to NCI. Among people with chronic pain ICD 9/10 conditions, the odds of receiving an opioid were also higher for those with CI (OR 1.43, 95% confidence interval 1.34-1.56) and AD/ADRD (OR 1.48, 95% confidence interval 1.23-1.78) compared to NCI. Among those with severe chronic pain, people with CI were more likely to receive an opioid (OR 1.17, 95% confidence interval 1.07-1.27) relative to NCI (OR 0.89, 95% confidence interval 0.75-1.06). People with AD/ADRD experiencing severe chronic pain were not more likely to receive an opioid compared to the NCI group. Adjusted predicted counts of opioid prescriptions showed more opioids in CI and AD/ADRD in all chronic pain cohorts, with the largest numbers of opioid prescriptions in the severe chronic pain and ICD 9/10 diagnoses groups. CONCLUSIONS: The results suggest increased opioid use in people living with CI and AD/ADRD in the ambulatory care setting and potentially indicate that these individuals either require more analgesics or that opioids may be overprescribed. Further research is needed to examine pain management in this vulnerable population.

Abstract Background Insurance databases contain valuable information related to the use of dental services. This data is instrumental in decision-making processes, enhancing risk assessment, and predicting outcomes. The objective of this study was to identify patterns and factors influencing the utilization of dental services among complementary insured individuals, employing a data mining methodology. Methods A secondary data analysis was conducted using a dental insurance dataset from Iran in 2022. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was employed as a data mining approach for knowledge extraction from the database. The utilization of dental services was the outcome of interest, and independent variables were chosen based on the available information in the insurance dataset. Dental services were categorized into nine groups: diagnostic, preventive, periodontal, restorative, endodontic, prosthetic, implant, extraction/surgical, and orthodontic procedures. The independent variables included age, gender, family size, insurance history, franchise, insurance limit, and policyholder. A multinomial logistic regression model was utilized to investigate the factors associated with dental care utilization. All analyses were conducted using RapidMiner Version 2020. Results The analysis encompassed a total of 654,418 records, corresponding to 118,268 insured individuals. Predominantly, restorative treatments were the most utilized services, accounting for approximately 38% of all services, followed by diagnostic (18.35%) and endodontic (13.3%) care. Individuals aged between 36 and 60 years had the highest rate of utilization for any dental services. Additionally, families comprising three to four members, individuals with a one-year insurance history, people contracted with a 20% franchise, individuals with a high insurance limit, and insured individuals with a small policyholder, exhibited the highest rate of service usage compared to their counterparts. The regression model revealed that all independent variables were significantly associated with the use of dental services. However, the patterns of association varied among different service categories. Conclusions Restorative treatments emerged as the most frequently used dental services among insured individuals, followed by diagnostic and endodontic procedures. The pattern of service utilization was influenced by the characteristics of the insured individuals and attributes related to their insurance.

Background Employee mental health and well-being (MH&WB) is critical to the productivity and success of organizations. Training line managers (LMs) in mental health plays an important role in protecting and enhancing employee well-being, but its relationship with other MH&WB practices is under-researched. Aims To determine whether organizations offering LM training in mental health differ in the adoption of workplace- (i.e. primary/prevention-focused) and worker-directed (including both secondary/resiliency-focused and tertiary/remedial-focused) interventions to those organizations not offering LM training and to explore changes in the proportions of activities offered over time. Methods Secondary analysis of enterprise data from computer-assisted telephone interview surveys. The analysis included data from organizations in England across 4 years (2020: n  = 1900; 2021: n  = 1551; 2022: n  = 1904; 2023: n  = 1902). Results Offering LM training in mental health was associated with organizations' uptake of primary-, secondary-, and tertiary-level MH&WB activities across all 4 years. The proportion of organizations offering primary-, secondary- and tertiary-level interventions increased over time. On average, tertiary-level activities were most adopted (2020: 80%; 2021: 81%; 2022: 84%; 2023: 84%), followed by primary-level activities (2020: 66%; 2021: 72%; 2022: 72%; 2023: 73%) and secondary-level activities (2020: 62%; 2021: 60%; 2022: 61%; 2023: 67%). Conclusions Offering LM training in mental health is associated with the adoption of other MH&WB practices by organizations. Suggesting that organizations that are committed to the mental health agenda are more likely to take a holistic approach (including both worker and workplace strategies) to promoting workforce mental health, rather than providing LM training in isolation. [ABSTRACT FROM AUTHOR]

This article is methodological in nature, addressing and discussing the challenges the research team encountered in constructing a new international well-being index called the World Love Index. This index represents the first quantitative operationalization of the concept of Social Love, which seeks to capture actions or social relationships characterized by excess and care for the benefit of individuals outside the primary circle, loved for their irreducibility. Starting with a discussion of the project's objective rooted in the Beyond GDP debate, the article first analyzes the theoretical definition of Social Love and its semantic dimensions for operationalization. It then focuses on the methodological construction of the index through secondary data analysis, particularly examining the transition from the first wave to the second wave. Through the first wave of the WLI, this concept was systematically investigated on a transnational level. However, the first wave faced criticism for its weaknesses due to decisions made during the index's construction. This paper, from a purely methodological perspective, demonstrates how the second wave of the WLI aims to address these challenges and turn them into strengths. [ABSTRACT FROM AUTHOR]

Research either focused on self‐interest or left–right ideology to explain support for demanding active labour market policies (ALMPs). This article focuses instead on how attitudes towards these policies are rooted in the underlying policy paradigm. We link attitudes towards ALMPs to two pillars of the activation paradigm: distributive justice and unemployment attributions. Structural equational modeling is employed on the Belgian National Election Study data of 2014 (N = 1901). Individuals supporting the principles of need and equity and who blame the unemployed are more in favour of demanding activation. These frameworks and hence the policy paradigm thus have substantial predictive power. [ABSTRACT FROM AUTHOR]

Introduction Tobacco use in women of reproductive age group (15–9 years) may contribute to poor maternal and child health outcomes. We estimated the prevalence of smokeless tobacco (ST), cigarette, and waterpipe use among these women in Pakistan and explored associations with socio-economic differences and birth weights after recent childbirths (past 2 years). Aims and Methods We used the Multiple Indicator Cluster Surveys datasets from three provinces in Pakistan. Prevalence was generated for current use of tobacco among women with recent childbirth (WWRC) and without recent childbirth (WWoRC). We further compared socio-economic status and birth weights between tobacco users and non-users. Results The prevalence of current ST use was 1.4% and 2.5%, and waterpipe smoking was 1.2% and 1.8%, in WWRC and WWoRC, respectively. ST use varied across Pakistan's provinces by 13 percentage points in WWRC and WWoRC while waterpipe smoking by 10 and 15 percentage points, respectively. The odds of using any form of tobacco were significantly lower with higher levels of education or wealth index. Compared to children born to mothers who did not use tobacco, the birth weight of children born to mothers who smoked waterpipe was on average 0.83 kg (95% CI −1.6 to −0.1) lower whereas it was 0.33 kg (95% CI −0.9 to 0.3) higher for ST users. Conclusions Tobacco use among women of reproductive age in Pakistan varied significantly based on province and tobacco type. Waterpipe smoking was associated with a reduction in birth weight. Raising awareness of the harms of tobacco use among women of reproductive age and targeting interventions in high-burden regions of Pakistan should be prioritized. Implications The prevalence of current smokeless tobacco use and waterpipe smoking varied significantly in Pakistan (~13 and ~15 percentage points, respectively) among women of reproductive age, and there seems to be little change in tobacco use behavior around pregnancy and early motherhood. The study highlights a need to better understand the prevalence of tobacco use in Pakistan, and further contextual research is warranted to understand the reasons for such high tobacco use in certain areas. This information highlights the need for improving current tobacco control interventions and policies, including measures that could help reduce its use and prevent its uptake. Furthermore, compared to children born to mothers who did not use any form of tobacco, we found a statistically significant difference (830 g) in birth weight for babies born to mothers who at the time of the interview smoked waterpipe and a non-statistically significant difference of about 330 g for children born to mothers who at the time of the interview used smokeless tobacco. In addition to our findings, some literature suggests the association of waterpipe smoking with low birth weight. A possible explanation could be the exposure to smoke that contains toxicants from the tobacco product itself in addition to the burning of charcoal, which is required when using waterpipe. Waterpipe smoking also results in high exposures to carbon monoxide and polycyclic aromatic hydrocarbons, which are known to be carcinogenic and teratogenic. In terms of smokeless tobacco use, further research is warranted to understand its impact on birth outcomes through longitudinal studies accounting for diverse products, its constituents and the amount of consumption. [ABSTRACT FROM AUTHOR]

Secondary data analysis is a cost-effective, accessible, and efficient means of utilizing existing data to answer new research questions. The manuscript provides an overview of the secondary data analysis process, as well as benefits and limitations inherent in the research method. An exemplar of pediatric focused research using a publicly available dataset is presented to facilitate understanding of the process. Novice and experienced researchers benefit from exploring the quantitative and qualitative secondary data analysis options available. [ABSTRACT FROM AUTHOR]

• The majority of older adult caregivers experience moderate caregiver burden. • Caregiver burden has an inverse relationship with quality of life. • SEM showed spirituality influenced quality of life through caregiver burden. • Enhancing spirituality may be an easy, low-cost way to decrease caregiver burden. Caregiver burden (CB) reduces quality of life (QOL) and causes poor health outcomes. Spirituality impacts this relationship. To determine prevalence of CB and investigate relationships among CB, spirituality, and QOL in older U.S. adult informal caregivers (n = 754). This was a cross-sectional, descriptive secondary analysis of data from the 2020 Health and Retirement Study using GLM and SEM. Caregiver mean age was 65.93 (SD=8.37). Caregivers were primarily female (n = 456, 54.0%), White (n = 500, 79.5%), and married (n = 469, 65.3%). Most caregivers had moderate CB (n = 369, 49.8%). Black caregivers who were spiritual (p =.031) and caregivers with a high school diploma/GED who were spiritual (p =.021) had lower CB. Lower CB was correlated with higher QOL (p =< 0.001). SEM depicting an influencing effect of spirituality revealed good model fit (NFI=0.988; IFI=0.993; TLI=0.983; PCFI=0.397, RMSEA=0.043; χ2=9.577, p =.048, DF=4) Fostering spirituality in older adult caregivers could reduce CB and improve QOL. [ABSTRACT FROM AUTHOR]

Background: Insurance databases contain valuable information related to the use of dental services. This data is instrumental in decision-making processes, enhancing risk assessment, and predicting outcomes. The objective of this study was to identify patterns and factors influencing the utilization of dental services among complementary insured individuals, employing a data mining methodology. Methods: A secondary data analysis was conducted using a dental insurance dataset from Iran in 2022. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was employed as a data mining approach for knowledge extraction from the database. The utilization of dental services was the outcome of interest, and independent variables were chosen based on the available information in the insurance dataset. Dental services were categorized into nine groups: diagnostic, preventive, periodontal, restorative, endodontic, prosthetic, implant, extraction/surgical, and orthodontic procedures. The independent variables included age, gender, family size, insurance history, franchise, insurance limit, and policyholder. A multinomial logistic regression model was utilized to investigate the factors associated with dental care utilization. All analyses were conducted using RapidMiner Version 2020. Results: The analysis encompassed a total of 654,418 records, corresponding to 118,268 insured individuals. Predominantly, restorative treatments were the most utilized services, accounting for approximately 38% of all services, followed by diagnostic (18.35%) and endodontic (13.3%) care. Individuals aged between 36 and 60 years had the highest rate of utilization for any dental services. Additionally, families comprising three to four members, individuals with a one-year insurance history, people contracted with a 20% franchise, individuals with a high insurance limit, and insured individuals with a small policyholder, exhibited the highest rate of service usage compared to their counterparts. The regression model revealed that all independent variables were significantly associated with the use of dental services. However, the patterns of association varied among different service categories. Conclusions: Restorative treatments emerged as the most frequently used dental services among insured individuals, followed by diagnostic and endodontic procedures. The pattern of service utilization was influenced by the characteristics of the insured individuals and attributes related to their insurance. [ABSTRACT FROM AUTHOR]

Background: The use of unique national personal identification numbers (PIN) for linkage of medical records across health facilities and population-based studies is limited in sub-Saharan Africa (SSA) countries. The disintegration of healthcare research with different participant identifiers creates methodological challenges in linking data from multiple sources to answer a diverse range of policy-relevant, clinical, administrative, and research questions. This commentary aims to provide recommendations for improved linkage of health services data in SSA for healthcare research. Main text: Linkage of health services data is a complex process that requires health system thinking, multisectoral collaboration between the public and private sectors, and long-term investments. We recommend transitioning from paper-based healthcare data collection and storage systems, at health facility and population levels, to the use of electronic computer-assisted systems and a focus on improved data quality. SSA countries implementing this transition will benefit from additional technical and financial support. At the health-facility level, change from collecting aggregated to individual-level data. The use of PIN across multiple data sources is paramount, in addition to clear and transparent legal and ethical data protection and sharing guidelines, centralized data linkage by the governments, and partnerships with the private sector. Conclusion: High-quality linked data in SSA are scarce. SSA countries should prioritize establishing a robust foundation for high-quality data collection and future linkage. [ABSTRACT FROM AUTHOR]

Background EuroQoL EQ-5D-5L is a commonly used measure of health-related quality of life in clinical trials given the use of its index score as a measure of health utilities. It is unclear whether EQ-5D-5L is sensitive to changes in neurocognitive function and progression that occur following brain radiation. This study sought to evaluate the sensitivity of EQ-5D-5L in reflecting these changes. Methods A secondary analysis of NRG Oncology CC001 was performed. Mean EQ-5D-5L index and visual analog scale (VAS) score changes from baseline between groups of patients stratified by neurocognitive function and intracranial progression status were assessed. MD Anderson Symptom Inventory for brain tumor (MDASI-BT) symptom and interference items were also analyzed between groups. Results EQ-5D-5L mean index and VAS score changes between patients who had cognitive failure and those who had preserved cognition showed no statistically significant differences at any timepoint. In contrast, VAS changes at 4 months (1.61 vs -5.13, P  = .05) and 6 months (8.17 vs −0.14, P  = .04) were significantly improved in the patients who survived without intracranial progression. MDASI-BT cognitive factor scores were improved in the cohort of patients with preserved neurocognitive function at 2 months (1.68 vs 2.08, P  = .05) and 4 months (1.35 vs 1.83, P  = .04). MDASI-BT symptom interference was significantly associated with intracranial progression at 4 months, but not with neurocognitive status. Conclusion EQ-5D-5L index and VAS scores were not sensitive to neurocognitive changes that patients experienced, but VAS scores were sensitive to progression. This study challenges the routine use of EQ-5D as a quality of life metric in brain metastases clinical trials that are focused on preventing neurocognitive dysfunction. Trial Registration NCT# 02360215. [ABSTRACT FROM AUTHOR]

Increasing school-based parental involvement—which has links to improved student outcomes like academic achievement—is a core area of focus in many preschool programs. Yet, little research to date has examined what the association is between attending preschool and school-based parental involvement in early elementary school. This study addresses this gap by drawing on nationally-representative data from the Early Childhood Longitudinal Study-Kindergarten Class of 2010 to 2011 (N = 18,174) to examine the association between preschool attendance and measures of school-based parental involvement in early elementary school. The findings reveal consistent positive associations between preschool attendance and school-based parental involvement. There is little evidence of variation in associations based on the type (e.g., private and Head Start) or location (e.g., center-based and school-based) of the preschool program. [ABSTRACT FROM AUTHOR]

Food insecurity impacts 13.5 million US households yearly. Although food security instability (FS-I) can have many temporal presentations, these are not measured in the current US Household Food Security Survey Module. Explore sociodemographic and chronic disease correlates of 4 FS-I types (chronic, seasonal, intramonthly, and intermittent) using a 3-item US Household Food Security Survey Module instability supplement. This study was a secondary analysis of cross-sectional survey pilot data collected to validate the US Household Food Security Survey Module instability supplement. Adults at risk for food insecurity (n = 420) were recruited and answered the survey on their households' behalf from April to June 2021. The participants were recruited from 7 community organizations from 5 states (California, Florida, Maryland, North Carolina, and Washington). The main outcomes were the odds of having a chronic, seasonal, intramonthly, or intermittent FS-I score ≥1 based on several sociodemographic factors and having ≥1 chronic disease. Differences among the 4 FS-I types were analyzed using contingency tables and χ2 tests of independence. Then, mixed-effects logistic binary and conditional regressions were run for each FS-I type using clustering by state and odds ratios and 95% CI to interpret results. The most common FS-I type experienced by the sample was intramonthly (n = 183 [43%]). Nonchronic food insecurity was most likely to happen during the winter, at the end of the month, or randomly with no certain time frame. FS-I in any form was associated with low income, chronic FS-I was associated with younger age and male sex, seasonal FS-I was associated with having no government-subsidized health insurance and females, intramonthly FS-I was associated with participation in nutrition assistance programs, and intermittent FS-I had lower odds among Hispanic/Latino households. Further research is needed to explore other FS-I correlates and establish causative relationships; however, these results can be used with clinical judgment for targeted food insecurity screening and treatment. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between text-to-speech (TTS) usage and item-by-item performance in the 2017 eighth-grade National Assessment of Educational Progress (NAEP) math assessment, focusing on students with disabilities (SWDs), English language learners (ELLs), and their general education (GE) peers. Results indicate that all students use TTS more for longer and more difficult math items as well as for multiple-choice or short-response formats. Among SWDs and GE students, lower math proficiency and higher perceived time pressure are linked to higher TTS usage. Moreover, among GE students, factors such as male gender, minority status, lower math persistence, and higher math interest and effort during testing contribute to higher TTS usage. TTS usage is positively associated with item performance for SWDs and ELLs who received extended time accommodations but not for those who did not receive such accommodations or for general education students. The study suggests that the time constraints of speeded digital assessments may limit the potential benefits of TTS for SWDs and ELLs in math problem-solving. [ABSTRACT FROM AUTHOR]

Background and aims: Total abstinence has historically been the goal of treatment for substance use disorders; however, there is a growing recognition of the health benefits associated with reduced use as a harm reduction measure in stimulant use disorders treatment. We aimed to assess the validity of reduced stimulant use as an outcome measure in randomized controlled trials (RCTs) of pharmacological interventions for stimulant use disorder. Design: We conducted a secondary analysis of a pooled dataset of 13 RCTs. Setting and participants: Participants were individuals seeking treatment for cocaine or methamphetamine use disorders (N = 2062) in a wide range of treatment facilities in the United States. Measurements We validated reduced stimulant use against a set of clinical indicators drawn from harmonized measurements, including severity of problems caused by drug use, comorbid depression, global severity of substance use and improvement, severity of drug‐seeking behavior, craving and high‐risk behaviors, all assessed at the end of the trial, as well as follow‐up urine toxicology. A series of mixed effect regression models was conducted to validate reduction in frequency of use against no reduction in use and abstinence. Findings More participants reduced frequency of primary drug use than achieved abstinence (18.0% vs. 14.2%, respectively). Reduced use was significantly associated with decreases in craving for the primary drug [60.1%, 95% confidence interval (CI) = 54.3%–64.7%], drug seeking behaviors (41.0%, 95% CI = 36.6%–45.7%), depression severity (39.9%, 95% CI = 30.9%–48.3%), as well as multiple measures of global improvement in psychosocial functioning and severity of drug‐related problems, albeit less strongly so than abstinence. Moreover, reduced use was associated with sustained clinical benefit at follow‐up, as confirmed by negative urine tests (adjusted odds ratio compared with those with no reduction in use: 0.50, 95% CI = 0.35–0.71). Conclusion: Reduced frequency of stimulant use appears to be associated with meaningful improvement in various clinical indicators of recovery. Assessment of reduced use, in addition to abstinence, could broaden the scope of outcomes measured in randomized controlled trials of stimulant use disorders and facilitate the development of more diverse treatment approaches. [ABSTRACT FROM AUTHOR]

Background The first wave of COVID led to an alarmingly high mortality rate among nursing home residents (NHRs). In hospitalised patients, the use of anticoagulants may be associated with a favourable prognosis. However, it is unknown whether the use of antithrombotic medication also protected NHRs from COVID-19-related mortality. Objectives To investigate the effect of current antithrombotic therapy in NHRs with COVID-19 on 30-day all-cause mortality during the first COVID-19 wave. Methods We performed a retrospective cohort study linking electronic health records and pharmacy data in NHRs with COVID-19. A propensity score was used to match NHRs with current use of therapeutic dose anticoagulants to NHRs not using anticoagulant medication. The primary outcome was 30-day all-cause mortality, which was evaluated using a logistic regression model. In a secondary analysis, multivariable logistic regression was performed in the complete study group to compare NHRs with current use of therapeutic dose anticoagulants and those with current use of antiplatelet therapy to those without such medication. Results We included 3521 NHRs with COVID-19 based on a positive RT-PCR for SARS-CoV-2 or with a well-defined clinical suspicion of COVID-19. In the matched propensity score analysis, NHRs with current use of therapeutic dose anticoagulants had a significantly lower all-cause mortality (OR = 0.73; 95% CI: 0.58–0.92) compared to NHRs who did not use therapeutic anticoagulants. In the secondary analysis, current use of therapeutic dose anticoagulants (OR: 0.62; 95% CI: 0.48–0.82) and current use of antiplatelet therapy (OR 0.80; 95% CI: 0.64–0.99) were both associated with decreased mortality. Conclusions During the first COVID-19 wave, therapeutic anticoagulation and antiplatelet use were associated with a reduced risk of all-cause mortality in NHRs. Whether these potentially protective effects are maintained in vaccinated patients or patients with other COVID-19 variants, remains unknown. [ABSTRACT FROM AUTHOR]

Purpose: Major lockdowns were imposed in Germany from March until May 2020 and from December 2020 until May 2021. We studied the influence of these lockdowns, the strain on intensive care units and the strictness of COVID-19-related containment strategies on the utilization of mental health care among patients with severe mental disorders. Methods: We used health insurance claims data to identify n = 736,972 patients with severe mental disorders shortly before the pandemic and n = 735,816 patients a year earlier. We applied entropy balancing to adjust for baseline differences by district. For a 12-month follow-up, we modeled monthly changes in utilization through meta-analytic models using both the COVID-19 stringency index and intensive care unit cases per 100,000 inhabitants as predictors. Our outcomes were changes in psychiatric hospital days and time treated by outpatient psychiatrists. Results: Psychiatric hospital days declined by at least 7.7% in all calender month during the pandemic. Peak reduction rates were observed in April (− 27.9%), May (− 22.3%) 2020 and January 2021 (− 18.3%). Utilization changes were associated with the stringency index and the second lockdown. Time treated by psychiatrists was shorter in April (− 16.2%) and May (− 11.5%) 2020 and in January 2021 (− 10.5%), which was partially offset by higher utilization in June and September 2020. These utilization changes were associated with the stringency index and the strain on intensive care units during both lockdowns. Conclusion: Hospitals did not maintain the level of utilization during the pandemic, while outpatient psychiatrists adapted more quickly, presumably due to digital and telemedical care. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance." Methods: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ² tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix. Results: The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol. Conclusion: Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care. [ABSTRACT FROM AUTHOR]

This paper describes a Capability Approach analysis of the capabilities, functionings, and conversion factors reported by learners on workplace-based mobile language learning courses. The study used secondary data from student satisfaction surveys from 556 learners who were all recent migrants to the US and who were using the courses to study English. Use of the Capability Approach highlights that the promises of mobile learning were not available to all learners as conversion factors (individual, social, environmental, and technological) inhibited their participation in the courses. The study shows how some learners experienced a tension between well-being and agency as they were unable to study the content they wanted in the way they wanted. It also demonstrates that factors around the business model of the company that created the courses impacted the level to which learners were able to participate in the program. Finally, the study illustrates that learners were able to extend the language they learned through the course into other areas of their lives and to help others. [ABSTRACT FROM AUTHOR]

Suboptimal viral suppression is associated with worse outcomes and increased HIV transmission among women with HIV (WWH). Based on syndemic theory, we hypothesized that women exposed to recent intimate partner violence (IPV) and current drug use would be most likely to have suboptimal HIV viral suppression. We analyzed baseline data from a longitudinal clinical trial (WHAT-IF? Will Having Alcohol Treatment Improve My Functioning?) that enrolled WWH from Miami, FL, who reported heavy drinking. Bivariate logistic regression was done, mean age was 48 years (n 5 194; SD: 8.7), 40% had current drug use (other than alcohol), and 14% reported recent IPV. WWH who reported both IPV and drug use had the highest rate of suboptimal viral suppression (45%), but these differences were not statistically significant. The high rates of suboptimal viral suppression, drug use, and IPV suggest a need to include screening for IPV in clinical guidelines related to HIV care in women. [ABSTRACT FROM AUTHOR]

With a goal of contextualizing teacher job dissatisfaction during the first full school year of the COVID-19 pandemic, we contrast teachers' experiences with the decade and a half leading up to the pandemic. We draw on nationally representative data from the Schools and Staffing Survey and National Teacher and Principal Survey from the 2003–04 to 2020–21 school years. Through descriptive and regression analysis, we show that (1) increases in teacher dissatisfaction beginning in the 2015–16 school year persisted into the 2020–21 school year, (2) levels of dissatisfaction during the pandemic were not equal across subpopulations of teachers, and (3) positive working conditions consistently predicted lower job dissatisfaction, including in the 2020–21 school year. [ABSTRACT FROM AUTHOR]

Exclusionary school discipline is one of the primary ways that schools address student behavior. Existing scholarship has focused on examining the implications of exclusionary school discipline for two sets of outcomes: academic achievement and future juvenile and criminal legal involvement. However, these two areas of scholarship are largely treated as separate. In this paper, we bridge these two research areas by drawing on scholarship examining the negative educational consequences of police contact for youth. Specifically, we formally test the proposition that the association between school suspension in childhood and adolescent academic achievement is mediated by police contact experienced in early adolescence. Using data from the Future of Families and Child Wellbeing Study, we find support for this hypothesis: Early adolescent police contact explains approximately 30% of the association between school suspension in childhood and adolescent GPA. By relying on exclusionary school discipline, our results suggest that schools are setting the stage for youth to become involved in the criminal legal system, which, in turn, hinders future academic achievement. [ABSTRACT FROM AUTHOR]

Abstract Background This study aims to estimate average COVID-19-associated healthcare costs per capita in Germany from a payer perspective. In addition, insights into COVID-19-associated mortality should be gained. Methods For this purpose, a retrospective longitudinal analysis using health insurance claims data was performed. Patients affected by COVID-19 in Q1/2021 (investigation group (IG)) were compared to a matched non-COVID-19 control group (CG) (1:1 propensity score matching (PSM)). Mean values of healthcare costs in 2020 and 2021 were computed for both groups and then separated by age and by development of Post-COVID-19 Syndrome (PCS). Group differences were examined using Mann–Whitney U test (α = 0.05). Difference-in-Differences approach (DiD) was used to estimate average cost effects of COVID-19 in 2021. Concerning mortality, the number of deaths in 2021 was compared between IG and CG using χ2 test of independence. Results A total of 8,014 insurants were included (n = 4,007 per group; n = 536 per group examining PCS patients only). Total healthcare costs varied a lot in the sample, were comparable between IG and CG in 2020, but were significantly higher in the IG in 2021 (DiD estimate = € 1,063 (in total); € 3,242 (PCS group)). This was more pronounced in the older age groups. High hospital costs of a minority of patients were the most influential driver of COVID-19-associated healthcare costs. Mortality was more than doubled in the IG (tripled in patients aged ≥ 60). Conclusions COVID-19 is associated with significantly increased healthcare costs and mortality, especially in older age groups. The additional development of PCS further increases the costs of COVID-19.

Background/Objectives: Aneurysms and dissections of the iliac artery (ADIAs) are significant vascular conditions often associated with aortic pathologies. Despite their importance, reports on isolated iliac artery pathologies are rare. This study aimed to investigate the epidemiology of ADIA in Switzerland including treatment incidence and hospital outcomes. Methods: A retrospective analysis of diagnosis-related group (DRG) statistics from 2011 to 2018 in Switzerland was conducted, identifying all cases of ADIA while excluding those with concomitant treatment of aortic pathologies. Age-standardized incidence rates and treatment outcomes were assessed, with multivariable logistic regression performed to identify factors associated with hospital mortality. Results: From 2011 to 2018, 1037 ADIA cases were hospitalized in Switzerland. Incidence rates for elective treatment were significantly higher in men than women, increasing in men from 1.5 to 2.4 cases per 100,000 men (p = 0.007), while remaining stable in women at around 0.2 cases per 100,000 women. Acute treatment incidence rates were lower but still higher in men, at 0.9 cases per 100,000 men and 0.2 cases per 100,000 women. Crude hospital mortality rates were lower for endovascular repair than open surgical repair in both elective (0.8% vs. 3.1%, p = 0.023) and emergency treatment (6.7% vs. 18.4%, p = 0.045). Multivariable analysis showed that endovascular repair was associated with significantly reduced hospital mortality compared to open repair (OR 0.27, 95%-CI: 0.10 to 0.66, p = 0.006). Conclusions: This nationwide study of iliac artery pathologies shows that the treatment incidence was about 10 times higher in men than in women for elective procedures, but only about five times higher for emergency treatment. Endovascular procedures were associated with significantly lower hospital mortality than open procedures, while hospital mortality rates were comparable for men and women. [ABSTRACT FROM AUTHOR]

Background: NYU Langone Health offers a collaborative research block for PGY3 Primary Care residents that employs a secondary data analysis methodology. As discussions of data reuse and secondary data analysis have grown in the data library literature, we sought to understand what attitudes internal medicine residents at a large urban academic medical center had around secondary data analysis. This case report describes a novel survey on resident attitudes around data sharing. Methods: We surveyed internal medicine residents in three tracks: Primary Care (PC), Categorical, and Clinician- Investigator (CI) tracks as part of a larger pilot study on implementation of a research block. All three tracks are in our institution's internal medicine program. In discussions with residency directors and the chief resident, the term "secondary data analysis" was chosen over "data reuse" due to this being more familiar to clinicians, but examples were given to define the concept. Results: We surveyed a population of 162 residents, and 67 residents responded, representing a 41.36% response rate. Strong majorities of residents exhibited positive views of secondary data analysis. Moreover, in our sample, those with exposure to secondary data analysis research opined that secondary data analysis takes less time and is less difficult to conduct compared to the other residents without curricular exposure to secondary analysis. Discussion: The survey reflects that residents believe secondary data analysis is worthwhile and this highlights opportunities for data librarians. As current residents matriculate into professional roles as clinicians, educators, and researchers, libraries have an opportunity to bolster support for data curation and education. [ABSTRACT FROM AUTHOR]

Background Mental ill health has a high economic impact on society and employers. National and international policy advocates line manager (LM) training in mental health as a key intervention, but little is known about employer training provisions. Aims To explore the prevalence and characteristics of organizations that offer LM training in mental health. Methods Secondary analysis of existing longitudinal anonymised organizational-level survey data derived from computer-assisted telephone interview surveys collected in four waves (2020:1900 firms, 2021:1551, 2022:1904, 2023:1902) in England, before, during and after a global pandemic. Results The proportion of organizations offering LM training in mental health increased pre- to post-pandemic (2020:50%, 2023:59%) but 41% do not currently provide it. Logistic regression confirmed that LM training is more likely to be offered by large-sized enterprises, organizations with a larger proportion of employees who are younger (aged 25–49), female, disabled and from ethnic minority communities. Sector patterns were inconsistent, but in 2023, organizations from the 'Hospitality' and 'Business Services' sectors were more likely to provide LM training than other sectors. Conclusions Continued efforts are needed to increase the proportion of employers offering LM training in mental health, particularly small- to medium-sized enterprises, and organizations with predominantly male, White and/or older workforces. [ABSTRACT FROM AUTHOR]

This paper delves into the Global Peace Index (GPI), a comprehensive metric evaluating global peace through factors like safety, security, ongoing conflict, and militarization. The objective is to dissect the GPI's assessment of global peace, identifying key factors that influence a nation's peace status. Employing statistical analysis alongside data visualization techniques, the study methodically examines the GPI's multifaceted criteria. The findings underscore the critical role of safety and security, alongside the impact of ongoing conflicts, in determining a nation's peace status. Notably, the analysis reveals pronounced regional disparities in peace, illustrating the intricate challenges of bolstering global peace. The paper concludes by proposing targeted peace-building initiatives, advocating for a holistic strategy to foster safer, more secure societies globally. It is recommended to address the underlying issues identified, marking a significant step towards realizing the aspirations of the GPI for enhanced global peace. [ABSTRACT FROM AUTHOR]

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The objective of this research is to study the impact of the COVID-19 pandemic on employment with data visualization via R. The COVID-19 pandemic has significantly disrupted employment, resulting in an unprecedented decline in working hours. Leveraging secondary data, this study examines the varying consequences of COVID-19 on employment in 189 countries across six continents of the world, utilizing R programming language visualizing tool kit with statistical techniques: tree maps, bar charts, pie chart, and grouping and faceting. The findings of this study indicate that South American countries experienced the highest average loss of working hours at 15%, followed by North American countries at 12%, and Asian, African, and European countries at 9%, 8%, and 7%, respectively. While regions of Oceania are the least affected with a 5% loss in working hours compared to 4th quarter of 2019. This study underscores the necessity to reduce the pandemic's negative consequences on employment and provide policymakers with valuable insights to offer post-pandemic support and focused interventions. [ABSTRACT FROM AUTHOR]

Background: This study aims to estimate average COVID-19-associated healthcare costs per capita in Germany from a payer perspective. In addition, insights into COVID-19-associated mortality should be gained. Methods: For this purpose, a retrospective longitudinal analysis using health insurance claims data was performed. Patients affected by COVID-19 in Q1/2021 (investigation group (IG)) were compared to a matched non-COVID-19 control group (CG) (1:1 propensity score matching (PSM)). Mean values of healthcare costs in 2020 and 2021 were computed for both groups and then separated by age and by development of Post-COVID-19 Syndrome (PCS). Group differences were examined using Mann–Whitney U test (α = 0.05). Difference-in-Differences approach (DiD) was used to estimate average cost effects of COVID-19 in 2021. Concerning mortality, the number of deaths in 2021 was compared between IG and CG using χ2 test of independence. Results: A total of 8,014 insurants were included (n = 4,007 per group; n = 536 per group examining PCS patients only). Total healthcare costs varied a lot in the sample, were comparable between IG and CG in 2020, but were significantly higher in the IG in 2021 (DiD estimate = € 1,063 (in total); € 3,242 (PCS group)). This was more pronounced in the older age groups. High hospital costs of a minority of patients were the most influential driver of COVID-19-associated healthcare costs. Mortality was more than doubled in the IG (tripled in patients aged ≥ 60). Conclusions: COVID-19 is associated with significantly increased healthcare costs and mortality, especially in older age groups. The additional development of PCS further increases the costs of COVID-19. [ABSTRACT FROM AUTHOR]

Aims Women are underrepresented in cardiovascular trials. We sought to explore the proportional representation of women in contemporary cardiovascular research and the factors (barriers and enablers) that affect their participation in cardiovascular studies. Methods and results Multiple electronic databases were searched between January 2011 and September 2021 to identify papers that defined underrepresentation of women in cardiovascular research and/or reported sex-based differences in participating in cardiovascular research and/or barriers for women to participate in cardiovascular research. Data extraction was undertaken independently by two authors using a standardised data collection form. Results were summarised using descriptive statistics and narrative synthesis as appropriate. From 548 identified papers, 10 papers were included. Of those, four were conducted prospectively and six were retrospective studies. Five of the retrospective studies involved secondary analysis of trial data including over 780 trials in over 1.1 million participants. Overall, women were reported to be underrepresented in heart failure, coronary disease, myocardial infarction, and arrhythmia trials, compared to men. Barriers to participation included lack of information and understanding of the research, trial-related procedures, the perceived health status of the participant, and patient-specific factors including travel, childcare availability, and cost. A significantly higher likelihood of research participation was reported by women following a patient educational intervention. Conclusion This review has highlighted the underrepresentation of women in a range of cardiovascular trials. Several barriers to women's participation in cardiovascular studies were identified. Researchers could mitigate against these in future trial planning and delivery to increase women's participation in cardiovascular research. Registration The protocol was published on the public Open Science Framework platform on 13th August 2021 (no registration reference provided) and can be accessed at https://osf.io/ny4fd/. [ABSTRACT FROM AUTHOR]

Objective: Several studies have shown that Adult ADHD presents differently in younger and older adults. We sought to assess the difference in care between these two groups using previously identified quality measures (QMs). Methods: Using electronic health record data, we matched a younger group of ADHD patients to an older group. We then assessed the achievement of the QMs using probit models with and without interaction terms. Results: The majority of QMs shown an increase in achievement for both groups over time. However, significant differences in quality of care between younger and older adult ADHD patients persisted. By the end of the study period, with the exception of three QMs, younger patients achieved the QMs more. Conclusion: While, in general, the quality of care for adult ADHD increased from 2010 to 2020, there were still differences in care between younger and older adult ADHD patients. [ABSTRACT FROM AUTHOR]