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Learning to descend stairs requires motor and cognitive capacities on the part of infants and opportunities for practice and assurance of safety offered by caregivers. The American Academy of Pediatrics prescribes the age strategy to teach toddlers to safely descend stairs but without much consideration for individual differences in infants' skills or caregivers' techniques. The purpose of this study was to observe the natural ways in which caregivers teach infants to descend stairs at home and the extent to which infants abide. Of particular interest was to examine the dynamic nature of caregivers' teaching and infants' learning over the session with attention to individual differences. Dyads (N = 59) were videorecorded on Zoom for 10 min interacting on stairs at home in the United States, Brazil, Canada, Italy, and Spain. Infants (n = 30 girls, 29 boys; 13-month-olds ± 1 week) were novice walkers (M = 2.04 months walking experience). Caregivers used a variety of teaching strategies and focused on "backing" and "scooting." Infants were more likely to heed caregivers' guidance when caregivers provided hands-on support and verbal encouragement suggesting infants were engaged and responsive to caregivers' overtures. Infants' walking experience predicted change in descent strategy over the session. Although infants did not show evidence of learning over the session, consistent caregiver instruction suggested caregivers were persistent, if not effective, teachers. Teaching and learning motor skills in a potentially risky task creates a unique opportunity for interaction, allowing infants and caregivers to learn from one another. Public Significance Statement: This work contributes to the general body of knowledge regarding infant motor development and problem solving in specific contexts. This study is one of the first to explore the nature of caregiver-infant interaction on stairs and identifies caregiver teaching strategies and infant motor characteristics that are associated with safe infant stair descent. By doing so, we hope to encourage further investigation of infant behavior in this context, upon which recommendations to caregivers for safe infant descent may be based. [ABSTRACT FROM AUTHOR]

The article presents a study which examined relationship between childhood neighborhood cohesion and safety and adverse childhood experiences (ACEs) and whether this relationship differs across race/ethnicity. Topics discussed include racial and ethnic differences in ACEs and childhood neighborhood cohesion and safety, methodology of the study, and limitations of the study.

The current study explored men's (N = 1,298) reports of sexual behaviors, hypersexuality, pornography use, pornography avoidance self-efficacy, and sensation seeking with respect to men's sexual orientation (heterosexual = 68.5%, gay = 11.2%, bisexual = 16.0%, and uncertain = 4.3%). Results revealed that heterosexual men reported less frequent pornography viewing and higher pornography avoidance self-efficacy than gay, bisexual, and uncertain men. Heterosexual men reported lower hypersexuality than bisexual and uncertain men. Differences in sensation seeking behaviors by sexual orientation did not reach significance. Future research should examine factors contributing to hypersexual behaviors, sensation seeking, and pornography using behaviors and avoidance self-efficacy among men identifying with different sexual orientations. [ABSTRACT FROM AUTHOR]

Understanding users' individual differences may provide clues to help identify computer users who are prone to act insecurely. We examine factors that impact home users' reported computer security behaviour. We conducted two online surveys with a total of 650 participants to investigate the relationship between self-reported security behaviour and users' knowledge, motivation, confidence, risk propensity and sex-typed characteristics. We found that all of these factors impacted security behaviour, with knowledge as the most important predictor. We further show that a user's affinity to feminine or masculine characteristics is a better determinant of security behaviour than using binary male/female descriptors. Our study enabled us to confirm earlier results in the literature in a non-organisational setting, and to extend the literature by studying additional factors and by comparing the relative importance of each factor as a predictor of security behaviour. [ABSTRACT FROM AUTHOR]

This study examines gender differences in cumulative abuse, measured by the Juvenile Victimization Questionnaire, bystander intervention outcomes and survivors' long‐term health, using student survey data from seven universities (N = 4080). By conducting chi‐squared tests, t‐tests and regression analyses, the results show that more female students reported higher cumulative abuse than male students. Survivors of cumulative abuse reported higher intimate partner violence (IPV) victimisation. Female survivors reported poorer mental health, while male survivors were more involved in alcohol and drug use. Most survivors remembered the bystander presence at the incident of abuse as neither helpful nor harmful, which was not significantly different by gender. Findings suggest that campus service providers need to tailor services considering the gendered effects of cumulative abuse on IPV and its long‐term health ramifications to enhance the effectiveness of services for college students. [ABSTRACT FROM AUTHOR]

Background: To estimate the incidence, risk factors, and impact on mortality and functional outcomes for early coagulopathy after the return of spontaneous circulation (ROSC) in pediatric out-of-hospital cardiac arrest (OHCA) patients. Methods: A post hoc analysis of the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial was conducted. Early coagulopathy was defined as presence of at least one of the following coagulation abnormalities upon admission: international standard ratio (INR), platelets, and age-adjusted activated partial thromboplastin time (APTT) within 6 h after OHCA and before therapeutic hypothermia initiation. The outcomes included 28-day mortality and functional prognosis. Multivariable logistic regression models were used to explore risk factors and association between early coagulopathy and outcomes. Results: Of the 227 patients included, 152 (67%) were male and the median age was 2.3 years [interquartile range (IQR), 0.7–8.6 years]. The overall 28-day mortality was 63%. The incidence of early coagulopathy was 46%. Lower age, longer duration of chest compression, lower temperature, and higher white blood cell (WBC) upon admission increased the risk of early coagulopathy. Early coagulopathy [OR, 2.20 (95% CI, 1.12–4.39), P = 0.023] was independently associated with 28-day mortality after adjusting for confounders. Conclusions: Early coagulopathy occurred in almost half of pediatric patients with OHCA. Lower age, longer duration of chest compression, lower temperature, and higher WBC increased the risk. The development of early coagulopathy was independently associated with increased mortality. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the cues college students use to determine a sexual partner is refusing vaginal-penile sex (i.e., refusal interpretations). As a secondary aim, we explored the influence of item wording (not willing/non-consent vs refusal) on college students' self-reported refusal interpretations. A sample of 175 college students from Canada and the United States completed an open-ended online survey where they were randomly assigned to one of two wording conditions (not willing/non-consent vs refusal); students were then prompted to write about the cues they used to interpret their partner was refusing. An inductive coding procedure was used to analyze open-ended data. Themes included explicit and implicit verbal and nonverbal cues. The refusal condition elicited more explicit and implicit nonverbal cues than the not willing/non-consent condition. Frequency results suggested men reported interpreting more explicit and implicit verbal cues. Women reported interpreting more implicit nonverbal cues from their partner. Our findings reflect prior research and appear in line with traditional gender and sexual scripts. We recommend researchers consider using the word refusal when assessing the cues students interpret from their sexual partners as this wording choice may reflect college students' sexual experiences more accurately. [ABSTRACT FROM AUTHOR]

Introduction: Despite the support for and benefits of data-driven learning, physician engagement is variable. This study explores systemic influences of physician use of data for performance improvement in continuing professional development (CPD) by analyzing and interpreting data sources from organizational and institutional documents. Methods: The document analysis is the third phase of a mixed-methods explanatory sequential study examining cultural factors that influence data-informed learning. A gray literature search was conducted for organizations both in Canada and the United States. The analysis contains nonparticipant observations from professional learning bodies and medical specialty organizations with established roles within the CPD community known to lead and influence change in CPD. Results: Sixty-two documents were collected from 20 Canadian and American organizations. The content analysis identified the following: (1) a need to advocate for data-informed self-assessment and team-based learning strategies; (2) privacy and confidentiality concerns intersect at the point of patient data collection and physician-generated outcomes and need to be acknowledged; (3) a nuanced data strategy approach for each medical specialty is needed. Discussion: This analysis broadens our understanding of system-level factors that influence the extent to which health information custodians and physicians are motivated to engage with data for learning. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a major international public health concern that poses significant mental and physical health risks for affected individuals. To improve prevention efforts, it is imperative that researchers and government bodies understand risk factors for IPV. One such risk factor concerns the extent to which violence is intergenerational, such that exposure to violence predisposes individuals to engage in violence toward intimate partners. The purpose of this research is to assess childhood exposure to violence as a risk factor for perpetration of IPV in adulthood, and to evaluate the Dark Tetrad personality traits as mediators in this relationship. We recruited 153 men and 246 women (age range = 18–73, M age = 33.50, SD age = 10.26) through Amazon's Mechanical Turk to complete a series of questionnaires and an open-ended IPV perpetration assessment. Results showed no relationship between IPV perpetration and childhood IPV exposure, indicating that mediation analyses were not possible. Possible explanations are discussed. Follow-up exploratory analyses demonstrated that gender moderated the relationships between childhood IPV exposure and levels of Factor 1 psychopathy and Machiavellianism. Specifically, men who were exposed to IPV in childhood were more likely to develop higher levels of Factor 1 psychopathy and Machiavellianism, whereas women were not. Overall, our findings highlight the importance of providing researchers and clinicians with a greater understanding of environmental events preceding maladaptive trait development. It is also important for researchers and clinicians to consider gender differences in pathways between exposure to IPV and subsequent development of dark personality traits. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Rationale and objectives: Medical humanities are becoming increasingly recognized as positively impacting medical education and medical practice. However, the extent of medical humanities teaching in medical schools is largely unknown. We reviewed medical school curricula in Canada, the UK and the US. We also explored the relationship between medical school ranking and the inclusion of medical humanities in the curricula. Methods: We searched the curriculum websites of all accredited medical schools in Canada, the UK and the US to check which medical humanities topics were taught, and whether they were mandatory or optional. We then noted rankings both by Times Higher Education and U.S. News and World Report and calculated the average rank. We formally explored whether there was an association between average medical school ranking and medical humanities offerings using Spearman's correlation and inverse variance weighting meta‐analysis. Results: We identified 18 accredited medical school programmes in Canada, 41 in the UK, and 154 in the US. Of these, nine (56%) in Canada, 34 (73%) in the UK and 124 (80%) in the US offered at least one medical humanity that was not ethics. The most common medical humanities were medical humanities (unspecified), history, and literature (Canada); sociology and social medicine, medical humanities (unspecified), and art (UK); and medical humanities (unspecified), literature and history (US). Higher ranked medical schools appeared less likely to offer medical humanities. Conclusions: The extent and content of medical humanities offerings at accredited medical schools in Canada, the UK and the US varies, and there appears to be an inverse relationship between medical school quality and medical humanities offerings. Our analysis was limited by the data provided on the Universities' websites. Given the potential for medical humanities to improve medical education and medical practice, opportunities to reduce this variation should be exploited. [ABSTRACT FROM AUTHOR]

Background/Objective: Hip- and knee-muscle-strengthening programs are effective in improving short-term patient-reported and disease-oriented outcomes in individuals with patellofemoral pain (PFP), but few to no data exist on moderate- to longterm postrehabilitative outcomes. The first purpose of the study was to assess differences in pain, function, strength, and core endurance in individuals with PFP before, after, and 6 mo after successful hip- or knee-muscle-strengthening rehabilitation. The second purpose was to prospectively follow these subjects for PFP recurrence at 6, 12, and 24 mo postrehabilitation. Methods: For 24 mo postrehabilitation, 157 physically active subjects with PFP who reported treatment success were followed. At 6 mo postrehabilitation, pain, function, hip and knee strength, and core endurance were measured. At 6, 12, 18, and 24 mo, PFP recurrence was measured via electronic surveys. Results: Sixty-eight subjects (43%) returned to the laboratory at 6 mo. Regardless of rehabilitation program, subjects experienced significant improvements in pain and function, strength, and core endurance pre- to postrehabilitation and maintained improvements in pain and function 6 mo postrehabilitation (Visual Analog Scale/Pain--pre 5.12 ± 1.33, post 1.28 ± 1.14, 6 mo 1.68 ± 2.16 cm, P < .05; Anterior Knee Pain Scale/ Function--pre 76.38 ± 8.42, post 92.77 ± 7.36, 6 mo 90.27 ± 9.46 points, P < .05). Over the 24 mo postrehabilitation, 5.10% of subjects who responded to the surveys reported PFP recurrence. Conclusions: The findings support implementing a hip- or knee-muscle-strengthening program for the treatment of PFP. Both programs improve pain, function, strength, and core endurance in the short term with moderate- and long-term benefits of improved pain and function and low PFP recurrence. [ABSTRACT FROM AUTHOR]

Survival for hypoplastic left heart syndrome (HLHS) has improved dramatically. Little is known about early family function, quality of life (QOL), or well-being/adjustment for parents of infants with HLHS. Parent/family outcomes over time, predictors, and differences in 143 mothers and 72 fathers were examined. Parents reported better family function compared with published norms, but 26% experienced family dysfunction. QOL and well-being were significantly lower than adult norms. QOL scores generally declined over time, whereas self-reported well-being improved. Responses from mothers and fathers showed different trends, with mothers having worse scores on most measures and at most time points. Being a single parent was a risk factor for poorer family function, but not for lower individual QOL or well-being. Family characteristics, stress, and coping skills were predictive of outcomes. Parents' psychosocial responses to the challenges of life with infants with HLHS change over time. Individually tailored psychosocial support is needed. [ABSTRACT FROM AUTHOR]

Objective: To shorten the Patient Engagement In Research Scale (PEIRS) to its most essential items and evaluate its measurement properties for assessing the degree of patients' and family caregivers' meaningful engagement as partners in research projects. Methods: A prospective cross‐sectional web‐based survey in Canada and the USA, and also paper‐based in Canada. Participants were patients or family caregivers who had engaged in research projects within the last 3 years, were ≥17 years old, and communicated in English. Extensive psychometric analyses were conducted. Results: 119 participants: 99 from Canada, 74 female, 51 aged 17‐35 years and 50 aged 36‐65 years, 60 had post‐secondary education, and 74 were Caucasian/white. The original 37‐item PEIRS was shortened to 22 items (PEIRS‐22), mainly because of low inter‐item correlations. PEIRS‐22 had a single dominant construct that accounted for 55% of explained variance. Analysis of PEIRS‐22 scores revealed the following: (1) acceptable floor and ceiling effects (<15%), (2) internal consistency (ordinal alpha = 0.96), (3) structural validity by fit to a Rasch measurement model, (4) construct validity by moderate correlations with the Public and Patient Engagement Evaluation Tool, (5) good test‐retest reliability (ICC2,1 = 0.86) and (6) interpretability demonstrated by significant differences among PEIRS‐22 scores across three levels of global meaningful engagement in research. Conclusions: The shortened PEIRS is valid and reliable for assessing the degree of meaningful patient and family caregiver engagement in research. It enables standardized assessment of engagement in research across various contexts. Patient or public contribution: A researcher‐initiated collaboration, patient partners contributed from study conception to manuscript write‐up. [ABSTRACT FROM AUTHOR]

LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) youth are at increased risk for negative outcomes. Yet little is known about their engagement with communities and resources that may ameliorate risk, particularly online. Oriented by a uses and gratifications approach, this secondary analysis (n = 4,009) of LGBTQ+ youth (aged 14–29) compares online versus offline experiences. Respondents were significantly more likely to participate in LGBTQ+ communities online. Youth were also more active, and felt safer and more supported, when participating in online LGBTQ + communities. Additionally, respondents sought online information, support, and resources at higher rates than offline. Increased attention toward online programming and resource development is warranted. [ABSTRACT FROM AUTHOR]

Context: Low back pain (LBP) remains a societal burden due to consistently high rates of recurrence and chronicity. Recent evidence suggested that a provider's treatment orientation influences patient beliefs, the clinical approach, and subsequently, rehabilitation outcomes. Objective: To characterize American athletic trainer (AT) and Canadian athletic therapist (C-AT) treatment orientations toward LBP. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: A total of 273 ATs (response rate = 13.3%) and 382 C-ATs (response rate = 15.3%). Main Outcome Measure(s): Participants completed demographic questions and the Pain Attitudes and Beliefs Scale (PABS) for ATs/C-ATs. The PABS measures the biomedical and biopsychosocial treatment orientation of health care providers and is scored on a 6-point Likert scale. Descriptive statistics characterized the participants; t tests and 1-way analyses of variance identified differences between group means; and Spearman correlations assessed relationships between the biomedical and biopsychosocial scores and age, number of LBP patients per year, and years of experience. Results: Athletic trainers treating 9 to 15 LBP patients per year had higher biomedical scores (35.0 6 5.7) than ATs treating 16 to 34 (31.9 6 5.5, P =.039) or .34 (31.7 6 8.6, P = .018) LBP patients per year. The C-ATs treating 16 to 34 (31.8 6 6.3, P = .038) and .34 (31.0 6 6.7, P < .001) LBP patients per year had lower biomedical scores than those treating <-8 LBP patients per year (34.8 6 5.9). The C-ATs with <-5 years of experience had higher biomedical scores than those with 10 to 15 (31.0 6 6.7, P = .011) and 16 to 24 (29.8 6 7.5, P < .001) years of experience. Canadian athletic therapists treating the general public had higher (31.7 6 4.0) biopsychosocial scores than ATs treating athletes (31.3 6 3.5, P = .006). The C-ATs <-35.6 years of age had higher biomedical scores (33.1 6 5.9) than those .35.6 years of age (30.5 6 7.0, P < .001). Conclusions: Athletic trainers and C-ATs who treated more LBP patients per year were more likely to score low on a biomedical treatment orientation subscale. Because this orientation has predicted poor outcomes in other health care providers, further research is needed to determine the effects of ATs' and C-ATs' biomedical orientations on rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

The article examines a study on the role of general education teachers in providing support to elementary school students with visual impairments in accessing science curriculum in the United States. Topics discussed include the methodology used in the study, importance of preteaching vocabulary terms with students, and the use of American Printing House for the Blind reference materials.

Abstract: Quality organizational structures and nursing practices are key to positive patient outcomes. Whereas structures have been largely studied over the past few decades, less is known of the nursing practices that account for patient outcomes, such as patient satisfaction. This is especially true in psychiatric, mental health care settings. The aim of the present study is to determine the relative importance of eight Essential Professional Nursing Practices (EPNPs) on the satisfaction of hospitalized patients on mental health care units. A cross‐sectional design was selected; 226 point‐of‐care mental health nurses completed the online EPNP questionnaire in Spring 2015. Statistical analyses included MANOVAs and a 2‐step linear regression. A significant relationship was found between university preparation and scores on two EPNP subscales: autonomous decision‐making and practicing with competent nurses. Scores on patient advocacy and control over practice subscales were significantly related to nurse‐rated patient satisfaction. The findings reinforce the positive link between university education and the work of nurses and highlight the power dynamics that are salient in mental health care. The pertinence of EPNPs in psychiatric settings is brought to the fore, with practices of patient advocacy and nurse control over care examined in relation to empowerment. Implications for clinical and administrative leaders are addressed, with a focus on strategies for empowering patients and nurses. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to develop a method for the assessment of audiology author impact as a function of institution and compare these results to a recent college ranking of audiology graduate programs. Method: Scopus author impact metrics (i.e., number of documents, number of citations, and h index) from a previous study (Stuart, Faucette, & Thomas, 2017) were generated for 79 accredited graduate programs in audiology in the United States and Canada. Author impact metrics were summed to represent the total institution output, and median values were calculated to reflect a measure of central tendency of individual faculty performance. Results: Three hundred and seventy-nine audiology faculty members were identified and of those 86.0% (n = 326) were found in Scopus. Database presence increased with increasing rank (p = .003). Scopus index values were positively skewed. The total summed number of documents, citations, and h indices were positively correlated with the total number of faculty in the institutions and with the summed number of coauthors (p < .001). The median number of documents, citations, and h indices were not significantly correlated with the total number of faculty in the institutions but were positively correlated with the median number of coauthors (p < .001). In general, indices were higher for research/doctoral versus nonresearch universities. Higher college program rankings were statistically related with better Scopus index values. Conclusion: These institutional metrics may be used to serve as a benchmark for institutional production, attracting students, hiring faculty, and assessing allocation of institutional funding. [ABSTRACT FROM AUTHOR]

Little information exists about the patterns of practice of athletic training and therapy (ATT) professionals in different countries. The purpose of this study is to examine similarities in the patterns of practice of ATT professionals in three Mutual Recognition Agreement (MRA) countries--the United States, Canada, and Ireland. We compared the practice frequency of 24 ATT tasks performed by ATT professionals in these countries. Only two tasks, involving emergency care and patient education, were carried out differently in the United States and Canada. Our results therefore suggest that patterns of practice are very similar among ATT professionals in these countries. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to examine author-level impact metrics for faculty in the communication sciences and disorder research field across a variety of databases. Method: Author-level impact metrics were collected for faculty from 257 accredited universities in the United States and Canada. Three databases (i.e., Google Scholar, ResearchGate, and Scopus) were utilized. Results: Faculty expertise was in audiology (24.4%; n = 490) and speech-language pathology (75.6%; n = 1,520). Women comprised 68.1% of faculty, and men comprised 31.9% of faculty. The percentage of faculty in the field of communication sciences and disorders identified in each database was 10.5% (n = 212), 44.0% (n = 885), and 84.4% (n = 1,696) for Google Scholar, ResearchGate, and Scopus, respectively. In general, author-level impact metrics were positively skewed. Metric values increased significantly with increasing academic rank (p < .05), were greater for men versus women (p < .05), and were greater for those in audiology versus speech-language pathology (p < .05). There were statistically significant positive correlations between all author-level metrics (p < .01). Conclusions: These author-level metrics may serve as a benchmark for scholarly production of those in the field of communication sciences and disorders and may assist with professional identity management, tenure and promotion review, grant applications, and employment. [ABSTRACT FROM AUTHOR]

Purpose:To test a model of child, family and service determinants of participation in family and recreational activities for young children with cerebral palsy (CP). Methods:Participants were a convenience sample of 429 children (242 males) with CP, aged 18 to 60 months, representing all levels of the Gross Motor Function Classification System (GMFCS). Children were divided into two groups by GMFCS levels, levels I to II and levels III to V. Data on impairments and gross motor function were collected by therapists; parents provided information about children’s health conditions and adaptive behaviour. Seven months later, parents reported on family life and services received. One year after the beginning of the study, parents reported their children’s participation. Data from the two groups of children were analysed separately using structural equation modelling. Results:The model explained 35% and 40% of the variance of frequency of participation in family and recreation and 28% and 38% of enjoyment in participation, for the two groups of children, respectively. Children’s adaptive behaviour, family ecology, and number of community recreational programs were associated with the frequency of participation for both groups. Gross motor function was only associated with the frequency of participation for children in levels III–V. Adaptive behaviour was associated with enjoyment for both groups. The extent services met children’s needs was associated with enjoyment for children in levels I to II and family ecology was a determinant of enjoyment for children in levels III to V. Conclusion:Supporting children’s adaptive behaviour, family ecology, and access to community recreational programmes may foster participation in family and recreational activities for young children with CP.Implications for RehabilitationParticipation in family and recreational activities for young children with CP is complex and influenced by child, family and environmental factors.Practitioners are encouraged to support children’s adaptive behaviour and access to community programs and family relationships, involvement in community activities and expectations of their children.Optimizing gross motor function for children who have limitations in self-mobility may enhance their participation in family and recreational activities.For children with a good prognosis for walking, providing services perceived by parents to meet their children’s needs may enhance children’s enjoyment of participation. [ABSTRACT FROM PUBLISHER]

Aims: Poverty kills children. This study assesses the relationship between poverty and child mortality rates (CMRs) in 71 societies from three world regions to determine whether some countries, relative to their region, neglect their children. Methods: Spearman rank order correlations were calculated to determine any association between the CMR and poverty data, including income inequality and gross national income. A current CMR one standard deviation (SD) above or below the regional average and a percentage change between 1988 and 2010 were used as the measures to assess the progress of nations. Results: There were positive significant correlations between higher CMRs and relative poverty measures in all three regions. In Western countries, the current CMRs in the USA, New Zealand and Canada were 1 SD below the Western mean. The narrowest income inequalities, apart from Japan, were seen in the Scandinavian nations alongside low CMRs. In Asia, the current CMRs in Pakistan, Myanmar and India were the highest in their region and were 1 SD below the regional mean. Alongside South Korea, these nations had the lowest percentage reductions in CMRs. In Sub-Saharan Africa, the current CMRs in Somalia, Burkina Faso, Sierra Leone, Chad, Democratic Republic of Congo and Angola were the highest in their region and were 1 SD below the regional mean. Conclusions: Those concerned with the pursuit of social justice need to alert their societies to the corrosive impact of poverty on child mortality. Progress in reducing CMRs provides an indication of how well nations are meeting the needs of their children. Further country-specific research is required to explain regional differences. [ABSTRACT FROM AUTHOR]

Breast density notification laws, passed in 19 states as of October 2014, mandate that patients be informed of their breast density. The purpose of this study is to assess the impact of this legislation on radiology practices, including performance of breast cancer risk assessment and supplemental screening studies. A 20-question anonymous web-based survey was emailed to radiologists in the Society of Breast Imaging between August 2013 and March 2014. Statistical analysis was performed using Fisher's exact test. Around 121 radiologists from 110 facilities in 34 USA states and 1 Canadian site responded. About 50% (55/110) of facilities had breast density legislation, 36% of facilities (39/109) performed breast cancer risk assessment (one facility did not respond). Risk assessment was performed as a new task in response to density legislation in 40% (6/15) of facilities in states with notification laws. However, there was no significant difference in performing risk assessment between facilities in states with a law and those without (p < 0.831). In anticipation of breast density legislation, 33% (16/48), 6% (3/48), and 6% (3/48) of facilities in states with laws implemented handheld whole breast ultrasound ( WBUS), automated WBUS, and tomosynthesis, respectively. The ratio of facilities offering handheld WBUS was significantly higher in states with a law than in states without (p < 0.001). In response to breast density legislation, more than 33% of facilities are offering supplemental screening with WBUS and tomosynthesis, and many are performing formal risk assessment for determining patient management. [ABSTRACT FROM AUTHOR]

The article discusses a study which aimed to determine the role of religious involvement and related indicators such as religious coping, intrinsic religiosity and forgiveness in reducing the negative impact of early traumatic stress on the mental and physical health of adult survivors.

We surveyed researchers in the health and exercise sciences to explore different areas and magnitudes of bias in researchers’ decision making. Participants were presented with scenarios (testing a central hypothesis withp = .06 orp = .04) in a random order and surveyed about what they would do in each scenario. Participants showed significant bias in deciding to randomize additional participants whenp = .06 (24.5%) compared to whenp = .04 (6.5%),χ2 = 19.86, odds ratio (OR) = 13.5. Based on this bias to randomize additional participants, we present statistical simulations showing the cumulative negative effect this bias has on the false positive rate for a field. While it is important for researchers to have flexibility in their data-processing decisions, there is a cost/benefit trade-off to experimenter degrees of freedom and it is important that these decisions be unbiased. These data highlight the importance of a priori analysis plans in research. [ABSTRACT FROM PUBLISHER]

Objective: Most health professions recognize the value of evidence-based practice (EBP), yet the uptake of EBP across most health disciplines has been suboptimal. To improve EBP uptake, it is important to first understand the many dimensions that affect EBP use. The Evidence-Based practice Attitude and utilization SurvEy (EBASE) was designed to measure the attitudes, skills, and use of EBP among practitioners of complementary and alternative medicine (CAM); however, the dimensionality of the instrument is not well understood. The aim of the current research was to examine the psychometric properties of the attitudes, skills, and use subscales of EBASE. Design: This was a secondary analysis of data obtained from the administration of EBASE. Data were examined using principal components analyses and confirmatory methods. Internal consistency reliabilities of resultant subscales were also computed. Participants: 1314 U.S. chiropractors and 554 Canadian chiropractors. Results: A unidimensional structure best fit the attitudes and use subscales. Skills subscale items were best represented by subscales with a multidimensional structure. Specifically, the skills construct was best modeled with three dimensions (identification of the research question, locating research, and application of EBP). All subscales had acceptable internal consistency reliability estimates. Conclusions: The findings support the modification of the scoring guidelines for the original EBASE. These changes are likely to result in a more accurate measure of EBP attitudes, skills, and use among chiropractors, and possibly CAM providers more generally. [ABSTRACT FROM AUTHOR]

Background: Childhood acquired brain injuries can disrupt communication functions needed for success in school, work and social interaction. Cognitive-communication difficulties may not be apparent until adolescence, when academic, environmental and social-emotional demands increase. Objective: The Functional Assessment of Verbal Reasoning and Executive Strategies for Students (S-FAVRES) is a new activity-level measure of cognitive-communication skills in complex, contextual and integrative tasks that simulate real world communication challenges. It is hypothesized that S-FAVRES performance would differentiate adolescents with and without acquired brain injury (ABI) on scores for Accuracy, Rationale, Reasoning Subskills and Time. Methods: S-FAVRES was administered to 182 typically-developing (TD) and 57 adolescents with mild-to-severe ABI aged 12–19. Group differences, internal consistency, sensitivity, specificity, reliability and contributing factors to performance (age, gender, brain injury) were examined statistically. Results: Those with ABI attained statistically lower Accuracy, Rationale and Reasoning sub-skills scores than their TD peers. Time scores were not significantly different. Performance trends were consistent across tasks, administrations, gender and age groups. Inter-rater reliability for scoring was acceptable. Conclusion: The S-FAVRES provides a reliable, functional and quantifiable measure of subtle cognitive-communication difficulties in adolescents that can assist speech-language pathologists in planning treatment and integration to school and real world communication. [ABSTRACT FROM AUTHOR]

Background: There is growing interest in designing cities that support not only walking, but also cycling. Bike Score® is a metric capturing environmental characteristics associated with cycling that is now available for over 160 US and Canadian cities. Our aim was to determine if Bike Score was associated with between and within-city variability in cycling behavior. Methods: We used linear regression to model associations between Bike Score and journey to work cycling mode share (US: American Community Survey, 2013 or 2012 5-year estimates; Canada: 2011 National Household Survey) for 5664 census tracts in 24 US and Canadian cities. Results: At the city level, the correlation between mean Bike Score and mean journey to work cycling mode share was moderate (r = 0.52). At the census tract level, the correlation was 0.35; a ten-unit increase in Bike Score was associated with a 0.5 % (95 % CI: 0.5 to 0.6) increase in the proportion of population cycling to work, a meaningful difference given the low modal shares (mean = 1.9 %) in many North American cities. Census tracts with the highest Bike Scores (>90 to 100) had mode shares 4.0 % higher (β =4.0, 95 % CI: 2.9 to 5.0) than the lowest Bike Score areas (0-25). City specific analyses indicated between-city variability in associations, with regression estimates between Bike Score and mode share ranging from 0.2 to 3.5 %. Conclusions: The Bike Score metric was associated bicycle mode share between and within cities, suggesting its utility for planning bicycle infrastructure. [ABSTRACT FROM AUTHOR]

Background. The attainment of walking is a focus of physical therapy intervention in children with cerebral palsy (CP) and may affect their independence in mobility and participation in daily activities. However, knowledge of determinants of independent walking to guide physical therapists' decision making is lacking. Objective. The aim of this study was to identify child factors (postural control, reciprocal lower limb movement, functional strength, and motivation) and family factors (family support to child and support to family) that predict independent walking 1 year later in young children with CP at Gross Motor Function Classification System (GMFCS) levels II and III. Design. A secondary data analysis of an observational cohort study was performed. Methods. Participants were 80 children with CP, 2 through 6 years of age. Child factors were measured 1 year prior to the walking outcome. Parent-reported items representing family factors were collected 7 months after study onset. The predictive model was analyzed using backward stepwise logistic regression. Results. A measure of functional strength and dynamic postural control in a sit-to-stand activity was the only significant predictor of taking ≥3 steps independently. The positive likelihood ratio for predicting a "walker " was 3.26, and the negative likelihood ratio was 0.74. The model correctly identified a walker or "nonwalker " 75% of the time. Limitations. Prediction of walking ability was limited by the lack of specificity of child and family characteristics not prospectively selected and measurement of postural control, reciprocal lower limb movement, and functional strength 1 year prior to the walking outcome. Conclusions. The ability to transfer from sitting to standing and from standing to sitting predicted independent walking in young children with CP. Prospective longitudinal studies are recommended to determine indicators of readiness for independent walking. [ABSTRACT FROM AUTHOR]

Objective: Despite growing adoption, the impact of prehospital initiation of therapeutic hypothermia on outcomes of cardiac arrest patients is unknown. The objective of this study was to determine if prehospital administration of cold intravenous fluids improved the time-to-target temperature.Methods: All patients enrolled in an institutional post– cardiac arrest treatment pathway were prospectively registered into a quality assurance database. Patients undergoing cooling induction on hospital arrival were compared to those receiving a new treatment protocol initiated during the study period involving prehospital cooling with 4°C (39.2°F) normal saline. The primary outcome was the time-to-target temperature. Secondary outcomes included emergency medicine system transport time metrics, mortality, and neurologic status at discharge and 1 year.Results: One hundred thirty-two patients were enrolled during the study period. The initial rhythm was ventricular fibrillation/tachycardia in 63% and asystole/pulseless electrical activity in 36%. Eighty patients received prehospital cooling and 52 patients did not and comprised the historical control group. Time-to-target temperatures were not significantly different between prehospital and hospital cooled groups (256 v. 271 minutes, respectively, p=0.64), nor was there any improvement in hospital survival (54% v. 50%, p=0.67), good neurologic outcome (49% v. 44%, p=0.61), or 1- year survival (49% v. 42%, p=0.46) between the two groups. Transport times were longer in the prehospital cooled group.Conclusions: Out-of-hospital cardiac arrest patients treated with prehospital cooling before arrival at our urban hospital did not have faster time-to-target temperature or improvement in outcomes compared to patients cooled immediately on emergency department arrival. Further research is needed to determine if any benefits exist from prehospital cooling prior to its widespread adoption. [ABSTRACT FROM PUBLISHER]

Objective: To test a model of child, family and service determinants of self-care participation of children with cerebral palsy (CP), grouped by Gross Motor Function Classification System levels (I-II and III-V). Methods: Participants were a convenience sample of 429 children (242 males) with CP, aged 18-60 months. Data on impairments and gross motor function were collected by reliable therapists; parents provided information about children's health conditions and adaptive behaviour. Seven months later parents reported on family life and services received. One year after study onset, parents documented children's self-care participation. Data from two groups of children were analysed using structural equation modelling. Results: The model explained a significant proportion of the variance of self-care participation, with higher motor function, fewer health conditions and higher levels of adaptive behaviour being associated with greater self-care participation. Conclusion: Supporting children's gross motor function, health and adaptive behaviour may optimize self-care participation. [ABSTRACT FROM AUTHOR]

Objectives: Validity of the Early Clinical Assessment of Balance (ECAB), to monitor postural stability in children with cerebral palsy (CP), was evaluated. Methods: 410 children with CP, 1.5 to 5 years old, participated. Physical therapists scored children on the Movement Assessment of Infants Automatic Reactions section and Pediatric Balance Scale. Through consensus, researchers selected items from both measures to create the ECAB. Content and construct validity were examined through item correlations, comparison of ECAB scores among motor ability, age and gender groups and correlations with the Gross Motor Function Measure 66 basal and ceiling (GMFM-66-B&C). Results: Internal consistency was high (Cronbach's alpha = 0.92). ECAB differed significantly among motor ability, children <31 months old scored lower than older children, but there was no difference between boys and girls. ECAB and GMFM-66-B&C scores correlated strongly ( r = 0.97). Conclusion: Validity of the ECAB was supported. Reliability and responsiveness need study. [ABSTRACT FROM AUTHOR]

This study aimed to assess the communicative skills of children and young adults with ring 14 syndrome and linear 14q deletions, investigating the relationships among their language development and their genetic, clinical, psychomotor and behavioural characteristics. Participants were 36 individuals with chromosome 14 aberrations whose parents completed a questionnaire, specifically developed in five languages, to assess their son's/daughter's development. Data analysis showed that chronological age does not account for the high individual variability found in the participants' skills. The comparison between participants with ring 14 syndrome and participants with 14q linear deletions showed that the former were characterised by a higher occurrence of epilepsy, abnormalities of the retina and autism. The participants with smaller amounts of deleted genetic material were those who had a higher level of language development. Because ring 14 syndrome is a rare genetic disease, the collection of data from a large group of individuals could be helpful to create expectations about the possible developmental outcomes of these children. [ABSTRACT FROM AUTHOR]

Recent acceleration in development of computerized neuropsychological tests and test batteries has led to gains in sophistication, intuitiveness, and capability with concomitant opportunities for greater adoption among practitioners. Advantages attributed to computerized methods (e.g., standardization, large-scale screening, measurement of performance attributes inaccessible by traditional means) enhance prospects for growth. Despite technological improvement and potential benefit to neuropsychological assessment, the regularity with which neuropsychologists utilize computer-based methods remains unsettled. As part of a 10-year follow-up study of neuropsychological test usage practices, we surveyed neuropsychologists' utilization of computerized instruments and investigated practice-related factors that influence computerized test adoption. Respondents were 512 doctorate-level psychologists residing in the United States and Canada (26% usable response rate; 54% female) affiliated with the National Academy of Neuropsychology or the International Neuropsychological Society. Of the 693 distinct instruments reported by respondents, only 6% (n = 40) were computerized, and the average respondent reported rarely using computerized tests. We present the top-ranked computerized instruments and results of correlational analyses, which indicate that fewer years practicing and the youth of respondents associates with increased likelihood of computerized test utilization, along with increased utilization of neuropsychological tests with alternative or parallel forms. Implications for existing and emerging technologies in research and clinical settings are considered. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of research evidence to guide health care providers' practice in pediatric palliative care. At the same time, some clinicians and Institutional Review Boards are reluctant to approve such studies because of concerns about further burdening families. Yet, there is some evidence that research participation can have positive effects for families. Objective: To obtain parents' perceptions about their experience of participating in one of two research studies. Design: Descriptive, quantitative survey. Setting/Subjects: Caregivers of children with life-threatening conditions ( n=323) who were caring for the child at home. Measurements: Researcher-designed Impact of Participation questionnaire. Results: Few differences between the two groups were found on Impact responses. Not a single parent reported regretting participating in their study and almost all (96.3%) reported that conducting research about family's experiences in pediatric palliative care had value. Just over three-quarters (76.2%) did not find participation at all painful, and 73.7% reported that participation was about as painful as expected, with 23.2% reporting less painful. Approximately half (50.5%) said that participation had at least some positive effect and only three parents reported any negative effect. An overwhelming majority (93.4%) would recommend participation to other parents in a similar situation. Conclusions: Participation in research for families with children who have a life-threatening condition is not only acceptable to parents, but may in fact have a positive effect. Although clinicians and Institutional Review Boards may be hesitant to fully support such research, it is clear that conducting research in the field of pediatric palliative care is important. [ABSTRACT FROM AUTHOR]

The willingness of male-male dyads to use couples voluntary HIV counseling and testing (CVCT) has not been previously investigated globally among men who have sex with men (MSM). Using online advertisements, data were collected from 3245 MSM in seven countries who were ≥18 years of age and had ≥1 male sex partner in the previous 12 months. The analysis examined associations between individual characteristics and willingness to utilize CVCT. The willingness to utilize CVCT was compellingly high, ranging from 79% in Australia and UK to 90% in Brazil. Older MSM and those who reported not knowing their sero-status reported lower odds of willingness to use CVCT. The relationship between being in a relationship and willingness to use CVCT varied across countries, perhaps reflecting varied local understandings of the nature and content of CVCT. Further work is required to examine willingness to use CVCT among a more heterogeneous population of MSM, and to examine how CVCT services are locally perceived in order to provide information vital for the development of locally appropriate messages to promote CVCT for MSM. [ABSTRACT FROM PUBLISHER]

Objectives. (1) To develop two independent measurement scales for use as items assessing hand movements and hand activities within the Motor Assessment Scale (MAS), an existing instrument used for clinical assessment of motor performance in stroke survivors; (2) To examine the psychometric properties of these new measurement scales. Design. Scale development, followed by a multicenter observational study. Setting. Inpatient and outpatient occupational therapy programs in eight hospital and rehabilitation facilities in the United States and Canada. Participants. Patients (N = 332) receiving stroke rehabilitation following left (52%) or right (48%) cerebrovascular accident; mean age 64.2 years (sd 15); median 1 month since stroke onset. Intervention. Not applicable. Main Outcome Measures. Data were tested for unidimensionality and reliability, and behavioral criteria were ordered according to difficulty level with Rasch analysis. Results.The new scales assessing hand movements and hand activitiesmet Rasch expectations of unidimensionality and reliability. Conclusion. Following a multistep process of test development, analysis, and refinement, we have redesigned the two scales that comprise the hand function items on the MAS.The hand movement scale contains an empirically validated 10-behavior hierarchy and the hand activities item contains an empirically validated 8-behavior hierarchy. [ABSTRACT FROM AUTHOR]

The moderating role of decision latitude on the relationship between work-family conflict and psychological strain was examined across five countries. It was hypothesised that decision latitude would moderate the relationship more strongly in the individualistic countries (the United States and Canada) than in the collectivistic countries ( India, Indonesia, and South Korea). The results supported the hypotheses of this five-country-based cross-national investigation. The implications of the findings for theory and practice in the area of international and cross-cultural research on work and family conflicts in the organisational context are discussed. [ABSTRACT FROM AUTHOR]

Objective: To identify problematic work tasks involving cognitive function in employed brain tumor survivors. Methods: Work tasks involving cognitive functions were compared between employed brain tumor survivors (n = 137) and a disease-free group (n = 96). Multivariable logistic regressions were conducted. Results: In the brain tumor survivors, 44% (26/59) of work tasks were more likely to be problematic. Top five problematic work tasks included were as follows: following the flow of events (odds ratio [OR] = 11.72; 95% confidence interval [Cl] = 3.19 to 43.07), remembering train of thought while speaking (OR = 11.70; 95% CI = 5.25 to 26.10), putting together materials for a task (OR = 10.90; 95% CI = 2.80 to 42.38), shifting between tasks (OR = 10.71; 95% CI = 3.62 to 31.74), and following written instructions (OR = 9.96; 95% CI = 2.65 to 37.41). Conclusion: Findings identified problematic work tasks involving major domains of cognitive function. [ABSTRACT FROM AUTHOR]

My purpose in this study was to explore the concepts of health and the health promotion process among Korean women who migrated to North America for their children's education. Interviews and surveys were analyzed using a grounded theory analysis and descriptive statistics. Women in this study established their health concept and health promotion process in accordance to their socially constructed mother role. The women established unique meanings of health and developed an altruistic motivation to be healthy that allowed them to actively pursue health promotion despite their traditional care provider roles. [ABSTRACT FROM AUTHOR]

Some research suggests that the risk of physical aggression by an intimate partner is related to marital status, but this relationship may vary across cultures and by gender. In the present study, we systematically examine the relationship between marital status and physical partner aggression by gender across 19 countries. Logistic and multilevel regression confirmed previous findings of lower rates of physical aggression for legally married versus cohabiting and separated/divorced women and men across most, but notably, not all countries. Single status was associated with higher risk in some countries and lower in others reflecting possible cultural differences in risk for different marital statuses. For example, single women had significantly lower rates of victimization than did married women in India where violence against wives is often accepted. The variation in the cross-cultural findings highlights the importance of examining both men and women and considering the cultural context when interpreting the relationship between partner aggression and marital status. [ABSTRACT FROM AUTHOR]

Objectives To determine the effect of advancing age on the clinical outcomes of Clostridium difficile ( CDI) treatment. Design Regression modeling of results from two double-blind randomized multicenter studies on the treatment of primary and first recurrent cases of CDI to examine for effects of age and study drug on outcomes of cure (resolution of diarrhea), recurrence within 4 weeks of completing successful therapy, and cure without recurrence. Setting Participants were randomized into studies in the United States, Canada, and Europe. Participants Nine hundred ninety-nine individuals with toxin-positive CDI were randomized to receive vancomycin (125 mg 4 times daily) or fidaxomicin (200 mg twice daily) for 10 days. Measurements The effect of advancing age in those aged 18 to 40 years and in 10-year increments thereafter was examined. Results The model predicts a 17% lower clinical cure, 17% greater recurrence, and 13% lower sustained clinical response by advancing decade than in those younger than 40 ( P < .01 each). Clinical cure was similar in the fidaxomicin and vancomycin treatment groups, although fidaxomicin was associated with a more than 50% lower relative risk for recurrence than vancomycin ( P < .001). Multivariate regression modeling showed that risk factors accounting for poorer outcomes with advancing age include infection with the BI strain type, inpatient status, renal insufficiency, leukocytosis, hypoalbuminemia, and concomitant medication exposure. Conclusion Measurable and progressive deterioration in CDI treatment outcomes occurred with advancing age in those aged 40 and older, highlighting the need for prevention and treatment strategies. Fidaxomicin treatment was associated with a 60% lower risk of recurrence than vancomycin after adjusting for age, concomitant antibiotics, and C. difficile strain. [ABSTRACT FROM AUTHOR]

Background Although on the decline, smoking-related fires remain a leading cause of fire death in the United States and United Kingdom and account for over 10% of fire-related deaths worldwide. This has prompted lawmakers to enact legislation requiring manufacturers to implement reduced ignition propensity (RIP) safety standards for cigarettes. The current research evaluates how implementation of RIP safety standards in different countries influenced smokers' perceptions of cigarette self-extinguishment, frequency of extinguishment, and the impact on consumer smoking behaviors, including cigarettes smoked per day and planning to quit. Methods Participants for this research come from Waves 3 through 8 of the International Tobacco Control (ITC) Four Country Survey conducted longitudinally from 2004 through 2011 in the United States, United Kingdom, Australia, and Canada. Results Perceptions of cigarette self-extinguishment and frequency of extinguishment increased concurrently with an increase in the prevalence of RIP safety standards for cigarettes. Presence of RIP safety standards was also associated with a greater intention to quit smoking, but was not associated with the number of cigarettes smoked per day. Intention to quit was higher among those who were more likely to report that their cigarettes self-extinguish sometimes and often, but we found no evidence of an interaction between frequency of extinguishment and RIP safety standards on quit intentions. Conclusions Overall, because these standards largely do not influence consumer smoking behavior, RIP implementation may significantly reduce the number of cigarette-related fires and the associated death and damages. Further research should assess how implementation of RIP safety standards has influenced smoking-related fire incidence, deaths, and other costs associated with smoking-related fires. [ABSTRACT FROM AUTHOR]

The aging population is recognized by many as a unique global phenomenon and has become a subject of interest among multidisciplinary professionals. Perhaps one of the most common key concerns among individuals and family members in many countries today is to meet the increasing demand for elderly healthcare, particularly the real challenges and crisis in old age morbidity and health. As the socioeconomic, demographic and cultural context of populations. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the prevalence of harassment in high school and into university, and the impact of one particular form of harassment: cyber-harassment. Participants were 1,368 students at one US and two Canadian universities (mean age = 21.1 years, 676 female students). They responded on five-point scales to questions about the frequency and impact of harassment. A total of 33.6% of students stated they had been cyber-harassed and 28.4% had been harassed off-line when in high school. Also, 8.6% were cyber-harassed and 6.4% were harassed off-line while in university. Hierarchical logistic regression analyses show that the type of harassment experienced in high school is associated with the type of harassment experienced in university. Various negative outcomes of cyber-harassment were also identified. [ABSTRACT FROM PUBLISHER]

Objective The goal of the study was to systematically review available evidence regarding differences in injury incidence between rural and urban paediatric populations in Canada and the USA. Data source Eight electronic databases, institutional websites and reference lists of relevant studies including published and unpublished reports. Selection criteria Population-based observational studies or surveys published from 1970 to February 2011 that compared injury incidence or injury-related healthcare outcomes between rural and urban children (<18) living in Canada or the USA. Data collection and analysis Two reviewers independently applied selection criteria and assessed methodological quality of studies. Data were extracted by one author and independently verified by the second author. Injury rate ratios for rural and urban children were extracted or calculated. Data were synthesised descriptively due to substantial heterogeneity among studies. Results A total of 41 studies were included for this review (seven surveys and 34 studies using administrative health databases). Internal validity of included studies was moderate. Rural children were at higher risk of overall injury, motor vehicle crash injury and suicide, whereas urban children in the USA experienced higher rates of firearm-related homicides. Greater rural-urban injury disparities were likely to be found between more extreme rural and urban areas. In particular, children in remote rural areas are at increased risk of severe injuries than urban counterparts. Overall, healthcare costs per child for injury were higher for rural children. Conclusion These findings indicate the need of developing geographic area-specific injury-prevention strategies. Future research is required to investigate rural-urban disparity for less-studied injuries and related health outcomes (eg, disability). Systematic review registration number CRD42011001244 (PROSPERO 2011). [ABSTRACT FROM AUTHOR]

Social work faculty's attitudes contribute to creating inclusive and productive classroom climates when discussing racism, sexism, and heterosexism. Little is known about faculty's attitudes toward marginalized groups and the intersection of these attitudes with religion. This study describes social work faculty's attitudes about people of Color, women, and lesbian and gay people, and the relationship among these attitudes, religious affiliation, and religiosity. Results indicate religiosity predicts less accepting attitudes towards lesbian and gay people for Christian faculty; religious affiliation and religiosity did not predict attitudes towards women or people of Color. Intergroup dialogue is recommended for social work faculty learning. [ABSTRACT FROM PUBLISHER]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

Limited previous literature on peers influenced by students with problems of professional competence has descriptively focused on rates of peer identification and actions in response to identification. Prior research has suggested that students who exhibit diminished functioning due to life Stressors or psychological distress may be qualitatively different than students who lack the capacity to ever perform the duties of a competent professional psychologist. Thus, the current study explored peer perceptions of various problems that graduate students in professional psychology might experience. A survey given to a cross-section of clinical psychology doctoral-level students found that (a) awareness of policies regarding identification of problem students is associated with degree of faith in faculty effectiveness in handling student issues, (b) students differently perceived trait problems (e.g., lack of self-awareness, immaturity) from externalizing psychopathology (e.g., drug and alcohol problems) and other indices of psychological distress (e.g., anxiety, depression, financial strain), and (c) peers who are seen as lacking capacity to achieve competence are perceived less sympathetically and are recommended for different remediation strategies compared with students with diminished functioning. Implications for program policies and the function of graduate programs as gatekeepers are discussed. [ABSTRACT FROM AUTHOR]