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This study focused on how adopted adults who have reunited with at least one birth family member experienced identity shifts related to their original birth certificates (OBCs). Framed by the Communication Theory of Identity (CTI), 50 adopted adults discussed their experiences related to their OBCs and how their identities are connected to this symbol through three of the layers of CTI, the personal, enacted, and relational layers. Participants discussed the presence of an ambiguous and unsolvable identity that interpenetrated with their other identity layers. Findings extend CTI to include an additional layer for adoptees – phantom identity – which can explain the life adoptees would have lived had they not been adopted. This identity was salient for participants as it manifested in ways such as expressing frustration with obstacles in gaining access to their OBC and refocusing their professional life to support other adopted adults. Moreover, findings offer implications for the examination into current adoption record practices in the United States, additional state mutual consent registries, and increased access to adoption-competent counselors for adoptees. [ABSTRACT FROM AUTHOR]

Background: Incarcerated trans women experience significant victimization, mistreatment, barriers to gender-affirming care, and human rights violations, conferring high risk for trauma, psychological distress, self-harm, and suicide. Across the globe, most carceral settings are segregated by sex assigned at birth and governed by housing policies that restrict gender expression—elevating ‘safety and security’ above the housing preferences of incarcerated people. Aim/methods: Drawing upon the lived experiences of 24 formerly incarcerated trans women in Australia and the United States and employing Elizabeth Freeman’s notion of chrononormativity, Rae Rosenberg’s concept of heteronormative time, and Kadji Amin’s use of queer temporality, this paper explores trans women’s carceral housing preferences and contextual experiences, including how housing preferences challenge governing chrononormative and reformist carceral housing systems. Findings: Participants freely discussed their perspectives regarding housing options which through thematic analysis generated four options for housing: 1) men’s carceral settings; 2) women’s carceral settings; 3) trans- and gay-specific housing blocks; and 4) being housed in protective custody or other settings. There appeared to be a relationship between the number of times the person had been incarcerated, the duration of their incarceration, and where they preferred to be housed. Conclusions: This analysis contributes to richer understandings regarding trans women’s experiences while incarcerated. This paper also informs the complexities and nuances surrounding housing preferences from the perspectives of trans women themselves and considers possible opportunities to enhance human rights, health and wellbeing when engaging in transformative approaches to incarceration. [ABSTRACT FROM AUTHOR]

This paper addresses the experiences of US child welfare professionals during the COVID pandemic. Using an online survey, we report on a convenience sample of 444 child welfare workers. The majority reported receiving adequate guidance on staying safe; 86.3% were given access to face masks. Workers reported 75.8% of clients used masks; 10.7% reported contracting COVID through work. About 80% worried that child clients were more at-risk. Workers who felt the most supported and least at-risk were those with stay-at-home orders. Results are discussed in terms of supporting child welfare professionals during periods of crisis. [ABSTRACT FROM AUTHOR]

In this paper, we present findings from four separate studies using different data sources and methods to examine Chinese attitudes toward the United States amid the COVID-19 pandemic. The empirical results consistently indicate a marked and significant decline in Chinese attitudes toward the US between late 2019 and the end of 2022. Using a quasi-experimental design and granular survey data that exploit daily variations in public opinion, we offer additional evidence that the decline in Chinese attitudes toward the United States followed a distinct pattern not true for Chinese attitudes toward other countries. Specifically, the rise in Chinese unfavorability toward the United States closely corresponded to the heightened Chinese attention to the pandemic's progression in the United States. These results collectively suggest a causal effect of COVID-19, shedding light on how public health crises, international relations, and media jointly shape the increasing enmity between the two great powers. [ABSTRACT FROM AUTHOR]

Earlier pubertal onset has been associated with increased disordered eating symptoms in cisgender girls. Although this finding has been replicated across studies of disordered eating, most studies have focused on white samples. The lack of studies is surprising given that early pubertal timing may impact disordered eating risk in Black and Latinx girls differently due to trends of earlier pubertal onset in these groups and increased stressors related to interpersonal and structural racism and economic marginalization. Current methods of examining pubertal timing among Black and Latinx girls may also not fully capture their experience. Contextual factors (e.g., neighborhood and school racial/ethnic composition) may influence how minoritized girls both perceive and are affected by their pubertal timing. Moreover, factors such as ethnic–racial identity development and experiences of discrimination may be important mechanisms explaining the association between pubertal timing and disordered eating risk. This paper aims to provide a brief overview of studies examining pubertal timing and disordered eating risk among Black and Latinx girls in the US and to discuss recommendations for future research that integrate contextual factors in the examination of pubertal timing and its effects. Public significance: Early pubertal timing has been associated with increased risk of disordered eating symptoms among cisgender girls; however, studies have been limited due to the use of predominantly white samples. The article provides a brief overview of findings related to pubertal timing effects among Black and Latinx girls, discusses considerations for the measurement of pubertal timing, and highlights the need for inclusion of contextual factors in future research. [ABSTRACT FROM AUTHOR]

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

ABSTRACT BACKGROUND The Healthy, Hunger-Free Kids Act of 2010 ( HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing the changes. METHODS Food service directors from rural school districts were invited to complete a semistructured telephone interview and online survey. A total of 51 respondents completed both, 6 completed only the online survey, and 16 completed only the telephone interview. Qualitative interview data were analyzed through open thematic coding; descriptive statistics were calculated for the quantitative data. RESULTS Food service directors mostly perceived the changes as negative, challenging, and burdensome. They believed that the changes resulted from concern about childhood obesity, which they did not view as a problem for their students. Diverse challenges were reported related to cost, preparation, and student preference. CONCLUSIONS Food service directors in isolated, rural areas need support to enhance understanding of HHKA requirements, build professional networks to learn from one another, and communicate with students, families, and other stakeholders. Future efforts should focus on changing perceptions and supporting directors in order to make implementation a success. [ABSTRACT FROM AUTHOR]

Aims: A discussion of the personal and social contexts for Millennial family caregivers and the value of including complex identity and intersectionality in Millennial family caregiving research with practical application. Design: Discussion paper. Data sources This discussion paper is based on our own experiences and supported by literature and theory. Implications for Nursing: Millennial family caregivers have distinct generational, historical and developmental experiences that contribute to the care they provide as well as their own well‐being. Complex identity, the integration of multiple identities, and intersectionality, systems and structures that disempower and oppress individuals with multiple identities, need to be addressed in nursing research so intervention tailoring and health equity can be better supported in this population. From research conceptualization and design to data analysis, data must be used intentionally to promote equity and reduce bias. The inclusion of diverse Millennial caregivers throughout all stages of the research process and having a diverse nursing research workforce will support these efforts. Conclusion: Millennial family caregivers comprise one‐quarter of the family caregiving population in the United States, and they are more diverse than previous family caregiving generational cohorts. Their needs will be more fully supported by nursing scientists with the adoption of methods and techniques that address complex identity and intersectionality. Impact: Nursing researchers can use the following research approaches to address complex identity and intersectionality in Millennial caregivers: inclusion of qualitative demographic data collection (participants can self‐describe); data disaggregation; data visualization techniques to augment or replace frequencies and descriptive statistics for demographic reporting; use of researcher reflexivity throughout the research process; advanced statistical modelling techniques that can handle complex demographic data and test for interactions and differential effects of health outcomes; and qualitative approaches such as phenomenology that centre the stories and experiences of individuals within the population of interest. [ABSTRACT FROM AUTHOR]

On January 6th, 2021, Donald Trump's speech during a 'Save America' rally was followed by mass violence, with Trump's supporters storming the U.S. Capitol to prevent the certification of Joe Biden's victory in the presidential election. In its wake, there was a great deal of debate around whether the speech contained direct instructions for the subsequent violence. In this paper, we use a social identity perspective on leadership (and more specifically, on toxic leadership) to analyse the speech and see how its overall argument relates to violence. We show that Trump's argument rests on the populist distinction between the American people and elites. He moralises these groups as good and evil respectively and proposes that the very existence of America is under threat if the election result stands. On this basis he proposes that all true Americans are obligated to act in order prevent Biden's certification and to ensure that the good prevails over evil. While Trump does not explicitly say what such action entails, he also removes normative and moral impediments to extreme action. In this way, taken as a whole, Trump's speech enables rather than demands violence and ultimately it provides a warrant for the violence that ensued. [ABSTRACT FROM AUTHOR]

Public libraries in the United States (U.S.) are important sources of health information. Immigrants comprise a large portion of the U.S. population, and research suggests that public libraries help immigrants adjust to life in a new country. Public libraries help immigrants access information directly related to health and provide programs that have indirect impacts on health outcomes, including learning a new language and forging social ties. The purpose of this paper was to examine perspectives from librarians related to interactions with immigrant patrons and how their library supports them in this role. Public librarians (n = 205) from two selected U.S. states completed an online survey focusing on how comfortable they were in helping immigrants with inquiries related to health and the role of the public library in supporting librarians in this endeavor. Respondents generally reported high levels of comfort interacting with immigrants, although there was limited interaction on potentially sensitive topics (i.e., immigration, health). Library staff perceived that libraries overall were not effective in meeting the needs of immigrant populations and that librarians were infrequently offered professional training related to cultural competency and diversity. The findings echo previous studies that demonstrate the need for professional development to ensure that librarians are aware of library resources available to assist immigrant patrons. Findings from this study suggest opportunities for public health professionals and public librarians to collaborate to ensure the provision of reliable resources, health information, and referrals to community-based services. [ABSTRACT FROM AUTHOR]

Background: As of 2017, American Indian/Alaska Natives (AI/AN) had the highest prevalence of illicit drug use of any ethnic group in the United States, with 17.6% of the population aged 12 and older reporting using illicit drugs in the last month. Studies have shown the positive correlation between a history of trauma and substance use disorder. In fact, the majority of youth in treatment for substance misuse reported a history of trauma. Intergenerational trauma, systematic discrimination, and displacement are downstream effects of colonization, and experiences of racism often define the life experiences of AI/ANs who use substances. This paper describes the process of designing a developmentally and culturally appropriate primary prevention supplement for an evidence‐based program to prevent substance use and increase cultural identity among AI/AN youth. [ABSTRACT FROM AUTHOR]

Neutrality in librarianship is a nonsensical concept that libraries of all kinds (e.g., public, academic, special, etc.) should not strive to embody in any shape or form. The following paper investigates the intricate relationships between neutrality and racism as they are demonstrated by tangible and intangible forms in library and information science (LIS) spaces. Ian Williams' book chapter, "More Than Half of Americans Can't Swim", from his book, Disorientation: Being Black in the World (2021), is utilized to critically reflect on Blackness as identity and some ways in which antiracist practices clash with neutrality within LIS spaces. I conclude with urgent reminders of how detrimental neutrality can be if it is not thoroughly rooted out and supplanted with antiracist practices that the LIS field is in dire need of. [ABSTRACT FROM AUTHOR]

Abortion is a common medical procedure in the United States that is frequently the target of political and legal restrictions. These restrictions can negatively impact care and interfere with the patient-provider relationship. In this paper, we aim to review the historic context in which feticidal agents became more utilized in later abortion; describe current practices and protocols of using feticidal agents use for later abortion by dilation and evacuation and induction of labor; evaluate patient and provider perspectives on feticidal agent use; and propose areas of further ethical and research inquiry to characterize the use of these agents in later abortion procedures. [ABSTRACT FROM AUTHOR]

This article maps and compares four universities' policies and procedures for addressing faculty and staff sexual misconduct in higher education in the UK and US. While universities have engaged in significant work to grapple with student-student sexual misconduct, attention to misconduct perpetrated, and experienced, by higher education employees is relatively nascent. In this paper, we explore the maze of institutional processes and actors that victimsurvivors of FASSM might encounter. We describe what is known about prevalence of FASSM in the US and UK and offer an overview of the policy landscape in both settings. Inspired by Patricia Yancey Martin, we analyze publicly available policy documents on FASSM from two US and two UK universities and map out visually the range of investigative, reporting, and sanctioning processes. We introduce an analytic distinction between an actor and a practitioner within the FASSM context, whereby actors are those tasked with administrative duties in handling sexual misconduct reports, while practitioners are those with specialized knowledge and training that enables them to prioritize victim-survivor needs. These illustrative diagrams suggest that while university employees are tasked to act on reports and disclosures of sexual misconduct, it is difficult to identify specialist practitioners with expertise to support victim-survivors of FASSM. Ultimately, this work provides a deeper understanding of what practice looks like in relation to higher education FASSM, and we outline implications for future research directions. [ABSTRACT FROM AUTHOR]

Objectives: In 2019 the United States experienced the largest outbreak of measles in 27 years, 19 years after the United States declared measles eliminated. The purpose of this paper was to present a population study of a measles outbreak within Orthodox Jewish communities in New York that led to the elimination of religious exemption for school mandated vaccines. Methods: Peer reviewed articles, news media, health department, and government resources were used to investigate environmental factors that led to this outbreak. State, county, and city immunization records were accessed to explore measles compliance rates before and after policy change. Results: Rockland County had low compliance rates compared to the rest of the state, and the elimination of religious exemptions raised compliance rate almost to state level. In all but one affected New York City zip codes, compliance following policy change rose to 97.95%–99.15%. Conclusions: Overall, changes in measles compliance rates reflect policy goals, but localized differences imply a need for more customized interventions for each unique community. Public health planning to promote vaccination should be sensitive to the concerns and perceptions of each community in order for health interventions to have a positive effect. [ABSTRACT FROM AUTHOR]

Consumers around the world give away billions of dollars annually in the form of voluntary payments (aka, tips) to service workers who have served them. This widespread and important economic activity varies across geographic areas within nations, but that geographic variability has been under-studied. This paper seeks to answer the question: "Are state differences in tipping attitudes and behavior attributable to state differences in motivations for tipping?" To that end, new measures of average tipping attitudes and motives in each of the states of the United States are developed, and their relationships with state tipping behaviors, as well as other theoretically relevant state-level measures, are tested. Results suggest meaningful and reliable state differences in attitudes toward and motivations for tipping, and that the latter differences underlie some, but not all, state differences in tipping behavior. [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) is highly prevalent among adults in the US and is associated with substantial personal and societal costs. Yet only a small percentage of adults with AUD initiate treatment, including those with severe AUD symptoms who are most in need of treatment. In this paper we use latent profile analysis (LPA) to describe differences in symptoms of AUD severity and alcohol-related consequences among untreated adults with severe AUD symptoms who were recruited from the community. Identification of such differences will result in better understanding of this population and will improve methods of treatment outreach. The LPAs were conducted on the baseline data of 403 (50% male, 77% White, M age = 40.74 with severe AUD recruited from the community and enrolled in a trial of an intervention designed to encourage treatment initiation. Participants reported no prior AUD treatment history. The LPAs were based on indicators of AUD severity, alcohol-related negative consequences, and self-reported intention to initiate AUD treatment. The LPAs revealed 4 profiles. Profile membership was predicted by baseline participant sex and whether they were living with a partner and was associated with baseline past 30-days alcohol consumption. The findings characterize and describe the variability among adults in the community with untreated severe AUD on variables that tend to motivate such individuals to seek treatment, which could significantly advance treatment outreach efforts. [ABSTRACT FROM AUTHOR]

The novel coronavirus (COVID-19) has spread across the United States, resulting in significant changes in almost all aspects daily life. These changes place parents at increased risk for parental burnout. Parental burnout is a chronic condition resulting from high levels of parenting-related stress due to a mismatch between the demands of parenting and the resources available for parents to meet those demands. Research on parental burnout has suggested that parents who experience burnout are more likely to engage in child abuse and neglect, placing children at risk for detrimental short- and long-term outcomes. The purpose of this paper is to review the concept of parental burnout, discuss parental burnout in the context of the current COVID-19 pandemic, and focus specifically on the effects of child maltreatment. Implications for practitioners will be discussed. [ABSTRACT FROM AUTHOR]

As the population of students identified as English learners (ELs) with disabilities grows, schools need to be preparing educators to serve this vulnerable population. This paper presents findings from an inductive analysis of interviews with teachers and administrators in one suburban district. We examine the ways teachers and administrators perceive their roles and the needs of these students. We found that teachers grapple with identifying needs of students at the intersection of English Learning and Special Education, determining how best to support them, and coordinating across programs. These struggles seem to stem from a lack of understanding and expertise. We posit that through creative collaboration, special education teachers and ELs can help each other build capacity and dispel misconceptions. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

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

Purpose: The purpose of this paper is to describe and discuss both the early implementation of a US mental health intervention for young children in the context of its introduction to a pilot site in a London borough and the progress made in establishing a randomised controlled trial (RCT). Design/methodology/approach: This paper describes an evaluation of a new intervention and the learning that followed in terms of its implementation and future evaluation. Qualitative data were collected from a range of stakeholders and practitioners through interviews and small group discussions. These interviews focussed on both of these issues, with particular reference to the proposal to conduct an RCT. Findings: The findings of this evaluation add to the evidence on how best to support new initiatives that have been introduced from other settings and countries to embed in a receiving site and the optimal timing and feasibility of conducting an RCT. At the end of the feasibility study, which took place within the year of the service being introduced and which was only open to clients for six months of this year the conclusion was that an RCT at that point was neither possible nor desirable. Over the following years, the commitment of the judiciary to examine if there was a way to make an RCT study in respect of this intervention meant that a template was established that may well have broader application. Research limitations/implications: At a time when there is an increasing demand for evidence on effective interventions this paper makes a valuable contribution to the development of RCTs in general and specifically in the family court arena. It also recommends that attention must also be paid to the time, which is needed to implement and establish interventions and then to test them. Practical implications: This paper highlights the need to establish realistic timescales not only around the implementation of initiatives but also for their evaluation. Originality/value: This study breaks new ground in considering implementation challenges in the court and children's services' context. It brings to the fore the important role of the judiciary in approving new processes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the results of an online program evaluation survey conducted in the USA in 2018 which was designed to understand how members of an enhanced multidisciplinary team (E-MDT) use the expertise of a forensic accountant (FA) in suspected cases of elder financial exploitation. Design/methodology/approach: This paper analyzes responses to an online survey from 54 E-MDT members. Narrative responses to open-ended questions were analyzed by using cross-case thematic analysis. Data from demographic questions and those with nominal response options were analyzed using descriptive statistics. Findings: Overwhelmingly, the E-MDT members described how useful the FA's expertise and subsequent detailed reports are in helping determine whether financial exploitation is taking place and providing information needed to continue an investigation and pursue criminal charges. Practical implications: The increasing longevity and sheer number of older adults present ongoing challenges in the fight to address financial exploitation. Findings suggest that FAs working with E-MDTs can help identify signs, collect evidence and help investigate cases of suspected financial abuse of older adults. The development of training programs focused on educating accountants to fill a need in a growing area of forensic accounting may be needed. Originality/value: This paper adds to the growing evidence of multidisciplinary teams as an effective model for investigating cases of financial elder exploitation by focusing specifically on the expertise of an FA. [ABSTRACT FROM AUTHOR]

Syringe service programs (SSP) increasingly serve rural areas of the United States, yet little is known about access and perceived need for their services. Objectives: This paper presents the HIV and viral hepatitis prevention, testing, and treatment, and, substance use disorder treatment and overdose prevention services offered at three SSPs and which services their clients accessed. Across the three SSPs, 45 clients (people who inject drugs [PWID]), 11 staff, and five stakeholders were interviewed. Results: Most clients (n = 34) reported accessing SSP services weekly and primarily for sterile syringes and injection-related supplies. All clients reported testing for HIV at least once, though concern for acquiring or transmitting HIV was divided between some or no concern. Most clients (n = 43) reported testing for hepatitis C virus (HCV). Concern for acquiring or transmitting HCV was also mixed. Vaccination for hepatitis A and/or B teetered around half (HAV: n = 23) to a third (HBV: n = 15). Most clients (n = 43) knew where to access the overdose countering medication, Narcan. Feelings about substance use treatment options varied, yet most felt not enough were available. Of note, not all assessed services were offered by the sampled SSPs. Conclusions/Importance: The findings help us understand PWIDs' rationale regarding services accessed and preference for particular services. The need for some services was not perceived by those at risk for the illness the services addressed. Discussing risk and providing tailored education is important when providing SSP services to rural residing PWIDs. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has impacted routine health care services including immunization delivery. The most common sexually transmitted infection in the United States is the human papillomavirus (HPV), and its sequelae may be prevented by vaccination. Sequelae that can develop if one's immune system is not able to clear the infection include warts, precancerous lesions, and cancer. The American College of Obstetricians & Gynecologists (ACOG) reports almost everyone who is sexually active will encounter the virus at some time during their life. Most of the estimated 79 million infections occur among people who are in their late teens or early 20s. Since 2006, there has been a vaccine available to prevent HPV infections in both males and females; however, administration of this vaccine has only been about half the rate of other vaccines and vaccine hesitancy may play a role. Public health nurses are vital in providing accurate and nonjudgmental vaccine education to their clients, especially unaccompanied minors seeking care in public health department clinics. This paper will explore the recommendations for providing this vaccine as well as a snapshot of current practice in two health departments in the Southeast region of the United States during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

This study investigates the Rejection-Identification Model (RIM) by examining impacts of group-level and personal experiences with discrimination on different measures of ethnic identity and cultural importance among Hispanic immigrants. The RIM is used to describe associations between discrimination and increased ethnic identity and the mediating role of ethnicity on negative outcomes of discrimination. Growing empirical support for the RIM has prompted inquiry into its application among different populations, including immigrants who face numerous types of discrimination. Using the Latino Immigrant National Election Survey, the study found that the perception of group-level discrimination was associated with a higher likelihood of reporting Hispanic identity importance, however, personal experiences with discrimination were not. Further, results showed that neither type of discrimination impacted cultural or Spanish language maintenance importance. This paper discusses the implications of these findings and how the protective factors presented by the RIM may vary among populations and when considering personal and group-level discrimination. [ABSTRACT FROM AUTHOR]

The impacts of this pandemic have not been felt equally. The current pandemic has aggravated preexisting prejudices and shed light on long-standing social, economic, and health inequities that have been and continue to be perpetuated by systems of oppression. Psychologists are in a unique position to collaboratively work with marginalized individuals navigating pandemic threat, discrimination, and oppressive systems. This paper presents best practice recommendations for U.S.-based psychologists working with marginalized populations impacted by COVID-19. Psychologists are encouraged to synchronously develop the following three areas of evidence-based practice, as they relate to the impacts of COVID-19: (a) self-reflection and self-awareness in a COVID-19 context (i.e., reflecting on one's identities and one's knowledge and attitudes toward sociohistorical inequities), (b) knowledge acquisition (i.e., adopting an attitude of cultural humility, identifying "emotional contagion," identifying impacts of systemic injustice that may be compounded by COVID-19, and recognizing racial trauma in clients of color), and (c) collaboration with clients (i.e., identify the mental health toll of oppressive systems, explore COVID-19 relevant and culturally responsive methods of healing, encourage virtual community engagement, and incorporate ethnic and racial identity development in personal and professional work). Engaging with these best practice recommendations should result in the psychologist's improved ability to identify and address the consequences of systemic oppression that have been highlighted and exacerbated by COVID-19 on their own behavior and their clients' mental health. Furthermore, psychologists engaged with these best practice recommendations should find themselves better prepared to utilize culturally responsive interventions despite barriers created by COVID-19. [ABSTRACT FROM AUTHOR]

This paper analyzes the relationship between individuals' attitudes towards risk and their decision to migrate. We consider migration in the United States across metropolitan statistical areas (MSAs) between 1997 and 2015, based on data from the Panel Study of Income Dynamics (PSID). Using random‐effects specifications, we find that being relatively more willing to take risks is positively and significantly related to cross‐MSA migration. For cross‐state migration and migration across larger distances, risk attitudes are slightly more important. A recursive bivariate probit model of simultaneous equations addresses the potential endogenous nature of attitudes towards risk and allows ruling out reverse causality. [ABSTRACT FROM AUTHOR]

This paper explores how surrogates negotiate the meaning of familial belonging and family identity when they discuss surrogacy with their husband, children, and other relatives. We suggest that surrogacy necessitates reflexive explication of what a family is and how this family is implicated in surrogacy. Our comparative study analyzes ethnographic data on Israeli and US surrogates to illuminate key similarities in surrogates' strategies vis-a-vis their husband and children, pointing to the importance of daily family practices in how people understand family belonging. First, we map out the ways surrogates engage their husbands in order to gain their support and protect their nuclear family unit before entering the process. Next, we look at how surrogates explain surrogacy to their children in efforts to clarify siblingship and the boundaries between the two families, and to make surrogacy into an educational family project. We analyze the metaphors and rituals in surrogates' family-bounding practices. [ABSTRACT FROM AUTHOR]

In this paper, we articulate a conceptual model for the process of ethnic identity development and integration among Asian American children and youth that offers potential explanations for their marginalization as they negotiate multiple facets of their identities and locate themselves in local and national contexts. The conceptual model is based on an integration of theory and empirical research on the intertwined processes of ethnic identity development and socialization of children and youth in Asian American families and is anchored in the developmental domain of identity formation and integration. We present the conceptual model as three overlapping circles to represent salient features of physical and social contexts, prevalent metanarratives that have been empirically established as salient meaning-making frames pertinent to the lived experience of Asian Americans in the United States, and the dynamic individual-context interplay and mutual adjustment that is part of developmental process. We then build on the work of scholars who have advanced the theoretical and empirical literature on the Asian American experience in the United States, to illustrate how the three components (features of context, master narratives, and developmental processes) intersect in the overlapping spaces of the model to foreground the dialectic processes whereby identity is constructed as contextualized in place. The primary contribution of the model is to facilitate generating research questions that can unravel the complexities of how specific ethnic backgrounds (e.g., immigration and settlement histories), developmental status, individual position on societal racial/ethnic hierarchy, and prevalent societal metanarratives contextualize the development of an Asian American ethnic-racial identity. [ABSTRACT FROM AUTHOR]

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

Context Few qualitative findings have been published that explore and identify the challenges experienced by independent abortion providers during the COVID‐19 pandemic in the United States (US). In this paper, we explore these themes while expanding the concept of "abortion exceptionalism" beyond its original legal meaning to address the impact of abortion stigma. Methods: Twenty abortion providers from independent abortion clinics throughout the US South and Midwest participated in semi‐structured interviews in June and July 2020. Interviews explored the challenges of providing abortion care in the wake of the COVID‐19 pandemic and sought to identify how clinics strategized and amended their clinical practices to continue providing abortion care during this time. Results: All providers we spoke to noted significant challenges to providing abortion care in the early days of COVID‐19. In addition to experiencing the same concerns as other health care institutions, abortion clinics also faced additional, unique burdens that can only be attributed to the politics of abortion exceptionalism. Examples of this abortion exceptionalism include abrupt orders to close clinics, the need to rely on traveling physicians, legislature‐imposed limits on telemedicine, heightened activities of protesters, and non‐evidence‐based regulation of medication abortion. Conclusion: Despite major challenges and differential treatment, independent abortion clinics in the US persevered to continue to provide abortion care throughout the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

The psychological bases of the selection and attitudinal response to news media have received ample attention in political communication research. However, the interplay between three crucial factors in today's online, high-choice news media settings remains understudied: (1) textual versus multimodal (text-plus-visual) communication; (2) attitude congruent versus attitude incongruent versus balanced content; and (3) political versus nonpolitical genres. Relying on an experimental study of refugee and gun control news in the United States (N = 1,159), this paper investigates how people select and avoid, and also the extent to which they agree with, congenial, uncongenial, and balanced political news in a realistic multimodal selective-exposure setting in which political news is presented alongside sports and entertainment news. Although the findings partially depend on the issue, we find that the presence of multimodal (compared to textual) entertainment and sport items can increase avoidance of political news. Multimodal (compared to textual) political news augments attitude congruent selective exposure instead of encouraging cross-cutting selective exposure. Once selected, multimodal political news articles evoke stronger emotions and lead to higher issue agreement than textual news, regardless of an article's attitude congruence. By linking research on text-alone to multimodal selective exposure, this study shows that visuals in high-choice media environments can contribute to the selective avoidance of political news generally and cross-cutting political news more specifically. [ABSTRACT FROM AUTHOR]

White, politically conservative males in the United States have been widely found to maintain petro‐masculine attitudes that include aspects of racism, misogyny, and climate change denial. These beliefs and their associated behaviors, including climate destructiveness, can be conceptualized as compensatory reactions to modern‐day racial, gender, and climate‐related anxieties that are experienced as threats to traditional white male privilege and power. They then manifest as and energize authoritarian desires and their associated sociopolitical movements, including the current Republican effort to Make American Great Again. This paper utilizes psychoanalytic concepts concerning individual and large‐group identity, group psychodynamics and processes, and the intergenerational transmission of idealized myth and fantasy to further elucidate and expand upon these complex phenomena. It then suggests specific strategies for disentangling the strong links between white hegemonic masculinity, fossil fuel use, and climate change denial, thus opening doors to alternative, non climate‐destructive yet still empowering notions of individual, large‐group, and national identity that are, instead, based in communal concern and climate care. [ABSTRACT FROM AUTHOR]

This paper evaluates American-Muslims' perceptions of the police. With regard to studies of the police and Muslim communities, much of the focus has centered on evaluating police officers' perceptions of the Muslim community. Attitudes toward the police reflect an important measure of police legitimacy for minority communities. The current study analyzes responses from a convenience sample (N = 142) collected from around the United States. Our t test analysis of first-and-second generation American Muslims found no significant differences between attitudes toward the police. However, our OLS Regression models suggest that education, fear of negative treatment due to race, ethnicity, or religion, fear of victimization, negative media portrayal, and neighborhood factors significantly affected perceptions of the police. [ABSTRACT FROM AUTHOR]

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

This paper reports on research into undergraduate students' engagement with university library social media. Social media (SM) applications enable university libraries to reach users in ways that may better meet their needs and preferences, but evidence suggests that undergraduate students' engagement with library social media is limited. This raises the question of whether libraries have a good understanding of student preferences for library SM content and approaches and whether students want to engage with the library at all through SM applications. This research aimed to identify if, how and why undergraduate students in select Nigerian universities engage with their library's SM through a questionnaire survey drawing on the Elaboration Likelihood Model (ELM) of persuasive communication. The results indicate that most students are unaware of university library SM posts. Those who are aware prefer content related to events and happenings on campus as well as news about library service developments. Results of the multiple regression reveal that students attach importance to the content of SM posts suggesting that the university library may still be able to reach them through social media for more meaningful interactions. Recommendations for the management of the content and approach to SM communications for university libraries are provided. [ABSTRACT FROM AUTHOR]

Objective: To determine factors and barriers associated with scholarly activity among faculty members at urology residency programs in the United States.Methods: An online survey was sent to all 134 urology residency program directors. The survey assessed program characteristics including size, location and definition of scholarly activity. It assessed available support for and barriers to resident scholarly activity, faculty participation in scholarly activity and mentorship of residents. Linear regression analysis was used.Results: We had a 40% response rate (N = 40). Faculty attitudes toward conducting scholarly activity (P < .001) and lack of a research curriculum (P = .05) were barriers to the outcome 'participation in scholarly activity'. Faculty attitudes toward conducting scholarly activity was also a barrier to the outcomes 'mentorship of residents' (P = .004) and 'publication of at least 1 paper' (P = .004). Available statistician was positively associated with the outcomes 'publications' (P = .062) and 'presentations' (P = .032). A minimum requirement of a local presentation (P=0.04) and chairman support (P = .015) were positively associated with the outcome 'presentation at a conference.'Conclusion: Training residents in research matters for the resident, the institution and future generations of surgeon scientists. Higher levels of faculty scholarly activity were associated with a minimum requirement for residents to submit a manuscript for publication, strong chairman support for resident research, and the availability of a statistician. A common barrier to faculty scholarly activity, publications, and resident mentorship was faculty attitudes toward resident scholarly activity. Urology residency programs seeking to prioritize scholarly activity among faculty should consider these factors. [ABSTRACT FROM AUTHOR]

The article comments on the paper "Shame: An Acute Stress Response to Interpersonal Traumatization," by Dianne Trumbull. Topics mentioned include the visual dimension, power, and pain of shame, distinction between shame and guilt, the role of shame in development and attachment emotion, the impact of shame on self-esteem, and the interaction of shame and culture.

Aim: To explore the factors that influence provider pain treatment decision‐making and the receipt of pain management by injured Black patients in the United States. Design: We completed a systematic mixed studies review using a results‐based convergent synthesis design. Data Sources: PubMed, SCOPUS and CINAHL were searched for articles published between 2007–2017 using the search terms 'African American', 'Black American', 'race', 'pain treatment', 'pain management' and 'analgesia'. Twenty studies were included in this review. Review Method: A search of databases and hand‐searching identified peer‐reviewed published papers. The Mixed Method Appraisal Tool was used to appraise the studies. Results: The results indicate that healthcare provider characteristics, racial myths about pain sensitization and assumed criminality all impact provider treatment decision‐making and the receipt of pain treatment by injured Black patients. Impact: This review addresses racial disparities in pain management by focusing on the factors that impact the receipt of pain treatment by injured Black patients. The findings will have an impact on providers who prescribe pain treatment and on the patients they treat. These findings suggest that assumed criminality of certain patients can negatively impact care, which is a type of bias not frequently explored or discussed in health disparities research. This review will help inform further research in healthcare disparities and prompt providers to examine their assumptions about the patients for whom they care. Conclusion: These results provide important areas for further study, including how assumed criminality of certain patients can have a negative impact on care. [ABSTRACT FROM AUTHOR]

Racial minority families engage in "racial socialization," the process by which individuals develop meaning and understanding of what race is, and its implications. While parents are often seen as the site of this socialization, we wanted to explore which racial socialization messages were salient for young adults, and from whom they received these messages. This paper utilized focus groups to explore messages that young Black adults received about race, and what this means for their racial identity. We identified three dominant themes in our analyses: (a) the content of familial messages regarding race, identity, and prejudice, (b) critical incidents that shaped individuals' understandings of Black racial identity, and (c) familial sources. Each of these themes is constituted by various experiences and examples that shed light on racial socialization in today's social climate. Overall, parents, extended family members, and community members were sources of socializing what race meant to young Black adults. We discuss implications for research on racial socialization and family communication. [ABSTRACT FROM AUTHOR]

This paper examines the effort devoted to securing interviews with a very wealthy part of the sample for the 2007 Survey of Consumer Finances (SCF). Only about a quarter of the group completed an interview. At the close of the field period, more than a third of this part of the sample was judged by the field staff to be still workable - that is, those cases were neither complete nor final refusals. The evolution of the field work was driven both by the behavior of respondents and the behavior of the field staff. The paper uses the formal data coded in the call records for each case to describe the work. But that information is inconclusive about the factors that drove the work. However, informal notes in the call records do provide a clear picture of the points of resistance among respondents. Although it was difficult to locate, contact, and convince respondents of the legitimacy and value of the survey, it appears that the ultimate constraint in a large proportion of cases was the length of the interview - potentially several hours for these respondents. Examination of the available auxiliary data provides little evidence of nonresponse bias. [ABSTRACT FROM AUTHOR]

Recent scholarship suggests that the urban design profession is flourishing with many newly created urban design departments, programmes and certificates. Within this context, this paper suggests that urban design education should explore how urban designers can acquire a deeper understanding of the larger socio-economic processes which have an impact on urban form and different groups in the city. More specifically, it posits that urban designers should take notice of the informal urbanism that is burgeoning in many cities of the Global North. For this to happen, urban design pedagogy should prepare future urban designers to better understand and positively intervene in informal urban landscapes, and the urban design studio is an appropriate venue where this can happen. The paper articulates a four-tier framework of responding to informal urbanism through urban design that concentrates on the scope, context, process and practice of urban design. It details a graduate urban design studio that followed this framework to offer spatial solutions and accommodation of street vending in one Los Angeles inner city neighbourhood. [ABSTRACT FROM PUBLISHER]

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

The term 'pure sociology' reflects some of the most important disciplinary concerns that have helped shape the intellectual development of sociology in the United States, particularly in the effort to establish disciplinary boundaries and achieve academic legitimacy. To flesh out the thesis, the current paper recounts briefly the early discussions associated with pure sociology before examining the various usages in the U.S. since the establishment of the discipline. While selected classical theorists employed the concept in framing their discussions, pure sociology represents a distinctively American idiom. The etymological history coincides with the institutionalization of sociology in U.S. universities, while informing key debates about the nature of sociological analysis throughout the past 120 years. Drawing upon an electronic search of multiple databases, a content analysis highlights the prevalence of the different meanings that mainly U.S. social scientists have attached to the concept. The paper then traces the varying trajectories of the many different usages over time, concluding with a discussion of the ascendance of Donald Black's theoretical paradigm that has appropriated the term with considerable success. [ABSTRACT FROM AUTHOR]

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

Studies of W. E. B. Du Bois typically emphasize his shift from an elitist devotion to European classics to a more radical promotion of African culture. These essays move beyond this simple dichotomy. We aim to demonstrate that throughout his life, Du Bois used classical ideas to challenge white Americans' exclusive claims to power, even as he recognized and critiqued the role of Classics in sustaining racist hierarchies and institutions. Rather than focus exclusively on explicit citations of Greece and Rome in Du Bois's writing, we use Henry Louis Gates, Jr.'s model of Signifyin(g) and Lorna Hardwick's conception of 'fuzzy connections' to trace and interrogate Du Bois's elusive engagement with Classics. We provide detailed studies of three works: The Souls of Black Folk (1903), The Star of Ethiopia (1910s) and 'Of the Ruling of Men' (1920). The concluding essay situates Du Bois's classicism in the wider context of African American literature and at the intersection of debates on education, humanism, and race in America. Throughout these papers, we examine Du Bois's understanding of what is at stake for those who present themselves as the inheritors and interpreters of antiquity. By putting Du Bois back at the centre of ongoing scholarly conversations on black classicism, we hope to show that his inventive and political approach to the past provides a valuable model for reception studies today. [ABSTRACT FROM AUTHOR]

Objective: To estimate the proportion of obstetrician-gynecologists (ob-gyns) who provided induced abortion in the prior year, disaggregated by surgical and medication methods, and document barriers to provision of medication abortion.Methods: In 2016-2017, we conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists Fellows and Junior Fellows who were part of the Collaborative Ambulatory Research Network. We sent the survey by email, and mailed nonresponders paper surveys. We performed descriptive statistics, χ tests, and logistic regression analyses.Results: Sixty-seven percent (655/980) of Collaborative Ambulatory Research Network members responded. Ninety-nine percent reported seeing patients of reproductive age, and 72% reported having a patient in the prior year who needed or wanted an abortion. Among those seeing patients of reproductive age, 23.8% (95% CI 20.5%-27.4%) reported performing an induced abortion in the prior year; 10.4% provided surgical and medication abortion, 9.4% surgical only, and 4.0% medication only. In multivariable analysis, physicians practicing in the Midwest (adjusted odds ratio [AOR] 0.31, 95% CI 0.16-0.60) or South (AOR 0.22, 95% CI 0.11-0.42) had lower odds of provision compared with those practicing in the Northeast, whereas those practicing in an urban inner city (AOR 2.71, 95% CI 1.31-5.60) or urban non-inner-city area (AOR 2.89, 95% CI 1.48-5.64 vs midsize towns, rural areas, or military settings) had higher odds of provision. The most common reasons for not providing medication abortion were personal beliefs (34%) and practice restrictions (19%). Among those not providing medication abortion, 28% said they would if they could write a prescription for mifepristone.Conclusion: Compared with the previous national survey in 2008-2009, abortion provision may be increasing among practicing ob-gyns, although important geographic disparities persist. Few provide medication abortion, but uptake might increase if mifepristone could be prescribed. [ABSTRACT FROM AUTHOR]

In this paper, we examine discourse in public deliberations in pre-development locales in the UK and US about advantages and disadvantages of future shale development ('fracking'). We aimed to understand how people anticipate potential health effects, broadly construed, of environmental toxicity and disturbance in the context of planned, but not yet implemented, energy development. In day-long deliberations with small, diverse groups in two cities in each country (London, Cardiff in the UK; Los Angeles, Santa Barbara in the US), participants discussed impacts on health and well-being using three main rubrics: 'It's money or health', 'Why take chances?' and 'Beyond the tipping point'. Throughout, participants framed health as an intrinsically moral issue, with collective responsibility as a dominant normative frame. We identify the concept of compound risk to underscore effects of multiple risks and hazards on people's sensibilities about anticipated future health and environmental harm. The findings demonstrate how and why diverse publics in pre-impact sites in both countries saw shale extraction as high stakes development that poses significant, often unacceptable, risks to human and environmental health and well-being. Risks extended beyond toxicity to broad threats to health, including, for some, the end of life as we know it on the planet. Overall, participants' discussions of health were more connected to social categories and their underlying moral principles than to technological details. This work contributes evidence of blurred boundaries between environment and health as well as the importance people place on social risks in the context of proposed energy system change. [ABSTRACT FROM AUTHOR]

Background: Despite a fast-paced environment, the emergency clinician has a duty to meet the palliative patient's needs. Despite suggested models and interventions, this remains challenging in practice. Aim: To raise awareness of these challenges by exploring the experience of palliative care patients and their families and informal carers attending the emergency department, and of the clinicians caring for them. Design: Qualitative systematic literature review and thematic synthesis. Search terms related to the population (palliative care patients, family carers, clinicians), exposure (the emergency department) and outcome (experience). The search was international but restricted to English and used a qualitative filter. Title, abstracts and, where retrieved, full texts were reviewed independently by two reviewers against predefined inclusion criteria arbitrated by a third reviewer. Studies were appraised for quality but not excluded on that basis. Data sources: MEDLINE [1946-], Embase[1947-], CINAHL [1981-] and PsycINFO [1987-] with a bibliography search. Results: 19 papers of 16 studies were included from Australia (n = 5), the United Kingdom (n = 5), and United States (n = 9) representing 482 clinical staff involved in the emergency department (doctors, nurses, paramedics, social workers, technicians), 61 patients and 36 carers. Nine descriptive themes formed three analytic themes: 'Environment and Purpose', 'Systems of Care and Interdisciplinary Working' and 'Education and Training'. Conclusion: In the included studies, provision of emergency palliative care is a necessary purpose of the emergency department. Failure to recognise this, gain the necessary skills or change to systems better suited to its delivery perpetuates poor implementation of palliative care in this environment. [ABSTRACT FROM AUTHOR]