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While the literature is abundant on hand therapy assessment and treatment of nonsurgical thumb carpometacarpal (CMC) osteoarthritis (OA), clarity and uniformity are meager, making it a desirable diagnosis to establish expert consensus. This study aimed to ascertain if consensus exists for the assessment and treatment of nonsurgical management of thumb CMC OA in the hand therapy clinical setting. This was a consensus paper via the modified Delphi approach. A modified Delphi method was used to determine consensus among an expert panel, including hand therapists and hand surgeons, via two online surveys. A consensus paper steering committee (from the American Society of Hand Therapist's research division) designed the surveys and analyzed responses. Consensus was established as 75% agreement among the expert panel. Demographic information was collected from the expert panel. The expert panel included 34 hand therapists and seven hand surgeons. The survey response rates were 93.6% for the first survey and 90.2% for the second survey. Consensus recommendations were classified according to the World Health Organization categorization. These included evaluating the body structures for clinical signs/clinical testing and body functions for pain, range of motion for palmar abduction, radial abduction, opposition, and thumb metacarpal phalangeal flexion/extension, and grip and tripod pinch strength. Further consensus recommendations were for the assessment of function using a region-specific, upper extremity patient-reported outcome measure (activity and participation), environmental factors, outcome expectation, and illness perception within the patient's unique environmental and social contexts. Treatment recommendations included the use of an orthosis during painful activities, a dynamic stability program (stable C posture, release of tight adductors, and strengthening of stabilizers), patient education, joint protection techniques, adaptive equipment, and functional-based intervention. The findings describe the consensus of a group of experts and provide a clinical reference tool on the hand therapy assessment and treatment of nonsurgical thumb CMC joint OA. • A consensus paper using a modified Delphi process to determine consensus on non-surgical assessment and treatment of thumb CMC OA. • Assessment recommendations: evaluate clinical signs/testing, pain, thumb range of motion grip and tripod pinch, a region-specific PROM, environmental factors, outcome expectation, and illness perception. • Treatment: orthosis during painful activities as needed, a dynamic stability program, patient education, joint protection techniques, adaptive equipment, and functional based intervention. • Findings provide a clinical reference tool on hand therapy assessment and treatment of non-surgical CMC joint OA. [ABSTRACT FROM AUTHOR]

Examine the relationship between nutrition knowledge, diet quality, and eating behavior among active-duty US Army Soldiers. Cross-sectional study with data collection in February 2018 via paper surveys during the validation of the Military Eating Behavior Survey. Among 440 US Army Soldiers, nutrition knowledge was positively and significantly associated with diet quality (b = 0.29, P < 0.001). For every 1-point increase in nutrition knowledge, the Healthy Eating Index-2015 score was expected to increase by 0.29 points. Nutrition knowledge was not significantly associated with skipping breakfast (odds ratio, 1.01; 95% confidence interval, 0.98–1.04) or dining out (odds ratio, 1.01; 95% confidence interval, 0.98–1.03). The outcomes of this study warrant further investigation to determine what interventions provide the strongest outcomes for improving nutrition knowledge and diet quality, as well as create and support an environment that enhances healthy behaviors regarding nutrition that lead to improved diet quality among active-duty Soldiers. [ABSTRACT FROM AUTHOR]

To describe the quality of food and physical activity (PA) environments by World Bank Income level in jurisdictions from the Children's Healthy Living Program. Baseline cross-sectional community data were analyzed from 11 jurisdictions categorized by World Bank Income levels to describe exposure to different food and PA outlets. The Children's Healthy Living Program was a multilevel, multijurisdictional prevalence study and community intervention trial that reduced child obesity in the US-Affiliated Pacific region. US-Affiliated Pacific region. Food (n = 426) and PA (n = 552) Outlets. Physical activity and food scores that reflect the quality of the outlets that support being physically active and healthy eating options, respectively. Descriptive statistics are presented as means ± SD or percentages. High-income-income level jurisdictions had higher food and PA scores than middle-income level jurisdictions. The US-Affiliated Pacific region has limited quality food and PA outlets in underserved communities at risk for obesity. The findings in this paper can be used to develop tools and design interventions to improve the food and PA environment to increase a healthier, active lifestyle. [ABSTRACT FROM AUTHOR]

The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a frequently used cancer-specific health-related quality of life (HRQoL) questionnaire. To aid interpretation of data obtained via EORTC QLQ-C30, general population norm data have been published for many countries. However, despite its frequent use in the United States, no normative data by sex and age exist to date. Therefore, this study aimed to generate sex- and age-specific EORTC QLQ-C30 normative data for the United States. Recruitment and data collection were carried out via online panels as part of a larger cross-sectional study. For the recruitment, the sample was stratified by sex and age (18–39, 40–49, 50–59, 60–69, ≥ 70 years) to achieve a balanced distribution, with n = 100 per subgroup. Descriptive statistics are presented by age and age/sex. A total of N = 1009 respondents completed the survey (n = 508 females, n = 501 males). More than two thirds of participants (72.5%) reported at least one health condition, e.g., arthritis (26%). Across EORTC QLQ-C30 scales, women and men 60 years and older reported generally better/higher functioning and better/lower symptom scores compared to the younger age groups. To date, no specific EORTC QLQ-C30 general population normative data have been published for the United States. This paper provides these important normative data, which will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from US cancer patients, and also enable comparison with European norms. • EORTC QLQ-C30 is a cancer-specific health related quality of life (HRQoL) measure. • HRQoL normative data from US general population was collected (1009 respondents). • EORTC QLQ-C30 look-up tables for the US general population by sex/age are presented. • Participants ≥ 60 years reported overall better functioning than younger age groups. • Results will enhance interpretation and validity from EORTC QLQ-C30 data in the US. [ABSTRACT FROM AUTHOR]

This paper examines the experiences of adolescents from mixed migratory status families affected by deportation. We analyze the impacts on their mental and emotional health when they are separated from one parent in the United States, forcibly displaced with another to Oaxaca, and experience the consequences of their deportation in Mexico. We use a qualitative and ethnographic methodology. This paper focuses on data from semi-structured interviews and focus groups with 15 parents who had been deported from the United States and 53 adolescents who moved with them to Mexico. The data was collected between 2018 and 2020. The main findings show the existence of emotions that are sustained in the transnational flow and acquire new nuances upon return. They also show the emergence of new conditions related to family separation, all of which have an impact on the adolescents' well-being and on important areas of their lives, such as education. The research contributes to knowledge in two main ways: 1) it addresses the impacts of parental deportation on the well-being of adolescents in mixed-status families, which have typically focused on children; 2) it studies how parental deportation affects the mental and emotional health of adolescents de facto deported to Mexico, a field still little studied. • De facto deportation has mental health consequences among adolescents. • The forced nature of de facto deportation produces helplessness, aggression and anger. • The code of silence associated with deportation generates fear, stress, anxiety. • Ambiguous loss is accentuated at important moments in academic and developmental life. • Family separation and de facto deportation affect school performance. [ABSTRACT FROM AUTHOR]

To assess the national and state prevalence of being "Healthy and Ready to Learn" (HRL) and associated sociodemographic, health, family and neighborhood factors. Cross-sectional analysis of the 2016 National Survey of Children's Health, a nationally representative parent-reported survey administered by web and paper June 2016 to February 2017. Four domains were constructed from 18 items through confirmatory factor analyses: "Early Learning Skills", "Social-Emotional Development", "Self-Regulation", and "Physical Well-being and Motor Development." Each item and domain were scored according to age-specific standards as "On-Track", "Needs Support", and "At Risk" with overall HRL defined as "On-Track" in all domains for 7565 randomly selected children ages 3 to 5 years. In 2016, 42.2% of children ages 3 to 5 years were considered HRL with the proportion considered "On-Track" ranging from 58.4% for Early Learning Skills to 85.5% for Physical Well-being and Motor Development"; approximately 80% of children were considered "On-Track" in Social-Emotional Development and Self-Regulation, respectively. Sociodemographic differences were mostly non-significant in multivariable analyses. Health, family, and neighborhood factors (ie, special health care needs status/type, parental mental health, reading, singing and storytelling, screen time, adverse childhood experiences, and neighborhood amenities) were associated with HRL. HRL prevalence ranged from 25.5% (NV) to 58.7% (NY), but only 4 states were significantly different from the U.S. overall. Based on this pilot measure, only about 4 in 10 US children ages 3 to 5 years may be considered "Healthy and Ready to Learn." Improvement opportunities exist for multiple, modifiable factors to affect young children's readiness to start school. [ABSTRACT FROM AUTHOR]

Many Latinx and Indigenous Mexican populations in the United States Southwest live in unincorporated communities in the US-Mexico borderlands called colonias. These environmental justice communities often lack basic infrastructure, including healthcare services, prompting many to seek services across the border. However, due to geopolitical factors more vulnerable caregivers are limited to utilize healthcare services in the US. This paper reports the experiences and healthcare decision-making of caregivers living in colonias in the US-Mexico border region who care for children with respiratory health conditions. This study was carried out from September to December 2020. Focus groups and interviews were conducted with Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress. Qualitative interviews elicited caregivers' perspectives on the environmental factors affecting children's chronic health conditions and use of healthcare services. The analysis employed the concept of structure vulnerability to theorize geography as a structural determinant of health for caregivers faced with making healthcare decisions for their suffering from respiratory health conditions. A survey was administered to collect basic sociodemographic information. A total of 36 caregivers participated in the study. Structural factors including unincorporated community status and government inaction intersected with social determinants of health to prompt caregivers to cross the US-Mexico border to access healthcare services in Mexico for their children. Yet, more vulnerable caregivers (i.e., those without documentation status in the US) and their children, accessing healthcare services in the US was not an option limiting caregivers' ability to meet their children's healthcare needs. In such cases, geography acts as a structural determinant of health. This study shows the importance of geography in health. Rural unincorporated colonias located in the borderlands are precariously located and lack basic critical infrastructure including healthcare access. Within such places, historically and socially marginalized populations become invisible, are subject to the health effects of environmental hazards, and are limited depending on their positionality and thus vulnerability to healthcare services. • Municipal unincorporation contributes to health disparities among Latinx families in US-Mexico borderlands. • Latinx children in colonias are disproportionately exposed to environmental toxins. • Geography acts as a structural determinant of health for Latinx families in colonias. • A binational approach to health services should be prioritized for families in the borderlands. [ABSTRACT FROM AUTHOR]

The rates of annual emergency department (ED) visits in the United States for suicidal behaviour has nearly doubled over the last 10–15 years, with a decreased rate of hospitalizations, indicating the importance of intervention in the ED presentation. This paper describes the patterns of psychotropic use immediately before and after emergency department presentation to enhance understanding of interventions for increasing safety in these individuals. 5070 adults seen in psychiatric consultation in two tertiary EDs with linkage to population-based administrative data to describe psychotropic prescriptions immediately before and after ED presentation. 55.9% of suicide attempts were by overdose, with 13.4% of suicide attempts occurring in the 18–21 age group. While no causal relationship can be inferred, half of those who presented to the ED with suicidal ideation or behaviour or non-suicidal self-injury were prescribed an antidepressant prior to ED presentation, with a spike in new prescriptions in the month immediately prior. 20% of those who presented to the ED with thoughts or behaviour received a new or different prescription for an antidepressant in the 1-month post-presentation. Prescribing of tricyclic antidepressants and opioids were decreased following ED presentation, however 21% of people still received opioids after a suicide attempt. Rates of antipsychotic prescriptions were increased. Patients are seeking help in the one-month prior to emergency presentation. Clinicians must consider the risk in this period of heightened clinical distress, especially among those under age 21. It is important to consider the changes that can be made in the ED to impact safety. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to explore: (a) What stories do the Street Soccer players draw upon to construct meaning around their experiences of trauma, social exclusion, and homelessness? and (b) What stories are linked to the subjective sport programming experience and resulting future orientations? A longitudinal narrative approach was adopted with semi-structured interviews conducted with players from Scotland and the United States (n = 16, 7 female, 9 male, M age = 27.5) across three time points. Interviews were also conducted with significant others (n = 13) at time point three. All data were analyzed using thematic narrative analysis and represented in creative non-fiction approaches through three composite narratives. These narratives depicted visceral accounts of complex and developmental trauma, along with consequential experiences that unfolded before, during, and after the Homeless World Cup. While both preparing for and attending the event, players recalled concurrent feelings of anxiety and pride which manifested in various resilient and maladaptive coping behaviors. As the stories progressed, players battled a post event crash by engaging in support seeking and/or self-destructive behaviors before positive implications of the Homeless World Cup materialized. Through creative narrative approaches, this study presents novel and engaging accounts of players' experiences before, during, and after the event. We also identify potential safeguarding concerns that can be addressed through trauma-informed practices. • Novel stories exploring the lives of socially excluded and homeless people and their unique experiences in sport. • Composite narratives illuminate depictions of trauma, along with consequential experiences through the Homeless World Cup. • The universal post-event crash was observed in each story before varying resilient and support seeking behaviors prevailed. • Trauma-informed practices may ensure a safe transition between players' return home and positive future orientations. [ABSTRACT FROM AUTHOR]

A rising emphasis on patient involvement in clinical research and healthcare improvement has led to the steady incorporation of patients and caregivers into this work. However, interactional factors shaping recruitment processes are not well understood. In this paper, we present a qualitative analysis of interviews with twenty-six patients, family members, engagement staff and healthcare providers who are engaged in healthcare improvement work in the United States. We focus on how stakeholders account for recruitment decisions to participate in healthcare improvement work. We find that expressions of and judgments about patients' and caregivers' cultural health capital shape providers' decisions to extend invitations to participate in healthcare improvement work. These findings extend current conceptualizations of cultural health capital beyond the clinical encounter to reveal factors shaping patient recruitment into healthcare improvement work. In theorizing how cultural health capital shapes action in this new setting, we found that healthcare providers, engagement staff, and patients/caregivers attended to different aspects of cultural health capital when accounting for why they extended or received a recruitment pitch. We further found that participating in healthcare improvement work led to a boost in cultural health capital for patients and caregivers, which they could use to develop transmissible forms of cultural health capital for less centrally involved patients and caregivers. Finally, we describe how participants in healthcare improvement collaboratives account for a lack of diversity among partners. These findings help us hypothesize the consequences of recruitment processes that rely on displays and judgments of cultural health capital and identify possibilities for change. Using the case of healthcare improvement work in Collaborative Learning Health Systems, our findings advance past work on cultural health capital in medical sociology by theorizing the role of cultural health capital in recruitment processes. • Providers recruit patients for healthcare improvement work with subjective criteria. • Providers often recruit high-resourced, privileged patients that they "vibe" with. • Partners build cultural health capital from doing healthcare improvement work. • Recruiting for cultural health capital may exclude patients from diverse backgrounds. • The role of recruitment should be considered to improve partner representation. [ABSTRACT FROM AUTHOR]

Abstract: Health worker migration is an issue of first order concern in global health policy circles and continues to be the subject of much policy debate. In this paper, we contribute to the discussion by studying the impact of economic conditions on the migration of physicians from developing countries. To our knowledge, this is one of the first papers to do so. A major contribution of this paper is the introduction of a new panel dataset on migration to the US and the UK from 31 sub-Saharan Africa countries. The data spans the period 1975–2004. Using this data, we estimate the impact of changes in economic conditions on physician migration. In our preferred specification that allows for country-specific time trends, we find that a temporary one percentage point decline in GDP per capita increases physician migration in the next period by approximately. 3 percent. In our IV models a one percentage point decline in GDP per capita increases physician migration in the next period by between 3.4 and 3.6 percent. Overall, our results suggest a significant effect of developing country economic conditions on physician migration. [Copyright &y& Elsevier]

• Immigration-related family separation is a crisis in the US. • There are many forms of immigration-related family separation. • Immigration-related family separation leads to poorer education outcomes for children. • Length of time of separation leads to poorer outcomes for immigrant children. • Family separation affects children from all countries and regions of origin. Forced separation of immigrant children from their parents in 2018 spurred calls for immigration reform. Research shows that immigrant children experience separation from parents during the immigration process for many reasons and that they experience a wide range of negative outcomes. This paper builds on the scholarship exploring the relationship between family separation and education outcomes of US immigrant children. Using the sample of immigrant children (n = 94,731) in the 2010–2018 American Community Survey, this study analyzes the association between separation and the likelihood of a peer education gap using descriptive statistics and multivariate logistic regression analysis. This paper supports prior scholarship and finds that immigrant children who experience separation are over 35% more likely to experience a peer education gap. It adds to the literature by exploring patterns of immigrant children from all countries of origin and examining the effects of length of separation on education outcomes. While children from all places of origin experience separation, the percentage of such children is much smaller when children come from wealthier countries and regions and, more importantly, the length of separation is much longer for immigrant children from poorer countries. This study finds that the length of separation correlates with poorer education outcomes. [ABSTRACT FROM AUTHOR]

• InPlace® Learning is a feasible and acceptable approach to suicide prevention education for youth services workers in a large and varied workforce. • InPlace® Learning participants demonstrated knowledge and increased self-efficacy in suicide prevention skills. • Perception of training relevance and potential for transfer to practice was strong across human services roles and settings. • Leveraging implementation science frameworks and strategies strengthened the workforce education suicide prevention initiative. Suicide is the second leading cause of death for youth in the U.S. and equipping clinical and non-clinical staff in youth services to address suicide concerns is a challenge. This paper evaluates InPlace Learning, an innovative and sustainable blended learning approach to suicide prevention workforce education in youth services. InPlace Learning combines group video-guided workshops, follow-up Q&A via web-based 'office hours', and continual learning through job aids and brief refreshers. Hillside identified 25 programs to adopt InPlace Learning for suicide prevention training, and 1,162 staff to participate in the training. The purpose of the first phase of this program evaluation was to evaluate the feasibility of this approach, including examining adoption and reach of InPlace Learning, as well as education outcomes for staff, including knowledge, self-efficacy, and transfer of learning. The program evaluation sample consisted of 556 staff who completed post-training evaluations. Ten staff shared their experience and feedback through post-training interviews. Results show that 100 % (N = 25) of programs adopted InPlace Learning and 64 % of staff participated in the training, showing evidence of reach. Post-training evaluations indicated participants learned skills in suicide prevention. Self-efficacy in connecting around and assessing and responding to suicide concerns rose significantly for both clinical and non-clinical staff. Non-clinical staff who had lower ratings for self-efficacy before training showed the greatest gains post-training. The perception of transfer of learning to practice was high. Staff interview data aligned with quantitative findings. Taken together, these findings indicate that InPlace Learning is a feasible and acceptable approach to suicide prevention workforce education in youth services with a positive impact on educational outcomes for staff. [ABSTRACT FROM AUTHOR]

Substance use among Latino adolescents continues to be a growing concern for researchers and clinicians. This paper reviews relevant literature regarding the impact of inter-parental conflict (IPC), deviant peer associations (DPA) and parenting behaviors, namely as parental support, psychological control, and parental monitoring knowledge on substance use among Latino adolescents. Although mediating models of IPC and similar parenting behaviors on adolescent externalizing behaviors have been represented in empirical studies, none have included the influence of peer associations or have analyzed these factors with substance use among Latino adolescents in the U.S. This study investigated direct relationships of IPC and DPA with adolescent substance use, and tested parental support, psychological control and parental monitoring knowledge as mediators between those relationships in Latino adolescents. Structural equation modeling was used to analyze direct and indirect relationships of the variables mentioned among 744 Latino adolescents. Results indicated that DPA was positively associated with substance use, parental monitoring knowledge was negatively associated with substance use and that parental monitoring knowledge partially mediated the relationship between DPA and substance use. Implications of the findings are discussed in terms of areas of focus for interventions. [ABSTRACT FROM AUTHOR]

While the overall impact of the COVID-19 pandemic on U.S. population health has been devastating, it has not affected everyone equally. The risks of hospitalization and death from the disease are relatively low for the population as a whole, but much higher for specific subpopulations defined by age, health status, and race or ethnicity. The extent to which Americans perceive these disparities is an open question, with potentially important political implications. Recognition of unequal impacts may prime concerns about justice and fairness, making Americans more concerned and willing to support government intervention. On the other hand, belief that the pandemic primarily threatens "other people" or out-groups may reduce, rather than increase, a person's concern. Partisanship and media consumption habits are also likely to play a role in these perceptions, as they do in most issues related to COVID-19. In this paper, we use original survey data from the Cooperative Election Study (N = 1000) to explore Americans' perceptions of which groups are most harmed by the pandemic, the demographic and political determinants of these perceptions, and the relationship of these perceptions with their opinions about COVID-related mitigation policy. We find that, on average, people perceived accurately that certain groups (e.g., Black Americans, older people) were more affected, but these group perceptions varied by demographic and political characteristics of respondents. We find, in contrast with recent experimental evidence, that the perception that populations of color were harmed was associated with more support for pandemic mitigation strategies. More research should investigate the relationships among pandemic politics and the racial dynamics of the target populations most affected. • In fall 2020, survey participants recognized groups harmed by COVID based on age. • They had lower recognition of racial groups harmed, lowest for Native Americans. • Perceptions of groups harmed varies by information exposure and politics. • Perceiving group disparities was associated with more support for pandemic policy. • The racial dynamics surrounding the politics of COVID-19 requires more attention. [ABSTRACT FROM AUTHOR]

Purpose This paper compares the mortality burden of heart disease versus cancer among women by age, race, and ethnicity. Methods U.S. death and population data for the years 2000 through 2013 were used to calculate heart disease and cancer death rates. Detailed analyses focused on age (15–19 years old to ≥100 years old) and race and ethnicity (Whites, Blacks, Hispanics, Asians and Pacific Islanders (A/PIs), and American Indians and Alaska Natives (AI/ANs)). Results Among women aged 15 years and older, there were 289,467 heart disease deaths and 276,716 cancer deaths in 2013. The majority of heart disease deaths (51.6%) occurred among women 85 years or older, compared with 18.9% of female cancer deaths. The age-adjusted death rates (per 100,000 population) were 171 (95% confidence interval [CI], 170–171) for heart disease versus 177 (95% CI, 176–178) for cancer. For all racial and ethnic groups, cancer mortality was significantly higher than heart disease mortality among women younger than 80 years of age. For all ages combined, cancer deaths exceeded heart disease deaths among Hispanics, A/PIs, and AI/ANs. Black non-Hispanic women were the only racial/ethnic group who had a higher age-adjusted death rate for heart disease than for cancer: 224 (95% CI, 222–226) versus 207 (95% CI, 205–209). Conclusions Heart disease remains the leading cause of death among all women combined in the United States by a narrow margin. However, cancer predominantly kills middle-aged and young women, whereas heart disease predominantly kills the very old. New research on the overreporting of heart disease on death certificates for elderly women is needed. National summary statistics obscure the fact that cancer is already the overall leading cause of death for Hispanic women, Asian and Pacific Islander women, and American Indian and Alaska Native women. [ABSTRACT FROM AUTHOR]

Socioeconomic inequalities in childhood Body Mass Index (BMI) are becoming increasingly more pronounced across the world. Although countries differ in the direction and strength of these inequalities, cross-national comparative research on this topic is rare. This paper draws on harmonized longitudinal cohort data from four wealthy countries—Germany, the Netherlands, the United Kingdom (UK), and the United States (US)—to 1) map cross-country differences in the magnitude of socioeconomic inequalities in childhood BMI, and 2) to examine cross-country differences in the role of three energy-balance-related behaviors—physical activity, screen time, and breakfast consumption—in explaining these inequalities. Children were aged 5–7 at our first timepoint and were followed up at age 8–11. We used data from the German National Educational Panel Study, the Dutch Generation R study, the UK Millennium Cohort Study and the US Early Childhood Longitudinal-Kindergarten Study. All countries revealed significant inequalities in childhood BMI. The US stood out in having the largest inequalities. Overall, inequalities between children with low versus medium educated parents were smaller than those between children with high versus medium educated parents. The role of energy-balance-related behaviors in explaining inequalities in BMI was surprisingly consistent. Across countries, physical activity did not, while screen time and breakfast consumption did play a role. The only exception was that breakfast consumption did not play a role in the US. Cross-country differences emerged in the relative contribution of each behavior in explaining inequalities in BMI: Breakfast consumption was most important in the UK, screen time explained most in Germany and the US, and breakfast consumption and screen time were equally important in the Netherlands. Our findings suggest that what constitutes the most effective policy intervention differs across countries and that these should target both children from medium as well as low educated families. • All countries showed substantial socioeconomic inequalities in childhood BMI. • In all countries, inequalities in BMI steepen over course of primary school. • Protective factors among the most advantaged seem to mainly drive inequalities. • Across most countries, underlying mechanisms for inequalities in BMI are similar. • The relative contribution of each mechanism to BMI inequalities differs per country. [ABSTRACT FROM AUTHOR]

The article presents a paper that studies association between incarceration and inpatient resource use and death rates using a U.S. veteran sample. It informs that the U.S. Justice Department numbers show that more than 131,000 U.S. veterans are incarcerated in U.S. prisons and more than 50 percent reported mental health problems. It informs that Recently Incarcerated Veterans (RIVs)showed higher rates of mental illnesses.

Objective: Premature mortality is a public health concern that can be quantified as years of potential life lost (YPLL). Studying premature mortality from in-hospital mortality can help guide hospital initiatives and resource allocation. This paper identified the diagnosis categories associated with in-hospital deaths that account for the highest YPLL and their trends over time. Study design: Retrospective review of the Nationwide Inpatient Sample (NIS), 1988-2010. Methods: Using the NIS, YPLL on patients hospitalized in the United States from 1988 to 2010 was calculated. Hospitalizations were categorized by related principal diagnoses using the Healthcare Cost and Utilization Project (HCUP) single-level Clinical Classification Software (CCS) definitions. Results: Between 1988 and 2010, total in-hospital estimated mortality of 20,154,186 people accounted for 198,417,257 YPLL (9.84 YPLL per in-hospital mortality; 8,626,837 estimated annual mean YPLL). The ten highest YPLL diagnosis categories accounted for 51% of the overall YPLL. The liveborn disease category (i.e., in-hospital live births) was the most common principal diagnosis and accounted for the highest YPLL at 1,070,053. The septicemia category accounted for the second highest YPLL at 548,922. The highest in-hospital mortality rate (20.8%) was associated with adult respiratory failure/insufficiency/arrest. The highest estimated in-hospital annual mean deaths occurred in patients with pneumonia at 69,134. For all in-hospital mortality, the inflation adjusted total in-hospital charges per YPLL was highest for acute myocardial infarction at $9292 per YPLL. Conclusions: Using YPLL, a framework has been provided to compare the impact of premature in-hospital mortality from dissimilar diseases. The methodology and results may be used to help guide further investigation of hospital quality initiatives and resource allocation. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy of interventions and environmental factors on increasing fluid intake or reducing dehydration risk in older people living in long-term care facilities. Design Systematic review of intervention and observational studies. Data Sources Thirteen electronic databases were searched from inception until September 2013 in all languages. References of included papers and reviews were checked. Eligibility Criteria Intervention and observational studies investigating modifiable factors to increase fluid intake and/or reduce dehydration risk in older people (≥65 years) living in long-term care facilities who could drink orally. Review Methods Two reviewers independently screened, selected, abstracted data, and assessed risk of bias from included studies; narrative synthesis was performed. Results A total of 4328 titles and abstracts were identified, 325 full-text articles were obtained and 23 were included in the review. Nineteen intervention and 4 observational studies from 7 countries investigated factors at the resident, institutional, or policy level. Overall, the studies were at high risk of bias due to selection and attrition bias and lack of valid outcome measures of fluid intake and dehydration assessment. Reported findings from 6 of the 9 intervention studies investigating the effect of multicomponent strategies on fluid intake or dehydration described a positive effect. Components included greater choice and availability of beverages, increased staff awareness, and increased staff assistance with drinking and toileting. Implementation of the US Resident Assessment Instrument reduced dehydration prevalence from 3% to 1%, P = .01. Two smaller studies reported positive effects: one on fluid intake in 9 men with Alzheimer disease using high-contrast red cups, the other involved supplementing 13 mildly dehydrated residents with oral hydration solution over 5 days to reduce dehydration. Modifications to the dining environment, advice to residents, presentation of beverages, and mode of delivery (straw vs beaker; prethickened drinks vs those thickened at the bedside) were inconclusive. Two large observational studies with good internal validity investigated effects of ownership; in Canada, for-profit ownership was associated with increased hospital admissions for dehydration; no difference was seen in dehydration prevalence between US for-profit and not-for-profit homes, although chain facilities were associated with lower odds of dehydration. This US study did not suggest any effect of staffing levels on dehydration prevalence. Conclusions A wide range of interventions and exposures were identified, but the efficacy of many strategies remains unproven due to the high risk of bias present in many studies. Reducing dehydration prevalence in long-term care facilities is likely to require multiple strategies involving policymakers, management, and care staff, but these require further investigation using more robust study methodologies. The review protocol was registered with the International Prospective Register of Systematic Reviews ( http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42012003100 ). [ABSTRACT FROM AUTHOR]

Background: Pressure ulcers are associated with a nearly three-fold increase in in-hospital mortality. It is essential to investigate how other factors besides the Braden scale could enhance the prediction of pressure ulcers. Data mining modeling techniques can be beneficial to conduct this type of analysis. Data mining techniques have been applied extensively in health care, but are not widely used in nursing research. Purpose: To remedy this methodological gap, this paper will review, explain, and compare several data mining models to examine patient level factors associated with pressure ulcers based on a four year study from military hospitals in the United States. Methods: The variables included in the analysis are easily accessible demographic information and medical measurements. Logistic regression, decision trees, random forests, and multivariate adaptive regression splines were compared based on their performance and interpretability. Results: The random forests model had the highest accuracy (C-statistic) with the following variables, in order of importance, ranked highest in predicting pressure ulcers: days in the hospital, serum albumin, age, blood urea nitrogen, and total Braden score. Conclusion: Data mining, particularly, random forests are useful in predictive modeling. It is important for hospitals and health care systems to use their own data over time for pressure ulcer risk prediction, to develop risk models based upon more than the total Braden score, and specific to their patient population. [ABSTRACT FROM AUTHOR]

Objectives The purposes of this study were to (a) examine the prevalence of disordered eating among female figure skaters, (b) compare levels of disordered eating between skaters and their same-age peers, (c) compare levels of disordered eating between elite skaters and their sub-elite counterparts, and (d) examine general and sport-related correlates of disordered eating (i.e., four sport-related weight pressures, general and sport-related body dissatisfaction, positive and negative perfectionism, self-esteem, and athletic identity). Design This study employed a cross-sectional design. Methods Participants completed paper–pencil surveys, including measures for disordered eating, four sport-related weight pressures, general and sport-related body dissatisfaction, positive and negative perfectionism, self-esteem, and athletic identity. Participants included 272 female figure skaters ages 12–25 ( M = 15.63) across five US states. Results Thirteen percent of participants scored within range of problematic eating attitudes and behaviors but were no more symptomatic than their same-age peers when compared to existing normative data. Levels of disordered eating did not significantly differ between those competing at the elite and sub-elite level. After controlling for body mass index and age, disordered eating was significantly predicted by self-consciousness of weight and appearance, general and sport-related body dissatisfaction, and positive perfectionism. Conclusions Disordered eating occurs in female figure skaters across competitive levels. Concern over weight and appearance, dissatisfaction with one's body in general and in sport, and positive perfectionism may serve as important tools in the prevention and detection of disordered eating in female figure skaters. [ABSTRACT FROM AUTHOR]

Research in several countries shows higher Covid-19 vaccination willingness and uptake among physicians than nurses. Our paper aims to characterize and explain this difference. In early 2021, we surveyed 1047 U.S. primary care professionals who served adolescents, ages 11–17. The national sample included physicians (71%) as well as nurses and advanced practice providers. The survey assessed the three domains of the Increasing Vaccination Model: thinking and feeling , social processes , and direct behavior change. Covid-19 vaccine uptake was higher among physicians than among nurses and advanced practice providers (91% vs. 76%, p <.05). Overall, in the thinking and feeling domain, higher confidence in Covid-19 vaccination, higher perceived susceptibility to the disease, and stronger anticipated regret were associated with higher vaccine uptake (all p <.05). In the social processes domain, perceiving more positive social norms for Covid-19 vaccination, receiving recommendations to get the vaccine, and wanting to help others were associated with higher vaccine uptake (all p <.05). In the direct behavior change domain, receiving an invitation to get the vaccine and better access to vaccination were associated with higher uptake (both p <.05). Of these variables, most of the thinking and feeling and social processes variables mediated the association of training with vaccine uptake. Physicians had higher Covid-19 vaccine uptake than nurses and advanced practice providers, corresponding with their more supportive vaccine beliefs and social experiences. Efforts to reach the remaining unvaccinated cohort can build on these findings. • Covid-19 vaccine uptake among advanced practice providers and nurses was lower than in physicians. • Vaccine confidence and social norms explained the difference in Covid-19 vaccine uptake. • Recommendations from employers and providers suppressed some differences in vaccination. • Behavioral nudges – invitation and incentives – were associated with more vaccine uptake. • Offers directions and contexts for future vaccination interventions and programs in the U.S. [ABSTRACT FROM AUTHOR]

• Differences in income explain some racial inequities in child welfare contact. • Differences in hardship do not explain racial inequities in child welfare contact. • Material hardship predicts child welfare contact across racialized groups. Child protective services (CPS) contact is consistently linked with poverty in the US, and empirical evidence is mounting to indicate that disparate exposure to income poverty explains a substantial portion of racial inequities in CPS involvement. Evidence about the different distributions of income poverty and material hardship also suggests that income poverty may not sufficiently capture economic wellbeing among families. This paper assessed whether differences in exposure to income poverty and/or material hardship explain racial inequities in CPS contact and further examined whether income poverty and material hardship predict CPS contact differently within racialized groups. We used data from the Fragile Families and Child Wellbeing Study (FFCWS), an urban cohort representative of births in large US cities in 1998–2000. The FFCWS data are ideal for this study in capturing each of the key constructs: racialized group membership, income, material hardship, and CPS contact. We measured income poverty and material hardship when children were age 1 and measured any CPS contact by age five. Our final sample included 3,517 families, including 1,848 Black, 614 white, and 1,055 Latinx families. We employed logistic regression to assess the associations between income poverty and material hardship, independently and jointly, and CPS contact. We conducted analyses in our full analytic sample and among subsamples of the Black, white, and Latinx families. We found that differences in income-to-poverty ratio account for differences in CPS contact between Black and white families. Differences in CPS contact between Black and Latinx families were not explained by economic wellbeing measures alone but were ameliorated when differences in income poverty, material hardship, and a full set of family characteristics were considered. Additionally, we found that material hardship was a consistent predictor of CPS contact in the full sample and within each of the Black, white, and Latinx subsamples, even accounting for differences in income and other family characteristics. The clear role of income poverty in explaining inequities in CPS contact between Black and white families and the consistent importance of material hardship in predicting CPS contact across all families underscore the critical importance of reducing income poverty and hardship and of distinguishing material need from maltreatment in the context of CPS. Our findings offer clear implications for policy intervention to reduce income poverty and material hardship. Such interventions might include extending the temporarily expanded Child Tax Credit and expanded food and housing assistance benefits, toward the ends of supporting child and family wellbeing and reducing economic and racial inequities in CPS contact. [ABSTRACT FROM AUTHOR]

This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries have a less well developed mental model of depression for black compared with white patients. [ABSTRACT FROM AUTHOR]

Physical activity is an important determinant of obesity and overall health for children, but significant race/ethnic and nativity disparities exist in the amount of physical activity that children receive, with immigrant children particularly at risk for low levels of physical activity. In this paper, we examine and compare patterns in physical activity levels for young children of U.S.-born and immigrant mothers from seven race/ethnic and nativity groups, and test whether physical activity is associated with subjective (parent-reported) and objective (U.S. Census) neighborhood measures. The neighborhood measures include parental-reported perceptions of safety and physical and social disorder and objectively defined neighborhood socioeconomic disadvantage and immigrant concentration. Using restricted, geo-coded Early Childhood Longitudinal Study-Kindergarten (ECLS-K) data (N = 17,510) from 1998 to 1999 linked with U.S. Census 2000 data for the children's neighborhoods, we utilize zero-inflated Poisson (ZIP) models to predict the odds of physical inactivity and expected days of physical activity for kindergarten-aged children. Across both outcomes, foreign-born children have lower levels of physical activity compared to U.S.-born white children. This disparity is not attenuated by a child's socioeconomic, family, or neighborhood characteristics. Physical and social disorder is associated with higher odds of physical inactivity, while perceptions of neighborhood safety are associated with increased expected days of physical activity, but not with inactivity. Immigrant concentration is negatively associated with both physical activity outcomes, but its impact on the probability of physical inactivity differs by the child's race/ethnic and nativity group, such that it is particularly detrimental for U.S.-born white children's physical activity. Research interested in improving the physical activity patterns of minority and second-generation immigrant children should consider how neighborhood context differentially impacts the health and physical activity of children from various racial, ethnic and nativity backgrounds. [ABSTRACT FROM AUTHOR]

Social scientists have long demonstrated that socioeconomic resources benefit health. More recently, scholars have begun to examine the potential stratification in the health returns different groups receive for a given resource. Motivated by fundamental cause theory, this paper examines homeownership as a salient health resource with potentially stratified benefits. Homeowners have significantly greater housing quality, wealth, neighborhood quality and integration, and physical and mental health than renters. However, there are compelling theoretical reasons to expect the health advantage of homeownership to be unequally distributed across racial and ethnic groups. Regression analyses of 71,874 household heads in the United States from the 2012 March Current Population Survey initially suggest all homeowners experience a significant health advantage. Further examination finds robust evidence for a homeowner health advantage among Whites, on par with the difference between the married and divorced. The advantage among minority households is considerably smaller, and not significant among Latinos or Asians. Conditioning on a broad array of observable characteristics, White homeowners emerge as exceptionally healthy compared to White renters and all minority groups. This leads to the unexpected finding that racial/ethnic differences in health are concentrated among homeowners. The findings demonstrate the interactive nature of racial/ethnic stratification in health through both access to and returns from socioeconomic resources. [ABSTRACT FROM AUTHOR]

The objective of this paper was to investigate the association between contextual social capital and immunization coverage rates. A cross-sectional, ecologic study design was used. Three different estimations of contextual social capital in American states have been used. Data on immunization coverage rates at state level comes from Centers for Disease Control and Prevention. Correlation coefficients were calculated to investigate the bivariate association between the independent variable social capital and the dependent variable 2009 A(H1N1) immunization coverage rates. A multivariate OLS regression model was used to investigate the association between contextual social capital and immunization, under control for state-level health care spending per capita, state population, population per square mile, and median age in the American States. Results show that Social capital was strongly correlated with 2009 A(H1N1) immunization acceptance among American States. In a multivariate regression analysis, the association remains strong and significant also when controlling state-level confounders. In conclusion, social capital, at least in a U.S. context, is shown to be associated with the state-level uptake of vaccination against the 2009 A(H1N1) pandemic. [ABSTRACT FROM AUTHOR]

Abstract: The increases in suicide among middle-aged baby boomers (born between 1946 and 1964) in the United States since 1999 suggest a changing epidemiology of suicide. Using data from 1935 to 2010, this paper conducts age-period-cohort analyses to determine the impact of cohorts in shaping temporal patterns of suicide in the United States. The analysis demonstrates that age, period and cohort effects are all important in determining suicide trends. Net of age and period effects, the cohort pattern of suicide rates is U-shaped, with cohorts born between 1915 and 1945 possessing among the very lowest suicide rates. Suicide rates begin to rise with boomers and subsequent cohorts exhibit increasingly higher rates of suicide. The general pattern exists for both men and women but is especially pronounced among males. The average suicide rate over the entire period for males is about 28 per 100,000, 95% CI [27.4, 28.7]. For males born in 1930–34, the suicide rate is estimated to be 17.4 per 100,000, 95% CI [15.9, 18.8]; for males born between 1955 and 1959, the rate is essentially the same as the average for the period while for males born between 1985 and 1989, the suicide rate is estimated to be 37.8 per 100,000, 95% CI [33.1, 43.4]. The results dispute popular claims that boomers exhibit an elevated suicide rate relative to other generations, but boomers do appear to have ushered in new cohort patterns of suicide rates over the life course. These patterns are interpreted within a Durkheimian framework that suggests weakened forms of social integration and regulation among postwar cohorts may be producing increased suicide rates. [Copyright &y& Elsevier]

Objectives: This paper provides a quantitative review that estimates exposure rates by type of violence, setting, source, and world region. Design: A quantitative review of the nursing violence literature was summarized. Data sources: A literature search was conducted using the CINAHL, Medline and PsycInfo data bases. Studies included had to report empirical results using a nursing sample, and include data on bullying, sexual harassment, and/or violence exposure rates. A total of 136 articles provided data on 151,347 nurses from 160 samples. Procedure: Articles were identified through a database search and by consulting reference lists of review articles that were located. Relevant data were coded by the three authors. Categories depended on the availability of at least five studies. Exposure rates were coded as percentages of nurses in the sample who reported a given type of violence. Five types of violence were physical, nonphysical, bullying, sexual harassment, and combined (type of violence was not indicated). Setting, timeframe, country, and source of violence were coded. Results: Overall violence exposure rates were 36.4% for physical violence, 66.9% for nonphysical violence, 39.7% for bullying, and 25% for sexual harassment, with 32.7% of nurses reporting having been physically injured in an assault. Rates of exposure varied by world region (Anglo, Asia, Europe and Middle East), with the highest rates for physical violence and sexual harassment in the Anglo region, and the highest rates of nonphysical violence and bullying in the Middle East. Regions also varied in the source of violence, with patients accounting for most of it in Anglo and European regions, whereas patents' families/friends were the most common source in the Middle East. Conclusions: About a third of nurses worldwide indicated exposure to physical violence and bullying, about a third reported injury, about a quarter experienced sexual harassment, and about two-thirds indicated nonphysical violence. Physical violence was most prevalent in emergency departments, geriatric, and psychiatric facilities. Physical violence and sexual harassment were most prevalent in Anglo countries, and nonphysical violence and bullying were most prevalent in the Middle East. Patients accounted for most physical violence in the Anglo region and Europe, and patient family and friends accounted for the most in the Middle East. [ABSTRACT FROM AUTHOR]

Abstract: A central hypothesis of Child Development Accounts (CDA) suggests that savings accounts in childhood lay a foundation for connecting to mainstream banking institutions and diversifying asset portfolios in young adulthood and beyond. While children may have limited savings to invest initially, they are financial actors who may increasingly invest money into different types of savings products over time. This paper uses propensity score weighted, longitudinal data from the Panel Study of Income Dynamics and its supplements to examine the types of financial and nonfinancial assets owned by young adults and whether or not they are more likely to own these assets when they have savings accounts as children. The most commonly owned assets in young adulthood included savings accounts (89%), vehicles (54%) and credit cards (51%). Smaller percentages owned stocks (9%), bonds (6%), and homes (8%). On average, young adults owned two to three different assets. Having savings accounts in childhood was associated with being two times more likely to own savings accounts, two times more likely to own credit cards, and four times more likely to own stocks in young adulthood, compared to not having savings accounts in childhood. Young adults' ownership of more total financial assets was also associated with having savings accounts in childhood. Findings provide some supporting evidence of demand for children's savings accounts. Policy endeavors that remove barriers to account ownership may be advantageous for children and mainstream banks. [Copyright &y& Elsevier]

Abstract: In recent years, research examining determinants and consequences of the means-tested child care subsidy program (the Child Care and Development Fund [CCDF]) has grown dramatically. To measure subsidy utilization, existing studies typically rely on parent-reported measures of subsidy receipt drawn from large surveys. As the research literature on child care subsidies has grown, however, so have concerns about the trustworthiness of parent-reported subsidy use. One way to assess the quality of parent-reported subsidy use is to examine its overlap with another subsidy receipt measure, drawn from a different source. The current paper uses the Fragile Families and Child Well-Being Study (FFCWS), the only existing survey data source that contains an alternate measure of subsidy receipt — based on child care provider report — which permits a comparison to parent-reported measures. We find evidence that increases our confidence in the trustworthiness of parents as accurate reporters of subsidy receipt. In recognition that neither data source reflects “true” subsidy receipt, however, we conclude with a discussion of limitations and steps for future research. [Copyright &y& Elsevier]

Abstract: There is considerable policy interest in the impact of macroeconomic conditions on health-related behaviours and outcomes. This paper sheds new light on this issue by exploring the relationship between macroeconomic conditions and an indicator of problem drinking derived from state-level data on alcoholism-related Google searches conducted in the US over the period 2004–2011. We find the current recessionary period coincided with an almost 20% increase in alcoholism-related searches. Controlling for state and time-effects, a 5% rise in unemployment is followed in the next 12 months by an approximate 15% increase in searches. The use of Internet searches to inform on health-related behaviours and outcomes is in its infancy; but we suggest that the data provides important real-time information for policy-makers and can help to overcome the under-reporting in surveys of sensitive information. [Copyright &y& Elsevier]

Abstract: While it is well documented that economic expansions provide widespread and immediate financial benefits, the evidence on how an economic downturn affects individual''s health behaviors is surprisingly mixed. In this paper, we take a structural approach to investigate the effects of wages and working hours on health behaviors of low-educated persons using variations in wages and hours caused by changes in local economic activity. In the empirical analysis, we adopt a two-sample instrumental variables approach to combine the data on individual health behaviors from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) with the data on individual employment from the Current Population Survey (CPS). The total sample size of the combined CPS-BRFSS data for the time period of 1984–2005 is 967,594, while that of the combined CPS-NHIS data for the time period of 1976–2001 is 364,078. We find that increases in wages caused by economic expansions are associated with greater consumption of cigarettes in the United States. We also find that increases in hours of work caused by economic expansions are associated with more cigarette consumption, but less physical activity and physician visits. More importantly, the evidence suggests that most of such effects associated with changes in hours of work can be attributed to the changes at the extensive margin of employment, meaning the changes in employment status, rather than the changes at the intensive margin, meaning changes in hours of work conditional on being employed. These findings imply that changes in employment may have heterogeneous impacts on time-intensive and less time-intensive health behaviors and also provide additional evidence on the importance of time in health production, particularly for time-intensive activities. [Copyright &y& Elsevier]

Abstract: This study examines the interactive contextual effect of income inequality on health. Specifically, we hypothesize that income inequality will moderate the relationships between individual-level risk factors and health. Using National Health Interview Survey data 1984–2007 (n = 607,959) and U.S. Census data, this paper estimates the effect of the dramatic increase in income inequality in the U.S. over the past two decades on the gradient of socioeconomic status on two measures of health (i.e., physical functioning and activity limitations). Results indicate that increasing income inequality strengthens the protective effects of family income, employment, college education, and marriage on these two measures of health. In contrast, high school education''s protective effect (relative to less than a high school education) weakens in the context of increasing income inequality. In addition, we find that increasing income inequality exacerbates men''s disadvantages in physical functioning and activity limitations. These findings shed light on research about growing health disparities in the U.S. in the last several decades. [Copyright &y& Elsevier]

Abstract: Due to the high incidence of poverty among custodial-parent families, most countries have a variety of policies designed to increase these families'' income security, including child support. However, despite policy efforts, in a wide range of countries the majority of custodial-parent families do not receive these transfers. Does this suggest that a low receipt rate is a core issue of child support policy across contexts? To explore this question, this paper focuses on child support receipt in two very different countries, Colombia and the United States. The overarching question is whether the country of residence is associated with the likelihood of child support receipt. The Colombian 2008 Quality of Life Survey and the U.S. 2008 Current Population Survey‐Child Support Supplement provide information on 6751 custodial mothers. Based on a series of probit models, our study shows that living in the U.S. is associated with an increase in the likelihood of child support receipt. However, once we control for custodial mother''s characteristics, the marginal effect of country of residence decreases significantly, and variables such as custodial mother''s education and income quintile become important as well. These findings suggest that in both countries custodial mothers have similar issues when it comes to receiving financial support from their children''s father, despite the differences in economic development and attention to child support policy in Colombia and the U.S. [Copyright &y& Elsevier]

This paper models racialized perceptions of child welfare workers and tests the hypothesis that these perceptions contribute to the racial disproportionality in reported and/or substantiated child maltreatment. A method is adopted which captures the salient features of racial stereotypes deriving from visual representations of neglectful situations that meet state definitions of child maltreatment and reportable offenses. Caseworkers are shown pictures of a neglectful situation that randomly varies with respect to whether a child in the picture is black or white or whether there is no child at all pictured. If things that “look black” are more likely to be perceived of by caseworkers as reportable offenses or to meet state definitions of child maltreatment than things that “look white,” then this indicates racialized perceptions. Data are collected from a sample of all caseworkers from every county in Minnesota for 2005. Linear and logistic fixed effects models are estimated for the responses as to whether the situation in the picture meets the state definition and whether the offense is reportable. Independent variables include: the respondent''s age, gender, and race; whether the respondent was born in the Twin Cities, majored in social work, was an intake worker, or worked in Hennepin County. The results show statistically significant impacts of the black baby vignette (compared to no baby or white baby) on the likelihood that respondents agree that the situation depicted in the picture meets the state definition of neglect and is reportable. Also estimated are the impacts of these racialized beliefs on racial disproportionalities in reported and substantiated child maltreatment rates across counties. There are strong and statistically significant impacts of indices of caseworker racialized beliefs on racial disproporationalities in reported and substantiated maltreatment rates. [Copyright &y& Elsevier]

Peer victimization is a serious social problem that can negatively affect children''s psychosocial development and school adjustment, and may have lasting effects for victims. The rates of peer victimization among preschool children with disabilities, however, are unknown. This paper examines the prevalence and nature of peer victimization among children with disabilities in school settings using data from the Pre-Elementary Education Longitudinal Study (N =1270). One-quarter to one-third of preschool children with disabilities experienced some form of peer victimization in school. Peer victimization increased over the 2003–2006 period (21% in Year 1, 25% in Year 2, 30% in Year 3), and there were also substantial rates of co-occurring types of victimization among children with disabilities. These results suggest the urgent need to provide bullying prevention strategies for children with disabilities—strategies which have been previously neglected in the context of school-based bullying prevention and intervention programs. [Copyright &y& Elsevier]

Abstract: This paper examined the importance of household and economic contextual factors as determinants of ethnic disparities in adolescent body mass index (BMI). Individual-level data from the National Longitudinal Survey of Youth 1997 for the years 1997 through 2000 were combined with economic contextual data on food prices, outlet density and median household income. The Oaxaca–Blinder decomposition method was used to examine the factors that could help explain ethnic disparities in BMI. Ethnic differences in household demographic, parental socioeconomic status (SES), and economic contextual factors explained the majority of the male black–white (63%), male Hispanic–white (78%) and female Hispanic–white (62%) BMI gaps but less than one-half of the female black–white BMI gap (44%). We found that adding the economic contextual factors increased the explained portion of the ethnic BMI gap for both female and male adolescents: the economic contextual factors explained 28% and 38% of the black–white and Hispanic–white BMI gaps for males and 13% and 8% of the black–white and Hispanic–white BMI gaps for females, respectively. Parental SES was more important in explaining the Hispanic–white BMI gap than the black–white BMI gap for both genders, whereas neighborhood economic contextual factors were more important in explaining the male BMI gap than the female BMI gap for both black–white and Hispanic–white ethnic disparities. A significantly large portion of the ethnic BMI gap, however, remained unexplained between black and white female adolescents. [Copyright &y& Elsevier]

Abstract: Although the population of homeschooled children in the United States is large and growing, little is known about their access to and utilization of preventive health care services. This paper compares the health care access and utilization of homeschooled children and public school children in the United States using data from the nationally-representative 2007 National Survey of Children''s Health. Using logistic regression models, this study finds that homeschooled children were significantly less likely than public school children to have access to a medical home, to visit a health care professional annually, and to receive the Human Papillomavirus vaccine. They were not statistically less likely to have health insurance, to receive annual dental care, or to receive Tetanus or Meningitis vaccinations. This research suggests that public health practitioners, medical providers, researchers, and educators should be attentive to the health care needs of homeschooled children. [Copyright &y& Elsevier]

Abstract: This paper examines the associations between Chinese and Korean immigrant parents’ early life material and food deprivation and their concern about their child’s diet or weight, preferences for heavier children, and weight-promoting diet and child weight, alongside the moderating role of parents’ acculturation toward American culture. In 2010, Chinese and Korean immigrant parents of children ages 3–8 years in the United States (N = 130) completed interviews which asked about their perceived early life material deprivation and food insecurity, acculturation, child feeding practices, and evaluations of whether their child weighed more or less than the ideal, and child consumption of soda and candy. Independent measures of child and parent BMI were also obtained. Regression analyses revealed that parents’ early life food insecurity was associated with the evaluation that their child should weigh more than they do and greater consumption of soda and sweets by their child, among the least acculturated parents. Parental material deprivation was associated with more laissez-faire child feeding practices: less monitoring, less concern about the child’s weight or diet, and less perceived responsibility for the child’s diet, but only among less acculturated parents. Overall, the results suggest that immigrant parents’ child feeding practices and body size evaluations are shaped by material hardship in childhood, but these influences may fade as acculturation occurs. [Copyright &y& Elsevier]

Abstract: This paper examines the relationship between welfare reform and child care costs among low-income single mothers and the effects of post reform child care subsidy receipt on the status and duration of these mothers'' employment. A two-step model analysis of data from the Survey of Income and Program Participation (1993, 1996, and 2001 panels) revealed marginal effects of welfare reform on child care costs, indicating that child care costs increased significantly among low-income single mothers after welfare reform. Results from a Tobit model revealed that child care subsidy receipt also had significant effects on employment status. Finally, families with only a mother and children in the household had a higher probability of using paid child care and spent more on care than mothers with other adults in the household. [Copyright &y& Elsevier]

Summary Professional athletes provide high-profile role models of health and human performance. Increased body mass can be adaptive for human performance but also presents a health threat. This paper examines 145 years of data on body mass in 17,918 male professional baseball players in the United States at the time of their professional debut. Both height and weight at debut have increased over time. Controlling for age at debut, players debuting in the current decade were significantly more likely to be overweight or obese than at any time in history. The prevalence of overweight and obesity increased to approximately 70% and 10%, respectively, while normal weight prevalence decreased from approximately 60% to 20% during that time. The causes of these changes over the past 25 years are not clear although they coincide with the steroid era. These trends warrant further attention because of the potential for adverse long-term health consequences in this population and those who perceive them as role models for health and human performance. [ABSTRACT FROM AUTHOR]

[Display omitted] • Respondents adapted their delivery of the Lidcombe Program during the pandemic. • Perceived advantages outweigh disadvantages to using telepractice. • Respondents easily adapted the components of the Lidcombe Program to telepractice. • Most speech-language pathologists would use telepractice in the future. Telepractice has been shown to be a viable modality for the delivery of stuttering treatment. Since the advent of COVID-19, speech-language pathologists must adapt in-clinic treatments for online presentation. This research aimed to gather information from speech-language pathologists on their experiences of telepractice to deliver the Lidcombe Program to treat stuttering in young children. This paper presents the findings of an online survey that polled the clinical experiences of 106 speech-language pathologists who were delivering the Lidcombe Program via telepractice during COVID-19. The majority of respondents were experienced clinicians from the United States and Canada who had attended a Lidcombe Program workshop. Prior to COVID-19, 80 % had provided some clinical services online (up to 10 % of the time), and at the start of COVID-19 public lockdown orders, 77 % viewed telepractice as both a necessity and an opportunity. Three months after the public lockdown orders, the large majority, 94 %, said that they would continue to use both telepractice and in-clinic treatment in the future. Technology issues, concerns about establishing the clinical relationship, and identification of mild stuttering featured as challenges of telepractice service delivery, while benefits included time efficiency, flexibility of scheduling, and improved clinical processes. Respondents reported that the Lidcombe Program was easily translatable to telepractice and the majority intend to continue telepractice in the future. [ABSTRACT FROM AUTHOR]

Almost half of renters in the United States are rent-burdened, meaning that they pay more than 30% of their income toward housing costs. Rental assistance through programs administered by the U.S. Department of Housing and Urban Development, alleviates these financial strains for around 5 million households. However, due to budgetary constraints, fewer than one in four eligible households actually receive this assistance and waitlists average two years nationally. Using longitudinal data from a cohort of 400 low-income adults living in New Haven, CT, this paper investigates how access to rental assistance affects mental health through two analytical methods that address selection into rental assistance. First, we performed a cross-sectional analysis to identify how psychological distress differs among those receiving and those on a waitlist for rental assistance. Second, we used a within-person fixed-effects analysis to compare changes in individuals following entry into rental assistance. We find that those receiving rental assistance report significantly less psychological distress than those on waiting lists and that transitions into rental assistance are associated with statistically non-significant decreases in psychological distress. Our findings suggest that expanding rental assistance may be one potential step toward improving the mental health of low-income individuals in the United States. • Lack of affordable housing is associated with poor mental health. • We find that rent assistance is associated with reduced psychological distress. • Addressing unmet need for rental assistance may improve mental health. [ABSTRACT FROM AUTHOR]

Self-presentation, the social process by which people reveal information about themselves and perform the social roles that structure everyday interactions, has been significantly altered by today's social technologies. Where Goffman's influential self-presentation framework focused on in-person, real-time role performances, today's technologies routinely involve viewing text and visual content aggregated over time and linked to an individual's persistent online identity, the capacity for both ephemeral and more permanent content, and novel modes of audience engagement such as liking and commenting. These new socio-technical affordances not only allow for novel behaviors, but also alter the temporal dynamics of the self-presentation process in ways that are not well understood. In this paper we address this gap through an interview study of 32 young gay and bisexual male (GBM) Instagram users in the United States. Results extend our understanding of the relationship between social technology affordances and the temporal dynamics of self-presentation. We show how participants drew on Instagram's affordances for identity persistence, content persistence and audience engagement to slow down or speed up their role performances to particular audiences, to increase the visibility of their performances without appearing overtly to seek attention, and to make their audience at any given point in time a part of the performance seen by future audiences. • Unlike in-person, performing social roles online can occur across multiple time scales. • The temporality of online affordances and self-presentation are interrelated and used strategically by participants. • Audience plays a novel role in social media self-presentation, akin to extras on a film set. [ABSTRACT FROM AUTHOR]

Home health care is a rapidly growing healthcare sector worldwide. Home health professionals face unique challenges related to preventing and controlling infections, which are likely to amplify during an infectious disease outbreak (e.g. SARS-CoV-2). Little is known about the current state of infection prevention and control-related policies and outbreak preparedness at U.S. home health agencies. In this study, we conducted a national survey to assess infection prevention and control-related policies, infrastructure, and procedures prior to the SARS-CoV-2 pandemic. Cross-sectional study. Using a stratified random sample of 1506 U.S. home health agencies, we conducted a 61-item survey (paper and online) from November 9, 2018 to December 31, 2019. Survey data were linked to publicly-available data on the quality of patient care, patient satisfaction, and other agency characteristics. Probability weights were developed to account for sample design and nonresponse; Pearson's χ2, Fisher's exact, t-tests or linear regression were used to compare the universe of agencies/respondents and urban/rural agencies. 35.6% of agencies responded (n = 536). Most home health personnel in charge of infection prevention and control have other responsibilities; one-third have no formal infection prevention and control training. Rural agencies are more likely to not have anyone in charge of infection prevention and control compared to those in urban areas. About 22% of agencies implement recommended guidelines when administering antibiotics. Less than a third (26.4%) report that their staff vaccination rates were higher than 95% during the last flu season. Only 48.1% of agencies accept patients requiring ventilation, and of those, 40.9% located in rural areas do not have specific infection prevention and control policies for ventilated patients, compared to 20.8% in urban areas (p < 0.001). Only 39.7% of agencies provide N95 respirators to their clinical staff; rural agencies are significantly more likely to provide those supplies than urban agencies (50.7% vs. 37.7%, p = 0.004). Lastly, agencies report their greatest challenges with infection prevention and control are collecting/reporting infection data and adherence to/monitoring of nursing bag technique. Prior to the SARS-CoV-2 pandemic, we found that infection prevention and control was suboptimal among U.S. home health care agencies. Consequently, most agencies have limited capacity to respond to infectious disease outbreaks. Staff and personal protective equipment shortages remain major concerns, and agencies will need to quickly adjust their existing infection prevention and control policies and potentially create new ones. In the long-term, agencies also need to improve influenza vaccination coverage among their staff. Tweetable abstract: Infection prevention and control infrastructure, policies and procedures and outbreak preparedness at U.S. home health agencies was found to be suboptimal in nationally-representative survey conducted just prior to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

To understand rural–urban differences in stressors, this study compared the cognitive and emotional language in geolocated Twitter posts in the United States against survey-reported county-level trends from the Gallup-Sharecare Well-Being Index. Mentions of stress on Twitter can predict population-level trends in stress in both rural (R2=31.6%) and urban (R2=26.7%) communities. While mentions of poor health are limited to only rural areas with low socioeconomic status, higher emotional expression is associated with higher stress across all rural communities. Controlling for socioeconomic status, urban communities reporting higher stress are also more likely to discuss relationships on Twitter. The findings contribute to an understanding of how language use on social media acts as a barometer of the social and cultural differences between regions. The data and stress topics developed in this paper are publicly available and can be accessed at https://osf.io/af8ce/. • Methods to derive data-driven dictionaries from social media, validated against survey data on community-level outcomes. • Social media mentions of stress discuss appraisal, problems, and coping processes aligning with psychological theory. • Controlling for socioeconomic status, rural areas with higher stress are more emotionally expressive on Twitter. • Controlling for socioeconomic status, urban areas with higher stress are more likely to discuss relationships on Twitter. [ABSTRACT FROM AUTHOR]

• Very large changes were observed in the behaviors targeted by SafeCare across implementations. • SafeCare can be used with a range of families and is likely to result in changes to behaviors targeted. • Effect sizes across targeted behaviors of SafeCare were comparable to prior research. Child maltreatment is a significant public health problem affecting more than 3.4 million children per year in the U.S. Child protective systems (CPS) are increasingly adopting evidenced-based practices (EBP), with many specifically adopting behaviorally-based parenting programs (BPTs). One challenge with scaling-up potentially promising interventions it to continue monitoring outcomes for evaluation purposes because program impacts tend to decline when disseminated. Little is known regarding the influence of client diversity on program impacts in the field. This paper examined immediate target skill behavior change among parents receiving the SafeCare model across six implementations. Program impacts were also examined according to family characteristics. Data for 493 families were collected as part of 64 SafeCare implementations between 2008 and 2014, and included family characteristics and behavior change indices. Behavior change indices for the three SafeCare modules (parenting-child interactions, home hazards, and child health care skills) were collected at pre- and post-training sessions by the SafeCare provider. Behavior change across the three modules were substantial. Parents healthcare skills specifically for their children increased by 29.4 percentage points (sd = 26.8, d = 1.74, p <.01). Home safety hazards decreased by 12.54 hazards (sd = 13.9; d = 3.00, p <.01), and parent-child interaction scores increased by 25.0 percentage points (sd = 23.9, d = 2.10, p <.01). There was no evidence that behavior change was moderated by family characteristics including parent age, sex, child protective service status, number of children, or income. [ABSTRACT FROM AUTHOR]

• Adopted Chinese youth scored more favorably on BASC-3 than non-adopted Chinese youth. • Adopted Chinese youth scored more favorably on BASC-3 than non-adopted US youth. • High adoptive family SES benefited adopted youth adjustment. • Testing measurement invariance is important for cross-cultural comparison. In this paper, we examined if high SES families had an effect on youth's adjustment by comparing 226 internationally adopted female Chinese youth who experienced pre-adoption institutionalization with 1059 non-adopted Chinese peers living in China, as well as 209 non-adopted American peers. On average, the adopted youth's families had a higher SES status than the two comparison groups. Survey data on behavioral problems and prosocial adjustment were collected with the third edition of the Behavioral Assessment for Children (BASC-3). We found the adopted Chinese youth outperformed their Chinese counterparts in all comparisons and their US counterparts in most comparisons. These results offer some evidence that a high family SES may compensate for the adoption-related risks such as earlier institutionalization. Possible mechanisms underlying the benefit of high SES were discussed. [ABSTRACT FROM AUTHOR]