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Objectives: The objectives of this paper is to conduct a bibliometric analysis to examine the research status and development trend of anterior cruciate ligament injury and reconstruction in children and adolescents over the past 20 years. Design: Descriptive Research. Methods: This study obtained information regarding studies on Anterior Cruciate Ligament Reconstruction in Children and Adolescents from the Web of Science Core Collection database. Visual and bibliometric analysis were conducted using VOSviewer, Origin 2022, Pajek64 5.18and Excel 2019. These analytic tools facilitated the analysis of various aspects, including countries/regions, institutions, authors, journals and keywords related to the research. Results: From 2003 to 2023, a total of 1328 articles were retrieved in WOS, and 637 articles were selected by two authors. The most productive institutions are Childrens Hosp Philadelphia, Kocher, ms. Their articles have the highest number of publications and citations. The American journal of sports medicine is the most frequently cited journal for articles on anterior cruciate ligament reconstruction in children and adolescents. The most common keywords used in these articles were "anterior cruciate ligament reconstruction", "injury, children, adolescent", and "skeletally immature patients". Conclusions: This study provides valuable insights into the research focus of anterior cruciate ligament reconstruction in children and adolescents. In recent years, there has been significant attention paid to areas of "the return to sport, re-repture rate and functional recovery after anterior cruciate ligament reconstruction" in this specific population. These aspects have emerged as key directions for future research in this field. [ABSTRACT FROM AUTHOR]

The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (Mage = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha =.93) and test–retest (ICC =.95) reliability. Scores were normally distributed and sensitive to age (r = −.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = −.35), and challenging behaviors (r =.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children. [ABSTRACT FROM AUTHOR]

Prostate cancer is the most common cancer after non-melanoma skin cancer and the second leading cause of cancer deaths in US men. Its incidence and mortality rates vary substantially across geographical regions and over time, with large disparities by race, geographic regions (i.e., Appalachia), among others. The widely used Cox proportional hazards model is usually not applicable in such scenarios owing to the violation of the proportional hazards assumption. In this paper, we fit Bayesian accelerated failure time models for the analysis of prostate cancer survival and take dependent spatial structures and temporal information into account by incorporating random effects with multivariate conditional autoregressive priors. In particular, we relax the proportional hazards assumption, consider flexible frailty structures in space and time, and also explore strategies for handling the temporal variable. The parameter estimation and inference are based on a Monte Carlo Markov chain technique under a Bayesian framework. The deviance information criterion is used to check goodness of fit and to select the best candidate model. Extensive simulations are performed to examine and compare the performances of models in different contexts. Finally, we illustrate our approach by using the 2004-2014 Pennsylvania Prostate Cancer Registry data to explore spatial-temporal heterogeneity in overall survival and identify significant risk factors. [ABSTRACT FROM AUTHOR]

Background: Recruiting large cohorts efficiently can speed the translation of findings into care across a range of scientific disciplines and medical specialties. Recruitment can be hampered by factors such as financial barriers, logistical concerns, and lack of resources for patients and clinicians. These and other challenges can lead to underrepresentation in groups such as rural residents and racial and ethnic minorities. Here we discuss the implementation of various recruitment strategies for enrolling participants into a large, prospective cohort study, assessing the need for adaptations and making them in real-time, while maintaining high adherence to the protocol and high participant satisfaction. Methods: While conducting a large, prospective trial of a multi-cancer early detection blood test at Geisinger, an integrated health system in central Pennsylvania, we monitored recruitment progress, adherence to the protocol, and participants' satisfaction. Tracking mechanisms such as paper records, electronic health records, research databases, dashboards, and electronic files were utilized to measure each outcome. We then reviewed study procedures and timelines to list the implementation strategies that were used to address barriers to recruitment, protocol adherence and participant satisfaction. Results: Adaptations to methods that contributed to achieving the enrollment goal included offering multiple recruitment options, adopting group consenting, improving visit convenience, increasing the use of electronic capture and the tracking of data and source documents, staffing optimization via leveraging resources external to the study team when appropriate, and integrating the disclosure of study results into routine clinical care without adding unfunded work for clinicians. We maintained high protocol adherence and positive participant experience as exhibited by a very low rate of protocol deviations and participant complaints. Conclusion: Recruiting rapidly for large studies – and thereby facilitating clinical translation – requires a nimble, creative approach that marshals available resources and changes course according to data. Planning a rigorous assessment of a study's implementation outcomes prior to study recruitment can further ground study adaptations and facilitate translation into practice. This can be accomplished by proactively and continuously assessing and revising implementation strategies. [ABSTRACT FROM AUTHOR]

Background: There is a growing body of literature that indicates positive outcomes of group treatment approaches to intervention for communication difficulties in chronic traumatic brain injury (TBI). The published research to date examines face‐to‐face group intervention. Aim: This study draws on one of these approaches, 'Improving Natural Social Interaction: Group reHabilitation after Traumatic brain injury' (INSIGHT), and examines the adaptation of this program to a virtual setting. The principles underlying the program, which involved providing an authentic contextualised and natural environment for group interactions and enhancing opportunities for identity expression, were maintained. Methods & Procedures: Six participants with mild to severe TBI and cognitive communication difficulties participated in an 8‐week pilot program of the virtual INSIGHT program. Goal Attainment Scaling (GAS) scores completed over the course of the intervention served as the primary outcome measure. Secondary outcomes measures included The Repeatable Battery for the Assessment of Neuropsychological Status Update, The Awareness of Social Inference Test‐Revised, the La Trobe Communication Questionnaire and the Satisfaction with Life Scale. Outcomes & Results: A mixed multilevel analysis revealed significant improvement in GAS scores. A Wilcoxon signed rank test revealed no significant changes in secondary measures. Conclusions & Implications: There is a growing potential for this group treatment approach, in an online medium, and progress towards individualised goals was clear. The data have implications for examining the assessment measures typically used to document functional outcomes in clinical intervention. Future directions indicate a need to pursue more ecologically valid assessment methods. What this paper adds: What is already known on the subject: Recent literature has focused on the benefits of group intervention for cognitive communication diffuclties after traumatic brain injury (TBI). However, research to date examines only face‐to‐face group rehabilitation. As there has been a demand for a shift in the way we communicate worldwide, we must make adaptations to current intervention procedures to continue to serve individuals with diverse communication needs. What this paper adds to existing knowledge: This study contributes new information about the feasibility of a virtual communication skills group for individuals with TBI. This virtual INSIGHT (Improving Natural Social Interaction: Group ehabilitation after Traumatic brain injury) group intervention facilitates progress towards collaboratively set communication goals and the online setting has the potential to increase the accessibility of these services. What are the potential or actual clinical implications of this work?: Progress towards cognitive and social communication goals can be facilitated by an online group intervention. However, this progress was not correlated with scores on standard assessments of cognitive communication, social communication and quality of life. This has implications for the evaluation of the assessments typically used and their ecological validity and applicability to the communication context. [ABSTRACT FROM AUTHOR]

Physical activity is known to contribute to good health, but most adults in the United States do not meet recommended physical activity guidelines. Social incentive interventions that leverage insights from behavioral economics have increased physical activity in short-term trials, but there is limited evidence of their effectiveness in community settings or their long-term effectiveness. The STEP Together study is a Hybrid Type 1 effectiveness-implementation study to address these evidence and implementation gaps. This paper describes the process of adapting study procedures prior to the effectiveness trial using Community Engagement (CE) Studios, facilitated meetings during which community members provide feedback on research projects. Six CE Studios were held with community members from the priority population. They were conducted remotely because of the COVID-19 pandemic. Fifteen liaisons representing 13 community organizations and 21 community members from different neighborhoods in Philadelphia participated. Three elements of the study design were modified based on feedback from the CE Studios: lowering the age requirement for an 'older adult', clarifying the definition of family members to include second-degree relatives, and adding a 6-month survey. These adaptations will improve the fit of the effectiveness trial to the local context and improve participant engagement and retention. CE Studios can be used to adapt intervention strategies and other aspects of study design during hybrid implementation-effectiveness trials. This approach was successfully used with remote online participation due to the COVID-19 pandemic and serves as a model for future community-engaged implementation research. [ABSTRACT FROM AUTHOR]

Over the last few years, much attention has been focused on the nationwide teacher shortage. As teachers begin to retire in record numbers, and the number of students entering teacher education majors continues to decline, concern around the teacher shortage heightens (US Dept. of Ed., 2016). The numbers are even more dire when looking at Teachers of Color entering the profession (US Dept. of Ed., 2016). To address this TOC shortage, Pennsylvania’s Department of Education called for Institutions of Higher Education to create programs aimed at attracting and retaining students of color in their teacher education programs. The Aspiring to Educate (A2E) program was Pennsylvania’s intentional attempt to diversify the teacher workforce. This paper describes the work of three Black educators, as they examine their positionality and work independently and collectively to answer PA’s call to action through the implementation of start-up Grow Your Own programs. [ABSTRACT FROM AUTHOR]

In this paper, we draw on raciolinguistic ideologies and chronotopes to critique career readiness, a race-evasive educational policy discourse that purportedly benefits all students, as grounded in white linguistic ideologies. Drawing on critical discourse analysis, we analyze state-level career readiness policy documents from Pennsylvania and interviews with teachers and administrators from an ethnographic study at a career and technical education center. Findings show how educators reproduce notions of career readiness as an implicit endorsement of white linguistic norms, informed by standard language ideology, which delegitimizes the linguistic practices of racialized speakers. We conclude with a discussion of the implications for school systems to move toward more inclusive and equitable educational policies and practices for English learners in U.S. schools. [ABSTRACT FROM AUTHOR]

Social workers have long been active in social and political organizing to ensure a living wage. Yet recent social work research largely neglects efforts to raise wages and effective means for organizing to do so. This paper draws on in-depth interviews from a longitudinal study of low-wage hospital workers who formed a union and negotiated annual, incremental wage increases to achieve a $15 minimum wage floor to understand their perceptions of the effects of the initial wage increase. Results show workers have a wide spectrum of perceptions, with many feeling no effect or even a negative effect due to losses in public benefits. A visualization used to aid interpretation of results identifies race and family structure as salient factors, pointing to the role of structural discrimination in experiences and perceptions of wage increases. Given that this workplace, like many other employers and localities, has implemented a $15 minimum wage through incremental raises across time, it is important that social workers be aware of the experiences of workers at each stage of this process. This study examines the impact of the first raise, establishing a framework from which future research can examine how individuals' perceptions and experiences develop over time. [ABSTRACT FROM AUTHOR]

The charter school sector has expanded beyond brick-and-mortar schools to cyber schools, where enrollment grew almost tenfold between 2015 and 2020. While a large literature documents the effects of charter schools on test scores, fewer studies explore impacts on attainment or postsecondary outcomes and there is almost no work exploring the consequences of cyber charter enrollment for these outcomes. In this paper, I examine the impacts of Pennsylvania's charter high schools on student attendance, achievement, graduation, and postsecondary enrollment, distinguishing the impacts of brick-and-mortar from cyber schools. I find that brick-and-mortar charters have no or positive effects across outcomes, and that effects are concentrated in urban districts and among Black and economically disadvantaged students. By contrast, attending a cyber charter is associated with almost universally worse outcomes, with little evidence of heterogeneity. Students who enroll in a cyber charter at the beginning of ninth grade are 9.5 percentage points (pp) less likely to graduate, 16.8 pp less likely to enroll in college, and 15.2 pp less likely to persist in a postsecondary institution beyond one semester. These results suggest that additional regulation and oversight of cyber charter schools is warranted and also bring into question the efficacy of online education. [ABSTRACT FROM AUTHOR]

Background: Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature. Objective: The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities. Design/Patients: This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26–October 10, 2021). Approach/Key Results: We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting "medical professionals" and "word of mouth" had higher odds of COVID-19 vaccine acceptance but those who cited trusting "social media" had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability. Conclusion: These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information. [ABSTRACT FROM AUTHOR]

Batteries participating in frequency regulation (FR) markets earn revenue at the expense of longevity. The declining reward prices and highly stochastic automatic generation control (AGC) signals with short update intervals necessitate research into aging-aware real-time FR strategies for the battery. To address these challenges, this paper develops an online battery dispatch strategy based on Lyapunov optimization, accounting for Ah-throughput, C-rate, and temperature aging effects to enhance the service profitability of the battery. The strategy operates independently of probabilistic data from random processes, with its optimality gap inversely correlated with the control parameter. A systematic and intuitive approach is established for constructing virtual queues and determining the maximum feasible parameter. The proposed method is validated through extensive numerical simulations using actual lithium-ion battery aging data, along with year-long regulation signal and market price data from Pennsylvania-New Jersey-Maryland (PJM). Results show that the strategy can extend the battery lifespan by 83.41% and increase the net present value (NPV) by 172.67% compared to the conventional Ah-based strategy. • An aging-aware online frequency regulation strategy for profit-driven batteries. • Critical aging factors Ah-throughput, C-rate, and temperature are considered. • Lyapunov optimization enables the strategy not reliant on future forecasts. • A systematic method is designed to determine virtual queues and control parameter. [ABSTRACT FROM AUTHOR]

Research to assess and inform health policy is an essential component of the policymaking process to advance equity in public health practice. This study investigated health disparities during the COVID-19 pandemic (2020–2022) in older adult institutional settings in Philadelphia, PA, to inform policy initiatives, interventions, and infrastructure development. We first explored the changing patterns of nursing staffing levels (total direct care staff and registered nurses [RNs]) measured by hours per resident per day (HPRD) before and after COVID-19. Our findings revealed that HPRD levels consistently fell below the Centers for Medicare and Medicaid Services recommended standards from 2018 to 2022, with notable declines observed starting from 2021. Results from multilevel modeling showed significant declines in HPRD for total direct care nursing staff in nursing homes located in zip codes with a high proportion of Black residents (≥40%). In contrast, HPRD for RNs significantly declined in nursing homes located in zip codes with a lower proportion of Black residents (<40%). Moreover, higher reported direct care HPRD and RN HPRD were associated with any reported COVID-19 cases only within zip codes with a low proportion of Black residents. These findings indicate the need for additional policies to address these observed patterns in staffing levels. Our study provides a foundation for future policy reviews utilizing a conceptual framework that is health equity-centric for local and state health departments program and units intended for institutional care settings for older adults. [ABSTRACT FROM AUTHOR]

Rural communities are considered disadvantaged communities as they suffer from a lack of transport options. Thus, rural regions provide less accessibility for commuters to reach their destination as opposed to urban regions. However, the issues of transport disadvantage and shared use mobility in rural areas within the United States (US) have not been well investigated. Furthermore, transport disadvantage differs between communities and regions across the globe; thus, there is a need to study the behavioral choices of rural commuters within the US context. This study contributes by analyzing the behavioral choices of rural communities within the US through a case study site of Waynesburg, Pennsylvania, for adopting a shared use shuttle service. K-means clusters showed that trips from the survey data were a good representation of real trips from Ecolane. Furthermore, random parameter-based binary logit models were calibrated using data collected from students, faculty, and residents in Waynesburg, Greene County, to study the behavioral choices of commuters. The findings for the faculty and students group revealed that prior experience with shared services increases the likelihood of using a shared shuttle. An important personal characteristic of inconvenience showed a higher propensity toward using existing modes as opposed to a shared shuttle. Such commuters value personal vehicles as more convenient as they have childcare responsibilities and varying schedules for work that require them to move back and forth across locations, thus making a shared shuttle less attractive for them. The socioeconomic factors of age and gender show a higher propensity for using shared shuttles. The findings from this study could be helpful for agencies in improving rural mobility and considering such shared mobility services for rural communities. [ABSTRACT FROM AUTHOR]

Introduction: In 2018, The Live Well Allegheny: Lifting Wellness for African Americans (LWA2) Initiative was developed to support six priority, Black communities in Allegheny County, Pennsylvania to address health equity in chronic disease. The LWA2 coalition members participated in ongoing anti-racism and racial equity sessions with a nationally recognized anti-racist facilitation team. The sessions included a 2-days experience in January 2020 along with follow up meetings throughout 2020. Methods: Surveys were administered to understand their perceptions related to anti-racism and oppression and subsequent actions as a result of the sessions. Additionally, we conducted nine in-depth interviews with organizational partners (January -May 2020) to evaluate the overall effectiveness of the coalition and inform future activities. Results: Ten participants completed the post session surveys. Seven out of 10 survey respondents felt they had a good understanding of how oppression (racism, sexism, capitalism) influenced their life and work. However, the majority indicated needing the tools to implement anti-racist strategies in their work. The in-depth interviews with organizational partners revealed that racial equity was of concern to all partners but there was variability in intentionality around racial equity as a core element of each organization's mission, goals and subsequent actions. Discussion: As a result of the interviews, coalition members developed a racial equity statement and theory of change for implementation in the coalition work and within individual organizations along with a plan for implementing an equity audit of the coalition. Coalitions of this kind should be intentional about implementing continuous strategies related to anti-racism for structural changes toward achieving racial equity in their overall work. [ABSTRACT FROM AUTHOR]

The current study utilizes a dataset of 1,300 individuals who have been released from a Pennsylvania county jail between 2015 to 2017 to assess the competing risks of returning to jail on a probation violation versus committing a new offense. The study also examines differences between males and females. The findings suggest that while traditional predictors of recidivism help to explain male behavior, they do not allow for an understanding of women's recidivism. Future research must continue to explore gender-specific factors to provide more clarity on the experiences of men and women upon release. [ABSTRACT FROM AUTHOR]

• Paper estimates a CMF for high friction surface treatment (HFST) applied to horizontal curves on undivided two-lane roads. • Propensity score matching is incorporated into EB before-after methodology to select more appropriate reference group. • Results indicate significant reductions in crash frequency (of all types considered) when applying HFST. Horizontal curves are locations that, as a result of the changing alignment, may be a contributing factor in roadway departure crashes. One low-cost countermeasure to mitigate crashes at these locations is the installation of the high friction surface treatment (HFST), which increases roadway friction and is intended to help keep drivers on the roadway when traversing a horizontal curve. This treatment has been implemented at numerous curves in Pennsylvania, but the overall safety effectiveness is not known. The purpose of this study is to estimate a suite of Crash Modification Factors (CMFs) for HFST applied to curve sections of undivided two-lane roadways. A novel combination of the empirical Bayes observational before-after study design and propensity score matching was used to estimate CMFs for multiple crash types, crash severities, and roadway settings (urban and rural). Propensity score matching was implemented to identify the most appropriate reference group to use within the empirical Bayes methodology. The results indicate that the installation of HFST is associated with a statistically significant decrease in all crash types and severities considered. [ABSTRACT FROM AUTHOR]

Despite significant efforts to improve access to medications for opioid use disorder (MOUD), uptake remains low relative to the scope of the problem in the United States. A growing body of quantitative and qualitative research has documented consistent barriers to MOUD treatment access and retention, at the level of individuals, institutions, and society at large. Stigma - surrounding both people who use opioids (PWUO) and treatment using MOUD – is among the most-cited barriers by patients and providers alike, yet few studies have examined provider-based stigma specifically, or considered its interaction with other impediments to OUD care. This paper employs a qualitative approach to the analysis of provider-based stigma among professionals involved in the treatment or supervision of individuals with OUD. We conducted and analyzed interviews with 19 professionals as part of a larger mixed methods study on stigma among substance use treatment providers and court personnel in Pennsylvania. Beyond capturing providers' perceptions of PWUO and MOUD, the authors asked participants to describe barriers to recovery, and the effective delivery of care within this population. Interviewees enumerated multiple entrenched barriers that sometimes operated at different levels, such as criminal-legal involvement, which weakened PWUO's social networks and employment prospects, while undermining providers' attempts at continuity of care; moreover, participants cited the "War on Drugs" as an overarching impediment to effective substance use treatment, not least for its role in perpetuating stigma against PWUO. Interestingly, while an overwhelming majority of participants named stigma as a barrier to treatment at every level, most also articulated stigmatizing beliefs around PWUO. Namely, providers evoked one element of stigma – blameworthiness – in their contention that many PWUO are inadequately motivated to recover. In addition to adding further complexity to MOUD barriers research, this study troubles the notion that professional training and education on the disease model of addiction serve to eradicate stigma. • Uptake of medications for opioid use disorder remains low despite efforts to expand access. • Individual, institutional, and systemic barriers to MOUD interact to reduce usage. • Treatment providers identify stigma as a primary barrier to MOUD effectiveness at all levels. • Many treatment providers also express conceptions of people who use opioids as "blameworthy." [ABSTRACT FROM AUTHOR]

Stormwater green infrastructure (GI) has been applied as a method to address urban flooding for over forty years. However, GI has not yet been widely utilized across the US. Prior studies identified some challenges with technical, engineering, and socioeconomic aspects of GI, but detailed examination of non-scientific papers to identify and analyze real-world barriers that may hinder the implementation of GI has not yet been done. To achieve this goal, we conducted a meta-analysis of 351 public documents from federal, state, and 62 municipalities in Eastern Pennsylvania to systematically review the support of different levels of government for implementing GI. We summarized barriers in three categories: 1) governance and policy: failure to integrate GI into existing stormwater management policies due to unclearly defined responsibility and infrequent policy updates, 2) stormwater fees and credits: inequity in stormwater fee structures and debate of stormwater credits connected to GI, and 3) public education and outreach: most municipal governments provide little or no stormwater and GI-related information to their residents, but some municipalities with higher population density have tried to offer more. These barriers will restrain the original intention and vision of GI implementation and cause difficulties in effectively conveying GI's information from the federal and state levels to municipalities and residents. Our discussion highlights these difficulties of GI implementation at all governmental levels and shed light on potential solutions to address these barriers. • Barriers to Green Infrastructure (GI) adoption in the US context are identified. • Qualitative and quantitative methods are conducted to identify GI barriers. • Three categories of GI barriers are summarized at different levels of government. [ABSTRACT FROM AUTHOR]

Existing approaches to infrastructure management neglect the impact of infrastructure condition on safety performance, even though poorly maintained roadways can contribute to increased crash frequencies. This is perhaps because very few studies have quantified the impact of infrastructure condition on safety performance. Hence, this work develops safety performance function (SPF) models that relate pavement condition—specifically, roughness, as measured using the international roughness index (IRI)—and other roadway factors with observed crash frequencies. These SPFs are then combined with pavement roughness deterioration models to better understand how maintenance decisions can be used to improve roadway safety performance. Data from two-lane rural roadways in Pennsylvania are used for this effort. The SPF estimation results reveal that accounting for IRI in SPF development significantly improves model fit, and that IRI has a significant and positive impact on crash outcomes. The results further suggest that the IRI has a different impact on total crash frequency as compared to fatal and injury crash frequency, and rear-end crashes. This is likely due to how roughness of the roadway can impact travel speeds. Finally, the results also show that maintenance activities that reduce IRI can have significant safety benefits. This suggests that pavement management decisions should also consider the anticipated safety benefits, in addition to other factors. [ABSTRACT FROM AUTHOR]

When analyzing spatially referenced event data, the criteria for declaring rates as "reliable" is still a matter of dispute. What these varying criteria have in common, however, is that they are rarely satisfied for crude estimates in small area analysis settings, prompting the use of spatial models to improve reliability. While reasonable, recent work has quantified the extent to which popular models from the spatial statistics literature can overwhelm the information contained in the data, leading to oversmoothing. Here, we begin by providing a definition for a "reliable" estimate for event rates that can be used for crude and model-based estimates and allows for discrete and continuous statements of reliability. We then construct a spatial Bayesian framework that allows users to infuse prior information into their models to improve reliability while also guarding against oversmoothing. We apply our approach to county-level birth data from Pennsylvania, highlighting the effect of oversmoothing in spatial models and how our approach can allow users to better focus their attention to areas where sufficient data exists to drive inferential decisions. We then conclude with a brief discussion of how this definition of reliability can be used in the design of small area studies. [ABSTRACT FROM AUTHOR]

In response to escalating energy demands and global warming concerns, the Passive House Standard has emerged as a solution in residential construction, aiming to drastically reduce energy consumption and operational costs primarily through high-performance building envelopes. While a considerable volume of the literature has focused on the Passivhaus Institute (PHI) standards, predominantly in European contexts, there is a gap in research on the Passive House Institute US (Phius) standards, particularly in North American climates. This study conducts a quantitative comparative analysis of two adjacent multifamily residential buildings in Central Pennsylvania, Climate Zone 5A—one built using conventional construction methods and the other following Passive House (PHIUS+ 2015) certification standards—to validate the energy efficiency improvements attributed to Passive House designs. A comparative analysis of the whole building energy use over two years reveals that the Passive House building consumes approximately 50% less energy than its conventional counterpart in terms of whole building energy use and the national median recommended benchmark metric defined by the Energy Star Portfolio Manager. These findings emphasize the potential for significant energy savings and greenhouse gas reductions in residential buildings, highlighting the necessity for policymakers and governments to incentivize the adoption of Passive House standards to achieve environmental sustainability and reduce energy costs for society. [ABSTRACT FROM AUTHOR]

The 2023 checklist for Pennsylvania bryophytes lists 547 taxa including 426 mosses, 118 liverworts, and 3 hornworts, but only 48 confirmed moss species and one liverwort species collected during the last 100 years from Perry County. As a result of fieldwork reported herein and review of herbarium data from 1923 to present, an additional 49 moss and 2 liverwort species are now included in the Perry County bryoflora. Significant bryophyte species reported from the county include the moss Bucklandiella venusta, which represents the first collection of this species in Pennsylvania during the past 100 years. Currently, 97 moss and 3 hepatic taxa are reported from Perry County, Pennsylvania. [ABSTRACT FROM AUTHOR]

Much of the American response to the COVID-19 pandemic was characterized by a divergence between general public opinion and public health policy. With little attention paid to individuals incarcerated during this time, there is limited direct evidence regarding how incarcerated people perceived efforts to mediate the harms of COVID-19. Prisons operate as a microcosm of society in many ways but they also face unique public health challenges. This study examines vaccine hesitancy—and acceptance—among a sample of individuals incarcerated within adult prisons in Pennsylvania. Using administrative records as well as rich attitudinal data from a survey of the incarcerated population, this study identifies a variety of social and historical factors that are—and are not—associated with an incarcerated person's willingness to receive the COVID-19 vaccine. Our findings highlight vaccination challenges unique to the carceral context and offer policy recommendations to improve trust in credible health messengers and health service provision for this often overlooked but vulnerable population. [ABSTRACT FROM AUTHOR]

Photo-experiencing and Reflective Listening (PEARL) is a trauma-informed intervention developed to promote recovery engagement in survivors of gender-based violence (GBV). This study aimed to understand the feasibility and acceptability of PEARL and identify potential healing elements. GBV survivors were recruited in Philadelphia through an online survey (n = 20). Participants completed the PEARL intervention, a postintervention survey, and a follow-up interview. Results revealed PEARL to be both feasible and acceptable, with thematic analysis revealing its ability to facilitate purposeful reflection, connection to the present, and progress toward healing goals. PEARL shows promise as an engaging strategy to promote healing for survivors of GBV. [ABSTRACT FROM AUTHOR]

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The Chesapeake Bay watershed is representative of governance challenges relating to agricultural nonpoint source pollution and, more generally, of sustainable resources governance in complex multi-actor settings. We assess information flows around Best Management Practices (BMPs) undertaken by dairy farmers in central Pennsylvania, a subregion of the watershed. We apply a mixed-method approach, combining Social Network Analysis, the analysis of BMP-messaging (i.e. information source, flow, and their influences), and qualitative content analysis of stakeholders' interviews. Key strategic actors were identified through network centrality measures such as degree of node, betweenness centrality, and clustering coefficient. The perceived influence/credibility (by farmers) of BMP-messages and their source, allowed for the identification of strategic entry points for BMP-messages diffusion. Finally, the inductive coding process of stakeholders' interviews revealed major hindrances and opportunities for BMPs adoption. We demonstrate how improved targeting of policy interventions for BMPs uptake may be achieved, by better distributing entry-points across stakeholders. Our results reveal governance gaps and opportunities, on which we draw to provide insights for better tailored policy interventions. We propose strategies to optimize the coverage of policy mixes and the dissemination of BMP-messages by building on network diversity and actors' complementarities, and by targeting intervention towards specific BMPs and actors. We suggest that (i) conservation incentives could target supply chain actors as conservation intermediaries; (ii) compliance-control of manure management planning could be conducted by accredited private certifiers; (iii) policy should focus on incentivizing inter-farmers interaction (e.g. farmers' mobility, training, knowledge-exchange, and engagement in multi-stakeholders collaboration) via financial or non-pecuniary compensation; (iv) collective incentives could help better coordinate conservation efforts at the landscape or (sub-)watershed scale; (v) all relevant stakeholders (including farmers) should be concerted and included in the discussion, proposition, co-design and decision process of policy, in order to take their respective interests and responsibilities into account. [ABSTRACT FROM AUTHOR]

Purpose: Some preschool students with complex communication needs explore eye-gaze computer technology (EGCT) and adopt computer-based augmentative and alternative communication (AAC). The objective of this study was to follow preschool explorers of EGCT who are now school aged to describe the children’s use of technology and parents’ perceptions of its utility for communication, participation, or leisure. Method: Ten parents completed survey questions by Internet and phone and reported their perceptions of nine children’s effectiveness in the use and acceptance of AAC and the support they received in implementing technology. The results are reported as a descriptive study. Results: All children in this research continue to use AAC technology in school and most at home. Many children who tried and obtained EGCT while in preschool continue to use that technology. Most parents agreed that the children understood how to use the devices, which enhanced the children’s communication, and that the parents received sufficient support. Most children were limited in their use of the devices for leisure and control of their environments. Conclusions: Computer-based AAC for school-aged children who trialed it when they were in preschool appears to be a powerful means for them to communicate and participate. However, the technology appears not to be used to its full capabilities to support the children’s agency to control environments and to pursue leisure. Teams may want to consider how to support children in using their AAC devices to meet multiple needs. The study was limited by its small sample size and its descriptive nature. Additional research on this subject is needed. [ABSTRACT FROM AUTHOR]

The sustained recruitment and retention of students in STEM majors is a national concern. Although the rate of attrition in these majors is comparable to other majors, the demand for trained scientists to enter the workforce with a baccalaureate degree is high. To enhance retention and support of STEM students from their first year until graduation, we established a Residential Learning Community (RLC) for STEM majors at York College of Pennsylvania. Although similar learning communities already existed, this was the first of its kind at this institution. The primary components included living on campus with a roommate also in the program, taking courses like general chemistry and First-Year Seminar as a designated cohort, and receiving increased faculty mentoring through advising. The RLC, named STEM Scholars, was developed with significant institutional buy-in and interdisciplinary faculty support but without financial backing. Several key takeaways are reported in this article, notably the need for funding to support a STEM cohort program. The effectiveness of the program and its components continues to be assessed; results of the assessment will be shared in the future. Successful components of STEM Scholars can be incorporated at other institutions to enhance STEM education. [ABSTRACT FROM AUTHOR]

We introduce a compact core model for double-gate (DGFET) and surrounding-gate (SGFET) MOSFETs designed for circuit simulations. Despite its high precision, the model is crafted to retain the same analytic formulation of the industry standard Pennsylvania State and Philips (PSP). Instead of linearizing the drain current as in the PSP model, we employ a quadratic symmetric polynomial interpolation of the charge in the channel. This eliminates the need for cumbersome derivatives, simplifications, and intricate coding when integrating into a circuit simulator, thereby preventing singularities during numerical iterations. Moreover, thanks to its mathematical formulation equivalent to PSP, this model simplifies the coding of terminal charges, capacitances, potentials, and electric fields in the channel within circuit simulators. We validate the accuracy of the model through comparisons with numerical solutions and experiments from the literature. [ABSTRACT FROM AUTHOR]

Background: Substantial work has been done to update or create evidence-based practices (EBPs) in the changing health care landscape. However, the success of these EBPs is limited by low levels of clinician implementation. Objective: The goal of this study is to describe the use of standardized/simulated patient/person (SP) methodology as a framework to develop implementation bundles to increase the effectiveness, sustainability, and reproducibility of EBPs across health care clinicians. Design: We observed 12 clinicians' first-time experiences with six unique decision-making algorithms, developed previously using rigorous Delphi methods, for use with patients exhibiting concerning behaviors associated with long-term opioid therapy (LTOT) for chronic pain. Clinicians were paired with two SPs trained to portray individuals with one of the concerning behaviors addressed by the algorithms in a telehealth environment. The SP evaluations were followed by individual interviews, guided by the Consolidated Framework for Implementation Research (CFIR), with each of the clinician participants. Participants: Twelve primary care clinicians and 24 SPs in Western Pennsylvania. Main measurement: The primary outcome was identifying likely facilitators for the successful implementation of the EBP using the SP methodology. Our secondary outcome was to assess the feasibility of using SPs to illuminate likely implementation barriers and facilitators. Results: The SP portrayal illuminated factors that were pertinent to address in the implementation bundle. SPs were realistic in their portrayal of patients with concerning behaviors associated with LTOT for chronic pain, but clinicians also noted that their patients in practice may have been more aggressive about their treatment plan. Conclusions: SP simulation provides unique opportunities for obtaining crucial feedback to identify best practices in the adoption of new EBPs for high-risk patients. Setting: Zoom simulated patient evaluations. [ABSTRACT FROM AUTHOR]

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

Background: Police violence is increasingly recognized as an urgent public health problem. Basic questions about police violence, however, remain unanswered, including which types of law enforcement agency are responsible for fatal police violence deaths. Methods: We estimated the proportion of police violence deaths in the U.S. (2013–2022) that were attributable to local, county, state, federal, or tribal police agencies, using mapping police violence data. We examined proportions overall, by decedent race/ethnicity, and by state. Results: Nationally, 60% of decedents were killed by municipal, 29% by county, 8% by state, and 3% by federal, police, with < 1% killed by tribal or other officers. These proportions varied by race/ethnicity, with 56% of Native American decedents killed by municipal police compared to 70–75% among other racially minoritized people. While municipal police were responsible for most deaths in most states, in the Southeast, county police predominated. In some Northeastern states (and Alaska), state police were responsible for > 40% of deaths. Conclusions: We identify wide geographic & racial/ethnic variation in the agencies responsible for fatal police violence. Findings suggest that the budgetary and infrastructural shifts required to prevent fatal police violence need to occur at multiple levels of government. [ABSTRACT FROM AUTHOR]

Immense pressure is being put on criminal justice agencies to adopt and implement evidence-based practices (EBP). Empirical evidence highlights the need for leadership support to make agencies more evidence-based. The current study is an empirical examination of how criminal justice leaders understand EBP and its correlates or predictors in the domains of agency characteristics, individual characteristics, and openness to research partnerships. Data were collected through a statewide survey of police chiefs and chief probation/parole officers in Pennsylvania. Using a multinomial logistic regression model and a binary logistic regression model, correlates and predictors of familiarity and accuracy with EBP were identified. About 32% had never heard of EBP, 27% were familiar with it but did not define it correctly, and 41% held some knowledge of it. Results showed that EBP training may have introduced EBPs to leaders, but it failed to teach them what EBP actually is, and their lack of knowledge of EBP may be contributing to their lack of participation in research partnerships. By providing recommendations based on findings related to EBP training and research partnerships, the current research contributes to the ongoing discussion regarding challenges associated with EBP implementation and acceptance of EBPs among criminal justice practitioners. [ABSTRACT FROM AUTHOR]

In 2010, the Supreme Court held in Padilla v. Kentucky that criminal defense attorneys have a constitutional obligation to advise noncitizen clients of the immigration consequences of a guilty plea in criminal court proceedings. Though it has been over a decade since the decision, little research has been done regarding Padilla’s implementation by defense counsel on a statewide level. This Article provides findings from a case study on Padilla advising in Pennsylvania. Pennsylvania is unique because its state courts have interpreted Padilla narrowly and permit immigration advisals that would be deemed constitutionally deficient in other jurisdictions. Pennsylvania also does not have a state-funded public defense system, which means standards for indigent representation vary by county. Interviews with public defenders and prosecutors in Pennsylvania reveal significant variation in the scope of advice provided to noncitizens in criminal court proceedings and the willingness of district attorney offices to consider immigration status during plea negotiations. Each Pennsylvania county has an individual method of identifying noncitizen clients, analyzing immigration consequences, warning clients of these adverse consequences, and negotiating with district attorneys. The scope of advice provided to noncitizens and counsel’s understanding of their Padilla obligations vary considerably in both content and scope. Counties suffer from Pennsylvania’s systemic failure to provide adequate funding to public defense offices to ensure that they can effectively comply with Padilla—a problem that is especially salient in a state with limited postconviction remedies for those who receive deficient advice. Based on these findings, this Article offers various policy recommendations that would improve the criminal defense representation of noncitizens in Pennsylvania. While these findings and recommendations are specific to Pennsylvania, they are relevant to nationwide research on Padilla’s impact and what can be done to promote immigration-conscious criminal defense advocacy. [ABSTRACT FROM AUTHOR]

This article analyzes the material culture and sources that trace the history of the Brown's Mill School in Franklin County, Pennsylvania. It outlines the school's construction, intended use, and its perception in memory. Brown's Mill School's architecture portrays a range of themes. Despite the growing separation between church and state, these themes included the community's roots in family and religious instruction as well as the new progressively egalitarian democratic and republican institutions of the state. Originally called "Trinity" School, Brown's Mill School represents an interesting departure from larger democratic trends. The people of Antrim Township championed ecumenical ideals, showing that not all communities had the same outlook on how to separate church and state, or more importantly, how not to. Having one room for a schoolhouse that serves the multiple civil functions of a village emphasizes how rural communities sought to include the institutions of the church, the home, and the state in one unified whole. [ABSTRACT FROM AUTHOR]

The Lacawac Sanctuary is a non-profit nature and environmental research and education center located in the Pocono Mountains of northeastern Pennsylvania. An inventory of the bryophytes was conducted in the fall of 2015 to increase understanding of the rich bryoflora of the sanctuary and the surrounding region. A total of 105 mosses and 23 liverworts were collected and identified. Of these, 52 mosses and 15 liverworts are reported as new county records. A single new state moss record is documented. [ABSTRACT FROM AUTHOR]

The main challenge in addressing constrained multi-objective optimization problems (CMOPs) lies in achieving a balance among convergence, diversity, and feasibility. To address this issue, this paper proposes a constrained multi-objective evolutionary algorithm with Pareto estimation via neural network named CMOEA-PeNN. In order to exploit and explore the decision space, the proposed algorithm employs a dual-population mechanism, which is trained with a self-organizing map (SOM). Firstly, the population distribution structure in decision space is mapped to objective space while preserving neighborhood information, and then the neuron weight is utilized to estimate the Pareto front (PF). Secondly, a novel approach is devised to preserve the feasibility of the population and enhance the estimation of the Pareto front by SOM. The achievement scalarizing function (ASF) is employed to choose promising solutions. This strategy could guide the population toward the optimal solution while exploring the small feasible regions. Finally, the performance of CMOEA-PeNN is compared with five state-of-the-art constrained multi-objective evolutionary algorithms (CMOEAs) on three widely used benchmark problems and a real-world problem. The experimental results show that CMOEA-PeNN could archive competitive performance in solving CMOPs. [ABSTRACT FROM AUTHOR]

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

Gun violence in school settings has recently been of great concern in the US. However, research on youth carrying a gun to school is limited in numbers and scope. This study strove to improve the understanding of the risk factors associated with gun carrying in the general public and taking a gun to school among middle- and high-school students. Based on a dataset collected from rural, urban, and suburban schools in New York, New Jersey, and Pennsylvania (n = 5648), this study explored the predictor value of several potential risk factors derived from two prominent theoretical frameworks: "crime facilitation" and "fear and loathing" on two major outcome variables; carrying a handgun in public, and taking a handgun to school. The predictor variables included measures of bullying, violence against a dating partner, and non-gun delinquency. The bivariate analysis (group comparisons) indicated no significant difference between the likelihood of carrying a hand gun in public and taking a handgun to school among participants. The multivariate analysis indicated that non-gun delinquency was the most important risk factor increasing the likelihood for carrying a hand gun in public and taking a handgun to school. How future risk/threat assessment efforts should interpret these findings is discussed, along with the implications on how taking a gun to school is an extension of general gun carrying and may primarily be shaped by the presence of a delinquent lifestyle, rather than any other possible predictors examined. [ABSTRACT FROM AUTHOR]

An implementation and effectiveness evaluation of the Community Scholars Program was conducted at the University of Pennsylvania to enhance community capacity to collaborate with academics in mutually beneficial, equitable, and transformative research. Mixed methods were employed using administrative data, surveys, and key informant interviews. Participants expressed high satisfaction, valued interactive learning, and identified areas for improvement. The program increased knowledge and self-confidence in research-related skills and trust in the research process. The program serves as an institutional model to create long-term, mutually beneficial community–academic partnerships. (Am J Public Health. 2024;114(3):284–288. https://doi.org/10.2105/AJPH.2023.307549) [ABSTRACT FROM AUTHOR]

Background: Patient navigation (PN) improves cancer-related care, especially care among vulnerable populations who have limited access to medical and preventive care. The Cancer Navigation and Survivorship Network (CaNSuN), established in 2018, aims to connect, educate, and share evidence-based practices among navigators in Pennsylvania. Objectives: To conduct an environmental scan to increase understanding of navigation in Pennsylvania and identify strategies to better support and strengthen PN. The scan sought to describe characteristics of navigators, funding for and primary location of PN, measures of success, and important challenges. Methods: A 19-question survey was developed, piloted, and then administered in September 2021. The survey was initially distributed to the 169 CaNSuN newsletter subscribers and members of the Pennsylvania Cancer Coalition with a request to complete the survey and distribute the survey to colleagues. Additionally, requests were emailed to health system partners, state Department of Health, American Cancer Society, and community- based organizations. Descriptive and bivariate analyses were conducted. Results: Of the 82 complete responses, 77% were from nurse navigators and community health workers and were almost equally divided between working in community, clinical, and hospital settings. Navigators reported being in the field, on average, for 6 years. Challenges identified were lack of clarity on the role (32%), lack of guidelines for navigation (28%), measuring program success (28%), and funding (25%). About 40% reported their positions were funded by a hospital, and 20% by nonprofits. Patient satisfaction (50%) and time to treatment (24%) were the most common measures used to evaluate success. Significant relationships were observed between the navigator type and work setting, involvement at different stages of the cancer continuum, evaluation methods, and challenges. Conclusion: Results identified opportunities to strengthen support for both navigators and navigation systems in Pennsylvania. Navigation is a growing field with many navigators being new to the role. Groups like CaNSuN can provide professional development and facilitate a statewide learning community of navigators. CaNSuN can advocate for systems and policy change that will better support PN. [ABSTRACT FROM AUTHOR]

We performed content analysis using a qualitative descriptive approach of 15 semistructured interviews with pregnant and postpartum women who have experienced opioid use disorder (OUD) and intimate partner violence (IPV) regarding their experiences seeking help with both issues. Participants described that their partners impacted their ability to seek OUD care; seeking help for OUD and IPV was siloed; they felt more comfortable disclosing OUD than IPV; they perceived pregnancy as a barrier and facilitator to OUD care; and they wished for integrated services. Pregnant and postpartum women experiencing OUD and IPV acknowledged these phenomena intersect and identified a need for more comprehensive services. [ABSTRACT FROM AUTHOR]

Due to a growing physician shortage, patients have difficulty accessing primary care. In an effort to expand access and support patient health, many states are reducing barriers for advanced practice registered nurses to provide primary care without physician collaboration. Maryland provides an interesting case study. We leverage Maryland's policy change to explore the effects of full practice authority (FPA), focusing on the number of professionals and health outcomes for patients. Employing a border county comparison between Maryland and Pennsylvania, we estimate the effect of FPA. Our analysis of health outcomes focuses on three county-level health outcomes: poor or fair health, poor mental health days, and preventable hospital stays. We find that FPA is associated with increases in the number of certified nurse midwives by 0.6 per 100,000 residents and nurse practitioners by 22.4 per 100,000 residents. We also find evidence of an association of FPA with reductions in the share of residents who report being in poor or fair health by 2.8 percentage points and poor mental health days per month by 0.354 days per person. Combined, our results provide suggestive evidence that moving to FPA improves access to care and leads to improved health outcomes for Maryland residents. Removing regulatory barriers that prevent certified nurse midwives and nurse practitioners from working to the full extent of their training may increase access to primary care and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Multiple methods have been suggested for quantifying syntactic complexity in speech. We compared eight automated syntactic complexity metrics to determine which best captured verified syntactic differences between old and young adults. Method: We used natural speech samples produced in a picture description task by younger (n = 76, ages 18-22 years) and older (n = 36, ages 53-89 years) healthy participants, manually transcribed and segmented into sentences. We manually verified that older participants produced fewer complex structures. We developed a metric of syntactic complexity using automatically extracted syntactic structures as features in a multidimensional metric. We compared our metric to seven other metrics: Yngve score, Frazier score, Frazier–Roark score, developmental level, syntactic frequency, mean dependency distance, and sentence length. We examined the success of each metric in identifying the age group using logistic regression models. We repeated the analysis with automatic transcription and segmentation using an automatic speech recognition (ASR) system. Results: Our multidimensional metric was successful in predicting age group (area under the curve [AUC] = 0.87), and it performed better than the other metrics. High AUCs were also achieved by the Yngve score (0.84) and sentence length (0.84). However, in a fully automated pipeline with ASR, the performance of these two metrics dropped (to 0.73 and 0.46, respectively), while the performance of the multidimensional metric remained relatively high (0.81). Conclusions: Syntactic complexity in spontaneous speech can be quantified by directly assessing syntactic structures and considering them in a multivariable manner. It can be derived automatically, saving considerable time and effort compared to manually analyzing large-scale corpora, while maintaining high face validity and robustness. [ABSTRACT FROM AUTHOR]

Background. Culturally relevant exercises may help improve health and address disparities faced by older immigrants due to language and cultural barriers. Few studies have focused on such exercise interventions among older Chinese immigrants at US daycare centers. Methods. We conducted a 10-week nonrandomized controlled trial in older Chinese immigrants in Philadelphia, US. The intervention group practiced Chinese Qigong (Baduanjin) 5 days a week guided by trained research assistants and video instructions. The control group maintained their usual daily activities. We collected self-report assessments on overall health, sleep, and fatigue and implemented two computerized cognitive tests measuring psychomotor vigilance task (PVT) and memory twice, preintervention and postintervention. Repeated measures general linear model (GLM) and paired samples t-tests were used for data analyses. Results. Eighty-eight older adults (Qigong, n = 53; control, n = 35) with an average age of 78.13 (SD = 5.05) were included. Groups showed no significant differences at baseline evaluation. After the 10-week exercise, the intervention group showed significant improvements in overall health (p = 0.032), fatigue (p < 0.001), and cognitive functions including memory (p = 0.01), response speed (p = 0.002), and response time (p = 0.012) on the PVT, as well as marginally significant benefits in sleep (p = 0.058). Between-group comparisons identified significant group-by-time interactions in health (p = 0.024), sleep (p = 0.004), fatigue (p = 0.004), and memory (p = 0.004). Conclusion. We revealed significant positive effects of Qigong in older Chinese immigrants across multiple health domains. Findings highlight the potential of a culturally relevant exercise in addressing health disparities. [ABSTRACT FROM AUTHOR]