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Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

6–11-year-old children provide a critical window for physical activity (PA) interventions. The Virtual Fitness Buddy ecosystem is a precision health PA intervention for children integrating mixed reality technology to connect people and devices. A cluster randomized, controlled trial was conducted across 19 afterschool sites over two 6-month cohorts to test its efficacy in increasing PA and decreasing sedentary behavior. In the treatment group, a custom virtual dog via a mixed reality kiosk helped children set PA goals while sharing progress with parents to receive feedback and support. Children in the control group set PA goals using a computer without support from the virtual dog or parents. 303 children had 8+ hours of PA data on at least one day of each of the 3 intervention time intervals. Conversion of sedentary time was primarily to light-intensity PA and was strongest for children with low baseline moderate-to-vigorous PA than children above 45 min of baseline moderate-to-vigorous PA. Findings suggest that the VFB ecosystem can promote sustainable PA in children and may be rapidly diffused for widespread public health impact. [ABSTRACT FROM AUTHOR]

Regulatory focus theory (RFT; Higgins, 1997) can be useful in studying working adults' goal-pursuing strategies for family and work success (e.g., marital adjustment and job satisfaction). We tested core hypotheses from RFT in a sample (N = 227) of married immigrants living and working in the United States. Confirmatory factor analyses supported the measurement model, and structural equation modeling was used to test study hypotheses. Results supported nearly all the RFT-derived hypotheses. Specifically, a promotion-focus orientation was more strongly associated with adults' life success than a prevention-focus orientation. A promotion-focused orientation was solely associated with family-to-work enrichment, whereas a prevention-focused orientation was solely associated with family-to-work conflict. Finally, as expected, family-to-work enrichment mediated the association of promotion-focused orientation with job satisfaction. The overall pattern of results suggests RFT has strong potential for understanding adults' success in their work and family lives, thereby providing a long-needed integrative theory for the multidisciplinary literature. [ABSTRACT FROM AUTHOR]

Targeted, goal-focused approaches to mentoring can improve behavioral and mental health outcomes than more recreational, non-specific approaches. However, a focus on goals needs to be balanced with openness to including mentees' preferences. This study builds on prior work by exploring the benefits of goal- and youth-focused approaches to mentoring relationships from the youth mentee's perspective, including their associations with relationship measures (closeness and tension) and mental health outcomes (i.e., conduct problems, emotional symptoms, and depressive symptoms). This study was a secondary analysis of data from 2165 youth participating in thirty nationally representative mentoring programs in the United States. On average, youth were 12.3-years-old (SD = 1.43, range = 9–16) and the majority were female (55%); 36.7% were Black/African American, 22.4% were White, and 23.5% were Latino/Hispanic. Path analyses revealed 1) youth- and goal-focused approaches were positively associated with closeness, 2) youth-focused approaches were negatively associated with tension, 3) goal-focused approaches were positively associated with tension. At follow-up, a stronger mentoring relationship (less tension and greater closeness) was related to positive youth outcomes. As the field of mentoring corrects for an overemphasis on intuitive approaches and moves towards more targeted directions, it should resist veering too far from what sets the field apart from skills-training models: the role of a caring relationship. [ABSTRACT FROM AUTHOR]

Latinx students experience stress at higher rates than European-American college-students in the U.S. and report the highest levels of anxiety among all other college-students, which can be a potential barrier to success. However, family members are identified as important sources of support by Latinx young-adults, and feeling support from family indicates a higher likelihood to remain enrolled in college. Few studies have explored the role of siblings in this relationship. This study examined whether positive and negative relationship qualities (RQ) between Latinx siblings may interact with level of anxiety, predicting academic stress (AS) and future aspirations (FA). Findings indicated that younger siblings with high anxiety and high negative RQ experienced higher levels of AS, while older siblings with low or mean-level anxiety and high negative RQ experienced high AS. Younger siblings with low anxiety, and high negative RQ with older siblings experienced low FA. The findings provide evidence that sibling relationship quality in Latinx students moderates the associations with anxiety, academic stress, and future aspirations, and that the presence of negative relationship qualities carried particular implications for future aspirations and academic stress. Understanding the influence of Latinx sibling RQ on mental health and AS can offer insight into the role of sibling relationships in the context of health, academic retention, and success in Latinx young people. Highlights: Examined if relationship qualities between Latinx siblings interact with anxiety, academic stress, and future aspirations. The presence of negative relationship qualities carries particular implications for future aspirations and academic stress Younger siblings with high anxiety and high negative relationship qualities experienced higher levels of academic stress. The higher the positive sibling relationship quality, the higher the future aspirations. Understanding influences of Latinx sibling relationships on mental health and academics can guide university efforts. [ABSTRACT FROM AUTHOR]

Adaptive development through adulthood entails developmental progress within multiple domains of life, such as health, work, and family. Adult status within these life domains is often solidified during established adulthood (30–45 years of age). Developmental progress within these central life domains is reflected in high perceived control and satisfaction, which should coincide with improved well-being. To test this proposition, we examined how developmental progress in central life domains codevelops with well-being during established adulthood. Multilevel growth model analyses were conducted using data from the Midlife in the United States study (MIDUS I, II, and III) for participants who completed at least two study assessments when they were between the ages of 30 and 45 (n = 614). The results indicated that established adults reported high levels of domain progress in their work, romantic partner and child relationships, and health, as well as moderate levels of prosocial and financial domain progress. While overall levels of well-being declined during established adulthood, higher levels of and positive changes in domain progress were linked with improved well-being during established adulthood. With few exceptions, demographic characteristics (age, sex, education, and income) did not moderate these linkages. Cumulatively, the results suggest that established adulthood is a developmental stage during which individuals progress in central developmental domains of adulthood, with the extent of this progress coinciding with improved well-being. [ABSTRACT FROM AUTHOR]

Background: Aspirations refer to wishes, ways of defining quality of life (QOL), and life goals. Living with chronic illness likely impacts a person's life aspirations. Duchenne Muscular Dystrophy (DMD) is an inherited disorder characterized by the inevitable and progressive loss of ambulation and independence. The present cross-sectional case–control study investigated how aspirations differed between people with DMD and a stratified comparison group of nationally representative children/adults. Methods: A web-based survey was administered October through December 2020. Recruitment was stratified by age group: 8–12, 13–17, and > = 18, reflecting the DMD disability trajectory. Aspirations were measured using qualitative (open-ended) and quantitative (closed-ended) questions. Qualitative prompts asked participants about wishes, how they would define "QOL"; and goals; answers to the prompts were then coded by six trained raters. Quantitative questions included 29 closed-ended goal-delineation items from the QOL Appraisal Profilev2. These data were analyzed using multivariate models adjusting for propensity scores (demographic differences), and testing for the effects of role (patient or comparison), age, and role-by-age interactions. Results: The study sample of DMD (n = 285) and comparison (n = 292) participants provided open-text data: 577 wishes statements, 283 QOL-definition statements, and 149 goals statements. Inter-rater reliability (kappa = 0.77) reflected good agreement between different raters' codes. Results suggested that people with DMD have aspirations that differ from their peers in several important ways. Both open-text and closed-ended data in both unadjusted and adjusted analyses generally showed that people with DMD were more focused on intrinsic aspirations such as health, healthcare, and independence than their peers. Compared to non-DMD persons, DMD individuals were much less focused on financial or housing concerns, community contributions, or spiritual growth. With age, patients' aspirations focused less on extrinsic aspirations such as careers and work and increasingly emphasized emotion-oriented goals. Patients were markedly less likely to give a direct answer to the open-ended goals question. Conclusion: There were important differences in aspirations between people with DMD and their peers. These findings may be helpful for developing psychosocial interventions. [ABSTRACT FROM AUTHOR]

The Multidimensional Cognitive Attentional Syndrome Scale (MCASS) was developed to assess the seven maladaptive forms of self-regulation that make up the cognitive attentional syndrome (CAS). Both theory and empirical evidence highlight important distinctions among the seven forms of self-regulation underlying the CAS. The primary purpose of the present study was to determine whether the MCASS item scores are sufficiently multidimensional to warrant the use of subscale scores. A secondary aim was to examine the incremental utility of the MCASS domain-specific factors. A battery of self-report measures was administered to adults recruited through a crowd-sourcing website (N = 359). Bifactor analysis was used to examine the multidimensionality of MCASS item scores. This analytic approach allowed for the quantification of variance captured by each domain-specific item score independent of the general factor. Results from the bifactor analysis suggest that the MCASS is a multidimensional measure, consisting of a strong general factor and domain-specific factors that are sufficiently distinct. Additionally, the majority of domain-specific factors provided incremental utility in predicting two criterion variables (i.e., general distress, happiness emotion goals) after accounting for the general factor. Taken together, results support continued use of the MCASS total scale and subscale scores and suggest that researchers may want to consider using a bifactor model when examining structural models that include the MCASS. [ABSTRACT FROM AUTHOR]

Purpose: State Title V programs collaborate with diverse partners to improve maternal and child health. Since 2014, the National Maternal and Child Health Workforce Development Center has trained Title V leaders in facilitating system change. This article describes aspects of initial collaborative readiness differentiating state and jurisdiction teams that later reported meeting their goals to greater or lesser degrees. Description: We used quantitative data from initial team leader reports to characterize readiness to collaborate with external partners, and their responses twelve months later to a prompt about how fully they had accomplished their goals. In addition, we coded excerpts from team leader accounts six and twelve months into their work with the Center, and retrospective coach perspectives, to identify collaborative readiness patterns. Assessment: Teams whose leaders reported higher goal accomplishment twelve months after beginning work with the Center had initially reported higher levels of collaboration with key partners. Our analyses suggest that such teams were also better able to use their cohort experience with the Center to improve collaboration, including information sharing with external stakeholders. Challenges working with Medicaid were reported both by teams with more and less goal accomplishment. Conclusions: Title V teams with lower levels of initial collaborative readiness may benefit from additional support in skill development, connections to key partners, and convening power. Given the crucial and increasing role of Medicaid in maternal and child health systems, more attention may be warranted to supporting all Title V programs in partnering with this funder. Significance: What is already known on this subject?: Prior research has identified the ability to convene diverse stakeholders as key to achieving partnership synergies, and in turn improved community outcomes. What this study adds: State and territorial Title V programs may achieve greater synergies with external partners by initially assessing and strategically enhancing collaborative readiness. Training and technical assistance providers might enhance partnership synergies through focused assistance to states with lower initial levels of external collaboration. Title V leaders may improve outcomes by leveraging their strongest collaborations to foster relationships with additional stakeholders. Title V programs in general could benefit from support cultivating relationships with Medicaid. [ABSTRACT FROM AUTHOR]

In the present study, we investigated the ways in which the ideographic goal descriptions and goal appraisals of European American high school seniors reflect potentials for intentional self-development during emerging adulthood (EA), a lifespan phase characterized by increasing levels of freedom and decreasing age-graded, socially sanctioned developmental norms. Additionally, we investigated whether variation in participants' goal appraisals and the motivational qualities emergent in their goal descriptions would predict variation in dimensions of identity development, both concurrently at age 18 and prospectively at age 23. Results of an exploratory, mixed method analysis of participants' (N = 129, 56.6% male, Mage = 18.24, SD = 0.37) goal data revealed diversity in education and work goals, strong potentials for intentional self-development reflected across goal appraisals, and more nuanced reflections of intentional self-development across the motivational qualities emergent in goal descriptions. Results partially supported the hypothesis that goal appraisals and motivational qualities that reflect potentials for intentional self-development would predict kindred processes of identity development across the first five years of EA. These findings contribute to a nascent empirical literature focused on the interrelationship of goal and identity constructs during EA and suggest new avenues for future research. [ABSTRACT FROM AUTHOR]

Background: The infertility experience is often surrounded by frustration and discouragement associated with the thwarted goal to have a child. Though research has identified commonly used strategies to cope with infertility, this study is the first to examine how different goal attributes and processes associated with the experience of infertility relate to coping strategy use and psychological distress. Method: Women (N = 353) recruited from online support forums reported on the nature of their goal to have a child, their psychological distress, and their use of strategies to cope with the failure to achieve that goal. Results: Women reported high striving toward a goal high in importance and commitment, coupled with high goal–related stress and feeling that achievement is blocked. Consistent with the notion that coping strategy use is specific to the features of the experience, no single goal attribute nor combination of attributes consistently accounted for coping strategy use, suggesting that the latter may be specific to the cognitions and processes of pursuit of the goal to have a child. With one exception, perceptions of impediment were better predictors of psychological distress than any level of perceived facilitators of goal pursuit, positing potential targets for future psychological interventions. Conclusion: Understanding how women cope with infertility may require a detailed conceptualization of their goal to have a child. In the present sample, dynamic processes and coping strategies that otherwise detract from success were generally beneficial by providing alternatives to the pursuit of a thwarted goal. [ABSTRACT FROM AUTHOR]

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Background Vancomycin dosing strategies targeting trough concentrations of 15–20 mg/L are no longer supported due to lack of efficacy evidence and increased risk of nephrotoxicity. Area-under-the-curve (AUC24) nomograms have demonstrated adequate attainment of AUC24 goals ≥ 400 mg h/L with more conservative troughs (10–15 mg/L). Objective The purpose of this study is to clinically validate a vancomycin AUC24 dosing nomogram compared to conventional dosing methods with regards to therapeutic failure and rates of acute kidney injury. Setting This study was conducted at a tertiary, community, teaching hospital in the United States. Method This retrospective, cohort study compared the rates of therapeutic failures between AUC24-extrapolated dosing and conventional dosing methods. Main outcome measure Primary outcome was treatment failure, defined as all-cause mortality within 30 days, persistent positive methicillin-resistant Staphylococcus aureus blood culture, or clinical failure. Rates of acute kidney injury in non-dialysis patients was a secondary endpoint. Results There were 96 participants in the extrapolated-AUC24 cohort and 60 participants in the conventional cohort. Baseline characteristics were similar between cohorts. Failure rates were 11.5% (11/96) in the extrapolated-AUC24 group compared to 18.3% (11/60) in the conventional group (p = 0.245). Reasons for failure were 6 deaths and 5 clinical failures in the extrapolated-AUC24 cohort and 10 deaths and 1 clinical failure in the conventional group. Acute kidney injury rates were 2.7% (2/73) and 16.4% (9/55) in the extrapolated-AUC24 and conventional cohorts, respectively (p = 0.009). Conclusion Extrapolated-AUC24 dosing was associated with less nephrotoxicity without an increase in treatment failures for bloodstream infections compared to conventional dosing. Further investigation is warranted to determine the relationship between extrapolated-AUC24 dosing and clinical failures. [ABSTRACT FROM AUTHOR]

In the United States, underachieving fertility desires is more common among women with higher levels of education and those who delay first marriage beyond their mid-20s. However, the relationship between these patterns, and particularly the degree to which marriage postponement explains lower fertility among the highly educated, is not well understood. We use data from the National Longitudinal Survey of Youth 1979 cohort to analyze differences in parenthood and achieved parity for men and women, focusing on the role of marriage timing in achieving fertility goals over the life course. We expand on previous research by distinguishing between entry into parenthood and average parity among parents as pathways to underachieving, by considering variation in the impact of marriage timing by education and by stage of the life course, and by comparing results for men and women. We find that women with a bachelor's degree who desired three or more children are less likely to become mothers relative to women with the same desired family size who did not attend college. Conditional on becoming mothers, however, women with at least a bachelor's degree do not have lower completed family size. No comparable fatherhood difference by desired family size is present. Postponing marriage beyond age 30 is associated with lower proportions of parenthood but not with lower parity among parents. Age patterns are similar for women and men, pointing at social rather than biological factors driving the underachievement of fertility goals. [ABSTRACT FROM AUTHOR]

Objectives: The socialization goals of immigrant parents in the United States for their children reflect the childrearing priorities of both their culture of origin and the mainstream culture. These goals, which guide parenting, likely have shared and unique characteristics with other immigrant groups from the same geographical region of origin. The current study aimed to explore and compare the socialization goals of Chinese and Korean immigrant mothers in the United States; the role of child gender in mothers' socialization goals was also investigated. Methods: Ninety-six Chinese (Mage = 37.60) and 97 Korean immigrant mothers (Mage = 35.87) with preschool-age children living in the United States were interviewed regarding their socialization goals. The qualitative interview transcripts were coded by trained research assistants. Results: The interviews revealed seven socialization goals (Self-maximization, Lovingness, Personal Integrity, Proper Demeanor, Religious Values, Self-control, and No High Expectations) across both groups. Findings demonstrated that Chinese and Korean immigrant mothers were similar on their endorsement of five socialization goals. However, group differences were found for goals of Religious Values and No High Expectations, which further differed across child gender. Conclusions: These findings highlighted the common socialization priorities of Chinese and Korean immigrant mothers of young children in urban contexts, but also the need to examine sub-ethnic groups separately to understand their shared and unique parenting experiences. These findings have meaningful implications for clinicians and other professionals towards providing more effective services to Asian immigrant families in the U.S. [ABSTRACT FROM AUTHOR]

Objectives: Parents' beliefs, practices, and goals for children vary across cultures in the extent to which they promote dimensions of independence and interdependence. Parental preferences also vary within cultures according to nativity, generation status, and education level. Yet, within-culture studies of parenting among Mexican Americans are extremely scarce, especially among parents of young children. Methods: In this study, 103 Mexican American mothers of one- to six-year-old children (M = 4.6 years) completed two questionnaires measuring (1) beliefs about the importance of socialization practices with young children, and (2) long-term goals and values for children as adults. We investigated differences in seven scales across three dimensions of independence and interdependence: agency, conformity, and relatedness. Results: Practice beliefs and long-term goals varied according to mother's generation status, controlling for maternal education. Later generation mothers were more concerned with promoting autonomy (agency) (F2,97 = 6.85, partial eta squared =.12), and less with teaching obedience and manners (conformity) (F2,97 = 7.33, partial eta squared =.13), than earlier generation mothers. While they continued to value close relationships (relatedness), third generation mothers attached somewhat less importance to this long-term goal than earlier generation mothers (F2,97 = 4.89, partial eta squared =.09). Finally, generation status moderated relations between maternal education and teaching obedience and manners: maternal education level was more strongly negatively associated with the belief in teaching obedience and manners in third generation than in second-generation mothers (b = −.123, F3,99 = 16.911, R2 =.346, p <.001). Conclusions: Despite these intergenerational trends, across all generations, Mexican-origin mothers highly valued aspects of both agency and conformity as well as relatedness, providing further support for the emotional interdependence cultural model of parenting. This study increases our knowledge of Mexican American mothers' beliefs and goals, and may inform the design of evidence-based, culturally-sensitive interventions. [ABSTRACT FROM AUTHOR]

Research is critical for developing HIV and tuberculosis (TB) programming for U.S. African-born communities, and depends on successful recruitment of African-born people. From January 2014 to June 2016, we recruited African-born people for HIV and TB research in King County, Washington. We compared the characteristics of study participants and the underlying populations of interest, and assessed recruitment strategies. Target enrollment for the HIV study was 167 participants; 51 participants (31%) were enrolled. Target enrollment for the TB study was 218 participants; 38 (17%) were successfully recruited. Of 249 prior TB patients we attempted to contact by phone, we reached 72 (33%). Multiple recruitment strategies were employed with variable impact. Study participants differed from the underlying populations in terms of gender, country of origin and language. Inequities in research participation and in meaningful opportunities for such participation may exacerbate existing health disparities. [ABSTRACT FROM AUTHOR]

Although the field of special education advocacy is growing, little is known about the perceptions and goals of individuals who participate in advocacy trainings. It is important to understand why individuals want advocacy training to design more effective programs and determine whether training meets participant expectations. In this study, we evaluated the perceptions of 142 participants who completed the Volunteer Advocacy Project (VAP), a special education advocacy training. Using participants' responses to open-ended questions on the VAP application, we examined the perceptions of caregivers and professionals to understand their motivations for becoming advocates, their plans for using their newfound knowledge and skills, and their perceptions of the attributes of special education advocates. Findings indicated some key differences between caregivers and professionals in their reasons for becoming advocates and plans for using their newfound knowledge and skills. Participants wanted to become special education advocates to help their own child (if they were caregivers) and to help others. Participants planned to use their newfound knowledge and skills to advocate and to provide service to the community at three levels depending on their role: school, community, and state/national. Finally, regardless of role, participants perceived warmth, competence, and grit to be necessary attributes of successful advocates. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Rates of participation in physical activity are often not the same between groups in a given demographic category. These differences have been termed 'inequities,' and major health organizations are advocating large-scale initiatives to create 'equity' in physical activity. The aim of this paper is to explain why equity in physical activity is a misguided goal. Equity is a misguided goal because it ignores absolute rates of physical activity (i.e., it is a metric of how one group compares with another), and because it is an automated goal that ignores sizes of 'gaps' between groups. Moreover, equity initiatives incorrectly assume that groups with relatively high physical activity rates are always at lower health risk; that non-targeted groups will remain static in their levels of physical activity; that individuals are part of only one demographic category; that complete equity can be achieved; that the causal relationship between equity initiatives and their desired outcome can be known; and that differences in physical activity rates between groups are due to differences in 'opportunity.' Due to these issues, health organizations should abandon the goal of equity. Instead, they should aim to increase physical activity in groups that are most sedentary and/or at greatest health risk to a level that is as high as is feasible and possible, irrespective of how that new level compares with other groups. This goal is objective and not based on the misguided premises that underpin the current equity narrative. [ABSTRACT FROM AUTHOR]

Goal-striving stress refers to the psychological consequences of seeking but failing to reach upward mobility and is more common among low-income and people of color. Intergenerational mobility—or improved socioeconomic standing relative to one's parents—may be an important predictor of goal-striving stress for Blacks. We used the National Survey of American Life to investigate the association between intergenerational mobility and goal-striving stress among U.S.-born African Americans, U.S.-born Caribbean Blacks, and foreign-born Caribbean Blacks. Intergenerational mobility was associated with lower goal-striving stress and U.S.-born African Americans and Caribbean Blacks reported lower goal-striving stress than foreign-born Caribbean Blacks. Goal-striving stress was relatively high among foreign-born Blacks, regardless of level of intergenerational mobility attained. Goal-striving is an important stressor for foreign-born Caribbean Blacks, regardless of their level of educational success. Given increasing Black migration, future studies should disaggregate the Black racial category based on ethnicity and nativity. [ABSTRACT FROM AUTHOR]

Filipinos, the second largest Asian subgroup in the U.S., experience significant youth behavioral health disparities but remain under-represented in health research. We describe lessons learned from using the Matching Model of Recruitment to recruit 215 Filipinos to participate in a large, randomized controlled trial of a culturally tailored video aimed at increasing enrollment in the Incredible Years® Parent Program. We recruited participants from schools, churches, clinics, community events, and other community-based locations. Facilitators of participation included: partnership with local community groups, conducting research in familiar settings, building on existing social networks, and matching perspectives of community members and researchers. Findings suggest recruitment success occurs when there is a match between goals of Filipino parents, grandparents and the research community. Understanding the perspectives of ethnic minority communities and effectively communicating goals of research studies are critical to successful recruitment of hard-to-reach immigrant populations in randomized controlled trials. [ABSTRACT FROM AUTHOR]

Progress in reducing HIV infections has been suboptimal despite availability of effective prevention and treatment interventions and national strategies to bring them to scale. As part of a community-driven process, we expanded previous epidemiologic models using updated surveillance data from the Centers for Disease Control and Prevention to estimate quantitative parameters for ambitious but attainable national HIV prevention goals. We estimated new HIV infections could be reduced by up to 67% and prevalence could begin to decline by 2030 if 95% targets for diagnosis, care retention, and viral suppression are met by 2025 and an additional 20% of transmissions are averted through targeted interventions such as pre-exposure prophylaxis. Notably, this would require the percentage of diagnosed persons retained in HIV care to increase by more than 35 percentage points, which would necessitate innovative models and a substantial expansion of supportive services. Although the HIV incidence reduction goal of 90% as unveiled in the 2019 State of the Union Address is likely unachievable with the current intervention toolkit, it is possible to begin to substantially reduce HIV prevalence in the next decade with sufficient investments and innovation. [ABSTRACT FROM AUTHOR]

The United States (US) federal government allocates hundreds of billions of dollars to provide resources to Americans with disabilities, older adults, and the poor. The American Community Survey (ACS) influences the distribution of those resources. The specific aim of the project is to introduce health researchers to Public Use Microdata Sample file from 2009 to 2011. The overall goal of our paper is to promote the use of ACS data relevant to disability status. This study provides prevalence estimates of three disability related items for the population at or over the age of 15 years who reside in one of the continental states. When population weights are applied to the 7,198,221 individuals in the sample under analysis, they are said to represent 239,641,088 of their counterparts in the US population. Detailed tabulations by state (provided as Microsoft Excel® spreadsheets in ACS output) clearly show disability prevalence varies from state-to-state. Because analyses of the ACS data have the ability to influence resources aiding individuals with physical mobility challenges, its use should be promoted. Particular attention should be given to monetary allocations which will improve accessibility of the existing built environment for the individuals with mobility impairment. [ABSTRACT FROM AUTHOR]

Contingency management (CM) has extensively been shown to be effective in reducing substance use disorders, but its effects in reducing child maltreatment have yet to be determined. The current study provides preliminary support for the utilization of an innovative family-assisted CM component in 18 mothers who were referred to an evidence-supported behavioral treatment for concurrent child neglect and drug abuse by Child Protective Service caseworkers. In the examined CM, participants were invited to indicate from a list of common actions incompatible with child neglect (i.e. positive parenting actions), the extent to which these actions had been experienced utilizing a 3-point scale (almost never, sometimes, almost always). For each item that was indicated to be almost never or sometimes experienced, the participants were queried to indicate if the neglect incompatible action should be targeted as a therapeutic goal. Contingencies were subsequently established in which the participants were rewarded by involved family members for their completion of therapeutic goals. At baseline, results indicated that there was a negative association between the number of neglect incompatible parenting actions that were infrequently experienced and child abuse potential. A hierarchical multiple regression analysis showed that the number of neglect incompatible actions targeted as therapeutic goals at baseline, but not the number of positive parenting actions experienced infrequently at baseline, predicted reduced child maltreatment potential following treatment. These findings suggest the examined CM may assist evidence supported behavioral treatment specific to child neglect and drug abuse. [ABSTRACT FROM AUTHOR]

Based on ecocultural theory, this study utilizes focus group interviews to explore the ways Latino immigrant mothers and fathers transmit the values and beliefs they wish their young children to internalize. Findings suggest that parents purposely 'pick and choose' values they deem 'Latino,' such as the importance of family and values they deem 'American,' such as independence, to pass on to their children. Parents recognized three main barriers that might stand in their way of teaching their children to adapt to two cultural groups: balancing work and family, low self-esteem, and lack of good parental role models. However, they also pointed out two sources of strength that can help them overcome these barriers: optimism and motivation. This study provides a basis for generating hypotheses to be tested with larger datasets and informs the development of theory and culturally sensitive interventions and measures to evaluate Latino parenting. [ABSTRACT FROM AUTHOR]

Background: Latino youth are one of the fastest growing populations in the United States and are at a disproportionately higher risk for experiencing negative life events (NLEs). However, there are few studies examining risk and protective factors for the potentially negative outcomes that Latino youth who experience high levels of NLEs may face. Objective: This study examined the effect of NLEs on self-reported delinquency in a sample of Latino youth and evaluated academic aspirations as a moderator of these associations. It was hypothesized that the association between NLEs and delinquency would be buffered by high levels of academic aspirations. Methods: Participants included 144 Latino adolescents (males = 78, M = 16.25 years, SD = 1.46) attending a charter high school in a large, Midwestern city. Students completed a survey that included NLEs, self-reported delinquency, and academic aspiration measures. Results: Findings supported a link between NLEs and delinquency. Further, academic aspirations moderated the associations between NLEs related to safety and health and delinquency. For safety-related NLEs, the highest levels of delinquency occurred when academic aspirations were low and safety-related NLEs were high. For health-related NLEs, at low levels of academic aspirations delinquent behaviors were consistently high. Further, the lowest levels of delinquency occurred when academic aspirations were high and health-related NLEs were low. Conclusion: Results have important implications for targeting Latino students who report high levels of NLEs for the prevention of delinquent behaviors. Encouraging academic goals may be an effective strategy for deterring delinquent behavior among students who experience NLEs. [ABSTRACT FROM AUTHOR]

A growing body of recent research has linked romantic relationships, body dissatisfaction, and disordered eating. Exploring these linkages in the present study by using a broader framing than in previous research, we investigated the influence of normative romantic ideologies on college women's bodies. Drawing on post-structural feminism, we examined effects of gendered dating and marital scripts and 'singlism' (investing in romance as a primary life goal) on investment in thinness/appearance and disordered eating among 496 undergraduate women attending a large U.S. Southwestern university. We predicted that higher endorsement of romantic relationship ideologies will directly predict higher disordered eating as well as directly predict higher investment in thinness/appearance. We also predicted that investment in thinness/appearance will directly predict disordered eating. Using Structural Equation Modeling, our findings indicated that higher endorsement of normative romantic ideologies was associated with higher preoccupation with thinness/appearance and preoccupation with thinness was linked to higher disordered eating. Normative romantic ideologies were not directly related to disordered eating. Our findings indicate that underlying ideologies about normative romance are likely contributing to a desire to be thin/look attractive which, in turn, puts women at risk for disordered eating. We call attention to problematic normative heterosexual romantic ideologies and post-feminist sensibilities circulating within contemporary contexts. [ABSTRACT FROM AUTHOR]

The article discusses the implications of making obesity a social disease as a health care policy. It mentions the negative aspects of applying the biomedical measures to address the social determinants of obesity. It also mentions whether obesity is a disease and presents an analysis of obesity according to the philosophy of medicine.

This study used data from a phone survey inventory of US veterans' courts to provide descriptive information on the current status of their various elements. To identify which items were most predictive of a court's percentage of subjects terminated from their program, a linear regression was performed. The following were associated with higher rates of termination from the veterans' court (VC) program: (a) programs that offered phase progression based on measurable goals, (b) programs that conduct frequent drug and alcohol testing, and (c) programs for which sanctions are more severe for failing immediate goals (sobriety) versus long-term ones (completion of training). The following were associated with lower rates of termination from the VC program: (a) programs in which later phases permit less stringent testing, (b) programs utilizing behavioral contracts, (c) programs utilizing brief incarcerations. This inventory provides nationwide empirical data that may be used in the development of veterans' courts. [ABSTRACT FROM AUTHOR]

Recently adopted health care practices and policies describe themselves as 'patient-centered care.' The meaning of the term, however, remains contested and obscure. This paper offers a typology of 'patient-centered care' models that aims to contribute to greater clarity about, continuing discussion of, and further advances in patient-centered care. The paper imposes an original analytic framework on extensive material covering mostly US health care and health policy topics over several decades. It finds that four models of patient-centered care emphasize: patients versus their parts; patients versus providers; patients/providers/states versus 'the system'; and patients and providers as persons. Each type is distinguishable along three dimensions: epistemological orientations, practical accommodations, and policy tools. Based on this analysis, the paper recommends that four questions be asked of any proposal that claims to provide patient-centered care: Is this care a means to an end or an end in itself? Are patients here subjects or objects? Are patients here individuals or aggregates? How do we know what patients want and need? The typology reveals that models are neither entirely compatible nor entirely incompatible and may be usefully combined in certain practices and policies. In other instances, internal contradictions may jeopardize the realization of coherent patient-centered care. [ABSTRACT FROM AUTHOR]

A key aspect of supporting teachers' learning on a large scale concerns mathematics leaders' practices in designing for and leading high-quality professional development. We report on a retrospective analysis of an initial design experiment aimed at supporting the learning of three math leaders who were charged with supporting the learning of middle-grades mathematics teachers across a large US school district. Initial goals for the math leaders' learning included: (a) viewing teachers' improvement of their classroom practices as a progression; (b) designing supports for teachers' learning that were informed by assessments of teachers' current practices, were oriented towards long-term goals for teachers' practices, and would enable teachers to attain short-term goals that constituted reasonable next steps; and (c) facilitating professional development by pressing on teachers' ideas differentially and building on their contributions. Findings suggest that the math leaders increasingly viewed teachers' improvement of their classroom practices as a developmental progression and began to design connected sequences of activities. However, they struggled to facilitate the activities in ways that would meet their ambitious goals for teachers' learning. Based on our findings, we indicate potential improvements to our design for supporting math leaders' learning. More generally, we provide the field with a set of potentially revisable learning goals for math leaders' learning, a set of principles to guide the design of supports for their learning, and a provisional design to support the development of their practices. [ABSTRACT FROM AUTHOR]

In July, 2010, President Barack Obama released the National HIV/AIDS Strategy (NHAS). The NHAS set forth ambitious goals for the year 2015. These goals were potentially achievable had the appropriate level of resources been invested; however, investment at the necessary scale has not been made and the 2015 goals now may well be out of reach. Therefore, we propose that an updated NHAS be developed with goals for the year 2020 clearly articulated. For the purposes of fostering discussion on this important topic, we propose bold yet achievable quantitative 2020 goals based on previously published economic and mathematical modeling analyses. [ABSTRACT FROM AUTHOR]

The article discusses the exclusion of babies from the benefits of meaningful use standards. This will undermine the goal of decreasing health disparities in the Affordable Care Act (ACA). Transition of the healthcare system to electronic medical records (EMRs) and the unsuitability of meaningful use standards for the neonatal intensive care unit (NICU) are the reasons hospitals are left without a means of addressing patient needs in Health Information Technology (HIT) when it comes to babies.

This paper examines the influence of the state police law enforcement academy on the performance of commissioned officers in the field training officer (FTO) program in a state in the Southeastern region of the United States. The police training academy is paramount in preparing cadets for the roles, responsibilities, and activities that graduates assume independently in the field. As such, it is important to understand the value added to future performance in the field through adequate preparation in the training academy. This study analyzes a sample of officers in the Southeastern region of the United States and explores the relationship between their performance as cadets in the academy and their performance as commissioned officers in the field training officer program. Through stepwise regression, the researcher concluded that the law enforcement training academy accounts for 10% of the performance variance of newly commissioned officers in the field officer training program. The researcher recommended further analysis of the law enforcement curriculum and of the field training officer program. This research should focus on the specific goals and objectives of the FTO program to ensure that the curriculum taught in the academy is properly aligned with the performance measures of the FTO program. [ABSTRACT FROM AUTHOR]

While there is great deal of research that tracks self-regulatory academic beliefs and behaviors of students, relatively few efforts examine the specific self-beliefs of high achieving African American students. This study compared the intelligence-related beliefs, efficacy beliefs and academic goal orientations of 257 African American ( N = 196) and White ( N = 61) sophomore and senior students from among honors-level language arts classes in three large midwestern high schools. The results of this study suggest that while African American students and their White peers do not significantly differ with respect to efficacy beliefs or goal orientation, African American students expressed more strongly-held beliefs that were consistent with an entity view of intelligence than did White students. The implications of these results are discussed, as well as a practical means of application for academic settings. [ABSTRACT FROM AUTHOR]

Scholars have shown renewed interest in the construct of courage. Recent studies have explored its theoretical underpinnings and measurement. Yet courage is generally discussed in its broad form to include physical, psychological, and moral features. To understand a more practical form of moral courage, research is needed to uncover how ethical challenges are effectively managed in organizational settings. We argue that professional moral courage (PMC) is a managerial competency. To describe it and derive items for scale development, we studied managers in the U.S. military and examined prior work on moral courage. Two methods were used to measure PMC producing a five dimensional scale that organized under a single second-order factor, which we termed overall PMC. The five dimensions are moral agency, multiple values, endurance of threats, going beyond compliance, and moral goals. Convergent and discriminant validity are analyzed by use of confirmatory factor analysis procedures. We conclude by presenting a framework for proactive organizational ethics, which reflects how to support PMC as a management practice. [ABSTRACT FROM AUTHOR]

The author discusses issues he believes need urgent attention to make it possible the 2015 National HIV/AIDS Strategy for the U.S. in 4 areas including reductions in HIV incidence and transmission rate, better linkage to and retention in HIV care and reductions in HIV-related health disparities among gay men, African-American and Latino communities. He suggests serving all communities affected by HIV and remove vestiges of antiquated laws criminalizing HIV transmission.

The acute respiratory distress syndrome (ARDS), a process of non-hydrostatic pulmonary edema and hypoxemia associated with a variety of etiologies carries a high morbidity, mortality (10-90%) and financial cost. The reported annual incidence in the United States is 150,000 cases, but this figure has been challenged and may be different in Europe. Part of the reason for these uncertainties is the heterogeneity of diseases underlying ARDS and the lack of uniform definitions for ARDS. Thus, those whose wish to know the true incidence and outcome on this clinical syndrome are stymied. The European American Consensus Committee on ARDS was formed to focus on these issues and on the pathophysiologic mechanisms of the process. It was felt that international coordination between North America and Europe in clinical studies of ARDS was becoming increasingly important in order to address the recent plethora of potential therapeutic agents for the prevention and treatment of ARDS. [ABSTRACT FROM AUTHOR]

The article presents a result of randomized controlled trial conducted with the goal of increasing the activity of sedentary U.S. employees assigned to one of four reimbursement schemes. Topics discussed include the combined incentive plan, use of both individual and team incentives to boost performance and unintended consequences of reimbursement structures.