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Research and theory on deviance in work groups suggest that non-prototypical members risk devaluation and mistreatment by their peers. Drawing on the self-categorisation theory, we propose and test a contextual model to explain workplace bullying from a target perspective, using non-prototypicality as a predictor and social identification and anti-bullying norms at the work group level as two- and three-way cross-level moderators. Multilevel modelling and a sample of employees from the university sector in the Low Lands (n = 572) was employed. In line with our first hypothesis, we found that risk of exposure to workplace bullying is particularly high for non-prototypical work group members. We also hypothesised that work group social identification would facilitate bullying of non-prototypical members, while anti-bullying norms would buffer it. Results showed, however, that both conditions acted as buffering moderators on the main association. Lastly, the combination of the two also entailed a cross-level three-way interaction effect, showing that non-prototypicality is associated with bullying only in work groups characterised by low levels on both moderators. These novel and partly unexpected results demonstrate the relevance and significance of group level explanations for workplace bullying, holding significant implications for scholars and practitioners. [ABSTRACT FROM AUTHOR]

This study used focus group interviews with older Chinese long-term care residents (N = 40), to explore their perspectives and experiences of social participation in long-term care institutions. Based on previously established taxonomy of different activity levels, we found that their social participation centered on level 3 (involvement with others), level 4 (task-oriented activities), and level 5 activities (helping others). Participants indicated that their social participation had changed after relocation. Thematic analysis revealed three main themes: increased spare time, increased presence of peers, and new participation opportunities with lost old hobbies. Focusing on the positive changes after relocation and promoting meaningful activities of different levels may benefit long-term care residents. [ABSTRACT FROM AUTHOR]

Shortly after fixating on webpages, users form initial impressions. These initial impressions influence how much users will use and return to websites. Researchers have understudied how objective design features (e.g. visual complexity) influence subjective perceptions of website content and the favorability of initial user impressions. In the present study, the influence of two dimensions of visual complexity – feature complexity and design complexity – were tested within the boundaries of the persuasive model of web design. More specifically, the study examined how visual complexity influences perceptions of visual informativeness, cues for engagement, favourable initial impressions, and behavioural intentions in a sample of young adults (N = 277). Results suggest relationships for both dimensions of visual complexity on all outcome variables using ANOVA and OLS regression procedures and that perceptions of visual informativeness and cues for engagement mediate the relationship between visual complexity and favourable initial impressions and behavioural intentions. The study offers support for the utility of the persuasive model of web design for linking objective design features with subjective design perceptions to better understand favourable initial user impressions. [ABSTRACT FROM AUTHOR]

Individuals, (media-) organisations, and crisis responders who are involved in ad hoc crisis communication steadily deploy social media to contribute to collective sense-making as an endeavour to create meaning in highly uncertain situations. Exerting sense-giving in order to shape others' conceptions is causally preceded by an initial breakup of existing understanding. This study aims to explore patterns of sense-breaking in social media crisis communication and its impact on collective sense-making and sense-giving. To this end, we conducted a case study of the Manchester bombing in 2017, including a social network analysis of 708,147 Twitter postings and a content analysis of 2006 original tweets. We found individual role types to be initiators of sense-breaking in early crisis stages when uncertainty is at its height. Exerting successive sense-giving becomes more challenging if the collective sense-making has progressed along with the sequence of events. This understanding aims to encourage emergency management organisations to move their sense-giving actions closer to the point in time when sense-breaking occurs. [ABSTRACT FROM AUTHOR]

The Acute Recovery and Stress Scale (ARSS) and the Short Recovery and Stress Scale (SRSS) are well-established monitoring tools in German-speaking countries. This study aimed at validating them for English-speaking populations. Overall, 996 athletes (536 males, 24.9 ± 9.1 years) of Australia/New Zealand (n = 380), the United Kingdom (n = 316), and North America (n = 300) participated. The 32-item ARSS consists of eight scales. These scales constitute the eight items of the SRSS with the corresponding ARSS items as descriptors. Confirmatory factor analysis (CFA), internal consistency (α), and discriminatory power of the items (rit) were calculated for the total and subsamples separately. Satisfactory discriminatory power (rit >.30) for all ARSS and SRSS items and acceptable internal consistency (α >.70) was achieved. CFA indicated good fit indices for the total sample and subsamples, and strong measurement invariance was found across subsamples and gender. Correlations between corresponding scales and items (rs =.68 –.78) support theoretical congruency as well as independent usage of both questionnaires. Construct validity of both tools is shown through hypothesis-conforming correlations with the Recovery-Stress Questionnaire for Athletes. Future studies may apply the ARSS and SRSS as monitoring tools in English-speaking regions worldwide. [ABSTRACT FROM AUTHOR]

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In Tanzania, women suffer high rates of intimate partner violence (IPV). We conducted a pilot cluster randomised controlled trial to test the feasibility, acceptability and preliminary effectiveness of IPV prevention interventions targeting men and communities in nine villages randomly assigned to one of three study arms (n = 450 couples). In the Control Group, women participated in savings groups while male partners received no intervention. In Intervention Group 1, women participated in savings groups and men participated in peer-groups addressing gender relations and IPV prevention. In Intervention Group 2, women participated in savings groups, men participated in peer-groups, and community leaders facilitated dialogues on similar topics. Recruitment was completed within one month with 95% retained in the intervention and 81% retained in the endline survey. Acceptability was high, with men participating in 82% of peer-group session hours. More men in Interventions 1 (24%) and 2 (19%) disagreed with wife-beating compared to men in the Control (13%); and more men reported non-perpetration of IPV in Interventions 1 (16%) and 2 (14%) compared to the Control (−2%). Findings suggest a fully powered RCT may detect significant reductions in men's justification and use of IPV, paving the way for evidence-based violence prevention programming. Trial registration: This study is registered with ClinicalTrials.gov. Identifier: NCT02434796 [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to assess memory, imitation of motor actions and motor performance by 12 children (age range 40–151 months) with Angelman syndrome (AS), a rare neurogenetic disorder associated with learning and memory impairments. Methods: Children's functioning was assessed at several time points over a 3-month period. Results: Memory and motor performance tests had acceptable test-retest and inter-rater reliability whereas the motor imitation test did not. Children were able to recall action sequences after a 24-h delay. Memory and motor performance scores were correlated with children's chronological age and raw scores on subdomains of the Vineland-II. Conclusions: These behavioral tests require further development and evaluation but may show promise to accompany standardized assessments that are currently in use with children with AS. [ABSTRACT FROM AUTHOR]

Introduction: Community-dwelling stroke survivors generally show low levels of physical activity (PA). An improved understanding of the factors influencing participation in PA after stroke is imperative to improve levels of PA. Furthermore, gender differences in PA have received little attention in stroke research. The objective of this study was to examine gender differences in PA, physical functioning and psychological factors and the association between these factors and PA in men and women 1-3-year post-stroke. Materials and methods: A total of 187 community-dwelling individuals with stroke (65-85 years old, 29% women) were included in a secondary analysis based on data from a cross-sectional study. The exclusion criteria were severe cognitive or language dysfunction or dementia. The level of PA was measured by the Physical Activity Scale for the Elderly. Physical function included balance, walking speed and mobility. Psychological factors included depression, health-related quality of life and fall-related self-efficacy. Falls and fear of falling were each measured with a single question. Results: There were no significant differences in PA levels between men and women. In multiple regression analyses, walking speed (p < 0.001) was associated with PA in men, and balance (p = 0.038) was associated with PA in women. Conclusions: The results indicate that strategies to increase PA levels 1-3-year post-stroke could be improved by considering gender-specific factors. [ABSTRACT FROM AUTHOR]

It is recognised that physical activity has a positive impact on quality of life, social well-being and overall health of people with severe mental illness. However, there is a lack of theory informed programmes that support people with mental illness to adopt regular physical activity behaviour. The aim of this case study was to identify determinants of long-term physical activity among people with severe mental illness that may then inform the development of more suitable physical activity programmes. Semi-structured interviews were conducted with 15 people (13 men and 2 women) with a mean age of 36.7 [standard deviation (SD)=11.8] who had a diagnosed mental illness and were attending a physical activity programme run by a mental health non-governmental organisation. Interview data was analysed using the documentary method to emphasise the perspective of people with severe mental illness. Three participation types were generated in the context of individuals' physical activity orientation and social background—first 'rehabilitative orientated' (physical activity as a supportive measure to re-enter the labour market and develop a daily routine); second 'social-orientated' (social well-being within the group as the primary motive); finally, 'trust-orientated' (a sense of trust that encourages participation). Based on these type-specific categories, it is suggested that different settings (mental health care centres and sport clubs) might be needed to attract and maintain the physical activity engagement of people with severe mental illness. In the context of sport clubs, it is recommended that coaches undergo training in mental health literacy. [ABSTRACT FROM AUTHOR]

Efforts to improve cultural competence in pediatric hearing loss services should be informed by evidence of how culture can affect services, yet there is a paucity of research in the field of audiology. The aim of this study was to gain insight into practitioners' experiences with offering early hearing loss services to minority culture families. Specifically, the objective was to examine possible barriers and facilitators to improving cultural competence in early hearing loss services by exploring the perspectives of the providers of care from across Canada. A survey, informed by our previous studies, was disseminated to practitioners providing hearing loss services. Responses to all survey questions were analyzed descriptively. Open-ended questions were analyzed with simple content analysis. Results indicate practitioners reported barriers at each stage of service delivery: during diagnoses, amplification discussions, language assessments, and interventions. Practitioners also described various strategies used to facilitate culturally competent care. Findings stemming from this study can be used to inform practitioners seeking to provide culturally competent care. [ABSTRACT FROM AUTHOR]

We investigated the impact of an eclectic framework for combining theoretical conceptual practice models on occupational therapists' theoretical reasoning using concurrent mixed methods with repeated measures and grounded theory designs. Study participants (n = 9) attended two workshops to review select occupational therapy theoretical conceptual practice models and learn how to use the eclectic framework. We assessed skills in eclectic combination of theoretical conceptual practice models using the Theory Application Assessment Instrument. The skills improved significantly [χ2(2, 9) = 7.09, p =.02], a finding that was corroborated by the qualitative findings indicating that the eclectic framework may potentially help improve theoretical reasoning among occupational therapists. [ABSTRACT FROM AUTHOR]

The Strengths Model for case management has demonstrated success with adults, and has recently been adapted and piloted for youths aged 12-18 in a community mental health center in a Midwestern state. For this qualitative study, researchers interviewed case managers to elicit their insight about how the model impacted their work with youth and youth outcomes. Qualitative analysis yielded themes and subthemes, organized into three categories: Model components, intermediate impact, and longterm impact. Results indicate overall success and satisfaction with the model, and improvements for both the case managers and youth. Implications for further research are also discussed. [ABSTRACT FROM AUTHOR]

Background: Limited research exists on mental health correlates of behaviors of weight-conscious drinking (BWCD) and students' perceptions of how BWCD should be addressed. Purpose: The objectives were to (1) examine BWCD and different aspects of mental health and (2) gain insight into students' perceptions of such behaviors and potential strategies to address them. Methods: Four-hundred-twelve students completed a survey consisting of validated measures for: BWCD, eating disorders, exercise addiction, alcohol use, and psychological distress. Eight focus groups explored students' understanding of BWCD, its presence on campus, and potential intervention strategies. Results: Majority (62%) of participants indicated they engaged in at least one behavior associated with BWCD "very often" or "all the time." Hierarchical linear regression analysis indicated that disordered eating and exercise addiction were significant predictors of BWCD. Focus groups indicated participants struggled with awareness and ability to identify concerning BWCD. Taken together, the results indicated high prevalence of behaviors, but limited awareness of associated health consequences, and identification of BWCD. Discussion: BWCD are pervasive in this college sample, but students do not perceive them as harmful or problematic. Translation to Health Education Practice: There is a need for comprehensive education to address the intersection between alcohol use, exercise, and disordered eating. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common malignant condition afflicting females globally although there is limited information regarding the determinants that prompt females to participate in breast cancer screening in Botswana. The study explored the Health Belief Model (HBM) constructs in explaining factors associated with breast cancer screening amongst female students in Botswana. A cross-sectional study was conducted using multi-stage random sampling. Self-administered questionnaires were used to elicit information from 383 female participants. Binary logistic regression and chi-square statistic were used for inferential analysis. The results showed that 40 (10.4%) of the participants had gone for breast cancer screening and 195 (50.9%) participants obtained information on breast cancer screening via television. There was a significant relationship between breast cancer screening uptake and health professionals as the source of information (p < 0.001). A belief that screening leads to loss of breast was associated with fear of breast cancer screening uptake (Adjusted Odds Ratio [AOR]: 0.532, 95% Confidence Interval [CI]: 0.330–0.857). Female students who believed that having breast examinations performed by a physician was expensive were 0.63 times less likely to have breast cancer screening (AOR: 0.626, 95% CI: 0.465–0.843). The study revealed that breast cancer screening among female students was lower than the 93% target set by the Healthy People 2020 in the United States of America. Our findings suggest that there is a need for interventional health programs to encourage breast cancer screening uptake, targeting the negative beliefs and perceptions acting as barriers to breast cancer screening. [ABSTRACT FROM AUTHOR]

The lexical-grammatical divide has been a widely addressed topic in aphasia. Speech parts are generally classified as either belonging to a lexical or a grammatical category based on the frequency of acquisition of new members in their paradigms (open vs. closed classes), thus neglecting heterogeneity within categories. Such an approach has led to contradictory findings. First, prepositions form closed classes, but are classically taken as lexical items. Pronouns, also belonging to a closed class, are analyzed as grammatical elements. Second, both within the group of prepositions and pronouns, forms with different syntactic and semantic properties co-exist. Following the theoretical notions granted by a usage-based theory of grammar, the ProGram theory, and taking focalizability as the classification criteria, we hypothesize that individuals with non-fluent aphasias will experience more severe problems with grammatical prepositions and pronouns, given that these elements are secondary and dependent, whereas informants in the fluent group will experience more severe trouble with lexical forms, potentially primary and independent. We focused on the performance of nine Spanish-speaking individuals with aphasia from the Rosell (2005) corpus. Samples of 300 words were transcribed and analyzed. As predicted, grammatical prepositions were found to be more severely compromised in the speech output of individuals with deficits of motor predominance, whereas lexical prepositions are more severely affected in individuals with deficits of sensory predominance. Although less conclusively, the same tendency holds in the case of pronouns. Our results, consistent with previous findings, confirm the heterogeneity of prepositions and pronouns, which should no longer be analyzed en bloc. [ABSTRACT FROM AUTHOR]

HIV/AIDS stigmatizing attitudes and their consequences on preventative behaviors are among the most poorly understood aspects of the AIDS epidemic. This paper analyzes the socioeconomic determinants of discriminating attitudes toward people living with HIV and their implications on the likelihood of HIV testing. These effects are tested using the 2004 and 2009 Demographic and Health Surveys conducted in Lesotho, where HIV/AIDS is a pervasive problem. We find that HIV/AIDS stigmatizing attitudes are negatively associated with education and wealth and positively correlated with Catholic religion for women and traditional circumcision for men. The analysis also shows a negative association between stigmatizing beliefs and the probability of being tested for HIV. [ABSTRACT FROM AUTHOR]

FGID is one of the most common pain conditions in children and adversely affects their functioning and quality of life. Recent approaches to the management of paediatric FGID recognise the importance of an integrated biopsychosocial approach. Unfortunately, research findings show that psychosocial factors are often not adequately addressed in the management of FGID in children. We recently conducted a survey of 327 paediatric doctors in Australia to investigate their approaches to managing two of the most common childhood FGID - functional abdominal pain (FAP) and irritable bowel syndrome (IBS). Findings provide important insights into paediatricians' perceptions of the role of psychosocial issues and interventions in these conditions. Implications for social work are discussed. [ABSTRACT FROM AUTHOR]

This study aimed to explore how the aging population in Appalachia manages its transportation and plans for the transition to non-driving and to seek possible solutions to the challenge of meeting rural transportation needs. Four focus groups (N = 38) were conducted, supplemented by a questionnaire, in Appalachian Kentucky. The results showed that few alternative transportation existed except a local paratransit service and informal transportation support. Compared to older adults, middle-aged adults reported a greater willingness to use mobile phones and the Internet to arrange transportation if they were available. Participants also recommended expanding the use of existing transportation in the community – such as church vans – to better meet the aging population's needs. The findings suggest that partnership between government, non-profit, and private sectors is needed, not solely focusing on a tax-dependent solution. Additionally, information and communication technology-based transportation management system would help maximize the use of scare but existing resources in rural areas. [ABSTRACT FROM AUTHOR]

This study examined the roles of future time perspective and affective commitment on the work engagement of a select group of aging Filipino professoriate. A total of 208 respondents aged 40–60 years old, teaching at the largest Catholic University in the Philippines, were requested to accomplish a multi-aspect questionnaire covering the variables of the study. Data gathered were processed through SPSS v.17 and AMOS v.19. The structural equation model reveals (i) a positive relationship between future time perspective and affective commitment (β =.485) and (ii) a positive relationship between affective commitment and dimensions of work engagement, namely, vigor (β =.986), dedication (β =.943), and absorption (β =.983). Also, of all the dimensions of work engagement, absorption has the biggest impact, while dedication has the smallest impact on work engagement. Findings yielded in this study provide valuable information in structuring human resource programs that can help address the aging workforce's needs and concerns, thus improving their future orientation, commitment, and work engagement. [ABSTRACT FROM AUTHOR]

Purpose: To establish the construct validity and internal consistency of the Arabic Children Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) and to determine the effects of age, gender, and disability status on diversity and intensity of participation. Methods: The World Health Organization guidelines for translation of measures were applied to translate the CAPE and PAC, 75 children with cerebral palsy (mean age = 10.7 ± 2.9 years) and 75 children with typical development (mean age = 10.8 ± 2.7 years) completed the translated measures. The construct validity of the translated measures was demonstrated by principle component analyses in addition to the known-groups method by examining the effects of age, gender, and presence of disability on diversity and intensity scores. The internal consistencies of the extracted components were examined by Cronbach's alpha. Results: Four components emerged: (1) physical activities; (2) home-based activities; (3) self-improvement activities; and (4) social activities. Cronbach's alpha varied from 0.61 (social activities) to 0.83 (physical activities). Age, gender, and disability were significant determinants of types of activities. Conclusions: The Arabic CAPE and PAC are culturally valid in measuring participation of children with or without disabilities in Jordan. The child's age, gender, and disability should be considered to provide participation-based plans of care that are considerate for children and their families. The Arabic CAPE and PAC are culturally valid measures for participation of children with or without disabilities in Jordan. The Arabic CAPE and PAC measures can guide participation-based plans of care that are meaningful and considerate for children and their families. Child age and gender should be considered to provide appropriate activities and to facilitate participation of children with and without disabilities. Families and service providers in Jordon are encouraged to provide children opportunities to participate in desired physical, self-improvement, and social activities. [ABSTRACT FROM AUTHOR]

Background: Although conceptualisation of addiction varies with time and culture, literature on intercultural studies between high and low income countries is scarce. This article uses Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 guidelines on diagnosis of Alcohol Use Disorder (AUD) and the Capability Opportunity Motivation - Behaviour (COM-B) model to explore perspectives on alcohol addiction and its facilitating factors in Uganda and Belgium. Method: Sixty qualitative interviews (40 with service providers and 20 service users) were administered in four alcohol treatment centres, two in Uganda and two in Belgium. Interviews were transcribed and analysed thematically using Nvivo software. Result: While addiction was primarily regarded as a disease enabled by capability factors (affordability and the absence of life and social skills) by Belgian respondents, many Ugandans viewed it as a moral or criminal issue; motivated by the varied roles of informal alcohol use amidst weak restrictions. Opportunity-related factors including; acceptability, availability, media influence, cultural/religious beliefs and practices and peer influence were recognised as facilitating factors in both countries, while stigma was equally prevalent. Conclusion: Interventions in Uganda could explore strengthening legislation and research on utilisation of the well-entrenched religious and cultural institutions to encourage alternatives to alcohol use. In Belgium, promotion of life and social skills, alcohol regulation in educational institutions and other demand reduction strategies seem essential to delay the onset of (mis)use. In both societies; general reduction of opportunities for access, early intervention, programmes for young persons and prevention of stigma through awareness-raising can be explored for mitigation of AUD. [ABSTRACT FROM AUTHOR]

Objective: Ethnic minorities in the Netherlands experience worse (mental) health than Dutch natives. So far, socioeconomic factors, discrimination, and the migration process have been identified as underlying factors, neglecting the potential role of health-related behaviours. This study investigates the mediating effect of lack of physical activity, smoking and alcohol consumption on ethnic inequalities in (mental) health in the Netherlands. Design: Data from a municipal health survey (2012) in the four largest cities in the Netherlands, including 15,633 Dutch natives, 1,297 Surinamese, 850 Turks and 779 Moroccans were analysed. Mediation analyses were performed on the associations between ethnicity and psychological distress (range 10-50) and self-rated health (range 1-5). Results: Being from an ethnic minority was associated with higher distress and poorer self-rated health, especially for Turks (higher distress 4.69, 95%CI 4.22-5.16; poorer health 0.35, 95%CI 0.30-0.40). Moroccans and Turks were the least physically active, Turks smoked the most, and Dutch natives drank the most. Lack of physical activity partially mediated the association between Turks (6% respectively 11%) and Moroccans (13% respectively 9%) for psychological distress and self-rated health. Smoking played a mediating role (3%) in Turks. Conclusion: Lower physical activity and smoking more cigarettes partly explained ethnic health inequalities in the Netherlands. The current findings suggest that intervening and facilitating certain ethnic groups in engaging in health behaviours could contribute to improving their health and reduce ethnic health inequalities. [ABSTRACT FROM AUTHOR]

Objective: Medical care alone cannot adequately improve population health or eliminate inequities; social determinants of health (SDH) must be addressed. This study's purpose was to describe the research, teaching, service, and clinical practice activities implemented by RWJF Nurse Faculty Scholars to act on the SDH. Design: A cross-sectional survey design was used with a sample of RWJF Nurse Faculty Scholars, chosen because they were provided specialized mentoring, grants, and other support that allowed them to explore SDH. Results: Respondents (n = 57) addressed SDH in their research (86.0%), teaching (68.4%), service (66.7%), and clinical practice (33.3%). Leading research foci were quality of health care (56.1%), social and physical environmental stressors (54.4%), and access to health care services (49.1%). Leading SDH areas in teaching were discrimination in society against vulnerable populations (54.4%), quality of health care received by vulnerable populations (50.9%), and vulnerable populations' access to health care services (50.9%). Service activities included addressing discrimination against diverse populations. Leading SDH areas in clinical practice were quality of health care received by vulnerable populations (28.1%), vulnerable populations' access to health care services (22.8%), and discrimination in society against vulnerable populations (19.3%). Respondents also addressed SDH through personal mentoring (71.9%); efforts to recruit and/or retain underrepresented faculty (59.6%); developing a diverse pipeline of nurses (59.6%); and participation on a diversity committee (40.4%). Conclusion: The RWJF Nurse Faculty Scholars were able to leverage their awards to address SDH; however, further research is needed to assess the impact of the SDH work conducted. Knowledge from this study can be used as a road map for SDH elements and areas of professional work that nurses and other health professionals could address SDH in research, teaching, service, and practice. [ABSTRACT FROM AUTHOR]

The objectives of this study are to investigate climates that could facilitate innovative use of information systems (IS), and to examine how psychological climate and individual goal orientation interact to promote employees' innovative IS use. A total of 174 questionnaires were collected from enterprise resource planning (ERP) users from nine firms in China. Hierarchical regression analysis was used to test the research hypotheses. The empirical results suggest that (1) psychological climates (psychological autonomy climate and psychological innovation climate) are positively associated with IS users' innovative use, (2) avoidance orientation weakens the relationship between psychological autonomy climate and innovative use, (3) learning orientation weakens the relationship between psychological innovation climate and innovative use, and (4) learning orientation strengthens the relationship between psychological autonomy climate and innovative use. This study contributes to IS literature by identifying psychological climate as a critical antecedent of innovative use. The findings also fulfil an identified need for more empirical studies of the combined effect of individual and environmental factors on employees' innovative behaviour in the workplace, especially in the context of IS innovation. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about public perception of physical therapy (PT) delivery by type of provider in the United States (US). Purpose: This study aimed to describe differences in ambulatory PT visits and expenditures according to perceived provider type, and to determine if visits and expenditures varied by provider type. Methods: This study employed the Medical Expenditure Panel Survey (MEPS), which is a nationally representative survey of US households that used a complex, stratified, cluster sample design. Data from cross-sectional samples over 4 years of the MEPS Household Component were used to study adults with musculoskeletal conditions who reported receiving ambulatory PT. National-level, average annual estimates of numbers of visits, and reported total expenditures by perceived provider type were computed. Associations between perceived provider type and visits and expenditures were determined by linear regression, accounting for the sample design, and adjusting for demographic and clinical covariates. Results: Estimated annual perceived PT visits were 60.00 million with physical therapists, 39.66 million with non-physical therapist providers, and 20.66 million with multiple providers. Estimated annual expenditures for PT were $9.37 billion with physical therapists, $4.62 billion with non-physical therapist providers, and $3.09 billion with multiple providers. Compared with non-physical therapist providers, physical therapist provider status and multiple provider status were associated with higher numbers of visits and expenditures. Conclusion: Non-physical therapist providers are responsible for a substantial amount of PT delivery in the US. Numbers of visits and total expenditures varied by the type of provider delivering PT. [ABSTRACT FROM AUTHOR]

Background: Public health professionals advocate school-based and community physical activity (PA) interventions as an effective method to increase PA levels and improve physical fitness. Purpose: This evaluation independently assessed a school-community linked PA intervention by exploring the provision, process, and impact of the program and its outcomes. Methods: Students aged 7 to 12 years (n = 468, intervention group [IG]; n = 128, control group [CG]), teachers (n = 19), head teachers (n = 4), school program contacts (n = 4), and program administrator (n = 1) took part in the evaluation. Program content and processes were assessed using questionnaires and semistructured interviews. A mixed effect model was used to assess changes in physical fitness, PA levels, and attitudes toward PA at baseline and postintervention. Results: CG increased body mass (P > .001), aerobic capacity (P > .001), and push-ups (P = .005), as well as improved attitudinal scores toward health and fitness and vertigo (P < .05) compared to the IG. Process evaluation revealed struggles with implementation and design, including pedagogical issues to facilitate program goals. The intervention did not improve attitudinal outcomes, PA levels, or physical fitness above that of the CG. Translation to Health Education Practice: Sustainable PA interventions should consider adopting a sociocultural approach that is grounded in learning models and delivered by staff with relevant pedagogical content knowledge. [ABSTRACT FROM AUTHOR]

This research described the perspective of family members and significant others to illicit drug users regarding illicit drug use prevention initiatives. A descriptive quantitative study was developed in a local health care center in an inner city of São Paulo, Brazil. A total of 100 adults were interviewed, who considered themselves as personally affected by having a family member or significant who has been or is a user of illicit drugs. Data capture was standardized through a form developed in the EpiData program, and analyzed using descriptive statistics with the support of the Statistical Package for Social Sciences (SPSS®). Results pointed different prevention initiatives and the institutions that should be responsible for them. For preventive actions to be successful, they must be intersectoral and involve community and families. [ABSTRACT FROM AUTHOR]

Objective: The study examined how a couple's capacity for mutuality as conceptualized by the Relational-Cultural Theory plays a role in their managing the stresses accompanying breast cancer. Methods: Eighty-six women treated for a primary, non-metastatic breast cancer and their partners completed measures of quality of life, relational mutuality, and dyadic coping. Demographic and clinical factors were self-reported. The relationship between mutuality and dyadic coping was evaluated using the Actor-Partner Interdependence Model (APIM). Results: Relational mutuality was positively associated with both the patients' and the caregivers' scores on common and positive dyadic coping. Similarly, relational mutuality was associated with both patients' and caregivers' reduced scores on avoidance of dyadic coping. Conclusions: Relational mutuality emerges as a significant factor in our understanding about dyadic coping in the context of cancer and this study highlights the role it plays in dyadic coping behaviors. Implications: The promotion of relational mutuality in couples coping with cancer-related stress should be a major focus in couple-based interventions. [ABSTRACT FROM AUTHOR]

Purpose: To explore exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type and to explore patient experiences of physiotherapy. Methods: A cross sectional questionnaire survey design was used to collect quantitative and qualitative data from adult members of the Hypermobility Syndromes Association and Ehlers-Danlos Syndrome Support UK. Descriptive and inferential statistics were used to analyse the data. Qualitative data was analysed thematically. Results: 946 questionnaires were returned and analysed. Participants who received exercise advice from a physiotherapist were 1.75 more likely to report high volumes of weekly exercise (odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.30-2.36, p < 0.001) than those with no advice. Participants who believed that exercise is important for long-term management were 2.76 times more likely to report a high volume of weekly exercise compared to the participants who did not hold this belief (OR = 2.76, 95% CI = 1.38-5.50, p = 0.004). Three themes emerged regarding experience of physiotherapy; physiotherapist as a partner, communication - knowledge, experience and safety. Conclusion: Pain, fatigue and fear are common barriers to exercise. Advice from a physiotherapist and beliefs about the benefits of exercise influenced the reported exercise behaviours of individuals with Ehlers-Danlos syndrome - hypermobility type in this survey. Implications for rehabilitation: Exercise is a cornerstone of treatment for Ehlers-Danlos syndrome/Ehlers-Danlos syndrome - hypermobility type. Pain, fatigue and fear of injury are frequently reported barriers to exercise. Advice from physiotherapists may significantly influence exercise behaviour. Physiotherapists with condition specific knowledge and good verbal and non-verbal communication facilitate a positive therapeutic experience. [ABSTRACT FROM AUTHOR]

Purpose: Persons with cerebral palsy, even if they have relatively good motor functions, have a lower level of independence and participation in everyday activities than persons of the same age without disabilities. However, there are few descriptions of how persons with cerebral palsy themselves perceive their performance of activities in everyday life. The aim of this study was to describe the perceptions that young adults with cerebral palsy have of occupational performance in everyday life. Methods: This qualitative interview study includes 10 participants with cerebral palsy classified with Manual Ability Classification System level I-II, aged 19-30 years. The data were analyzed using a phenomenographic approach. Results: The interviews resulted in five categories: "Important to do"; "Demanding but can be facilitated"; "Excludes or includes"; "Diminishes me or makes me grow"; and "Comes at a price". Conclusions: The young adults with cerebral palsy consider that, despite life being so demanding, it is extremely important to perform activities themselves and to feel included, as this enables personal growth. Hence, it is necessary to advance intervention methods based on personally important activities to enable individuals with cerebral palsy to find their own way to perform activities. Further research is needed to increase opportunities for individuals with cerebral palsy to perform everyday activities without too much fatigue and struggle. Implications for Rehabilitation: For young adults with cerebral palsy it is extremely important to perform everyday activities independently; by DOING activities they form their identity. Intervention models aimed to enable persons with cerebral palsy to be involved and find their own way to perform everyday activities should be emphasized. Attention must be paid to how mental fatigue is manifested in persons with cerebral palsy. To build self-awareness and self-efficacy, individuals with cerebral palsy need information, early in life, about cerebral palsy and the multifaceted difficulties the disability might lead to. [ABSTRACT FROM AUTHOR]

Family functioning is influenced by different factors like social context, qualitative characteristics, and an individual's medical or psychiatric condition. We examine the effects of sociodemographic factors and individual psychopathology on family functioning in a non-clinical sample. Cross- sectional study. Data were collected: age, gender, occupation, education, and description of the family, history and/ or presence of mental or physical illnesses, Family Assessment Device and Symptom Checklist-90-R. A healthy sample of 137 families with a total of 407 individuals was analysed. Multilevel analysis showed that individual psychopathology was the only significant factor for family dysfunction. Thus, there is a strong association between family dysfunction and psychopathology of a member. [ABSTRACT FROM AUTHOR]

Racism has a long history in the United States. For generations, people of color have been systematically oppressed, whereas White people have benefitted from unearned privilege. Despite major advances in civil rights, the ongoing presence and legacy of racism and White privilege result in pervasive inequities. Social work education prepares graduates to advocate for racial justice. The present study describes the historical knowledge of oppression that students (N=305) possess at the beginning of their MSW education and examines the relationship between this knowledge and the endorsement of a color-blind ideology. Students with more historical knowledge reported fewer color-blind beliefs; millennial generation students reported fewer color-blind beliefs than older students. Implications are discussed for race-conscious and competency-based social work education. [ABSTRACT FROM AUTHOR]

Work-related mental distress and its impact on employees' working life is a mounting issue among Finnish social workers. This article focuses on identifying the factors associated with child welfare social workers' occupational well-being. The occupational well-being of Finnish child welfare social workers (N = 364) and social workers whose duties do not include child protection work (N = 524) was explored and compared with each other using t-test statistics and logistic regression analysis. The data, collected in 2014/2015, were obtained from an ongoing longitudinal cohort study on work-related well-being among Finnish public sector employees. A multi-dimensional and holistic approach to occupational well-being was used as the outline for the analysis and comparison of the two groups. Child protection social workers reported higher levels of burnout and secondary traumatic stress than social workers without child protection duties. Despite these burdens, both groups showed a similar level of general health, compassion satisfaction and overall occupational well-being. Individual and organizational factors associated with high occupational well-being were identified. Supervision was found to be an important supporting element. This study identified multiple determinants related to social workers' occupational well-being, comprising positive and negative elements with regard to organizational and individual factors. [ABSTRACT FROM AUTHOR]

Supervision has been an integral aspect of social work practice since the early days of the profession. The literature suggests that 'supervision is an essential and integral part of the training and continuing education required for the skillful development of professional social workers' (p. 5). The literature does appear to support that all social workers ought to have some level of supervision; however, within interprofessional settings, where social work is one of many professions, that goal may not be easily attained. Although some interprofessional settings, like hospitals, have social work departments, other settings, like schools, may only have one social worker, resulting in a workplace environment devoid of social work supervision. This article presents findings from a national study of social workers employed in interprofessional organizations. It was hypothesized that this cohort could provide important insights about the nature of social work supervision in agencies characterized by an interdisciplinary workforce. Using both open-ended and specific categorical questions, respondents were asked to describe and convey information about the supervision process and experience in their agency. An Internet-based survey was used to reach a broad spectrum of social work practitioners and educators (975 deliverable and 426 completed) across the United States. [ABSTRACT FROM AUTHOR]

The differences between meaningful and psychologically rewarding occupations were investigated. Fifty-two individuals from the United States and South Africa participated in the research, which was conducted using the Experience Sampling Method. Participants were cued at random, five times per day for 7 days. Each time when cued, they documented the types of occupations in which they were participating, associated mood, and perceived meaning of the occupations. Meaningful and psychologically rewarding occupations were similar: Both were physically stimulating and connected participants with other people. There were differences between U.S. and South African participants regarding perceived meaning of occupations and associated mood. [ABSTRACT FROM AUTHOR]

Caregivers are frequent sources of information of their children's behavioral health and other service needs. It is particularly challenging to engage child welfare-involved caregivers who risk losing custody of their children. This case study explores how caregivers who were about to lose custody of their children engage in their children's behavioral health screening and assessment from the perspective of child welfare and behavioral health workers. Using qualitative data collected via focus groups from child welfare and behavioral health workers, themes were identified related to the process of engaging caregivers in child behavioral health screening and assessment, determinants (both internal and external) for the caregiver engagement process, and how this process affected screening and assessment outcomes. Findings have implications for screening and assessing behavioral health needs of children involved with the child welfare system and recommended strategies to better engage caregivers in the process. [ABSTRACT FROM AUTHOR]

This study extends research on financial inclusion by exploring the composition of financial services within communities. Using propensity-score-adjusted probit regression, we explored associations with savings account ownership using restriscted-access, cross-sectional data from the 2015 National Financial Capability Study with merged financial services and community demographic data. Living in communities where the density of banks and credit unions outnumbered that of alternative financial services was associated with lower-income households' greater probability of owning a savings account, all else being equal. These results have implications for efforts aiming to improve financial inclusion. [ABSTRACT FROM AUTHOR]

Background: Bullying as a stressor in the workplace has been evaluated in numerous settings. It has never been evaluated in the emergency medical service (EMS) environment where bullying can occur from many different sources. The Negative Acts Questionnaire-Revised (NAQ-R) is a 22-question validated tool for evaluating bullying. Our hypothesis was that we could identify a shortened version of the NAQ-R that identifies bullying as accurately as the full screening tool. Methods: This was a cross sectional study of EMS providers in our local EMS transport agency. The local EMS agency transports approximately 50,000 patients per year and is a paramedic level response system. Results on the NAQ-R were on a 5-point Likert scale for each of 22 different categories of bullying that were summed by adding each questions 1-5 response for the 22 questions. Respondents were also categorized as victims or non-victims of bullying based on being positive for any of the 22 types of bullying at least once a week. We performed a binomial decision tree analysis and a cross-validation. Results: Data were collected from 153 providers. Mean age was 33 ± 10 years and 50% were male. Total years in EMS were 8 ± 8 years. NAQ-R summed results in our group ranged between 22 and 88, with an average of 40 ± 15. A NAQ-R score of 33 or less was 91% accurate in identifying non-victims and a score of 45 or more was 94% accurate in identifying victims. The majority at 51% (77/152) of respondents were victims of one or more types of bullying. A combination of five questions was 94% accurate in identifying a victim of bullying among EMS providers. Cross validation resulted in a misclassification risk estimate of 0.12 ± .03. Conclusion: NAQ-R bullying scores in EMS are similar or higher than numbers in other fields. Five questions on the NAQ-R were 94% accurate in identifying victims of bullying in EMS providers. [ABSTRACT FROM AUTHOR]

Policies and programs relating to successful aging in place are premised on the fact that older people's housing is stable and suitable. Home-based aged care delivery models such as individual budgets aim to deliver increased service flexibility, choice, and control for consumers. Little attention has been paid to the consequences of such models for older renters, who often have less stable housing and restricted rights to modify their accommodation. This article reports on a project in Australia that explored the delivery and receipt of individual budget style models of home-based aged care services to older renters. [ABSTRACT FROM AUTHOR]

Shared decision making (SDM) is a central component of patient-centered care; however, a minimal amount is known about what health care chaplains contribute to this process. Data from 463 full-time chaplains practicing in the United States collected by an online survey was analyzed using SPSS 26 for bivariate and multivariate logistical regressions to identify variables impacting chaplain integration into SDM. Coding of free text responses yielded multiple domains for chaplain contributions and barriers. Thirty-eight percent of chaplains reported being often or frequently integrated into health care team discussions regarding medical decisions, with years of professional experience, time spent supporting the emotional processing of medical decisions, and being well-prepared as the strongest predictors for high integration. Qualitative analysis yielded a multifaceted picture that includes chaplain attention to the impact religion has on decision making, a focus on the patient story, and chaplains as mediators between patients, families, and the health care team. The full integration of chaplains into SDM will require education of the interdisciplinary team regarding the scope of chaplain knowledge and skills, as well as organizational level changes in chaplain to patient ratios and coverage models. In this era of increased fragmentation of health care provision and advancing complexity of medical decision making, models of Interprofessional Shared Decision Making (IP-SDM) such as the one proposed here that appreciate the specialized knowledge and skills of each member of the health care team hold promise for enhancing patient-centered care. [ABSTRACT FROM AUTHOR]

Purpose: Compared to groups with other disabilities, people with a severe mental illness face the greatest stigma and barriers to employment opportunities. This study contributes to the understanding of the relationship between workplace social support and work productivity in people with severe mental illness working in Social Enterprises by taking into account the mediating role of self-stigma and job tenure self-efficacy. Method: A total of 170 individuals with a severe mental disorder employed in a Social Enterprise filled out questionnaires assessing personal and work-related variables at Phase-1 (baseline) and Phase-2 (6-month follow-up). Process modeling was used to test for serial mediation. Results: In the Social Enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems. When testing serial multiple mediations, the specific indirect effect of high workplace social support on work productivity through both low internalized stigma and high job tenure self-efficacy was significant with a point estimate of 1.01 (95% CI = 0.42, 2.28). Conclusions: Continued work in this area can provide guidance for organizations in the open labor market addressing the challenges posed by the work integration of people with severe mental illness. Implications for Rehabilitation:: Work integration of people with severe mental disorders is difficult because of limited access to supportive and nondiscriminatory workplaces. Social enterprise represents an effective model for supporting people with severe mental disorders to integrate the labor market. In the social enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems. [ABSTRACT FROM AUTHOR]

Introduction: Our aim is to investigate pediatric primary healthcare providers' (PPCPs) perceptions about e-cigarettes and current e-cigarette-related clinical practices with adolescents. Methods: In-depth interviews were conducted with 25 PPCPs who regularly counsel adolescents about preventive care. Prompts included topics about e-cigarettes PPCPs felt it was important to discuss in counseling, strategies for facilitating these conversations and barriers to these discussions. Results: Important topics included debunking myths and addressing risks associated with e-cigarette use, identifying the behavior as a potential gateway substance, and emphasizing lack of e-cigarette regulation. Strategies included emphasizing medical uncertainty, utilizing motivational interviewing, and providing outside resources. Barriers included a lack of medical knowledge, unfamiliarity with adolescents' motivations and slang, inadequate screening tools, and lack of time. Discussion: Providers negotiated the tension between discouraging e-cigarette use while not overstating the known harms of vaping with adolescent patients. Providers generally felt underprepared to have in-depth clinical conversations about e-cigarettes. [ABSTRACT FROM AUTHOR]

In a multicultural nation such as Australia, it is important for young people from migrant and refugee backgrounds to have access to quality relationships and sexuality education, as they are known to be less well engaged with mainstream services. A study was undertaken to explore the complexities and opportunities for engaging this group with sexual and reproductive health information and care in Sydney, Australia. Interviews were undertaken with 27 migrant and refugee young people (aged 16-24 years), and 34 expert informants. Relationships and sexuality education was a dominant theme throughout both data sets. Nearly all young people reported that they were unable to discuss sexuality or sexual health with their parents, and most identified secondary school as the place where they first learned about these issues. Other sources of information were identified as the Internet, friends, health professionals and pornography. Participants appeared to have limited awareness of the different services available to them. Schools, as well as other education settings such as universities, private colleges and intensive English centres, are well placed to deliver relationships and sexuality education, and for migrant and refugee young people these may be valuable settings in which to access information rarely discussed in family or community environments. [ABSTRACT FROM AUTHOR]

Social interactions play an important role in people’s life and people’s health but their scope and intensity tend to decrease with age, challenging social support dynamics and increasing the risk of social isolation and helplessness. In Portugal, policymakers still seem to rely on traditional social relations in eldercare, while contextual changes and trends are redefining family roles and behaviors and defying the established social support structure. In this work, we aim to examine the scope, structure and experiences of the informal social support network available in the country for stroke patients 6 months after their discharge from the acute care unit in the context of a larger study. The results seem to confirm the importance of family as a source of social support and shed light on different bonding experiences with non-kin social groups, such as neighbors and friends. A coordinated care provision, combining formal and informal support is vital and beneficial for patients, their caregivers and the care system. [ABSTRACT FROM AUTHOR]

A number of studies have reported the suicidal ideation (SI) or suicide attempts (SA) of patients with rheumatic diseases. However, the estimated prevalence of those disorders varies substantially between studies. This systematic review aimed to describe the prevalence of SI and SA in rheumatic diseases. Literature search was done using Web of Science, Embase, the Cochrane database library, PubMed and CNKI database through June 2017. Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data was analyzed using STATA version 12.0. A randomeffect meta-analysis was conducted on all eligible data. A total of 17 identified studies matched the inclusion criteria, involving 5174 participants with systemic lupus erythematosus (SLE), osteoarthritis (OA), rheumatoid arthritis (RA) and fibromyalgia (FM). Metaanalysis showed that rheumatic diseases patients have high prevalence of SI (26%, 95% CI: 19%-32%, I²=96.2%) and SA (12%, 95% CI: 3%-21%, I²=96.6%). We also found the prevalence of SI and SA in females may be higher than in males. All of these indicated that rheumatologists should screen for SI and SA in their patients. Early appropriate intervention is therefore essential to promote the patients' good mental health. [ABSTRACT FROM AUTHOR]

There is a need to better understand long-term disaster recovery and reconstruction challenges in diverse communities. This case study was part of a larger study undertaken by the Rebuilding Lives Post-Disaster research partnership, where field research was conducted in disaster-affected communities in Canada, the USA, Australia, India, Pakistan, and Taiwan. The objective of this exploratory case study was to focus on experiences of affected migrant workers from diverse communities in Florida, USA, in relation to long-term disaster recovery and reconstruction work following hurricanes, to ensure that lessons learned from these experiences could inform best practices and policy. The study focused particularly on the role of community processes and dynamics in shaping postdisaster recovery. Qualitative research explored diverse experiences of participants through interviews with government officials, community leaders, and disaster responders. The study found that migrant workers faced challenges due to the lack of consideration with regard to immigration status, linguistic, and cultural needs in disaster recovery. IMPLICATIONS Disaster recovery processes need to consider the diversity of affected populations to ensure assistance and responses meet the differing needs of all community members in postdisaster recovery. All members of diverse communities should be included in disaster response and longer-term recovery efforts. Social workers can assist in ensuring that diversity is a consideration in disaster and emergency management. [ABSTRACT FROM AUTHOR]

Purpose: To understand how a Fijian community supports people with communication disability (PWCD) and whether their support is associated with participant demographics. Method: Thematic analysis of 144 questionnaires that asked about participants’ actions to support a fictional child and adult with communication disability. Result: Participant responses fell into two categories: what they would do directly (self-help) and people and places where they would seek assistance (help-seeking). Self-help behaviours included: making a change to their own communication style or mode; trying to change their own and others’ behaviour; teaching new skills; praying; changing the physical environment; seeking information independently; assessing or observing; and, using traditional medicine, western medicine, or traditional belief practices. Help-seeking behaviours included seeking help from: other community members; education professionals; a professional in another country; spiritual leaders; traditional belief practitioners; traditional medicine practitioners; western health care practitioners; or, an alternative provider (e.g. home, orphanage, nursing home). Younger participants and those of iTaukei Fijian ethnicity were more likely to seek help from other community members. Conclusion: This Fijian community actively supports people with communication disability within available networks. Development of speech-language pathology services for people with communication disability living in similar communities should harness the informal knowledge within these networks. [ABSTRACT FROM AUTHOR]

Guided by social exchange theory, this study investigates the association between grandparenting and support from adult children, and the role of children’s international migration in moderating such association. Data were derived from a 2012 survey of older adults in Beijing, China (478 adult children nested in 300 older parents). The results of independent cluster logistic and linear regressions showed that regardless of children’s migration status, grandparenting was significantly associated with a greater likelihood of receiving household help and personal care, but not with emotional or financial support from children. Children’s migration status moderated the associations between grandparenting and receiving support from children. Theoretical implications for research and practical implications for services and policies are discussed. [ABSTRACT FROM AUTHOR]

Objective: To explore anti-diabetic medication taking behaviour in Nepalese patients with type 2 diabetes and investigate the factors impacting medication taking in this population. Design: Face-to-face interviews (n = 48) were conducted with Nepalese patients with type 2 diabetes in Sydney (Australia) and Kathmandu (Nepal). All interviews were audio-recorded, transcribed verbatim and thematically analysed. Participants’ medication adherence was also assessed quantitatively using the summary of diabetes self-care activity (SDSCA) questionnaire. Results: The medication taking behaviour of Nepalese participants aligned with the Stages of Change Model, with some notable patterns of behaviour. Most participants initiated and implemented anti-diabetic medications soon after obtaining their prescription. However, a few, delayed initiation and/or ceased medications after initiation to recommence later. Nonetheless, upon recommencement, participants persisted fairly well with their medications. The self-reported medication adherence was high (97.3%). Although some participants expressed adherence as a challenge at the start of therapy, medication taking on a day-to-day basis was not reported as difficult. Factors such as participants’ reluctance towards using medications and preference for natural methods of treatment, together with inadequate understanding about diabetes and treatment resulted in the delay in initiating therapy, and contributed to cessation of therapy. On the other hand, ooccasional non-adherence in daily medication taking was mostly related to inconsistency in meal practices and forgetfulness. Encouragement from doctors and increased awareness about the disease and treatment facilitated medication adherence, including initiation of therapy. Conclusion: This study demonstrates that Nepalese patients are likely to delay or cease anti-diabetic medications until they fully accept and acknowledge the benefits and necessity of medications for effective diabetes management. Thus, educating patients about the need for medications, as well as implementing strategies to address patients’ psychological resistance towards medications will be essential for effective medication management. [ABSTRACT FROM AUTHOR]