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Background and Aims: Increasing numbers of school‐based drug surveys are transitioning data collection to electronic tablets from paper‐and‐pencil, which may produce a survey mode effect and consequent discontinuity in time trends for population estimates of drug prevalence. This study tested whether (a) overall, self‐reported drug use prevalence is higher on electronic tablets versus paper‐and‐pencil surveys, (b) socio‐demographics moderate survey mode effects and (c) levels of missing data are lower for electronic tablet versus paper‐and‐pencil modes. Design A randomized controlled experiment. Setting: Results are nationally representative of students in the contiguous United States. Participants: A total of 41 866 8th, 10th and 12th grade students who participated in the 2019 Monitoring the Future school‐based survey administration. Intervention and comparator: Surveys were administered to students in a randomly selected half of schools with electronic tablets (intervention) and with paper‐and‐pencil format (comparator) for the other half. Measurements Primary outcome was the total number of positive drug use responses. Secondary outcomes were the percentage of respondents completing all drug questions, percentage of drug questions unanswered and mean number of missing drug items. Findings The relative risk (RR) for total number of positive drug use responses for electronic tablets versus paper‐and‐pencil surveys were small and their 95% confidence intervals (CI) included the value of one for reporting intervals of life‐time (RR = 1.03; 95% CI, 0.93–1.14), past 12 months (RR = 1.01; 95% CI, 0.91–1.11), past 30 days (RR = 1.05; 95% CI, 0.93–1.20) and for heavy use (RR = 1.10; 95% CI, 0.93–1.29). Multiplicative interaction tests indicated no moderation of these relative risks by race (white versus non‐white), population density, census region, public/private school, year of school participation, survey version or non‐complete drug responses. Levels of missing data were significantly lower for electronic tablets versus paper‐and‐pencil surveys. Conclusions: Adolescent drug prevalence estimates in the United States differed little across electronic tablet versus paper‐and‐pencil survey modes, and showed little to no effect modification by socio‐demographics. Levels of missing data were lower for electronic tablets. [ABSTRACT FROM AUTHOR]

The emphasis on research evaluation has brought scrutiny to the role of self‐citations in the scholarly communication process. While author self‐citations have been studied at length, little is known on national‐level self‐references (SRs). This paper analyses the citation context of national SRs, using the full‐text of 184,859 papers published in PLOS journals. It investigates the differences between national SRs and nonself‐references (NSRs) in terms of their in‐text mention, presence in enumerations, and location features. For all countries, national SRs exhibit a higher level of engagement than NSRs. NSRs are more often found in enumerative citances than SRs, which suggests that researchers pay more attention to domestic than foreign studies. There are more mentions of national research in the methods section, which provides evidence that methodologies developed in a nation are more likely to be used by other researchers from the same nation. Publications from the United States are cited at a higher rate in each of the sections, indicating that the country still maintains a dominant position in science. On the whole, this paper contributes to a better understanding of the role of national SRs in the scholarly communication system, and how it varies across countries and over time. [ABSTRACT FROM AUTHOR]

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

Objectives: Recruitment through Facebook is gaining favor as an approach for research, including clinical trials, because of the platform's ability to reach broad and diverse populations. As older adults increase their social media use, recruitment through Facebook has become a viable option. The purposes of this paper are to report the methodological process and lessons learned from recruiting custodial grandmothers (CGMs) for a cross‐sectional study examining parenting self‐efficacy and psychological well‐being. Participants: A total of 113 people consented and accessed the survey online, with 40 (35.4%) completing surveys. The final sample comprised 68 grandmothers, with 59% recruited via Facebook. Methods: Facebook recruitment for the online survey included creating a dedicated Facebook study page, accessing existing Facebook pages for custodial grandparents, and using paid advertising. Face‐to‐face recruitment strategies also were used with paper surveys. Results: We compared the characteristics of those completing online surveys versus paper surveys. CGMs completing the survey online were significantly younger and more likely to be Caucasian than those completing the paper survey. Conclusions: Findings indicated online recruitment via Facebook is an advantageous method to reach CGMs. However, additional research is needed to determine if other online and social media platforms would be useful in recruiting this population. [ABSTRACT FROM AUTHOR]

Background: Impaired discourse production is commonly reported for individuals with traumatic brain injury (TBI). Discourse deficits can negatively impact community integration, return to employment and quality of life. COVID‐19 restrictions have reduced in‐person assessment services for people with communication impairments. Advances in telehealth may help speech and language therapists (SLTs) to assess monologic discourse more systematically and improve access to services for patients who may find it difficult to attend in‐person. Aims: To examine the feasibility of telehealth administration of narrative and procedural discourse tasks with individuals with TBI and matched controls. Methods & Procedures: A total of 20 individuals with TBI and 20 healthy controls, aged 18–55 years, were directly recruited from the UK and indirectly recruited from the US. For participants with TBI, time post‐injury was at least 3 months with no diagnosis of aphasia. Control participants were matched for sex and as closely as possible for age. Feasibility of measures was based upon the time to administer both narrative tasks, the report of any technological problems, and participant feed. Discourse samples were transcribed verbatim and analysed using story grammar analysis (for narrative discourse) and identification of propositions (for procedural discourse). Interrater reliability was calculated using percentage agreement for 50% of the data. Non‐parametric analyses were used to analyse the performance of the two groups. Outcomes & Results: Narrative and procedural discourse samples were collected via telehealth in approximately 10 min with no reported technical difficulties or complaints from any participants. For narrative discourse performance, there were significant differences for the TBI and control groups for measures of complete episodes (p < 0.001) and missing episodes (p = 0.005). No significant group differences were noted for any of the procedural discourse measures. Conclusions & Implications: Results support the feasibility of collecting discourse samples via telehealth. Although the participants' discourse performance distinguished the TBI and control groups on the narrative task, no differences between the groups were noted for the procedural task. The narrative discourse task may have been more difficult than the procedural task, or video cue support reduced the cognitive load of the procedural task. This finding suggests the use of more complex procedural tasks without video cue support may be needed. WHAT THIS PAPER ADDS: What is already known on this subject: Although little research has explored the feasibility of administering discourse assessments for individuals with TBI via telehealth, some studies have found that discourse interventions can be feasibly administered via telehealth. It is also well established that individuals with TBI struggle with the supra‐structural and macro‐linguistic elements of discourse production. Both procedural and narrative discourse tasks have been found to differentiate individuals with TBI from healthy controls. What this paper adds to existing knowledge: Few studies have investigated the feasibility of, and procedures for, administering discourse tasks via telehealth. Additionally, the inclusion of multiple types of discourse tasks to parse cognitive–communication abilities is lacking in the current literature. Findings from this study support that narrative and procedural discourse can be feasibly sampled via telehealth and that international collaboration for research on this topic can facilitate such studies. Individuals with TBI performed more poorly on three measures of narrative discourse. No differences between groups were identified for the procedural task. What are the potential or actual clinical implications of this work?: Telehealth assessment for discourse provides flexibility for both the individual with TBI and the speech–language therapist and does not compromise the quality of data collected. The administration of discourse tasks and collection of data was not time‐consuming and was well accepted by the study participants. Additionally, international research collaboration not only expands potential participation in research but increases the opportunity to recruit and study more diverse groups. [ABSTRACT FROM AUTHOR]

Purpose Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. Methods We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida's state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. Findings Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants' usability ratings. Conclusions Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research. [ABSTRACT FROM AUTHOR]

Purpose: Most people living with HIV (PLH) in the United States are over age 50 and this sector of PLH continues to grow. Aging with HIV can be challenging due to comorbid medical conditions, mental health disorders, substance use, and lack of social and practical support. Additional challenges are faced by older PLH living in the rural United States, such as longer distances to health care, concerns over privacy and stigma, and social isolation. PLH in rural areas have higher mortality rates than urban PLH. We aimed to understand factors associated with HIV care engagement and quality of life in rural US adults over age 50. Methods: We conducted a cross‐sectional study to evaluate the association between patient‐level factors and a combined outcome variable encompassing multiple aspects of care engagement. Findings: Either online or on paper, 446 participants completed our survey. One‐third of the participants (33%) were from the southern United States; one‐third were women; one‐third were non‐White; and 24% completed the survey on paper. In multiple regression analysis, lower income, residing in the southern United States, lacking internet access at home, not having an HIV specialist provider, higher levels of stress, living alone, and longer distance to an HIV provider were all associated with lower engagement in HIV care. Conclusions: Our findings demonstrated multiple potential options for interventions that could improve care engagement, such as providing and enhancing access to technology for health care engagement and remotely delivering social support and mental health services. Research on such potential interventions is needed for older, rural PLH. [ABSTRACT FROM AUTHOR]

Background: There is a large body of research showing the negative impact of a total laryngectomy on the resultant voice signal across multiple outcomes (e.g., speech intelligibility/acceptability, listener comprehension, voice quality). However, there is limited information on the effects of laryngectomy on broader communication acts, particularly in the area of pragmatics, commonly referred to as the social use of language. Considering that individuals with a laryngectomy (IWL) frequently report reduced quality of life as well as reduced communicative competency, expanding the current research to include pragmatics is warranted. Aim: To explore the pragmatic changes in communication experienced by tracheoesophageal speakers. Methods & Procedures: The current study adapted an existing 17‐item measure to assess verbal, non‐verbal, paralinguistic and receptive communication competence via self‐report. This adapted measure was then distributed to 65 tracheoesophageal speakers (52 males, 13 females, mean age = 63.4 ± 8.5 years). Outcomes & Results: Both negative and positive pragmatic changes to communication were reported by participants secondary to laryngectomy. This included changes in verbal (negative –37.5%, positive –15.15%); non‐verbal (negative –9.54%, positive –35.45%; and paralinguistic acts (negative –29.55%, positive –34.09%). Changes to receptive communication were also noted (negative –14.78%, positive –43.19%). Conclusions & Implications: The overall results suggest that communication changes post‐laryngectomy exist well beyond the paralinguistic areas (e.g., intelligibility, voice quality) and that males and females may approach or respond to changes in communication differently. Results are discussed specific to clinical intervention and the importance of including assessment of pragmatic function post‐laryngectomy. WHat this paper adds: What is already known on this subject: While there is a large body of research on the changes to the speaker and listener following laryngectomy, there is minimal information on how the use of alaryngeal speech affects overall communication, specifically in the area of pragmatics or the social use of language. What this paper adds to existing knowledge: This study used an adapted version of the widely used Pragmatic Protocol to delineate changes in pragmatic components of communication for tracheoesophageal speakers. What are the potential or actual clinical implications of this work?: Clinically, this information can be used by healthcare professionals to educate and prepare IWL on potential changes in the underrecognized area of pragmatics. [ABSTRACT FROM AUTHOR]

Background: Online knowledge translation (KT) approaches are becoming increasingly prevalent within healthcare due to their accessibility and facilitation of international support networks. Online platforms enable timely and far‐reaching dissemination of current evidence and best‐practice recommendations. Although there is potential to improve the uptake of rehabilitation guidelines, it is essential to consider the acceptability of online approaches to healthcare professionals to ensure their successful integration within everyday clinical settings. Aims: To establish the prospective acceptability of a theoretically informed online intervention for speech pathologists, Aphasia Nexus: Connecting Evidence to Practice, that aims to facilitate the implementation of aphasia best practice. Methods & Procedures: A mixed‐methods multinational electronic survey based on the Theoretical Framework of Acceptability (TFA) completed by aphasia researchers and clinicians. Outcomes & Results: A total of 43 participants completed the survey with 91% (n = 39) indicating that they would use Aphasia Nexus. Understanding the intervention and how it works (intervention coherence as per the TFA) was the key factor influencing the likelihood of integration within everyday clinical practice. Participants identified potential areas where the intervention could influence service change and also recommended further design and content changes to improve the intervention. Conclusions & Implications: Aphasia Nexus is an acceptable platform for further feasibility testing in the form of a pilot trial within an Australian‐based health service. The study progresses the theory of TFA as it was a valuable framework facilitating the identification of prominent factors influencing acceptability. The study also informs further intervention refinements in preparation for the next stage of research. WHAT THIS PAPER ADDS: What is already known on the subject: Online strategies have the potential to enhance KT and promote the uptake of rehabilitation guidelines. An online intervention, however, can only be effective if implemented well. For this reason, it is essential to establish the acceptability of online interventions to the intended recipients and therefore increase the likelihood of successful implementation. What this paper adds to existing knowledge: This study used a theoretically based framework to establish the acceptability of an online implementation intervention, Aphasia Nexus, to multinational aphasia clinicians and researchers. It demonstrated the value in identifying the prominent factors influencing acceptability to inform further intervention refinements and warrant continuing research. What are the potential or actual clinical implications of this work?: Speech pathologists should use online platforms to drive the implementation of best practice on an international scale. It is important for clinicians to have an in‐depth understanding of online interventions and how they work to enhance their successful uptake into routine clinical practice. Aphasia Nexus is an acceptable online platform for implementing best practice in aphasia. [ABSTRACT FROM AUTHOR]

Objective: Recent public awareness of racial and ethnic disparities has again brought to light issues of diversity, equity, and inclusion in the eating disorders field. However, empirical information on racial and ethnic representation in eating disorders research is limited, making it difficult to understand where improvements are needed. Method: This study reviewed all studies including human participants published in the International Journal of Eating Disorders in 2000, 2010, and 2020. Differences in likelihood of reporting race and ethnicity were calculated based on study year, location, and diagnostic categories. Results: Out of 377 manuscripts, 45.2% reported information on the race and ethnicity of study participants. Studies conducted in the United States were more likely to report (128/173), and those conducted in Europe were less likely to report (5/61) on race and ethnicity than those conducted outside of those regions. Rates of reporting increased from 2000 to 2020. White participants made up approximately 70% of the samples that reported race and ethnicity data. Hispanic participants made up approximately 10% of samples reporting race and ethnicity. Participants from all other races and ethnicities made up less than 5% each. Discussion: Although rates of reporting race and ethnicity increased over time, most participants were White. Rates of reporting also differed by the geographical region, which may reflect variability in how information on race and ethnicity is collected across countries. More attention toward capturing the cultural background of research participants and more inclusivity in research are needed in the eating disorders field. [ABSTRACT FROM AUTHOR]

Purpose: To identify how speech‐language pathologists (SLPs) in the United States are screening for and identifying dysphagia. To do this, we examined the approaches most often used to screen for dysphagia and the influence of contextual factors such as setting, continuing education and means of staying up to date with the most current literature on screening approaches. Method: A web‐based survey composed of 32 questions was developed and field tested for content, relevance and workflow. The survey was distributed online, via social media, online SLP forums and through the American Speech‐Language‐Hearing Association's Special Interest Group 13 (swallowing disorders). One hundred and thirty‐seven clinicians from the United States completed the survey and were included for analysis using descriptive statistics and linear regression modelling to assess associations of continuing education and years practicing with screening protocols and consumption of evidence. Results: Respondents worked in a variety of settings, including acute care, skilled nursing facilities, and inpatient rehabilitation. Most respondents worked with adult populations (88%). The most common screening protocols reported were a volume‐dependent water swallow test (74%), subjective patient report (66%), and trials of solids/liquids (49%). Twenty‐four percent (24%) reported using a questionnaire, the Eating Assessment Tool (80%) being most common. How clinicians consume their evidence was significantly associated with the types of screening approaches used. Continuing education hours were significantly associated with dysphagia screening protocol choice (p < 0.001) and how clinicians stayed up to date with evidence (p < 0.001). Conclusions: Results from this study provide an in‐depth look at the choices clinicians are making in the field regarding how to effectively screen patients for the presence of dysphagia. Contextual factors such as evidence base consumption patterns should serve researchers to continue seeking alternative ways to share evidence with clinicians, accessibly. Associations between continuing education and protocol choice show the need for continued evidence‐based and high‐quality continuing education opportunities. WHAT THIS PAPER ADDS: This study provides an in‐depth look at the choices clinicians are making in the field regarding effective dysphagia screening practices. Clinician screening choices are examined with contextual factors such as evidence base consumption patterns and continuing education. This paper increases knowledge of the most used dysphagia screening practices and context for clinicians and researchers to improve use, evidence and dissemination of best practices. [ABSTRACT FROM AUTHOR]

Background: Adequate housing is a basic human right. The many millions of people experiencing homelessness (PEH) have a lower life expectancy and more physical and mental health problems. Practical and effective interventions to provide appropriate housing are a public health priority. Objectives: To summarise the best available evidence relating to the components of case‐management interventions for PEH via a mixed methods review that explored both the effectiveness of interventions and factors that may influence its impact. Search Methods: We searched 10 bibliographic databases from 1990 to March 2021. We also included studies from Campbell Collaboration Evidence and Gap Maps and searched 28 web sites. Reference lists of included papers and systematic reviews were examined and experts contacted for additional studies. Selection Criteria: We included all randomised and non‐randomised study designs exploring case management interventions where a comparison group was used. The primary outcome of interest was homelessness. Secondary outcomes included health, wellbeing, employment and costs. We also included all studies where data were collected on views and experiences that may impact on implementation. Data Collection and Analysis: We assessed risk of bias using tools developed by the Campbell Collaboration. We conducted meta‐analyses of the intervention studies where possible and carried out a framework synthesis of a set of implementation studies identified by purposive sampling to represent the most 'rich' and 'thick' data. Main Results: We included 64 intervention studies and 41 implementation studies. The evidence base was dominated by studies from the USA and Canada. Participants were largely (though not exclusively) people who were literally homeless, that is, living on the streets or in shelters, and who had additional support needs. Many studies were assessed as having a medium or high risk of bias. However, there was some consistency in outcomes across studies that improved confidence in the main findings. Case Management and Housing Outcomes: Case management of any description was superior to usual care for homelessness outcomes (standardised mean difference [SMD] = −0.51 [95% confidence interval [CI]: −0.71, −0.30]; p < 0.01). For studies included in the meta‐analyses, Housing First had the largest observed impact, followed by Assertive Community Treatment, Critical Time Intervention and Intensive Case Management. The only statistically significant difference was between Housing First and Intensive Case Management (SMD = −0.6 [–1.1, −0.1]; p = 0.03) at ≥12 months. There was not enough evidence to compare the above approaches with standard case management within the meta‐analyses. A narrative comparison across all studies was inconclusive, though suggestive of a trend in favour of more intensive approaches. Case Management and Mental Health Outcomes: The overall evidence suggested that case management of any description was not more or less effective compared to usual care for an individual's mental health (SMD = 0.02 [−0.15, 0.18]; p = 0.817). Case Management and Other Outcomes: Based on meta‐analyses, case management was superior to usual care for capability and wellbeing outcomes up to 1 year (an improvement of around one‐third of an SMD; p < 0.01) but was not statistically significantly different for substance use outcomes, physical health, and employment. Case Management Components: For homelessness outcomes, there was a non‐significant trend for benefits to be greater in the medium term (≤3 years) compared to long term (>3 years) (SMD = −0.64 [−1.04, −0.24] vs. −0.27 [−0.53, 0]; p = 0.16) and for in‐person meetings in comparison to mixed (in‐person and remote) approaches (SMD = −0.73 [−1.25,−0.21]) versus −0.26 [−0.5,−0.02]; p = 0.13). There was no evidence from meta‐analyses to suggest that an individual case manager led to better outcomes then a team, and interventions with no dedicated case manager may have better outcomes than those with a named case manager (SMD = −0.36 [−0.55, −0.18] vs. −1.00 [−2.00, 0.00]; p = 0.02). There was not enough evidence from meta‐analysis to assess whether the case manager should have a professional qualification, or if frequency of contact, case manager availability or conditionality (barriers due to conditions attached to service provision) influenced outcomes. However, the main theme from implementation studies concerned barriers where conditions were attached to services. Characteristics of Persons Experiencing Homelessness: No conclusions could be drawn from meta‐analysis other than a trend for greater reductions in homelessness for persons with high complexity of need (two or more support needs in addition to homelessness) as compared to those with medium complexity of need (one additional support need); effect sizes were SMD = −0.61 [−0.91, −0.31] versus −0.36 [−0.68, −0.05]; p = 0.3. The Broader Context of Delivery of Case Management Programmes: Other major themes from the implementation studies included the importance of interagency partnership; provision for non‐housing support and training needs of PEH (such as independent living skills), intensive community support following the move to new housing; emotional support and training needs of case managers; and an emphasis on housing safety, security and choice. Cost Effectiveness: The 12 studies with cost data provided contrasting results and no clear conclusions. Some case management costs may be largely off‐set by reductions in the use of other services. Cost estimates from three North American studies were $45–52 for each additional day housed. Authors' Conclusions: Case management interventions improve housing outcomes for PEH with one or more additional support needs, with more intense interventions leading to greater benefits. Those with greater support needs may gain greater benefit. There is also evidence for improvements to capabilities and wellbeing. Current approaches do not appear to lead to mental health benefits. In terms of case management components, there is evidence in support of a team approach and in‐person meetings and, from the implementation evidence, that conditions associated with service provision should be minimised. The approach within Housing First could explain the finding that overall benefits may be greater than for other types of case management. Four of its principles were identified as key themes within the implementation studies: No conditionality, offer choice, provide an individualised approach and support community building. Recommendations for further research include an expansion of the research base outside North America and further exploration of case management components and intervention cost‐effectiveness. [ABSTRACT FROM AUTHOR]

Background: Teachers often rely on the use of open‐ended questions to assess students' conceptual understanding of assigned content. Particularly in the context of mathematics; teachers use these types of questions to gain insight into the processes and strategies adopted by students in solving mathematical problems beyond what is possible through more close‐ended problem types. While these types of problems are valuable to teachers, the variation in student responses to these questions makes it difficult, and time‐consuming, to evaluate and provide directed feedback. It is a well‐studied concept that feedback, both in terms of a numeric score but more importantly in the form of teacher‐authored comments, can help guide students as to how to improve, leading to increased learning. It is for this reason that teachers need better support not only for assessing students' work but also in providing meaningful and directed feedback to students. Objectives: In this paper, we seek to develop, evaluate, and examine machine learning models that support automated open response assessment and feedback. Methods: We build upon the prior research in the automatic assessment of student responses to open‐ended problems and introduce a novel approach that leverages student log data combined with machine learning and natural language processing methods. Utilizing sentence‐level semantic representations of student responses to open‐ended questions, we propose a collaborative filtering‐based approach to both predict student scores as well as recommend appropriate feedback messages for teachers to send to their students. Results and Conclusion: We find that our method outperforms previously published benchmarks across three different metrics for the task of predicting student performance. Through an error analysis, we identify several areas where future works may be able to improve upon our approach. Lay Description: What is already known about this topic: Open‐ended questions are used by teachers in the domain of mathematics to assess their students understanding but automated support for these types of questions are limited in online learning platforms. Recent advancements in areas of machine learning and natural language processing have led to promising results in a range of domains and applications. What this paper adds: Emulating how teachers identify similar student answers can be used to build tools that support teachers in assessing and providing feedback to student open‐ended work. Implications for practice: Developing better automated supports can increase the amount of direct feedback students receive to guide their learning. [ABSTRACT FROM AUTHOR]

Purpose: Housing is essential to health. Governmental rental assistance is one way to increase access to affordable housing, but little is known about how it varies by rural/urban location. This paper seeks to address that gap by examining rural/urban and within‐rural differences in receipt of rental assistance, with particular attention differences by health and disability. Methods: We used data from the 2021 National Health Interview Survey (n = 28,254) to conduct bivariate analyses to identify significant differences in receipt of rental assistance by rural/urban location. We then conducted logistic regression analyses to generate odds ratios of receiving rental assistance, adjusting for self‐rated health, disability, sociodemographic characteristics, and the US Census region. Findings: When limiting the sample to those who rent (20.6% of rural residents and 29.6% of urban residents), rural residents were nearly 5 percentage points more likely to receive rental assistance (13.1% vs 8.2%, P<.001). Rural recipients of rental assistance were more likely to have a disability than urban residents (27.9% vs 20.3%, P<.05) and were more likely to report fair/poor health (41.6% vs 31.4%, P<.05). Conclusions: Rural residents are less likely to rent their homes, but, among those who rent, they are more likely to receive governmental rental assistance. This may be reflective of the greater need for rental assistance among rural residents, who were in poorer health and of lower socioeconomic status than urban renters. As housing is essential to good health, policy attention must prioritize addressing a persistent and growing need for affordable housing in rural and urban areas alike. [ABSTRACT FROM AUTHOR]

Background: Valuable safeguards against fast‐spreading conjectures about learning in times of fear and uncertainty are evidence‐based approaches to the assessment of the impact of sudden and unforeseen disruptions on learning practices. The present research focused on physics learning in such times because conceptual and computational literacy in physics is critical to the development of a scientifically and technologically literate society. Objectives: The present research aimed (a) to offer an objective assessment of whether performance differences in a physics course of the general education curriculum existed between the face‐to‐face medium (familiar mode of instruction) and the online medium (unfamiliar mode of instruction) for both male and female students, and then (b) to develop a response to the evidence collected to ensure a quality education for all parties involved. The research intended to fill two critical gaps in the extant literature: mixed findings concerning students' performance in the face‐to‐face and online mediums as well as scarce coverage of specific domains of knowledge that are critical to STEM learners. Methods: Students' performance was examined as a function of the type of assessment (formative and summative), instructional mode (online and face‐to‐face), and gender. An understudied student population of STEM students of Middle Eastern descent without prior formal exposure to online instruction was targeted. Results and Conclusions: In both formative and summative assessments, male students performed better online than face‐to‐face, whereas the performance of female students was either higher online or equivalent between instructional mediums. The evidence collected suggested that consideration be given to remedies that foster academic success in the face‐to‐face instructional medium, particularly for male students. Takeaways: An evidence‐based approach to learning dismantled emotion‐driven expectations regarding the impact of the online medium on physics learning, and encouraged new perspectives about instruction. Lay Description: What is already known?: Ongoing debates on the impact of the pandemic on students' learning shape decisions regarding future reliance on the online medium for instruction. What this paper adds: The extant literature is mixed concerning performance in the face‐to‐face and online mediums, including particular domains of knowledge critical to STEM learning.This study focused on physics learning in an understudied population of STEM students who were unaccustomed to online instruction.Performance was higher online than face‐to‐face, but gender differences emerged. Implications for practice: Lessons learned focused on the flexibility of online learning and on the need to develop materials to enhance learning in males enrolled in face‐to‐face or hybrid/blended classes. [ABSTRACT FROM AUTHOR]

Background: Low nursing home staffing in the United States is a growing safety concern. Socioeconomic deprivation in the local areas surrounding a nursing home may be a barrier to improving staffing rates but has been poorly studied. Thus, the objective of this paper was to assess the relationship between neighborhood deprivation and nursing home staffing in the United States. Methods: This cross-sectional study used 2018 daily payroll-based staffing records and address data for 12,609 nursing homes in the United States linked with resident assessment data. Our primary exposure of interest was severe economic deprivation at the census block group (neighborhood) level, defined as an area deprivation index score ≥85/100. The primary outcome was hours worked per resident-day among nursing home employees providing direct resident care. Marginal linear regression models and generalized estimating equations with robust sandwich-type standard errors were used to estimate associations between severe neighborhood deprivation and staffing rates. Results: Compared to less deprived neighborhoods, unadjusted staffing rates in facilities located within severely deprived neighborhoods were 38% lower for physical and occupational therapists, 30% lower for registered nurses (RNs), and 5% lower for certified nursing assistants. No disparities in licensed practical nurse (LPN) staffing were observed. In models with state-level and rurality fixed effects and clustered on the county, a similar pattern of disparities was observed. Specifically, RN staffing per 100 resident-days was significantly lower in facilities located within severely deprived neighborhoods as compared to those in less deprived areas (mean difference: 5.6 fewer hours, 95% confidence interval [CI] 4.2–6.9). Disparities of lower magnitude were observed for other clinical disciplines except for LPNs. Conclusions: Significant staffing disparities were observed within facilities located in severely deprived neighborhoods. Targeted interventions, including workforce recruitment and retention efforts, may be needed to improve staffing levels for nursing homes in deprived neighborhoods. [ABSTRACT FROM AUTHOR]

Purpose: Rural older people living with HIV (PLH) in the United States are a population of growing size and significance. A better understanding of factors associated with quality of life (QOL), depressive symptoms, and stress in this population—especially modifiable factors—could inform future interventions. Methods: Online or on paper, we surveyed 446 PLH aged 50+ residing in rural counties across the United States (Mage = 56, 67% male, 67% White, and 23% Black). Associations between social support, HIV stigma, satisfaction with medical care, discrimination in health care settings, and structural barriers and health‐related QOL, depressive symptoms, and perceived stress were assessed using multiple linear regressions. Findings: Controlling for demographics, greater social support was associated with better QOL, fewer depressive symptoms, and less stress. Greater HIV stigma was associated with more depressive symptoms and stress. Satisfaction with care was associated with better QOL and less stress. Discrimination in medical settings was associated with lower QOL and more depressive symptoms and stress. Finally, experiencing more structural barriers was associated with lower QOL and more depressive symptoms and stress. Conclusions: In addition to engagement in care and viral suppression, QOL and mental health are also critical considerations for rural older PLH. Increasing social support, reducing or providing skills to cope with HIV stigma, improving quality of care, reducing discrimination and stigma in medical settings, and reducing or mitigating the impact of structural barriers present potential targets for interventions aiming to improve the well‐being of older rural PLH. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol consumption increased in the early phases of the COVID‐19 pandemic in the United States. Alcohol use disorder (AUD) and risky drinking are linked to harmful health effects. This paper aimed to project future health and cost impacts of shifts in alcohol consumption during the COVID‐19 pandemic. Design: An individual‐level simulation model of the long‐term drinking patterns for people with life‐time AUD was used to simulate 10 000 individuals and project model outcomes to the estimated 25.9 million current drinkers with life‐time AUD in the United States. The model considered three scenarios: (1) no change (counterfactual for comparison); (2) increased drinking levels persist for 1 year ('increase‐1') and (3) increased drinking levels persist for 5 years ('increase‐5'). Setting: United States. Participants: Current drinkers with life‐time AUD. Measurements: Life expectancy [life‐years (LYs)], quality‐adjusted life‐years (QALYs), alcohol‐related hospitalizations and associated hospitalization costs and alcohol‐related deaths, during a 5‐year period. Findings Short‐term increases in alcohol consumption (increase‐1 scenario) resulted in a loss of 79 000 [95% uncertainty interval (UI]) 26 000–201 000] LYs, a loss of 332 000 (104 000–604 000) QALYs and 295 000 (82 000–501 000) more alcohol‐related hospitalizations, costing an additional $5.4 billion ($1.5–9.3 billion) over 5 years. Hospitalizations for cirrhosis of the liver accounted for approximately $3.0 billion ($0.9–4.8 billion) in hospitalization costs, more than half the increase across all alcohol‐related conditions. Health and cost impacts were more pronounced for older age groups (51+), women and non‐Hispanic black individuals. Increasing the duration of pandemic‐driven increases in alcohol consumption in the increase‐5 scenario resulted in larger impacts. Conclusions: Simulations show that if the increase in alcohol consumption observed in the United States in the first year of the pandemic continues, alcohol‐related mortality, morbidity and associated costs will increase substantially over the next 5 years. [ABSTRACT FROM AUTHOR]

Many features of the U.S. political economy arise from the interactions between large political and economic institutions, and yet we know little about the nature of their interactions and the power distribution between these institutions. In this paper, we present a detailed analysis of networks of U.S.‐based organizations, where edges represent three different kinds of relationships, namely owner–owned (ownerships), donor–donee (donations), and service provider–payee (transactions). Our findings suggest that in the ownerships network, the financial organizations form the core, and banking organizations hold strategic locations in the network. In the transactions network, the government organizations and agencies form the core, and defense‐related organizations form the backbone. In contrast, with the donations network, no specific domain of organizations forms either the core or the backbone. [ABSTRACT FROM AUTHOR]

Background: Providing students with worked out problem solutions is a beneficial instructional technique in STEM disciplines, and studying examples that have been worked out incorrectly may be especially helpful for reducing misconceptions in students with low prior content knowledge. However, past results are inconclusive and the effects of incorrect worked examples alone or in combination with correct examples remains unclear. Objectives: We aim to address whether studying incorrect examples alone or in combination with correct examples can support the reduction of students' fraction misconceptions, operationalized as errors made with high confidence. Methods: After incorrectly solving a sampling problem, 130 students in 4th through 11th grade in the U.S. were randomly assigned to a condition in an online problem set focused on fraction equivalence. Students studied either single‐type worked examples (i.e., correct or incorrect; n = 49) or combination‐type worked examples (correct and incorrect; n = 41) or engaged in a problem‐solving control (n = 50). Results: Studying a combination of correct and incorrect worked examples was as effective as the problem‐solving control with feedback at improving fraction equivalence knowledge and reducing the rate of high‐confidence errors. Students in both the combination condition and the problem‐solving with feedback condition outperformed those who studied either correct or incorrect worked examples alone. Conclusions: Results support the inclusion of a combination of correct and incorrect worked examples when teaching students with low prior content knowledge. Studying a combination of example types within an online tutor helps to reduce misconceptions about fractions, a topic students commonly struggle with. A problem‐solving task with corrective feedback worked equally well. Lay Description: What is already known about this topic: Studying worked examples of mathematical solutions improves student learning.Incorrect examples, either alone or in combination with correct examples, are particularly effective for improving learning for students with low prior knowledge in the target content.Comparing correct and incorrect examples is also effective at improving problem‐solving but this effect may be specific to those with high prior knowledge.Still unknown are the impacts of these different combinations of examples on misconceptions in particular. What this paper adds: We show that studying a combination of correct and incorrect examples reduces math misconceptions.Problem‐solving with corrective feedback within an online tutor also has this effect. Implications for practice and/or policy: Using a combination of example types will help reduce students' misconceptions about fractions. [ABSTRACT FROM AUTHOR]

Background: Students' tendencies to seek feedback are associated with improved learning. Yet, how soon this association becomes robust enough to make predictions about learning is not fully understood. Such knowledge has strong implications for early identification of students at‐risk for underachievement via digital learning platforms. Objectives: We sought to understand how early in the academic year students' end‐of‐year learning outcomes could be predicted by their performance and feedback‐seeking behaviours within a digital learning platform. We analysed data collected at different time points in the academic year and across different cohorts of students within the context of high school advanced placement (AP) Statistics courses. Methods: High school students enrolled in AP Statistics spanning three academic years between 2017 and 2020 (N = 726; Mage = 16.72 years) completed 3 or 4 homework assignments, each 2 and 3 months apart. Results and conclusions: Across the three cohorts, and even as early as the first assignment, a model consisting of demographic variables (gender, race/ethnicity, parental education), assignment performance, and interaction with the digital score report explained significant variation in students' final course grades (R2 = 0.314–0.412) and AP exam scores (κ = 0.583–0.689). Students' assignment performance was positively associated with end‐of‐year learning outcomes. Students who more frequently checked their digital score reports tended to receive better learning outcomes, though not consistently across cohorts. Implications: These findings further an understanding of how students' early performance and feedback‐seeking behaviours within a digital learning platform predict end‐of‐year learning outcomes. Lay Description: What is already known about this topic: Students' early academic performance predicts end‐of‐year success.Students' self‐regulated learning behaviours are another predictor of academic success.Clickstream data have been used as an indicator of the application of self‐regulated learning strategies, particularly behaviours associated with seeking feedback.Indicators of feedback‐seeking behaviours reflected via clickstream data have been shown to predict student learning.Yet, how soon associations between early performance and such indicators of self‐regulated learning as feedback‐seeking are robust across different groups of learners, different learning circumstances, and different types of learning outcomes has yet to be more fully understood. What this paper adds: We investigated whether performance and feedback‐seeking behaviours predict end‐of‐year learning outcomes at different points during the academic year across multiple cohorts of learners (2017–2018, 2018–2019, and 2019–2020) and using two different learning outcomes (class grades, AP exam scores).One cohort was affected by COVID‐19 during the 2019–2020 academic year, allowing us to examine whether differences emerge amidst unprecedented circumstances.We used assignment scores and online feedback‐seeking to predict end‐of‐year learning outcomes.Assignment scores were positively associated with end‐of‐year grades.First assignment performance predicted AP exam scores.Use of feedback (an indication of self‐regulated learning behaviours) tended to predict learning outcomes, though not consistently across cohorts. Implications for practice and/or policy: The findings from this study could improve understanding of how digital learning platform measurements predict end‐of‐year learning outcomes though also highlight the importance of context differences.Such findings hold implications for early identification of at‐risk students and appreciation for differences between learners and contexts.These findings also contribute to a growing understanding of the impact of the COVID‐19 pandemic on student engagement and learning. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper is to systematically and critically appraise the available scientific evidence concerning the prevalence of edentulism among diabetic patients compared to non‐diabetic people. Methods: MEDLINE‐PubMed and Cochrane‐CENTRAL databases were comprehensively searched up to April 2023 to identify appropriate studies. The inclusion criteria were observational studies conducted in human subjects ≥18 years of age with the primary aim of investigating the prevalence of edentulism among diabetic patients. Based on the extracted data, a meta‐analysis was performed. Recommendations based on the body of evidence were formulated using the GRADE approach. Results: Independent screening of 2085 unique titles and abstracts revealed seven publications that met the eligibility criteria. Study size ranged from 293 to 15,943 participants. Data from all seven studies were suitable for meta‐analysis. Overall, 8.3% of the studied population was edentulous. The weighted mean prevalence of edentulism among diabetic and non‐diabetics was 14.0% and 7.1%, respectively. The overall odds ratio for diabetic patients to be edentulous as compared to non‐diabetics was 2.39 (95% CI [1.73, 3.28], p < 0.00001). Conclusion: There appears to be moderate certainty that the risk of being edentulous for diabetic patients compared to non‐diabetic people is significant, but the odds ratio is estimated to be small. [ABSTRACT FROM AUTHOR]

Background: There is an increasing number of technological resources available to speech and language therapists (SLTs) for use in clinical practice, but the factors that influence SLTs' selection and use of such resources are not well understood. In related fields, technology acceptance models have been employed to explain users' adoption of technology and to inform the advancement of empirically supported technological resources. Aims: To determine the factors that influence SLTs' use of technology for clinical practice by testing a model of their technology acceptance and use. Methods & Procedures: We surveyed 209 practising SLTs in the United States representative of the speech and language membership of the American Speech–Language–Hearing Association (ASHA). Participants completed a 38‐item electronic survey representing four categories: (1) technology use, (2) technology attitudes and factors influencing technology use, (3) employment information and (4) demographics. Items measuring technology attitudes served as indicators of the research model, which mapped the primary relationships of a technology acceptance model. Survey data were collected before the Covid‐19 pandemic. Outcomes & Results: The research model accounted for 66% of the variance in SLTs' behavioural intention to use technology, which significantly and positively predicted the amount of time they reportedly spent using technology in the workplace. Subjective norms and attitudes towards technology use directly predicted the intention to use technology. Perceived usefulness and ease of use indirectly predicted intention to use technology. Survey respondents reported using technology during 48% (SD = 24%) of their overall weekly work hours on average, with a large majority reporting using technology at least once per week for planning (89% of respondents), assessment (66% of respondents) or intervention (90% of respondents). Conclusions & Implications: These findings statistically explain the relationships between SLTs' attitudes and their intention to use technology for clinical practice, contributing to our understanding of why SLTs adopt certain technologies. We also detail the nature and frequency of technology use in the clinical practice of SLTs. Future directions for this work include further exploring use categories, employing direct measurements of technology use and exploring the impact of recent changes in SLT service delivery due to the Covid‐19 pandemic on SLTs' technology attitudes. What this paper addsWhat is already known on the subjectExisting research about the adoption and use of technological resources by SLTs indicates that they select tools based on convenience, cost and recommendations by others.What this paper adds to existing knowledgeThis study is the first to develop and test a research model of SLTs' technology attitudes. The findings from model testing demonstrate the significant predictors of SLTs' behavioural intention to use technology for clinical purposes. Intent of use is related to how much SLTs use technology in the workplace.What are the potential or actual clinical implications of this work?The present findings can inform interventions targeting the design and adoption of electronic SLT resources that are empirically supported. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To conduct a systematic review and meta‐analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past‐month marijuana use prevalence among adolescents. Methods: A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta‐analyzed. Estimates of MML effects on any past‐month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non‐MML states over comparable time‐periods. These estimates were standardized and entered into a meta‐analysis model with fixed‐effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F‐test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Results: None of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non‐MML states for marijuana use prevalence among adolescents. The meta‐analysis yielded a non‐significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non‐MML states on pre‐MML differences and all found higher rates of past‐month marijuana use in MML states pre‐MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non‐significant results, although limited heterogeneity may warrant further study. Conclusions: Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has reinforced awareness that the health of populations is inextricably linked around the globe. Nurses require increased knowledge and preparation in global health. Nursing educators need examples of how to improve content in the curriculum. Aims: The purpose of this paper is to describe reconceptualization of a master’s level nursing course entitled “Population Health in a Global Society” to include global health competencies. Methods: We identified four global health competencies within the following three domains: globalization of health and healthcare; collaboration, partnering, and communication; and sociocultural and political awareness. Implementation: We utilized guest lectures, a panel discussion, discussion forums and an independent research assignment. The methods used were well received by students, and the content delivered improved their perceived knowledge in global population health. Discussion: The global health domains and competencies provided a roadmap for improving our course to focus on population health from a global perspective. Conclusion: In order to prepare nurses to contribute to global population health, population health courses should integrate global health competencies. The content of the revised course will better prepare nurses who will practice in a wide variety of settings and is designed for interdisciplinary education. [ABSTRACT FROM AUTHOR]

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

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Introduction: 'Fit' refers to an applicants' perceived compatibility to a residency programme. A variety of structural, identity‐related and relational factors contribute to self‐assessments of fit. The 2021 residency recruitment cycle in the USA was performed virtually due to the COVID‐19 pandemic. Little is known about how video‐interviewing may affect residency applicants' ability to gauge fit. Methods: A multidisciplinary, anonymous survey was distributed to applicants at a large academic institution between rank order list (ROL) certification deadline and Match Day 2021. Using Likert‐type scales, applicants rated factors for importance to 'fit' and their ease of assessment through video‐interviewing. Applicants also self‐assigned fit scores to the top‐ranked programme in their ROL using Likert‐type scales with pairs of anchoring statements. Results: Four hundred seventy‐three applicants responded to the survey (25.7% response rate). The three most important factors to applicants for assessment of fit (how much the programme seemed to care, how satisfied residents seem with their programme and how well the residents get along) were also the factors with the greatest discrepancy between importance and ease of assessment through video‐interviewing. Diversity‐related factors were more important to female applicants compared with males and to non‐White applicants compared with White applicants. Furthermore, White male applicants self‐assigned higher fit scores compared with other demographic groups. Conclusion: There is a marked discrepancy between the most important factors to applicants for fit and their ability to assess those factors virtually. Minoritised trainees self‐assigned lower fit scores to their top‐ranked programme, which should raise concern amongst medical educators and highlights the importance of expanding current diversity, equity and inclusion efforts in academic medicine. This paper offers examination of how residency applicants assess fit to the programs at which they interview during the virtual recruitment era, showing that female and minority applicants perceive poorer fit. [ABSTRACT FROM AUTHOR]

Previous research has demonstrated that becoming vaccinated with the Coronavirus vaccine may lower mental distress. However, it remains uncertain whether this relationship holds amid concerns of vaccine side effects and doubts of the vaccine's protective capabilities. We presented three studies that showed how vaccine confidence negatively influences the relationship between vaccine uptake and mental distress. Using two‐way fixed effects regression models, Study 1 analyzes longitudinal survey of respondents from Los Angeles County in the US, while Study 2 uses the same analytical strategy but generalises findings by analysing longitudinal data of participants across all 50 US states. Main results of both studies show that (i) vaccination uptake is linked with reduced mental distress among individuals with high vaccine confidence (ii) vaccine uptake has no effect on mental distress among individuals with low vaccine confidence. Lastly, Study 3 applies multilevel analysis to a large‐scale pseudo‐panel study of 15 developed countries. Results for the third study corroborate finding (i) but not (ii) in that the multinational study finds that vaccine uptake is actually associated with higher mental distress among individuals with low vaccine confidence. In sum, our paper shows that the palliative effect of vaccination on mental health only exists when vaccine confidence is high. Results are mixed on whether vaccination affects mental distress when individual vaccine confidence is low. [ABSTRACT FROM AUTHOR]

Background: The sudden growth in online instruction due to COVID‐19 restrictions has given renewed urgency to questions about remote learning that have remained unresolved. Web‐based assessment software provides instructors an array of options for varying testing parameters, but the pedagogical impacts of some of these variations has yet to be examined. Objectives: The current study examines whether question order affects student performance on online college math assessments. Drawing on the literature of testing and math anxiety, we hypothesized that difficult questions near the beginning of an assessment would have a destructive effect on student confidence, which would in turn have a deleterious effect on their performance. Methods: We employed an observational 'big data' methodology, analysing 23,468 final exams completed by students in 10 different courses over eight semesters at a Math Emporium in a large technical university in the eastern United States. Students were freshmen and sophomores enrolled in non‐engineering math courses. We regressed the final score on the difficulty level of the first and second questions, controlling for several other factors. Results and Conclusions: We found that several factors—day of the week, amount of time before the deadline, number of minutes spent on the exam—have more of an impact on score than question order. This pattern was consistent across sexes. Takeaways: Our findings contradict some previous studies, which have found that difficult early questions degrade student performance, and that this affect is more pronounced in females. This work enriches our understanding of how students respond to online assessment. Lay Description: What is already known about this topic: Previous studies have had mixed results about the effect of question difficulty ordering on student performance.Furthermore, few studies have examined this issue for computer assessments. What this paper adds: We employ a novel methodology with a uniquely large data set.Our findings indicate that difficulty ordering has no effect on student performance. Implications for practice: Math instructors can use the random ordering feature of computer assessment generating tools because question order does not affect performance. [ABSTRACT FROM AUTHOR]

Background: The language of the science curriculum is complex, even in the early grades. To communicate their scientific observations, children must produce complex syntax, particularly complement clauses (e.g., I think it will float; We noticed that it vibrates). Complex syntax is often challenging for children with developmental language disorder (DLD), and thus their learning and communication of science may be compromised. Aims: We asked whether recast therapy delivered in the context of a science curriculum led to gains in complement clause use and scientific content knowledge. To understand the efficacy of recast therapy, we compared changes in science and language knowledge in children who received treatment for complement clauses embedded in a first‐grade science curriculum to two active control conditions (vocabulary + science, phonological awareness + science). Methods & Procedures: This 2‐year single‐site three‐arm parallel randomized controlled trial was conducted in Delaware, USA. Children with DLD, not yet in first grade and with low accuracy on complement clauses, were eligible. Thirty‐three 4–7‐year‐old children participated in the summers of 2018 and 2019 (2020 was cancelled due to COVID‐19). We assigned participants to arms using 1:1:1 pseudo‐random allocation (avoiding placing siblings together). The intervention consisted of 39 small‐group sessions of recast therapy, robust vocabulary instruction or phonological awareness intervention during eight science units over 4 weeks, followed by two science units (1 week) taught without language intervention. Pre‐/post‐measures were collected 3 weeks before and after camp by unmasked assessors. Outcomes & Results: Primary outcome measures were accuracy on a 20‐item probe of complement clause production and performance on ten 10‐item unit tests (eight science + language, two science only). Complete data were available for 31 children (10 grammar, 21 active control); two others were lost to follow‐up. Both groups made similar gains on science unit tests for science + language content (pre versus post, d = 2.9, p < 0.0001; group, p = 0.24). The grammar group performed significantly better at post‐test than the active control group (d = 2.5, p = 0.049) on complement clause probes and marginally better on science‐only unit tests (d = 2.5, p = 0.051). Conclusions & Implications: Children with DLD can benefit from language intervention embedded in curricular content and learn both language and science targets taught simultaneously. Tentative findings suggest that treatment for grammar targets may improve academic outcomes. What this paper adds: What is already known on the subject: We know that recast therapy focused on morphology is effective but very time consuming. Treatment for complex syntax in young children has preliminary efficacy data available. Prior research provides mixed evidence as to children's ability to learn language targets in conjunction with other information. What this study adds: This study provides additional data supporting the efficacy of intensive complex syntax recast therapy for children ages 4–7 with Developmental Language Disorder. It also provides data that children can learn language targets and science curricular content simultaneously. What are the clinical implications of this work?: As SLPs, we have to talk about something to deliver language therapy; we should consider talking about curricular content. Recast therapy focused on syntactic frames is effective with young children. [ABSTRACT FROM AUTHOR]

Background: The involvement of speech and language therapists (SLTs) within paediatric palliative care (PPC) settings has been recognized within the extant literature. However, there is little understanding of SLT's specific roles and practices when working with this vulnerable cohort of children and their families. As part of a larger body of work to develop consensus‐based recommendations for SLTs working in PPC, it is important to investigate demographic and caseload characteristics. Aims: This exploratory study aimed to gather previously undocumented international demographic data pertaining to SLT service provision, caseload and training in PPC. Additionally, it sought to ascertain the current treatment and assessment approaches of SLTs, and if variations exist in beliefs and practices. Methods & Procedures: An anonymous cross‐sectional survey was designed and reported according to the Checklist for Reporting Results of Internet E‐Surveys (CHERRIES). The online survey consisted of 40 items spanning four domains: (1) demographic information, (2) caseload information, (3) service provision and (4) training and education. SLTs from Australia, Canada, New Zealand, the UK, Ireland and the United States were recruited using a purposive snowball sampling approach. Descriptive analysis of closed‐ended survey responses and content analysis of open‐ended responses are presented. Outcomes & Results: A total of 52 respondents completed the survey. SLTs worked in a variety of PPC settings, with patients of varying age and disease groups. Over 50% of participants reported working in PPC for ≤ 4 years. Genetic disorders (34%), oncology (27%) and neurological conditions (21%) made up a significant portion of respondents' caseloads. Reported treatments and assessment approaches used by SLTs are not unique to a PPC population. Barriers and enablers for practice were identified. A portion of participants did not feel trained and prepared to assess (19.2%) or treat (15.4%) PPC clients. Conclusions & Implications: This study confirms that SLTs internationally have a role in the management of communication and swallowing impairments in a PPC context. However, whether current training and resources adequately support SLTs in this role remains questionable. This paper helps to provide SLTs, administrators, professional associations and tertiary institutions with foundational data to help inform workforce planning, advocacy efforts and training priorities. What this paper addsWhat is already known on the subjectThe published multidisciplinary literature has identified that SLTs have a role in PPC. However, there has been no targeted research investigating the professional characteristics of clinicians in this context, nor any detailed information regarding associated clinician beliefs or management approaches.What this paper adds to existing knowledgeThis study is a snapshot of attributes, practice patterns and beliefs of SLTs who work with a PPC population. It highlights SLT perspectives of education and training, as well as meta‐perceptions of themselves within the multidisciplinary team.What are the potential or actual clinical implications of this work?Data presented in this paper will help to enable SLTs, organizations and associations to augment service provision and determine future professional development priorities within the field of PPC. [ABSTRACT FROM AUTHOR]

Background: Immersive virtual reality (VR) is increasingly used in organizational training interventions. However, few studies have systematically investigated VR compared to standard training methods in actual organizational contexts. Objectives: The focus of this study was to evaluate the effectiveness of a VR simulation for training professionals in the biotech industry. Aligning training needs to unique media affordances, the study designed an immersive story‐based VR simulation for training customer‐facing employees on a new product and tested it in an international biotech company. Methods: The system was evaluated by comparing its effectiveness to a traditional video presentation with the same content in a randomized between subjects experiment. The sample consisted of 95 employees across three locations: Brazil, Denmark, and USA. Results: The VR simulation group performed better than the video presentation group on the outcomes of conceptual knowledge (d = 0.41) spatial knowledge (d = 0.61), transfer intentions (d = 0.57), enjoyment (d = 1.74), self‐efficacy (d = 0.68), perceived learning (d = 0.89), personal value (d = 0.83), and organizational value (d = 0.82), but no significant difference was found for factual knowledge (d = −0.10). Implications: Results suggest that VR simulations can be effective across cultures in organizational training interventions. VR is specifically effective when the goals of the training are to increase conceptual and spatial understanding as well as enjoyment, and self‐efficacy, but not factual knowledge. Furthermore, employees report higher levels of perceived learning, personal and organizational value and transfer intentions after VR training compared to standard video‐based training. Lay Description: What is currently known about the subject matter: Immersive virtual reality (VR) is increasingly used in organizational training interventions. This interest has especially surged amid recent global challenges, and the sudden need for companies and employees to adapt to the new remote working conditions.However, few studies have systematically investigated VR compared to standard training methods in actual organizational contexts that include a real‐world scenario and a representative testing sample.Applied research that assesses the outcomes of VR based training in realistic learning and training settings is needed. What their paper adds: We propose and test an interdisciplinary approach that links unique features of VR with training needs and multidimensional outcome measures in an organizational training context within the biotech industry in Brazil, Denmark and USA.The findings suggest that a specifically designed VR tool is superior to a comparable video presentation for the outcomes of spatial and conceptual knowledge acquisition and transfer intentions, but not factual knowledge acquisition.The VR group also reported significantly higher personal value, organizational value, self‐efficacy, perceived learning, and enjoyment compared to the video group. Implications of study findings for practitioners: The results support the value of using VR simulations in organizational training, specifically related to affective outcomes as well as spatial and conceptual knowledge and transfer intentions.The study suggests that it is not the medium of VR, but rather the alignment between the training goals with the instructional methods and the unique affordances of VR that will contribute to better or worse learning outcomes.The article describes how to evaluate the effectiveness of VR tools in applied contexts, suggesting that we have to evaluate the effectiveness of tested content with respect to different outcome variables, which coincide with the training outcomes of a particular organizational context.The project as a whole, can be used as a blueprint for future applied research efforts, exemplifying how to bridge gaps between small‐medium‐enterprises, international corporate companies and academic institutions. [ABSTRACT FROM AUTHOR]

Background: Process data, data generated by a user's interaction with a web‐based application, is an emerging tool in educational research. The current study explores using process data as a measure of implementation fidelity to a randomized control trial (RCT) of the Read It Again Mobile (RIA‐M) curricular supplement. Objectives: To determine the extent to which teachers implemented RIA‐M and to assess the utility of using process data in the assessment of fidelity. Methods: The RCT involved 30 pre‐kindergarten classrooms with a sample of n = 216 students. RIA‐M provides a curricular supplement which teachers may incorporate into classroom instruction and is delivered via a tablet computer. Pre and post literacy assessments are used to determine treatment effect. Process data, produced from teacher interactions with the tablet, and classroom observations are used to assess fidelity. Results and Conclusions: Our findings indicate no difference between treatment and control students in the RCT. Yet, we find that process data provides unique fidelity information concerning treatment exposure, adherence, and quality of program delivery. Specifically, process data indicated that teachers did not demonstrate the same level of fidelity that was captured in classroom observations. This finding provides some evidence for the absence of an intervention effect. Major Takeaways: The current study improves our understanding of how web‐based interventions may be assessed for implementation fidelity using process data. Further, process data offers a potentially reliable and scalable measure of fidelity for other web‐based educational interventions. Lay Description: What we know about the topic: Mobile technology‐based interventions are on the rise in many educational settings.Fidelity to educational interventions can be difficult to reliably assess.Teachers may be resistant to implementing technology in classrooms. What this paper adds: Examines a pilot study of a mobile technology‐based curricular intervention for teachers designed to improve early reading and literacy.Examines a new method for assessing fidelity of mobile technology‐based interventions.Compares the new method to traditional methods of assessing fidelity to educational interventions. Implications for practice and/or policy: The presence of technology in the classroom does not assure that the technology will be used effectively.Mobile technology‐based interventions may require additional monitoring and coaching to assure use as intended.Process data, generated in the use of technology‐based interventions, may provide a unique way to measure fidelity to the intervention. [ABSTRACT FROM AUTHOR]

Aims Since 2003, the US Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA, CSAT) has awarded 32 Screening, Brief Intervention and Referral to Treatment (SBIRT) grants to states, territories and tribal organizations to enhance services for persons with, or at risk for, substance use disorders. The grants supported an expansion of the continuum of care to include screening, brief intervention, brief treatment and referral to treatment in general medical and community settings. This paper describes the SAMHSA SBIRT program in the context of the scientific research that motivated its development, as well as the two cross-site evaluations that are the subject of subsequent papers in this Supplement. Methods A narrative review of research evidence pertaining to SBIRT and of the cross-site evaluation design that made it possible to determine whether the SAMHSA SBIRT grant program achieved its intended aims. The 11 programs within the two cohorts of grant recipients that were the subject of the cross-site evaluations are described in terms of SBIRT service components, performance sites, providers, management structure/activities and patient/client characteristics. Conclusion The US SAMHSA SBIRT program is an effective way to introduce a variety of new services that extend the continuum of care for substance-involved individuals, ranging from early intervention with non-dependent substance users to referral of more serious cases to specialized substance abuse treatment. [ABSTRACT FROM AUTHOR]

This paper proposes a model that accounts for 'export-platform' FDI - a form of FDI that is common in the data but rarely discussed in the theoretical literature. Unlike the previous literature, this paper's theory nests all the typical modes of supply, including exports, horizontal and vertical FDI, horizontal and vertical export-platform FDI. The theory yields the testable hypothesis that a decrease in either inter-regional or intra-regional trade costs induces firms to choose export-platform FDI. The empirical analysis provides descriptive statistics that point to large proportions of third country exports of US FDI, and an econometric analysis, whose results are in line with the model's predictions. The paper suggests policy implications for nations seeking to attract FDI. [ABSTRACT FROM AUTHOR]

The Family Group Conference (FGC) is grounded in a rights‐based framework, whereby children and their families have the right and responsibility to be primary decision‐makers when child protection issues arise, and the statutory agency has the responsibility to convene the entitled members of the family network to lead the decision‐making. A distinct core component of FGC—private family time (PFT)—allows families to discuss the information and formulate their responses and plans privately during conferencing. This paper describes how a large child welfare agency in the United States adapted PFT in two ways: (1) including a parent advocate (PA) and (2) abbreviating the amount of time allowed for this discussion. Given the lack of empirical research on the PFT component, this qualitative exploratory study sought to understand the functions and perceived impacts of PA‐supported PFT during initial child protective services (CPS) conferences at which decisions of child removal or placement were being contemplated. PFT served multiple beneficial functions and impacted families in several positive ways: families gained greater awareness of safety concerns, felt empowered and confident in the preferred safety and service plan, became increasingly engaged and involved in the case decision‐making process and ultimately felt less apprehensive. [ABSTRACT FROM AUTHOR]

Previous research has found that music brings back more vivid and emotional autobiographical memories than various other retrieval cues. However, such studies have often been low in ecological validity and constrained by relatively limited cue selection and predominantly young adult samples. Here, we compared music to food as cues for autobiographical memories in everyday life in young and older adults. In two separate four‐day periods, 39 younger (ages 18–34) and 39 older (ages 60–77) adults recorded their music‐ and food‐evoked autobiographical memories in paper diaries. Across both age groups, music triggered more frequent autobiographical memories, a greater proportion of involuntary memories, and memories rated as more personally important in comparison to food cues. Age differences impacted music‐ and food‐evoked memories similarly, with older adults consistently recalling older and less specific memories, which they rated as more positive, vivid, and rehearsed. However, young and older adults did not differ in the number or involuntary nature of their recorded memories. This work represents an important step in understanding the phenomenology of naturally occurring music‐evoked autobiographical memories across adulthood and provides new insights into how and why music may be a more effective trigger for personally valued memories than certain other everyday cues. [ABSTRACT FROM AUTHOR]

This paper investigates dynamic changes in instrumental (i.e., work‐related) tie‐seeking patterns and the structure of a communication network following a downsizing event—whereby many employees are simultaneously eliminated from a network. Our analysis spans a two‐year period and applies a resource‐ and network‐change approach to examine how survivors develop revised resource‐acquisition strategies while repositioning themselves after a downsizing. Our results demonstrate that two temporary logics of tie formation—a suspension of within‐unit homophily and a preference for seeking ties with long‐tenured employees—help employees acquire betweenness centrality during the disruption period. Specifically, we find that disruption initiates a transitional period after downsizing in which new tie‐making logics are employed, including seeking out ties with long‐tenured employees and employees outside of one's department. We observed post‐disruption, during the stabilization period after downsizing, where logics used for tie‐making in the disruption period were abandoned, pre‐disruption tie‐making logics were resumed, and betweenness centrality remained relatively constant. We discuss the theoretical and managerial implications of these results and suggest future research directions. [ABSTRACT FROM AUTHOR]

Background: Computer‐based assessment allows for the monitoring of reader behaviour. The identification of patterns in this behaviour can provide insights that may be useful in informing educational interventions. Objectives: Our study aims to explore what different patterns of reading activity exist, and investigates their interpretation and consistency across different task sets (units), countries, and languages. Three patterns were expected: on‐task, exploring and disengaged. Methods: Using log data from the PISA 2012 digital reading assessment (9226 students from seven countries), we conducted hierarchical cluster analyses with typical process indicators of digital reading assessments. We identified different patterns and explored whether they remained consistent across different units. To validate the interpretation of the identified patterns, we examined their relationship to performance and student characteristics (gender, socio‐economic status, print reading skills). Results and Conclusions: The results indicate a small number of transnational clusters, with unit‐specific differences. Cluster interpretation is supported by associations with student characteristics—for example, students with low print reading skills were more likely to show a disengaged pattern than proficient readers. Exploring behaviour tended to be exhibited only once across the three units: It occurred in the first unit for proficient readers and in later units for less skilled readers. Major Takeaways: Behavioural patterns can be identified in digital reading tasks that may prove useful for educational monitoring and intervention. Although task situations are designed to evoke certain behaviours, the interpretation of observed behavioural patterns requires validation based on task requirements, assessment context and relationships to other available information. Lay Description: What is already known about the subject matter?: Students differ in how they read, comprehend and use digital information.Indicators from process data provide insight about how students engage with digital reading tasks. What does this paper add to the subject matter?: Based on multiple process indicators, a small number of clusters indicating different behavioural activity can be distinguished.These clusters can be described as on‐task, passive, hasty, exploring, disengaged, persistent and lost interest.A meaningful interpretation of the clusters must consider the requirements of the underlying tasks. Implications for practice and/or policy: Knowledge of how students engage with digital resources may provide useful feedback for teachers to guide students' learning or intervene when they struggle.Educational monitoring: The high comparability of country‐specific results suggests an invariant set of solution strategies in the digital reading assessment. [ABSTRACT FROM AUTHOR]

The response process of problem‐solving items contains rich information about respondents' behaviours and cognitive process in the digital tasks, while the information extraction is a big challenge. The aim of the study is to use a data‐driven approach to explore the latent states and state transitions underlying problem‐solving process to reflect test‐takers' behavioural patterns, and to investigate how these states and state transitions could be associated with test‐takers' performance. We employed the Hidden Markov Modelling approach to identify test takers' hidden states during the problem‐solving process and compared the frequency of states and/or state transitions between different performance groups. We conducted comparable studies in two problem‐solving items with a focus on the US sample that was collected in PIAAC 2012, and examined the correlation between those frequencies from two items. Latent states and transitions between them underlying the problem‐solving process were identified and found significantly different by performance groups. The groups with correct responses in both items were found more engaged in tasks and more often to use efficient tools to solve problems, while the group with incorrect responses was found more likely to use shorter action sequences and exhibit hesitative behaviours. Consistent behavioural patterns were identified across items. This study demonstrates the value of data‐driven based HMM approach to better understand respondents' behavioural patterns and cognitive transmissions underneath the observable action sequences in complex problem‐solving tasks. Lay Description: What is already known about this topic?: Process data of interactive problem‐solving tasks contains rich information about test‐takers.To extract underlying information from process data is a big challenge. ​ What this paper adds?: The hidden Markov model helps identify latent states underlying problem‐solving process.Different performance groups displayed different behaviour characteristics.A consistent behavioural pattern was observed across problem‐solving items. ​ Implications for practitioners: The use of HMM holds promise in better visualize and understand behaviour patterns in response process.HMM is potential in understanding cognitive transmissions underneath the observable action sequences. ​ [ABSTRACT FROM AUTHOR]

The current socio‐political circumstances in the United States (US), constituted by the increasing visibility of police shootings of Black people, present a compelling moment for analysing how news media report about law enforcement, culpability, and racism. This paper conducts a membership categorization analysis of recent news media reports of police shootings of Black people (May 2020–October 2020) and investigates how news media negotiate culpability of agents involved these shootings. Findings illustrate how news reports (1) use the repeated category formulation 'police shooting of a Black man' to imply police are culpable for engaging in racist shootings, (2) upgrade culpability of police officers through adding to racial categorization of victims in ways that foreground victims' moral character (e.g., 'unarmed Black man'), and (3) highlight racism as an explanation for shootings and culpability of police through using racial categorizations for police officers. Overall, news media reports use racial categories as a resource to construct racism as an explanation for police shootings and to construct police officers and policing institutions as culpable for these shootings. Thus, we highlight how race and racism are constitutive of, and inseparable from, culpability in news media reports. [ABSTRACT FROM AUTHOR]

Purpose: Despite the efforts of numerous medical schools to produce rural physicians, many rural communities in the United States still experience physician shortages. This study describes the current landscape of rural efforts in US undergraduate medical education and catalogs medical school characteristics and activities that evidence has suggested, and that many experts in rural medical education believe, may result in more graduates choosing rural practice. Methods: This is a descriptive study of publicly available and rurally relevant characteristics of all 182 allopathic and osteopathic medical schools operating in the 50 states and the District of Columbia in 2016, with rural program information for these schools updated in 2019. The authors constructed a "rural program" definition in order to systematically catalog coordinated and strategic medical school efforts to produce a rural physician workforce. Findings: Few (8.2%) medical schools expressed an explicit commitment to producing rural physicians in public mission statements. However, most (64.8%) provided rural clinical experiences and many demonstrated their commitment in other ways. Only 39 (21.4%) did so through a formal rural program. Conclusions: In establishing an explicit rural program definition and documenting other markers of rural commitment, this paper provides a baseline for future studies of rural workforce production and medical school investment in these programs, activities, and personnel. Demonstrating the effectiveness of schools' rural physician education efforts will require collaboration across institutions and more intensive evaluations of programs involving students who, though relatively few in number, have great potential for contributing to the health of rural communities across the nation. [ABSTRACT FROM AUTHOR]

Background and aims: Reports of youth e‐cigarette use often do not disaggregate by underlying smoking status. This study compared annual 2014–19 youth estimates of past 30‐day e‐cigarette use prevalence and frequency by smoking status in the United States. Design Nationally representative, cross‐sectional, school‐based survey [National Youth Tobacco Surveys (NYTS)]. General linear models accounting for complex survey design compared e‐cigarette use prevalence by smoking status by year, overall and stratified by frequency, separately for high school (HS) and middle school (MS) students. The 2019 survey was analyzed separately because of its change in survey methodology. Setting: MSs and HSs in the United States. Participants: A total of 116 704 students from 1268 schools, ages 9–19. Measurements Students self‐reported (paper 2014–18, electronic 2019) ever and past 30‐day (current) use of e‐cigarettes and cigarettes, as well as frequent use (20–30 days of month). Findings From 2014 to 2018, current e‐cigarette use prevalence increased among never, current and former smokers in HS, but only among never and current smokers in MS (each P‐value < 0.001). E‐cigarette use increases for current HS smokers were primarily among frequent e‐cigarette users. In 2018, the absolute number of HS frequent users who were never or former smokers (420 000 combined) surpassed current smokers (370 000). In 2019, current e‐cigarette use prevalence for never, former and current smokers was 17.5% [95% confidence interval (CI) = 16.0–19.0], 53.6% (95% CI = 45.2–61.9) and 85.8% (95% CI = 81.6–89.9) for HS students, respectively, and 6.8% (95% CI = 5.9–7.7), 40.8% (95% CI = 34.7–47.0) and 78.0% (95% CI = 71.9–84.2) for MS students. That year, the number of HS never (420 000) and former smokers (570 000) using e‐cigarettes frequently eclipsed that of current smokers (390 000). Conclusions: E‐cigarette use prevalence and frequency among youth vary by smoking status, with highest levels of use among current smokers. However frequent e‐cigarette use among never smokers and former smokers has increased. [ABSTRACT FROM AUTHOR]

Background: The overall prevalence of U.S. young adult alcohol use has decreased, but little is known about historical change in related behaviors such as simultaneous alcohol and marijuana (SAM) use that may increase alcohol‐related risks and societal costs. The purpose of this paper was to examine historical change in SAM use prevalence among U.S. young adult alcohol users from 1977 to 2016, and consider the extent to which observed historical change in SAM use among alcohol users reflects co‐occurring change in marijuana use during these years. Methods: Data on past 12‐month alcohol, marijuana, and SAM use at up to 6 modal ages (19/20, 21/22, 23/24, 25/26, 27/28, and 29/30) were collected from 11,789 individuals (45.0% men) participating in the Monitoring the Future panel study. Annual prevalence estimates within modal age group were obtained; historical SAM use trends among alcohol and marijuana users were estimated. Results: From 2014 to 2016, SAM use was reported by approximately 30% of alcohol users aged 19/20 and 21/22, and 20 to 25% of alcohol users aged 23/24 through 29/30. Since the mid‐1990s, age‐specific historical trends in SAM use prevalence among alcohol users followed 1 of 4 patterns: significant increase followed by oscillating increases/decreases (at modal age 19/20), consistent and significant increases (at modal ages 21/22, 23/24, and 25/26), stability followed by increase (at modal ages 27/28), or stability (at modal ages 29/30). In contrast, SAM use trends among marijuana users primarily reflected stability, with some evidence of a decrease across time at modal ages 19/20 and 23/24. Historical change in SAM prevalence among alcohol users was strongly and positively correlated with changes in overall marijuana use prevalence. Conclusions: A growing proportion of early and mid‐young adult alcohol users reported SAM use, with the highest risk among those in the early years of young adulthood. Young adult SAM use may continue to increase in proportion to the degree that young adult marijuana use continues to increase. This paper examined historical change in simultaneous alcohol and marijuana (SAM) use prevalence among U.S. young adult alcohol users from 1977‐2016. While the overall prevalence of U.S. young adult alcohol use has decreased, a growing proportion of early and mid‐young adult alcohol users reported SAM use, with the highest risk among those in the early years of young adulthood. Young adult SAM use may continue to increase in proportion to the degree that young adult marijuana use continues to increase. [ABSTRACT FROM AUTHOR]

Policy Points: Historically, reforms that have increased the duration of job‐protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well‐being. Context: Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co‐operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes. Methods: We conducted a systematic review of the peer‐reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta‐analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs. Findings: We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave‐taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied. Conclusions: There is substantial quasi‐experimental evidence to support expansions in the duration of job‐protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job‐protected paid leave or lack a national paid leave entitlement altogether. [ABSTRACT FROM AUTHOR]

Despite the use of support groups among adoptive parents, few empirical works have assessed outcomes associated with participation in these groups, particularly those delivered via virtual platforms. The purpose of this study was to assess the impact of participation in a virtual, pilot-phase 10-week adoptive parent support group, on adoptive parent stress and parental competence. The pilot included support groups at two sites in one south-eastern state, one urban and the other rural. Data were collected via a retrospective pre-/post-design and utilized the Parental Stress Scale and Parental Sense of Competency measures to assess variables of interest. Analyses indicate significant increases in adoptive parent competency and significant decreases in parental stress within support groups at the urban site. No such significant differences were detected for participants in the rural group. Overall, findings indicate that support groups can be beneficial in addressing challenges associated with caregiver stress and competency among adoptive parents. As well, data suggest the need to be attentive to support group structure and duration, among other factors. After a brief review of pertinent background information, this paper will outline findings from this study and discuss salient implications derived from this effort. [ABSTRACT FROM AUTHOR]

Objective: To shorten the Patient Engagement In Research Scale (PEIRS) to its most essential items and evaluate its measurement properties for assessing the degree of patients' and family caregivers' meaningful engagement as partners in research projects. Methods: A prospective cross‐sectional web‐based survey in Canada and the USA, and also paper‐based in Canada. Participants were patients or family caregivers who had engaged in research projects within the last 3 years, were ≥17 years old, and communicated in English. Extensive psychometric analyses were conducted. Results: 119 participants: 99 from Canada, 74 female, 51 aged 17‐35 years and 50 aged 36‐65 years, 60 had post‐secondary education, and 74 were Caucasian/white. The original 37‐item PEIRS was shortened to 22 items (PEIRS‐22), mainly because of low inter‐item correlations. PEIRS‐22 had a single dominant construct that accounted for 55% of explained variance. Analysis of PEIRS‐22 scores revealed the following: (1) acceptable floor and ceiling effects (<15%), (2) internal consistency (ordinal alpha = 0.96), (3) structural validity by fit to a Rasch measurement model, (4) construct validity by moderate correlations with the Public and Patient Engagement Evaluation Tool, (5) good test‐retest reliability (ICC2,1 = 0.86) and (6) interpretability demonstrated by significant differences among PEIRS‐22 scores across three levels of global meaningful engagement in research. Conclusions: The shortened PEIRS is valid and reliable for assessing the degree of meaningful patient and family caregiver engagement in research. It enables standardized assessment of engagement in research across various contexts. Patient or public contribution: A researcher‐initiated collaboration, patient partners contributed from study conception to manuscript write‐up. [ABSTRACT FROM AUTHOR]

Introduction Collabo RATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate Collabo RATE scores and response rates across multiple clinical settings with varied patient populations. Method All adult patients at three United States primary care practices were eligible to complete Collabo RATE post-visit. To inform key learnings, we aggregated all mentions of unanticipated decisions, problems and administration errors from field notes and email communications. Mixed-effects logistic regression evaluated the impact of site, clinician, patient age and patient gender on the Collabo RATE score. Results While Collabo RATE score increased only slightly with increasing patient age ( OR 1.018, 95% CI 1.014-1.021), female patient gender was associated with significantly higher Collabo RATE scores ( OR 1.224, 95% CI 1.073-1.397). Clinician also predicts Collabo RATE score (random effect variance 0.146). Site-specific factors such as clinical workflow and checkout procedures play a key role in successful in-clinic implementation and are significantly related to Collabo RATE scores, with Site 3 scoring significantly higher than Site 1 ( OR 1.759, 95% CI 1.216 to 2.545) or Site 2 (z=−2.71, 95% CI −1.114 to −0.178). Discussion This study demonstrates that Collabo RATE can be used in diverse primary care settings. A clinic's workflow plays a crucial role in implementation. Patient experience measurement risks becoming a burden to both patients and administrators. Episodic use of short measurement tools could reduce this burden. [ABSTRACT FROM AUTHOR]

Objectives To prioritize research topics relevant to the care of the growing population of older adults with multiple chronic conditions ( MCCs). Design Survey of experts in MCC practice, research, and policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older adults with MCCs. Setting Survey conducted through the Health Care Systems Research Network ( HCSRN) and Claude D. Pepper Older Americans Independence Centers ( OAICs) Advancing Geriatrics Infrastructure and Network Growth Initiative, a joint endeavor of the HCSRN and OAICs. Participants Individuals affiliated with the HCSRN or OAICs and national MCC experts, including individuals affiliated with funding agencies having MCC-related grant portfolios. Measurements A 'top box' methodology was used, counting the number of respondents selecting the top response on a 5-point Likert scale and dividing by the total number of responses to calculate a top box percentage for each of 37 topics. Results The highest-ranked research topics relevant to the health and healthcare of older adults with MCCs were health-related quality of life in older adults with MCCs; development of assessment tools (to assess, e.g., symptom burden, quality of life, function); interactions between medications, disease processes, and health outcomes; disability; implementation of novel (and scalable) models of care; association between clusters of chronic conditions and clinical, financial, and social outcomes; role of caregivers; symptom burden; shared decision-making to enhance care planning; and tools to improve clinical decision-making. Conclusion Study findings serve to inform the development of a comprehensive research agenda to address the challenges relating to the care of this 'high-need, high-cost' population and the healthcare delivery systems responsible for serving it. [ABSTRACT FROM AUTHOR]