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Background: The United States is increasingly recognizing period product insecurity, insufficient access to menstrual products and limited private spaces for managing menstruation due to financial constraints, as an issue impacting the well-being and dignity of Americans. One strategy to address period product insecurity has been distributing free period products via period supply banks. The outcomes of period product distribution outside the school setting are absent from the literature. Objectives: This study, a formative evaluation of the free period product distribution efforts of the Alliance for Period Supplies, aims to identify (1) characteristics of individuals receiving products from period supply banks and their experiences of period product insecurity and (2) health and social outcomes experienced by recipients of free period products. Design: Survey data collection occurred at two points: baseline and one-year follow-up. All study participants provided verbal consent. Methods: Between Fall 2018 and Spring 2020, 1863 baseline and 80 follow-up surveys were administered. Participants received free period products for themselves and/or a household member from one of 20 participating Alliance for Period Supplies period supply banks directly or from one of their 64 partner agencies. Results: At baseline, 72.4% of participants had to choose between buying period products and another basic need. One year after accessing a period supply bank, 36.3% of participants reported this experience (p = 0.018). Participants reported at baseline, on average, 7.8 days in the past year of avoiding seeing others, canceling appointments, or skipping work or school because they did not have access to period products. At follow-up, this was reduced to 1.2 days, on average, t (68) = 2.214, p < 0.05. Conclusion: Period supply banks play an essential role in facilitating access to period products and the resulting benefits. Our study highlights the need for sustainable, well-funded policies and interventions to address period product insecurity effectively in society. Plain Language Summary: How people in the United States benefit when they get free period products from a period supply bank Why we did this study: In the United States, many individuals cannot afford to buy period supplies and the other stuff they need to live. Period supply banks want to help by giving them free period products. Researchers do not know if getting free period products is helpful for individuals. What we wanted to learn: The Alliance for Period Supplies is a membership program for period supply banks. We wanted to learn about the individuals who get free period products and whether getting them was helpful. What we did: For a year, starting in Fall 2018, we asked 1863 individuals to fill out paper surveys. A year later, we asked 80 of those same individuals to fill out a second survey. We asked participants to take the survey if they got free period products from a period supply bank for themselves or someone they live with. Individuals only participated in the study if they told us they wanted to. What we learned: Individuals who cannot afford period products must navigate difficult decisions between purchasing products or choosing other basic needs. Providing free products through a period supply bank has lessened the burden on these individuals, reducing the number who had to choose. Individuals unable to afford period products may sometimes opt out of going places they want to go for pleasure or miss important events, like work or school, because they do not have period products. Getting free period products has eased these challenges, letting individuals participate more fully in activities and engagements without worry about period products. Why is this important: Period supply banks are essential places where individuals receive free period products. The period supply banks need more individuals, including our government, to donate period supplies or money to buy them so they can help more individuals. [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]

Background: The ongoing COVID-19 pandemic has significantly impacted nursing education in developing and developed countries. In response to pandemic-related challenges such as campus shut downs, nursing schools implemented open and distance learning programs (ODL) that allowed them to continue offering nursing education. This paper reports on an ODL patient safety course implemented during the COVID-19 pandemic that was also used to facilitate an international, cross-cultural learning experience. Method: Forty undergraduate senior nursing students in the United States (U.S.) and the Dominican Republic (D.R.) enrolled in a synchronous and asynchronous ODL nursing patient safety course implemented by [Blinded] in conjunction with [Blinded]. Results: Thirty-seven students completed all of the program requirements. The majority of students rated their course experience highly; they agreed or strongly agreed with all course evaluation statements, including whether their overall course evaluation was positive (95%) and whether the curriculum was culturally appropriate (97%). Conclusions: Our experience in implementing a nursing patient safety ODL course can serve as a model for (1) how ODL can help nursing schools respond to restrictions imposed by an ongoing pandemic; (2) how ODL can be used to enhance cross-cultural nursing education; and (3) how nursing schools can collaborate effectively across borders. [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]

This paper describes a national survey of Master of Social Work (MSW) program leaders' religious and spiritual beliefs and practices across the United States. Of the 257 eligible MSW programs primary contacts, 119 (46.8%) responded to the survey, with 90 completing the items related to religion and spirituality (RS). Specifically, those RS items assessed participants' religious affiliation, intrinsic religiosity, frequency of religious service attendance and private religious activities, the degree to which the respondent is religious or spiritual, and their RS practices. Among our respondents, 80 (88.9%) held a position of leadership (e.g., dean/chair, associate dean, or program director). The results indicated that these MSW program leaders consider religion and spirituality to be important, are engaging in various RS practices, and over half reporting elements of intrinsic religiosity. Additionally, we compared this sample's responses to these items with a national sample of clinical social workers and another sample of adults across the United States. Interestingly, a number of differences emerged between MSW program leaders' RS with LCSWs and US adults. This paper addresses the implications of these findings, particularly in light of the sample being predominantly MSW program leaders, including how leaders' RS may influence the implicit and explicit curricula. [ABSTRACT FROM AUTHOR]

Purpose: We examined positive behavioral resources and characteristics that might distinguish resilient personality prototypes among persons with chronic spinal cord injury/disorder (SCID). Positive psychology variables with clear linkages to existing psychological interventions were examined as potential mediators of the resilience–well-being relationship. Research Method and Design: A cross-sectional, self-report study was conducted. Two hundred and ninety-eight consenting members of the Paralyzed Veterans of America (268 male; 236 self-identified as white) provided useable survey data for analysis (including 161 veterans with tetraplegia, 107 with paraplegia, 30 with cauda equina). Cluster analysis of Big Five personality traits identified resilient and nonresilient personality profiles. Tests of mean differences between resilient and nonresilient participants on behavioral resources and characteristics were performed. Path models predicting well-being and health-related quality of life (HRQL) were conducted. Results: One hundred and sixty-three respondents had resilient personality profiles and 135 had nonresilient profiles. Resilient individuals reported significantly more optimal scores on every positive psychology variable, and greater well-being and HRQL than nonresilient respondents. Path models found the relationship of resilience to well-being was explained through its beneficial associations with psychological flexibility, use of personal strengths, meaning in life (MIL), and gratitude. Psychological flexibility also mediated the resilience–HRQL relationship. Cauda equina was significantly associated with higher pain interference and lower HRQL. Conclusions: Higher gratitude, MIL, use of personal strengths, and psychological flexibility appear to characterize resilience and well-being among persons with chronic SCID. Further studies are needed to understand the impact of pain interference on HRQL among individuals with cauda equina. Impact and Implications: The present study documents several positive behavioral resources and characteristics that typify resilience among persons with chronic spinal cord injury/disorder. The results should prompt rehabilitation psychologists to consider further study of the positive psychology variables examined in this paper, and the potential use of the existing interventions associated with each one. [ABSTRACT FROM AUTHOR]

Purpose: Bullying is a specific pattern of repeated victimization explored with great frequency in school-based literature, but receiving little attention within sport. The current study explored the prevalence of bullying in sport, and examined whether bullying experiences were associated with perceptions about relationships with peers and coaches. Method: Adolescent sport team members (n = 359, 64% female) with an average age of 14.47 years (SD = 1.34) completed a pen-and-paper or online questionnaire assessing how frequently they perpetrated or were victimized by bullying during school and sport generally, as well as recent experiences with 16 bullying behaviors on their sport team. Participants also reported on relationships with their coach and teammates. Results: Bullying was less prevalent in sport compared with school, and occurred at a relatively low frequency overall. However, by identifying participants who reported experiencing one or more act of bullying on their team recently, results revealed that those victimized through bullying reported weaker connections with peers, whereas those perpetrating bullying only reported weaker coach relationships. Conclusion: With the underlying message that bullying may occur in adolescent sport through negative teammate interactions, sport researchers should build upon these findings to develop approaches to mitigate peer victimization in sport. [ABSTRACT FROM AUTHOR]

This paper explores the use of withdrawal as a harm reduction approach to adolescent pregnancy prevention and its association with condom use. Data come from a baseline survey of a randomised controlled trial to test the effectiveness of FLASH, a sexual health education curriculum. Study participants completed electronic self-report surveys in health classes in their first or second year of high school (age range 14.1–17.9, mean 15.3 years). One-hundred and ninety-one students (12% of full sample) reported engaging in vaginal intercourse in the 3 months prior to the survey; of these, 66.0% reported using withdrawal as a birth control method, without significant differences by race, gender, region or birth control beliefs. Withdrawal was often used in combination with condoms (55.5%), periodic abstinence (40.0%) and birth control pills (13.4%). The effectiveness of withdrawal and its prevalence suggest an opportunity to reflect on how withdrawal is taught – moving from avoiding its use to a harm reduction approach to help sexually active youth avoid risk, reduce risk and reduce potential harm associated with sexual behaviours. Rather than focusing on withdrawal as risky, youth-serving professionals should acknowledge young people's efforts to prevent pregnancy and recognise the social and relational contexts of contraceptive choices. [ABSTRACT FROM AUTHOR]

Relying on two unique data-sets on Chinese older immigrants (N = 3,157) and younger immigrants with ageing parents (N = 469) in Chicago, this study compared the level of filial expectation among the two groups and examined the predictors and mental health implications of having high filial expectation among each group. Results of t-tests, logistic regression and negative binominal analyses showed that, regardless of socio-demographic variables, acculturation, physical health and family relations, Chinese adult children had higher filial expectations on themselves than older immigrants' filial expectation on the younger generation. Chinese older immigrants who had less education, lower levels of acculturation, poorer health and closer relationships with children reported higher filial expectation. In the cohort of younger immigrants, high filial expectation was associated with lower income, better health and closer relations with their parents. In addition, having high filial expectation was associated with lower levels of depression and anxiety among the older immigrants, but not among the younger cohort. The results indicated that, whereas Chinese older immigrants seemed to adapt their filial expectation in the new society, the younger cohort still strongly adhere to this traditional family norm. Maintaining strong filial expectation might be a protective factor for older immigrants' mental health. Practice and policy implications of these findings are discussed in the paper. [ABSTRACT FROM AUTHOR]

Solid‐organ transplantation is the treatment of choice for end‐stage organ failure. Parents of pediatric transplant recipients who reported a lack of readiness for discharge had more difficulty coping and managing their child's medically complex care at home. In this paper, we describe the protocol for the pilot study of a mHealth intervention (myFAMI). The myFAMI intervention is based on the Individual and Family Self‐Management Theory and focuses on family self‐management of pediatric transplant recipients at home. The purpose of the pilot study is to test the feasibility of the myFAMI intervention with family members of pediatric transplant recipients and to test the preliminary efficacy on postdischarge coping through a randomized controlled trial. The sample will include 40 family units, 20 in each arm of the study, from three pediatric transplant centers in the United States. Results from this study may advance nursing science by providing insight for the use of mHealth to facilitate patient/family–nurse communication and family self‐management behaviors for family members of pediatric transplant recipients. [ABSTRACT FROM AUTHOR]

Background Comparing body fat and the effect of body fat on metabolic abnormalities in Chinese and USA teenagers may provide clues for the early prevention and control of cardiovascular disease (CVD). We aimed to compare the prevalence of glucose and lipid metabolism abnormalities, body fat amount and distribution, and the effect of body fat on glucose and lipid metabolism in Chinese and US teenagers. Methods We included 5424 Chinese teenagers (48.5% male) from the China Child and Adolescent Cardiovascular Health (CCACH) study and 8704 USA teenagers (55.6% male) from the USA National Health and Nutrition Examination Survey (NHANES). Blood lipid, blood glucose, and body fat indicators were obtained using the same standardised measurements. Results The prevalence of dyslipidaemia in Chinese teenagers was of those in the USA (hypercholesterolaemia = 3.5% vs 7.4%; high low-density lipoprotein cholesterol (LDL-C) = 3.6% vs 5.0%; low high-density lipoprotein cholesterol (HDL-C)=9.9% vs 14.3%; hypertriglyceridaemia=3.7% vs 10.1%) (P<0.05). However, with the increase in body mass index (BMI), the prevalence of high LDL-C increased more in Chinese than in US teenagers, even exceeding them in the obese group (2.7% in non-overweight to 9.7% in overweight group in China, P<0.05; 3.5% in non-overweight to 6.5% in the obese group in the USA, P<0.05). The prevalence of impaired fasting glucose was higher in China than in the USA (28.0% vs 17.5%, P<0.05). Besides, Chinese adolescents are more likely to accumulate fat in the abdomen, and the per-unit fat increase would bring a higher risk of dyslipidaemia in Chinese boys than in USA boys. Conclusions Dyslipidaemia was more prevalent in US teenagers than in Chinese teenagers, but with the increase in BMI, the prevalence of high LDL-C increased more in Chinese than in US teenagers. Impaired fasting glucose (IFG) was significantly more prevalent in China than in the USA. The unfavoured body fat and higher risk of body fat on metabolic disorders in Chinese teenagers suggest that Chinese teenagers should pay more attention to the adverse effect of body fat on metabolic abnormalities. [ABSTRACT FROM AUTHOR]

This study explores the complex nature of female genital mutilation/cutting (FGM/C) by juxtaposing the mental and sexual health of women who had undergone FGM/C as part of initiation/membership into a traditional women's society (TWS) with those who were also cut but not initiated into a TWS. While considerable differences emerged between TWS members and nonmembers, there was no evidence that TWS membership was protective against the physical and psychological trauma typically ascribed to FGM/C. In fact, the pattern of results would tend to suggest the opposite. Possible explanations for and implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The increased funding provided for Community Health Worker (CHW) hiring and training as part of the COVID‐19 pandemic response was to increase their impact in alleviating the effects of negative social determinants of health in the lives of the most vulnerable individuals and communities. This enhanced use of CHW in vulnerable populations can also be used to improve access to such populations for applied research to study ways to improve health outcomes for low‐income minority populations. We carried out a feasibility study using the State CHW association as partners to reach CHWs working with low‐income minority population. Three hundred and three (303) clients of CHWs were interviewed on various demographic, health access, and employment information and both univariate and multivariate analyses was used to determine factors associated with being unvaccinated against COVID‐19 and chi‐squared used to determine if employment was associated with having health insurance. About half of the clients self‐identified as Black/African American and half as Hispanic. Two‐thirds were women and 52.1% were unemployed and 55.1% had no health insurance. There was no association between employment status and having health insurance. Majority (71.6%) had received one dose of a type of COVID‐19 vaccine and being younger and being African American were associated with not getting a dose of COVID‐19 vaccine, as well as being unemployed and not having health insurance. Most of the clients came to see the CHW about a Health/Healthcare issue of the five social determinants of health (SDOH). There were 38 different job titles provided by the clients and the job titles were mainly blue collar jobs and jobs in health and personal care. Our results indicate that CHWs reach the most vulnerable population who have limited health access and high unemployment and that CHWs can effectively be used for linkage to low‐income minority population for applied research. Our analyses found that in this low‐income population, being younger, being African American, being unemployed, and not having health insurance are each associated with not getting vaccinated against COVID‐19, and employment is not associated with having health insurance. We have shown that partnership with CHWs to access their clients as research subjects leads to elucidating new information on the population that can be used in addressing public health programming. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7–10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy. We conducted a randomized controlled trial at a tertiary care academic medical center in the southeastern US with 100 postpartum individuals (50 per arm) from 2018 to 2019. Among 100 trial participants, blood pressure follow-up within 7–10 days postpartum was higher albeit not statistically significant between postpartum individuals randomized to the remote assessment intervention versus office-based standard care (absolute risk difference 18.0%, 95% CI −0.1 to 36.1%, p = 0.06). Patient-reported facilitators for remote blood pressure monitoring were maternal convenience, clarity of instructions, and reassurance from the health assessments. These positive aspects occurred alongside barriers, which included constraints due to newborn needs and the realities of daily postpartum life. [ABSTRACT FROM AUTHOR]

Objectives: To characterize the epidemiology of simultaneous traumatic brain injury (TBI) and ocular trauma. Materials and Methods: In this retrospective, observational study, de-identified data from patients admitted with ocular trauma and TBI was extracted from the National Trauma Data Bank (2008-2014) using International Classification of Diseases 9th Revision, Clinical Modification diagnostic codes and E-codes relating to injury circumstances. Mechanisms, types of ocular and head injuries, intention, and demographic distribution were determined. Association of variables was calculated with Student's t and chi-squared tests and logistic regression analysis. Results: Of 316,485 patients admitted with ocular trauma, 184,124 (58.2%) also had TBI. The mean (standard deviation [SD]) age was 41.8 (23) years. Most were males (69.8%). Race/ethnicity distribution was 68.5% white, 13.3% black, and 11.4% Hispanic patients. The mean (SD) Glasgow Coma Score (GCS) was 12.4 (4.4) and Injury Severity Score (ISS) was 17 (10.6). Frequent injuries were orbital fractures (49.3%) and eye/adnexa contusions (38.3%). Common mechanisms were falls (27.7%) and motor vehicle-occupant (22.6%). Firearm-related trauma (5.2%) had the greatest odds of very severe injury (ISS >24) (odds ratio [OR]: 4.29; p<0.001) and severe TBI (GCS <8) (OR: 5.38; p<0.001). Assault injuries were associated with the greatest odds of mild TBI (OR: 1.36; p<0.001) and self-inflicted injuries with severe TBI (OR: 8.06; p<0.001). Eye/adnexal contusions were most associated with mild TBI (OR: 1.25; p<0.001). Optic nerve/visual pathway injuries had greater odds of severe TBI (OR: 2.91; p<0.001) and mortality (OR: 2.27; p<0.001) than other injuries. Of associated head injuries, the odds of severe TBI were greatest with skull base fractures (OR: 4.07; p<0.001) and mortality with intracerebral hemorrhages (OR: 4.28; p<0.001). Mortality occurred in 5.9% of patients. Conclusion: TBI occurred in nearly two-thirds of ocular trauma admissions. The mortality rate was low with implications for challenging rehabilitation and long-term disability in survivors. [ABSTRACT FROM AUTHOR]

Policing domestic violence (DV) poses significant challenges in China due to cultural, legal, and organizational complexities. Policing DV in China favors mediation over assertive interventions, complicating law enforcement's role. While previous research has focused on coercive interventions by Chinese police, there is limited information on non-coercive, supportive approaches. This study investigates the relationship between police officers' knowledge and training regarding the Anti-DV law and their willingness to provide supportive services to DV victims in China. It also considers various individual and organizational factors. The data used in this study are derived from the Policing DV in China project, with a sample of 1,353 respondents who had experience dealing with DV cases within the past 3 years. The study focuses on three dependent variables representing supportive approaches to DV cases: Referral, Counseling, and Protection orders. Independent variables include officers' knowledge of the Anti-DV law and agency training. Control variables include the use of body-worn cameras (BWC) and attitudes toward Violence Tolerance, Male Dominance, and Gender Equality. Additionally, demographic variables, working environment, length of service, and police rank are considered. The analytical approach involves a three-step strategy, incorporating descriptive, bivariate analyses, and regression analyses. The results are interpreted using odds ratios and average marginal effects, and statistical software such as SPSS by IBM and R by Open-Source Model is utilized for data analysis. Key findings indicate that more than half of the officers referred intimate partner violence survivors to shelters and assisted victims in filing protection orders. Counseling practices varied across provinces and between male and female officers. Agency training and the use of BWC were positively associated with non-coercive and supportive approaches, while knowledge of the DV Act, male dominance score, and gender equality score did not predict the use of such approaches. Demographic characteristics, including police rank, length of service, and province of employment, influenced the utilization of non-coercive and supportive approaches. This study examines the challenges faced by Chinese police officers when responding to DV cases and their willingness to provide supportive interventions. The study highlights the complexities surrounding the initiation of protection orders due to officers' legal knowledge and discretion. The study emphasizes the importance of police support in addressing DV in China and the role of agency training in promoting non-coercive responses. It highlights regional variations in police support and underscores the need for addressing disparities in service provision across different provinces. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we examined the role of plate size in an individual's ability to draw what they had for dinner the previous evening. Methods: A sample of 199 students at one US university were given large pieces of paper with the image of a plate printed on them and asked to make an accurate drawing on the plate of what they had for dinner the previous evening once per week for 10 weeks. The sizes of the printed plates either stayed constant at 10.5 inches or 8.5 inches or started at 10.5 inches and decreased in small weekly increments to 8.5 inches. We hypothesized that participants given the changing size plates would unknowingly alter their drawn meal sizes in relation to the size of the plate offered. Results: Participants drew more food on larger plates than smaller plates. Participants given plates that decreased in size also decreased the size of their drawings and reported consuming a total of 69 square inches less food on the decreasing than the large plates. Conclusion: These findings suggest that changes in plate size may be useful in influencing food portion sizes over time when the size of the plates is decreased incrementally. [ABSTRACT FROM AUTHOR]

Over 2 million children in the US have uncontrolled asthma. African American children are disproportionately affected with a risk of dying from asthma that is 7.6 times higher than non‐Hispanic White children. Racial disparities in childhood asthma are partially attributed to differential exposures to poverty; unsafe and stressful neighborhoods; and unhealthy physical environments. This paper describes the protocol for an ongoing National Institutes of Health/National Institute of Nursing Research‐funded descriptive, cross‐sectional study to investigate two neighborhood factors that may influence children's asthma. Building on an existing dataset, this study examines associations among neighborhood greenspace, neighborhood safety, and level of asthma control while controlling for indoor asthma triggers in an urban sample of predominantly low‐income, African American children with persistent asthma. Two new variables are added to the dataset: availability of neighborhood greenspace and neighborhood violent crime rate. Greenspace is being accessed using geographic information systems and measured using the normalized difference vegetation index. Neighborhood violent crime rate is calculated using geocoded, point locations for crimes downloaded from the city police department. It is hypothesized that parents living in unsafe neighborhoods are likely to keep their children indoors, thereby increasing their children's exposure to indoor asthma triggers and limiting the potential benefits of neighborhood greenspace. The biggest challenges thus far are related to limited variability in greenspace and violent crime rates. Progress to date and strategies to address these challenges are discussed. Results have the potential to inform interventions to improve asthmatic children's health and influence public health policy. [ABSTRACT FROM AUTHOR]

Background: Drawing on prospective data from the National Health and Nutrition Examination Survey (NHANES), our goal was to construct and validate a 5-year survival prediction model for individuals with cognitive impairment (CI). Methods: This study entailed a prospective cohort design utilizing information from the 2011-2014 NHANES dataset, encompassing individuals aged 40 years or older, with updated mortality status as of December 31, 2019. Predictive models within the derivation and validation cohorts were assessed using logistic proportional risk regression, column-line plots, and least absolute shrinkage and selection operator (LASSO) binomial regression models. Results: The study enrolled a total of 1,439 participants (677 men, mean age 69.75 ± 6.71 years), with the derivation and validation cohorts consisting of 1,007 (538 men) and 432 (239 men) individuals, respectively. The 5-year mortality rate stood at 16.12% (n = 232). We devised a 5-item column-line graphical model incorporating age, race, stroke, cardiovascular disease (CVD), and blood urea nitrogen (BUN). The model exhibited an area under the curve (AUC) of 0.772 with satisfactory calibration. Internal validation demonstrated that the column-line graph model displayed strong discrimination, yielding an AUC of 0.733, and exhibited good calibration. Conclusion: To sum up, our study successfully developed and internally validated a 5-item nomogram integrating age, race, stroke, cardiovascular disease, and blood urea nitrogen. This nomogram exhibited robust predictive performance for 5-year mortality in individuals with CI, offering a valuable tool for prognostic evaluation and personalized care planning. [ABSTRACT FROM AUTHOR]

Background: We sought to understand the innovativeness of nurses engaging in innovative behaviors and quantify the associated characteristics that make nurses more able to innovate in practice. We first compared the innovativeness scores of our population; then we examined those who self-identified as an innovator versus those who did not to explore differences associated with innovativeness between these groups. Methods: A cross-sectional survey study of nurses in the US engaging in innovative behaviors was performed. We performed an exploratory factor analysis (EFA) to determine the correlates of innovative behavior. Results: Three-hundred and twenty-nine respondents completed the survey. Respondents who viewed themselves as innovators had greater exposure to HCD/DT workshops in the past year (55.8% vs. 36.6%, p = 0.02). The mean innovativeness score of our sample was 120.3 ± 11.2 out of a score of 140. The mean innovativeness score was higher for those who self-identified as an innovator compared with those who did not (121.3 ± 10.2 vs. 112.9 ± 14.8, p =< 0.001). The EFA created four factor groups: Factor 1 (risk aversion), Factor 2 (willingness to try new things), Factor 3 (creativity and originality) and Factor 4 (being challenged). Conclusion: Nurses who view themselves as innovators have higher innovativeness scores compared with those who do not. Multiple individual and organizational characteristics are associated with the innovativeness of nurses. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the use of after‐visit instructions (AVIs) in an academic rheumatology clinic and assess the impact of standardized AVIs (sAVIs) and teach‐back (TB) on comprehension of health information. Methods: A retrospective review of adult patients seen between October 1 and 8, 2021, at the rheumatology clinic collected data on patient demographics, clinical features, and the presence, content, and readability of AVIs. During a subsequent prospective proof‐of‐concept study, routinely scheduled patients seen at the rheumatology clinic were randomized into three groups: control (received standard of care), received sAVIs only, and received sAVIs plus TB. Patients completed a health literacy questionnaire, satisfaction survey, and a one‐ to two‐week postvisit telephone survey to assess AVI comprehension. Results: Out of 316 retrospective patient visits, 82 (25.9%) received AVIs. Among 210 of 316 patients (66.5%) with management changes, 76 (36.1%) received AVI, with 74.2% of the instructions considered concordant with the provider's note. Use of AVIs was higher with management changes, new patient visits, and medical trainee/teaching clinics. AVIs were written at a median 6.8 grade level. A total of 75 patients completed the prospective study: 31 (41.3%) were in the control group, 19 (25.3%) were in the group that received sAVIs only, and 25 (33.3%) were in the group that received AVIs with TB. There were no differences in overall postvisit survey comprehension/retention scores among the three patient groups evaluated. Conclusion: Although a lack of AVI use was identified, implementation of sAVIs did not appear to impact patient retention or comprehension of discharge health information. [ABSTRACT FROM AUTHOR]

This study examined how the #MeToo movement, and backlash against it (#HimToo), influence rape myth acceptance (RMA) and negative affect among female sexual trauma survivors and controls. We randomly assigned college women (N = 389) to three social media conditions that either promoted RMA (#HimToo), challenged RMA (#MeToo), or did not address rape myths (general social media (GSM)). The findings demonstrated that women in the #HimToo condition reported more RMA, whereas women in the #MeToo and GSM conditions reported less negative affect. The results highlight that the way we talk about rape on social media influences momentary affect and RMA. [ABSTRACT FROM AUTHOR]

The literature on tobacco control funding has focused on its impact on the demand for tobacco products. This paper turns the issue around by utilizing state-level panel data to address the determinants of per capita tobacco control funding. Tobacco control funding is found to be increasing with per capita income, cigarette consumption, and cigarette taxes, but decreasing with population density and neighbor-state tobacco control funding. Political affiliation, cancer and heart attack mortalities, as well as the extent of smoke-free air laws, have little impact on tobacco control funding. Results are robust to addressing the endogeneity of cigarette consumption and cigarette taxes. [ABSTRACT FROM AUTHOR]

Background: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine. Methods: A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), sleep-related impairments (SRI), and insomnia. Each model was controlled for age, sex, headache frequency, anxiety, and depression. Results: A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with photophobia exhibited significantly poorer sleep quality compared to patients without photophobia (p < 0.001). Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), SRI (p = 0.020), and insomnia (p = 0.005) after controlling for age, sex, headache frequency, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.007), SOL (p = 0.010), and insomnia (p = 0.014). Conclusion: Results suggest that photophobia is a significant predictor of poor sleep quality and sleep disturbances in migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine. [ABSTRACT FROM AUTHOR]

Background: This study aims to thoroughly study the connection between congenital heart disease (CHD) and neurodevelopmental disorders (NDDs) through observational and Mendelian randomization (MR) designs. Methods: This observational study uses data from the National Survey of Children's Health (2020–2021). Multivariable logistic regression and propensity score matching (PSM) were performed to analyze the association. PSM was used to minimize bias for covariates such as age, race, gender, maternal age, birth weight, concussion or brain injury, preterm birth, cerebral palsy, Down syndrome, and other inherited conditions. In MR analyses, inverse variance-weighted measures, weighted median, and MR-Egger were employed to calculate causal effects. Results: A total of 85,314 children aged 0–17 were analyzed in this study. In regression analysis, CHD (p = 0.04), the current heart condition (p = 0.03), and the severity of current heart condition (p < 0.05) had a suggestive association with speech or language disorders. The severity of current heart condition (p = 0.08) has a potential statistically significant association with attention deficit hyperactivity disorder(ADHD). In PSM samples, ADHD(p = 0.003), intellectual disability(p = 0.012), and speech or language disorders(p < 0.001) were all significantly associated with CHD. The severity of current heart condition (p < 0.001) also had a significant association with autism. MR analysis did not find causality between genetically proxied congenital cardiac malformations and the risk of NDDs. Conclusions: Our study shows that children with CHD have an increased risk of developing NDDs. Heart conditions currently and severity of current heart conditions were also significantly associated with these NDDs. In the future, we need to try more methods to clarify the causal relationship between CHD and NDDs. [ABSTRACT FROM AUTHOR]

Introduction: Missed visits have been estimated to cost the U.S. healthcare system $50 billion annually and have been linked to healthcare inefficiency, higher rates of emergency department visits, and worse outcomes. COVID-19 disrupted existing outpatient healthcare utilization patterns. In our study, we sought to examine the frequency of missed outpatient visits over the course of the COVID-19 pandemic and to examine patient-level characteristics associated with non-attendance. Methods: This study utilized data from a longitudinal cohort study (the Chicago COVID-19 Comorbidities (C3) study). C3 participants were enrollees in 1 of 4 active, "parent" studies; they were rapidly enrolled in C3 at the onset of the pandemic. Multiple waves of telephone-based interviews were conducted to collect experiences with the pandemic, as well as socio-demographic and health characteristics, health literacy, patient activation, and depressive and anxiety symptoms. For the current analysis, data from waves 3 to 8 (05/01/20-05/19/22) were analyzed. Participants included 845 English or Spanish-speaking adults with 1 or more chronic conditions. Results: The percentage of participants reporting missed visits due to COVID-19 across study waves ranged from 3.1 to 22.4%. Overall, there was a decline in missed visits over time. No participant sociodemographic or health characteristic was consistently associated with missed visits across the study waves. In bivariate and multivariate analysis, only patient-reported anxiety was significantly associated with missed visits across all study waves. Conclusion: Findings reveal that anxiety was consistently associated with missed visits during the COVID-19 pandemic, but not sociodemographic or health characteristics. Results can inform future public health initiatives to reduce absenteeism by considering patients' emotional state during times of uncertainty. [ABSTRACT FROM AUTHOR]

Introduction/Objective: Chronic pain disorders affect about 20% of adults in the United States, and it disproportionately affects individuals living in the neighborhoods of extreme socioeconomic disadvantage. In many instances, chronic pain has been noted to arise from an aggregation of multiple risk factors and events. Therefore, it is of importance to recognize the modifiable risk factors. The aim of this study was to investigate the comorbid medical conditions and risk factors associated with chronic pain disorders in patients aged 65 years and older. Methods: Our team retrospectively reviewed medical records of elderly patients (65 years and older) who were evaluated in our outpatient medicine office between July 1, 2020 and June 30, 2021 for acute problems, management of chronic medical problems, or well visits. We divided our patients into a group who suffered from chronic pain disorder, and another group who did not have chronic pain disorder. The association of variables were compared between those groups. Results: Of the 2431 patients, 493 (20.3%) had a chronic pain disorder. A higher frequency of females in the group with chronic pain disorder was found compared to the group without a chronic pain disorder (60.6% vs 55.2%; P =.033). The mean ages between the two groups were similar in the group with a chronic pain disorder compared to the group without (76.35 ± 7.5 year vs 76.81 ± 7.59 year; P =.228). There were significant associations of certain comorbidities in the group with a chronic pain disorder compared to the group without a chronic pain disorder, such as depression (21.9% vs 15.2%; P <.001), anxiety (27.0% vs 17.1%; P <.001), chronic obstructive pulmonary disease (8.7% vs 6.1%; P =.036), obstructive sleep apnea (16.8% vs 11.6%; P =.002), gastroesophageal reflux disease (40.8% vs 29.0%; P <.001), osteoarthritis (49.3% vs 26.1%; P <.001), other rheumatologic diseases (24.9% vs 19.4%; P =.006), and peripheral neuropathy (14.4% vs 5.3%; P <.001). Conclusion: Female sex, depression, anxiety, chronic obstructive pulmonary disease, obstructive sleep apnea, gastroesophageal reflux disease, osteoarthritis, other rheumatologic diseases, and peripheral neuropathy were significantly associated with chronic pain disorder in elderly patients, while BMI was not associated with chronic pain disorder. [ABSTRACT FROM AUTHOR]

This paper presents findings from a retrospective observational records review study that compares the outcomes associated with implementation of supported employment (SE) with and without prior Project SEARCH with ASD Supports (PS-ASD) on wages earned, time spent in intervention, and job retention. Results suggest that SE resulted in competitive employment for 45 adults with ASD. Twenty-five individuals received prior intervention through PS-ASD while the other 20 individuals received SE only. Individuals in this sample who received PS-ASD required fewer hours of intervention. Additionally, individuals in the PS-ASD group achieved a mean higher wage and had higher retention rates than their peers who received SE only. Further research with a larger sample is needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Introduction: Chest pain is the second most common chief complaint for patients undergoing evaluation in emergency departments (ED) in the United States. The American Heart Association recommends immediate physician interpretation of all electrocardiograms (ECG) performed for adults with chest pain within 10 minutes to evaluate for the finding of ST-elevation myocardial infarction (STEMI). The ECG machines provide computerized interpretation of each ECG, potentially obviating the need for immediate physician analysis; however, the reliability of computer-interpreted findings of "normal" or "otherwise normal" ECG to rule out STEMI requiring immediate intervention in the ED is unknown. Methods: We performed a prospective cohort analysis of 2,275 ECGs performed in triage in the adultED of a single academic medical center, comparing the computerized interpretations of "normal" and "otherwise normal" ECGs to those of attending cardiologists. ECGs were obtained with a GE MAC 5500 machine and interpreted using Marquette 12SL. Results: In our study population, a triage ECGwith a computerized interpretation of "normal" or "otherwise normal" ECG had a negative predictive value of 100% for STEMI (one-sided, lower 97.5% confidence interval 99.6%). None of the studied patients with these ECG interpretations had a final diagnosis of STEMI, acute coronary syndrome, or other diagnosis requiring emergent cardiac catheterization. Conclusion: In our study population, ECG machine interpretations of "normal" or "otherwise normal" ECG excluded findings of STEMI. The ECGs with these computerized interpretations could safely wait for physician interpretation until the time of patient evaluation without delaying an acute STEMI diagnosis. [ABSTRACT FROM AUTHOR]

Background: A common method of pain assessment is the numerical rating scale, where patients are asked to rate their pain on a scale from 0 to 10, where 0 is "no pain" and 10 is "pain as bad as you can imagine". We hypothesize such language is suboptimal as it involves a test of a cognitive skill, imagination, in the assessment of symptom severity. Methods: We used a large-scale online research registry, ResearchMatch, to conduct a randomized controlled trial to compare the distributions of pain scores of two different pain scale anchors. We recruited adults located in the United States who reported a chronic pain problem (> 3 months) and were currently in pain. Participants were randomized in a 1:1 ratio to receive pain assessment based on a modified Brief Pain Inventory (BPI), where the anchor for a score of 10 was either "extremely severe pain", or the original BPI, with the anchor "pain as bad as you can imagine". Participants in both groups also answered additional questions about pain, other symptomatology and creativity. Results: Data were obtained from 405 participants for the modified and 424 for the original BPI. Distribution of responses to pain questions were similar between groups (all p-values ≥ 0.12). We did not see evidence that the relationship between pain score and the anchor text differed based on self-perceived creativity (all interaction p-values ≥ 0.2). However, in the key analysis, correlations between current pain assessments and known correlates (fatigue, anxiety, depression, current pain compared to a typical day, pain compared to other people) were stronger for "extreme" vs. "imaginable" anchor text (p = 0.005). Conclusion: Pain rating scales should utilize the modified anchor text "extremely severe pain" instead of "pain as bad as you can imagine". Further research should explore the effects of anchors for other symptoms. [ABSTRACT FROM AUTHOR]

Bottle feeding beyond the recommended weaning age of 12 months is a risk factor for childhood obesity. This paper describes a sample of toddlers at high risk for obesity: prolonged bottle users from a low-income multi-ethnic community. We report here baseline mealtime and feeding behaviour, 24 h dietary recall and bottle intake data for Feeding Young Children Study ( FYCS) participants, by overweight (≥85% weight-for-length) status. FYCS enrolled 12-13-month-olds from urban nutrition programmes for low-income families in the United States who were consuming ≥2 bottles per day. Our sample was predominately Hispanic (62%), 44% of mothers were born outside of the United States and 48% were male. Overall, 35% were overweight. Overweight status was not associated with mealtime/feeding behaviours, bottle use or dietary intake. Most (90%) children ate enough, were easily satisfied and did not exhibit negative (e.g. crying, screaming) mealtime behaviours, per parent report. The sample's median consumption of 4 bottles per day accounted for 50% of their total calories; each bottle averaged 7 ounces and contained 120 calories. Mean daily energy intake, 1098.3 kcal day−1 (standard deviation = 346.1), did not differ by weight status, nor did intake of fat, saturated fat, protein or carbohydrates. Whole milk intake, primarily consumed via bottles, did not differ by weight status. Thus, overweight 12-13-month-olds in FYCS were remarkably similar to their non-overweight peers in terms of several obesity risk factors. Findings lend support to the set-point theory and prior work finding that weight and intake patterns in the first year of life alter subsequent obesity risk. [ABSTRACT FROM AUTHOR]

Objectives. We evaluated an intervention designed to identify patients at risk for hepatitis C virus (HCV) through a risk screener used by primary care providers. Methods. A clinical reminder sticker prompted physicians at 3 urban clinics to screen patients for 12 risk factors and order HCV testing if any risks were present. Risk factor data were collected from the sticker; demographic and testing data were extracted from electronic medical records. We used the t test, v2 test, and rank-sum test to compare patients who had and had not been screened and developed an analytic model to identify the incremental value of each element of the screener. Results. Among screened patients, 27.8% (n = 902) were identified as having at least 1 risk factor. Of screened patients with risk factors, 55.4% (n = 500) were tested for HCV. Our analysis showed that 7 elements (injection drug use, intranasal drug use, elevated alanine aminotransferase, transfusions before 1992, ‡ 20 lifetime sex partners, maternal HCV, existing liver disease) accounted for all HCV infections identified. Conclusions. A brief risk screener with a paper-based clinical reminder was effective in increasing HCV testing in a primary care setting. [ABSTRACT FROM AUTHOR]

Background: This paper examines differences in drinking and binge drinking between Mexican Americans living along the U.S.-Mexico border and those living in 2 metropolitan areas away from the border (Houston, Texas and Los Angeles, California). Methods: Respondents in the non-border area (Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288), who were interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the U.S.-Mexico border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results: There were no differences between border and non-border Mexican American men in the proportion of drinkers, the proportion who binge drink at least once a year, and volume of alcohol consumption. However, within each location, there were significant differences in drinking by age, indicating that younger men drank more than men who were older. Border women showed significant differences across age-groups in the proportion of drinkers, in binge drinking, and volume of alcohol consumption, which were not seen among non-border women. Conclusions: Women's drinking seems to be more affected than men's by their residence on or off the U.S.-Mexico border. This is seen most clearly among young women 18 to 29 years old, and it is associated with an increased proportion of drinkers, a higher volume of drinking, and an increased proportion of women who report binge drinking. Increased drinking in this group of younger women seems to be associated with drinking in Mexico. [ABSTRACT FROM AUTHOR]

Background: There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion: The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption. [ABSTRACT FROM AUTHOR]

This study used a novel survey instrument to evaluate the hypothesis that U.S. agricultural producers have significantly different stress and recovery experiences following acute-onset natural disaster compared to their non-agricultural counterparts. Participants were recruited through local organizations and targeted email and social media in communities in Arkansas and Nebraska that had experienced violent tornadoes in 2014 and/or severe flooding in 2019. The survey instrument incorporated the Brief Resilience Scale, the Revised Impact of Event Scale referencing two time points, the Posttraumatic Growth Inventory-Short Form, and original questions. Demographic, exposure, stress, and recovery measures were analyzed in SAS with Chi-square tests, t-tests, Wilcoxon tests, and multiple linear regression modeling to test for differences between agricultural and non-agricultural groups in resilience, event exposure, stress symptoms in the week after the event, stress symptoms in the month before the survey, a calculated recovery ratio, and posttraumatic growth. Analysis sample (N = 159) contained 20.8% agricultural occupation, 71.1% female, and 49.1% over age 55. No significant differences were found between agricultural and non-agricultural participants when comparing resilience, stress, or recovery ratio measures. Unadjusted posttraumatic growth score was significantly lower in the agriculture group (P =.02), and an occupation group by sex interaction was significantly associated with posttraumatic growth score (P =.02) when controlled for number of initial posttraumatic stress symptoms in the adjusted model, with agricultural women showing lower growth. Overall, there was no evidence of significant difference in disaster stress and recovery between agricultural and rural, non-agricultural groups in this study. There was some evidence that women in agriculture may have lower levels of recovery. Data indicated that rural residents continue to experience posttraumatic-type symptoms up to 8 years beyond the acute-onset natural disaster events. Communities should include strategies to support mental and emotional health in their preparedness, response, and recovery plans with intentional inclusion of agricultural populations. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence of medial vascular calcifications in the oral and maxillofacial region and their association with systemic diseases. Materials and Methods: The study included 211 consecutive patients with systemic diseases (January 2015–May 2016). Medical history and radiographic images were evaluated. Univariate analysis (t‐test) was performed for continuous variables (age). The Chi square test was applied for the categorical variables (Mönckeberg medial arteriosclerosis [MMA], gender). Results: There was a 6.2% prevalence of MMA. The mean age of patients with MMA was 65.46 ± 13.38. The prevalence of kidney disease in patients with MMA was significantly higher than in those without MMA (p < 0.001). This finding was maintained even after adjusting for other systemic diseases (OR = 31.84 [8.63–136.78]). Conclusion: A significant prevalence of MMA in kidney disease patients was observed in this pilot study. [ABSTRACT FROM AUTHOR]

With advances in the treatment of HIV, people living with HIV (PLWH) are now expected to have a near-normal life expectancy, but challenges remain in the form of substantially poorer health-related quality of life (HRQoL) than the general population. Being overweight or obese may pose an additional burden in PLWH, but few studies have evaluated the relationship between body mass index (BMI) and HRQoL in PLWH. This study aimed to evaluate and describe the association between HRQoL and BMI among PLWH in the US. Data were obtained from the 2018 and 2019 US National Health and Wellness Survey, an online, self-reported, general population survey. Analyses included 575 PLWH who self-reported a physician diagnosis and prescription use for the treatment of HIV, as well as 1725 propensity score matched non-HIV controls. After adjusting for age, sex, race, and comorbidities, higher BMI was associated with poorer physical (β = −0.18, p = 0.005) and general (β = −0.42, p = 0.014) HRQoL among PLWH. Additionally, PLWH reported poorer mental, physical, and general HRQoL than non-HIV controls; these relationships were not moderated by BMI. The potential negative impact of higher BMI on patients' humanistic outcomes should be considered in HIV management, including selection of treatment. [ABSTRACT FROM AUTHOR]

Immigrant populations are more likely to suffer a significant amount of distress caused by type 2 diabetes mellitus (T2DM). Mobile health applications (mHealth apps) make T2DM self-care knowledge and tools more accessible, which holds promise to improve diabetes outcomes among immigrants. The social distancing protocol and concerns about virus spread in healthcare facilities during the COVID-19 pandemic further highlights the value of mobile technology to facilitate T2DM self-care management among underserved populations. This study examined Chinese and Hispanic immigrants' acceptability for adopting a mHealth app to facilitate T2DM self-management. This study used an embedded mixed methods design. Surveys were completed by 118 participants to understand their status quo of using mobile technology. Smartphones were used by 72.88% of respondents, and among them, the frequency of use was almost every day. Half participants had not used technology for health-related purposes. Then, semi-structured interviews with sixteen Chinese and eight Hispanic participants were completed to delve into intentions, facilitators, and barriers for adopting a T2DM app for tracking self-management. Performance expectancy and effort expectancy appeared to influence participants' intention to use the app. Family to provide technical support was an essential facilitator, while poor eyesight was a major barrier. These findings showed that Chinese and Hispanic immigrants were conditionally accepting a mobile application for T2DM self-management. Developing smartphone apps meeting performance and effort expectancies and addressing the technical support and eyesight issues are critical to adoption of mHealth to reduce T2DM disparities among Chinese and Hispanic immigrants. [ABSTRACT FROM AUTHOR]

Backgro und: Accurate prediction of risk for chronic diseases like type 2 diabetes (T2D) is challenging due to the complex underlying etiology. Integration of more complex data types from sensors and leveraging technologies for collection of -omics datasets may provide greater insights into the specific risk profile for complex diseases. Methods: We performed a literature review to identify feature selection methods and machine learning models for prediction of weight loss in a previously completed clinical trial (NCT02278939) of a behavioral intervention for weight loss in Filipinos at risk for T2D. Features included demographic and clinical characteristics, dietary factors, physical activity, and transcriptomics. Results: We identified four feature selection methods: Correlation-based Feature Subset Selection (CfsSubsetEval) with BestFirst, Kolmogorov–Smirnov (KS) test with correlation featureselection (CFS), DESeq2, and max-relevance-min-relevance (MRMR) with linear forward search and mutual information (MI) and four machine learning algorithms: support vector machine, decision tree, random forest, and extra trees that are applicable to prediction of weight loss using the specified feature types. Conclusion: More accurate prediction of risk for T2D and other complex conditions may be possible by leveraging complex data types from sensors and -omics datasets. Emerging methods for feature selection and machine learning algorithms make this type of modeling feasible. [ABSTRACT FROM AUTHOR]

Peer support is effective in improving self-management behaviors and health outcomes among individuals with Type 2 diabetes. Volunteer peer support programs offer a cost-effective resource for diabetes self-management support; however, factors affecting the retention of volunteer peer leaders remain understudied. Herein, we examined factors associated with volunteer retention and satisfaction among 34 predominantly Mexican-origin peer leaders who assisted patients from a Federally Qualified Health Center located on the US/Mexico border with their diabetes management. Peer leaders completed surveys with open- and close-ended questions at baseline, 6 months and 12 months. Quantitative and qualitative data analyses were guided by the Volunteer Process Model. Using nonparametric Mann–Whitney U tests, self-efficacy as a peer leader at 6 months was most associated with interest to continue volunteering (P  = 0.01), and satisfaction with support from the program at 12 months was most associated with interest to continue volunteering (P  = 0.01). The qualitative data indicated that the relationship between the peer leaders and their patients was the primary factor for a satisfying volunteer experience. Future research should focus on increasing peer leaders' self-efficacy and satisfaction with program support and examine how organizations can support the development of the patient–peer relationship. Practitioners should consider appealing to volunteer peers' motivations to promote their retention. [ABSTRACT FROM AUTHOR]

While there has been a growth in studies examining sexual violence among sexual minority men, little research attention has been paid to the experience of sexual violence among young sexual minority men (YSMM). In this article we analyze secondary data from the baseline of a pilot randomized control trial with 318 YSMM aged 15 to 24 years in the United States who were in relationships with other males to examine the associations between sexual minority-specific stigma and sociodemographic and relationship characteristics and experiences of intimate partner violence (IPV) and sexual IPV in their relationships. Approximately one-in-five participants reported experiencing any form of IPV and 6% reported sexual IPV in their current relationship. Participants who reported sexual minority-specific familial rejection (Adjusted Odds Rato (aOR) = 2.33, 95% confidence interval [CI] [1.03, 5.26], p < .05), internalized heterosexism (aOR = 3.17, 95% CI [1.45, 6.95], p < .01), and housing insecurity (aOR = 7.22, 95% CI [1.66, 31.34], p < .01) reported higher odds of sexual IPV in their relationship. Study findings point to the role of multiple sexual minority-specific forms of stigma in creating vulnerabilities for the experience of sexual IPV among YSMM, and highlight the need for continued research and interventions that address sexual minority-specific stigma and structural vulnerabilities to guide violence prevention efforts with YSMM. [ABSTRACT FROM AUTHOR]

Dating app facilitated sexual assault (DAppSA) is a concerning phenomenon with minimal published research. This retrospective study explored if DAppSAs were different than other sexual assaults (SAs) committed by acquaintances through a review of 3,413 sexual assault medical forensic examination (SAMFE) charts from 2017 to 2020 in a Mountain West state in the United States. Routine Activities Theory and Confluence Model of sexual aggression provided the theoretical framework for the study. Inclusion criteria for DAppSA cases included (1) victim was 14 years of age or older; (2) victim indicated meeting the perpetrator on a dating app; (3) SA occurred at initial in-person meeting; and (4) victim had a SAMFE with SA kit evidence collection. DAppSAs (n = 274) represented 8.02% of overall cases and 13.92% of acquaintance SAs (n = 1,968). DAppSA victims had unique characteristics including a higher percentage of male victims (7.5%), college students (22.2%), and victims with self-reported mental illness (MI) (59.6%). Victims were less likely to fight back during the assault with lower percentages of kicking (5.8%) and hitting (9%). DAppSA victims and perpetrators were less likely to use drugs or alcohol before or during the assault. DAppSAs were found to be more violent SAs with increased strangulation (32.4%); assaultive/penetrative acts; and victim injuries, especially anogenital and breast injuries. Unique and troubling differences were found in DAppSA cases than other SAs committed by acquaintances. Due to the increased violent nature of DAppSAs, the researchers propose that sexual predators use dating apps as hunting grounds for vulnerable victims. Recommendations to address dating app safety concerns, influence dating app usage policies, and improve care to survivors are discussed through systems-based and trauma-informed approaches. [ABSTRACT FROM AUTHOR]

The article focuses on the variation in firearm screening and access based on LGBT status among Veterans with the risk of firearm-related suicide in both LGBT individuals and Veterans. It mentions that the study aims to fill this gap by examining LGBTQI+ status, emergency department visits, and firearm screening and access using natural language processing and machine learning algorithms applied to clinical notes in the Veterans Affairs (VA) electronic health records.

Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers' understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur. [ABSTRACT FROM AUTHOR]

This study surveyed a national sample of victim service professionals (N = 222) and compared rural versus urban/suburban participants' perceptions of a variety of issues, such as the impact of the pandemic on gender-based violence victimization and safety advice for isolated victims. Increased interference with victim employment and the abuser monitoring of online activities were reported by participants across all communities. However, urban/suburban participants rated the magnitude of all victim challenges as greater, while more rural participants noted child abuse as a particular problem in their communities. The results highlight the importance of community context for improving coordinated responses to gender-based violence (n = 101). [ABSTRACT FROM AUTHOR]

Objective: The goal of this study was to evaluate whether differences in gestational weight gain (GWG) and adverse perinatal outcomes exist for Black and White women who are overweight or have obesity (OW/OB) at entry to prenatal care. Methods: We enrolled 183 pregnant women with BMI 25-45 kg/m2 (71% black, 29% white) prior to 14 weeks gestation. Data were collected on demographic, medical history, diet and physical activity during pregnancy. Relationships between race and maternal outcomes and infant outcomes were assessed using multivariable logistic regression models. Results: The average age of pregnant women were 26 years (±4.8), with a mean BMI of 32.1 (±5.1) kg/m2 at the time of enrollment. At delivery, 60 women (33%) had GWG within Institute of Medicine recommendations and 69% had at least one comorbidity. No significant differences by race were found in GWG (in lbs) (11±7.5 vs. 11.4±7.3, p=0.2006) as well as other perinatal outcomes including maternal morbidity, LBW and PTB. Race differences were noted for gestational diabetes, total energy expenditure and average daily calorie intake, but these differences did not result in significant differences in GWG or maternal morbidity. Conclusion: The lack of racial differences in GWG and perinatal outcomes demonstrated in this study differs from prior literature and could potentially be attributed to small sample size. Findings suggest that race differences in GWG and perinatal outcomes may diminish for women with a BMI in the overweight or obese range at conception. [ABSTRACT FROM AUTHOR]

Objective: The relationship between maternal health and health outcome of offspring has been studied extensively. However, measures such as family resilience in the context of maternal health are not well understood. The objective of this study was to determine if overall maternal health status is associated with family resilience. Methods: Using the 2016 National Survey of Children's Health, a nationally representative survey of parents/guardians of children ages 0–17, we evaluated the association of overall maternal health status with measures of family resilience. The analysis was performed using descriptive and multivariable analyses. The study adjusted for current health insurance status, family structure of child's household, income level, highest education of adult in household, child race, primary household language, children with special health care needs, emotional support, neighborhood support, parental aggravation, and adverse childhood experiences. Results: Compared to mothers who reported their physical health to be good, mothers who had a very good/excellent physical health status reported significantly higher adjusted rates for family resilience measures [Adjusted Odds Ratio (AOR) 0.741, 95% Confidence Interval (CI) (0.640, 0.859); p < 0.001]. Results suggested also that mothers whose mental health was very good/excellent were more likely to exhibit greater family resilience as compared to those that were good [(AOR) 0.452, 95% (CI) (0.390, 0.525); p < 0.001] or poor/fair [(AOR) 0.283, 95% (CI) (0.223, 0.360); p < 0.001]. Conclusion: Our findings suggest that maternal mental and physical health may contribute to how families respond to adversity. Our findings highlight the importance of evaluating interventions that target both physical and mental aspects of maternal health status to better the resilience of the family unit. In the healthcare setting, maternal health services should ensure early detection and prevention of chronic conditions beyond obstetric care and detection and treatment of mental health. [ABSTRACT FROM AUTHOR]

PURPOSE: Early in the COVID‐19 pandemic, there was a concern that cyberbullying incidents would increase as youth were spending more time online. Additionally, reports emerged that Asian American citizens were being disproportionately targeted due to the purported origination of the disease. The current study explores whether cyberbullying incidents increased among adolescents overall—and Asian American youth in particular—since the onset of the coronavirus. METHODS: Three unique national surveys of teens (aged 13–17, mean = 14.96) conducted in 2016 (N = 4742), 2019 (N = 4250), and 2021 (N = 2546) were analyzed to track experience over time with general cyberbullying, as well as cyberbullying based on race or color. Additionally, respondents were asked in 2021 whether they had been cyberbullied more or less since the start of the COVID‐19 pandemic. RESULTS: More youth have experienced cyberbullying since the beginning of the COVID‐19 pandemic, with Asian American youth most likely to report increased victimization during the pandemic. For example, in 2021, 23.2% of youth reported experiencing cyberbullying compared to 17.2% in 2019 and 16.7% in 2016. Among Asian American youth, 23.5% said they were cyberbullied because of their race in 2021, compared to 7.4% in 2019 and 13.9% in 2016. CONCLUSIONS: As more adolescents continue to spend more time online, cyberbullying victimization may increase across all racial groups. In the current politicized environment, Asian Americans may continue to be targeted because of their race. Schools and communities should augment existing implementations and pedagogy with more population‐specific approaches that are culturally relevant, culturally sustaining, and that reflect the unique lived experiences of Asian American youth. IMPLICATIONS AND CONTRIBUTION: The current study shows that more adolescents have experienced cyberbullying (both general and race‐based) since the start of the COVID‐19 pandemic. The increase in race‐based victimization was highest among Asian American youth. [ABSTRACT FROM AUTHOR]

Objectives This study investigates whether the year of arrival to the United States (U.S.) and birthplace relate to postmigration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life. Methods We analyzed 19 years (2000–2019) of data from the American Community Survey Public Use Microdata Samples (weighted N = 393,501; ages ≥ 50 years). Cognitive difficulty was based on self-reported data, and weighted means, percentages, adjusted prevalence estimates, and adjusted odds ratio were calculated. Results Controlling only for demographics, foreign-born Arabs reported higher odds of cognitive difficulty compared to U.S.-born Arabs across all arrival cohorts (p <.001). After accounting for economic and integration factors, those who arrived between 1991 and 2000 had higher odds (odds ratio [OR] = 1.06, 95% confidence interval [CI] =1.00, 1.19, p <.01), while those who arrived after 2001 had lower odds (OR = 0.87, 95% CI = 0.78, 0.97, p <.001) of cognitive difficulty. Lacking English proficiency (OR = 1.90, 95% CI = 1.82, 1.98, p <.001) was related to higher odds, whereas not being a U.S. citizen was significantly associated with lower odds (OR = 0.89, 95% CI = 0.52, 0.94, p <.001) of cognitive difficulty. Yet, results varied by birthplace. Migrants born in Iraq consistently reported the highest odds of cognitive difficulty across all arrival cohorts. Discussion Migration history and birthplace may be important factors explaining cognitive disparities among the diverse group of Arab migrants and Arab Americans. Future research examining mechanisms underlying these associations and the impact of migration on cognitive health is needed to address cognitive disparities in migrants. [ABSTRACT FROM AUTHOR]

Objectives: Minimal research has assessed COVID-19's unique impact on the Native Hawaiian/Pacific Islander (NH/PI) population—an Indigenous-colonized racial group with social and health disparities that increase their risk for COVID-19 morbidity and mortality. To address this gap, we explored the scope of COVID-19 outcomes, vaccination status, and health in diverse NH/PI communities. Methods: NH/PI staff at partner organizations collected survey data from April through November 2021 from 319 community-dwelling NH/PI adults in 5 states with large NH/PI populations: Arkansas, California, Oregon, Utah, and Washington. Data were analyzed with descriptive statistics, Pearson χ2 tests, independent and paired t tests, and linear and logistic regression analyses. Results: During the COVID-19 pandemic, 30% of survey participants had contracted COVID-19, 16% had a close family member who died of the disease, and 64% reported COVID-19 vaccine uptake. Thirty percent reported fair/poor health, 21% currently smoked cigarettes, and 58% reported obesity. Survey participants reported heightened COVID-19–related psychosocial distress (mean score = 4.9 on 10-point scale), which was more likely when health outcomes (general health, sleep, obesity) were poor or a family member had died of COVID-19. Logistic regression indicated that age, experiencing COVID-19 distress, and past-year use of influenza vaccines were associated with higher odds of COVID-19 vaccine uptake (1.06, 1.18, and 7.58 times, respectively). Conclusions: Our empirical findings highlight the acute and understudied negative impact of COVID-19 on NH/PI communities in the United States and suggest new avenues for improving NH/PI community health, vaccination, and recovery from COVID-19. [ABSTRACT FROM AUTHOR]