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This paper examined the prevalence of depressive symptomotology among women of Mexican ancestry (N = 205), over the age of 18, of diverse incomes and nativity. We examined differences in rates of diagnosis by Spanish/English preference and the sensitivity and specificity of three common measures: the Patient Health Questionnaire (PHQ9), the Kessler Psychological Distress Scale (K-10), and depression questions from the Composite International Diagnostic Interview, Short Form (MDD CIDI-SF); PHQ9 was used as the 'gold standard' measure. Results indicated 18-32 % of participants met criteria for depression with higher rates found among Spanish preference participants. The K-10 had significantly higher sensitivity (0.81) but lower specificity (0.79) than the MDD CIDI-SF items (0.57 and 0.89, respectively). This study suggests that the K-10 and MDD CIDI-SF measures are complementary to each other for screening of depressive symptomatology. Implications for cultural and linguistic assessment of depression are further discussed. [ABSTRACT FROM AUTHOR]

The underlying structure of obsessive-compulsive disorder (OCD) remains to be confirmed in child and adolescent populations. In this paper we report the first factor analytic study of individual OCD items from Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). OCD symptoms were assessed using the CY-BOCS symptom checklist in a sample of 854 patients with OCD (7-18 years of age) recruited from clinics in five countries. Pooled data were subjected to exploratory and confirmatory factor analysis (CFA) to identify the optimal factor structure. Various models were tested for age and gender subgroups. Also, the invariance of the solution across age and gender was tested and associations with demographic and clinical factors were explored. A three-factor model provided the best-fit solution. It consisted of the following factors: (1) harm/sexual, (2) symmetry/hoarding, (3) contamination/cleaning. The factor structure was invariant for age and gender across subgroups. Factor one was significantly correlated with anxiety, and factor two with depression and anxiety. Factor three was negatively correlated with tic disorder and attention-deficit/hyperactivity disorder (ADHD). Females had higher scores on factor two than males. The OCD symptom structure in children and adolescents is consistent across age and gender and similar to results from recent child and adolescents although hoarding may not be a separate factor. Our three-factor structure is almost identical to that seen in early studies on adults. Common mental disorders had specific patterns of associations with the different factors. [ABSTRACT FROM AUTHOR]

One of the most effective strategies to end the human immunodeficiency virus (HIV) epidemic is HIV screening technologies. Routine HIV screening reaches the first-time tester, people with undiagnosed HIV, and those persons who are in need of frequent retesting due to their ongoing risk. This secondary analysis examined nurse practitioners' (NPs) rates of offering routine HIV screening and health center HIV screening characteristics. A convenience sample of NPs completed either a paper and pencil or an online survey in February 2016. Nurse practitioners responded to several questions about their behaviors and the health center characteristics where they work related to HIV screening. Many NPs (31%) never offer routine HIV screening to patients. Efforts are needed to implement structural changes to increase HIV screening rates among NPs and the health centers where they work. Nurse practitioners, health centers, and the health center policiesmust align to address theHIV epidemic and implement nationalHIV screening recommendations. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Among academic medical disciplines, Family Medicine (FM) research is notable for its breadth of health-care content areas, making it particularly susceptible to interdisciplinary collaboration. AIM: This study characterises the degree and typology of such collaborations, and determines whether collaboration patterns are associated with citation frequency and funding. METHODS: This cross-sectional study describes collaboration patterns for publications from 2015 indexed in Web of Science and authored by faculty from United States (US) departments of family medicine (DFMs). We determined mean number of total and FM authors per publication, and percentage of publications with FM first or last authors. Publications were categorised by inclusion of non-FM faculty author(s) and number of DFMs represented. RESULTS: Overall, 919 FM faculty from 109 DFMs authored a total of 1872 unique publications in 2015. There was an average of 6.8 authors per publication with 1.4 authors being FM faculty. FM faculty were first author on 26.2% and last author on 29.2% of publications. Of all publications, 0.9% were single FM Author; 1.0% were same DFM; 0.3% were multiple DFMs; 72.4% were single FM Author+non-FM; 19.3% were same DFM+non-FM; 6.0% were multiple DFMs+non-FM. FM publications with non-FM faculty authors showed higher citation rates, higher rates of funding, and lower rates of having no funding source. DISCUSSION: Most FM publications involved non-FM faculty authors. Collaborations involving non-FM authors were correlated with higher impact publications and projects that were more likely to have been funded. [ABSTRACT FROM AUTHOR]

Research on job assignments has generally assumed employees will accept assignments when offered. In this study, we examine managerial preferences for potential job assignment opportunities conceptualized using human capital theory to provide a holistic understanding of this phenomenon. Using two pilot studies, we refine the list of reasons managers use when forming lateral assignment preferences. In the main study, we collected data from a representative sample of more than 1200 managers in a large US organization who provided preferences for all possible assignment locations (about 40) in their regions and reported reasons for their preferences. Results showed career development reasons (e.g., promotion potential, opportunity to learn) and social information reasons (e.g., location manager, customers) attracted managers to assignments, and health and well‐being reasons (e.g., commuting, stress) repelled managers. There were several differences in these relationships by managerial level such that health and well‐being reasons were more important than career development reasons for lower‐level managers than higher‐level managers, who seemed to generate their preferences based more evenly on both types of reasons. We ask whether gender moderates the relationship between health and well‐being reasons and preferences and find little support. We also explore whether manager racioethnicity moderates the relationship between community racioethnicity and preferences and find a few differences. Most findings were replicated when predicting actual movement 2 years later. Results suggest managerial preferences should consistently be considered in job assignment research and that organizations should obtain and use preference data when making internal staffing decisions. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to examine the prevalence of overweight/obesity and to explore sex differences in body weight perceptions and correlates of weight gain among Black students at 2 historically Black colleges and universities (HBCUs) in the USA. Methods: Participants completed a paper-based survey, and their height and weight were measured (67% completion rate). Results: The overweight and obesity rates were 33.8% and 26.9%, respectively. More females than males accurately assessed their weight (p < 0.05). Body weight underestimation was associated with male sex, excellent/very good perceived overall health, and not being informed by a doctor of having overweight or obesity (p <0.01). Higher odds of =5% weight gain were related to female sex, living on campus, and not being informed by a doctor of having overweight or obesity (p <0.05). Conclusion: Given the high overweight and obesity rates among Black students, HBCUs in the USA should develop intervention strategies for the prevention and management of overweight and obesity. College health educators at HBCUs need to provide regular check-ups or health screenings that help male students perceive their weight accurately and prevent weight underestimation. It is important for HBCUs to monitor and address weight gain among Black students as early as possible. [ABSTRACT FROM AUTHOR]

This paper applies models of the onset of adolescent sexual intercourse using national data from Denmark and the USA. The model gave excellent fits to data on Danish Whites and a good fit to American Whites, but the model-fits for American Blacks and Hispanics were not as good. The weakness of the latter model fits may reflect either real processes that the model does not capture or problems in the reliability of adolescent sexuality data. [ABSTRACT FROM PUBLISHER]

Background: It has been shown that inflammation may be associated with cognitive impairment (CI). Diet modulates inflammation. However, there is currently a scarcity of epidemiological studies exploring the connection between the inflammatory potential of diet and CI. The objective was to investigate the correlation between the dietary inflammatory index (DII) and cognitive impairment in older adults in the United States. Methods: The present investigation utilized a cross-sectional dataset obtained from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. Dietary intake data was used to calculate DII scores, which were then used to categorize participants into quartiles. Participants' cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Individuals who scored in the lowest quartile on any of these tests were classified as exhibiting low cognitive performance. The association between DII and cognitive impairment was investigated by multivariate logistic regression, smooth curve fitting, and subgroup analysis. Results: A total of 947 older adults were enrolled in the study. Following the adjustment of confounding variables, DII scores exhibited a significant and positive correlation with low cognitive performance, as measured by AFT (OR 1.15, 95% CI 1.02-1.28, p = 0.02) and the DSST (OR 1.38, 95% CI 1.13-1.68, p = 0.004). Compared with the lowest quartile of DII, the highest weighted odds ratio of cognitive impairment based on AFT was observed in the fourth quartile group (OR 1.89, 95% CI 1.05-3.38, p = 0.03). Similarly, a comparable pattern was evident in DSST (OR 4.30, 95% CI 1.85-9.98, p = 0.003). Additionally, the smooth curve fitting results showed a nonlinear relationship between DII and cognitive decline evaluated by DSST (p for nonlinearity = 0.016). No interaction effects between cognitive impairment and age or gender were observed in relation to all cognitive test scores. Conclusion: This research reveals a positive link between diet with higher inflammatory potential and cognitive decline among elderly individuals in America. However, additional studies on dietary interventions are necessary to explore the cause-and-effect relationship. [ABSTRACT FROM AUTHOR]

Personality changes have been reported following organ transplantation. Most commonly, such changes have been described among heart transplant recipients. We set out to examine whether personality changes occur following organ transplantation, and specifically, what types of changes occur among heart transplant recipients compared to other organ recipients. A cross-sectional study was conducted in which 47 participants (23 heart recipients and 24 other organ recipients) completed an online survey. In this study, 89% of all transplant recipients reported personality changes after undergoing transplant surgery, which was similar for heart and other organ recipients. The only personality change that differed between heart and other organ recipients and that achieved statistical significance was a change in physical attributes. Differences in other types of personality changes were observed between these groups but the number of participants in each group was too small to achieve statistical significance. Overall, the similarities between the two groups suggest heart transplant recipients may not be unique in their experience of personality changes following transplantation, but instead such changes may occur following the transplantation of any organ. With the exception of physical attributes, the types of personality changes reported were similar between the two groups. These finding indicate that heart transplant recipients are not unique in their reported experience of personality changes following organ transplantation. Further studies are needed to deepen our understanding of what causes these personality changes. [ABSTRACT FROM AUTHOR]

Adolescent mental health is an urgent global public health issue. Youth participatory action research is an effective strategy to amplify youth voices and can serve as a catalyst for evidence-based action addressing the mental health crisis. To illustrate the benefits of youth participatory action research for informing community health, we describe an ongoing collaboration with a youth council located in the central coast of California, USA. Research methods included an anonymous online self-report survey to gather information about the mental health of high school students in 2020 (n = 176) and 2022 (n = 234), 93% Latinx/Mexican American. Both surveys included a four-item patient health questionnaire to screen for depression and anxiety risk, in addition to scaled and open-ended survey questions selected by the youth leaders based on their research questions. Quantitative and qualitative results indicated a significant but small decrease in mental health risk, and a continued need for resources to access mental health support. Results led to community-based action aimed at improving local youth mental health. The interdisciplinary research team (psychology and public health) and youth leaders share reflections highlighting the innovative, empowering, and transformative impact of youth participatory action research as a tool for improving community health. [ABSTRACT FROM AUTHOR]

Sexual minority, individuals who are not heterosexual, college students experience high rates of intimate partner violence (IPV), which is linked to a myriad of deleterious outcomes. However, little work has evaluated whether there are differences in IPV outcomes among sexual minority college students as compared to heterosexual college students. Further, the extent to which minority stress at the institutional and individual level relates to IPV outcomes among sexual minority students is understudied. As such, the purpose of the current study was to evaluate IPV outcomes in a large sample of undergraduate students attending 18 medium- to large-sized universities across the contiguous U.S. Results supported that sexual minority victims of IPV had more anxious and depressive symptoms than heterosexual victims of IPV but were not more likely to engage in hazardous drinking. Further, analyses supported that several campus-level (but not individual-level) indicators of minority stress moderated the relation between IPV victimization and negative outcomes among sexual minority students, such that the association between IPV and negative outcomes was stronger among students embedded in campuses with higher levels of minority stressors. Results support the critical importance of interventions addressing campus-level minority stressors to reduce deleterious IPV outcomes among sexual minority college student victims. [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]

Background: More than 1.6 million people are diagnosed with cancer each year. Despite the different treatment options available for cancer, many individuals refuse treatment for various reasons. However, little is known about the cumulative group of individuals who refuse treatment. Objectives: Our primary objective was to use the 2017-2020 Behavioral Risk Factor Surveillance System (BRFSS) to quantify the number of individuals who refuse or delay treatment by cancer type and conduct a demographic analysis of these individuals. Secondarily, we aimed to assess whether individuals who refuse or delay cancer treatment have different levels of pain compared with those who receive treatment. Population and Setting: Individuals diagnosed with cancer who were respondents to the 2017-2020 BRFSS. Secondary data analysis of 2017-2020 BRFSS. Methods and Study Design: We performed a cross-sectional study using the 2017-2020 BRFSS to analyze the prevalence of individuals who refuse or delay cancer treatment by type of cancer and sociodemographics using chi-square tests. Additionally, we used logistic regression to determine whether individuals who refused treatment were more likely to report cancer-related pain. Results: The sample included 6238 individuals, of whom 83% were White, 53% were female, and over half reported attending college or technical school. Individuals with cancer of internal organs had higher rates of cancer treatment refusal at 8.43%, compared with 4.41% with breast cancer, 5.94% with skin cancer, and 4.15% with other types of cancer. Individuals who did not graduate high school were nearly twice as likely to refuse cancer treatment than other education groups (11.57%; P<.01). Conclusion: Our investigation contributes to the literature as it brings awareness to the sociodemographic disparities in cancer treatment refusal rates, allowing future research to focus on these groups. Focused efforts on educating these groups may improve cancer screening rates and treatment awareness, thus increasing cancer survival rates. [ABSTRACT FROM AUTHOR]

School-based health centers (SBHCs) are associated with numerous positive aspects of student health services. Many schools in the United States (US) do not have transparent policies on chronic health condition (CHC) management. Of particular concern is the underreporting of the delivery of health services in U.S. schools concerning CHC management and its relationship with the presence or absence of a SBHC. Data from the 2020 School Health Profiles (SHP) Survey were examined in New York public secondary schools. Specific health services were reviewed, together with the presence or absence of a SBHC, including daily medication administration, stock rescue medication, case management services, community partners, chronic disease-specific education, and assurance that students with CHCs were enrolled in an insurance program. A significantly greater proportion of schools with a SBHC compared with schools without a SBHC provided: (1) daily medication administration (92.9% vs. 86.5%; p <.001), (2) stock or rescue medication (84.9% vs. 77.4%; p <.001), (3) case management services (83.1% vs. 67.2%; p <.001), (4) disease-specific education for families (63.1% vs. 57.2%; p =.022), (5) student and family connection to community health services (84.2% vs. 76.5%; p <.001), and (6) ensured that a protocol existed whereby students with a CHC were enrolled in an insurance plan if eligible (79.6% vs. 66.8%; p <.001). Findings suggest that data on a national scale include essential facts for states to consider concerning school health policies and practices. Additional research should examine the intricacy of elements connected with school-based health care to understand better the care provided to children with CHCs. [ABSTRACT FROM AUTHOR]

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one's partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants' engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful. [ABSTRACT FROM AUTHOR]

Quality care in healthcare is a multifaceted concept that encompasses the execution of effective medical treatments and the patient's overall experience. It involves a multitude of factors, including effectiveness, safety, timeliness, equity, and patient centeredness, which are important in shaping the healthcare landscape. This cross-sectional study used the data from the Health Information National Trends Survey 6 (HINTS 6), which collects data on various aspects of health communication and information-seeking behaviors, to investigate the factors associated with quality care among White and Hispanic populations. All adults who participated in HINTS 6 and visited healthcare service at least once in the past 12 months were included in this study. Multivariable logistic regression was used to determine the association between quality care and delay or discriminated care with the adjustment of all other sociodemographic variables. We analyzed a total of 3611 participants. Poor social determinants of health (SDOHs) (OR 0.61, CI 0.43–0.88, p = 0.008), delayed needed medical care (OR 0.34, CI 0.26–0.43, p < 0.001), and discriminated care (OR 0.29, CI 0.15–0.54, p < 0.001) were all negatively associated with optimal quality care. Negative SDOHs could also be positively associated with delayed care and discriminated care. [ABSTRACT FROM AUTHOR]

Purpose: This study had two aims. Aim 1 was to query both communication science and disorders (CSD) faculty and school-based speech-language pathologists (SLPs) regarding how written language is/was covered in their graduate programs. Aim 2 was to query school-based SLPs about their written language service provision. Method: CSD faculty (n = 143) and school-based SLPs (n = 610) completed an online survey examining (a) if and how written language was addressed in their graduate program, (b) what content related to written language was covered in graduate school, and (c) provision of written language services in schools (SLPs only). Results: There was a discrepancy in reports of training provision. Faculty reported providing more training than SLPs reported receiving. However, SLPs with fewer years of experience reported slightly higher levels of training compared to those with more years of experience. Additionally, there was variability among SLPs in how often they targeted written language in therapy. Finally, receipt of training in written language was a significant predictor of provision of written language services, as reported by SLPs. Conclusions: SLPs play a key role on literacy teams in schools, but many SLPs did not receive adequate training in written language. In order to ensure SLPs are trained to work with children with reading difficulties, graduate programs should ensure that written language is part of the clinical and academic curricula. [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]

Research has largely neglected the issue of intimate partner violence (IPV) among transgender and gender-diverse (TGD; e.g., nonbinary and genderqueer) individuals. However, existing research suggests that TGD individuals are disproportionately affected by IPV. The current study sought to explore if and how rates of IPV vary among subgroups of TGD undergraduate students and contextual factors of IPV among TGD individuals including the co-occurrence of multiple forms of IPV victimization, the type of relationship in which IPV occurred, and the gender identity of the IPV perpetrator. Participants were 280 TGD undergraduate students attending 20 medium- and large-sized residential public universities across the contiguous United States. Of the entire sample of TGD undergraduate students (N = 280), a total of 27.5% endorsed past 6-month IPV victimization (20.0% psychological, 6.1% physical, 8.9% sexual, 11.4% coercive control, and 5.7% LGBTQIA+-specific). Among only the participants who endorsed past 6-month IPV victimization (N = 77), 45.4% reported one form of IPV victimization, 26.0% two forms, 22.1% three forms, and 6.5% four forms. Further, 41.3% of TGD IPV victims were in a casual relationship, 56.0% were in a serious relationship, and 2.7% were in multiple relationship types. Finally, 55.8% of victims reported their perpetrator was a man, 22.1% a woman, and 22.1% a TGD individual. No significant differences in rates of IPV were found between TGD respondents. These data highlight the urgent need for programming efforts on college campuses that are specifically designed to prevent and address IPV among and against TGD students. Future research should evaluate universal- and population-specific risk and protective factors for IPV among TGD individuals to inform prevention and response efforts for this highly vulnerable population. [ABSTRACT FROM AUTHOR]

We investigated a subject directory in the US Agriculture Department- Economic Research Service portal. Parent-child relationships, related connections among the categories, and related connections among the subcategories in the subject directory were optimized using social network analysis. The optimization results were assessed by both density analysis and edge strength analysis methods. In addition, the results were evaluated by domain experts. From this study, it is recommended that four subcategories be switched from their original four categories into two different categories as a result of the parent-child relationship optimization. It is also recommended that 132 subcategories be moved to 40 subcategories and that eight categories be moved to two categories as a result of the related connection optimization. The findings show that optimization boosted the densities of the optimized categories, and the recommended connections of both the related categories and subcategories were stronger than the existing connections of the related categories and subcategories. This paper provides visual displays of the optimization analysis as well as suggestions to enhance the subject directory of this portal. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

Early HIV detection and treatment decreases morbidity and mortality and reduces high-risk behaviors. Many Emergency Departments (EDs) have HIV screening programs as recommended by the Centers for Disease Control and Prevention. Recent federal legislation includes incentives for electronic health record (EHR) adoption. Our objective was to analyze the impact of conversion to EHR on a mature ED-based HIV screening program. A retrospective pre- and post-EHR implementation cohort study was conducted in a large urban, academic ED. Medical records were reviewed for HIV screening rates from August 2008 through October 2013. On 1 November 2010, a comprehensive EHR system was implemented throughout the hospital. Before EHR implementation, labs were requested by providers by paper orders with HIV-1/2 automatically pre-selected on every form. This universal ordering protocol was not duplicated in the new EHR; rather it required a provider to manually enter the order. Using a chi-squared test, we compared HIV testing in the 6 months before and after EHR implementation; 55,054 patients presented before, and 50,576 after EHR implementation. Age, sex, race, acuity of presenting condition, and HIV seropositivity rates were similar pre- and post-EHR, and there were no major patient or provider changes during this period. Average HIV testing rate was 37.7% of all ED patients pre-, and 22.3% post-EHR, a 41% decline (p < 0.0001), leading to 167 missed new diagnoses after EHR. The rate of HIV screening in the ED decreased after EHR implementation, and could have been improved with more thoughtful inclusion of existing human processes in its design. [ABSTRACT FROM PUBLISHER]

Background Alcohol-related blackouts are periods of amnesia that reflect the failure of the brain to record memories of what transpires while drinking. This paper examined the incidence, predictors, and behavioral correlates of blackouts among emerging adults and examined whether questions about blackouts could serve as better markers of risk for other alcohol related harms than questions about levels of consumption. Methods In 2012 to 2013, 1,463 (68%) of 2,140 respondents 1-year past high school reported having consumed alcohol. They were asked whether, in the past 6 months because of drinking, they forgot where they were or what they did. The survey also explored demographics, substance use behaviors, and other alcohol-related problems in the past 6 months. Chi-square and logistic regression analyses explored bivariate and multivariate predictors of blackouts and other alcohol-related problems. Results Twenty percent of respondents who ever drank alcohol reported a blackout in the past 6 months. Blackouts were more prevalent among females and those who, in the past 30 days, used multiple drugs, more frequently binged, were drunk, smoked, had lower body weight, and lived in college dorms. After controlling for drinking levels, having a blackout was the strongest independent predictor of most other alcohol problems examined, including in the past 6 months because of drinking, missing class or work, getting behind in work or school, doing something respondents later regretted, arguing with friends, experiencing an overdose, and total number of alcohol problems reported. It was also an independent predictor of hangovers, damaging property, getting hurt, and trouble with police. Conclusions Because blackouts indicate drinking at levels that result in significant cognitive and behavioral impairment, questions about blackouts could serve as important, simple screeners for the risk of experiencing other alcohol related harms. Additional work on this subject is warranted. [ABSTRACT FROM AUTHOR]

Social capital is gaining prominence in social work discourse given its role in social and economic mobility. Yet measuring social capital pragmatically in terms of policy, practice and research is challenging because it suffers from lack of definitional clarity, leading to measurement disputes. We define social capital as access to knowledge and opportunities through networks to enhance social and/or economic mobility. To facilitate the integration of social capital into social work practice, we present the Resource Generator (RG) adapted for an urban US context to measure specific network-embedded resources. This paper reports the results from exploratory factor analyses measuring the reliability of this tool. Analyses suggested that a three-factor model was robust (χ²(29) = 30.93, p = 0.37; CFI = 0.994; TLI = 0.996; RMSEA = 0.024; AIC = 1917.26; BIC = 1863.71), which is dissimilar to the RG results reported in the UK. These factors--Expert Access, Problem Solving and Personal Support--provide insight as to how social capital resources converge in the USA. These findings also present a potential list of social capital items salient for the US context and highlight the utility of a measure for mezzo and macro social work practice in urban US settings. [ABSTRACT FROM AUTHOR]

Background: The correlates of alcohol misuse among female Veterans are not well understood. The present study explored associations among alcohol misuse, demographic/military-related characteristics, interpersonal violence exposure, and posttraumatic stress disorder (PTSD) and depression symptom severity. Method: Participants were 369 female Veteran patients of the VA New England Healthcare System. Participants completed a paper-and-pencil mail survey that included validated assessments of alcohol misuse, interpersonal violence, and psychological distress. Results: Younger age, adulthood physical abuse, military sexual trauma, past-year psychological aggression by an intimate partner, and PTSD and depression symptom severity showed significant univariate associations with alcohol misuse (as indicated by unsafe drinking levels, presence or incipience of an alcohol use disorder, intrapersonal alcohol-related concerns, and/or interpersonal alcohol-related concerns). A couple of these associations remained significant when examined in logistic regression models. Conclusions: Findings suggest that female Veterans who are at risk for alcohol use disorders and/or are experiencing alcohol-related problems may benefit from screening and intervention efforts that take into account interpersonal violence exposures and mental health symptoms on a case-by-case basis. Results also suggest the importance of future research examining correlates and risk factors for substance misuse among female Veterans. [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]

Background: Fewer than 9% of 12–17 year olds in need (∼146,000 of 1.7 million) receive inpatient or outpatient substance abuse recovery services or other mental health services (SAMHSA, 2012). The literature on adolescent addiction is sparse, however, as most published addiction recovery efforts involve adult populations—often college students. Objectives: The present study examined social influences on escalating substance use (from tobacco, alcohol, and marijuana use to polysubstance use involving opioids) for students enrolled in recovery high schools. Methods: A sample of 31 adolescents enrolled in substance use recovery high schools were surveyed on their patterns of substance use leading to their abuse of opioids. Results: Youth who begin their substance use as young as age 8 are often pressured by peer culture to do so and come from substance-using families. Their escalation in polysubstance use to a pattern including opioids was also most often attributed to peer influence over several years. Conclusions/Importance: This paper is one of scant few that address patterns of use in high school students. Perhaps most salient from this study are the tertiary prevention implications: similar to their adult counterparts, students enrolled in recovery high school programs are likely from substance-using families and have combined complex constellations of substances including opioids by dint of their relationships with substance-using peers. [ABSTRACT FROM PUBLISHER]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

Few studies have investigated the prevalence of hepatitis B virus (HBV) and C virus (HCV) infection among Vietnamese Americans (VAs). The purpose of this paper is to assess the prevalence of HBV and HCV infection, identify the sociodemographic characteristics of the HBV infected population and the level of HBV knowledge among VAs in the Baltimore-Washington metropolitan areas with data from a health fair in 2011. A total of 617 VAs received serological testing for HBV and HCV, and 329 completed a survey of HBV knowledge assessment. About 9 % were infected with HBV and 5 % with HCV. Vietnamese Americans younger than 30 years had the highest HBV prevalence (13.1 %) followed by those age 41-50 years (12.1 %). The prevalence of HCV infection was particularly higher among those older than 70 years old (13.9 %). Misunderstanding HBV as a food-borne disease is prevalent among VAs. Efforts to develop public health screening and education programs targeting this population are warranted. [ABSTRACT FROM AUTHOR]

The need to harmonize different outcome metrics is a common problem in research synthesis and economic evaluation of health interventions and technology. The purpose of this paper is to describe the use of multidimensional item response theory (IRT) to equate different scales which purport to measure the same construct at the item level. We provide an overview of multidimensional IRT in general and the bi-factor model which is particularly relevant for applications in this area. We show how both the underlying true scores of two or more scales that are intended to measure the same latent variable can be equated and how the item responses from one scale can be used to predict the item responses for a scale that was not administered but are necessary for the purpose of economic evaluations. As an example, we show that a multidimensional IRT model predicts well both the EQ-5D descriptive system and the EQ-5D preference index from SF-12 data which cannot be directly used to perform an economic evaluation. Results based on multidimensional IRT performed well compared to traditional regression methods in this area. A general framework for harmonization of research instruments based on multidimensional IRT is described. [ABSTRACT FROM AUTHOR]

Background and Aims There has been insufficient research attention to the alcohol industry's use of corporate sponsorship as a marketing tool. This paper provides a systematic investigation of the nature and extent of alcohol sponsorship-at the brand level-in the United States. Methods The study examined sponsorship of organizations and events in the United States by alcohol brands from 2010 to 2013. The top 75 brands of alcohol consumed by underage drinkers were identified based on a previously conducted national internet-based survey. For each of these brands, a systematic search for sponsorships was conducted using Google. The sponsorships were coded by category and type of sponsorship. Results We identified 945 sponsorships during the study period for the top 75 brands consumed by underage drinkers. The most popular youth brands were far more likely to engage in sponsorship and to have a higher number of sponsorships. The identified sponsorships overwhelmingly associated alcohol brands with integral aspects of American culture, including sports, music, the arts and entertainment, and drinking itself. The most popular brands among underage drinkers were much more likely to associate their brands with these aspects of American culture than brands that were less popular among underage drinkers. Conclusions Alcohol brand sponsorship must be viewed as a major alcohol marketing strategy that generates brand capital through positive associations with integral aspects of culture, creation of attractive brand personalities, and identification with specific market segments. Alcohol research, practice and policy should address this highly prevalent form of alcohol marketing. [ABSTRACT FROM AUTHOR]

Background: Shigellosis is an acute diarrheal disease transmitted through contaminated food, water, objects, poor hand hygiene, or sexual activity. Healthcare providers (HCP) may not be aware of the multiple routes of Shigella transmission, populations at increased risk, or importance of antibiotic susceptibility testing (AST). This study assessed HCP knowledge and clinical practices regarding shigellosis and antibiotic resistance. Methods: Porter Novelli Public Services administered a web-based survey (Fall DocStyles 2020) to HCP in the United States. Pediatricians, primary care physicians, nurse practitioners, and physician assistants completed questions about knowledge and clinical practice of acute diarrhea and shigellosis. Results: Of 2196 HCP contacted, 1503 responded (68% response rate). Most identified contaminated food (85%) and water (79%) as routes of Shigella transmission; fewer recognized person-to-person contact (40%) and sexual activity (18%). Men who have sex with men (MSM) were identified as being at risk for shigellosis by 35% of respondents. Most reported counseling patients to wash hands (86%) and avoid food preparation (77%) when ill with shigellosis; 29% reported recommending avoiding sex. Many HCP reported treating shigellosis empirically with ciprofloxacin (62%) and azithromycin (32%), and 29% reported using AST to guide treatment. Conclusions: We identified several gaps in shigellosis knowledge among HCP including MSM as a risk group, person-to-person transmission, and appropriate antibiotic use. Improving HCP education could prevent the spread of shigellosis, including drug-resistant infections, among vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: Understanding the interplay between psychosocial factors and polygenic risk scores (PRS) may help elucidate the biopsychosocial etiology of high alcohol consumption (HAC). This study examined the psychosocial moderators of HAC, determined by polygenic risk in a 10-year longitudinal study of US military veterans. We hypothesized that positive psychosocial traits (e.g. social support, personality traits, optimism, gratitude) may buffer risk of HAC in veterans with greater polygenic liability for alcohol consumption (AC). Methods: Data were analyzed from 1323 European-American US veterans who participated in the National Health and Resilience in Veterans Study, a 10-year, nationally representative longitudinal study of US military veterans. PRS reflecting genome-wide risk for AC (AUDIT-C) was derived from a Million Veteran Program genome-wide association study (N = 200 680). Results: Among the total sample, 328 (weighted 24.8%) had persistent HAC, 131 (weighted 9.9%) had new-onset HAC, 44 (weighted 3.3%) had remitted HAC, and 820 (weighted 62.0%) had no/low AC over the 10-year study period. AUDIT-C PRS was positively associated with persistent HAC relative to no/low AC [relative risk ratio (RRR) = 1.43, 95% confidence interval (CI) = 1.23–1.67] and remitted HAC (RRR = 1.63, 95% CI = 1.07–2.50). Among veterans with higher AUDIT-C PRS, greater baseline levels of agreeableness and greater dispositional gratitude were inversely associated with persistent HAC. Conclusions: AUDIT-C PRS was prospectively associated with persistent HAC over a 10-year period, and agreeableness and dispositional gratitude moderated this association. Clinical interventions designed to target these modifiable psychological traits may help mitigate risk of persistent HAC in veterans with greater polygenic liability for persistent HAC. [ABSTRACT FROM AUTHOR]

The ability to respond flexibly in situations is critical to individual well-being and couples' functioning in romantic relationships. The Flexibility in Partner Perspectives Scale (FiPPS) was developed and validated so that two key aspects of relational flexibility—specifically the ability to generate alternative perspectives and respond non-defensively when alternative perspectives are raised within challenging partner situations—can be studied and targeted in interventions for distressed couples. We introduce the FiPPS as an 8-item self-report questionnaire composed of two 4-item subscales that measure these aspects, respectively. In Study 1, individuals (N = 208) in committed relationships were recruited online to answer questionnaires relating to relational flexibility and various aspects of the couple's and individual's functioning. We used parallel analysis and exploratory factor analysis to examine the psychometric properties of the 25 items developed for the FiPPS and to reduce the number of items retained in the final measure. The FiPPS was then validated in Study 2 using confirmatory factor analysis with a separate online sample of individuals (N = 430) in committed relationships. A subset of Study 2's sample (N = 196) was used to establish test–retest reliability. Studies 3 and 4 demonstrated FiPPS' predictive validity by showing in two additional samples (N = 260 treatment-seeking couples, N = 85 Hispanic/Latinx couples) that individuals who scored higher on the FIPPS scale also reported greater relationship satisfaction. Taken together, the FiPPS appears to be a brief and useful measure that predicts relationship satisfaction above and beyond general cognitive flexibility and perspective taking. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the relationship between cancer history and healthcare utilization among Asians residing in the United States. Methods: A cross-sectional analysis used 2011-2018 National Health and Nutrition Examination Survey data, focusing on the Asian demographic. Multiple logistic regression analyses evaluated the relationships between sociodemographic characteristics, cancer history, and healthcare utilization outcomes. These outcomes included self-rated health, healthcare usage during the previous year, overnight hospitalizations during the previous year, and the establishment of a routine healthcare facility. Results: A total of 2,956 Asian participants were included in our study. We found that cancer history significantly influences self-rated health, the frequency of healthcare visits, and the likelihood of overnight hospital stays. However, it did not significantly correlate with having a consistent healthcare provider. Among the various sociodemographic characteristics, both citizenship and health insurance emerged as influential factors in healthcare utilization among Asians. Conclusion: Our findings emphasize the importance of enhancing the well-being of individuals with a history of cancer, aiming to optimize their access to, and use of, healthcare services. Continued research in this area is essential for the formulation of targeted interventions and policies to bridge health disparities and improve health outcomes of Asian Americans. [ABSTRACT FROM AUTHOR]

This study aims to describe and understand the relationship between sociodemographic factors and PrEP awareness, and willingness to use a PrEP modality (oral or injectable).Despite the availability of effective prevention tools such as HIV preexposure prophylaxis (PrEP), African immigrants in the United States are disproportionately affected by HIV. Although PrEP can significantly reduce HIV infection in this population, research evidence on PrEP outcomes, such as awareness, knowledge, and willingness to use, is extremely limited. Between April and May 2022, 92 participants completed an online survey assessing their awareness, knowledge, and willingness to use oral or injectable PrEP. The association between sociodemographic characteristics and PrEP-related measures was examined using descriptive and Pearson's chi-squared or Fisher's exact tests. Participants (N = 92) were born between 1990 and 1999 (46.7%), female (70.76%) and highly educated (59.6%). About 52.2% were unaware of PrEP, and 65.6% were willing to use a PrEP modality. Findings indicate that individuals who reported being aware of PrEP demonstrated a high level of knowledge regarding the medication. Having a healthcare provider was associated with PrEP awareness and willingness to use, while educational status was associated with PrEP awareness. 51.1% of participants were willing to use an oral pill for prevention and 47.8% were willing to use injectable PrEP. Our findings highlight the need for PrEP-related research and interventions for African immigrants to increase awareness and provide options for HIV prevention, as African immigrants are currently not well-represented in PrEP delivery systems in the US. [ABSTRACT FROM AUTHOR]

When constructing measurement scales, regular and reversed items are often used (e.g., "I am satisfied with my job"/"I am not satisfied with my job"). Some methodologists recommend excluding reversed items because they are more difficult to understand and therefore engender a second, artificial factor distinct from the regular-item factor. The current study compares two explanations for why a construct's dimensionality may become distorted: response difficulty and item extremity. Two types of reversed items were created: negation items ("The conditions of my life are not good") and polar opposites ("The conditions of my life are bad"), with the former type having higher response difficulty. When extreme wording was used (e.g., "excellent/terrible" instead of "good/bad"), negation items did not load on a factor distinct from regular items, but polar opposites did. Results thus support item extremity over response difficulty as an explanation for dimensionality distortion. Given that scale developers seldom check for extremity, it is unsurprising that regular and polar opposite items often load on distinct factors. [ABSTRACT FROM AUTHOR]

We examined public opinion regarding unique aspects of abortion legality to better understand potential contexts in which stigma may occur and the extent that people (a) believe actors involved in abortion (i.e., pregnant woman, healthcare provider, man involved in the pregnancy, someone providing information about where to get an abortion, parents of a minor) should be held responsible for illegal abortion, (b) believe abortion should be illegal across different circumstances, and (c) endorse different punishments for pregnant women and healthcare providers, including variation by responsibility. An online survey was administered to 2,489 English and Spanish-speaking U.S. adults, using quota-based sampling, with post-stratification weights applied to match U.S. benchmarks. People scored healthcare providers and women more responsible than other actors. Although the majority did not support abortion being illegal for most circumstances, a substantial proportion were unsure. Additionally, "no punishment" was most frequently selected for the woman and healthcare provider. However, those who endorsed any punishment, compared with no punishment, typically indicated the pregnant woman and healthcare provider were more responsible. Our findings suggest that current laws criminalizing abortion are misaligned with public opinion and that pregnant women and healthcare providers are likely most susceptible to abortion-related stigma. [ABSTRACT FROM AUTHOR]

Background: Studies show conflicting evidence on the association of age and occupational injury in agriculture, and few studies have addressed the effect of age on work-related chronic conditions or preventive practices among farmers. Methods: We examined the probability of injury, work-related stress, musculoskeletal symptoms (MSS), and preventive practices for MSS as a function of aging using surveillance data of 7,711 farm and ranch operators in the central United States. Findings: Segmented regression analyses of men (85% of sample) indicated that the probability of all four outcomes increased up to a certain age and then decreased; the changepoints in years of age being 59.6 for injury, 55.4 for work-related stress, 59.6 for MSS, and 67.9 for MSS preventive practices. Female operators had an increasing trend for stress up to age 29.7, while they showed no changepoints across their age spectrum in the proportion of injury, MSS, and prevention techniques. Conclusion/Application to Practice: These findings emphasize the need for preventive efforts particularly among younger and middle-aged farmers and ranchers, and the need to modify work duties to match work abilities at older ages. [ABSTRACT FROM AUTHOR]

Distrust and partisan identity are theorized to undermine health communications. We examined the role of these factors on the efficacy of discussion groups intended to promote vaccine uptake. We analyzed survey data from unvaccinated Facebook users (N = 371) living in the US between January and April 2022. Participants were randomly assigned to Facebook discussion groups (intervention) or referred to Facebook's COVID-19 Information Center (control). We used Analysis of Covariance to test if the intervention was more effective at changing vaccination intentions and beliefs compared to the control in subgroups based on participants' partisan identity, political views, and information trust views. We found a significant interaction between the intervention and trust in public health institutions (PHIs) for improving intentions to vaccinate (P =.04), intentions to encourage others to vaccinate (P =.03), and vaccine confidence beliefs (P =.01). Among participants who trusted PHIs, those in the intervention had higher posttest intentions to vaccinate (P =.008) and intentions to encourage others to vaccinate (P =.002) compared to the control. Among non-conservatives, participants in the intervention had higher posttest intentions to vaccinate (P =.048). The intervention was more effective at improving intentions to encourage others to vaccinate within the subgroups of Republicans (P =.03), conservatives (P =.02), and participants who distrusted government (P =.02). Facebook discussion groups were more effective for people who trusted PHIs and non-conservatives. Health communicators may need to segment health messaging and develop strategies around trust views. [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]

Vaccine hesitancy has, for a considerable time, been a significant risk to global health. As an integral part of disease prevention, vaccines have become a public health matter which is often debated among the community in spite of proven scientific evidence of their efficiency. A questionnaire was designed to evaluate the perception and knowledge of a population and compare it with behavior in order to assess a demographic within a sample population of 245 individuals selected at random within the United States, Here, we aim to clarify the difference between vaccine opinion among the general public as compared to vaccination status. Chi-squared analysis was done with the categorical data showing a statistically significant result when comparing parents versus non-parents, and Asian/Asian Americans against other ethnicities. All other comparisons were statistically insignificant. When looking at participant responses, PCPs did not discuss vaccines at all with 32% of the sample. The need for PCPs to provide educational information to certain ethnicities may play an important role in public health. [ABSTRACT FROM AUTHOR]

Background: The coronavirus 2019 (COVID-19) pandemic fundamentally changed how populations interface with the healthcare system. Despite historical spikes in US mortality during the pandemic, emergency department (ED) visits were paradoxically low. This is a concerning phenomenon that raises a red flag regarding access to care, especially among vulnerable populations. In this study we sought to understand how ED utilization evolved during the COVID-19 pandemic among traditionally understudied, low-income, racially diverse US- and foreign-born mothers. Methods: This is a secondary analysis of a pre-existing dataset of 3,073 participants enrolled in the Boston Birth Cohort at birth and followed prospectively. We obtained ED visit diagnoses from 2019 and 2020 via electronic health records, categorized according to the International Classification of Diseases, 10th Revision, and compared them using graph plots, chi-square, and negative binomial regression. Results: The number of ED visits decreased by 29.1% (P < 0.001) from 2019 (1,376) to 2020 (976). However, visits for infectious and parasitic diseases, including COVID-19, increased by 90.6% (32:61) with COVID-19 accounting for 77%of those visits in 2020 (47/61).Mental health-related visits increased by 40.9% (44:62), with diagnoses of alcohol use disorder increasing by 183% (6:17). Regression analysis showed 50% less EDutilization among foreign- vsUS-born participants; however, the increase in infectious diseases visits was greater among foreign-born compared to US-born mothers (185% vs 26%, P = 0.01), while the increase in mental health diagnoses was greater among US-born mothers (69% vs -33%, P = 0.10). Conclusion: Despite a decrease in total ED visits during the pandemic, there was an increase in COVID-19- (immigrant > US born) and mental health- (US-born only) related visits. Our findings demonstrate that EDs remain a critical access point for care for minority populations and have implications for preparedness, resources, and services of EDs in urban settings to better address the needs of communities. However, alternative avenues for healthcare services for these populations, particularly during health crises, warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: During the early evolution of femoroacetabular impingement (FAI) treatment, undercorrection of femoral deformity was a leading cause of hip arthroscopy failures. As the pendulum has swung, overresection of femoral deformity has increased in prevalence as a cause of persistent hip pain after arthroscopy. Computed tomography (CT) scans are increasingly being used in hip arthroscopy for preoperative planning purposes and may allow for improved 3-dimensional (3D) assessment of complex femoral deformities after previous femoroplasty. Purpose: To assess whether CT scans provide additional utility over standard radiographs in understanding proximal femoral morphology in patients being evaluated for revision hip arthroscopy after previous femoroplasty in the setting of FAI. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: Preoperative CT scans and standard radiographs were obtained in 80 patients who underwent revision hip arthroscopy for FAI. The anteroposterior and Dunn radiographic views were used to assess patients for residual proximal femoral deformity and were compared with the CT scan views using a commercially available software program. Determinations of underresection were made using alpha angle, while overresection was determined according to a previously described technique. Chi-square tests were performed to determine statistical significance between radiographic and CT classifications of overresection, underresection, and concomitant over- and underresection. A kappa value was calculated to determine the agreement between measurements on the radiographs and CT scans. Results: There were 30 patients (37.5%) for whom the CT scans revealed information about femoral morphology that was not detected on the radiographs. The kappa value of agreement was 0.28 between CT and radiographic measurements. Underresected cams were detected in 30 patients (37.5%) on CT scans versus 17 patients (21.3%) on radiographs (P =.024). Overresected cams were detected in 31 patients (38.8%) on CT scans versus 14 patients (17.5%) on radiographs (P =.0049). Concomitant areas of under- and overresection were detected in 12 patients (15.0%) on CT scans versus 3 patients (3.8%) on radiographs (P =.027). Conclusion: CT scans with 3D planning software may be more sensitive than traditional radiographic views at detecting aberrant proximal femoral anatomy in the setting of failed FAI surgery. The use of 3D planning software may be considered as an adjunctive tool to better understand complex deformity in the proximal femur for the planning of revision hip arthroscopy. [ABSTRACT FROM AUTHOR]

Introduction: Orthognathic surgery is routinely practiced, yet little comparative data exists to evaluate post-orthognathic surgery diet protocols. Objective: To evaluate which postoperative diet protocols are recommended and to quantify post-orthognathic surgery weight changes in our institutional cohort. Methods: An internet search was carried out on Google for "orthognathic surgery diet" and the postoperative diet recommendations from centers worldwide were quantified. Additionally, a retrospective analysis of patients that underwent orthognathic surgery at our institution was performed, and their preoperative and postoperative weights were recorded. Results: The internet search yielded 58 centers that met our inclusion criteria. Most centers were in the United States (n = 37, 63.8%) and were oral and maxillofacial surgeon (OMFS)-led centers (n = 39, 67.2%). Postoperative diets were categorized into 7 distinct protocols, ranging from most to least restrictive—the most popular was liquid diet for 2 to 4 weeks followed by soft diet for 2 to 6 weeks. There were no significant patterns observed across different geographical regions or specialties. In our institution, 135 patients were identified. Overall, there was an average maximum weight loss of 4.1 kg by week 4, followed by a gradual increase in weight. Linear regression analysis showed that patients with greater preoperative body mass index (BMI) lost more weight postoperatively than patients with lower BMI (R2 = 0.25, P <.001). Conclusion: There is a significant variability in recommended postoperative diets following orthognathic surgery. Following a moderately restrictive diet at our institution, patients returned to their preoperative weight after approximately 4 months. [ABSTRACT FROM AUTHOR]

Objective: A skewed percentage of industry payments goes to "key opinion leaders" (KOLs) whose prominence and influence has increased with time. Given that KOL is neither precisely defined nor quantifiable, we turned to the level of industry payments as a surrogate quantifiable metric and assessed the associations between industry payments to US rheumatologists and their authorships of publications in high‐impact rheumatology journals. Methods: Payments to US rheumatologists during the 2015‐2020 interval were obtained from the Centers for Medicare and Medicaid Services Open Payments database, and authorships were tallied for calendar year 2021 publications in the four rheumatology journals (Lancet Rheumatol, Nat Rev Rheumatol, Ann Rheum Dis, Arthritis Rheumatol) with the highest 2021 journal impact factors and journal citation indicators. Differences between groups were determined by chi‐squared test, unpaired Student's t‐test, one‐way analysis of variance (ANOVA), Mann–Whitney rank sum test, and Kruskal–Wallis one‐way ANOVA on ranks. Correlations were calculated using Spearman rank order. A P value ≤0.05 was considered significant. Results: There were 278 individual US rheumatologists who received industry payments and served as authors of publications in the four high‐impact rheumatology journals. Non–research‐associated payments to these individuals strongly correlated with research‐associated payments. Payments to male US rheumatologists were greater than those to their female counterparts, and payments strongly correlated with the number of publications among male authors but only weakly, and often not significantly, among female authors. Conclusion: A substantial fraction of the authorships in calendar year 2021 publications in four high‐impact rheumatology journals arose from a very small percentage of all US rheumatologists who had received industry payments during the 2015‐2020 interval. Payments to male US rheumatologist‐authors were strikingly different from those to female US rheumatologist‐authors, and further investigation is needed to explain the glaring difference in payments. [ABSTRACT FROM AUTHOR]

Background: Pre-injury opioid use is common, but the effects of opioid-related polysubstance use on mortality and health resources utilization (HRU) have not been investigated yet. The objective of this study was to investigate the effects of opioid-related polysubstance use on mortality and HRU among patients in trauma centres in the US. Methods: We conducted a retrospective cross-sectional study using the US National Trauma Databank from the year 2017 to 2019. Patients (≥ 18 years of age) who tested positive for opioids were included. Patients were analysed based on the number of substances used (i.e., opioids only, two substances (opioids + 1 substance), and three or more than three substances (opioids + ≥ 2 substances)), and polysubstance by type (i.e., opioids only, opioids and alcohol, opioids and stimulants, opioids and benzodiazepine, and other combinations). Multivariate logistic regression was used to determine the association between polysubstance use, mortality and HRU (i.e., need for hospital admission, ICU, and mechanical ventilation). Results: Both polysubstance by number and type analyses showed that opioid-related polysubstance use was not significantly associated with mortality compared to opioids only. The odds of hospital admission were higher among the opioids and benzodiazepines group (OR 1.15, 95% CI 1.06–1.24, p < 0.01). The need for ICU was magnified using benzodiazepines and stimulants with opioids (OR 1.44, 95% CI 1.27–1.63, p < 0.01) when compared to the opioids only group. Conclusion: Opioid-related pre-injury polysubstance use was associated with higher HRU in trauma patients. The evidence can be used by policymakers and practitioners to improve patient outcomes in trauma centers. [ABSTRACT FROM AUTHOR]