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Background: One in four South African women will experience intimate partner violence (IPV) in their lifetime, potentially increasing their biological stress. In South Africa, limited IPV and stress research has utilized multiple timepoints or examined modifying factors. Cash transfers (CTs) are associated with reduced IPV and stress and may be an intervention target. Aims: We used data-driven methods to identify longitudinal IPV trajectory groups among South African adolescent girls and young women (AGYW), estimate each group's association with stress, and assess modification by a CT. Methods: A total of 2,183 South African AGYW ages 13 to 24 years from the HIV Prevention Trials Network 068 study were randomized to a CT or control group. Physical IPV was measured five times (2011–2017), and stress was captured once (2018–2019). Stress measures included the Cohen Stress Scale and stress biomarkers (C-reactive protein (CRP), cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1)). Group-based trajectory modeling identified IPV trajectories; ordinal logistic regression estimated the association between trajectory group and stress. Results: A two-group quadratic trajectory model was identified (higher trajectory group = 26.7% of AGYW; lower trajectory group = 73.3%). In both groups, the probability of IPV increased from ages 13 to 17 years before declining in early adulthood. However, the higher group's probability peaked later and declined gradually. The higher trajectory group was associated with an increased odds of elevated CRP (OR: 1.41, 95% CI [1.11, 1.80]), but not with other stress measures. The CT modified the relationship with CMV: a positive association was observed among the usual care arm (OR: 1.59, 95% CI [1.11, 2.28]) but not the CT arm (OR: 0.85, 95% CI [0.61, 1.19]). Conclusions: Sustained IPV risk during adolescence was associated with elevated CRP in young adulthood. The relationship between IPV and elevated CMV was attenuated among those receiving a CT, suggesting that CTs could possibly reduce biological stress due to IPV. [ABSTRACT FROM AUTHOR]

Background: Workers' reporting of work-related injuries or illnesses is important for treatment and prevention, yet research often focuses on reporting barriers. This study aimed to identify factors related to work-related musculoskeletal disorder (WRMSD) reporting attitudes and their connection to reporting intention and behavior. Methods: We analyzed data from 377 direct care workers employed in 19 long-term care facilities in South Korea. A self-administered questionnaire collected demographics, job characteristics, physical and psychosocial factors, musculoskeletal symptoms, reporting attitudes, and WRMSD reporting intentions and behavior between May and August 2022. We used a generalized linear mixed model with a random intercept by employers to identify factors influencing reporting attitudes. To explore the relationship between reporting attitude and reporting intention and behavior, simple logistic regression was also conducted. Results: We achieved an 86% response rate. The majority of the study participants were female (87.2%), married (95.9%), and non-immigrant (72.8%). Of the study participants, 48.9% had no intention to report WRMSDs, and 44.3% held negative reporting attitudes. Among 200 workers with WRMSDs, 86.5% did not report them. Attitudes were associated with work duration, safety training, management safety priority, WRMSD experience, and symptom severity and frequency. Management safety priority did not moderate this relationship. Significant links existed between attitudes and reporting intention and behavior. Conclusions/Applications to Practice: This study highlights the vital influence of workers' attitudes on reporting work-related injuries and illnesses. Occupational health providers should employ strategies, such as tailored safety training and management commitment, with a focus on addressing the unique needs of long-tenured and musculoskeletal-exposed workers. Fostering a safety culture that promotes open and timely reporting is crucial, and implementing these strategies can significantly enhance workplace safety and health. [ABSTRACT FROM AUTHOR]

Background: Many long‐term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment. Objective: The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress. Design: This study was a descriptive, cross‐sectional survey using targeted sampling. Participants: A total of 215 participants completed the surveys. Participants were nationally representative of long‐term care nurses by age, years of experience, employment status, and type of health setting. Methods: This study was an online national survey of long‐term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long‐term care nurses. Results: The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = −0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = −0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = −0.19, p = 0.001). Conclusion: Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession. Clinical Relevance: Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay.Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession. [ABSTRACT FROM AUTHOR]

Core vocabulary lists are frequently used to select vocabulary for early symbolic communicators who require augmentative and alternative communication (AAC). The current study extended existing work by investigating how core vocabulary lists overlap and diverge from typical language development. We investigated when the words on seven core vocabulary lists emerge in typical language development, the composition of the lists based on their parts of speech, and how the composition of the words on the lists compare to the MacArthur Bates Communication Development Inventories (CDI). On average, the words on the seven core vocabulary lists appear after the second year of life in children with typical spoken language development (25, 27, 37, 45, 47, 50, and 66 months). Verbs were the most prevalent part of speech in all but one of the core vocabulary lists. Core vocabulary words made up only a small percentage of words on the CDI. The words on the core vocabulary lists do not emerge until later points in typical lexical development. Focussing on core words when working with early symbolic communicators who require AAC may lead to limited and variable lexicons with wide gaps. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the amount of time elementary and middle-school students spend away from the classroom and clinic time required to administer vaccines in school-located vaccination (SLV) clinics. We conducted a time study and estimated average time away from class and time to administer vaccine by health department (HD), student grade level, vaccine type, and vaccination process for SLV clinics during the 2012–2013 school year. Average time away from classroom was 10 min (sample: 688 students, 15 schools, three participating HD districts). Overall, time to administer intranasally administered influenza vaccine was nearly half the time to administer injected vaccine (52.5 vs. 101.7 s) (sample: 330 students, two HDs). SLV administration requires minimal time outside of class for elementary and middle-school students. SLV clinics may be an efficient way to administer catch-up vaccines to children who missed routine vaccinations during the coronavirus disease-2019 pandemic. [ABSTRACT FROM AUTHOR]

This study investigated the developmental trajectories of three perceptual domains related to regional dialect competence: the linguistic domain, tested through an intelligibility in noise task; the objective indexical domain, tested through locality judgments and a free classification task; and the subjective indexical domain, tested through smart and friendly judgments. To allow direct comparison across domains, participants aged 4–71 years (N = 302) completed all tasks with the same talkers from four regional dialects of American English. The results demonstrated that development in each of these domains is protracted, with changes occurring as late as early adulthood. However, the developmental trajectories for each task and the connections between them differed significantly among the stimulus dialects. These dialect-specific patterns suggest that dialect perception requires extensive exposure to variety-specific linguistic and socio-cultural information, and the lengthy timecourse of sociolinguistic development reflects the substantial exposure that is necessary to successfully integrate linguistic and social information. [ABSTRACT FROM AUTHOR]

BACKGROUND: Airway clearance therapy (ACT) is a core component of daily treatment for cystic fibrosis (CF). However, surprisingly little is known about sustained or persistent use of ACT over time among adults with CF. This longitudinal study examined persistent adherence to ACT over 12 months and its modifiable predictors, drawing on aspects of Social Cognitive Theory and the Theory of Planned Behavior. METHODS: Subjects were drawn from a regional CF center in the southern United States. Predictor variables evaluated at baseline included self-efficacy for ACT (ie, self-confidence in overcoming barriers), outcome expectations (ie, perceived necessity of ACT and concerns about its disruptive effects), and subjective norms (ie, perceptions of being influenced by others). The Cystic Fibrosis Treatment Questionnaire (CFTQ) was used to assess self-reported adherence to ACT at baseline, at 6 months, and at 12 months. RESULTS: The mean age of subjects was 27.2 ± 9.1 y, and mean FEV1% predicted was 65.5 ± 24.8. Forty-six percent of subjects reported persistent use of ACT (classified as adherent at all assessment periods). In bivariate analyses, all social cognitive predictor variables assessed at baseline were significantly related to persistent adherence (all P < .03), except subjective norms. In logistic regression analyses that modeled the effects of these predictors simultaneously while controlling for FEV1%, fewer baseline concerns about ACT (odds ratio = 0.82, 95% CI 0.69-0.99) and greater self-efficacy (odds ratio = 1.09, 95% CI 1.01-1.18) remained significant independent predictors. CONCLUSIONS: This longitudinal study addresses an important gap in the literature regarding adherence to ACT over time (12 mo) in a routine clinical setting. Persistent adherence was problematic. As anticipated, social cognitive variables (self-confidence and perceived concerns) predicted self-reported persistence, and these may represent practical targets for intervention. [ABSTRACT FROM AUTHOR]

Although communication is an essential part of the nursing process, nurses have little to no formal education in how to best communicate patient safety event (PSE) information to nursing home (NH) residents and their family members. The current mixed-methods study tested an intervention aimed at educating nurses on how to communicate a PSE to residents/ family members using a structured communication tool. Nurse participants improved their knowledge of PSE communication, especially about the cause of the event, what they would say to the resident/family member, and future prevention of the PSE. Through qualitative subgroup analysis, an increased number of empathic statements were noted postintervention. The tool tested in this study provides structure to an important care process that is necessary for improving the culture of safety in NH settings. [ABSTRACT FROM AUTHOR]

This study explored the influence of family health history-based obesity risk feedback for their child on 147 overweight mothers’ guilt related to children’s lifestyle behaviors and passing down a genetic propensity for overweight. Mothers were randomized to receive, or not, obesity risk feedback for their 4- to 5-year-old child and then made food choices for them using a virtual reality–based buffet. Receipt of risk information increased lifestyle- and genetics-related guilt. Choosing fewer unhealthful foods for the child attenuated both types of guilt. Work in this area may aid in development of obesity risk feedback strategies that enhance child feeding. [ABSTRACT FROM PUBLISHER]

Background. In 1998, the Centers for Disease Control and Prevention (CDC) published Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease, recommending HCV testing for populations most likely to be infected with HCV. However, the implementation of risk-based screening has not been widely adopted in health care settings, and 45% to 85% of infected U.S. adults remain unidentified. Objectives. To develop a better understanding of why CDC’s 1998 recommendations have had limited success in identifying persons with HCV infection and provide information about how CDC’s 2012 Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945-1965 may be implemented more effectively. Design. Qualitative data were collected and analyzed from a multidisciplinary team as part of the Birth Cohort Evaluation to Advance Screening and Testing for Hepatitis C project. Respondents. Nineteen providers were asked open-ended questions to identify current perspectives, practices, facilitators, and barriers to HCV screening and testing. Providers were affiliated with Henry Ford Hospital, Mount Sinai Hospital, the University of Alabama, and the University of Texas Health Science Center. Results. Respondents reported the complexity of the 1998 recommendations, and numerous indicated risk factors were major barriers to effective implementation. Other hindrances to hepatitis C testing included physician discomfort in asking questions about socially undesirable behaviors and physician uncertainty about patient insurance coverage. Conclusion. Implementation of the CDC’s 2012 recommendations could be more successful than the 1998 recommendations due to their relative simplicity; however, effective strategies need to be used for dissemination and implementation for full success. [ABSTRACT FROM AUTHOR]

Prescription drug misuse among older adults includes inappropriate and harmful use of these drugs. In this study, prescription drug misuse in assisted living settings as reported by direct care workers (DCWs) was examined. Data came from DCWs in 45 assisted living settings located in Pennsylvania. A total of 944 DCWs completed a questionnaire on their opinions of prescription drug misuse. DCWs believed most assisted living residents take prescription medications. In addition, 10% of DCWs observed or had evidence that residents used unnecessarily high doses, 30% were preoccupied with the cost of prescription drugs, and 26% had problems understanding the complexity of their drug treatment regimen. Prescription drug misuse may be a problem of importance in assisted living settings. Assisted living has experienced rapid growth in capacity, yet the ability of these settings and their residents to manage prescription drugs may not have kept pace with this growth. [ABSTRACT FROM AUTHOR]

People with high-functioning Autism (HFA) can accurately identify social categories from speech, but they have more difficulty connecting linguistic variation in the speech signal to social stereotypes associated with those categories. In the current study, the perception and evaluation of talker age by young adults with HFA was examined. The participants with HFA performed similarly to a typically-developing comparison group in age classification and estimation tasks. Moreover, the participants with HFA were able to differentiate among talkers of different ages in a language attitudes task and rated older talkers as more intelligent than younger talkers. These results suggest that people with HFA are able to make reasonable social judgments about talkers based on their speech, at least for familiar social categories and personally relevant social attitudes. [ABSTRACT FROM AUTHOR]

Introduction Hospitalized older adults experience more safety-related complications than younger patients, including increased falls and injurious falls, pressure ulcers, and adverse outcomes associated with restraint use. These clinical areas are dominantly under the control of nursing practice and thus are regarded as nursing-sensitive quality indicators. Certified nurses have demonstrated competency in evidence-based gerontological nursing care practice. However, the influence of nursing certification upon quality indicators is not established. Purpose The purpose of this study was to examine the relationship between nurse certification (in any specialty practice as well as gerontological) and unit-level, nursing- sensitive quality indicators in units that primarily serve older adults. Method In a sample of 44 medical and medical-surgical units in 25 NICHE (Nurses Improving Care for Healthsystem Elders) hospitals, a retrospective descriptive design used multivariate regression techniques. Findings Binary logistic regression modeling yielded a significant relationship between certification in any specialty and falls (chi-square wald=3.80, p=0.05, df=1). Conclusion Nursing-sensitive outcomes in hospitalized older adults may be influenced by nurse certification. The data from this pilot study support a larger prospective study that will investigate the relationship between nurse certification, workforce factors, and nursing-sensitive quality indicators in all types of units in both NICHE hospitals and non-NICHE hospitals. The inability of some program coordinators to obtain unit-level patient data points to the need for management tools and education related to quality improvement for mid-level managers. [ABSTRACT FROM AUTHOR]

Purpose of the Study: This study examines the association between nursing home accreditation and deficiency citations. Design and Methods: Data originated from a web-based search of The Joint Commission (TJC) accreditation and On-line Survey Certification of Automated Records from 2002 to 2010. Deficiency citations were divided into 4 categories: resident behavior and facility practices, quality of life, quality of care, and the most severe citations. Data were analyzed through negative binomial regression, where the number of residents at risk for each measure was the exposure level for that measure. Results: TJC-accredited nursing homes had fewer deficiency citations in all 4 deficiency categories examined. Comparing citations in the year of accreditation with the first year after accreditation, 3 of the 4 deficiency categories were significant. In comparing deficiency citations after 8 years of accreditation, all 4 categories of deficiencies were significant. In all cases, accreditation was associated with fewer deficiency citations. Implications: Our results indicate that TJC-accredited nursing homes improve their quality immediately after accreditation and continue to maintain these improvements over the long-term. These findings support the need for further discussion and facilitation of voluntary accreditation in nursing homes. [ABSTRACT FROM PUBLISHER]

Alcohol misuse and abuse in Assisted Living (AL) as reported by nurse aides is examined. Data came from a secondary analysis of nurse aides included in the Pennsylvania nurse aide registry. A total of 832 nurse aides had a prior place of employment in AL. Information reported from these nurse aides include the percent of residents identified as drinking alcohol, opinions of alcohol misuse and abuse, and the prevalence of alcohol misuse and abuse. Nurse aides believe a majority (69%) of AL residents drink alcohol. Of these residents, 34% are thought to drink alcohol daily. Estimated prevalence rates show that in 19% of cases nurse aides believe alcohol consumption has influenced residents’ health and 28% are suspected to make poor choices for alcohol consumption. The findings present preliminary evidence that alcohol misuse and abuse may be a problem of importance in AL. Given the potential impact of this on the health, safety, and quality of life for elders, more attention should be focused on alcohol misuse and abuse by residents living in AL. [ABSTRACT FROM PUBLISHER]

Previous research has documented shortages of personal care aides who provide Medicaid home and community-based services, but there are few detailed geographic data to determine the areas of greatest need and assess the availability of personal care aides nationwide. Using 2013-17 data from the American Community Survey and the Office of Management and Budget, we analyzed potential need for personal care aide services among adults and the supply of aides across the US. Areas with the highest percentages of adults with self-care disability were mainly in the South, and the gap between the potential need for personal care aide services and the aide supply was greatest in southern states. Within states, there were fewer personal care aides per 1,000 adults with self-care disability in the more rural and most rural areas than in the least rural areas. Wage and benefit increases, improved training and career opportunities, increased flexibility in state Medicaid policies on paid family caregiving, incentives and compensation for travel, and increased data collection and government tracking of workforce data could help boost the supply of personal care aides in rural America. [ABSTRACT FROM AUTHOR]