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Active learning tools are critical in imparting real world experiences to the students within a classroom environment. This is important because graduates are expected to develop software that meets rigorous quality standards in functional and application domains with little to no training. However, there is a well-recognized need for the availability of effective active tools. This need has been addressed by the authors by designing, developing, and delivering, twenty delivery hours of Case Studies, sixteen delivery hours of Class Exercises, and six delivery hours of Video Case Studies for use in V&V courses. The active learning tools focus on some specific SV&V topics such as "requirements engineering," "software reviews," "configuration management," and "software testing." Four key skill areas sought after by employers, namely "communication skills," "applied knowledge of methods," "applied knowledge of tools," and "research exposure" have been used to drive the development funded by a National Science Foundation grant and perfected through an industry-academia partnership. These tools have been successfully disseminated to over 25 universities with many CS, IS, SE programs incorporating the tools in their existing courses and others designing new courses based on these tools. In this paper we present data on the student feedback and pedagogical effectiveness of the strategies used to effectively incorporate and deliver the developed active learning tools by instructors at two universities. Traditional and flipped classroom delivery strategies are discussed as well as topics like prerequisite knowledge preparation prior to class, course module presentation sequence, homework, team/individual work, collaborative discussions, and assessment tools are deliberated. The student questionnaire data from the two University Partners who used the V&V instructional activities were quite positive and showed that students were interested in the activities, saw the real-world applications, and communicated with their classmates as they solved the problems. Educational outcomes assessment demonstrated more effective learning in all key learning areas.

An introductory course is the discipline's handshake; it is the greeting that either seals the deal or in varying degrees convinces the learner that this discipline has little usefulness. Given the huge stakes in forming a strategy for the introductory course, how should we structure the course? The argument in this paper is that we should encourage students to think deeply about the discipline. In other words, we should encourage an appreciation for the complexity of the vocabulary, the underlying assumptions, and the kinds of evidence relied on in the discipline in question. (Contains 1 table.)

Purpose: The purpose of this paper is to investigate the factor structure and the measurement invariance of the Multifactor Leadership Questionnaire (MLQ) across gender of K-12 school principals (n=6,317) in the USA. Design/methodology/approach: Nine first-order factor models and four second-order factor models were tested using confirmatory factor analysis. Findings: The results suggested that the nine-factor model provided the best fit for the data. Further examination revealed that most constructs lacked convergent validity and discriminant validity. Second-order factor models were tested and the hierarchical model with two higher order factors (i.e. transformational and transactional leadership) was deemed the best fit and it was then tested for measurement invariance between females and males. The measurement model was found to be invariant across gender. Findings suggested that female school principals demonstrated significantly greater transformational leadership behaviour, while male school principals demonstrated significantly greater transactional leadership behaviour. Originality/value: This study addressed construct and factor issues previously associated with the MLQ in the measurement of transformational and transactional leadership among a variety of organizations. By using a sample of K-12 school principals across gender, this study has provided support that may ameliorate contextual doubts of transformational leadership behaviour when examining the relational aspects needed to improve schools.

In this paper, we examine the benefits of employing an inverted or "flipped" class design in a Transition-to-Proof course for second-year mathematics majors. The issues concomitant with such courses, particularly student acquisition of "sociomathematical norms" and self-regulated learning strategies, are discussed along with ways that the inverted classroom can address these issues. Finally, results from the redesign of a Transition-to-Poof class at the author's university are given and discussed.

Motivating students in analytical chemistry can be challenging, in part because of the complexity and breadth of topics involved. Some methods that help encourage students and convey real-world relevancy of the material include incorporating environmental issues, research-based lab experiments, and service learning projects. In this paper, we describe an approach that combines all three of these methods by integrating environmental research-based activities into the second-year undergraduate analytical chemistry course. We discuss the development, implementation, and preliminary evaluation of the research-based labs employed during the new summer analytical chemistry course. Students perform environmental investigations of sites on Beaver Island, Michigan, and prepare reports to contribute to an ongoing research project analyzing these locations that began in the 1970s. Preliminary impacts on analytical students were examined using pre- and postsurveys, including the Chemistry Attitudes and Experiences Questionnaire, and a new survey and questionnaires developed for this work. Responses and grades were compared across three summers, and to those from students in the traditional analytical course. Results suggest that the research-based activities positively impacted aspects of student attitudes, their perceptions of how chemistry knowledge influences understanding of environment issues, and their perceptions of how analytical techniques are applied in the real-world. Students indicated that the new labs provided real-world applications of class content, helped them learn new concepts and gain skills working with others, and helped them feel more confident conducting chemistry-related experiments.

This paper reports the results of a survey of student satisfaction with electronic library resources other than the online catalog at Wayne State University. Undertaken in Fall Term 2000 as a class project for a marketing course, a student team designed, administered, and analyzed a survey of a random sample of students. Almost 40% of the responding students said that they were unaware of electronic resources though 53.8% of these same students answered subsequent questions about use of these resources. Students aware of electronic resources learned about them much more from their professors (38.3%) than from library efforts to publicize them (18.5%). Students were generally satisfied (68%) except when things went wrong. A high percentage of all students (92.4%) answered that the library should continue to expand electronic resources.

The Sequential Intercept Model has helped conceptualize interventions for people with serious mental illness in the criminal/legal system. This paper operationalizes the Sequential Intercept Model into a 35-item scorecard of behavioral health and legal practices. Using interviews, survey, and observational methods, the scorecard assesses an exploratory sample of 19 counties over 27 independent data collections. A series of ordinary least squares regression models assessed the predictor scores on four jail outcomes: prevalence of serious mental illness, length of stay, connections to treatment, and recidivism. Increases in pre-booking scores showed significant decreases in jail prevalence of serious mental illness at the p < 0.05 level, and post-booking scores and overall scores showed significant positive associations with connections to treatment at the p < 0.05 level, though these were non-significant after correcting for multiple comparisons. Preliminary findings suggest a combination of practices across the Sequential Intercept Model could have synergistic impacts on key jail diversion outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Arab Americans experience higher rates of mental illness and lower rates of treatment compared to the general population. While some factors leading to this disparity have been proposed, data in the literature remains lacking. This study aims to explore the mental health perspectives of Arab Americans living in Southeastern Michigan regarding barriers to mental health treatment, treatment resource preferences and telemental health preferences. Design/methodology/approach: Responses were collected through an anonymous bilingual Qualtrics survey from both Arab and non-Arab participants (n = 294, ages 18+) in Southeastern Michigan. Participants' perceptions regarding mental health barriers, resource preferences and telemental health were assessed. Comparisons were performed between Arabs and non-Arabs, and among Arabs. Findings: Compared to non-Arabs, Arabs were less likely to seek mental health treatment from a therapist or a primary care provider and were more likely to not seek treatment. Arabs were more likely than non-Arabs to list fear of being called crazy by others and cultural barriers. With regards to preferences on telemental health utilization, no significant differences between Arab and non-Arab participants were found. Originality/value: The results provide insights into Arab-American mental health perspectives, especially pertaining to mental health barriers, resources and telemental health preferences, adding a novel perspective on the mental health preferences of Arab-American subgroups, especially regarding gender and age differences. This study highlights the Arab-American population as a nuanced and diverse group, emphasizing the importance of future studies to show a more complete picture of Arab-American mental health. [ABSTRACT FROM AUTHOR]

Purpose: Mood and anxiety disorders affect 20–30 percent of school-age children, contributing to academic failure, substance abuse, and adult psychopathology, with immense social and economic impact. These disorders are treatable, but only a fraction of students in need have access to evidence-based treatment practices (EBPs). Access could be substantially increased if school professionals were trained to identify students at risk and deliver EBPs in the context of school-based support services. However, current training for school professionals is largely ineffective because it lacks follow-up supported practice, an essential element for producing lasting behavioral change. The paper aims to discuss these issues. Design/methodology/approach: In this pilot feasibility study, the authors explored whether a coaching-based implementation strategy could be used to integrate common elements of evidence-based cognitive behavioral therapy (CBT) into schools. The strategy incorporated didactic training in CBT for school professionals followed by coaching from an expert during co-facilitation of CBT groups offered to students. Findings: In total, 17 school professionals in nine high schools with significant cultural and socioe-conomic diversity participated, serving 105 students. School professionals were assessed for changes in confidence in CBT delivery, frequency of generalized use of CBT skills and attitudes about the utility of CBT for the school setting. Students were assessed for symptom improvement. The school professionals showed increased confidence in, utilization of, and attitudes toward CBT. Student participants showed significant reductions in depression and anxiety symptoms pre- to post-group. Originality/value: These findings support the feasibility and potential impact of a coaching-based implementation strategy for school settings, as well as student symptom improvement associated with receipt of school-delivered CBT. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Person‐centered care, as compared to standard approaches, is a widely accepted, evidence‐based approach for managing aggressive behaviour in persons with dementia. The attitudes, beliefs and values of long‐term care and mental health nursing employees are important prerequisites to implementing person‐centered practices. Research shows that nursing employees typically support person‐centered approaches; however, less is known about the attitudes of non‐nursing employee groups. What this paper adds to existing knowledge: Nurse managers and administrators tended to agree with person‐centered approaches for managing aggression in dementia, suggesting some prerequisites are in place to support wider adoption of person‐centered frameworks. Employees with more resident contact tended to support person‐centered approaches the least, suggesting discipline‐specific trainings may not be adequate for preparing frontline staff to use person‐centered techniques. Attitudes towards aggressive behaviour may be especially varied and contradictory within certain employee groups, providing implications for facility‐wide initiatives. Implications for practice: Person‐centered values and practices should be monitored and reinforced across the organization. Person‐centered trainings should be interdisciplinary in nature and focused on care areas, such as mealtime or bathing. Long‐term care facilities should consider allowing nurse management and registered nurses to share the burden of direct resident care with frontline employees on a more regular basis. Abstract: Introduction: Implementing person‐centered care requires shared attitudes, beliefs and values among all care employees. Existing research has failed to examine the attitudes of non‐nursing employees. Aim: This study examined attitudes towards aggression among nursing and non‐nursing employees to address gaps in existing research and assess readiness for wider adoption of person‐centered frameworks. Method: The Management of Aggression in People with Dementia Attitude Questionnaire was used to survey attitudes of employees in Michigan‐based nursing homes. Results: Overall, employees preferred person‐centered over standard approaches. Job title was a significant predictor of paradigm support. Frontline employees were found to support person‐centered attitudes the least. Wide‐ranging responses were noted within employee groups. Discussion: Job title may influence the degree to which an employee supports and utilizes person‐centered approaches. Employees with the most contact with persons with dementia may be the least likely to implement person‐centered approaches. In contrast to prior studies, years of experience was not a significant predictor of attitude towards aggressive behaviour. Wide‐ranging responses indicate that employee attitudes are varied and complex. Implications: Person‐centered approaches should be trained within care areas rather than individual employee groups. Programs should be interdisciplinary and seek to establish a shared understanding of person‐centered beliefs and values. [ABSTRACT FROM AUTHOR]

hma and obesity-related health problems disproportionately impact low-income ethnic minority communities residing in urban areas. Environmental risk factors, particularly those related to housing and indoor air, may impact the development or exacerbation of asthma. There is increasing evidence to suggest a link between obesity-related health problems and asthma. Previous studies have also reported that immigrant status may influence myriad risk factors and health outcomes among immigrant populations. The Arab American Environmental Health Project (AAEHP) was the first study to explore environmental health problems among Arab Americans. This paper examined whether hypertensive status modified the relationship between environmental risk factors and asthma among Arab Americans in metro Detroit. An environmental risk index (ERI) was used to quantify household environmental risk factors associated with asthma. Physician diagnosed hypertension was self-reported, and asthma status was determined using responses to a validated symptoms checklist and self-reported diagnosis by a physician. Hypertension significantly modified the relationship between ERI and asthma in this study population. The positive association between household environmental risk factors and asthma was stronger among participants diagnosed with hypertension. Effect modification of the relationship between environmental risk factors and asthma could have serious implications among high-risk communities. However, further research is needed to elucidate the relationships between hypertension, environmental risk factors, and asthma. [ABSTRACT FROM AUTHOR]

Pediatric vision screening is important because approximately 80% of visual impairments, including amblyopia, can be prevented or cured, especially if caught early. This retrospective study aims to determine whether the implementation of a machine photoscreener improves vision outcomes in 1- to 4-year-old children in an urban clinic. Before the vision screener, 91 patients were seen (control group), while 205 were seen following its implementation (study group). The number of children screened increased by 27.4% after implementing the photoscreener (57.1% study, 29.7% control, P <.001). All patients who failed the screening, 14.6% in the study period, were referred to ophthalmology (n = 30); 40% (n = 12) were evaluated, and 9 were diagnosed with a true vision abnormality. Instrument vision screening allows children as young as 1 year to be screened and allows for early intervention for potential vision-threatening pathologies in a vulnerable urban population. [ABSTRACT FROM AUTHOR]

The Kick and Cook-a-Palooza program was an interprofessional partnership between the Grand Valley State University Public Health Department and the therapeutic recreation (TR) program to provide a physical activity and nutrition program at three after-school sites in Grand Rapids, Michigan. Working with children classified as youth at risk, the purpose of the program was to teach children healthy habits related to nutrition and physical activity that they can continue and share with their families. In addition, interprofessional education occurred among university students as they experienced interprofessional collaboration between two health professions and a community agency. This paper presents a practice perspective on developing, implementing, and evaluating the results of the physical activity component of a program with youth at risk in an interprofessional collaborative environment. The program was funded by grants from the General Mills Foundation and the Academy of Nutrition and Dietetics Foundation and the Recreational Therapy Foundation. [ABSTRACT FROM AUTHOR]

A four-step, streamlined process to adapt a large battery of measures for a study of mother-child adjustment in Arab Muslim immigrants and the lessons learned are described. The streamlined process includes adapting content, translation, pilot testing, and extensive psychometric evaluation but omits in-depth qualitative inquiry to identify the full content domain of the constructs of interest and cognitive interviews to assess how respondents interpret items. Lessons learned suggest that the streamlined process is not sufficient for certain measures, particularly when there is little published information about how the measure performs with different groups, the measure requires substantial item revision to achieve content equivalence, and the measure is both challenging to translate and has little to no redundancy. When these conditions are present, condition-specific procedures need to be added to the streamlined process. [ABSTRACT FROM AUTHOR]

Background: It is generally accepted that obesity and depression are positively related in women. Very little prior research, however, has examined potential variation in this relationship across different racial/ethnic groups. This paper examines the association between obesity and depression in non-Hispanic White, non-Hispanic Black, and Mexican American women. Methods: The sample included women aged 20 years and older in the 2005-2008 National Health and Nutrition Examination Surveys ( n=3666). Logistic regression was used to assess the relationship between obesity and depression syndrome (assessed using the Patient Health Questionnaire-9), after adjusting for covariates. We then investigated whether this association varied by race/ethnicity. Results: Overall, obese women showed a 73% greater odds of depression (odds ratio [OR]=1.73; 95% confidence interval [CI]=1.19, 2.53) compared with normal weight women. This association varied significantly, however, by race/ethnicity. The obesity-depression associations for both Black and Mexican American women were different from the positive association found for White women (ORBlack*obese=0.24; 95% CI=0.10,0.54; ORMexican American*obese=0.42; 95% CI=1.04). Among White women, obesity was associated with significantly greater likelihood of depression (OR=2.37; 95% CI=1.41, 4.00) compared to normal weight. Among Black women, although not statistically significant, results are suggestive that obesity was inversely associated with depression (OR=0.56; 95% CI=0.28, 1.12) relative to normal weight. Among Mexican American women, obesity was not associated with depression (OR=1.01; 95% CI=0.59, 1.72). Conclusions: The results reveal that the association between obesity and depression varies by racial/ethnic categorization. White, but not Black or Mexican American women showed a positive association. Next research steps could include examination of factors that vary by race/ethnicity that may link obesity to depression. [ABSTRACT FROM AUTHOR]

An intergenerational initiative was developed and implemented to enhance gerontology in the first course of the practice sequence. Seventeen students met with older adults (ages 82–98) in the classroom and at an assisted living facility. The evaluation of this older adult infusion project was conducted through two questionnaires and by the review of reflection papers completed as a course assignment. Pre-post statistical analyses as well as qualitative analysis evidenced an increase in knowledge of the older adults' lives as well as a professional interest in aging. As a result of this experience, several of the students volunteered at the facility, interviewed residents, and requested gerontological placements. [ABSTRACT FROM PUBLISHER]

Recent policy shifts in the United States have resulted in an increase in the number of older workers remaining in the labor force. Increases in the retirement age for receiving full Social Security benefits coupled with declining pension funds and the erosion of employer retiree health benefits, mean that current cohorts of older workers may fully expect to work longer than previous generations. Yet, working longer may not always be possible due to health problems, outdated skills, economic insecurity, and competing obligations. We examine the consequences of unmet expectations for full time work after age 62 for life satisfaction in a nationally representative sample of older Americans. With longitudinal data from the Health and Retirement Study (1998-2008), this paper uses repeated measures of expectations for later life work among a cohort of Americans ( N = 1684) gathered prospectively over an 8-year period, and examines the effects of unfulfilled expectations on subsequent life satisfaction. Using generalized growth mixture modeling three latent classes of individuals were identified with distinct trajectories of later life work expectations (low expectations, high expectations, and neutral expectations for full time work after age 62). A majority of men had generally high expectations to work full time past age 62, whereas the majority of women reported a low probability of working full time after age 62. When comparing expectations to actual full time work past age 62, we found no effects of unmet expectations for women. However, men with less job stability (reflected by shorter job tenure and lower incomes) generally had high expectations to work longer, and their life satisfaction scores were significantly lower when these expectations were not realized. The hazards of missed expectations for later life work have consequences for subjective well-being in older adults. [ABSTRACT FROM AUTHOR]

The objectives of the project were (1) to determine the extent to which HIV-positive persons living in Michigan were aware of and understood Michigan's criminal HIV exposure law, (2) to examine whether awareness of the law was associated with seropositive status disclosure to prospective sex partners, and, (3) to examine whether awareness of the law was associated with potential negative effects of the law on persons living with HIV (PLWH) including heightened HIV-related stigma, perceived societal hostility toward PLWH, and perceived need to conceal one's HIV infection. The study design was cross-sectional. A statewide sample of 384 PLWH in Michigan completed anonymous pen and paper surveys in 1 of 25 data collection sessions. A majority of participants were aware of Michigan's HIV exposure law. Awareness of the law was not associated with increased seropositive status disclosure to all prospective sex partners, decreased HIV transmission risk behavior, or increased perceived responsibility for HIV transmission prevention. However, awareness of the law was significantly associated with disclosure to a greater proportion of sex partners prior to respondents’ first sexual interaction with that partner. Awareness of the law was not associated with increased HIV-related stigma, perceived societal hostility toward PLWH, or decreased comfort with seropositive status disclosure. Evidence of an effect of Michigan's HIV exposure law on seropositive status disclosure was mixed. Further research is needed to examine the various forms of HIV exposure laws among diverse groups of persons living with or at increased risk of acquiring HIV. [ABSTRACT FROM PUBLISHER]

Background: Despite high levels of clinically significant persistent cancer related fatigue in breast cancer survivors few treatments are currently available and most pose a significant burden on the part of the woman. Acupressure, a component of Traditional Chinese Medicine, has been shown to decrease fatigue levels by as much as 70% in cancer survivors while being inexpensive, non-toxic and an easy to use intervention. The primary aim of this study was to determine the efficacy of two types of self-administered acupressure (relaxation acupressure and stimulating acupressure), compared to standard of care on fatigue severity. Secondary aims were to evaluate the efficacy of two types of acupressure on sleep and kinetic parameters required for implementation of acupressure in a clinical setting; The purpose of this paper is to share the methodology used including challenges and insights. Methods/design: This study is a three group, randomized clinical trial. 375 breast cancer survivors at least 12 months after completion of cancer treatments, with moderate to severe persistent fatigue, are being randomized to one of 3 groups: self-administered relaxation acupressure; self-administered stimulating acupressure; or standard of care. Participants are assessed at baseline, 3 weeks, and 6 weeks followed by a 4-week follow-up period. The primary aim is to examine the effect of 6-weeks of relaxation acupressure compared to stimulatory acupressure or standard of care on fatigue as assessed by: weekly self-report using the Brief Fatigue Inventory; objective daytime physical activity on actigraph; or fatigue patterns assessed 4-times daily using a visual analog scale. Secondary endpoints include depression, anxiety, self-efficacy, and sleep quality. Discussion: This study has the potential to develop a low-cost, self-care intervention for the most troubling of late-term effects in breast cancer populations, fatigue. The methods used may lend constructive ideas to other investigators working with this population and/or intervention. Trial registration: ClinicalTrial.Gov Trials Register NCT01281904 [ABSTRACT FROM AUTHOR]

In this study, we sought to evaluate a modification of the Michigan Alcohol Screening Test designed to include problems associated with other drug abuse/dependence besides alcohol. Scores of the lifetime Michigan Assessment-Screening Test/Alcohol-Drug (MAST/AD) were compared to other lifetime measures of substance abuse and dependence and to psychiatric scales reflecting current or recent symptoms. Two university medical centers with alcohol-drug programs located within departments of psychiatry hosted 520 patients with alcohol-drug-related diagnoses. Patients completed their own MAST/AD using a paper-and-pencil format. Based on interviews with the patient, a research associate rated the patients' substance-related problems on the Minnesota Substance Abuse Problem Scale (M-SAPS) and obtained information on lifetime treatment for substance abuse. An addictions psychiatrist determined abuse or dependence and made a current diagnosis of alcohol abuse/dependence only, drug abuse/dependence only, and alcohol plus drug abuse/dependence. The MAST/AD was highly correlated with the M-SAPS and several other measures of substance abuse morbidity. Patients with alcohol-only and drug-only diagnoses did not differ from one another on the MAST/AD, although both groups had lower scores than those with alcohol plus drug diagnoses. Current psychosocial morbidity as assessed by the patient and the psychiatrist was associated with the MAST/AD, although less strongly than with lifetime substance abuse measures. The lifetime MAST/AD demonstrates reliability as a severity measure for alcohol and/or drug abuse. With minor modification, this standard measure can be expanded from alcohol diagnoses to all substance diagnoses. This study in a clinical population did not demonstrate its utility as a screening instrument; additional work is needed to reveal its utility for this purpose. [ABSTRACT FROM AUTHOR]

Objectives: Studies on immigration have shown that cultural changes can positively or negatively affect psychological, behavioral, and physical outcomes when different cultures settle into a new host community or country. The majority of research done in the United States and North America has focused on these changes for larger immigrant and minority groups such as Hispanics/Latinos and Asians. However, in the United States, there is a sub-group of immigrants that is largely understudied, resulting in misunderstood data on mental and physical health: Arab Americans. This study assesses mental health disparities between immigrant and non-immigrant populations, before and after COVID-19 restrictions, in Dearborn, MI, a city that has one of the largest concentrations of Arab immigrants in the nation. Design: Using an online survey instrument, this study assessed mental health disparities before and since COVID-19 restrictions, and stressors induced since the pandemic for immigrants and non-immigrants in Dearborn, MI. Results: Through inferential statistics and logistic regressions, results indicate that immigrants are less likely to have healthcare coverage, have lower annual incomes, lower educational attainment, and experience continuously higher mental health issues before the pandemic than non-immigrants faced during the pandemic. Conclusion: This study reinforces that the Arab-American immigrant population is a disadvantaged sub-group and faces considerable stress and mental health concerns as an acculturating population. This stress gets exacerbated when a worldwide event such as the COVID-19 pandemic strikes. Oversight of this population's health issues results in the inability to receive appropriate social services and healthcare that is vital to address this community's concerns. [ABSTRACT FROM AUTHOR]

BACKGROUND: Polybrominated biphenyls (PBB) and polychlorinated biphenyls (PCB) are persistent organic pollutants with potential endocrine-disrupting effects linked to adverse health outcomes. OBJECTIVES: In this study, we utilize high-resolution metabolomics (HRM) to identify internal exposure and biological responses underlying PCB and multigenerational PBB exposure for participants enrolled in the Michigan PBB Registry. METHODS: HRM profiling was conducted on plasma samples collected from 2013 to 2014 from a subset of participants enrolled in the Michigan PBB Registry, including 369 directly exposed individuals (F0) who were alive when PBB mixtures were accidentally introduced into the food chain and 129 participants exposed to PBB in utero or through breastfeeding, if applicable (F1). Metabolome-wide association studies were performed for PBB- 153 separately for each generation and ΣPCB (PCB-118, PCB-138, PCB-153, and PCB-180) in the two generations combined, as both had direct PCB exposure. Metabolite and metabolic pathway alterations were evaluated following a well-established untargeted HRM workflow. RESULTS: Mean levels were 1.75 ng/mL [standard deviation (SD). 13.9] for PBB-153 and 1.04 ng/mL (SD. 0.788) for ΣPCB. Sixty-two and 26 metabolic features were significantly associated with PBB-153 in F0 and F1 [false discovery rate (FDR) 푝<0.2], respectively. There were 2,861 features associated with ΣPCB (FDR 푝<0.2). Metabolic pathway enrichment analysis using a bioinformatics tool revealed perturbations associated with ΣPCB in numerous oxidative stress and inflammation pathways (e.g., carnitine shuttle, glycosphingolipid, and vitamin B9 metabolism). Metabolic perturbations associated with PBB-153 in F0 were related to oxidative stress (e.g., pentose phosphate and vitamin C metabolism) and in F1 were related to energy production (e.g., pyrimidine, amino sugars, and lysine metabolism). Using authentic chemical standards, we confirmed the chemical identity of 29 metabolites associated with ΣPCB levels (level 1 evidence). CONCLUSIONS: Our results demonstrate that serum PBB-153 is associated with alterations in inflammation and oxidative stress-related pathways, which differed when stratified by generation. We also found that ΣPCB was associated with the downregulation of important neurotransmitters, serotonin, and 4-aminobutanoate. These findings provide novel insights for future investigations of molecular mechanisms underlying PBB and PCB exposure on health. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess dentists' and dental hygienists' current motivation, attitudes, and knowledge regarding volunteering in a non-profit dental setting and the opportunity for earning continuing education (CE) credits. Methods: This cross-sectional study surveyed a convenience sample of dental and dental hygiene professionals from the state of Michigan. A 20-question paper survey was developed and pilot tested. The survey was disseminated to attendees at various component meetings of the dental and dental hygienists' associations in southeastern Michigan. Results: Out of the 274 surveys that were distributed, 182 (n=182) were completed, yielding a 66% response rate. Eighty percent of the participants were unaware of the opportunity for earning CE by volunteering and 79% were unaware of the volunteering site approval requirement by the Michigan Board of Dentistry. Thirty percent of participants were unable to determine how many unpaid days per year they were willing to volunteer and a similar percentage, (28%), were unable to determine how many paid days. The most common motivating factor to volunteer was to give back to the community (60%) while the greatest barrier was lack of time (62%). Conclusion: The opportunity to earn CE credit for volunteerism is seen as a benefit, however, it needs to be better promoted to potential volunteers, through dissemination of information by professional associations and in educational settings. Community-based clinics also need to be made aware of how to become a CE provider. Further research on the longitudinal impact of CE for volunteerism in community-based clinics is warranted. [ABSTRACT FROM AUTHOR]

Timely linkages are necessary for people with dementia and other disabling conditions to reduce caregiver burnout, prevent unnecessary hospitalization, or placement in alternate care settings. To identify needs, the Caregiver Resource Collaborative conducted a needs assessment of Michigan's sixteen area agencies on aging (AAA). Responses by the sixteen AAAs to an online questionnaire provided a point-in-time picture of current caregiver assessment and services conducted by AAAs. Fifteen AAAs responded there would definitely or probably be an increase in the number of caregivers. Fifteen responded that they purchase or contract out respite care services. Fourteen stated that they provide some type of direct caregiving resources. Twelve utilize staff to develop and monitor care plans. While some provide training, none of the AAAs provides supportive services. The AAAs anticipate rapidly increasing needs for caregiver supports and services. While each provides different services, demand will continue to grow as the older adult population increases. [ABSTRACT FROM AUTHOR]

This study characterizes the impact of the COVID-19 pandemic on the mental and physical health of nurses. Qualitative data (collected using semi-structured interviews) were integrated with quantitative data (collected concurrently using the SF-12 Health Survey). Nurses (N = 30) compared their health prior to and during the first pandemic wave (March–May 2020). Interviews were analyzed thematically; descriptive statistics and t -tests compared pre-pandemic to current SF-12 scores. Qualitative findings demonstrated an impact on nurses' mental health expressed as isolation, loss, intense emotions, and feelings of being expendable. Impact on nurses' physical health included exhaustion, personal protective equipment skin breakdown, limited breaks from work, and virus exposure. Quantitative results show nurses' experienced declines in overall mental health (p <.001), and multiple physical health domains: role limitations due to physical problems (p <.0001), bodily pain (p <.0001), and general health (p <.0001). Promotion of nurses' well-being and safety, as well as education in emergency preparedness, must be given precedence to protect nurses' health. [ABSTRACT FROM AUTHOR]

Anti-immigrant rhetoric and immigration policy enforcement in the United States over the last 2 decades has increased attention to fear of deportation as a determinant of poor health. We describe its association with mental health outcomes among Middle East and North African (MENA) residents of Michigan. Using a convenience sample of MENA residents in Michigan (n = 397), we conducted bivariate and multiple variable regression to describe the prevalence of deportation worry and examine the relationship between deportation worry and depressive symptoms (PHQ-4 scores). We found that 33% of our sample worried a loved one will be deported. Deportation worry was associated with worse mental health (p < 0.01). Immigration policies are health policies and deportation worry impacts mental and behavioral health. [ABSTRACT FROM AUTHOR]

The use of numerous social media formats (SMFs) has grown exponentially over the past several years. In many cases it has become the sole source of communication, the sole source of entertainment, and, unfortunately in many instances it exhibits the characteristics of a disruptive behavior. As a result, it has interfered with fundamental relationships. The following research sought to examine if there is a negative correlation between the disruptive use of SMFs and an individual's early life attachments to parents and/or other adults. In order to determine if a correlation existed, the research participants completed 4 standardized questionnaires of which 3 measured early life attachments to mothers, fathers, and/or other adults and a single questionnaire that measured their later life disruptive use of a variety of SMFs. This research did identitfy a significant negative correlation does exist between the positive protective factor of early childhood attachments when measured against the risk factor of later life disruptive use of SMFs. This finding was true for research participants who identified only parental attachment figures but the strength of the correlation was enhanced when a research participant also identified an other adult as an early attachment figure. The research further identified that certain of the 9 subcategories of the Disruptive Use Scale were more significant for female research participants while other subcategories were more significant for male research participants. This research clearly establisheda robust negative correlation between research participants' early childhood attachment experiences and their later life disruptive use of SMFs. However, to generalize the above findings, additional research needs to be conducted that is more inclusive of a variety of research participants. [ABSTRACT FROM AUTHOR]

Recreational therapists in Michigan and Pennsylvania were interviewed on their perceptions of the impact of COVID-19 on practice with older adults, including changes to their roles and responsibilities as well as the impact on older adults. Social distancing requirements, limitations on visitors and restrictions on groups transformed programming and practice, as well as negatively impacted older adults living in a variety of residential and community-based settings. This qualitative study included 14 recreational therapists. Related to practice, identified themes included the impact on programming, changing roles and responsibilities, how recreational therapists coped with adversity, and their considerations for future practice. Regarding impact on older adults, the resulting themes noted: 1) lack of socialization, 2) emotional and behavioral responses, 3) physical decline, and 4) cognitive decline. The challenges of working with clients living with cognitive impairments and barriers for older adults living in the community are discussed. Recommendations for practice and research to address the long-term effects of COVID-19 in recreational therapy with older adults are presented. [ABSTRACT FROM AUTHOR]

Objective: Describe trends in usage and shoppers of Eastern Michigan University's (EMU) food pantry over four academic years. Participants: Shoppers of EMU's pantry between September 2015 and April 2019. Methods: Data come from shopper questionnaires and pantry records of daily visits and food distribution. Descriptive statistics, t-tests, and chi-square analyses were used to explore shopper characteristics and pantry use over time. Results: Pantry use increased over four academic years (from 1,021 to 3,080 visits/year). An increasing proportion of shoppers use the pantry ≥ once/month (6.1% in 2015/2016; 15.1% in 2018/2019). Compared to irregular shoppers (≤7 visits/year), regular shoppers (≥8 visits) reported higher rates of housing instability and were less likely to have a university meal plan. Conclusion: Data revealed substantial growth of the campus pantry, likely reflecting greater awareness and greater need. The findings highlight financial and social challenges faced by Michigan's college students. Recommendations for pantry establishment/maintenance are indicated. [ABSTRACT FROM AUTHOR]

Measures to contain the global COVID-19 pandemic led to stay-at-home orders across the world, accompanied by fears of a global surge in intimate partner violence (IPV). We administered an online general-population survey to 1169 women and transgender/nonbinary individuals throughout the state of Michigan in June–August 2020 to assess changes in the prevalence, severity, and correlates of IPV during the COVID-19 pandemic. Quota sampling was used to match the racial/ethnic and urban/rural distribution of the state. More than one in seven (15.1%) participants reported physical, sexual, psychological, or technology-facilitated IPV since COVID, similar to the prevalence in the 3 months before COVID (16.2%). However, there were indications that IPV severity increased and that novel cases of IPV are occurring in relationships that previously had no abuse. A majority (64.2%) of individuals who experienced IPV since COVID reported that the IPV was new to the relationship (34.1%) or of increased severity during COVID-19 (26.6%), representing 9.7% of the overall sample. New or increased IPV was significantly more prevalent among those who were essential workers, pregnant, unable to afford rent, unemployed/underemployed or had recent changes to their job, had partners with recent changes to employment, and those who had gotten tested or tested positive for COVID-19. Urban residence, trans/nonbinary identity, and having a toddler were more strongly associated with IPV during COVID as compared to before COVID. While findings do not support significant changes in the overall prevalence of IPV, the majority of survivors reported incident IPV in relationships that had not previously been abusive, or IPV that became more severe since the start of the pandemic. Cases of new or increased IPV were more concentrated in marginalized groups. Potential touchpoints for outreach and services during future lockdowns include prenatal and pediatric settings, daycares, employers of essential workers, and COVID-19 testing centers. Policies providing rental, childcare, and unemployment support may mitigate increases in IPV during COVID-19. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a significant public health problem among college students and many students have difficulty identifying unhealthy and abusive behaviors. The aims of this mixed methods study are to: (a) create an inclusive tool that illustrates the power and control experiences of a diverse group of young adult college students, (b) ensure a broad scope of tactics are illustrated (related to technology and different types of relationships), and (c) measure the experience of these tactics, including how IPV knowledge, attitudes, and self-efficacy are influenced by a more inclusive tool. In Phase I, semi-structured interviews were conducted with students (n = 33) and staff (n = 10) at campus sexual assault centers at the three University of Michigan (UM) campuses to explore power and control tactics utilized by perpetrators on college campuses. Content analysis revealed 13 categories of tactics in college relationships. A draft tool was created and assessed for accuracy using cognitive interviews with students (n = 20) from all three campuses in Phase II. Cognitive interviews resulted in the following changes to the final tool: (a) new presentation of the Socioecological Model, (b) identification of substance use as a facilitator for multiple forms of violence, and (c) edits to tactic descriptions. In Phase III, 250 students at UM–Ann Arbor participated in a quasi-experimental evaluation in which 133 interacted with the tool and 117 received access to usual care (campus sexual misconduct policy). Both groups answered survey questions about IPV knowledge, attitudes, self-efficacy, and experiences at baseline, and after one month and five months. Among all college participants in Phase III, 33.5% had experienced lifetime IPV and 25.2% had experienced IPV in the past year. There were no significant differences among IPV knowledge, attitudes, or self-efficacy by group. The Dynamics of Interpersonal Coercion Among College Students tool was created by incorporating current tactics utilized among a diverse college population. [ABSTRACT FROM AUTHOR]

Background: Data with some values below a limit of detection (LOD) can be analyzed using methods of survival analysis for left-censored data. The reverse Kaplan-Meier (KM) estimator provides an effective method for estimating the distribution function and thus population percentiles for such data. Although developed in the 1970s and strongly advocated since then, it remains rarely used, partly due to limited software availability. Methods: In this paper, the reverse KM estimator is described and is illustrated using serum dioxin data from the University of Michigan Dioxin Exposure Study (UMDES) and the National Health and Nutrition Examination Survey (NHANES). Percentile estimates for left-censored data using the reverse KM estimator are compared with replacing values below the LOD with the LOD/2 or LOD/ radical2. Results: When some LODs are in the upper range of the complete values, and/or the percent censored is high, the different methods can yield quite different percentile estimates. The reverse KM estimator, which is the nonparametric maximum likelihood estimator, is the preferred method. Software options are discussed: The reverse KM can be calculated using software for the KM estimator. The JMP and SAS (SAS Institute, Cary, NC) and Minitab (Minitab, Inc, State College, PA), software packages calculate the reverse KM directly using their Turnbull estimator routines. Conclusion: The reverse KM estimator is recommended for estimation of the distribution function and population percentiles in preference to commonly used methods such as substituting LOD/2 or LOD/ radical2 for values below the LOD, assuming a known parametric distribution, or using imputation to replace the left-censored values. [ABSTRACT FROM AUTHOR]

Background Water insecurity poses a significant global challenge to health and development. While the biophysical and economic impacts of inadequate water and sanitation are well documented, the complex emotional and social tolls of water insecurity are less understood— particularly in the global North. In this article, we advance understandings of the psychosocial dimensions of water insecurity in Detroit, MI, where an estimated 100 000 households have been disconnected from water and sanitation services since the city declared bankruptcy in 2013. Methods A community-based participatory research study was conducted among residents of a local food pantry. A culturally relevant measure of water insecurity was developed through ethnographic engagement, then administered alongside the Kessler Psychological Distress scale. Results Our models reveal a substantial, statistically significant effect of water insecurity on psychological distress. Additionally, financial stress in paying for water and sanitation produces significant distress, even independent of water supply status. Conclusions Curtailing water and sanitation access has complex, intersecting effects, including implications for community mental health. Rapidly rising utility rates across the USA, in the context of growing poverty, underscore the urgency of addressing this issue. The present study is the first we know of in the USA to examine the relationship between water insecurity and psychosocial distress. [ABSTRACT FROM AUTHOR]