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Calls for professional papers for presentation at the mid-year Clinical Meeting of the American Society of Health-System Pharmacists in Orlando, Florida. Changes in the submission process to improve the quality of the presentations; Deadline for Management Case Study, professional, student and resident poster submissions; Selection criteria that will be used by a blinded peer review panel.

Faculty members face increasing pressure to secure external research funding, and as a result, there is a critical need for professional development in this area. This paper describes a series of tools and services that have been designed and implemented by a College of Education Office of Research at a southeastern university in order to help faculty identify grant opportunities and secure research funding. The effect of these actions on faculty professional development and grant activities is presented, and the lessons learned as a result of employing them are discussed.

Despite increased access to and improvements in contraceptives, unintended pregnancy continues to be a problem globally and is associated with adverse outcomes for mothers and infants. This paper seeks to unravel the mediators of intended versus unintended pregnancies among Black women living with HIV. The paper draws on survey data from a broader multi-country mixed methods study that used a community-based participatory research approach to investigate the psychosocial experiences of Black mothers living with HIV. The study participants were Black mothers living with HIV drawn through venue-based sampling from Ottawa, Canada (n = 89), Port Harcourt, Nigeria (n = 400), and Miami, Florida, United States (n = 201). We used Hierarchical Binary Logistic Regression Modelling (HBLM) to estimate the independent associations of pregnancy intention (intended versus unintended) with blocks of predictor variables (sociodemographic, sociocultural, and psychosocial predictors) at alpha level of 0.5. Specifically, 44.2%, 67.3%, and 17.7% of the women had unintended pregnancies in Ottawa, Miami, and Port Harcourt, respectively. There were important results from the HBLM. The odds of intended relative to unintended pregnancies were (i) reduced in larger households (OR = 0.56, 95% CI = 0.36/0.87), but increased with employment (OR = 7.84, 95% CI = 1.52/40.54) and HIV knowledge (OR = 3.13, 95% CI = 1.42/6.90) in Ottawa; (ii) reduced with age (OR = 0.93, 95% CI = 0.88/0.98), but increased with marriage (OR = 2.90, 95% CI = 1.43/5.88) and social support (pregnancy (OR = 3.77, 95% CI = 1.98/7.19) in Port Harcourt; (iii) reduced with social support (OR = 0.95, 95% CI = 0.91/1.00) but increased with HIV status disclosure (OR = 1.73, 95% CI = 1.01/2.97) and the influence of specific referent (OR = 1.68, 95% CI = 1.13/2.52) in Miami-FL. The incidence of unintended pregnancy is more prevalent among Black women living with HIV in the North American cities relative to the African city. Also, unique combinations of sociodemographic, sociocultural, and psychosocial factors influence pregnancy intention in each city. This implies that policy and practices to address reproductive health needs of WLHIV must consider these contextual issues. [ABSTRACT FROM AUTHOR]

Background: Core lexicon (CL) analysis is a time efficient and possibly reliable measure that captures discourse production abilities. For people with aphasia, CL scores have demonstrated correlations with aphasia severity, as well as other discourse and linguistic measures. It was also found to be clinician‐friendly and clinically sensitive enough to capture longitudinal changes in aphasia. To our knowledge, CL has never been investigated in individuals with neurologically progressive disease. Aims: As a preliminary investigation, we sought to investigate (1) whether CL scores correlate with dementia severity, (2) whether CL scores correlate with measures of discourse quality, and (3) whether CL scores correlate with other measures of lexical/semantic access. Methods & Procedures: Twelve participants with a cognitive impairment associated with dementia of the Alzheimer's type (DAT) completed several measures of language and cognitive ability, as well as provide a language sample from the wordless picture book, Picnic. Results & Conclusion: Results are informative, as they provide insight into characteristics of CL and provide support for potential use of CL in individuals with neurologically progressive disease. The results indicated that CL scores do correlate with dementia severity and several measures of language ability, indicating they may provide a useful measure of language abilities in DAT, but more research is needed. WHAT THIS PAPER ADDS: What is already known on the subject: Core lexicon (CL) analysis is an assessment measure of discourse ability, most closely related to informativeness or productivity, used in aphasiology that is easier to use and less time consuming than previous measures of informativeness, such as correct information units or type‐token ratio (TTR). For people with aphasia, CL analysis correlates with aphasia severity, measures of informativeness, as well as other measures of discourse quality. It has also been shown to be faster and more reliable between scorers than other informativeness measures. What this study adds: Core lexicon analysis is a new simple and online method for assessing the informativeness of a discourse sample without the need to record or transcribe the language sample. CL is receiving a lot of attention in aphasia, correlating with everything from aphasia severity to measures of productivity and lexical access, as well as measures of informativeness. Unfortunately, no one has investigated CL analysis in dementia. The study demonstrates the first evidence that CL analysis may be a useful measure for determining dementia severity and language quality in people with dementia. What are the clinical implications of this work?: Core lexicon analysis may provide clinicians and researchers with an easy method for assessing the discourse of people with a cognitive impairment associated with dementia of the Alzheimer's type. This will improve initial assessment, as well as improve ongoing language assessment that may provide clues into their functional ability to communicate effectively. [ABSTRACT FROM AUTHOR]

The housing unit method of population estimation is often characterized as being imprecise and having an upward bias. In an earlier paper we argued that the method itself cannot be properly characterized by a particular level of precision or direction of bias. Only specific techniques of applying the method can have such characteristics. In that paper we presented several new techniques for estimating the number of households and average number of persons per household (PPH). However, the testing of these new techniques was limited by the lack of census results against which the estimates could be compared. Complete census data on population, households, and PPH are now available and can be used to test alternate estimation techniques. In this paper we replicate the tests reported in our earlier paper using 1980 census data for Florida's 67 counties. These tests provide further evidence that the new techniques produce more precise, less biased estimates than previously used techniques. [ABSTRACT FROM AUTHOR]

The pandemic and resulting shift to remote work stressed the importance of distance library services. As librarians explored different modes of engagement, embedded librarianship became increasingly important but also more complicated than before. While there is a wealth of literature on embedded librarianship, few authors agree on how to define it or discuss its specific challenges during the pandemic. This paper will present the experiences of two academic librarians working in different departments at the same institution, informed by the literature; the authors will highlight the complexity of embedded librarianship during this unique time while addressing challenges and offering recommendations. [ABSTRACT FROM AUTHOR]

This article discusses the role of The Florida Institute for Child Welfare (Institute) in the overall goals of child welfare in the state of Florida. The complexity of child welfare requires thoughtful and innovative methods of training and practice. The Institute was created as a result of a series of child fatalities and negative child and family outcomes. The Institute has been tasked with maintaining a program of research that informs child welfare legislation. By creating the Institute, an objective voice, to focus on building an infrastructure of research, it is clear that state leaders have prioritized the effectiveness of our child welfare system. Prominent research has included an analysis of the frontline workforce, residential group care, and the behavioral health of child welfare-involved parents. With the passing of the new law, the Family First Prevention Services Act, research-based services are being promoted and prioritized among federal child welfare leaders. The Institute offers advisement and consultation to Florida's state child welfare system relating to workforce development, training, and the provision of research-based services. This paper will include the description of the Institute and ongoing research. [ABSTRACT FROM AUTHOR]

Purpose: There are extensive concerns about the size of speech-language caseloads in schools. However, little empirical data exist regarding the patterns of speech-language services enrollment. We reviewed data from several hundred schools in a large state to explore the role of school-level factors in speech-language case enrollment. Method: Child count and enrollment data reports from a stratified sample of schools located within 12 Florida school districts (N = 808) were drawn from the Florida Department of Education portal for the 2018-2019 school year. Three school districts were selected from each of several population sizes. To control for school population size, the raw numbers for each variable were converted into proportions. To examine the relations among variables, multiple correlational and regression analyses were conducted. Results: The results indicated that two school-level factors significantly predicted the total speech-language services enrollment and language therapy enrollment (e.g., proportion of students of low socioeconomic status [SES], passing the state reading assessment), whereas three school factors significantly predicted the speech therapy enrollment (e.g., proportion of low-SES students, passing the reading assessment, and enrolled in English as a second or other language services). Conclusions: The outcomes of this study suggested that school factors can predict speech-language service enrollment, which offers important implications for decision makers in schools. Implications for educational practices and further research are presented. [ABSTRACT FROM AUTHOR]

This section presents an update on the World Association for Public Opinion Research (WAPOR) as of September 2002. The most important prize of WAPOR, the Helen Dinerman Award, was awarded to Roger Tourangeau at this year's annual conference in Saint Petersburg, Florida. Tourangeau is currently the head of the Joint Program in Survey Methodology at the University of Maryland/University of Michigan. The Naomi C. Turner Award for the best student paper was given to Seung-Ahn Nah and Hernando Rojas of the University of Wisconsin-Madison for the paper: New Paths to Political Participation: A Comparative Analysis of Effects of Interpersonal Communication Networks and Media Use of Offline and Online Political Participation. Dietram A. Scheufele and William Eveland, was given the Robert Worcester Award for the best article in the International Journal of Public Opinion Research, for their article Perceptions of Public Opinion and Public Opinion Expression. Past-president Miguel Basanez, acting as chair of the electoral commission, announces the results of recent WAPOR elections. Professor Allan McCutcheon of the University of Nebraska-Lincoln was elected secretary-treasurer. The next WAPOR Annual Conference will be held in Prague, Czech Republic, during the month of September 2003.

Latinos/as, the fastest-growing ethnic group in the United States, experience high cancer rates. Factors contributing to treatment decisions among Latinos diagnosed with cancer must be studied. This paper aims to identify treatment decisions among Latinos with cancer and examine factors influencing these decisions. A qualitative exploratory study using semi-structured interviews of 60 Latino/as diagnosed with cancer was conducted. Close-ended responses were analyzed using percentages and frequency distributions, while open-ended responses were analyzed using open coding and thematic categorization. Surgery was the most commonly chosen treatment among participants because it was perceived as providing the highest chance of prolonging life. Only 57% of participants were provided with treatment options. Latinos/as typically prefer modest, paternalistic patient-physician relationships. Therefore, providing culturally appropriate information is valuable. This study underscores the need for health providers to present all available treatment options to enhance cancer treatment outcomes [ABSTRACT FROM AUTHOR]

Burnout and pay satisfaction were associated with intention to leave the profession; however, overall compensation dollar amount was not correlated with intention to leave. Approaches to nurse retention should employ a multifaceted approach to effectively enhance retention rates. [ABSTRACT FROM AUTHOR]

The National Criminal Justice Drug Abuse Treatment Studies research program conducted cluster randomized trials to test an organizational process improvement strategy for implementing evidence-based improvements in HIV services for preventing, detecting, and/or treating HIV for individuals under correctional supervision. Nine research centers conducted cluster randomized trials in which one correctional facility used a modified Network for Improvement of Addiction Treatment (NIATx) change team approach to implementing improved HIV services and the other facility used their own approach to implement the improved HIV services. This paper examines whether the intervention increased the perceived value of HIV services among staff of correctional and community HIV organizations. Baseline and follow-up measures of the perceived acceptability, feasibility, and organizational support for implementing HIV service improvements were collected from correctional, medical, and community HIV treatment staff. Results indicated that the perceived acceptability and feasibility of implementing HIV services improved among staff in the facilities using the modified NIATx change team approach as compared to staff in the comparison facilities. [ABSTRACT FROM AUTHOR]

The Center for Equal Health (CEH), a transdisciplinary Center of Excellence, was established to investigate cancer disparities comprehensively and achieve health equity through research, education, training, and community outreach. This paper discusses challenges faced by CEH, strategies employed to foster collaborations, lessons learned, and future considerations for establishing similar initiatives. [ABSTRACT FROM AUTHOR]

Editorial. Comments on papers presented at the conference on Teaching and Learning held in Jacksonville, Florida in April 2001. Rosalind Pickard's presentation on affective computing; IntelliMedia team's creation of knowledge-based multimedia learning environments that are populated by intelligent animated agents; Lessons from talk by author and neurologist Oliver Sacks.

There is a notable gap in empirical research regarding how Latino men define and demonstrate machismo, masculinity, and manhood as well as the behavioral consequences associated with these concepts. In our study, we employed a phenomenological thematic approach to analyze 20 semi-structured individual interviews conducted with Latino men residing in South Florida. Our primary objectives were twofold: to examine (1) how do Latino men ages 35 to 60 years describe what it means to be a man and (2) what are the attributes that these men seek to show others that demonstrate their character, cultural values, and gender identity. Findings suggest that Latino men understood expectations associated with machismo and explained that fulfillment of their role as provider, protector, and head of the family was important to their perception of self. While some participants reported a desire to embody characteristics associated with traditional machismo, others strived to demonstrate character, familism, and respect and to provide financial and other instrumental support to their families. Participants reported that their transition into middle age was accompanied by a shift in their perspectives on gender roles, moving away from rigid patriarchal views. Exposure to a more fluid and flexible approach to manhood offered relief from the pressures associated with inflexible manifestations of machismo, which can have negative social, behavioral, and physical health implications. The implications of our research extend to the conceptualization of gender ideals, highlighting the need to incorporate intersectionality, role strain, precarious manhood, and culturally specific notions of manhood as foundational elements in this discourse. [ABSTRACT FROM AUTHOR]

The housing unit method of population estimation is often characterized as being imprecise and having an upward bias. We believe that the method itself cannot properly be characterized by a particular level of precision or direction of bias. Only specific techniques of applying the method can have such characteristics. In this paper we discuss several new techniques we have developed for estimating households and the average number of persons per household. Estimates produced by these techniques are compared to estimates produced by several other techniques. Special census results from Florida provide preliminary evidence that the new techniques produce more precise, less biased estimates than the other techniques. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1–5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients. [ABSTRACT FROM AUTHOR]

Aims: In recent years, studies have indicated that consumers of alcohol mixed with energy drink (AmED) are more likely to drink heavily and experience more negative consequences than consumers who avoid these beverages. Although researchers have identified a number of plausible hypotheses that explain how alcohol-energy drink co-ingestion could cause greater alcohol consumption, there has been no postulation about reverse causal relations. This paper identifies several plausible hypotheses for the observed associations between AmED consumption and greater alcohol consumption, and provides initial evidence for one such hypothesis suggesting that heavy drinking may be a determinant of AmED use.Method: Data collected from 511bar patrons were used to examine the plausibility of one of the proposed hypotheses, i.e., AmED is an artifact of heavy drinking. Associations between the consumption of an assortment of alcoholic beverage types and total alcohol consumption were examined at the event-level, to assess whether AmED is uniquely related with greater alcohol consumption.Results: Increased alcohol consumption was associated with greater odds of consuming most alcoholic beverage types; this association was not unique to AmED.Conclusions: Results support the overlooked hypothesis that AmED use is an artifact of heavy drinking. Thus, AmED consumption may be a consequence or marker of heavier drinking. Much of the existing research on alcoholic beverage types is limited in its ability to implicate any specific type of drink, including AmED, as a cause of increased alcohol consumption and related harm. More rigorous study designs are needed to examine causal relationships. [ABSTRACT FROM AUTHOR]

Introduction: Technology has transformed our lifestyles in dramatic and significant ways, including new and less expensive options for recruiting study participants. This study examines cost and participant differences between two recruitment sources, Craigslist (CL), and print newspapers (PNs). This paper also reviewed and compared studies involving clinical trials published since 2010 that recruited participants using CL alone or in combination with other methods.Method: Secondary data analyses from a parent study involving a randomized controlled trial of a mail-based intervention to promote self-change with problem drinkers.Results: Significant differences were found between CL and PN participants on most demographic and pretreatment drinking variables. While all participants had AUDIT scores suggestive of an alcohol problem and reported drinking at high-risk levels, CL participants had less severe drinking problem histories, were considerably younger, and had a higher socioeconomic status than PN participants. The total advertising costs for the 65 CL ads ($275) were significantly less than the 69 PN ads ($33, 311). The recruiting cost per eligible participant was vastly less expensive using CL ($1.46) compared to print newspaper ads ($116.88).Conclusions: Using CL is a viable recruitment method for soliciting participants, particularly those that are younger, for alcohol intervention studies. It is also less expensive than newspaper ads. When CL participants were recruited, they reported being slightly more confident to change their drinking than PN participants. Limitations of using CL are discussed, including that some initial ad responders gave inconsistent answers to similar questions and a few tried to enter the study more than once. [ABSTRACT FROM AUTHOR]

This exploratory, qualitative study evaluated the impact of the Critical Ongoing Resource Family Education Teen Edition (CORE-Teen) post-licensure foster parent training curriculum designed to support foster/kinship caregivers caring for youth ages 12–20 years in the foster care system. A pilot study of the curriculum was implemented in three states (Florida, Pennsylvania, and Tennessee). Five semi-structured focus groups (three groups received CORE Teen training and the other two did not) were conducted with a total of 61 foster parents to explore the differences in parenting knowledge and practices among foster parents trained in CORE Teen versus those who were not. A thematic content analysis of the transcripts from the focus groups revealed three themes: (1) understanding what is considered normal teen behavior; (2) understanding and managing teen trauma and mental health; and (3) recommendations for building foster parents' skills to prepare for their role. Overall, CORE Teen-trained foster/kinship caregivers seemed to have deeper insight into normal teen behaviors, as well as how trauma and mental health challenges can underlie challenging behaviors. CORE Teen foster/kinship caregivers also seemed more satisfied with the training they had received to prepare them for caring for teens. The CORE Teen training curriculum offers promise for building the unique skills that foster/kinship caregivers need in order to effectively care for older youth in the foster care system. [ABSTRACT FROM AUTHOR]

Behavioral health issues are prevalent among child welfare-involved parents. Despite associations with parenting challenges and maltreatment, parents' behavioral health conditions often go untreated. In this study, we explore challenges with addressing behavioral health needs of parents involved in the child welfare system. Focus groups with child welfare and behavioral health providers were conducted to explore gaps and opportunities to enhance behavioral health care for child-welfare involved parents. Three themes were identified: parental motivation and buy-in, behavioral health assessments and screenings, and communication and service coordination. Implications for policy and practice include increased training on measurement-based care and effective cross-system collaboration. [ABSTRACT FROM AUTHOR]

The article presents a study on the ability of a student to balance a chemical equation in Florida. The methods of testing the ability of the student to balance chemical reactions by the utilization of multiple choice is presented in this article. A method called the sum of coefficients was used to measure the student's abilities. After the examination, the author became aware of certain types of errors that were negating the validity of the test scores. The details on the experiment which was designed to determine whether the errors were actually significant part of the student's grade was presented.

Background: Low-molecular-weight heparin (LMWH) is a commonly used anticoagulant for treatment of venous thromboembolism (VTE). Routine monitoring of therapeutic effects through anti-Xa levels is not recommended but may be beneficial in patients with altered pharmacokinetics (Cuker, 2018; Garcia, 2012). Inappropriate monitoring leads to excessive testing and premature dose adjustments, compromising safety and efficacy. The purpose of this project was to assess appropriateness of monitoring LMWH anti-Xa levels and identify opportunities to optimize utilization within a community health system. Methods: A random-sample, retrospective chart review at a multi-site hospital system was conducted over a 3-year period. Inclusion criteria were adults admitted with at least one anti-Xa level resulted. Primary outcomes consisted of anti-Xa level indication and corresponding dose adjustments. Secondary outcomes included anti-Xa levels ordered at the appropriate time window and incidence of adverse events after dose adjustments. Results: Only 28% (61/220) of patients reviewed had an appropriate indication for LMWH anti-Xa level monitoring. Of the 49 patients warranting dose adjustments, 92% received appropriate adjustments. Anti-Xa levels were drawn after the third therapeutic dose in 146 patients with 84 drawn three to five hours post-dose. Four patients had documentation of bleeding and one patient had thrombosis following inappropriate dose adjustments, compared to no reported events following appropriate adjustments. Conclusions: Appropriate LMWH anti-Xa monitoring in patients with altered pharmacokinetics resulted in justified dose adjustments and ensured therapeutic concentrations were attained. In patients with appropriate monitoring and dose adjustments, no adverse events were noted. These results will be used to develop a LMWH anti-Xa level monitoring protocol utilizing a multi-disciplinary approach. [ABSTRACT FROM AUTHOR]

Objective: Disparities in type 1 diabetes related to use of technologies like continuous glucose monitors (CGMs) and utilization of diabetes care are pronounced based on socioeconomic status (SES), race, and ethnicity. However, systematic reports of perspectives from patients in vulnerable communities regarding barriers are limited.Research Design and Methods: To better understand barriers, focus groups were conducted in Florida and California with adults ≥18 years old with type 1 diabetes with selection criteria including hospitalization for diabetic ketoacidosis, HbA1c >9%, and/or receiving care at a Federally Qualified Health Center. Sixteen focus groups were conducted in English or Spanish with 86 adults (mean age 42 ± 16.2 years). Transcript themes and pre-focus group demographic survey data were analyzed. In order of frequency, barriers to diabetes technology and endocrinology care included 1) provider level (negative provider encounters), 2) system level (financial coverage), and 3) individual level (preferences).Results: Over 50% of participants had not seen an endocrinologist in the past year or were only seen once including during hospital visits. In Florida, there was less technology use overall (38% used CGMs in FL and 63% in CA; 43% used pumps in FL and 69% in CA) and significant differences in pump use by SES (P = 0.02 in FL; P = 0.08 in CA) and race/ethnicity (P = 0.01 in FL; P = 0.80 in CA). In California, there were significant differences in CGM use by race/ethnicity (P = 0.05 in CA; P = 0.56 in FL) and education level (P = 0.02 in CA; P = 0.90 in FL).Conclusions: These findings provide novel insights into the experiences of vulnerable communities and demonstrate the need for multilevel interventions aimed at offsetting disparities in diabetes. [ABSTRACT FROM AUTHOR]

Climate change will alter natural areas on a global scale within the next century. In areas vulnerable to climate change, scientists are regularly challenged to justify the resources needed for research and conservation. We face what may seem like a losing battle, especially in low-lying coastal areas where sea-level rise is predicted to severely degrade or destroy many ecosystems. Using sea-level rise in the low-elevation state of Florida, USA, as a case study, we argue that it is critical to remain engaged in the research, restoration, and conservation of natural areas threatened by climate change for as long as possible. These areas will continue to provide invaluable ecological and societal benefits. Additionally, uncertainty surrounding climate change forecasts and their ecological impact leaves room for optimism, research, and actions that are necessary for developing adaptation plans and mitigating further sea-level rise and other consequences of climate change. We urge scientists and particularly students beginning their careers not to forego research and conservation efforts of these imperiled lands but to face this unprecedented challenge with determination, creativity, and solution-based strategies. [ABSTRACT FROM AUTHOR]

The article presents a study concerning how the high school teachers in Florida gives advise to their students. The study attempts to estimate the amount of counseling done per year by vocational homemaking teachers to their students concerning dating relationships, premarital and marital relationships, intrafamilial relationships, personal growth and psychosexual development. It aims to determine the relationship between counseling done on the concerns mentioned and selected factors associated with the teachers, including recency of formal education, counseling education of training, amount of time available for counseling, among others. It is also mentioned in the paper that the study does not evaluate the effectiveness of their counseling.

Adult day centers (ADCs) are nonresidential settings that support the health and social needs of vulnerable older adults. Due to ADCs' congregate nature and participants' compromised health status, many ADCs have been forced to close during the COVID-19 pandemic. It is unknown how closures have impacted service delivery at ADCs. Guided by the Resiliency Activation Framework, we (a) identified consequences resulting from closures of ADCs during the COVID-19 pandemic and (b) described factors that have enabled the ADC community to remain resilient in the wake of challenges brought on by the pandemic. We conducted 2 focus groups in California (n = 12), and individual interviews with ADC staff members (n = 8) in 7 other states. The results of a directed content analysis revealed perceived declines in physical, cognitive, and mental health of ADC users and increased caregiver strain. Access to human, social, economic, and political capital were essential for supporting ADCs in buffering the impacts of the pandemic on the older adults they serve but were not consistently available. Research is urgently needed that quantifies the impacts of the pandemic on ADC users and their caregivers to inform policy and advocacy efforts in the wake of the pandemic. [ABSTRACT FROM AUTHOR]

Purpose: Patients are frequently asked to share their personal health information. The objective of this study was to compare the effects on patient experiences of 3 electronic consent (e-consent) versions asking patients to share their health records for research.Methods: A multi-arm randomized controlled trial was conducted from November 2017 through November 2018. Adult patients (n = 734) were recruited from 4 family medicine clinics in Florida. Using a tablet computer, participants were randomized to (1) a standard e-consent (standard), (2) an e-consent containing standard information plus hyperlinks to additional interactive details (interactive), or (3) an e-consent containing standard information, interactive hyperlinks, and factual messages about data protections and researcher training (trust-enhanced). Satisfaction (1 to 5), subjective understanding (0 to 100), and other outcomes were measured immediately, at 1 week, and at 6 months.Results: A majority of participants (94%) consented to future uses of their health record information for research. No differences in study outcomes between versions were observed at immediate or 1-week follow-up. At 6-month follow-up, compared with the standard e-consent, participants who used the interactive e-consent reported greater satisfaction (B = 0.43; SE = 0.09; P <.001) and subjective understanding (B = 18.04; SE = 2.58; P <.001). At 6-month follow-up, compared with the interactive e-consent, participants who used the trust-enhanced e-consent reported greater satisfaction (B = 0.9; SE = 1.0; P <.001) and subjective understanding (B = 32.2; SE = 2.6, P <.001).Conclusions: Patients who used e-consents with interactive research details and trust-enhancing messages reported higher satisfaction and understanding at 6-month follow-up. Research institutions should consider developing and further validating e-consents that interactively deliver information beyond that required by federal regulations, including facts that may enhance patient trust in research. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC) worldwide, disproportionately affects minorities in the USA. Undiagnosed HBV precludes HCC screening and contributes to late-stage cancer presentation and decreased survival. Barriers to HBV and HCC screening include lack of insurance and limited diffusion of guidelines. We aimed to assess knowledge about HBV and HCC screening indications and explore barriers to screening.Methods: We surveyed trainees from the University of Miami/Jackson Memorial Hospitals, Palmetto General Hospital, and Mount Sinai Medical Center. We assessed knowledge using clinical vignettes. We performed bivariate and Chi-squared analyses.Results: There were 183 respondents; median age was 31 and 52% were male. The sample was 35% Hispanic, 29% White, 18% Asian, and 9% Black. Training department was Internal Medicine, 71%; Family Medicine, 11%; Infectious Diseases, 6%; or Gastroenterology, 7%. Only 59% correctly estimated national HBV prevalence; 25% correctly estimated global prevalence. In vignettes with behavioral risk factors, trainees correctly advised screening, 63-96%. However, when the risk factor was the birthplace, correct responses ranged from 33 to 53%. Overall, 45% chose an incorrect combination of HBV screening tests. Perceived barriers to screening included limited expertise in screening of immigrants and limited patient education. Respondents were more likely to recommend HCC screening in cirrhotic patients versus non-cirrhotic HBV patients. Key barriers to HCC screening included uncertainty about HCC guidelines and patient financial barriers.Conclusions: Knowledge of HBV and HCC screening recommendations is suboptimal among trainees. Efforts to broadly disseminate HBV and HCC guidelines through targeted educational interventions are needed. [ABSTRACT FROM AUTHOR]

Purpose: In designing a Project ECHO™ type 1 diabetes (T1D) program in Florida and California, the Neighborhood Deprivation Index (NDI) was used in conjunction with geocoding of primary care providers (PCPs) and endocrinologists in each state to concurrently identify areas with low endocrinology provider density and high health risk/poverty areas. The NDI measures many aspects of poverty proven to be critical indicators of health outcomes.Methods: The data from the 2013-2017 American Community Survey (ACS) 5-year estimates were used to create NDI maps for California and Florida. In addition, geocoding and 30-minute drive-time buffers were performed using publicly available provider directories for PCPs and endocrinologists in both states by Google Geocoding API and the TravelTime Search Application Programming Interface (API).Results: Based on these findings, we defined high-need catchment areas as areas with (1) more than a 30-minute drive to the nearest endocrinologist but within a 30-minute drive to the nearest PCP; (2) an NDI in the highest quartile; and (3) a population above the median (5199 for census tracts, and 1394 for census block groups). Out of the 12 181 census tracts and 34 490 census block groups in California and Florida, we identified 57 tracts and 215 block groups meeting these criteria as high-need catchment areas.Conclusion: Geospatial analysis provides an important initial methodologic step to effectively focus outreach efforts in diabetes program development. The integration of the NDI with geocoded provider directories enables more cost-effective and targeted interventions to reach the most vulnerable populations living with T1D. [ABSTRACT FROM AUTHOR]

This study used self-administered survey data from seven high schools in Florida with a majority Black and/or Hispanic sample to examine transgender students' perceptions and experiences related to school climate in comparison to cisgender students. Using propensity score matching, a matched analytic sample was created of transgender and cisgender students (n = 542, including 186 transgender youth). Adjusted weighted logistic regression models indicated that transgender students were significantly more likely to report ever being bullied at school, being bullied in the past 3 months, and not going to school ≥3 days during the past 30 days. Transgender students were significantly less likely to report feeling safe at school and having positive perceptions of all five school connectedness items compared to cisgender students. Recent bullying experiences moderated the association between transgender status and past month absences. Findings can inform potential roles for school nurses in improving school climate for transgender youth. [ABSTRACT FROM AUTHOR]

Introduction and Aims: People with opioid use disorder are prevalent in criminal problem-solving courts and dependency courts, which have rehabilitative aims. Medication for opioid use disorder (MOUD) is the standard of care. Court staff set treatment policies for court clients. They may receive training from MOUD manufacturers, but no studies have examined court staff receipt of such training.Design and Methods: To examine receipt of training from MOUD manufacturers, we designed a cross-sectional survey for court staff. We distributed it online to all Florida court staff in criminal problem-solving or dependency courts (n = 585). Outcome variables were receipt of training from one or more MOUD manufacturers and training source. Covariates included dichotomous measures of court type, staff role, gender and rurality. Logistic regression models estimated the relationship between receipt of training and covariates.Results: Twenty-one percent of Florida criminal problem-solving and dependency court staff completed the survey. The most common receipt of training was from the manufacturer of extended-release naltrexone (36%), followed by buprenorphine (24%) and methadone (11%). Fifty-seven percent of those who received training received it from more than one MOUD manufacturer. Criminal problem-solving court staff were more likely than dependency court staff to receive training from MOUD manufacturers. Court program co-ordinators were more likely than other staff roles to receive training from MOUD manufacturers.Discussion and Conclusions: A large minority of respondents received training from a MOUD manufacturer, primarily from extended-release naltrexone's manufacturer, raising concerns regarding information accuracy and conflicts of interest. Court staff should seek MOUD training from academic institutions and non-profit organisations instead. [ABSTRACT FROM AUTHOR]

Purpose: While the benefits of participating in stuttering support groups are well known, the factors that motivate adults who stutter (AWS) to continue attending these meetings are not documented. The purpose of this exploratory study is to investigate the narratives of AWS and identify their individual motivations for regularly attending stuttering support groups. Method: Seven AWS, ages 23--54 years, who attended more than one stuttering support group meeting participated in a semistructured interview about their stuttering and their experiences participating in a stuttering support group. Thematic analysis procedures were followed to investigate descriptions of motivating factors in each participant's narrative. Result: Four major themes emerged from the data including "Mutual Understanding and Common Ground," "Support Group Format," "Positive Changes," and "Give and Take of the Support Group." The support group served as a place to gain new perspectives by watching others who stutter more severely communicate while also creating a sense of not being "alone." Opportunities to speak and/or stutter freely as well as the role chapter leaders take in facilitating conversation were motivating factors in terms of the support group format. Positive changes in emotional well-being and socialization were reported. Participants also stated that they attend support groups because the group provides them with an opportunity to help others and learn from others. Conclusion: This exploratory study uncovered particular aspects of support groups, including group members and the structure of meetings, that motivate AWS to attend. Findings support the literature in that participants reported benefiting from participating in support groups. [ABSTRACT FROM AUTHOR]

Objectives: Repeat visits (revisits) to emergency departments (EDs) for psychiatric care reflect poor continuity of care and impose a high financial cost. We test whether rapid expansion of community health centers (CHCs)—which provide regional, low‐cost primary care—correspond with fewer repeat psychiatric‐related ED visits (PREDVs). Methods: We obtained repeated cross‐sectional time‐series data for 7.8 million PREDVs from the State Emergency Department Database for four populous U.S. states (California, Florida, North Carolina, and New York) from 2006 to 2011. We specified as the outcome variable the count of repeat visits per ED visitor with a psychiatric diagnosis. We retrieved aggregate‐level mental health visits at CHCs from the Uniform Data System. Negative binomial regression methods controlled for individual‐level confounders, county health system and sociodemographic attributes, year fixed effects, and county fixed effects. Results: The risk of a repeat PREDV decreased with a county‐level increase in mental health patients seen at CHCs (incidence rate ratio = 0.986, 95% confidence interval = 0.98 to 0.99). Conversion of this rate ratio to the number of revisits averted indicated 34,000 fewer repeat PREDVs in these four states statistically associated with a 1% expansion in CHC mental health visits. Exploratory analyses found that revisits decline for relatively mild/moderate illnesses (e.g., mood, anxiety disorders) but not for severe illnesses (e.g., schizophrenia/psychoses). Conclusion: An increase in mental health services at CHCs corresponds with a modest decline in repeat PREDVs. This decline concentrates among those with less severe mental illnesses. [ABSTRACT FROM AUTHOR]

With expected increases in extreme weather, there may be a greater risk of injury from extreme heat in outdoor worker populations. To plan for future adaptation measures, studies are needed that can characterize workers' physiologic responses to heat in outdoor settings such as agriculture. The objective of this study was to characterize occupational heat exposure, key vulnerability factors (e.g., gender, energy expenditure), and physiologic heat stress response in a sample of fernery workers. Forty-three fernery workers over 86 workdays were examined regarding heat-related illness (HRI) during the summer months of 2012 and 2013. The key outcome measure was whether a participant's body core temperature (Tc) reached or exceeded 38.0°C (100.4ºF; Tc38). Participants' Tc exceeded 38.0°C on 49 (57%) of the workdays, with 30 of 40 participants reaching or exceeding Tc38 on at least one workday. Adjusting for sex, there was a 12% increase in the odds of Tc38 for every 100 kilocalories of energy expended (OR: 1.12; 95% Confidence Interval [CI]: [1.03, 1.21]). Adjusting for energy expenditure, females had 5 times greater odds of Tc38 compared with males (OR: 5.38; 95% CI: [1.03, 18.30]). These findings provide evidence of elevated Tc in Florida fernery workers, indicating an increased risk of occupational HRI, and the need for policy and interventions to address this health risk. [ABSTRACT FROM AUTHOR]

There is a need to better understand long-term disaster recovery and reconstruction challenges in diverse communities. This case study was part of a larger study undertaken by the Rebuilding Lives Post-Disaster research partnership, where field research was conducted in disaster-affected communities in Canada, the USA, Australia, India, Pakistan, and Taiwan. The objective of this exploratory case study was to focus on experiences of affected migrant workers from diverse communities in Florida, USA, in relation to long-term disaster recovery and reconstruction work following hurricanes, to ensure that lessons learned from these experiences could inform best practices and policy. The study focused particularly on the role of community processes and dynamics in shaping postdisaster recovery. Qualitative research explored diverse experiences of participants through interviews with government officials, community leaders, and disaster responders. The study found that migrant workers faced challenges due to the lack of consideration with regard to immigration status, linguistic, and cultural needs in disaster recovery. IMPLICATIONS Disaster recovery processes need to consider the diversity of affected populations to ensure assistance and responses meet the differing needs of all community members in postdisaster recovery. All members of diverse communities should be included in disaster response and longer-term recovery efforts. Social workers can assist in ensuring that diversity is a consideration in disaster and emergency management. [ABSTRACT FROM AUTHOR]

Background: Surgical education relies heavily upon simulation. Assessment tools include robotic simulator assessments and Global Evaluative Assessment of Robotic Skills (GEARS) metrics, which have been validated. Training programs use GEARS for proficiency testing; however, it requires a trained human evaluator. Due to limited time, learners are reliant on surgical simulator feedback to improve their skills. GEARS and simulator scores have been shown to be correlated but in what capacity is unknown. Our goal is to develop a model for predicting GEARS score using simulator metrics.Methods: Linear and multivariate logistic regressions were used on previously reported data by this group. Subjects performed simple (Ring and Rail 1) and complex (Suture Sponge 1) tasks on simulators, the dV-Trainer (dVT) and the da Vinci Skills Simulator (dVSS). They were scored via simulator metrics and GEARS.Results: A linear model for each simulator and exercise showed a positive linear correlation. Equations were developed for predicting GEARS Total Score from simulator Overall Score. Next, the effects of each individual simulator metric on the GEARS Total Score for each simulator and exercise were examined. On the dVSS, Excessive Instrument Force was significant for Ring and Rail 1 and Instrument Collision was significant for Suture Sponge 1. On the dVT, Time to Complete was significant for both exercises. Once the significant variables were identified, multivariate models were generated. Comparing the predicted GEARS Total Score from the linear model (using only simulator Overall Score) to that using the multivariate model (using the significant variables for each simulator and exercise), the results were similar.Conclusions: Our results suggest that trainees can use simulator Overall Score to predict GEARS Total Score using our linear regression equations. This can improve the training process for those preparing for high-stakes assessments. [ABSTRACT FROM AUTHOR]

Objectives: To determine how frequently patients revisit the emergency department after an initial encounter, and to describe revisit capture rates for the same hospital, health system, and geographic region.Data Sources/study Setting: Florida state data from January 1, 2010, to June 30, 2011, from the Healthcare Cost and Utilization Project.Study Design: This is a retrospective cohort study of emergency department return visits among Florida adults over an 18-month period. We evaluated pairs of index and 30-day return emergency department visits and compared capture rates for hospital, health system, and geographic units.Data Collection/extraction Methods: Data were obtained from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project and the American Hospital Association Annual Survey Database.Principal Findings: Among 9,416,212 emergency department visits, 22.6 percent (2,124,441) were associated with a 30-day return. Seventy percent (1,477,772) of 30-day returns occurred to the same hospital. The 30-day return capture rates were highest within the same geographic area: county-level capture at 92 percent (IQR=86-96 percent) versus health system capture at 75 percent (IQR = 68-81 percent).Conclusions: Acute care utilization patterns are often independent of health system boundaries. Current population-based health care models that attribute patients to a single provider or health system may be strengthened by considering geographic patterns of acute care utilization. [ABSTRACT FROM AUTHOR]

Background: Obesity is common among individuals with COPD and associated with increased COPD morbidities. However, little is known about the impact of weight reduction on COPD-related outcomes in patients who are obese.Methods: Using the population-based ED and inpatient sample in three US states (California, Florida, and Nebraska), we performed a self-controlled case series study of 481 adults who were obese (40-65 years of age) with COPD who underwent bariatric surgery. The primary outcome was an ED visit or hospitalization for acute exacerbation of COPD (AECOPD) from 2005 through 2011. We compared each patient's risk of the outcome during sequential 12-month periods using presurgery months 13 through 24 as the reference period.Results: During the 13 to 24 months before bariatric surgery (ie, reference period), 28% (95% CI, 24%-32%) of patients had an ED visit or hospitalization for AECOPD. In the subsequent 12-month presurgery period, the risk did not change materially (31%; 95% CI, 27%-35%), with an adjusted OR (aOR) of 1.16 (95% CI, 0.88-1.53; P = .29). By contrast, during the first 12 months after bariatric surgery, the risk declined significantly (12%; 95% CI, 9%-15%; aOR, 0.35; 95% CI, 0.25-0.49; P < .001). Likewise, in the subsequent period of 13 to 24 months after bariatric surgery, the risk remained significantly low (13%; 95% CI, 11%-17%; aOR, 0.39; 95% CI, 0.28-0.55; P < .001).Conclusions: The risk of an ED visit or hospitalization for AECOPD substantially decreased after bariatric surgery in patients who are obese. This observation suggests the effectiveness of substantial weight reduction on COPD morbidity. [ABSTRACT FROM AUTHOR]