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Objectives: Depression and anxiety contribute to the burden of disease among college students. The current study determined if depressive and anxiety symptoms were more prevalent in first generation students and if social and emotional support moderated this relationship. Methods: Depressive and anxiety symptoms were measured in 432 U.S. college students via an online survey. Single items determined student generation status and available social support. The CES-D10 and GAD-7 measured depression and anxiety, respectively. Structural equation modeling was used to identify significant effects. Results: First generation status was associated with increased cognitive-emotional (p = 0.036) and somatic (p = 0.013) anxiety symptoms, but not depression. High social and emotional support appeared to suppress somatic anxiety symptoms experienced by first generation students (p = 0.004). Conclusions: Greater anxiety symptoms in first generation students may be due to increased general and acculturative stress, although more research is needed. Large national surveys of college students should consider adding a question about first generation status. [ABSTRACT FROM AUTHOR]

In 1785, Thomas Jefferson printed his plan for ending slavery in Virginia: all slaves born after a certain date should be free, and the state should educate the freed children, colonize them to some hospitable location, and then support the new nation until it was strong enough for independence. For a Virginian like Jefferson, emancipation seemed most possible when imagined in tandem with racial separation. However, while living in Europe during the late 1780s, Jefferson and his young secretary William Short began devising an alternative, much more inclusive plan to end slavery: import German laborers, mingle them with African-descended workers, and use European tenant farming—or métayage—to transition slaves to freedom. Although neither of Jefferson's plans came to fruition, examining his and Short's correspondence from the 1780s through the 1820s offers new insights into Jefferson's thought on immigration, race, and the possibility of a multiracial republic. [ABSTRACT FROM AUTHOR]

Using the 1832 political debates in Virginia following the 1831 Nat Turner Rebellion as a starting point, the article explores the public opinions regarding the work "Notes on the State of Virginia," written by Founding Father Thomas Jefferson. It considers both the justification of slavery and the antislavery movements, political comments made by Jefferson's nephew Thomas Jefferson Randolph, and Jefferson's ideals regarding the emancipation of slaves.

• The most common instruction to adolescents was to wear a helmet. • Over half of parents instructed their children (10–15 yrs) to ride on the sidewalk. • Agreement between parents and adolescents on bicycle riding instructions is low, overall. • Parent instructions were not reflected in adolescents' real-world riding behavior. • Results suggest parental training in effective safety communication strategies is needed. Efforts to encourage bicycling to school have increased in the United States. However, little is known about how parent-child communication affects bicycle safety. The purpose of this study was to examine parent-child agreement on biking instructions and their correlation with the early adolescents' real-world riding behavior. Parent-child dyads were asked open-ended questions about instructions they had given/received about bicycling. Answers were then coded into nine categories (e.g., crossing the road, bicycle control/handling). Distributions of parent-child agreement on parent-given bicycle safety instructions were examined in relation to the adolescent's real-world riding behaviors. 36 parent-child dyads were included. Average age was 11.9 (Range: 10–15) for adolescents and 43.3 (Range: 30–59) for parents. Common parental instructions included: wear helmet, ride on sidewalk, and trip routing specifications. High 'ride on sidewalk' instruction (38.9% both parent and adolescent, 22.2% parent only, 16.7% adolescent only) was concerning due to potential driveway conflicts. Agreement between parents and adolescents on reported instructions was low, overall. Mean safety-relevant event rates in real-world cycling did not differ significantly between bicycle safety instruction agreement groups (both parent & adolescent reported, parent only, adolescent only, neither). The proportion of time an adolescent rode on different infrastructure types (sidewalk, street, etc.) did not vary between dyads reporting parents had given instructions to ride on the sidewalk and those who had not. Results highlight lack of agreement between parents and adolescents on cycling instructions the adolescent receives from the parent. Parent instructions to adolescents regarding bicycling safety were not associated with actual riding behaviors. Results suggest parent messaging to adolescents may be ineffective. Given parents are in a position of influence, results indicate a need for parental training on effective safety-related communication strategies to assist them in capitalizing on their parental role to increase their child's safety. [ABSTRACT FROM AUTHOR]

Approximately one in three women in the United States experience intimate partner violence (IPV). IPV is associated with long-term negative health consequences; therefore, there is a need to examine potential prevention strategies. Evidence suggests that domestic violence protective orders (DVPOs), a legal intervention that prevents contact between two parties for up to 12 months, are an effective secondary prevention tool. However, because judges have relative autonomy in granting or denying DVPOs, research is needed to examine the processes they use to guide their decisions. The aim of the study was to investigate how District Court judges decide whether to issue a DVPO. Using in-depth interviews with 20 North Carolina District Court judges, the present study addressed three research questions: (a) what factors influence judges’ decisions to grant or deny a DVPO, (b) what heuristics or cognitive shortcuts potentially guide their decisions, and (c) what judges worry about when making decisions. Three themes emerged from the data analyses: (a) violent incidents must reach a certain threshold, (b) the presence of children creates competing concerns, and (c) judges worry about the negative impact their decisions may have on the lives of those involved. Recommendations for improving the DVPO issuance process are also discussed. [ABSTRACT FROM AUTHOR]

One in seven of the approximately 2.2 million Department of Defense active duty military personnel are women. Among active duty servicewomen, about 40% are under 26 years old, and almost half are young, lower ranking enlisted personnel. This article will include a review of the literature on military women's health topics such including contraception access, pregnancy, and pregnancy outcomes after environmental exposures. In these early adult years, contraception use may not be consistent, leading to higher rates of unintended pregnancy that is similar to their civilian counterparts, but it may affect troop readiness. Women who become pregnant after deployment must be evacuated from theater. Complications in pregnancy that require immediate intervention, such as ectopic pregnancy, may be more difficult to diagnose and manage if far away from comprehensive medical services. Environmental exposures may affect the pregnancy outcome, or may produce delayed responses for future childbearing. Women face other gynecologic choices including menstrual suppression while deployed. Many of these issues have not been fully studied, sample sizes are small or methodological flaws exist in the analysis limiting conclusions that can be drawn. Further research with greater rigor, larger sample sizes, and careful design are needed to address many of these questions. [ABSTRACT FROM AUTHOR]

The benefits of therapeutic camp for children with chronic conditions have been clearly delineated. However, medical trainees’ experiences at therapeutic camp have yet to be explored. This study characterizes pediatric fellows who have participated in therapeutic camp at any point in their training and assesses the impact of the camp experience. An anonymous 13-question online survey about therapeutic camps was deployed to medical fellows in Accreditation Council for Graduate Medical Education (ACGME) accredited programs. Basic demographic and training information were collected as well as details of the trainees’ therapeutic camp experience. Quantitative and qualitative analyses were conducted using a mixed-methods approach. A total of 382 pediatric subspecialty fellows from across the USA participated in this study. While the majority of respondents had never participated in therapeutic camp (261, 68.3%), 97.5% of those who had participated reported a positive experience. Trainees described camp as a time of medical growth (22.9%), a rewarding experience (19.8%), and a means of appreciating children with chronic conditions in a normal atmosphere (11.5%). Many trainees also reported that the experience had an effect on their subspecialty choice; specifically, those who participated in a therapeutic camp were significantly more likely to select a chronic illness subspecialty (X2=.92, p=.05). Medical trainees benefit from the therapeutic camp experience. Camp may also provide the opportunity to learn about the benefits of recreation therapy firsthand and to build professional relationships with recreational therapists. More opportunities should be offered for medical trainees to experience therapeutic camp. [ABSTRACT FROM AUTHOR]

The article discusses the prevalence of asthma attacks among asthmatics in the U.S. from 2001-2010. It states that the report aims to raise awareness of differences in asthma attacks among asthmatics and to provide actions to reduce these differences. Moreover, it found that rate of asthma attacks were higher for asthmatic females than males.

Concerns with the retention of women in engineering have led to the implementation of numerous programs to improve retention, including mentoring programs. The college of engineering at Washington State University (WSU) started a novel women's mentoring program in 2008, using professional engineers who graduated from WSU as mentors. The program is purely voluntary, and has grown from 30 mentors and 38 mentees in 2008 to 61 mentors and 90 mentees in 2011 (many mentors are willing to be paired up with more than one student). Preliminary results indicate that participants in the mentoring program are retained at a higher rate than students that do not participate; of the 42 freshmen entering WSU in the fall of 2010 and participating in the program, 74% have stayed in engineering compared to 68% for all 54 female freshman students. In past years (2003-2009), an average of 51% of female students are still in engineering at the end of their freshman year. This paper presents a model for a self-sustaining, effective women's mentoring program that has the potential to improve retention rates of women in engineering. [ABSTRACT FROM AUTHOR]

Americans do not know what percentage of the nation's residents are whites, blacks, Hispanics, Asians, and American Indians. Using the 2000 General Social Survey, I find that respondents of all races underestimate the percentages of whites and overestimate the percentages of racial/ethnic minority groups and multiracial Americans in the United States; however, they perceive their local communities quite differently. As a first step toward understanding this discrepancy, I test whether individuals' local surroundings serve as a source of information for their pictures of the United States. I examine the relationship between "objective" data and respondents' subjective perceptions of where they live, and compare their respective effects on Americans' perceptions of the nation. Multivariate multilevel analyses show that respondents' perceptions of different racial group sizes in their communities are the strongest predictors of innumeracy at the national level, while "objective" racial context measured at the local level has less of an effect. These findings have important implications for research on racial context, which assumes that census numbers for respondents' locales are good proxies for their perceptions of the size of racial/ethnic groups in their communities. Furthermore, these findings suggest that scholars need to start thinking about why whites and non-whites have similar "big pictures" of the nation, why their "little pictures" vary a great deal, and why the motivations for over-and underestimation may differ by racial/ethnic group. [ABSTRACT FROM AUTHOR]

Presents information on a study which investigated the association between homicide and pregnancy among teens in Maryland from 1994-1998. Background of the study; Methodology of the study; Results and discussion.

Examines the effect of white racism on the racial attitudes and self concept of African American children. Implication of racial attitude and identity development; Definition of skin tone from a socio-historical perspective; Role of skin tone in social stereotyping.

During the 1960s and 1970s Asian-Americans initiated local movements intended to raise ethnic consciousness and alter majority attitudes. Although Asian-American activists articulated many of the concerns voiced by other minorities in America and utilized basic tactics familiar to movement theorists, they failed to create a national movement like other minorities. This paper examines the implications of their experience for a revised understanding of movement rhetoric. The paper proposes the refinement of theories on social movements through the addition of a pre-inception stage to current theories. [ABSTRACT FROM AUTHOR]

The Burn Care Quality Platform (BCQP) consolidates data previously collected from the National Burn Repository and the Burn Quality Improvement Program into a single registry. Its data elements and their associated definitions are tailored to create consistency across other national trauma registries, namely the National Trauma Data Bank implemented by the American College of Surgeons Trauma Quality Improvement Program (ACS TQIP). The BCQP now includes 103 participating burn centers and has captured data from 375,000 total patients as of 2021. With 12,000 patients entered under the current data dictionary, the BCQP represents the largest registry of its kind. On behalf of the American Burn Association Research Committee, the aim of this whitepaper is to provide a succinct overview of the BCQP, showcasing its unique features, strengths, limitations, and relevant statistical considerations. This whitepaper will highlight the resources available to the burn research community and offer insight on proper study design when preparing to conduct a large data set investigation for burn care. All recommendations herein were formulated through the consensus of a multidisciplinary committee and based on the available scientific evidence., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Smartphone addiction is a rising problem in the United States. The current study estimated the prevalence of smartphone addiction in Rhode Island young adults and its associations with mental illness., Methods: The 2022 Rhode Island Young Adult Survey measured smartphone addiction, depression, anxiety, and suicide ideation. Covariates included age, sex/gender minority status, race/ethnicity, and social status., Results: The prevalence of smartphone addiction was 34%. Odds of experiencing depression (OR[95%CI]=2.69 [2.05,3.52]), anxiety (OR[95%CI]=2.06 [1.58,2.69]), and suicide ideation (OR[95%CI]=1.55 [1.08,2.20]) were greater in participants with smartphone addiction. The relationship between smartphone addiction and depression was strongest in heterosexual cis-males (OR[95%CI] = 8.45 [3.53, 20.3])., Discussion: Smartphone addiction is prevalent among Rhode Island's young adults and may be associated with depression, anxiety, and suicide ideation. Heterosexual cis-males may be particularly vulnerable. Screening programs and interventions to reduce smartphone use for all young adults, and particularly young men, should be considered.

Objective: Pediatric restraint use has increased over time in the United States, but motor vehicle crashes remain a leading cause of death for children under age 18. Age-appropriate use of safety restraints (safety seats, booster seats, seat belt) and statewide child restraint laws can greatly reduce injury or death in the event of a crash. Surveillance of pediatric restraint use and compliance with policy can inform prevention efforts. This study aims to examine time trends in pediatric restraint use and compliance with pediatric passenger laws in Iowa by rurality and age., Methods: Fourteen years of Iowa observational pediatric restraint use data (2006-2019) are included in this cross-sectional study. Proportions of restrained youth by year, age, and rurality (rural, urban) were calculated. Log-linear models were used to compute the Annual Percent Change (APC) by year to explore trends in restraint use over time by rurality and by age group., Results: A total of 42,007 observed pediatric passengers with complete data from 2006 to 2019 were included in this study. Restraint use increased across all years and all age groups observed, with the largest increases among the older pediatric age groups. However, restraint use was consistently highest among the youngest child passengers. With all study years combined, the odds of being compliantly restrained were 13% lower in rural areas (OR = 0.87, 95% CI = 0.80, 0.95) compared to urban areas., Conclusions: Restraint use was lower in rural areas and among older pediatric passengers, suggesting targeted efforts to increase restraint use among these groups may have the greatest impact on overall occupant protection.

Introduction: The aging population has been rapidly growing in the United States (U.S.). In line with this trend, older adults' mobility and transportation safety are an increasing priority. Many states have implemented driver licensure laws specific to older adults to limit driving among the elderly with driving skill decline. Evaluations of these laws have primarily focused on their safety benefits related to older drivers' fatal crash rate or injury rate. However, very few studies investigated licensure law effects on older adults' mobility., Objective: The objective of our study is to evaluate the association between older driver licensure laws and older adult daily traveling and passenger exposure., Methods: The 2003-2017 American Time Use Survey (ATUS) data were linked with statewide driver licensure law provisions. Adults aged 55-64 years were used as the reference group to control for the effects of non-licensure-law factors (e.g., economic trend). We used modified Poisson regressions with robust variance to estimate the relationships between licensure law provisions and the likelihoods of older men and women's daily traveling and passenger behaviors., Results: Laws requiring a vision test at in-person renewal were associated with increased daily traveling likelihood for women aged 75 years or older, primarily as a passenger. Laws requiring a knowledge test were related to a reduced daily overall traveling likelihood for women aged 75 years or older., Conclusions: In general, licensure law provisions are not strongly related to older adults' mobility, in particular for older male adults. Older female adults' daily mobility may be more likely to be influenced by the change of licensure laws than older male adults. The existence of gender-based disparities in responding to licensure laws requires future studies to account for the gender difference in estimating the effects of those traffic policies on older adults' mobility and traffic safety.

Objective: There are a plethora of child bicycle safety education programs worldwide. However, the content and durations vary widely from program to program and no gold standard has been established. The main objective of this project was to create an inventory of youth bicycle safety education programs and their content, approaches, and age and developmental considerations. Methods: Methods used to gather program information included web and online database searches, extraction from personal lists, and a widely distributed online survey. A total of 89 programs met inclusion criteria and were reviewed (78 from the United States and 11 from other countries). Results: Over half (56.2%) of the included programs were not explicitly age specific, meaning that the content was not appropriately designated by age and developmental cut points. Many programs had target age groups, but these were often very wide age ranges (e.g., all elementary school-age children) resulting in content too advanced for the youngest children. Only 12.4% of included programs had published program evaluations and their scientific rigor varied widely. Main results from this inventory revealed a weak evidence base for program effectiveness due to lack of program evaluations. Results also highlighted a need for age, development, and skill-level considerations in youth bicycle education programs. Conclusions: This study provides a comprehensive list of program components and approaches that can be used as a foundation upon which child bicycle education standards can be evaluated and built, with the long-term goal of increased childhood safety.

Objective: This study uses administrative data to assess the optimal timing for surgical repair of craniosynostosis and to identify factors associated with risk of perioperative complications., Design: Statistical analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database (2006, 2009, 2012)., Setting: KID-participating hospitals in 44 states., Patients: Children 0 to 3 years of age with ICD-9 codes for surgical correction of craniosynostosis (756 and 0124, 0125, 0201, 0203, 0204, or 0206)., Main Outcome Measure: Age-based cohorts were assessed for perioperative complications. We performed a multivariable analysis to determine characteristics associated with increased risk of complications., Results: 21 million admissions were screened and 8417 visits met criteria for inclusion. Seventy-five percent of procedures occurred before age 1. Complications occurred in 8.6% of patients: 6.6% of patients at age 0 to 6 months, 10.3% of patients aged 7 to 12 months, and 13.9% of patients 12 to 36 months. Patients with acrocephalosyndactyly or associated congenital anomalies experienced complications in 22.9% of cases (OR = 3.07, 95% CI = 2.33, 4.03)., Conclusion: Craniosynostosis repair is safe; however, the risk of complications increases with age at intervention. Presence of a syndromic congenital deformity at any age carries the greatest increased risk of perioperative complications. This suggests that optimal timing of intervention is within the first year of life, especially in those cases with additional factors increasing perioperative risk. These data support the importance of counseling patients of the increased risk associated with delaying craniosynostosis repair.

Introduction: Core data are crucial for detailing an accurate profile of the midwifery workforce in the United States. The American College of Nurse-Midwives (ACNM) and the American Midwifery Certification Board, Inc. (AMCB), at the request and with support from the US Health Resources and Services Administration (HRSA), are engaged in a collaborative effort to develop a data collection strategy (the Midwifery MasterFile) that will reflect demographic and practice characteristics of certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States., Methods: Two independent datasets, one collected by ACNM in 2012 and one by AMCB in 2013, were examined to determine key workforce information. ACNM data were collected from the online Core Data Survey sent to ACNM members. AMCB data were extracted from information submitted online by applicants seeking initial certification in 2013 and applicants seeking to recertify following 5 years of initial certification., Results: The ACNM 2012 survey was partially or fully completed by 36% (n = 2185) of ACNM members (N = 6072). AMCB respondents included 100% of new certificants (N = 539) and those applying for recertification in 2013 (n = 1323) of the total 11,682 certificants in the AMCB database. These two datasets demonstrate that midwives remain largely white, female, and older in age, with most engaged in clinical midwifery while employed primarily by hospitals and medical centers. Differences were reported between the ACNM membership and AMCB certification datasets in the numbers of midwives holding other certifications, working full-time, attending births, and providing newborn care., Discussion: The new collaboration among HRSA, ACNM, and AMCB, represented as the Midwifery MasterFile, provides the opportunity to clearly profile CNMs/CMs, distinct from advanced practice registered nurses, in government reports about the health care workforce. This information is central to identifying and marketing the role and contribution of CNMs/CMs in the provision of primary and reproductive health care services., (© 2015 by the American College of Nurse-Midwives.)

Asthma is a chronic inflammatory disorder of the airways that is characterized by episodic and reversible airflow obstruction, airway hyper-responsiveness, and underlying inflammation. Common asthma symptoms include wheezing, coughing, and shortness of breath. With correct treatment and avoidance of exposure to environmental allergens and irritants that are known to exacerbate asthma, the majority of persons who have asthma can expect to achieve optimal symptom control.

Purpose: This quality improvement project collected and analyzed short-term weight gain data for patients with restrictive eating disorders (EDs) treated in outpatient adolescent medicine-based ED programs nationally., Methods: Data on presentation and treatment of low-weight ED patients aged 9-21 years presenting in 2006 were retrospectively collected from 11 independent ED programs at intake and at 1-year follow-up. Low-weight was defined as < 90% median body weight (MBW) which is specific to age. Treatment components at each program were analyzed. Risk adjustment was performed for weight gain at 1 year for each site, accounting for clinical variables identified as significant in bivariate analyses., Results: The sites contained 6-51 patients per site (total N = 267); the mean age was 14.1-17.1 years; duration of illness before intake was 5.7-18.6 months; % MBW at intake was 77.5-83.0; and % MBW at follow-up was 88.8-93.8. In general, 40%-63% of low weight ED subjects reached ≥90% MBW at 1-year follow-up. At intake, patients with higher % MBW (p = .0002) and shorter duration of illness (p = .01) were more likely to be ≥90% MBW at follow-up. Risk-adjusted odds ratios controlled for % MBW and duration of illness were .8 (.5, 1.4)-1.3 (.3, 3.8), with no significant differences among sites., Conclusion: A total of 11 ED programs successfully compared quality improvement data. Shorter duration of illness before intake and higher % MBW predicted improved weight outcomes at 1 year. After adjusting for risk factors, program outcomes did not differ significantly. All adolescent medicine-based ED programs were effective in assisting patients to gain weight., (Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Macro-level legal and ethical issues play a significant role in the successful translation of knowledge into practice. The medicolegal milieu, in particular, can promote clinical inertia and stifle innovation. Embracing new clinical practice guidelines and best practice models has not protected physicians from superfluous torts; in some cases, emerging evidence has been used as the dagger of trial lawyers rather than the scalpel of physicians. Beyond the legal challenges are overarching justice issues that frame the broad goals of knowledge translation (KT) and technology diffusion. Optimal implementation of the latest evidence requires attention to be paid to the context of the candidate community and the key opinion leaders therein, characterized by the "8Ps" (public, patients, press, physicians, policy makers, private sector, payers, and public health). Ethical and equitable KT also accounts for the global burdens and benefits of implementing innovation such that disparities and gaps in health experienced by the least advantaged are prioritized. Researchers and thought leaders must attend to questions of fairness, economics, and legal risk when investigating ways to promote equity-oriented KT.