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BACKGROUND AND PURPOSE Although the prevalence of dissociative disorders (DDs) is up to 10 percent of the general population, psychiatric-mental health (PMH) registered nurses lack education on how to care for individuals diagnosed with these disorders. METHOD Sixty-two PMH nurse educators completed an anonymous online survey about their perceptions of teaching DDs to nursing students. Braun and Clarke’s six-phase framework was used to conduct an inductive, reflexive thematic analysis of the data. RESULTS Three primary themes were identified: lack of resources, differing opinions on the value of teaching DDs, and stigma. CONCLUSION Though roughly 75 percent of participants reported that they teach DDs to their nursing students, they endorsed concerning misperceptions about the diagnoses. By failing to properly educate future PMH RNs about DDs, individuals with DDs are at risk of receiving inadequate and inappropriate nursing care and experiencing poor outcomes. [ABSTRACT FROM AUTHOR]

Background: In 2022, suicide ranked as the 11th leading cause of death in the United States with 49,513 deaths. Provisional mortality data from 2022 indicate a 2.8% increase in the number of suicides compared to 2021. This paper examines overall suicide trends, sodium nitrite ingestion as an emerging suicide method, and the role that online forums play in sharing information about suicide methods (including sodium nitrite ingestion). Methods: Suicides were identified from CDC's National Vital Statistics System (2018-July 2023 provisional) multiple cause-of-death mortality files using International Classification of Diseases (ICD), Tenth Revision underlying cause-of-death codes U03, X60–X84, and Y87.0 and T code T50.6 (antidotes and chelating agents). Google search popularity metrics were captured from January 2019 to January 2023. Case reports of sodium nitrite related suicide and suicide attempts (through February 2024) were identified in the medical and forensic literature. Results: At least 768 suicides involving antidotes and chelating agents (including sodium nitrite) occurred between 2018 and July 2023, set in the context of 268,972 total suicides during that period. Overall, suicides involving antidotes and chelating agents (including sodium nitrite) represent <1% of all suicides, however, numbers are rising. Conclusions: Suicide methods are known to change over time. These changes can be influenced by, among other factors, online forums and means accessibility, such as internet purchase availability. CDC remains committed to prevention through comprehensive public health strategies that protect individuals, families, and communities. Practical Applications: States and community partners might consider leveraging physicians, emergency responders, and other appropriate crisis response groups to disseminate information on sodium nitrite self-poisoning and its antidote, methylene blue. Efforts should be part of a comprehensive public health approach to suicide prevention. [ABSTRACT FROM AUTHOR]

Objective: This study seeks to understand how liberal gun owners configure the rights and responsibilities of ethical gun citizenship in the face of a dominant public narratives that rejects guns as markers of liberal belonging. Methods: This study employs a qualitative, textual analysis approach to explore the narratives of liberal gun owners participating in online discussions of mass shootings and contentious political elections. Results: The results show how liberal gun owners, in these online forums, advocated for an emancipatory democracy that largely prioritized the collective over the individual, demanded an accountable government, and was radical in its insistence on the importance of accessibility and meaningful participation, thus configuring social belonging and commensurability as central to formal citizenship. Conclusion: The results suggest that how one formulates the values of citizenship is linked to how one practices the politics of democracy. Highlighting the greater range of possibilities for the alignment of guns and citizenship may thus offer some hope to the rancor of contemporary partisan politics as liberal gun owners seek to normalize a democracy that brings individual and collective identities and needs into its culture and practice. [ABSTRACT FROM AUTHOR]

In algorithmic work, algorithms execute operational and management tasks such as work allocation, task tracking and performance evaluation. Humans and algorithms interact with one another to accomplish work so that the algorithm takes on the role of a co‐worker. Human–algorithm interactions are characterised by problematic issues such as absence of mutually co‐constructed dialogue, lack of transparency regarding how algorithmic outputs are generated, and difficulty of over‐riding algorithmic directive – conditions that create lack of clarity for the human worker. This article examines human–algorithm role interactions in algorithmic work. Drawing on the theoretical framing of organisational roles, we theorise on the algorithm as role sender and the human as the role taker. We explain how the algorithm is a multi‐role sender with entangled roles, while the human as role taker experiences algorithm‐driven role conflict and role ambiguity. Further, while the algorithm records all of the human's task actions, it is ignorant of the human's cognitive reactions – it undergoes what we conceptualise as 'broken loop learning'. The empirical context of our study is algorithm‐driven taxi driving (in the United States) exemplified by companies such as Uber. We draw from data that include interviews with 15 Uber drivers, a netnographic study of 1700 discussion threads among Uber drivers from two popular online forums, and analysis of Uber's web pages. Implications for IS scholarship, practice and policy are discussed. [ABSTRACT FROM AUTHOR]

Campsites represent highly sought after recreational amenities in the national parks of the United States. Equitable allocation of scarce recreational resources has long been a key management issue in U.S. national parks, but has become increasingly difficult in an era of increasing demand. At present, a growing number of national park campsites are allocated through an online reservation system well in advance of a camper's arrival at a park. Compounding the challenge of allocating these campsites is a long history of exclusivity within national park camping--institutionalized through campground design and predicated on a legacy of the leisure class's affinity for camping in national parks. Given national park camping's history of exclusivity, this exploratory study seeks to explore how online reservation systems may impact the demographics of national park campers. Using mobile device location data, estimated demographics were calculated for campers in five national park campgrounds in the U.S. that each contained some sites requiring reservations and some sites available on a first-come, first-served basis. We detail results from analyses of variance between campsites requiring reservations and those that are available on a first-come, first-served basis. Results suggest that for each of the five campgrounds, those campers camping in sites that require reservations came from areas with higher median household incomes, on average. In three of the five campgrounds, this difference was significant. Additionally, in an urban-proximate setting, those camping in sites requiring reservations came from areas with a higher portion of White residency than those campers in campsites not requiring reservations, on average. We conclude with discussion that includes management implications concerning the growing prominence of online reservation systems for outdoor recreation amenities, and a brief research agenda for diversity, equity, and inclusion (DEI) as they relate to campgrounds. Principally, the former group of implications includes the realization that online reservation systems present the unintended consequence of excluding low-income, and perhaps non-White, would-be campers--a conclusion drawn from the results of this exploratory study. This discussion includes an analysis of the distributive justice of online reservation systems. [ABSTRACT FROM AUTHOR]

We used an internet-based survey platform to conduct a cross-sectional survey regarding the impact of COVID-19 on the LGBTQ + population in the United States. While this method of data collection was quick and inexpensive, the data collected required extensive cleaning due to the infiltration of bots. Based on this experience, we provide recommendations for ensuring data integrity. Recruitment conducted between May 7 and 8, 2020 resulted in an initial sample of 1251 responses. The Qualtrics survey was disseminated via social media and professional association listservs. After noticing data discrepancies, research staff developed a rigorous data cleaning protocol. A second wave of recruitment was conducted on June 11–12, 2020 using the original recruitment methods. The five-step data cleaning protocol led to the removal of 773 (61.8%) surveys from the initial dataset, resulting in a sample of 478 participants in the first wave of data collection. The protocol led to the removal of 46 (31.9%) surveys from the second two-day wave of data collection, resulting in a sample of 98 participants in the second wave of data collection. After verifying the two-day pilot process was effective at screening for bots, the survey was reopened for a third wave of data collection resulting in a total of 709 responses, which were identified as an additional 514 (72.5%) valid participants and led to the removal of an additional 194 (27.4%) possible bots. The final analytic sample consists of 1090 participants. Although a useful and efficient research tool, especially among hard-to-reach populations, internet-based research is vulnerable to bots and mischievous responders, despite survey platforms' built-in protections. Beyond the depletion of research funds, bot infiltration threatens data integrity and may disproportionately harm research with marginalized populations. Based on our experience, we recommend the use of strategies such as qualitative questions, duplicate demographic questions, and incentive raffles to reduce likelihood of mischievous respondents. These protections can be undertaken to ensure data integrity and facilitate research on vulnerable populations. [ABSTRACT FROM AUTHOR]

The current study analyzed comments posted on Internet message boards devoted to U.S. college football. The investigators collected comments (N = 3,800) about instances in which a player initially announced intent to attend a particular university, but later changed his mind and signed a National Letter of Intent to attend a different university. While few posts included explicit mention of race (n = 11), commenters more frequently used forms of "color-blind" racial rhetoric that invoked racialized meanings without the overt use of racial terms (n = 346). Comments often reflected a white colonial framing of football players' decisions, behaviors, and abilities, expressing a number of common racialized assumptions, including beliefs in the natural superiority of black physicality, doubts about black intellectual ability, and expectations about whites possessing skill, technique, and mental capacity. The presence of these racialized assumptions points to the continued salience of race in an era that is often claimed to be "color-blind" and free of racial discrimination. [ABSTRACT FROM AUTHOR]

Objective: To understand individual abortion providers' experiences with targeted harassment.Study Design: We conducted a cross-sectional survey of a convenience sample of US physicians with history of abortion provision, recruited through online groups, and listservs. Respondents completed a Qualtrics survey reporting personal and practice characteristics and experiences with harassment. We calculated descriptive statistics, comparing those who had and hadn't experienced targeted harassment using χ2 tests, and we qualitatively analyzed free-text descriptions of harassment experiences to identify themes.Results: Of 321 respondents, 112 (35%) reported harassment. Targeted harassment was more likely with each decade of increasing age, and was greater for respondents providing outpatient versus only inpatient surgical abortion care (40% vs. 7%, p < 0.001) and care beyond the first trimester compared to only in the first trimester (39% vs. 16%, p = 0.001). Sixty-two respondents (19%) were not currently providing abortions, with 33 (52%) explicitly forbidden from doing so by their employers. Qualitative analysis revealed that most harassment is invasive and intimidating rather than overtly violent, with many providers experiencing intentional public exposure of their abortion work and having their professionalism discredited. Ensuing isolation of providers from their communities both perpetuates and facilitates further abortion provider stigma and harassment.Conclusions: Targeted harassment toward abortion providers is widespread and attempts to intimidate providers and isolate them from their communities. More research is needed to explore ways to mitigate isolation of providers, which could improve safety, and have positive effects on the abortion workforce. [ABSTRACT FROM AUTHOR]

Few studies have examined the practices of U.S. oncology social workers since the implementation of distress screening. This study presents data about oncology social work practice behaviors, including participation in distress screening and interdisciplinary team integration. Using a cross-sectional survey design, Association of Oncology Social Work (AOSW) members were invited to complete the anonymous web-based survey between June and September 2019. AOSW members (N = 1116) were invited through email and listserv posts to participate in the survey with 533 (47.8%) responding. A quantitative on-line survey was used to investigate demographics, distress screening roles and other practice behaviors. Descriptive analyses were conducted on the data. Respondents engaged in a range of practice behaviors consistent with the Standards and Scope of Practice published by AOSW, primarily engaging in patient-focused work. They reported viewing their role as integrated with the interdisciplinary team. Respondents were highly involved in distress screening processes, primarily receiving referrals from distress screening but also collecting/reviewing screening results and referring patients to other providers based on those results. Knowledge about the ways that oncology social workers enact their role across settings and locations could be useful to those developing effective and integrated psychosocial oncology programs, especially distress screening protocols. Specific knowledge about the practice behaviors of oncology social workers in the U.S. may also help to delineate the role from the work of other interdisciplinary oncology team members. [ABSTRACT FROM AUTHOR]

Objective: Examine predictors of social media use among a nationally representative sample of adults with children in the household.Methods: Data were collected from the Health Information National Trends (HINTS) Survey from 2017 to 2020 (N = 3559). Multivariate logistic regression models assessed the association between sociodemographic variables and social networking site (SNS) use, SNS use to share health information, participation in online forum or support groups for health issues and watching health-related videos on YouTube.Results: Older adults and men were significantly less likely to use social media (p<.05). Non-Hispanic African American (aOR: 1.83; 95%CI: 1.30-2.57), Hispanic (aOR: 2.16; 95%CI: 1.56-2.99), and Asian (aOR: 2.82; 95%CI: 1.67-4.75) adults were more likely to watch health-related videos on YouTube.Conclusions: Racial/ethnic minorities with children in the household were more likely to seek health information on YouTube, highlighting opportunities to disseminate culturally relevant, accurate messages on the platform. Effective health communication targeted to specific demographics can help counter misinformation and promote health behavior particularly during public health emergencies.Practice Implications: Providers need to foster trust so that patients are comfortable to ask questions in addition to seeking information online. Providers can direct patients to credible resources to counter misinformation exposure and promote healthy behavior. [ABSTRACT FROM AUTHOR]

Objective: Some intrauterine devices (IUD) users self-remove their IUDs, and these experiences are not well understood. This study examines what IUD users post in internet forums about their experience, as well as advice and questions shared among IUD users about self-removal.Study Design: This study uses qualitative analysis of internet health and parenting forum postings about IUD self-removal identified from an internet search engine. We analyzed the data using inductive and deductive content analyses.Results: Twenty-eight sites, containing 1742 posts by 1197 unique users, satisfied our eligibility criteria. Users reported successful IUD self-removal attempts as "quick," "easy," and "painless"; it was rare to encounter IUD users describing complications of their self-removal attempts. Users described unsuccessful attempts as failure to find or grasp strings. Many IUD users described their successful removal techniques and gave advice to other users who were struggling with self-removal. Users frequently utilized the forum to ask questions about IUD self-removal methods and timing, pain, when to seek medical intervention, and the effects on future fertility.Conclusions: Posts describing successful IUD self-removal report positive experiences. IUD users who have difficulty with self-removal may utilize internet forums to learn from others' experiences.Implications: Exploring IUD users' experiences with and questions about self-removal may inform strategies to develop better resources for those who desire self-removal. [ABSTRACT FROM AUTHOR]

The meritocratic ideal prescribes that universities should admit students based on academic ability and individual effort. Yet as competition for scarce slots has increased, markets for services to improve the odds of admission have expanded. We use the case of a popular online forum for elite Taiwanese students seeking graduate study in the United States to argue that the moral values assigned to such markets provide useful information about the status of the meritocratic ideal. Using digital ethnography and interviews with forum participants, we find that individuals moralize markets for admissions services in ways that align with their social position. They valorize participation in markets that compensate for their "unfair" disadvantage around English while rejecting the legitimacy of adjacent markets that compensate for lack of cultural capital (which they possess). More generally, we argue that although individuals who benefit from meritocracy will tend to stigmatize associated markets, the positive moralization of such markets can reflect local contests over how meritocracy should be defined—yet not necessarily undermine the meritocratic ideal. [ABSTRACT FROM AUTHOR]

Introduction: Clinical psychologists often treat patients with a sleep disorder. Cognitive-behavioral treatments can independently, or in combination with medical interventions, effectively improve sleep health outcomes. No studies have examined sleep education and training among practicing clinical psychologists. Method: Actively practicing clinical psychologists were recruited through psychological associations' e-mail listservs across the United States and Canada. Respondents (N = 200) provided information about: 1) duration and format of formal sleep education and training; 2) perceived self-efficacy to evaluate and treat sleep disorders; and 3) interest in further sleep training. Results: Clinical psychologists reported a median of 10.0 hours of didactic sleep training (range 0–130 hours) across their training or career. Ninety-five percent reported no clinical sleep training during graduate school, internship, or post-doctoral fellowship. In terms of evaluation and treatment, 63.2% reported feeling at least "Moderately Prepared" to evaluate a patient's sleep and 59.5% felt at least "Moderately Prepared" to treat a common sleep disorder (insomnia disorder). However, most endorsed using insomnia disorder treatment approaches inconsistent with empirically supported guidelines. The vast majority (99.3%) desired additional sleep training across a variety of delivery formats. Discussion: Many clinical psychologists engaged in active patient care have received minimal formal sleep training. Despite this, they felt prepared to evaluate and treat sleep disorders. Their treatment recommendations were not aligned with evidence-based standards. This may result in a delay to, or absence of, effective treatment for patients, underscoring the critical need for sleep training among clinical psychologists. It is essential to improve sleep competencies for the field. [ABSTRACT FROM AUTHOR]

Understanding the characteristics of the rapidly evolving geospatial software ecosystem in the United States is critical to enable convergence research and education that are dependent on geospatial data and software. This paper describes a survey approach to better understand geospatial use cases, software and tools, and limitations encountered while using and developing geospatial software. The survey was broadcast through a variety of geospatial-related academic mailing lists and listservs. We report both quantitative responses and qualitative insights. As 42% of respondents indicated that they viewed their work as limited by inadequacies in geospatial software, ample room for improvement exists. In general, respondents expressed concerns about steep learning curves and insufficient time for mastering geospatial software, and often limited access to high-performance computing resources. If adequate efforts were taken to resolve software limitations, respondents believed they would be able to better handle big data, cover broader study areas, integrate more types of data, and pursue new research. Insights gained from this survey play an important role in supporting the conceptualization of a national geospatial software institute in the United States with the aim to drastically advance the geospatial software ecosystem to enable broad and significant research and education advances. [ABSTRACT FROM AUTHOR]

Background: Infusion therapy refers to the intravenous administration of medicines and fluids for the treatment of status migrainosus, severe persistent headaches, or chronic headache. Headache practices and centers offer this treatment for patients as an alternative to the emergency department (ED) setting. However, little information is available in the literature on understanding the operations of an infusion center. Objective: We sought to survey the Inpatient Headache & Emergency Medicine specialty section and the Academic Program Directors listserv of the American Headache Society (AHS) to better understand current practices. Methods: A survey was advertised and distributed to the listservs of both the Inpatient Headache & Emergency Medicine specialty section and the Academic Program Directors, which combined included both academic and private practices. In addition, the survey was available on laptops at related events at an annual AHS meeting in Scottsdale. Results: Of the 127 members of the combined group of both listservs, 50 responded with an overall survey response rate of 39%. Ten out of fifty were from programs with more than one responder completing the survey, leaving 40 unique headache programs. Academic programs made up the majority of programs (85%, 34/40). The total of 40 participating programs is comparable with the 47 academic headache programs listed on the American Migraine Foundation website at the time of the survey. Of the academic programs surveyed, most were hospital based (n = 23) compared with a satellite location (n = 11). Of all programs surveyed, 68% (27/40) offered infusion therapy. Of those that did not have an infusion practice (n = 13), the most common reason cited was insufficient staffing (n = 8). Key highlights of the survey included the following: The majority of programs offering infusions obtain prior authorization before scheduling (70%, 19/27) and offer patient availability 5 days/week (78%, 21/27) typically only during business hours (81%, 22/27). Programs reported that they typically give three to four medications during each infusion session (72%, 18/25). Treatment paradigms varied between programs. Programs surveyed were concentrated in the Northeast and Midwest regions of the United States. Conclusion: The limited number of headache infusion centers overall may contribute to the limited ability of headache infusion centers to prevent ED migraine visits. Headache patients can have unpredictable headache onset, and most of the infusion practices surveyed appeared to adapt to this by offering infusions most days during a work week. However, this need for multiple days per week may also explain the most common reason for not having an infusion practice, which is insufficient staffing. Various treatment paradigms are implemented by different practitioners, and future studies will have to focus on investigation of best practice. [ABSTRACT FROM AUTHOR]

In the media, during sporting events, in online forums, and in interpersonal interactions, whites often portray Black people as animals, especially as apes or monkeys. In this essay we consider what contemporary research on prejudice in American politics has to say about these dehumanizing portrayals of Black people. We argue that contemporary political science work has not done enough to understand both the historical roots and the continuing practices of whites' dehumanization of Black people, to the detriment of an accurate understanding of racial attitudes in the United States. To rectify this omission, we draw on the work of historians to map out a brief overview of race‐making and the dehumanizing attitudes that shaped this process. Then, we review political science literature on contemporary white attitudes toward Black people, emphasizing connections between prevailing conceptions of these attitudes and long‐standing processes of dehumanization. We conclude by charting directions for future scholarship; we seek to unsettle the mainstream of a subfield dominated by mild conceptions of racial attitudes. [ABSTRACT FROM AUTHOR]

Where do partisans get their election news in the contemporary media environment? We track the online news consumption of a national sample during the 2016 presidential campaign. We find levels of partisan isolation in news exposure are two to three times greater than in prior studies, although the absolute level of isolation remains modest. The partisan divide for election-related news exceeds the divide for non-political news. This tendency of partisans to follow like-minded news providers occurs despite the relatively small differences in the partisan slant of the content offered by the majority of sources they visited. Finally, we find that partisans who gravitated to congenial news providers did not shift their evaluations of the presidential candidates during the campaign. [ABSTRACT FROM AUTHOR]

The purpose of this small-group case study was to determine to what extent an asset-based social justice curriculum could cultivate critical consciousness as evidenced by teachers' written discourse about students of color and students living in poverty. Participants were selected based on enrollment in an online graduate course in diversity in the college of education of a state university in the southern United States. Participants wrote reflective responses and contributed to online discussion forums before, during, and after exposure to curriculum that was explicit in its social justice and asset-based approach. From a critical lens, analysis of discourse was applied to 7 weeks of participants' reflective writing in discussion forums and individual self-reflective assignments. Participants in this study exhibited varying degrees self-reflection and critical consciousness based on analysis of written discourse. Findings indicate participants' ability to engage in critically conscious thought coalesced into three categories of interaction with course content: (a) resistance, (b) critical consciousness interspersed with cognitive dissonance, and (c) adoption. Participants' discourse indicated the continued presence of deficit thinking and reliance on anecdotal evidence to support claims. Participants used a variety of strategies to avoid or minimize cognitive dissonance, including distancing language, reinterpretation, and anecdotal evidence. When participants were resistant or struggled with cognitive dissonance, anecdotal evidence served as a defense mechanism to support their beliefs. [ABSTRACT FROM AUTHOR]

OBJECTIVE To survey cattle producers and veterinarians about the use of analgesia on US cattle operations. SAMPLE 1,187 members of the following database, electronic mailing lists, and social media groups: Farm Progress master file, American Association of Bovine Practitioners, Academy of Veterinary Consultants, National Milk Producers Federation Farm Evaluators, Dairy Moms Facebook group, and Dairy Girl Network Facebook group. PROCEDURES An online survey was developed to gather information about the frequency of local and systemic analgesia use for common painful procedures and diseases cattle < 2,2 to 12, and > 12 months old. Respondents also rated their extent of agreement with each of 10 statements related to pain management in cattle. The survey was available from June I I to August 10.2018. Descriptive data were generated. Logistic regression was used for comparisons among cattle age groups and respondents on the basis of their industry role. RESULTS In general, frequency of analgesia use increased as cattle age increased, regardless of the procedure or disease. The odds of analgesia use were lower for men, compared with women, and greater for veterinarians, compared with producers. Many respondents indicated they were cognizant of the benefits of analgesia use in cattle but perceived federal regulations and drug costs as impediments to the implementation of pain mitigation protocols on cattle operations. CONCLUSIONS AND CLINICAL RELEVANCE Results provided insight into current perceptions and use of analgesia in cattle, which can be used to guide implementation of pain mitigation protocols on US beef and dairy cattle operations. [ABSTRACT FROM AUTHOR]

Background: There is a need for interventions to promote health management of older adults with pre-frailty and frailty. Technology poses promising solutions, but questions exist about effective delivery. Objectives: We present the results of a mixed-methods pilot evaluation of Virtual Online Communities for Older Adults (VOCALE), an 8-week intervention conducted in the northwestern United States, in which participants shared health-related experiences and applied problem solving skills in a Facebook group. Methods: We performed a mixed-methods process evaluation, integrating quantitative and qualitative data, to characterize the intervention and its effects. We focus on four areas: health-related measures (health literacy and self-efficacy), participation, problem solving skills enacted, and subjective feedback. Results: Eight older adults with pre-frailty and frailty (age = 82.7 ± 6.6 years) completed the study. There was an upward trend in health literacy and health self-efficacy post-intervention. Participants posted at least two times per week. Content analysis of 210 posts showed participants were able to apply the problem solving skills taught, and exit interviews showed participants' increased awareness of the need to manage health, and enjoyment in learning about others. Conclusion: This mixed-methods evaluation provides insight into feasibility and design considerations for online interventions to promote health management among vulnerable older adults. [ABSTRACT FROM AUTHOR]

This study demonstrates that the trend of how rhytidectomy is valued can be used to determine not only the pricing of this good but also how receptive developing economic markets are to the export of cosmetic facial plastic surgery. This study seeks to analyze and compare the value of rhytidectomy in an established market and an emerging market. A cross-sectional survey was administered through public online forums to 162 casual observers in the United States and 74 casual observers in India. Participants were shown pre- and postoperative photos of 10 patients who underwent cosmetic rhinoplasty and 2 patients who did not undergo surgery. Observers were asked to quantify the perceived change in attractiveness, change in age, and willingness to pay (WTP). There is a similar nonlinear trend between WTP and change in attractiveness in both the United States and India. Baseline values of rhytidectomy in the United States and India have a similar ratio of 2.122 compared with the ratio between both countries in the 2018 Big Mac index. The comparison of the trend in WTP in the United States and India shows that facial cosmetic surgery functions as a luxury good in both an established market and an emerging market. Our model successfully approximates the relationship between each country's purchasing power parity. Since the market behavior of rhytidectomy can be predicted based on purchasing power parity, there may be an untapped market for facial cosmetic surgery among populations with growing economies. [ABSTRACT FROM AUTHOR]

Electric bikes (ebikes) are an emerging technology that can partially mitigate many of the challenges facing the United States, such as improving mobility for the elderly and disabled, by mitigating diabetes and obesity, and reducing greenhouse gas emissions. Although ebikes have become increasingly common in the U.S., they have failed to gain significant market penetration despite their great promise. In this paper, we present the results of semi-structured interviews with 47 ebike users from around the U.S. to understand motivations and barriers to ebike use. Following prior research, our results suggest that cost savings and health benefits are the primary motivations behind ebike adoption, while lack of infrastructure is the primary impediment to ebike usage. Other barriers to ebike usage include shaming (primarily from other cyclists) and unwelcoming local policy environments. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the impact of courses redesigned using Quality Matters (QM) on student learning in an online program at a large university in the southeastern United States. The QM Rubric for course design is widely used in higher education. However, research about its use in nursing education is understudied. This pilot project compared 100% online courses--two courses redesigned to meet QM standards and two traditionally designed courses by faculty. Student outcomes such as quality of online discussion forums, student end of course evaluations, and end-of-course grades, were measured and analyzed. The data analysis included descriptive statistics and parametric group comparisons. Results showed that all indicators, although not statistically significant, were more positive in the QM-redesigned courses. As online education programs continue to explode, assurance of quality in course design is a key factor in meeting student needs. [ABSTRACT FROM AUTHOR]

Online question & answer (Q & A) is a distinctive type of online interaction that is impactful on student learning. Prior studies on online interaction in large-scale classes mainly focused on online discussion and were conducted mainly in non-STEM fields. This research aims to quantify the effects of online Q & A interactions on student performance in the context of STEM education. 218 computer science students from a large university in the southeastern United States participated in this research. Data of four online Q & A activities was mined from the online Q & A forum for the course, including three student activities (asking questions, answering questions and viewing questions/answers) and one instructor activity (answering questions/providing clarifications). These activities were found to have different effects on student performance. Viewing questions/answers was found to have the greatest effect, while interaction with instructors showed minimum effects. This research fills the gap of lacking research in online Q & A, and the results of this research can inform the effective usage of online Q & A in large-scale STEM courses. [ABSTRACT FROM AUTHOR]

Objective: The perspectives and experiences of intrauterine device (IUD) users who consider IUD self-removal are largely unknown. This study describes the reasons for IUD self-removal as documented in internet forums by IUD users discussing self-removal.Study Design: This qualitative study used an internet search strategy to document IUD users' reasons for self-removal in the United States. We employed a content analysis of online data using inductive and deductive qualitative techniques to examine the reasons why IUD users consider self-removal.Results: Search results initially identified 235 websites, of which 28 had online health or parenting forums with content related to IUD self-removal. Individual websites contained between 1 and 637 posts by between 1 and 454 individual users. IUD users described a variety of reasons for IUD discontinuation including undesired symptoms or side effects as well as planning for pregnancy. IUD users discussed difficulties accessing provider-removal because of cost or lack of appointment availability. IUD users also discussed how reading about others' successful self-removal experiences or approval by medical providers made self-removal a feasible or acceptable option.Conclusions: Some IUD users utilize online forums for advice about IUD removal, and attempt IUD self-removal due to side effects or because they desire pregnancy. Lack of access to a provider led some patients to attempt self-removal who may have preferred provider-removal.Implications: For those who prefer self-removal, anticipatory counseling from a clinician regarding self-removal might be useful and reassuring. Improving access to self-removal may help preserve reproductive autonomy for those who face barriers to IUD removal in the clinical setting. [ABSTRACT FROM AUTHOR]

Dermatology is arguably the most competitive residency (81.6% match rate for United States allopathic seniors) with significantly more applicants than available positions. To objectify this process, the National Residency Match Program (NRMP) has produced bi-annual Charting Outcomes in Match (COM) datasets, which aggregate data from the prior two application cycles and tabulate statistics to aid applicants. In parallel, online forums provide medical trainees with vast amounts of information, including residency application insights. Reddit medical school subforum compiles annual spreadsheets of anonymous, individualized applicant data to aid future applicants. We compared this data to NRMP data to show that although the data means are similar (e.g. Step 1), the Reddit dermatology spreadsheet collects more data and the individualized nature aids applicants in a personalized way unlike the mean aggregate data in NRMP. Under univariate analysis, Alpha Omega Alpha status, overall publications, and dermatology-specific publications are associated with interview invitation rates. Although limitations of the study include small data size and reporting bias, this is the first of its kind to our knowledge to compare these two often-used tools to aid dermatology applicants. Future endeavors should expand anonymous data reporting and use the data to carry out more extensive studies to investigate factors influencing the application process. [ABSTRACT FROM AUTHOR]

Recent evidence suggests mothers with infants are leaving the workforce (Cohany & Sok, 2007; Johnson, 2007), but research has not yet clarified why mothers make such a decision. The current research proposes that mothers form psychological contracts including content related to family that supervisors do not fulfill, resulting in intention to leave the organization. In a study of first-time mothers, participants reported experiencing contract breach. Findings also suggested supervisors may have an opportunity to control the outcomes of breach and retain mothers by effectively managing perceptions of fair treatment (i.e., interactional justice). This is the first empirical research to indicate that mothers' intentions to leave depend on fulfillment of their psychological contracts related to family and fair treatment from their supervisor. [ABSTRACT FROM AUTHOR]

Characterizes the questioning behavior on a consumer health-related electronic list focused on colon cancer in the United States. Two dimensions of the pattern of questioning on electronic lists; Common types of questions asked; Extent of the length of response entailed by the question; Methods of establishing context for questions.

This study presents an innovative approach to developing interlanguage pragmatics (ILP) by training students to engage in online participatory cultures and analyzing their participation through the lens of communities of practice. Participants were university-level English language learners studying in the United States who were trained on the basic layout and practices of a social news and discussion site (Reddit), then assigned weekly postings within forums based on their individual interests. Social media engagement metrics (upvotes and responses) were used to measure and observe the quantity and quality of online interaction, and post-task questionnaires and follow-up interviews investigated learner perceptions about the language and cyberpragmatics in the online communities they encountered. Quantitative results show that participants struggled to achieve high levels of interaction with other users, but qualitative results indicate a wide range of potential benefits for ILP exploration and development. The findings and implications of this study contribute towards best practices in developing strategies for ILP in online spaces and cyberpragmatic awareness among language learners, enabling them to reach higher levels of participation in online communities. [ABSTRACT FROM AUTHOR]

Increasingly biased Internet news and information is frequently cited as a cause of opinion polarization in the United States. But is it that easy for media messages to influence political opinion? Matched samples of face-to-face versus online respondents in the 2012 and 2016 American National Election Studies reveal that about 23% of online respondents likely "cheated" by referencing the Internet to inform their answers. Doing so allowed those participants to provide more ideologically consistent responses to 41 survey questions, creating a strikingly bimodal distribution of reported opinion by pulling moderate answers to the political right. Quantile regression confirms these results. Probable cheating also increased the effect of Internet news source bias. These findings suggest that in-themoment Internet messages can influence reported opinions, not because Internet media consumers are duped, but because online information empowers them to give answers consistent with dominant political schemata in survey options and online information. [ABSTRACT FROM AUTHOR]

Truck drivers constitute a highly vulnerable population with very limited opportunities for healthy foods and healthy eating choices. This cross-sectional study assessed the utility of the Theory of Planned Behavior (TPB) in understanding and predicting healthy eating intention among Midwestern truck drivers in the United States. Participants were recruited through online trucker forums and advertisements at truck stops. Each participant completed an anonymous, web-based questionnaire that measured attitude, subjective norms, and perceived behavioral control. One hundred and forty-six truck drivers responded, with the average Body Mass Index (BMI) 32.7 and working as a truck driver for 10.3 years. Hierarchical multiple regression analysis assessed the predictive value of individual TPB constructs and the model. The predictive model containing the TPB constructs explained 18% of the variance in healthy eating intention, with attitude and subjective norm making significant and unique contributions. With the variance explained, the findings minimally supported the utility of TPB in understanding and predicting healthy eating intention among the truck drivers. These findings should be interpreted in view of the study limitations; the small sample size and being a self-report study. Notwithstanding, the findings highlight the importance of attitude and subjective norms in understanding and predicting healthy eating intention among Midwestern truck drivers in the United States. [ABSTRACT FROM AUTHOR]

Online discussion had been proliferating on university campuses in U.S. higher education. Nevertheless, the quality of student postings had been a concern. Research showed that assessment played an important role in promoting the success of online discussion. This article reported a design-based research on designing, implementing, and investigating assessment rules in online discussion. The study was conducted in discussion-based online courses at a large urban university in the United States. Participants were graduate students who were studying for their master's degree. The majority of the participants were currently school teachers. Student discussion postings and written reflections were collected over the time span of three semesters. Content analysis was applied in analyzing student postings. Student written reflections were analyzed to corroborate the results of the content analysis. Suggestions for the next cycle of redesign were discussed. [ABSTRACT FROM AUTHOR]

This corpus-based study examines women's framing of health issues in online forums (MedHelp.org, AphroditeWomensHealth.com, and Connect.MayoClinic.org) prior to, during, and after implementation of the Affordable Care Act (ACA). Since worldviews affect how women describe health issues, their discourse is both a way to see ideology indexed in the forums, as well as how that discourse has been shaped by policy. Posts were collected December 2016-April 2017 and annotated using the UAM (Universidad Autónoma de Madrid) Corpus Tool to examine emergent categories and compare them to three time periods: pre-, during, and post-ACA. Data within posts were coded as to the linguistic moves being made. Three frequent categories of linguistic function in the data were identified: experience-sharing, advice-requesting and offering, and rationale-offering (N = 1268). These linguistic moves were sub-divided into further categories (e.g., under advice requesting, a request for diagnosis), and a discourse-analytical perspective provides insight into the values indexed in each. Before ACA, forum participants cited access, fear, and a history of unhelpful medical visits as obstacles to seeking care. After implementation, obstacles cited were prior unhelpful visits, followed by access, and uncertainty regarding care-seeking appropriateness. While ACA implementation reduced lack of insurance as an obstacle to obtaining healthcare, online forums indicate that patients continue to find doctors' visits unhelpful, instead choosing to seek medical advice from the lay public. Patients' distrust of the medical profession persisted following ACA implementation. There is a need for public health initiatives to improve this relationship in order to augment health care outcomes. [ABSTRACT FROM AUTHOR]

Entrepreneurship is an important aspect of the U.S. and global economy. As such, developing an entrepreneurial mindset is crucial for both engineering students and practicing engineers. The purpose of this paper is to investigate the role of online discussions, as a pedagogical approach, in the development of the entrepreneurial mindset. Online discussions prompts were developed using the Kern Engineering Entrepreneurial Network (KEEN) framework as a guide. The KEEN framework proposes an entrepreneurial mindset can be fostered in students by stimulating curiosity, strengthening connections, and creating value. This paper describes the methodology and rationale that served as the foundation for this exploratory study. Examples are provided for online discussion prompts developed and administered in two different environmental engineering undergraduate courses: Introduction to Environmental Engineering (three credit, undergraduate, online course offered during two different summer sessions) and Seminar in Environmental Engineering (one credit, undergraduate level, face-to-face course offered during one semester). Quantitative and qualitative methods were used to analyze and assess potential impacts of online discussion prompt use. The findings provide lessons learned for integrating the KEEN framework into undergraduate engineering courses through online discussions. [ABSTRACT FROM AUTHOR]

This paper aims at analyzing the content of Turkish Geography Discussion List (TGDL) which was an electronic e-mail list that functioned between 1997 and 2012 and completed an important mission as the medium of the diffusion of new geographic information and ideas. The TGDL was established by the author in the United States. Some 4000 e-mail messages were exchanged through the list and geographical ideas were discussed intensely for the first time. Therefore, it is necessary to portray the historical mission of the List that is more evident today. For that purpose, the list archive was analyzed, the main discussion areas were categorized and a content analysis was performed to identify the cognitive dimension of the list. The results show that many topics, new concepts, ideas and terms in geography were heard for the first time by Turkish geographers through the list during the 15 year period. Members with overseas experience and young members talked more about theoretical, institutional, methodological and technological issues while the others took a more cautious position and talked more about representation, class hours in schools, and employability issues. [ABSTRACT FROM AUTHOR]

As higher education institutions in United States offer online courses to growing audiences, there is increasing desire to understand how best to engage students with both course content and their peers. This case study examines the effects of assigning chat roles and facilitating self- and group reflection on student-content and student-student interaction outcomes in four synchronous chats conducted in an online introductory-level sustainability course. We also considered what occurred within group reflections to inform how they are structured in the future. We found that assigning roles increased the proportion of critical student-student interactions. Self-reflections had no effect on either interaction type. Groups completing group reflections had a greater proportion of critical student-content interactions in the third chat and critical student-student interactions in the fourth chat than the groups that did not complete the group reflections. Based on our results, we plan to keep roles and group reflections going forward, and eliminate self-reflections. Furthermore, to increase the effectiveness of the group reflections, we propose some ideas to increase student ability to convert their ideas into change during subsequent chats. [ABSTRACT FROM AUTHOR]

Laws requiring evidence of vaccination before children can enter schools or child care have been key to public health. However, as parents increasingly reject vaccines for their children, they rely on legal exemptions that allow children to access these settings without vaccination. Using qualitative data from interviews, ethnographic observations, and analyses of online forums, this article traces parents’ understandings of legal regulation and their strategies for navigating vaccine laws. Specifically, it shows how parents resent the lack of information about vaccine exemptions available, how they laboriously manage information about their children’s care to protect access to exemptions, and how they strategize how to use exemptions in ways they see as in their children’s best interests, but not necessarily as the laws were intended. It then shows how these efforts represent a way to challenge state power, which parents see as limiting individual freedoms. It concludes by considering the meanings for communities. [ABSTRACT FROM AUTHOR]

This paper continues the discussion about student-driven, interactive learning activities in higher education. Using object-oriented activity theory, the article explores the relational aspects of reflexive practice as demonstrated in five online discussions groups to develop students’ conceptual understanding. The purpose of the research is to describe both the process of reflection during online interaction and how practical engagement with the discipline is supported through pedagogical guidance. The students wrote short texts on the practice of health promotion ethics and discussed their perspectives in relation to theory and research. The analysis proved the importance of structural design in learning assignments to enable the cohesive and dialogic nature of interaction. Practical reflexivity is a necessary condition for enhancing the ability of professionals to question and justify critical aspects of their organisational relationships. [ABSTRACT FROM PUBLISHER]

This paper presents a longitudinal study, across three semesters following 19 elementary education preservice teachers registered in three blended courses (foundations of education, and integrated reading and language arts methods), at a university in Hawaii. In two courses the instructor, aside of regular course content, taught also about Bloom's Taxonomy, and used it as a rubric for grading students' discussions about language arts instructional methods in elementary education. A total of 912 forum postings (reflections and comments) were analyzed and scored. Results show that teaching Bloom's taxonomy as an instructional tool in a blended course, and using it as a rubric to score online postings, improved students' performance in online discussions. The level of assigned discussion task was also shown to be a factor in the level of students' responses in the online discussions. Results are presented by semester and type of posting (reflections vs. comments). Lessons learned and educational implications are presented. [ABSTRACT FROM AUTHOR]

Drawing on the current conceptualization of acculturation/enculturation as bilinear, multidimensional processes proceeding in interaction with surrounding contexts, this study examined ethnic identity development and cultural integration of 13 adolescents from East Asian immigrant families. Five domains emerged via the Consensual Qualitative Research method: ethnic/cultural identity and socialization; bicultural living; racial context-racism and stereotypes; family context-parental expectation; and peer context-friendship/dating. Overall, the participants experienced a cultural split and discontinuity between the 2 worlds of home and ethnic community versus school and society in general. They received strong ethnic socialization messages from family and ethnic community. Although most participants experienced hurtful racial discrimination, they used passive coping (e.g., dismiss, minimize, defend perpetrators). The model minority stereotype was prevalent and deeply engrained in many aspects of their lives including ethnic identity development, cultural socialization messages from mainstream society, discrimination experiences, and academic/occupational demands imposed by self, parents, peers, and society. Although they appreciated parents' high expectations of academic/occupational success, they felt pressured and desired to have space and independence. Friendship/dating patterns reflected ethnic identity development as well as contextual influence. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

This study aimed to understand how a threaded forum and asocial annotation tool, Diigo, supported online discussions. Forty-five pre-service teachers in two sections of an undergraduate course participated in two online discussion activities. A crossover studywas conducted to examine student participation and interaction, and students' perceived learning experience in the two environments. In the first activity, students in Section A used Diigo for the online discussion while students in Section B used a threaded discussion forum. In the second activity, the two sections switched their online discussion environments. A participatory survey was administered at the end of the study. Postings in the two activities were analyzed and compared in terms of participation, focus, and interaction types. The results indicated that the different design of the two activities and the different functions of two environments impacted student participation, knowledge construction processes, and the foci of discussions. Social annotation tools could be used as an alternative environment to encourage certain types of interaction during online discussions. [ABSTRACT FROM AUTHOR]

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The article shares lessons for social studies educators seeking for professional development to transform classroom instructions in the U.S. These include using online resources such as blogs and discussions, hosting and archiving webinars and incorporating multimedia materials into pedagogical investigations. The implementation of the College, Career and Civic Life (C3) Literacy Collaborative initiative is discussed.

Introduction After years of complex regulatory changes, levonorgestrel (LNG) emergency contraception (EC) is now approved for unrestricted sale in the United States. Timely access to EC pills is critical because they are more likely to work the sooner they are taken. This study assesses whether LNG EC is sold in accordance with current Food and Drug Administration regulations. Methods We distributed an online questionnaire through an EC-focused listserv for reproductive health professionals, asking data collectors to visit local stores and document product names, price, over-the-counter shelf availability, and misinformation about age restrictions. We used χ 2 analysis to assess bivariate associations and t tests and Wilcoxon rank-sum tests to determine differences in means. Results We collected information about 220 stores. The majority (65%) stocked EC on over-the-counter shelves, although only 22% of these displayed it without a locked security enclosure. Chain pharmacies were more likely to shelf-stock EC than independent pharmacies (77% vs. 5%; p = .000), but variation existed among stores within the same chain. Among stores that were asked, 40% incorrectly reported an age restriction for non-prescription purchase of LNG EC, whereas 95% correctly reported that men can buy LNG EC. The average price of branded and generic LNG EC was $49.64 and $40.05, respectively. Conclusions Changes in the regulatory status of LNG EC have resulted in widespread confusion about how EC can be sold, and its high price contributes to access barriers. Retailers should ensure that consumers can access LNG EC quickly and easily by stocking the product on over-the-counter shelves and educating staff about current regulations. [ABSTRACT FROM AUTHOR]

This article discusses the impact on professional identity for health sciences librarians participating in the curriculum revision and development process. A qualitative survey, designed to examine the current roles, values, and self-identification of health sciences librarians involved in curricular revision, was conducted. The respondents discussed how they had participated in the planning, implementation, and rollout phases of revised curricula. They identified skills and values essential to successful participation and described the impact of expanded professional relationships on new identities as educators, change agents, and problem solvers. The study may add to the knowledge base of skills and attitudes needed for successful practice in these newly emerging roles. [ABSTRACT FROM PUBLISHER]

Many social work clients are at an increased risk for negative outcomes related to sexual behavior, including unwanted pregnancies and sexually transmitted infections (STIs). However, there is a dearth of literature on social work student experiences with these topics in social work classrooms and their perceptions about the topic’s relevance to their practice. The purpose of this study is to explore relationships between experiences with STIs and contraception as topics in social work education and practica experiences on student perceptions toward sexual health as a relevant topic for social work. Among a national sample of MSW students (N = 443), experiences with STIs and contraception as topics in practica was significantly related to perceptions toward sexual health’s relevance to social work. Findings and implications are discussed. [ABSTRACT FROM AUTHOR]