Search

On October 27, 2018, a gunman killed eleven people attending Shabbat services in the Tree of Life synagogue in Pittsburgh, PA. For many -- both Jews and non-Jews -- this tragedy served as a wake-up call about the persistence of antisemitism in the United States today. MPA curricula and public affairs research have rarely addressed contemporary antisemitism, yet we argue for including conversations about antisemitism in MPA classrooms. This article serves as a resource for the public affairs teaching community so our colleagues can feel prepared and empowered to address antisemitism in their classrooms.

The marketing of heated tobacco products (HTPs), like IQOS, influences consumers' perceptions. This mixed-methods study analyzed (i) survey data (2021) of 2222 US and Israeli adults comparing perceptions of 7 IQOS attributes (design, technology, colors, customization, flavors, cost and maintenance) and 10 marketing messages (e.g. 'Go smoke-free...') across tobacco use subgroups and (ii) qualitative interviews (n  = 84) regarding IQOS perceptions. In initial bivariate analyses, those never using HTPs (86.2%) reported the least overall appeal; those currently using HTPs (7.7%) reported the greatest appeal. Notably, almost all (94.8%) currently using HTPs also currently used cigarettes (82.0%) and/or e-cigarettes (64.0%). Thus, multivariable linear regression accounted for current cigarette/e-cigarette use subgroup and HTP use separately; compared to neither cigarette/e-cigarette use (62.8%), cigarette/no e-cigarette use (17.1%) and e-cigarette/no cigarette use (6.5%), those with dual use (13.5%) indicated greater overall IQOS appeal (per composite index score); current HTP use was not associated. Qualitative data indicated varied perceptions regarding advantages (e.g. harm, addiction and complexity) of IQOS versus cigarettes and e-cigarettes, and perceived target markets included young people, those looking for cigarette alternatives and females. Given the perceived target markets and particular appeal to dual cigarette/e-cigarette use groups, IQOS marketing and population impact warrant ongoing monitoring to inform regulation. [ABSTRACT FROM AUTHOR]

Artificial intelligence has emerged as a technology to enhance productivity and improve life quality. However, its role in building energy efficiency and carbon emission reduction has not been systematically studied. This study evaluated artificial intelligence's potential in the building sector, focusing on medium office buildings in the United States. A methodology was developed to assess and quantify potential emissions reductions. Key areas identified were equipment, occupancy influence, control and operation, and design and construction. Six scenarios were used to estimate energy and emissions savings across representative climate zones. Here we show that artificial intelligence could reduce cost premiums, enhancing high energy efficiency and net zero building penetration. Adopting artificial intelligence could reduce energy consumption and carbon emissions by approximately 8% to 19% in 2050. Combining with energy policy and low-carbon power generation could approximately reduce energy consumption by 40% and carbon emissions by 90% compared to business-as-usual scenarios in 2050. AI reduces building energy and emissions in design/construction, equipment, occupancy, and control/operation. By accelerating high-efficiency and net-zero buildings, AI could cut energy and emissions by 40-90% by 2050 combined with adequate policies. [ABSTRACT FROM AUTHOR]

We explored temporal trends in drug-related infant deaths in the United States (U.S.) from 2018 to 2022. We used data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER). A total of 295 drug-involved infant deaths were identified from 2018 to 2022 (provisional mortality data for year 2022) based on the underlying cause of death. In the U.S. from 2018 to 2022, there was a significant 2.2-fold increase in drug-involved infant mortality. The observed increases were higher in non-Hispanic White and Black infants. The findings show that drug-involved infant deaths were more likely to occur in the postneonatal period, defined as ages 28–364 days (81.4 %) compared to the neonatal period. The most prevalent underlying causes of death included assault (homicide) by drugs, medicaments and biological substances (35.6 %) followed by poisoning due to exposure to narcotics and psychodysleptics (hallucinogens) (15.6 %). The most common multiple causes of drug-involved infant deaths were psychostimulants with abuse potential of synthetic narcotics. Drug-related infant mortality has increased significantly from 2018 to 2022. These increases are particularly evident among White and Black infants and occurred predominantly in the postneonatal period. These findings require more research but also indicate the need to address drug-involved infant deaths as preventable clinical and public health issues. Effective strategies to reduce drug-involved infant deaths will require preventing and treating maternal substance use disorders, enhancing prenatal care access, and addressing broader social and behavioral risk factors among vulnerable maternal and infant populations. [ABSTRACT FROM AUTHOR]

Social justice is listed as a professional value for the American Counseling Association (ACA) (2014), yet professional publication in this topic may not be commensurate with its importance to the profession. This article presents the results of a qualitative content analysis (QCA, Schreier, 2012) of titles and abstracts of 917 articles in 18 ACA journals and one American School Counselor Association journal to document each journal's publication rate of social justice‐related articles for 2 years: 2018 (2 years before the ACA Anti‐Racism Statement, 2020) and 2022 (2 years after the statement). Results for each journal are presented, and topics of social justice content are listed. Implications are provided for researchers, association leaders, editors, and reviewers. [ABSTRACT FROM AUTHOR]

AbstractThis article invites middle and high school social studies teachers and students to address the question, “Is the United States Exceptional?” We define American exceptionalism as the belief that the United States is qualitatively different from other nations based upon having some special virtue, ideology, or mission that makes it an outlier. We identify four themes or components of American exceptionalism: democracy, individual liberty, opportunity, optimism. We then call for letting students decide for themselves whether, when, and how the United States has been an exceptional nation while studying U.S. and world history. We close considering the advantages of allowing students to explore America as an exceptional nation in the current moment. Inquiring into American exceptionalism positions students studying U.S. and world history to construct their own nuanced understandings, to see from multiple perspectives, and to consider the United States in a global context. [ABSTRACT FROM AUTHOR]

In the United States, maternal health inequities disproportionately affect Global Majority (e.g., Asian, Black, and Hispanic) populations. Despite a substantial body of research underscoring the influence of racism on these inequities, little research has examined how experiences of gendered racial microaggressions during pregnancy and birth impact racially and ethnically diverse Global Majority pregnant and birthing people in obstetric hospital settings. We evaluated the psychometric properties of an adapted version of Lewis & Neville's Gendered Racial Microaggressions Scale, using data collected from 417 Global Majority birthing people. Findings from our study indicate that our adapted GRMS is a valid tool for assessing the experiences of gendered racial microaggressions in hospital-based obstetric care settings among Global Majority pregnant and birthing people whose preferred languages are English or Spanish. Item Response Theory (IRT) analysis demonstrated high construct validity of the adapted GRMS scale (Root Mean Square Error of Approximation = 0.1089 (95% CI 0.0921, 0.1263), Comparative Fit Index = 0.977, Standardized Root Mean Square Residual = 0.075, log-likelihood c2 = -85.6, df = 8). IRT analyses demonstrated that the unidimensional model was preferred to the bi-dimensional model as it was more interpretable, had lower AIC and BIC, and all items had large discrimination parameters onto a single factor (all discrimination parameters > 3.0). Given that we found similar response profiles among Black and Hispanic respondents, our Differential Item Functioning analyses support validity among Black, Hispanic, and Spanish-speaking birthing people. Inter-item correlations demonstrated adequate scale reliability, α = 0.97, and empirical reliability = 0.67. Pearsons correlations was used to assess the criterion validity of our adapted scale. Our scale's total score was significantly and positively related to postpartum depression and anxiety. Researchers and practitioners should seek to address instances of gendered racial microaggressions in obstetric settings, as they are manifestations of systemic and interpersonal racism, and impact postpartum health. [ABSTRACT FROM AUTHOR]

Constance Flanagan and Peter Levine survey research on civic engagement among U.S. adolescents and young adults. Civic engagement, they say, is important both for the functioning of democracies and for the growth and maturation it encourages in young adults, but opportunities for civic engagement are not evenly distributed by social class or race and ethnicity. Today's young adults, note the authors, are less likely than those in earlier generations to exhibit many important characteristics of citizenship, raising the question of whether these differences represent a decline or simply a delay in traditional adult patterns of civic engagement. Flanagan and Levine also briefly discuss the civic and political lives of immigrant youth in the United States, noting that because these youth make up a significant share of the current generation of young adults, their civic engagement is an important barometer of the future of democracy. The authors next survey differences in civic participation for youth from different social, racial, and ethnic backgrounds. They explore two sets of factors that contribute to a lower rate of civic engagement among low-income and minority young adults. The first is cumulative disadvantage--unequal opportunities and influences before adulthood, especially parental education. The second is different institutional opportunities for civic engagement among college and non-college youth during the young-adult years. Flanagan and Levine survey various settings where young adults spend time--schools and colleges, community organizations, faith-based institutions, community organizing and activism projects, and military and other voluntary service programs--and examine the opportunities for civic engagement that each affords. As the transition to adulthood has lengthened, say the authors, colleges have become perhaps the central institution for civic incorporation of younger generations. But no comparable institution exists for young adults who do not attend college. Opportunities for sustained civic engagement by year-long programs such as City Year could provide an alternative opportunity for civic engagement for young adults from disadvantaged families, allowing them to stay connected to mainstream opportunities and to adults who could mentor and guide their way. (Contains 1 figure and 52 endnotes.)

To quantify the burden of ocular injuries on deployed US service members by calculating disability-adjusted life years (DALYs). Retrospective, observational cohort study. US service members with ocular injuries sustained in combat zones from January 1, 2001 to May 19, 2020. Health states and duration of injuries were identified using data from the Defense and Veterans Eye Injury and Vision Registry. These health states were mapped to disability weights from the Global Burden of Disease (GBD) study. Average duration of injury or illness was calculated until remission or death. For the latter, life expectancy at age of sustaining injury, as identified from US Life Tables from the National Vital Statistics Reports 2020, was used. Using Defense Manpower Data Center reports capturing number of service members deployed per year, incidence rates were calculated for ocular injury and DALYs. Disability-adjusted life years of ocular injury. Seventeen thousand five hundred fifty-five patients sustained ocular injury that incurred DALYs. In total, these injuries resulted in 11 214 DALYs (average, 0.64 DALYs per included patient and 20.6 DALYs per 10 000 US service members per year). Severe impairment of distance vision (77.9%) and blindness (10.6%) were the primary contributors of DALYs. Although only 9.3% of patients sustained a permanent ocular injury, permanent disability accounted for 99.5% of total DALYs. The average yearly incidence rate of ocular injury was 32.0 cases per 10 000 US service members. Foreign body was the most frequent injury type (2754 occurrences), followed by abrasion (2419 occurrences) and multiple injury types (1429 occurrences). The most DALYs occurred in patients with multiple injury types (2485 DALYs), followed by abrasion (accounting for 725 DALYs) and foreign body (accounting for 461 DALYs). We report higher average DALYs per case ratio among US service members compared with the general population studied by the GBD study, highlighting the differences in probabilities of permanent injury between the two studies. Our study provides understanding of the impact of ocular injuries on active-duty service members and lays the groundwork for further research and interventions to mitigate their burden. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. [ABSTRACT FROM AUTHOR]

Simple Summary: Although women 70 years of age and older represent a large percentage of newly diagnosed breast cancer cases, older individuals are drastically underrepresented in clinical trials. Most women diagnosed with breast cancer at 70 years of age and older present with hormone receptor-positive (HR+) breast cancer. Cyclin-dependent kinase (CDK) 4/6 inhibitor-based therapy has become the standard of care for metastatic HR+ breast cancer. This study reports that metastatic breast cancer patients ≥70 years of age receiving CDK4/6 inhibitor-based treatment, particularly when combined with an aromatase inhibitor, experience prolonged progression-free survival but display no such prolongation in overall survival and report more frequent adverse effects to treatment. The reported findings can aid in the development of optimized treatments based on age and help older patients weigh treatment options. The largest portion of breast cancer patients diagnosed after 70 years of age present with hormone receptor-positive (HR+) breast cancer subtypes. Cyclin-dependent kinase (CDK) 4/6 inhibitor treatment, in conjunction with endocrine therapy, has become standard-of-care for metastatic HR+ breast cancer. In total, 320 patients with metastatic breast cancer receiving CDK4/6 inhibitor combined with fulvestrant or an aromatase inhibitor were enrolled in an ongoing observational study or were included in an IRB-approved retrospective study. All patients receiving CDK4/6 inhibitor-based therapy that were ≥70 years of age (n = 111) displayed prolonged progression-free survival (27.6 months) as compared to patients <70 years of age (n = 209, 21.1 months, HR = 1.38, p < 0.05). Specifically, patients receiving a CDK4/6 inhibitor with an aromatase inhibitor who were ≥70 years of age (n = 79) displayed exceptionally prolonged progression-free survival (46.0 months) as compared to patients receiving the same treatment who were <70 years of age (n = 161, 21.8 months, HR = 1.71, p < 0.01). However, patients ≥70 years of age also experienced more frequent adverse responses to CDK4/6 inhibitor-based treatment leading to dose reduction, hold, or discontinuation than the younger cohort (69% and 53%, respectively). Treatment strategies that may decrease toxicity without affecting efficacy (such as dose titration) are worth further exploration. [ABSTRACT FROM AUTHOR]

Background Detection and treatment of anal histologic high-grade squamous intraepithelial lesions (hHSIL) prevents anal cancer. However, anal hHSIL incidence among women with human immunodeficiency virus (HIV, WHIV) remains unknown. Performance of anal high-risk human papillomavirus ([hr]HPV), anal cytology (anal-cyt), and both for hHSIL detection longitudinally over 2 years also remains undetermined. Methods We determined 2-year incidence and cumulative risk estimates (2-y-CR) of anal hHSIL among WHIV using prevalence and incidence (per 100 person-years [py]) observations stratified by baseline hrHPV and/or anal-cyt results. Results In total, 229 WHIV with complete baseline data were included in the analysis; 114 women without prevalent anal hHSIL were followed with 2 annual evaluations. Median age was 51, 63% were Black, and 23% were Hispanic. Anal hrHPV or abnormal anal-cyt was associated with an increased risk of incident anal hHSIL at 2 years (18.9/100py [95% confidence interval {CI} 11.4–31.3] and 13.4/100py [95% CI 8.0–22.7], respectively) compared with no detection of anal HPV or negative cytology (2.8/100py [95% CI 1.1–7.4] and 4.2 [95% CI, 1.8–10.2]) The presence of anal hrHPV with abnormal cytology was associated with 2-y-CR of anal hHSIL of 65.6% (95% CI 55.4%–75%); negative hrHPV with negative cytology was associated with 2-y-CR of anal hHSIL of 9.2% (95% CI 7.0–16.0). Conclusions Detection of anal hrHPV or abnormal anal cytology are comparable predictors for 2-y-CR of anal hHSIL. The absence of anal hrHPV combined with negative cytology was predictive of a lower (but measurable) risk of developing anal hHSIL. These findings provide important data to inform anal cancer screening guidelines for WHIV. [ABSTRACT FROM AUTHOR]

Observed links between parasites, such as ticks, and climate change have aroused concern for human health, wildlife population dynamics, and broader ecosystem effects. The one‐host life history of the winter tick (Dermacentor albipictus) links each annual cohort to environmental conditions during three specific time periods when they are predictably vulnerable: spring detachment from hosts, summer larval stage, and fall questing for hosts. We used mixed‐effects generalized linear models to investigate the drivers of tick loads carried by moose (Alces alces) relative to these time periods and across 750 moose, 10 years, and 16 study areas in the western United States. We tested for the effects of biotic factors (moose density, shared winter range, vegetation, migratory behavior) and weather conditions (temperature, snow, humidity) during each seasonal period when ticks are vulnerable and off‐host. We found that warm climatic regions, warm seasonal periods across multiple partitions of the annual tick life cycle, and warm years relative to long‐term averages each contributed to increased tick loads. We also found important effects of snow and other biotic factors such as host density and vegetation. Tick loads in the western United States were, on average, lower than those where tick‐related die‐offs in moose populations have occurred recently, but loads carried by some individuals may be sufficient to cause mortality. Lastly, we found interannual variation in tick loads to be most correlated with spring snowpack, suggesting this environmental component may have the highest potential to induce change in tick load dynamics in the immediate future of this region. [ABSTRACT FROM AUTHOR]

Background: Remdesivir is an antiviral approved by the US Food and Drug Administration (FDA) for treatment of coronavirus disease 2019 (COVID-19), and aminotransferase elevation is commonly reported. Thresholds to be considered for discontinuation due to alanine aminotransferase (ALT) elevation differ between the FDA and European Medicines Agency (EMA). The primary objective was to describe aminotransferase thresholds being used in real-world practice for discontinuation of remdesivir in patients with COVID-19, and compare them with labeled recommendations. Methods: This study used a descriptive design based on an ongoing national registry of adverse events, the FDA ACMT COVID-19 ToxIC (FACT) pharmacovigilance project, with 17 participating health systems in the USA. Cases were identified retrospectively for an 18-month period (23 November 2020–18 May 2022). Classification of discontinuation as premature and due to aminotransferases was based on chart documentation by the treating team. Results: Of 1026 cases in the FACT registry, 116 cases were included with supplemental data forms completed for aminotransferase elevation with remdesivir, defined a priori for inclusion as ALT doubling or increasing by ≥ 50 U/L. ALT was elevated prior to remdesivir in 47% and increased above baseline during dosing by a median of 92 U/L [interquartile range (IQR) 51–164, max 8350]. Remdesivir was discontinued early in 37 (31.9%) patients due to elevated aminotransferases. The ALT threshold for premature discontinuation was median 200 U/L (IQR 145–396, range 92–5743). Among patients with premature discontinuation of remdesivir for aminotransferase elevation, only 21.6% met FDA criteria to consider discontinuation, and 40.5% met prior EMA criteria to consider discontinuation. Conclusion: In this descriptive study of real-world practice in the USA, clinicians are overall making more conservative treatment decisions than are recommended for consideration in approved drug labeling of discontinuation, with wide variation in the aminotransferase thresholds being used. [ABSTRACT FROM AUTHOR]

Various types of stress and the choice of coping strategies may be risk factors for higher levels of sleep disturbance in oncology patients. Purposes were to evaluate for differences in global, cancer‐specific, and cumulative life stress, as well as resilience and the use of coping strategies among three subgroups of patients with distinct sleep disturbance profiles (i.e., Low, High, Very High). Oncology outpatients (n = 1331) completed measures of global (Perceived Stress Scale), cancer‐specific (Impact of Event Scale‐Revised), and cumulative life (Life Stressor Checklist‐Revised) stress, resilience (Connor‐Davidson Resilience Scale) and coping (Brief Cope) prior to their second or third cycle of chemotherapy. Sleep disturbance was assessed six times over two chemotherapy cycles. Differences were evaluated using parametric and non‐parametric tests. All stress measures showed a dose response effect (i.e., as the sleep disturbance profile worsened, levels of all types of stress increased). Compared to Low class, the other two classes reported higher levels of global perceived stress and higher occurrence rates and effect from previous stressful life events. Impact of Event Scale‐Revised scores for the Very High class indicated post‐traumatic symptomatology. Patients in High and Very High classes had resilience scores below the normative score for the United States population and used a higher number of disengagement coping strategies. Our findings suggest that very high levels of sleep disturbance are associated with higher levels of various types of stress, lower levels of resilience, and higher use of disengagement coping strategies. Clinicians need to perform routine assessments and implement symptom management interventions to reduce stress and encourage the use of engagement coping strategies. [ABSTRACT FROM AUTHOR]

Mindfulness is an effective way for educators and students to manage their emotions, as well as reduce stress and anxiety. When implemented, mindfulness practices help students focus on the present moment and regulate their emotions. This article will first define mindfulness and explain how teachers can incorporate mindfulness strategies into an elementary classroom setting. Next, it examines mindfulness programs that school districts are using throughout the United States. Then, it explains social emotional learning and activities that support these practices within the classroom. The article concludes by offering outcomes and implications for mindfulness. Through mindfulness techniques, students can foster a positive environment and improve their social and physical well-being. [ABSTRACT FROM AUTHOR]

Our Grassroots Maternal and Child Health (MCH) Initiative works to build the capacity of individuals and organizations in zip codes with persistently high infant mortality rates to bring about systems change that will improve maternal and child health (MCH) outcomes. Foundational to the Initiative is the training and mentoring of local women to become Grassroots MCH Leaders. We greatly honor that these women possess community expertise, essential to the Initiative's success. Our training equips them with strategies they can use to bring about changes in social, economic, political, and/or cultural systems that underlie poor birth outcomes. One impactful strategy they learn is the use of critical narrative intervention (CNI). This approach, grounded in the crafting and sharing of stories, complements statistical, behavioral, and medical approaches to improve MCH outcomes. This article describes the impact of CNI within the Grassroots MCH Initiative. Drawing from 14 Grassroots MCH Leaders' narratives, we present five significant maternal traumas and influential supports in their surrounding contexts. We explore the leaders' reflections on the impact of story development and dissemination. Our findings reveal that situating CNI within the context of a grassroots initiative provides opportunities for leaders to use their stories to advocate for systems change. Personal MCH narratives provide a powerful and respectful approach to public health promotion, as they highlight important systems-level failures that need to be addressed to sustainability improve MCH outcomes. [ABSTRACT FROM AUTHOR]

Background: Cigarette smoking remains the leading avoidable cause of premature death in the United States, accounting for approximately 500,000, or 1 in 5, deaths annually. We explored trends in cigarette smoking among US adolescents. Methods: We used data for adolescents in grades 9 through 12 from 1991 to 2021 from the Youth Risk Behavior Survey provided by the US Centers for Disease Control and Prevention. We explored trends overall as well as by sex, race/ethnicity, and school grade. Results: All cigarette use—assessed as ever, occasional, frequent, or daily—among adolescents declined markedly from 1991 to 2021. Specifically, ever use significantly decreased from 70.1% in 1991 to 17.8% in 2021 (P<0.05), an almost 4-fold decline. Occasional use significantly decreased from 27.5% in 1991 to 3.8% in 2021 (P<0.05), a greater than 7-fold decline. Frequent use significantly decreased from 12.7% to 0.7%, a greater than 18-fold decline. Daily use declined from 9.8% in 1991 to 0.6% in 2021, a greater than 16-fold decline. Cigarette smoking significantly decreased from 1999 to 2021 across sex, race/ethnicity, and school grade (P<0.05). In 2021, daily use was higher in boys vs girls; Hispanic/Latino and White youth vs Black and Asian youth; and 12th graders vs 9th, 10th, and 11th graders. Conclusion: These data show large and significant decreases in cigarette use among US adolescents in high school grades 9 through 12 from 1991 to 2021. Nonetheless, the data also suggest residual clinical and public health challenges that will require targeted interventions. [ABSTRACT FROM AUTHOR]

INTRODUCTION: As e-cigarette marketing strategies diversify, it is important to examine exposure to and impact of e-cigarette advertisements and non-advertising content (e.g. on social media) via multiple media channels among adults in different regulatory contexts. METHODS: Using 2021 cross-sectional data among 2222 adults in the US (n=1128) and Israel (n=1094), multivariable regression examined past-month e-cigarette advertisement and non-advertising content exposure in relation to past-month e-cigarette use (logistic regression), as well as use intentions and risk perceptions (linear regressions), controlling for sociodemographics and tobacco use. RESULTS: Overall, 20.3% reported past-month e-cigarette use (15.5% US, 25.2% Israel), 46.1% any advertisement exposure (28.7% digital media, 25.2% traditional media, 16.8% retail settings), and 34.1% any non-advertising exposure (19.4% social media, 13.6% websites, 12.3% movie/television/theater, 5.8% radio/podcasts). Exposure to digital media advertisements (AOR=1.95; 95% CI: 1.42-2.66), traditional media advertisements (AOR=2.00; 95% CI=1.49-2.68), and social media non-advertising (AOR=1.72; 95% CI: 1.25-2.36) correlated with e-cigarette use. Exposure to traditional media advertisements (β = 0.23; 95% CI: 0.08-0.38) and social media non-advertising (β = 0.26; 95% CI: 0.09-0.43) correlated with use intentions. Exposure to digital media advertisements (β = -0.32; 95% CI: -0.57 - -0.08), retail setting advertisements (β = -0.30; 95% CI: -0.58 - -0.03), and radio/podcast non-advertising (β = -0.44; 95% CI: -0.84 - -0.03) correlated with lower perceived addictiveness. Radio/podcast non-advertising exposure (β = -0.50; 95% CI: -0.84 - -0.16) correlated with lower perceived harm. However, retail setting advertisement exposure was associated with e-cigarette non-use (AOR=0.61; 95% CI: 0.42-0.87), and traditional media advertisement (β = 0.38; 95% CI: 0.15-0.61) and social media non-advertising exposure (β = 0.40; 95% CI: 0.14-0.66) correlated with greater perceived addictiveness. CONCLUSIONS: E-cigarette-related promotional content exposure across media platforms impacts perceptions and use, thus warranting regulation. [ABSTRACT FROM AUTHOR]

Objective: Barriers to palliative care for children with serious illness include system constraints and vastly different training and attitudes toward palliative care. This study aimed to explore trainee and faculty physician perceptions of barriers to palliative care across two pediatric centers to (1) examine differences between trainees and faculty and (2) compare these data with previous studies. Methods: A mixed-methods study was conducted in fall 2021 among pediatric trainees and faculty physicians at three pediatric hospitals in two pediatric centers in the western United States. Surveys were distributed through hospital listservs and analyzed descriptively and through inductive thematic analysis. Results: There were a total of 268 participants: 50 trainees and 218 faculty physicians. Of the trainees, 46% (23) were fellows and 54% (27) were pediatric residents. Trainees and faculty reported the same four most common barriers, which were consistent with previous studies: family not ready to acknowledge an incurable condition (64% trainees and 45% faculty); family preference for more life-sustaining therapies than staff (52% and 39%); uncertain prognosis (48% and 38%); and parent discomfort with possibility of hastening death (44% and 30%). Other barriers commonly reported included time constraints, staff shortages, and conflict among family about treatment goals. Language barriers and cultural differences were also cited. Conclusions: This study examining palliative care across two pediatric centers suggests that providers' perceptions of family preferences and understanding of illness persist as barriers to the delivery of pediatric palliative care services. Future research should examine family-centered and culturally mindful interventions to better elucidate family perspectives on their child's illness to align care. [ABSTRACT FROM AUTHOR]

Divisive social rhetoric and prevalent racism make the need for infusing social justice throughout counselor education even more urgent than the decades-long calls for it. There is a dearth of empirical inquiry into the ways social justice concepts are enacted across rehabilitation counseling curricula. The current study used an exploratory survey to collect information about the techniques used by U.S. rehabilitation counselor educators (N = 71) to infuse social justice across all of their courses, including their pedagogical choices, rates of frequency for updating coursework, and professional development choices. Findings reveal that educators have favorable attitudes about social justice, are more likely to use academic journals and related disciplines in course development, and are more likely to use self-reflection and intuition-based opportunities for social justice professional development. Implications of the findings also include relevancy for supervisors and practitioners, who have the responsibility to and lead social justice education once trainees have entered the field as professionals. [ABSTRACT FROM AUTHOR]

Context.--More people receive a diagnosis of skin cancer each year in the United States than all other cancers combined. Many patients around the globe do not have access to highly trained dermatopathologists, whereas some biopsy diagnoses of patients who do have access result in disagreements between such specialists. Mechanomind has developed software based on a deep-learning algorithm to classify 40 different diagnostic dermatopathology entities to improve diagnostic accuracy and to enable improvements in turnaround times and effort allocation. Objective.--To assess the value of machine learning for microscopic tissue evaluation in dermatopathology. Design.--A retrospective study comparing diagnoses of hematoxylin and eosin--stained glass slides rendered by 2 senior board-certified pathologists not involved in algorithm creation with the machine learning algorithm's classification was conducted. A total of 300 glass slides (1 slide per patient's case) from 4 hospitals in the United States and Africa with common variations in tissue preparation, staining, and scanning methods were included in the study. Results.--The automated algorithm demonstrated sensitivity of 89 of 91 (97.8%), 107 of 107 (100%), and 101 of 102 (99%), as well as specificity of 204 of 209 (97.6%), 189 of 193 (97.9%), and 198 of 198 (100%) while identifying melanoma, nevi, and basal cell carcinoma in whole slide images, respectively. Conclusions.--Appropriately trained deep learning image analysis algorithms demonstrate high specificity and high sensitivity sufficient for use in screening, quality assurance, and workload distribution in anatomic pathology. [ABSTRACT FROM AUTHOR]

During times of crisis, those who are in recovery from pre-existing conditions such as eating disorders can be at increased risk for exacerbation of existing illnesses and other comorbid conditions. 37 blogs focused on eating disorder recovery were identified via internet searches (Google search, National Eating Disorder Association, HealthLine, and Psychology Today) and reviewed by the research team. Nine blogs with posts spanning November 2019 to June 2020 were chosen, using set inclusion/exclusion criteria of posts written prior to and during the Covid-19 pandemic, for thematic analysis. Persons who identified as being in recovery from eating disorders experienced many of the same stressors as the general population, but these were influenced by the nuances of their illness. Food scarcities led to anxiety and a focus on searching grocery stores to obtain provisions. Lockdown impacted the emotional status of bloggers by distancing them from their support networks and their treatment teams. Loss of support systems, including family and virtual communities, left bloggers feeling isolated. Persons struggling with eating disorders, attempting to overcome their illness but less stable in their recovery in the pre-Covid period tended not to improve during the Covid-19 period, and in some cases experienced increasing symptoms or complete relapse, a loss of motivation, and a sense of despair that can impact recovery status. [ABSTRACT FROM AUTHOR]

Research consistently shows that solid assessment designs lead to better student learning outcomes. The development of well-designed assessments presents a challenge to preservice teachers in their attempts to master the process and to the teacher educators who instruct them. This exploratory study examined strategies for teaching assessment design utilized by 87 teacher educators in the United States. Analysis of the results showed that expository, collaborative, and hands-on approaches were used, with assessment approaches aligning to structured or unstructured approaches. Data also revealed that the participants tended to focus more on the vocabulary related to assessments rather than the strategies for design. [ABSTRACT FROM AUTHOR]

Background: Understanding concordance between informants' and cognitively impaired participants' information reporting is crucial for Alzheimer's and Alzheimer's-related dementia studies. Methods: The Brain Attack Surveillance in Corpus Christi-Cognitive is a community-based cohort study. Households in Nueces County, Texas, USA, were randomly identified. 330 dyads of participants and their named informants answered questions. Models were generated to examine which predictors, including age, gender, ethnicity, cognitive function, and relationship to informant, influenced answer discordance. Results: For demographic items, female participants and participants with spouses/partners as informants had significantly less discordance, with incidence rate rations (IRRs) of 0.65 (CI = 0.44, 0.96) and 0.41 (CI = 0.23, 0.75), respectively. For health items, better cognitive function of the participant was associated with less discordance, with an IRR of 0.85 (CI = 0.76, 0.94). Conclusions: Demographic information concordance is most associated with gender and informant–participant relationship. Level of cognitive function is most associated with concordance for health information. ClinicalTrials.gov identifier NCT03403257. [ABSTRACT FROM AUTHOR]

A survey of 711 candidates for local offices in the United States, conducted in December 2021, reveals that many were concerned before they began their campaigns about the impact of politics on their work and family, the time demands of campaigning, their ability to raise funds, and their knowledge of the process, among other obstacles. Many candidates who had anticipated each concern found it less onerous than they had expected. Those who were parents, those with full-time jobs, and those who had experienced poverty as children were especially likely to have difficulty meeting work and family obligations while campaigning. Being liberal, being young, having less education, and experiencing poverty in childhood were all associated with concerns about being qualified to run. The study offers additional details about which backgrounds and experiences are associated with specific challenges in local campaigns. The results may inform efforts to recruit and support underrepresented candidates. [ABSTRACT FROM AUTHOR]

We investigated whether American dissertations that were deposited in university libraries or disseminated on microfilm prior to 1978 were "published" for copyright purposes. This question has direct bearing on the copyright status of these works today. In the absence of a directly relevant legal decision to clarify the matter, the authors examined how the former community of practice interpreted the law in the context of dissertation dissemination. A content analysis of written communications by members of this community indicates that both forms of dissertation dissemination were considered to be legal publication under the 1909 Copyright Act. (Contains 40 notes, 1 figure, and 3 tables.)

Scholars and reformers in the United States have called for converting large high schools into smaller units to provide a more effective, personal, and culturally responsive education for all students. Current literature argues that such "conversion high schools" should break into fully autonomous small schools rather than more interdependent smaller learning communities (SLCs). In contrast to existing recommendations, this comparative case study identifies four potential advantages of interdependent SLCs. A longitudinal study of teacher collaboration and teaching practices conducted over two years at two conversion high schools suggests that retaining a degree of interdependence among sub-units in conversion high schools may: support teaching and learning of specific academic subjects; promote more learning from other subunits on the campus of the high school; reduce the stress and chaos that accompany high school conversion; and offer more support for new teachers. (Contains 1 note, 1 table, and 1 figure.)

This article presents a brief overview of the state of university language education in the United States. Despite the impact of the world economic crisis on university language education in the United States, the profession has not yet been impacted to the extent many believe it has. Current scholarly debates allow for both a sober assessment of and an optimistic perspective on the field's trajectory in recent years. A brief summary is offered of recent enrollments in university courses in languages other than English, which shows that enrollments have indeed remained stable, though even these stable numbers point toward shortcomings in the place of language education in academia overall. The key points of the 2007 Modern Language Association Ad Hoc Committee Report, "Foreign languages and higher education: New structures for a changed world", are then presented, along with some scholarly responses to it. The report, and especially the academic debate it sparked, point toward a period of transformation in university language education; an increased attention to crucial links between theory, curriculum, research, and pedagogical practice; and an encouraging mood of advocacy for language education that transcends the defensive response to program reductions and eliminations. (Contains 1 note.)

Nestled in the Himalayan Mountains, Bhutan, a Buddhist country, is one of the most isolated nations in the world. After spending a month there, the authors all agreed it deserved its title of "The Last Shangri-La." Their team of professional development specialists spent the summer of 2010 providing professional development in the basic principles of special education to teachers, administrators, and government officials. At the end of their visit, they left with a new appreciation of the need for all professional developers to become more aware of cultural differences both overt and subtle. In the process, they sharpened their skills, increased their cultural sensitivities, and came back to the United States as more effective and more broadly engaged staff developers.

In the United States, considerable financial and human resources have been devoted to breaking some large high schools into smaller learning communities (SLCs). This article reviews research that compares SLCs to comprehensive high schools on a variety of measures. Extant research neither supports nor refutes the promise of SLCs to improve academic achievement; however, research does suggest that SLCs can improve attendance, graduation rates, and students' experience of high schools as supportive environments. The article also uses empirical research to identify three challenges SLCs must overcome if they are to improve academic achievement: focusing on instructional improvement, ensuring equity and rigor, and transcending school history. (Contains 1 table and 1 footnote.)

Purpose: Despite the critical role of support personnel in education, the literature about their supervision has been less than informative. In an effort to provide additional guidance to school leaders seeking to improve the supervision of such personnel, the purpose of this paper is to examine and compare three distinct groups of support personnel: school custodians/janitors, school secretaries, and paraprofessionals in special education. Design/methodology/approach: The paper begins with two analyses. One is that of the general importance of the role of support personnel in public schools in the USA. The other consists of a brief argument as to why the literature about the supervision of support personnel has not been overly informative. The paper proceeds with descriptions of three distinct support personnel groups. Findings: The examination of three support personnel groups highlights the visibility of the school custodian/janitor, the multi-dimensional responsibilities of the school secretary, and the background of the paraprofessional in special education. Research limitations/implications: A comparison of three distinct groups of support personnel has implications for their training, compensation and scheduling, and work design and supervision. Originality/value: The paper content offers an information-rich and multi-faceted view of support personnel in schools, with implications for their overall supervision and the importance of their contribution to the organization. (Contains 4 notes.)

Three field studies compared helping behavior across a sample of 24 small, medium and large cities across the United States. The relationship of helping to statistics reflecting the demographic, social, and economic characteristics of these communities was then examined. The strongest predictors of city differences in helping were population size, population density, economic purchasing power and, to a somewhat lesser extent, walking speed. Changes in several community variables over the past decade were also associated with helping: population size, economic well-being as measured by both purchasing power and poverty rates, and crime rates. These data were compared to similar data collected 13-15 years ago.

Emergency medical technicians (EMTs) are a critical segment in prehospital medical care. This study examined EMT-paramedic career success focused on minorities and women, as part of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). The LEADS data come from a representative sampling of EMTs throughout the United States. Analyses examined factors related to objective and subjective career success and did so with samples from 2000 and 2004. Regression results showed that education, experience, and hours worked predicted objective career success. In contrast, satisfaction with others and with supervisor predicted subjective career success. Minority status was not related to either objective or subjective career success, while gender appeared to have a negative influence on objective career success but was unrelated to subjective career success. Implications for HRD practitioners and researchers are discussed. (Contains 3 tables.)

This article considers how the private finance initiative, a contract for infrastructure, affected teachers' perceptions of efficacy, job satisfaction, and morale at an urban secondary school in the United Kingdom. Qualitative data collection techniques, including unstructured observation and semistructured personal interviews, were utilized to determine teachers' perceptions. The findings indicate that two facets of the initiative were problematic for educational programming: the private corporation's control over construction design and its subsequent control over facility management. Implications of this research for lease-purchase agreements in the United States are discussed.

The lead author, who formerly presided over Columbia's Teachers College, examines the quiet aftermath of his brash call two years ago for sweeping changes in how universities educate school leaders, including his proposal to eliminate the Ed.D. Every year a multitude of organizations and commissions issue a cornucopia of reports about myriad education concerns. Most receive scant notice; a few enjoy their moment in the sun, a day of news media attention. As a rule, these reports have little impact on American education. The standard of success by which all education reports seem to be measured is Abraham Flexner's "Medical Education in the United States and Canada. Bulletin Number Four." Published in 1910 by the Carnegie Foundation for the Advancement of Teaching, the report transformed the ways in which the nation's medical schools educate doctors. No other report in modern times has had this level of impact on a profession with the possible exception of "A Nation at Risk," which launched a two-decades-long school reform movement in the United States. This article discusses the reasons why the Flexner report was such a phenomenal success and examines "Educating School Leaders," which was the first in a series of reports on the state of America's education schools. Funded by the Annenberg, Ford, Ewing Marion Kauffman and Wallace foundations, the study involved large-scale surveys of education school faculty and deans as well as alumni and principals. The author included case studies of education schools, studies of the characteristics of education schools and their programs, their curricula, the degrees they award and the content of their student dissertations. This article presents three waves of response to "Educating School Leaders," ranging from acknowledgment to action.

The reported research examines the level of environmental knowledge of Michigan State University students relative to the results of a biannual national study of the environmental knowledge of the general population of the United States. While the university students were found to possess higher levels of environmental knowledge than the general public, the students' overall environmental knowledge, on average, was deficient with only 66% of them receiving a passing grade. The findings suggest a positive correlation between academic level, field of study and environmental knowledge.

OBJECTIVE: The authors explored psychiatry clerkship usage of the National Board of Medical Examiners (NBME) Subject Test. METHODS: U.S. and Canadian psychiatry clerkship directors (N=150) were sent an 18-item questionnaire surveying evaluation and remediation practices. RESULTS: Of 111 questionnaires (74%) returned, 76 (69%) reported using the NBME Subject Test. As part of the overall grade, the test was granted a mean weight of 31% and a median weight of 25%. Of 72 clerkship directors who use the test for grading, 42% convert the percentile score and 38% convert the subject score. Of 60 clerkship directors who use the test for passing, 72% convert the raw score (mean=58.3, median=58), and 28% convert the percentile score (mean=12.2th, median=11th percentile). CONCLUSIONS: Most psychiatry clerkship directors use the NBME Subject Test, but no predominant method exists for weighing the test or converting it into a grade.

A large number of previous studies have used self-construal to predict communication outcomes. Recent evidence, however, suggests that validity problems may exist in self-construal measurement. The current study conducted a multimethod multitrait (Campbell & Fiske, 1959) validation study of self-construal measures with data (total N = 578) collected in Korea (N = 200), Japan (N = 212), and the U.S. (N = 166). The data showed that the Singelis (1994) Self-Construal Scale, the Cross, Bacon, and Morris (2000) Relational Interdependent Self-Construal Scale (RISC), and the Kuhn and McPartland (1954) Twenty Statements Test (TST) lacked convergent and discriminant validity, both pan-culturally and within each of the three countries included in the study. Scores on the TST were not significantly related to scores on the self-construal scales, and the various self-construal measures correlated more highly with measures of communication directness than with alternative measures of the same type of self-construal. Substantial method effects were also observed. The results were tested for both 2- and 3-dimensional models of self-construal and for refined scales and scales with all items retained. The results of all analyses were inconsistent with the claim that self-construal measures are construct valid.