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The benefits of incorporating process information in a large-scale assessment with the complex micro-level evidence from the examinees (i.e., process log data) are well documented in the research across large-scale assessments and learning analytics. This study introduces a deep-learning-based approach to predictive modeling of the examinee's performance in sequential, interactive problem-solving tasks from a large-scale assessment of adults' educational competencies. The current methods disambiguate problem-solving behaviors using network analysis to inform the examinee's performance in a series of problem-solving tasks. The unique contribution of this framework lies in the introduction of an "effort-aware" system. The system considers the information regarding the examinee's task-engagement level to accurately predict their task performance. The study demonstrates the potential to introduce a high-performing deep learning model to learning analytics and examinee performance modeling in a large-scale problem-solving task environment collected from the OECD Programme for the International Assessment of Adult Competencies (PIAAC 2012) test in multiple countries, including the United States, South Korea, and the United Kingdom. Our findings indicated a close relationship between the examinee's engagement level and their problem-solving skills as well as the importance of modeling them together to have a better measure of students' problem-solving performance.

Research has linked cultural differences between a sojourner's home and host country with their cultural transformation. Nonetheless, the results of empirical studies are inconclusive due to different operationalizations of cultural differences and testing among different groups of sojourners. We extend previous investigations by examining the effects of cultural novelty (i.e., the subjective perception of cultural differences) on the experience of international students (N = 1114) in Denmark, Germany, Italy, Poland, and the USA. Drawing on acculturation and social learning theories, we conceptualized a model of students' adjustment and satisfaction taking into account cultural novelty. We tested the model through multi-group structural equation modeling (SEM) and examined the various relationships across subsamples from all five countries. We determined the significant effects of cultural novelty and a range of factors impacting students' intercultural experience, such as their cultural intelligence, cultural background, second-language skills, time in the host country, and socialization with domestic students, and how the effects may vary by the host country. We discuss implications for future research and practice.

Background: Health disparities of individuals with intellectual and developmental disabilities (IDD) have been a longstanding public health concern. Unlike the engagement of service sectors and governmental entities in advocating for human rights and health equity, the nursing profession remains absent from these discussions. Transformational changes are needed to promote systemic changes that will improve health outcomes of individuals with IDD. Method: Strategic planning is needed to effect transformational changes in nursing education. Innovation in nursing education involves an informed understanding of health care barriers that individuals with IDD experience and the necessary processes to effectively engage in partnerships with this population. Results: An approach for change in nursing education is proposed based on IDD concepts in federal legislation and initiatives, social policies, and the self-advocacy movement, and its application in nursing education is described. Conclusion: Integrating IDD concepts into nursing curricula can improve health care equity and health outcomes of individuals with IDD. [J Nurs Educ. 2025;64(2):75–80.] [ABSTRACT FROM AUTHOR]

Background: There is a need to systematically compare and contrast mortality predictors and disparities in people with intellectual disabilities (ID) for global prevention strategy development. Method: Bibliographic databases and grey literature were searched using systematic review methodology and the machine learning tool "Abstrackr." Results: Fifty-four relevant articles and reports published from 2010 to 2019 were identified. Nearly all (n = 53) were from high-income countries. Mortality disparities were apparent and consistent across countries and publication years, with no evidence of a decrease over time. People with ID can still expect to live 12-23 years less than the general population and are particularly vulnerable to deaths from respiratory infections and epilepsy. Conclusions: Both population and individual-level approaches to prevention are indicated to tackle the continuing mortality disparities in people with ID, including consideration of reasonable adjustments in general population efforts to reduce health inequalities.

We estimate the effect of job loss on households' bank account ownership using novel data: Federal Deposit Insurance Corporation (FDIC)‐sponsored biennial supplements to the Current Population Survey (CPS), linked to respondents' work history in surrounding months constructed from the Basic Monthly CPS. Leveraging differences in the timing of unemployment spells across households, we show that job loss leads to a large decrease in the likelihood of having an account among the lower‐income, renter households we study. Job loss also leads to increased use of other products and services that might substitute for a bank account, including prepaid cards, check cashing, and money orders. [ABSTRACT FROM AUTHOR]

Objective: Describe the epidemiology of cluster headache (CH) using Veterans Health Administration (VHA) Electronic Health Record (EHR) data. Background: Epidemiologic studies of CH at the population level are difficult because it has a prevalence of ~0.1%. Hospital system‐wide studies are an attractive alternative as they have large numbers of patients and broader populations than headache or neurology clinic‐based studies. The VHA is an ideal hospital‐based system in which to study CH because it is nationwide, predominantly male, has a strong focus on mood disorders and suicidality, and has accessible individual medical records. Here, we report the first headache study based on an ongoing longitudinal cohort of patients with CH using VHA EHR data. Methods: The VHA EHR data were accessed from Fiscal Year 2008 to 2019. Patients with CH consisted of all patients with at least one outpatient visit containing a CH diagnosis code from the International Classification of Diseases (ICD)‐9 or ‐10. We extracted data on demographic features, incidence, and prevalence, as well as pain and psychiatric comorbidities. Results: Of the 1,524,960 distinct patients who presented for headache treatment in the VHA between Fiscal Year 2008–2019, 24,131 had at least one visit with a CH diagnosis. The 1‐year period prevalence of a CH diagnosis in the VHA ranges from 0.08% to 0.10% for women and 0.10% to 0.18% for men. A larger proportion of women versus men received a diagnosis of unspecified CH (59.6% [1412/2368] vs. 53.6% [11,663/21,763], p < 0.001). Most patients with CH had both comorbid headache and non‐headache pain diagnoses. Headache not‐otherwise‐specified was the most common comorbid headache disorder at 70.0% (16,885/24,131) and was more common in women (76.1%, 1801/2368) compared to men (69.3%, 15,084/21,763). Other common comorbidities included migraine, depression, tobacco use, and obstructive sleep apnea. Rates of suicidal ideation or attempt were almost 50% higher in women (5‐year proportion 9.4%, 222/2368) with CH compared to men (6.6%, 1433/21,763). Conclusions: To our knowledge this is the largest hospital system study of CH to date and reinforces several previous studies. Pain, mental health, and sleep disorders comorbidities are particularly prevalent in this group and were often more common in women compared to men with CH. Future work should examine gender and race stratified prevalence estimates within the VHA and other healthcare systems. Plain Language Summary: This study describes the epidemiology of cluster headache among all Veterans Health Administration (VHA) enrollees using electronic medical record data from the VHA. We found that during any given 1‐year period, between 0.08–0.10% of women and 0.10–0.18% of men in the VHA were treated for cluster headache. Many of these patients also had co‐occurring disorders including other headache disorders and depression, so more research is needed to find the best ways to treat these patients. [ABSTRACT FROM AUTHOR]

Drawing a referent of a to-be-remembered word often results in better recognition and recall of this word relative to a control task in which the word is written, a pattern dubbed the drawing effect. Although this effect is not always found in pure lists, we report three experiments in which the drawing effect emerged in both pure- and mixed-lists on recognition and recall tests, though the effect was larger in mixed lists. Our experiments then compared drawing effects on memory between pure- and mixed-list contexts to determine whether the larger mixed-list drawing effect reflected a benefit to draw items, a cost to write items, or a combination. In delayed recognition and free-recall tests, a mixed-list benefit emerged for draw items in which memory for mixed-list draw items was greater than pure-list draw items. This mixed-list drawing benefit was accompanied by a mixed-list writing cost compared to pure-list write items, indicating that the mixed-list drawing effect does not operate cost-free. Our findings of a pure-list drawing effect are consistent with a memory strength account, however, the larger drawing effect in mixed lists suggest that participants may also deploy a distinctiveness heuristic to aid retrieval of drawn items. [ABSTRACT FROM AUTHOR]

Using high‐frequency spending data, we show that household consumption displays excess sensitivity to salient macroeconomic news, even when the news is not real. When the announced local unemployment rate reaches a 12‐month maximum, local news coverage of unemployment increases and local consumers reduce their discretionary spending by 1.5% relative to consumers in areas with the same macroeconomic conditions. Low‐income households display greater excess sensitivity to salience. The decrease in spending is not later reversed. Households in treated areas act as if they are more financially constrained than those in untreated areas with the same fundamentals. [ABSTRACT FROM AUTHOR]

Objective: Opioid use disorder (OUD) affects approximately 5.6 million people in the United States annually, yet rates of the use of effective medication for OUD (MOUD) treatment are low. We conducted an observational cohort study from August 2017 through May 2021, the MOUD Study, to better understand treatment engagement and factors that may influence treatment experiences and outcomes. In this article, we describe the study design, data collected, and treatment outcomes. Methods: We recruited adult patients receiving OUD treatment at US outpatient facilities for the MOUD Study. We collected patient-level data at 5 time points (baseline to 18 months) via self-administered questionnaires and health record data. We collected facility-level data via questionnaires administered to facility directors at 2 time points. Across 16 states, 62 OUD treatment facilities participated, and 1974 patients enrolled in the study. We summarized descriptive data on the characteristics of patients and OUD treatment facilities and selected treatment outcomes. Results: Approximately half of the 62 facilities were private, nonprofit organizations; 62% focused primarily on substance use treatment; and 20% also offered mental health services. Most participants were receiving methadone (61%) or buprenorphine (32%) and were predominately non-Hispanic White (68%), aged 25-44 years (62%), and female (54%). Compared with patient-reported estimates at baseline, 18-month estimates suggested that rates of abstinence increased (55% to 77%), and rates of opioid-related overdoses (7% to 2%), emergency department visits (9% to 4%), and arrests (15% to 7%) decreased. Conclusions: Our results demonstrated the benefits of treatment retention not only on abstinence from opioid use but also on other quality-of-life metrics, with data collected during an extended period. The MOUD Study produced rich, multilevel data that can lay the foundation for an evidence base to inform OUD treatment and support improvement of care and patient outcomes. [ABSTRACT FROM AUTHOR]

Accurate molecular diagnostic tests are necessary for confirming a diagnosis of coronavirus disease 2019 (COVID-19) and for identifying asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The number of available SARS-CoV-2 nucleic acid detection tests continues to increase as does the COVID-19 diagnostic literature. Thus, the Infectious Diseases Society of America (IDSA) developed an evidence-based diagnostic guideline to assist clinicians, clinical laboratorians, patients, and policymakers in decisions related to the optimal use of SARS-CoV-2 nucleic acid amplification tests. In addition, we provide a conceptual framework for understanding molecular diagnostic test performance, discuss nuances of test result interpretation in a variety of practice settings, and highlight important unmet research needs related to COVID-19 diagnostic testing. IDSA convened a multidisciplinary panel of infectious diseases clinicians, clinical microbiologists, and experts in systematic literature review to identify and prioritize clinical questions and outcomes related to the use of SARS-CoV-2 molecular diagnostics. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations. The panel agreed on 12 diagnostic recommendations. Access to accurate SARS-CoV-2 nucleic acid testing is critical for patient care, hospital infection prevention, and the public health response to COVID-19 infection. Information on the clinical performance of available tests continues to grow, but the quality of evidence of the current literature to support this updated molecular diagnostic guideline remains moderate to very low. Recognizing these limitations, the IDSA panel weighed available diagnostic evidence and recommends nucleic acid testing for all symptomatic individuals suspected of having COVID-19. In addition, testing is suggested for asymptomatic individuals with known or suspected contact with a COVID-19 case when the results will impact isolation/quarantine/personal protective equipment (PPE) usage decisions. Evidence in support of rapid testing and testing of upper respiratory specimens other than nasopharyngeal swabs, which offer logistical advantages, is sufficient to warrant conditional recommendations in favor of these approaches. [ABSTRACT FROM AUTHOR]

Immunoassays designed to detect SARS-CoV-2 protein antigens (Ag) are commonly used to diagnose COVID-19. The most widely used tests are lateral flow assays that generate results in approximately 15 minutes for diagnosis at the point-of-care. Higher throughput, laboratory-based SARS-CoV-2 Ag assays have also been developed. The number of commercially available SARS-CoV-2 Ag detection tests has increased rapidly, as has the COVID-19 diagnostic literature. The Infectious Diseases Society of America (IDSA) convened an expert panel to perform a systematic review of the literature and develop best-practice guidance related to SARS-CoV-2 Ag testing. This guideline is an update to the third in a series of frequently updated COVID-19 diagnostic guidelines developed by the IDSA. IDSA's goal was to develop evidence-based recommendations or suggestions that assist clinicians, clinical laboratories, patients, public health authorities, administrators, and policymakers in decisions related to the optimal use of SARS-CoV-2 Ag tests in both medical and nonmedical settings. A multidisciplinary panel of infectious diseases clinicians, clinical microbiologists, and experts in systematic literature review identified and prioritized clinical questions related to the use of SARS-CoV-2 Ag tests. A review of relevant, peer-reviewed published literature was conducted through 1 April 2022. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations. The panel made 10 diagnostic recommendations that address Ag testing in symptomatic and asymptomatic individuals and assess single versus repeat testing strategies. US Food and Drug Administration (FDA) SARS-CoV-2 Ag tests with Emergency Use Authorization (EUA) have high specificity and low to moderate sensitivity compared with nucleic acid amplification testing (NAAT). Ag test sensitivity is dependent on the presence or absence of symptoms and, in symptomatic patients, on timing of testing after symptom onset. In most cases, positive Ag results can be acted upon without confirmation. Results of point-of-care testing are comparable to those of laboratory-based testing, and observed or unobserved self-collection of specimens for testing yields similar results. Modeling suggests that repeat Ag testing increases sensitivity compared with testing once, but no empirical data were available to inform this question. Based on these observations, rapid RT-PCR or laboratory-based NAAT remain the testing methods of choice for diagnosing SARS-CoV-2 infection. However, when timely molecular testing is not readily available or is logistically infeasible, Ag testing helps identify individuals with SARS-CoV-2 infection. Data were insufficient to make a recommendation about the utility of Ag testing to guide release of patients with COVID-19 from isolation. The overall quality of available evidence supporting use of Ag testing was graded as very low to moderate. [ABSTRACT FROM AUTHOR]

Immunoassays designed to detect SARS-CoV-2 protein antigens are now commercially available. The most widely used tests are rapid lateral flow assays that generate results in ~15 minutes for diagnosis at the point-of-care. Higher throughput, laboratory-based SARS-CoV-2 antigen (Ag) assays have also been developed. The overall accuracy of SARS-CoV-2 Ag tests, however, is not well defined. The Infectious Diseases Society of America (IDSA) convened an expert panel to perform a systematic review of the literature and develop best-practice guidance related to SARS-CoV-2 Ag testing. This guideline is the third in a series of rapid, frequently updated COVID-19 diagnostic guidelines developed by IDSA. IDSA's goal was to develop evidence-based recommendations or suggestions that assist clinicians, clinical laboratories, patients, public health authorities, administrators, and policymakers in decisions related to the optimal use of SARS-CoV-2 Ag tests in both medical and nonmedical settings. A multidisciplinary panel of infectious diseases clinicians, clinical microbiologists, and experts in systematic literature review identified and prioritized clinical questions related to the use of SARS-CoV-2 Ag tests. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations. The panel agreed on 5 diagnostic recommendations. These recommendations address Ag testing in symptomatic and asymptomatic individuals as well as assess single versus repeat testing strategies. Data on the clinical performance of US Food and Drug Administration SARS-CoV-2 Ag tests with Emergency Use Authorization are mostly limited to single, one-time testing versus standard nucleic acid amplification testing (NAAT) as the reference standard. Rapid Ag tests have high specificity and low to modest sensitivity compared with reference NAAT methods. Antigen test sensitivity is heavily dependent on viral load, with differences observed between symptomatic compared with asymptomatic individuals and the time of testing post-onset of symptoms. Based on these observations, rapid reverse transcriptase–polymerase chain reaction (RT-PCR) or laboratory-based NAAT remain the diagnostic methods of choice for diagnosing SARS-CoV-2 infection. However, when molecular testing is not readily available or is logistically infeasible, Ag testing can help identify some individuals with SARS-CoV-2 infection. The overall quality of available evidence supporting use of Ag testing was graded as very low to moderate. [ABSTRACT FROM AUTHOR]

Background Accurate molecular diagnostic tests are necessary for confirming a diagnosis of coronavirus disease 2019 (COVID-19). Direct detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acids in respiratory tract specimens informs patient, healthcare institution and public health level decision-making. The numbers of available SARS-CoV-2 nucleic acid detection tests are rapidly increasing, as is the COVID-19 diagnostic literature. Thus, the Infectious Diseases Society of America (IDSA) recognized a significant need for frequently updated systematic reviews of the literature to inform evidence-based best practice guidance. Objective The IDSA's goal was to develop an evidence-based diagnostic guideline to assist clinicians, clinical laboratorians, patients and policymakers in decisions related to the optimal use of SARS-CoV-2 nucleic acid amplification tests. In addition, we provide a conceptual framework for understanding molecular diagnostic test performance, discuss the nuance of test result interpretation in a variety of practice settings and highlight important unmet research needs in the COVID-19 diagnostic testing space. Methods IDSA convened a multidisciplinary panel of infectious diseases clinicians, clinical microbiologists, and experts in systematic literature review to identify and prioritize clinical questions and outcomes related to the use of SARS-CoV-2 molecular diagnostics. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations. Results The panel agreed on 17 diagnostic recommendations. Conclusions Universal access to accurate SARS-CoV-2 nucleic acid testing is critical for patient care, hospital infection prevention and the public response to the COVID-19 pandemic. Information on the clinical performance of available tests is rapidly emerging, but the quality of evidence of the current literature is considered moderate to very low. Recognizing these limitations, the IDSA panel weighed available diagnostic evidence and recommends nucleic acid testing for all symptomatic individuals suspected of having COVID-19. In addition, testing is recommended for asymptomatic individuals with known or suspected contact with a COVID-19 case. Testing asymptomatic individuals without known exposure is suggested when the results will impact isolation/quarantine/personal protective equipment (PPE) usage decisions, dictate eligibility for surgery, or inform solid organ or hematopoietic stem cell transplantation timing. Ultimately, prioritization of testing will depend on institutional-specific resources and the needs of different patient populations. [ABSTRACT FROM AUTHOR]

VITAL faculty, also known as non-tenure-track instructors at colleges and universities in the United States, play critical roles in educating students but are often excluded from professional development and community-building opportunities that support their growth and development as instructors. In this article, we describe how we addressed these inequities as a consortium of institutions with differing missions, strategic goals, and student populations, by facilitating collaborative initiatives for our VITAL faculty. We apply various conceptual frameworks, theories, and research-supported principles to this work, including academic development as community development, social network theory, and professional development as critical to improving student outcomes. [ABSTRACT FROM AUTHOR]

Background: This study involved a scoping review to explore factors influencing dental hygienist demand and supply in high-income countries. Methods: A six-stage scoping review was conducted with separate search strategies tailored to four databases (MEDLINE, CINAHL, Google Scholar, and Google) plus a targeted scan of dental hygienist organization websites. This yielded 2,117 unique citations, leading to 148 articles included in the review. Results: Nearly half of the articles (47%) focused on the United States, with 11% on Canada. Most articles (91%) were in English, alongside 13 in Korean and one in French. Journal articles comprised 62% of the publications, followed by reports/working papers (11%) and websites (11%). Other types included conference abstracts, policy briefs, and presentation slides. Content-wise, 47% were original research, with analysis articles (14%), commentaries (11%), and reviews (8%) also present. The articles were coded into three main categories: workforce characteristics/projections, factor-specific analyses, and workforce opportunities. The articles on workforce characteristics covered demographic, geographic, and employment aspects of dental hygienists, along with projections for supply and demand using simulation modelling and geospatial analyses. Factor-specific articles investigated the (1) working environment, (2) policy/regulatory/training environment, (3) job/career satisfaction and related human resource issues, and (4) scope of practice. The third key category of articles highlighted opportunities for expanding the workforce through alternative models in different sectors/settings (e.g., public health, primary care, long-term care, hospitals, mobile outreach, and non-clinical roles including research, education and leadership) and for a range of vulnerable or underserved populations (e.g., geriatric and pediatric populations, persons with disabilities, those living in rural/remote areas, Indigenous peoples, and incarcerated people). Conclusions: This review provides a comprehensive documentation of the current state of the dental hygienist workforce, compiling factors affecting demand and supply, and highlighting opportunities for the dental hygienist workforce in Canada and other high-income countries. The findings offer a foundation for future research, highlighting the need for more focused and rigorous reviews and underscoring the necessity of high-quality studies to verify the effectiveness of various interventions and policies. This is crucial to address dental hygienist workforce challenges and ensure the sustainability and effectiveness of oral health care delivery. [ABSTRACT FROM AUTHOR]

Background: Patients with migraine often have poor sleep quality between and during migraine attacks. Furthermore, extensive research has identified photophobia as the most common and most bothersome symptom in individuals with migraine, second only to headache. Seeking the comfort of darkness is a common strategy for managing pain during an attack and preventing its recurrence between episodes. Given the well-established effects of daily light exposure on circadian activity rhythms and sleep quality, this study aimed to investigate the relationship between photophobia symptoms and sleep quality in a cohort of patients with migraine. Methods: A cross-sectional observational study was conducted using existing data extracted from the American Registry for Migraine Research (ARMR). Participants with a migraine diagnosis who had completed the baseline questionnaires (Photosensitivity Assessment Questionnaire (PAQ), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2)), and selected questions of the ARMR Sleep questionnaire were included. Models were created to describe the relationship of photophobia and photophilia with various sleep facets, including sleep quality (SQ), sleep disturbance (SDis), sleep onset latency (SOL), sleep-related impairments (SRI), and insomnia. Each model was controlled for age, sex, headache frequency, anxiety, and depression. Results: A total of 852 patients meeting the inclusion criteria were included in the analysis (mean age (SD) = 49.8 (13.9), 86.6% (n = 738) female). Those with photophobia exhibited significantly poorer sleep quality compared to patients without photophobia (p < 0.001). Photophobia scores were associated with SQ (p < 0.001), SDis (p < 0.001), SOL (p = 0.011), SRI (p = 0.020), and insomnia (p = 0.005) after controlling for age, sex, headache frequency, depression, and anxiety, signifying that higher levels of photophobia were associated with worse sleep-related outcomes. Conversely, photophilia scores were associated with better sleep-related outcomes for SQ (p < 0.007), SOL (p = 0.010), and insomnia (p = 0.014). Conclusion: Results suggest that photophobia is a significant predictor of poor sleep quality and sleep disturbances in migraine. These results underscore the necessity for comprehensive and systematic investigations into the intricate interplay between photophobia and sleep to enhance our understanding and develop tailored solutions for individuals with migraine. [ABSTRACT FROM AUTHOR]

Objective: Antibiotic prophylaxis is recommended before invasive dental procedures to prevent endocarditis in those at high risk, but supporting data are sparse. We therefore investigated any association between invasive dental procedures and endocarditis, and any antibiotic prophylaxis effect on endocarditis incidence. Subjects and Methods: Cohort and case‐crossover studies were performed on 1,678,190 Medicaid patients with linked medical, dental, and prescription data. Results: The cohort study identified increased endocarditis incidence within 30 days of invasive dental procedures in those at high risk, particularly after extractions (OR 14.17, 95% CI 5.40–52.11, p < 0.0001) or oral surgery (OR 29.98, 95% CI 9.62–119.34, p < 0.0001). Furthermore, antibiotic prophylaxis significantly reduced endocarditis incidence following invasive dental procedures (OR 0.20, 95% CI 0.06–0.53, p < 0.0001). Case‐crossover analysis confirmed the association between invasive dental procedures and endocarditis in those at high risk, particularly following extractions (OR 3.74, 95% CI 2.65–5.27, p < 0.005) and oral surgery (OR 10.66, 95% CI 5.18–21.92, p < 0.0001). The number of invasive procedures, extractions, or surgical procedures needing antibiotic prophylaxis to prevent one endocarditis case was 244, 143 and 71, respectively. Conclusions: Invasive dental procedures (particularly extractions and oral surgery) were significantly associated with endocarditis in high‐risk individuals, but AP significantly reduced endocarditis incidence following these procedures, thereby supporting current guideline recommendations. [ABSTRACT FROM AUTHOR]

We study the determinants associated with wealth advisors' consideration to leave or say at financial planning firms. Utilizing self‐determination theory as the foundational theoretical framework and focusing on the psychological aspect of the decision, we develop a structural equation model that defines the factors relating to work satisfaction, affective work commitment, and turnover intention in the wealth management profession. We provide evidence for the roles played by autonomous motivation, reward, and punishment in determining job retention and affective work commitment among wealth advisors in the United States. By showing the importance of autonomous motivation on retention, we are offering the wealth management industry one extra tool to influence employee retention. [ABSTRACT FROM AUTHOR]

COVID-19 increased the prevalence of clinically significant anxiety in the United States. To investigate contributing factors we analyzed anxiety, reported online via monthly Generalized Anxiety Disorders-7 (GAD-7) surveys between April 2020 and May 2022, in association with self-reported worry about the health effects of COVID-19, economic difficulty, personal COVID-19 experience, and subjective social status. 333,292 anxiety surveys from 50,172 participants (82% non-Hispanic white; 73% female; median age 55, IQR 42–66) showed high levels of anxiety, especially early in the pandemic. Anxiety scores showed strong independent associations with worry about the health effects of COVID-19 for oneself or family members (GAD-7 score +3.28 for highest vs. lowest category; 95% confidence interval: 3.24, 3.33; p<0.0001 for trend) and with difficulty paying for basic living expenses (+2.06; 1.97, 2.15, p<0.0001) in multivariable regression models after adjusting for demographic characteristics, COVID-19 case rates and death rates, and personal COVID-19 experience. High levels of COVID-19 health worry and economic stress were each more common among participants reporting lower subjective social status, and median anxiety scores for those experiencing both were in the range considered indicative of moderate to severe clinical anxiety disorders. In summary, health worry and economic difficulty both contributed to high rates of anxiety during the first two years of the COVID-19 pandemic in the US, especially in disadvantaged socioeconomic groups. Programs to address both health concerns and economic insecurity in vulnerable populations could help mitigate pandemic impacts on anxiety and mental health. [ABSTRACT FROM AUTHOR]

During public health emergencies, health communication materials to contain the outbreak are needed promptly, which prevents the use of standard approaches for getting feedback from the intended audience. We propose a strategy for rapidly obtaining community feedback on new health communication materials during the public health emergencies. We illustrate this with COVID-19 testing campaign in a Vietnamese–American enclave in the USA. The project included community-based COVID-19 testing and communication activities to increase the awareness of the testing centers and encourage frequent testing. Our strategy involves two main components: (i) use of a research team with an existing trust relationship with the community and that includes researchers from that community and (ii) co-design of communication materials using community-based gatekeepers and a cultural broker. We developed brochures and posters to increase the awareness of the COVID-19 testing services. The cultural broker and community-based partners identified salient message concepts and worked with the researchers to define the objectives and content of the materials, which were then reviewed by the entire team. In lieu of standard pretesting, we relied on feedback on mockups of the materials and subsequent revisions from the community-based gatekeepers and cultural broker. Our strategy strikes a balance between the need to urgently disseminate new materials and the need for community input. One key takeaway is that effective planning for public health emergencies must start long before the crisis occurs. [ABSTRACT FROM AUTHOR]

Are attitudes more resistant to change when they are more central to a belief system? Theories of inter‐attitude structure and belief system dynamics both suggest that the answer is yes. We demonstrate how to combine belief system network methods with pretest‐posttest experiments to empirically test this idea. We aimed to persuade US conservatives (Experiment 1 N = 890) and US liberals (Experiment 2 N = 1305, Experiment 3 N = 1293) using moral reframing persuasive strategies. Although we find that moral reframing was persuasive (9 of 12 attempts), there was no evidence that central attitudes were more difficult to change than peripheral attitudes. This was the case across all experiments, target attitudes and methods for assessing belief system structure. The results suggest that moral reframing persuades people, but that theories of inter‐attitude structure and belief system dynamics both do not make accurate predictions in this situation. [ABSTRACT FROM AUTHOR]

Associations between trajectories of depressive symptoms and subsequent tobacco and alcohol use were examined in two samples of girls assessed at age 11.5 (T1), 12.5 (T2), and 13.5 (T3). Two samples were examined to ascertain if there was generalizability of processes across risk levels and cultures. Study 1 comprised a United States-based sample of 100 girls in foster care; Study 2 comprised 264 girls in a United Kingdom community-based sample. Controlling for T1 aggression and T1 substance use, individual variation in intercept and slope of depressive symptoms was associated with tobacco use at T3 in both samples: greater intercept and increases in depressive symptoms increased the risk for T3 tobacco use. A similar pattern of associations was found for alcohol use in Study 1. The replicability of findings for the prediction of tobacco use from trajectories of depressive symptoms suggests potential benefit in identifying girls with elevated depressive symptoms for tobacco use prevention programs, prior to the transition to secondary school. (Contains 1 figure and 3 tables.)

Beginning in sixth grade at an average age of 11.9 years, 416 adolescents and their parents participated in 4 waves of data collection involving family observations and multiple-reporter assessments. Ecological theory and the process-person-context-time (PPCT) model guided the hypotheses and analyses. Lagged, growth curve models revealed that family hostility and peer deviance affiliation predicted adolescent aggression in the subsequent year. Family warmth played only a minor role in protecting against adolescent aggression. In hostile or low-warmth families, peer deviance affiliation linked to a declining aggression trajectory consistent with the arena of comfort hypothesis. The longitudinal findings suggest a nonadditive, synergistic interplay between family and peer contexts across time in adding nuance to understanding the adolescent aggression. (Contains 1 table and 2 figures.)

Automatic item generation represents a relatively new but rapidly evolving research area where cognitive and psychometric theories are used to produce tests that include items generated using computer technology. Automatic item generation requires two steps. First, test development specialists create item models, which are comparable to templates or prototypes, that highlight the features or elements in the assessment task that must be manipulated. Second, these item model elements are manipulated to generate new items with the aid of computer-based algorithms. With this two-step process, hundreds or even thousands of new items can be created from a single item model. The purpose of our article is to describe seven different but related topics that are central to the development and use of item models for automatic item generation. We start by defining item model and highlighting some related concepts; we describe how item models are developed; we present an item model taxonomy; we illustrate how item models can be used for automatic item generation; we outline some benefits of using item models; we introduce the idea of an item model bank; and finally, we demonstrate how statistical procedures can be used to estimate the parameters of the generated items without the need for extensive field or pilot testing. (Contains 4 notes, 2 tables and 4 figures.)

This article explores the role of Pell grants in the rise of for-profit colleges and universities (FPCUs) in the United States by examining National Center for Education Statistics data (Pell are financial "needs-based" grants to students to offset cost of tuition; Pell grants are the main source of federal financial support available to FPCUs). Two major findings are discussed: FPCUs have more than double the percentage of enrollment previously reported and receive greater Pell per FTE than not-for-profits (NFPs) or publics. FPCUs spend less on instruction than NFPs while some institutions have more Pell revenue than instructional expenses. Implications for educational inequality and public purposes of higher education are discussed. (Contains 12 tables and 7 endnotes.)

Research findings in recent years provide compelling evidence of the importance of encouraging student control over the learning process as a whole. The socially based tools and technologies of the Web 2.0 movement are capable of supporting informal conversation, reflexive dialogue and collaborative content generation, enabling access to a wide raft of ideas and representations. Used appropriately, these tools can shift control to the learner, through promoting learner agency, autonomy and engagement in social networks that straddle multiple real and virtual learning spaces independent of physical, geographic, institutional and organisational boundaries. As argued in this article, however, in order for self-regulated learning to come to fruition, students need not only to be able to choose and personalise what tools and content are available, but also to have access to the necessary scaffolding to support their learning. Emerging practices with social computing technologies, a number of examples of which are showcased in this article, signal the need for pedagogies that are more personal, social and participatory. The authors conclude with a discussion of some of the key implications for practice, including an outline of the current challenges faced by tertiary educators. (Contains 1 table.)

Purpose: This paper seeks to demonstrate the value and critical importance of negotiating skills within the wider context of "employability". It posits that the intensity, rich context, and ambiguity of juxtaposing ancient and modern cases provides a creative, engaging format to stimulate learning about negotiating and power among parties. Design/methodology/approach: This paper is the culmination of teaching undergraduate and graduate business students, as well as continuing education courses, in the USA and New Zealand respectively. The authors developed a participatory, mixed-mode educational simulation. Using thematic analysis of student survey responses, they summarize learning points associated with the suggested teaching case. Findings: An analysis of post-exercise questions suggested six key themes identified by students: value of leadership, self-knowledge, maturity, and judgment; need for creativity, versatility, and adaptability in bridging differences; focus on settlement (rather than absolute win-lose scenarios); managing risk due to uncertainty and unidentified incentives among participants; dire consequences of inflexibility, self-righteousness, and unhealthy ego; and need for increasing negotiating skill proficiency is valuable and timeless. Practical implications: The outlined teaching case is put forward as providing a creative, interesting and rich format to stimulate learning about negotiating and power among parties, as well as team dynamics. Originality/value: The paper outlines a novel teaching tool that allows students to learn and appreciate the dynamics of negotiating in complex environments. (Contains 3 notes.)

Background: Little is known about whether people who use both tobacco and cannabis (co-use) are more or less likely to have mental health disorders than single substance users or non-users. We aimed to examine associations between use of tobacco and/or cannabis with anxiety and depression. Methods: We analyzed data from the COVID-19 Citizen Science Study, a digital cohort study, collected via online surveys during 2020–2022 from a convenience sample of 53,843 US adults (≥ 18 years old) nationwide. Past 30-day use of tobacco and cannabis was self-reported at baseline and categorized into four exclusive patterns: tobacco-only use, cannabis-only use, co-use of both substances, and non-use. Anxiety and depression were repeatedly measured in monthly surveys. To account for multiple assessments of mental health outcomes within a participant, we used Generalized Estimating Equations to examine associations between the patterns of tobacco and cannabis use with each outcome. Results: In the total sample (mean age 51.0 years old, 67.9% female), 4.9% reported tobacco-only use, 6.9% cannabis-only use, 1.6% co-use, and 86.6% non-use. Proportions of reporting anxiety and depression were highest for the co-use group (26.5% and 28.3%, respectively) and lowest for the non-use group (10.6% and 11.2%, respectively). Compared to non-use, the adjusted odds of mental health disorders were highest for co-use (Anxiety: OR = 1.89, 95%CI = 1.64–2.18; Depression: OR = 1.77, 95%CI = 1.46–2.16), followed by cannabis-only use, and tobacco-only use. Compared to tobacco-only use, co-use (OR = 1.35, 95%CI = 1.08–1.69) and cannabis-only use (OR = 1.17, 95%CI = 1.00–1.37) were associated with higher adjusted odds for anxiety, but not for depression. Daily use (vs. non-daily use) of cigarettes, e-cigarettes, and cannabis were associated with higher adjusted odds for anxiety and depression. Conclusions: Use of tobacco and/or cannabis, particularly co-use of both substances, were associated with poor mental health. Integrating mental health support with tobacco and cannabis cessation may address this co-morbidity. [ABSTRACT FROM AUTHOR]

PURPOSE Cancer care-related greenhouse gas (GHG) emissions harm human health. Many cancer drugs are administered at greater-than-necessary doses, frequencies, and durations. Alternative dosing strategies may enable reductions in cancer care GHG emissions without compromising patient outcomes. MATERIALS AND METHODS We used streamlined life-cycle analysis in a case-control simulation to estimate the relative reductions in GHG emissions that would be expected to result from using each of three alternative dosing strategies of trastuzumab (6-month adjuvant treatment duration, once every 4-week dosing, and both) in human epidermal growth factor receptor 2 (HER2)1 breast cancer. Using primary data and conversion factors from the environmental science literature, we estimated per-patient relative reduction in GHG emissions and, using SEER data, health impacts (in terms of disability-adjusted life-years [DALYs] and excess mortality per kg CO2) on bystanders for each alternative dosing strategy. RESULTS Compared with the trastuzumab dosing strategy commonly used at baseline (12-month duration of adjuvant therapy and once every 3-week dosing in all settings), adoption of both 6-month adjuvant trastuzumab and once every 4-week trastuzumab dosing would reduce GHG emissions by 4.5%, 18.7%, and 14.6% in the neoadjuvant, adjuvant, and metastatic settings, respectively. We estimate that US-based adoption of alternative trastuzumab dosing would reduce annual DALYs and excess lives lost due to environmental impact of US-based trastuzumab therapy for HER21 breast cancer by 1.5 and 0.9, respectively. CONCLUSION Alternative dosing strategies may materially reduce the population health impacts of cancer care by reducing environmental impact. Regulatory decision making and health technology assessments should consider a treatment's environmental and population health impacts. Clinical trials of alternative dosing strategies are justified on the basis of environmental and population health impacts. [ABSTRACT FROM AUTHOR]

Introduction: Over the past decade, numerous efforts have encouraged the realization of the learning health system (LHS) in the United States. Despite these efforts, and promising aims of the LHS, the full potential and value of research conducted within LHSs have yet to be realized. New technology coupled with a catalyzing global pandemic have spurred momentum. In addition, the LHS has lacked a consistent framework within which "best evidence" can be identified. Positive deviance analysis, itself reinvigorated by recent advances in health information technology (IT) and ubiquitous adoption of electronic health records (EHRs), may finally provide a framework through which LHSs can be operationalized and optimized. Methods: We describe the synergy between positive deviance and the LHS and how they may be integrated to achieve a continuous cycle of health system improvement. Results: As we describe below, the positive deviance approach focuses on learning from high‐performing teams and organizations. Conclusion: Such learning can be enabled by EHRs and health IT, providing a lens into how digital clinical interventions are successfully developed and deployed. [ABSTRACT FROM AUTHOR]

This study investigated the attitude toward physical education of 1107 high school students from four countries, Czech Republic, Austria, England, and the United States. Survey data were gathered and measured using the Adams Scale survey instrument (Adams, 1963). While the data revealed individual differences, the overall sample indicated a decidedly positive attitude toward physical education. Students from the Czech Republic had significantly higher attitude scores than both U.S. and English respondents (p < .001), and males showed a more favorable attitude toward physical education than females (p < .001). Several notable differences were also found when the combined effect of gender and country of origin was measured.

Child welfare struggles to manage child abuse and neglect and to seek permanency for children, while being culturally responsive to the communities it serves. Family group conferencing, piloted in New Zealand and now used in the United States and other countries, is a strengths-based model that brings together families and their support systems to develop and carry out a plan that protects, nurtures, and safeguards children and other family members. This article describes the model and a culturally competent method for assessing and adapting the model for the African American, Cherokee, and Latino/Hispanic communities in North Carolina.

In this commentary, the authors propose new approaches for triaging, pricing, and financing that can reduce the costs of gene therapy, improve patient access, and address the historical neglect of patients with sickle cell disease. [ABSTRACT FROM AUTHOR]

Background: Adequate housing is a basic human right. The many millions of people experiencing homelessness (PEH) have a lower life expectancy and more physical and mental health problems. Practical and effective interventions to provide appropriate housing are a public health priority. Objectives: To summarise the best available evidence relating to the components of case‐management interventions for PEH via a mixed methods review that explored both the effectiveness of interventions and factors that may influence its impact. Search Methods: We searched 10 bibliographic databases from 1990 to March 2021. We also included studies from Campbell Collaboration Evidence and Gap Maps and searched 28 web sites. Reference lists of included papers and systematic reviews were examined and experts contacted for additional studies. Selection Criteria: We included all randomised and non‐randomised study designs exploring case management interventions where a comparison group was used. The primary outcome of interest was homelessness. Secondary outcomes included health, wellbeing, employment and costs. We also included all studies where data were collected on views and experiences that may impact on implementation. Data Collection and Analysis: We assessed risk of bias using tools developed by the Campbell Collaboration. We conducted meta‐analyses of the intervention studies where possible and carried out a framework synthesis of a set of implementation studies identified by purposive sampling to represent the most 'rich' and 'thick' data. Main Results: We included 64 intervention studies and 41 implementation studies. The evidence base was dominated by studies from the USA and Canada. Participants were largely (though not exclusively) people who were literally homeless, that is, living on the streets or in shelters, and who had additional support needs. Many studies were assessed as having a medium or high risk of bias. However, there was some consistency in outcomes across studies that improved confidence in the main findings. Case Management and Housing Outcomes: Case management of any description was superior to usual care for homelessness outcomes (standardised mean difference [SMD] = −0.51 [95% confidence interval [CI]: −0.71, −0.30]; p < 0.01). For studies included in the meta‐analyses, Housing First had the largest observed impact, followed by Assertive Community Treatment, Critical Time Intervention and Intensive Case Management. The only statistically significant difference was between Housing First and Intensive Case Management (SMD = −0.6 [–1.1, −0.1]; p = 0.03) at ≥12 months. There was not enough evidence to compare the above approaches with standard case management within the meta‐analyses. A narrative comparison across all studies was inconclusive, though suggestive of a trend in favour of more intensive approaches. Case Management and Mental Health Outcomes: The overall evidence suggested that case management of any description was not more or less effective compared to usual care for an individual's mental health (SMD = 0.02 [−0.15, 0.18]; p = 0.817). Case Management and Other Outcomes: Based on meta‐analyses, case management was superior to usual care for capability and wellbeing outcomes up to 1 year (an improvement of around one‐third of an SMD; p < 0.01) but was not statistically significantly different for substance use outcomes, physical health, and employment. Case Management Components: For homelessness outcomes, there was a non‐significant trend for benefits to be greater in the medium term (≤3 years) compared to long term (>3 years) (SMD = −0.64 [−1.04, −0.24] vs. −0.27 [−0.53, 0]; p = 0.16) and for in‐person meetings in comparison to mixed (in‐person and remote) approaches (SMD = −0.73 [−1.25,−0.21]) versus −0.26 [−0.5,−0.02]; p = 0.13). There was no evidence from meta‐analyses to suggest that an individual case manager led to better outcomes then a team, and interventions with no dedicated case manager may have better outcomes than those with a named case manager (SMD = −0.36 [−0.55, −0.18] vs. −1.00 [−2.00, 0.00]; p = 0.02). There was not enough evidence from meta‐analysis to assess whether the case manager should have a professional qualification, or if frequency of contact, case manager availability or conditionality (barriers due to conditions attached to service provision) influenced outcomes. However, the main theme from implementation studies concerned barriers where conditions were attached to services. Characteristics of Persons Experiencing Homelessness: No conclusions could be drawn from meta‐analysis other than a trend for greater reductions in homelessness for persons with high complexity of need (two or more support needs in addition to homelessness) as compared to those with medium complexity of need (one additional support need); effect sizes were SMD = −0.61 [−0.91, −0.31] versus −0.36 [−0.68, −0.05]; p = 0.3. The Broader Context of Delivery of Case Management Programmes: Other major themes from the implementation studies included the importance of interagency partnership; provision for non‐housing support and training needs of PEH (such as independent living skills), intensive community support following the move to new housing; emotional support and training needs of case managers; and an emphasis on housing safety, security and choice. Cost Effectiveness: The 12 studies with cost data provided contrasting results and no clear conclusions. Some case management costs may be largely off‐set by reductions in the use of other services. Cost estimates from three North American studies were $45–52 for each additional day housed. Authors' Conclusions: Case management interventions improve housing outcomes for PEH with one or more additional support needs, with more intense interventions leading to greater benefits. Those with greater support needs may gain greater benefit. There is also evidence for improvements to capabilities and wellbeing. Current approaches do not appear to lead to mental health benefits. In terms of case management components, there is evidence in support of a team approach and in‐person meetings and, from the implementation evidence, that conditions associated with service provision should be minimised. The approach within Housing First could explain the finding that overall benefits may be greater than for other types of case management. Four of its principles were identified as key themes within the implementation studies: No conditionality, offer choice, provide an individualised approach and support community building. Recommendations for further research include an expansion of the research base outside North America and further exploration of case management components and intervention cost‐effectiveness. [ABSTRACT FROM AUTHOR]

Background Context: Demographic factors contribute significantly to spine surgery outcomes. Although race and ethnicity are not proxies for disease states, the intersection between these patient characteristics and socioeconomic status significantly impact patient outcomes.Purpose: The purpose of this study is to investigate the frequency of demographic reporting and analysis in randomized controlled clinical trials (RCTs) published in the three highest impact spine journals.Study Design: Systematic review.Patient Sample: We analyzed 278 randomized control trials published in The Spine Journal, Spine, and Journal of Neurosurgery: Spine between January 2012 - January 2022.Outcome Measures: Extracted manuscript characteristics included the frequency of demographic reporting, sample size, and demographic composition of studies.Methods: We conducted a systematic review of RCTs published between January 2012 - January 2022 in the three highest impact factor spine journals in 2021: The Spine Journal, Spine, and Journal of Neurosurgery: Spine. We determined if age, gender, BMI, race, and ethnicity were reported and analyzed for each study. The overall frequency of demographic reporting was assessed, and the reporting trends were analyzed for each individual year and journal. Among studies that did report demographics, the populations were analyzed in comparison to the national population per United States (US) census reports. Studies were evaluated for bias using Cochrane risk-of-bias.Results: Our search identified 278 RCTs for inclusion. 166 were published in Spine, 65 in The Spine Journal, and 47 in Journal of Neurosurgery: Spine. Only 9.35% (N=26) and 3.9% (N=11) of studies reported race and ethnicity, respectively. Demographic reporting frequency did not vary based on the publishing journal. Reporting of age and BMI increased over time, but reporting of race and ethnicity did not. Among RCTs that reported race, 88% were conducted in the US, and 85.71% of the patients in these US studies were White. White subjects were overly represented compared to the US population (85.71% vs. 61.63%, p<.001), and non-White or Black patients were most underrepresented (2.89 vs. 25.96%, p<.001).Conclusions: RCTs published in the three highest impact factor spine journals failed to frequently report patient race or ethnicity. Among studies published in the US, study populations are increasingly represented by non-Hispanic White patients. As we strive to care for an increasingly diverse population and reduce disparities to care, spine surgeons must do a better job reporting these variables to increase the external validity and generalizability of RCTs. [ABSTRACT FROM AUTHOR]

Introduction: This research investigated how peer victimization and support are reciprocally related and how Cooperative Learning (CL) can reverse the progressive cascade that, unchecked, can culminate in youth mental health problems. Methods: The sample (N = 1890; 53% male) was derived from a randomized trial of CL in 15 middle schools in the United States. Students were recruited in the 7th grade. Structural Equation Modeling (SEM) was used to fit our cross‐lag difference score model across four waves of data. Results: The results indicated a reciprocal relationship between peer support and victimization across time, suggesting the potential for negative experiences with peers to become amplified over time in a "vicious cycle," negatively impacting mental health. Students in intervention schools reported significantly higher levels of peer support and lower levels of victimization, suggesting that CL can intervene in this cycle, with salutary effects on mental health; CL also demonstrated direct effects on mental health. Conclusions: The present study indicates that low peer support can be both a precursor to and an outcome of victimization, serving to maintain a vicious cycle that compounds negative effects on student mental health. Further, results demonstrate how CL can reverse this cycle. We conclude that CL can be of particular importance to the prevention field as a universal mental health program that does not require the associated stigma of identifying youth at elevated risk for referral to treatment programs. [ABSTRACT FROM AUTHOR]

Background: The contemporary uptake of lipid‐lowering therapies (LLT), including more intensive treatment with high‐intensity statins and non‐statin LLT, among U.S. older adults (≥75 years old) with ASCVD is unknown. Methods: In this multicenter retrospective cohort study of a large geographically diverse sample of commercially insured U.S. older adults with ASCVD, we assessed treatment with LLT. Secondary measures included LDL‐C above target ≥70 mg/dl, persistence and adherence to therapy. Results: Treatment with statins, high‐intensity statins, ezetimibe, and PCSK9 inhibitors was assessed in 194,503 older adults (49.9% female) with known ASCVD on January 31st, 2019. 49.3% of older adults with ASCVD were on any statin, with 16.6% receiving a high‐intensity statin and 32.7% on low‐or moderate‐intensity statins. Treatment with ezetimibe (2.4%) or PCSK9 inhibitors (0.24%) was rare and 62.6% of the overall cohort had an LDL‐C above target at ≥70 mg/dl. Patients on high‐intensity statins were more frequently male, had a diagnosis of coronary artery disease, and were more frequently seen by a cardiologist compared with those on low‐or moderate‐intensity statins and untreated individuals (p < 0.0001). The majority of older adults on high‐intensity statins remained on therapy at 12 months (91.9%) and 85.7% had ≥75% adherence to treatment. Conclusions: Less than half of eligible older adults with ASCVD are on statins and only a minority of patients are receiving more intensive lipid‐lowering to improve outcomes. [ABSTRACT FROM AUTHOR]

The article discusses developments regarding the U.S. Federal Arbitration Act (FAA) in 2022, including related Supreme Court rulings and the law's amendment by Congress in connection with claims asserting sexual harassment or sexual assault in 2022. The Supreme Court's rulings are said to reflect a decreased reliance on pro-arbitration policies embodied in the FAA. The amendment allows sexual assault or harassment claims to be brought in court despite having a predispute arbitration agreement.

Simple Summary: Mixed acinar neuroendocrine carcinoma of the pancreas (MANEC-P) is one of the rarest pancreatic carcinomas. Although MANEC-P is rare, it is associated with a bad prognosis. The distribution of this fatal cancer is unknown worldwide. Our contribution is expected to be a detailed understanding of the epidemiology of this cancer in the United States. Expected results from the proposed research include an estimation of the incidence, prevalence, and cancer-specific survival of patients diagnosed with MANEC-P from a population-based cancer registry. This study will be followed by multiple epidemiological studies on the distribution of this fatal cancer worldwide. These epidemiological benchmarks will be used to initiate a consortium to generate real-world evidence with a natural history study for risk identification and treatment optimization for MANEC-P. The long-term goal is to develop an up-to-date epidemiologic and multi-omics knowledge library to enhance the diagnostics and therapeutics options and improve survival among patients diagnosed with MANEC-P. Mixed acinar neuroendocrine carcinoma of the pancreas (MANEC-P) is an extremely rare malignancy with a poor prognosis. However, epidemiological estimates of MANEC-P remain unknown. This study aimed to estimate and compare the incidence, prevalence, and cancer-specific survival (CSS) of MANEC-P in the United States (US). Patients with MANEC-P were identified through the Surveillance, Epidemiology, and End Results (SEER) and National Program of Cancer Registries databases between 2000–2017. The primary outcomes included age-adjusted incidence rate, limited-duration prevalence, and CSS. A total of 630 patients were identified for the incidence analysis and 149 for the prevalence and CSS analyses. The MANEC-P incidence rate was 0.011 per 100,000 individuals, which was the lowest among pancreatic cancer histologic subtypes. The incidence rate was significantly higher in men and Black races and peaked at 75–79 years of age. The incidence rate was the lowest in the midwestern region (0.009) and the highest in the northeastern US (0.013). The 17-year prevalence was 0.00005%, indicating that 189 patients were alive in the United States at the beginning of 2018. The median CSS of MANEC-P was estimated to be 41 (23, 69) months. In conclusion, MANEC-P is very rare, and its incidence rate has been steady in the US over the last two decades. MANEC-P has a poor prognosis and is the 5th leading cause of pancreatic cancer-related death in the US. [ABSTRACT FROM AUTHOR]

While substantial progress has been made to improve our understanding of biogenic isoprene emissions under unstressed conditions, large uncertainties remain with respect to isoprene emissions under stressed conditions. Here, we use the US Drought Monitor (USDM) as a weekly drought severity index and tropospheric columns of formaldehyde (HCHO), the key product of isoprene oxidation, retrieved from the Ozone Monitoring Instrument (OMI) to derive top-down constraints on the response of summertime isoprene emissions to drought stress in the southeastern United States (SE US), a region of high isoprene emissions that is also prone to drought. OMI HCHO column density is found to be 6.7 % (mild drought) to 23.3 % (severe drought) higher than that under non-drought conditions. A global chemical transport model, GEOS-Chem, with version 2.1 of the Model of Emissions of Gases and Aerosols from Nature (MEGAN2.1) emission algorithm can simulate this direction of change, but the simulated increases at the corresponding drought levels are 1.1–1.5 times that of OMI HCHO, suggesting the need for a drought-stress algorithm in the model. By minimizing the model–OMI differences in HCHO to temperature sensitivity under different drought levels, we derived a top-down drought stress factor (γd_OMI) in GEOS-Chem that parameterizes using water stress and temperature. The algorithm led to an 8.6 % (mild drought) to 20.7 % (severe drought) reduction in isoprene emissions in the SE US relative to the simulation without it. With γd_OMI the model predicts a nonlinear increasing trend in isoprene emissions with drought severity that is consistent with OMI HCHO and a single site's isoprene flux measurements. Compared with a previous drought stress algorithm derived from the latter, the satellite-based drought stress factor performs better with respect to capturing the regional-scale drought–isoprene responses, as indicated by the near-zero mean bias between OMI and simulated HCHO columns under different drought conditions. The drought stress algorithm also reduces the model's high bias in organic aerosol (OA) simulations by 6.60 % (mild drought) to 11.71 % (severe drought) over the SE US compared to the no-stress simulation. The simulated ozone response to the drought stress factor displays a spatial disparity due to the isoprene-suppressing effect on oxidants, with an <1 ppb increase in O 3 in high-isoprene regions and a 1–3 ppbv decrease in O 3 in low-isoprene regions. This study demonstrates the unique value of exploiting long-term satellite observations to develop empirical stress algorithms on biogenic emissions where in situ flux measurements are limited. [ABSTRACT FROM AUTHOR]

Theories of belief system structure and dynamics assume that belief systems are a person-level construct. However, measures of belief system structure do not measure the structure of person-level belief systems and instead measure aggregated belief system structure (e.g., the belief system in a particular country). In this paper, I show that a measure of conceptual similarity between attitudes and identities of a belief system works as a valid, reliable, flexible, and efficient measure of person-level belief system structure in the United States. In Studies 1 (N = 387), 2 (N = 389), and 3 (N = 598), I show conceptual similarity judgments are reliable and are related to measures of political engagement, political knowledge, attitude consistency, and preference congruence as predicted by computational models of belief system dynamics. In Studies 4 (N = 981) and 5 (N = 983), I show that conceptual similarity judgments are affected by partisan frames and that changes in conceptual similarity judgments are associated with attitude change as predicted by computational models of belief system dynamics. Conceptual similarity judgments can be used with a variety of attitudes and identities in easy to administer studies. It provides a tool to fill an empirical gap identified by theories of belief system dynamics. [ABSTRACT FROM AUTHOR]

Belief systems are individual-level phenomena that describe the interrelationships of the political attitudes of a person. However, the modal study of the structure of political ideologies and beliefs uses cross-sectional survey data to estimate what is central to the belief system or the dimensionality of the belief system, aggregating across many people. Cross-sectional data, however, are ill-suited to the task of studying individual-level phenomena because they contain an unobservable mixture of within-person and between-person variation. In this project, we use longitudinal datasets from the Netherlands (representative) and the United States (convenience), spanning between 6 months and 10 years, to we ask whether between-subjects methods can help us understand the within-person structure of belief systems. First, we use Bayesian STARTS models (Lüdtke et al., 2018) to assess what type of variance cross-sectional studies are likely tapping into. We find that variability in measures of ideology and political beliefs is primarily due to stable between-person differences, with relatively smaller amounts of variation due to within-person differences. Second, we estimate between-person, within-person, and cross-sectional correlations between all items in our study and find that between-person correlations are larger and in some cases differ in their direction from within-person correlations. Furthermore, cross-sectional correlations are most similar to between-person correlations. Taken together, these findings indicate that the modal study may help describe differences between people, but is ill-suited to tell us about the structure of individuals' belief systems. New methods are necessary for a complete understanding of political belief systems that clarify both between- and within-person processes. [ABSTRACT FROM AUTHOR]

Psychological research has offered valuable insights into how to combat misinformation. The studies conducted to date, however, have three limitations. First, pre‐emptive ("prebunking") and retroactive ("debunking") interventions have mostly been examined in parallel, and thus it is unclear which of these two predominant approaches is more effective. Second, there has been a focus on misinformation that is explicitly false, but implied misinformation that uses literally true information to mislead is common in the real world. Finally, studies have relied mainly on questionnaire measures of reasoning, neglecting behavioural impacts of misinformation and interventions. To offer incremental progress towards addressing these three issues, we conducted an experiment (N = 735) involving misinformation on fair trade. We contrasted the effectiveness of prebunking versus debunking and the impacts of implied versus explicit misinformation, and incorporated novel measures assessing consumer behaviours (i.e., willingness‐to‐pay; information seeking; online misinformation promotion) in addition to standard questionnaire measures. In general, both prebunking and debunking reduced misinformation reliance. We also found that individuals tended to rely more on explicit than implied misinformation both with and without interventions. [ABSTRACT FROM AUTHOR]

Theories of moralization argue that moral relevance varies due to inter‐individual differences, domain differences, or a mix of both. Predictors associated with these sources of variation have been studied in isolation to assess their unique contribution to moralization. Across three studies (NStudy1 = 376; NStudy2a = 621; NStudy2b = 589), assessing attitudes towards new big data technologies, we found that moralization is best explained by theories focusing on inter‐individual variation (∼29%) and intra‐individual variation across technology domains (∼49%), and less by theories focusing on differences between technology domains (∼6%). We simultaneously examined 15 inter‐individual and 16 intra‐individual predictors that potentially explain this variation. Predictors directly relevant to the technologies (e.g., justice concerns), cognitive styles (e.g., faith in intuition), and emotional reactions (e.g., anger) best explain variation in moral relevance. Accordingly, scholars should simultaneously adopt and adapt moralization theories related to inter‐individual and intra‐individual differences across domains rather than in isolation. [ABSTRACT FROM AUTHOR]

We show that business microloans to U.S. subprime borrowers have a very large impact on subsequent firm success. Using data on startup loan applicants from a lender that employed an automated algorithm in its application review, we implement a regression discontinuity design assessing the causal impact of receiving a loan on firms. Startups receiving funding are dramatically more likely to survive, enjoy higher revenues, and create more jobs. Loans are more consequential for survival among subprime business owners with more education and less managerial experience. [ABSTRACT FROM PUBLISHER]

Benford’s Law gives the expected frequencies of the digits in tabulated data. The expected frequencies show a large bias toward the low digits. An analysis of the Center for Research in Security Prices (CRSP) data shows that the daily returns have a near-perfect fit to Benford’s Law. The daily volumes also have a close fit to Benford’s Law but there are deviations due to round lot trading and the fact that some of the data are rounded to the nearest hundred. An analysis of Compustat data also shows a close fit to Benford’s Law with some explainable deviations. The expected returns and the abnormal returns used in event studies over an extended period showed that these numbers also conformed to Benford’s Law. Recent studies have divided a population into subsets and then tested the subsets for conformity to Benford’s Law. The conclusions are that the subsets with the weakest fit to Benford were fraudulent. The problems with this approach are discussed, and these include statistical considerations, issues with using Compustat data, other plausible explanations for a lack of conformity, and the fact that there is no clear link between a change in the leading digit of a number and the materiality of the dollar value of the change. [ABSTRACT FROM AUTHOR]