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Background: Illicit substance sales facilitated by social media platforms are a growing public health issue given recent increases in overdose deaths, including an alarming rise in cases of fentanyl poisoning. However, little is known about how online users evaluate what features of social media posts convey safety, which can influence their intent to source illicit substances. Objectives: This study adapts conjoint analysis which assessed how attributes of social media posts (i.e., features) influence safety evaluations of mock posts selling illicit substances. 440 participants were recruited online for self-reporting use or purchase of controlled substances or prescription medicines recreationally. The following attributes were tested: drug packaging, drug offerings, profile photo of seller, payment info provided, and use of emojis. Results: Packaging was ranked the most important attribute (Average Importance =43.68, Offering=14.94, Profile=13.86, Payment=14.11, Emoji=13.41), with posts that displayed drugs in pill bottles assessed as the most safe. Attribute levels for advertising multiple drugs, having a blank profile photo, including payment information, and including emojis also ranked higher in perceived safety. Rankings were consistent across tested demographic factors (i.e., gender, age, and income). Survey results show that online pharmacies were most likely to be perceived as safe for purchasing drugs and medications. Additionally, those who were younger in age, had higher income, and identified as female were more likely to purchase from a greater number of platforms. Conclusions: These findings can assist in developing more precise content moderation for platforms seeking to address this ongoing threat to public safety. [ABSTRACT FROM AUTHOR]

Before the Fall 2020 semester, college presidents and the NCAA made decisions about playing college football. The current study aims to examine the association between college football games and COVID-19 infections at universities. More than 1,800 college campuses nationwide from The New York Times database on COVID-19 cases on college campuses. Random effects negative binomial regression is used to analyze the association between college football games, membership to college football organizations, and COVID-19 cases at the universities studied. The number of football games played was significantly associated with higher COVID-19 cases at the universities studied. Membership to certain college football organizations was also significantly associated with higher COVID-19 cases, particularly FBS and Power Five conferences. These findings provide a baseline for subsequent analyses across other sports and advocates for continued assessment of protocols that ensure the safety and well-being of student-athletes, fans, and university communities. [ABSTRACT FROM AUTHOR]

Adult survivors of childhood sexual trauma often report higher levels of marital dissolution, less sexual satisfaction, and higher rates of divorce. When it comes to childhood sexual abuse, the trauma often occurs with a known and trusted individual, inevitably connecting the experience of trauma to interpersonal relationships that carry implications for the survivor’s intimate partnership. This study developed a grounded theory of how partners help or hinder healing in couple relationships, when one partner has experienced childhood sexual abuse. The results describe a process model of change hinging on factors that contribute to healing and factors that hinder healing. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite representing 4% of the global population, the US has the fifth highest number of intentional homicides in the world. Peripartum people represent a unique and vulnerable subset of homicide victims. This study aimed to understand the risk factors for peripartum homicide. STUDY DESIGN: We used data from the 2018 to 2020 National Violent Death Reporting System to compare homicide rates of peripartum and nonperipartum people capable of becoming pregnant (12 to 50 years of age). Peripartum was defined as currently pregnant or within 1-year postpartum. We additionally compared state-level peripartum homicide rates between states categorized as restrictive, neutral, or protective of abortion. Pearson's chi-square and Wilcoxon rank-sum tests were used. RESULTS: There were 496 peripartum compared with 8,644 nonperipartum homicide victims. The peripartum group was younger (27.4 ± 71 vs 33.0 ± 9.6, p < 0.001). Intimate partner violence causing the homicide was more common in the peripartum group (39.9% vs 26.4%, p < 0.001). Firearms were used in 63.4% of homicides among the peripartum group compared with 49.5% in the comparison (p < 0.001). A significant difference was observed in peripartum homicide between states based on policies regarding abortion access (protective 0.37, neutral 0.45, restrictive 0.64; p < 0.01); the same trend was not seen with male homicides. CONCLUSIONS: Compared with nonperipartum peers, peripartum people are at increased risk for homicide due to intimate partner violence, specifically due to firearm violence. Increasing rates of peripartum homicide occur in states with policies that are restrictive to abortion access. There is a dire need for universal screening and interventions for peripartum patients. Research and policies to reduce violence against pregnant people must also consider the important role that abortion access plays in protecting safety. [ABSTRACT FROM AUTHOR]

• Pn-MAPS24v is a novel 24-valent pneumococcal candidate vaccine developed using the MAPS technology • The safety and immunogenicity of three Pn-MAPS24v dose levels were assessed vs PCV13 in toddlers primed with PCV13 • All tested Pn-MAPS24v dose levels showed acceptable safety and tolerability profiles • Each Pn-MAPS24v dose level elicited IgG and OPA responses for all 13 common and 10 of the 11 unique S. pneumoniae serotypes • These findings support progression of clinical trials of Pn-MAPS24v to the infant population Pneumococcal conjugate vaccines (PCVs) significantly reduced pneumococcal disease burden. Nevertheless, alternative approaches for controlling more serotypes are needed. Here, the safety, tolerability, and immunogenicity of a 24-valent (1/2/3/4/5/6A/6B/7F/8/9N/9V/10A/11A/12F/14/15B/17F/18C/19A/19F/20B/22F/23F/33F) pneumococcal vaccine based on Multiple Antigen-Presenting System (MAPS) technology (Pn-MAPS24v) was assessed in toddlers. In this phase 1, blinded, dose-escalation, active-controlled multicenter study conducted in the United States (September/2020–April/2022), 12–15-month-old toddlers primed with three doses of 13-valent PCV (PCV13) were randomized 3:2 to receive a single dose of one of three Pn-MAPS24v dose levels (1 μg/2 μg/5 μg per polysaccharide) or PCV13 intramuscularly. Reactogenicity (within 7 days), treatment-emergent adverse events (TEAEs, within 180 days), serious/medically attended adverse events (SAEs/MAAEs, within 180 days), and immunogenicity (serotype-specific anti-capsular polysaccharide immunoglobulin G [IgG] and opsonophagocytic activity [OPA] responses at 30 days post-vaccination) were assessed. Of 75 toddlers enrolled, 74 completed the study (Pn-MAPS24v 1 μg/2 μg/5 μg: 15/14/16, PCV13: 29). Frequencies of local (60 %/67 %/31 %) and systemic events (67 %/67 %/75 %) in the Pn-MAPS24v 1 μg/2 μg/5 μg and the PCV13 (55 %, 79 %) groups were in similar ranges. TEAEs were reported by 47 %/40 %/63 % of Pn-MAPS24v 1 μg/2 μg/5 μg recipients and 52 % of PCV13 recipients. No vaccine-related SAE was reported. At 30 days post-vaccination, for each of the 13 common serotypes, ≥93 % of participants in each group had IgG concentrations ≥0.35 μg/mL; >92 % had OPA titers ≥lower limit of quantitation (LLOQ), except for serotype 1 (79 %). For 7/11 unique serotypes (2/8/9N/11A/17F/22F/33F), at all dose levels, ≥78 % of Pn-MAPS24v recipients in each group had IgG concentrations ≥0.35 μg/mL and 80 %-100 % had OPA titers ≥LLOQ. In 12–15-month-old toddlers, a single dose of Pn-MAPS24v showed an acceptable safety profile, regardless of dose level; AEs were reported at similar frequencies by Pn-MAPS24v and PCV13 recipients. Pn-MAPS24v elicited IgG and OPA responses to all common and most unique serotypes. These results support further clinical evaluation in infants. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of artificial intelligence (AI) chat programs has opened two distinct paths, one enhancing interaction and another potentially replacing personal understanding. Ethical and legal concerns arise due to the rapid development of these programs. This paper investigates academic discussions on AI in medicine, analyzing the context, frequency, and reasons behind these conversations. Methods: The study collected data from the Web of Science database on articles containing the keyword "ChatGPT" published from January to September 2023, resulting in 786 medically related journal articles. The inclusion criteria were peer-reviewed articles in English related to medicine. Results: The United States led in publications (38.1%), followed by India (15.5%) and China (7.0%). Keywords such as "patient" (16.7%), "research" (12%), and "performance" (10.6%) were prevalent. The Cureus Journal of Medical Science (11.8%) had the most publications, followed by the Annals of Biomedical Engineering (8.3%). August 2023 had the highest number of publications (29.3%), with significant growth between February to March and April to May. Medical General Internal (21.0%) was the most common category, followed by Surgery (15.4%) and Radiology (7.9%). Discussion: The prominence of India in ChatGPT research, despite lower research funding, indicates the platform's popularity and highlights the importance of monitoring its use for potential medical misinformation. China's interest in ChatGPT research suggests a focus on Natural Language Processing (NLP) AI applications, despite public bans on the platform. Cureus' success in publishing ChatGPT articles can be attributed to its open-access, rapid publication model. The study identifies research trends in plastic surgery, radiology, and obstetric gynecology, emphasizing the need for ethical considerations and reliability assessments in the application of ChatGPT in medical practice. Conclusion: ChatGPT's presence in medical literature is growing rapidly across various specialties, but concerns related to safety, privacy, and accuracy persist. More research is needed to assess its suitability for patient care and implications for non-medical use. Skepticism and thorough review of research are essential, as current studies may face retraction as more information emerges. [ABSTRACT FROM AUTHOR]

Background: Incarcerated trans women experience significant victimization, mistreatment, barriers to gender-affirming care, and human rights violations, conferring high risk for trauma, psychological distress, self-harm, and suicide. Across the globe, most carceral settings are segregated by sex assigned at birth and governed by housing policies that restrict gender expression—elevating ‘safety and security’ above the housing preferences of incarcerated people. Aim/methods: Drawing upon the lived experiences of 24 formerly incarcerated trans women in Australia and the United States and employing Elizabeth Freeman’s notion of chrononormativity, Rae Rosenberg’s concept of heteronormative time, and Kadji Amin’s use of queer temporality, this paper explores trans women’s carceral housing preferences and contextual experiences, including how housing preferences challenge governing chrononormative and reformist carceral housing systems. Findings: Participants freely discussed their perspectives regarding housing options which through thematic analysis generated four options for housing: 1) men’s carceral settings; 2) women’s carceral settings; 3) trans- and gay-specific housing blocks; and 4) being housed in protective custody or other settings. There appeared to be a relationship between the number of times the person had been incarcerated, the duration of their incarceration, and where they preferred to be housed. Conclusions: This analysis contributes to richer understandings regarding trans women’s experiences while incarcerated. This paper also informs the complexities and nuances surrounding housing preferences from the perspectives of trans women themselves and considers possible opportunities to enhance human rights, health and wellbeing when engaging in transformative approaches to incarceration. [ABSTRACT FROM AUTHOR]

Assessing the psychological needs of students and employees as they return to campus is crucial to resuming University life in a safe and secure way. The current research aimed to explore how safety concerns, anticipatory worry, and mitigation efforts affected the well-being of individuals within a campus community. A five-part survey was distributed via student & employee listservs in the Fall 2020 at a midsize private university in the Mid-Atlantic Mid-Atlantic United States. Participants were surveyed about sources of worry regarding Covid-19, levels of anticipatory worry, amenability to various mitigation strategies and whether intended implementation of safety mitigation measures impacted worry levels. Data collected from 559 students and employees indicated a relationship between source of worry and level of distress, with the greatest source of worry being fear of getting sick. Anticipatory worry after thinking about safety mechanisms was significantly lower than anticipated worry before thinking about safety mechanisms. No differences were found between students and employee experiences of worry, and there was no moderating effect of role on the difference between anticipated worry after, as compared to before, thinking about the mechanisms. Findings highlight how different sources of concern related to Covid-19 are associated with varying levels of distress, the significant impact that the presence of mitigation strategies can have on reducing overall levels of anticipatory worry, and the universality of distress associated with Covid-19. [ABSTRACT FROM AUTHOR]

Drug importation raises several ethical and safety concerns relevant to prescribers and policy makers considering costs and benefits of international medicine importation. This article suggests key points to consider, especially from a policy perspective, when weighing imported medicines' perceived affordability and accessibility against additional resource expenditure needed to assure sufficient regulatory oversight and equitable distribution and to mitigate potential risks of harm to patients. [ABSTRACT FROM AUTHOR]

Firearms are the leading cause of intimate partner violence-related murders of women in the US. This study aimed to understand differing consequences of partners' firearm possession on abused women and barriers women face in reporting threats to safety due to the partners' possession of a firearm. Additionally, the study explored participants' perceptions of effective approaches to risk assessments and safety planning with women who are at-risk for being harmed by their partners' possession of a firearm. Qualitative semi-structured interviews with 17 service providers and 45 immigrant women survivors of intimate partner violence were conducted. Data were analyzed using a content analysis procedure. Participants shared that the partners' possession of a firearm can increase risk for firearm-related injury or fatality in situations of escalation of violence. Abused women living with a partner with firearm possession live in constant fear or threat. The presence of a firearm can also be a trigger of unwanted memories of the past and can have legal and other consequences for survivors. Impediments to reporting threats to safety were barriers such as lack of knowledge of firearm-related risks and gender and social norms. The findings can be informative for safety planning with survivors of IPV whose partners own or have access to a firearm. Comprehensive assessment of risks and barriers can be used to develop individualized and tailored safety plans for survivors with a partner who possesses a firearm. [ABSTRACT FROM AUTHOR]

Racial/ethnic disparities and inequities in regard to community crime, educational experiences and outcomes, and school safety for youth in the United States are evident; however, race/ethnicity is typically in the background of most school safety research. It is also increasingly important to center the investigation, understanding, and policy implementations that highlight the correlates, root causes, and consequences of racial/ethnic inequality in the pursuit of school safety. Therefore, the aim of this special issue is to highlight the intimate connection between racial/ethnic equity and school and community safety, the consequences of current inequities, and to establish the way forward in terms of future research, policy, and practice. [ABSTRACT FROM AUTHOR]

Introduction: Tenofovir‐based oral pre‐exposure prophylaxis is currently approved for HIV prevention; however, adherence in women has been low. A vaginal gel containing tenofovir (TFV) demonstrated partial protection to HIV but protection was not confirmed in additional studies. Vaginal rings offer user‐controlled long‐acting HIV prevention that could overcome adherence and protection challenges. TFV may also help prevent herpes simplex virus type 2 acquisition when delivered intravaginally. We evaluated the pharmacokinetics, safety, adherence and acceptability of a 90‐day TFV ring. Methods: Between January and June 2019, Microbicide Trials Network (MTN)‐038 enrolled 49 HIV‐negative participants into a phase 1, randomized (2:1) trial comparing a 90‐day ring containing 1.4 grams (g) TFV to a placebo ring. TFV concentrations were quantified in plasma, cervicovaginal fluid (CVF), rectal fluid and cervical tissue, and TFV‐diphosphate (TFV‐DP) in cervical tissue. Used rings were analysed for residual TFV. Safety was assessed by adverse events (AEs); acceptability and adherence by self‐report. Results: Mean age was 29.5; 46 identified as cisgender‐female and three gender non‐conforming. There were no differences in the proportion of participants with grade ≥2 genitourinary AEs in the TFV versus placebo arms (p = 0.41); no grade ≥3 AEs were reported. Geometric mean TFV concentrations increased through day 34 in CVF/rectal fluid and day 59 in plasma, but declined across compartments by day 91. Geometric mean TFV‐DP tissue concentrations exceeded the 1000 fmol/mg target through day 56, but fell to 456 fmol/mg at day 91. Among 32 rings returned at the end of the study, 13 had no or low (<0.1 g) residual TFV. Residual TFV did not differ by socio‐demographics, sexual activity, Nugent Score or vaginal microbiota. Most participants reported being fully adherent to ring use: 85% and 81% in the TFV and placebo arms, respectively (p = 1.00). A majority of participants reported liking the ring (median 8 on a 10‐point Likert scale) and reported a high likelihood of using the ring in the future, if effective (median 9). Conclusions: The 90‐day TFV ring was well‐tolerated, acceptable and exceeded target cervical tissue concentrations through day 56, but declined thereafter. Additional studies are needed to characterize the higher release from TFV rings in some participants and the optimal duration of use. [ABSTRACT FROM AUTHOR]

Women represent 15% of veteran callers to the Veterans Crisis Line (VCL); there has been little research identifying the experiences and needs of women veterans who use the VCL. The objective of this study was to identify women veterans' experiences with and recommendations for strengthening VCL services for women. We conducted qualitative interviews with 26 women veterans across the United States who had contacted the VCL in the preceding year. Interviews were conducted by telephone in 2022 and were audio recorded and transcribed. A team-based content analysis approach was used to identify participants' concerns around contacting the VCL and recommendations for strengthening the service. Interviews revealed women veterans' concerns with regard to contacting the VCL related to responder gender, appropriateness of VCL services for veterans not at imminent risk for suicide, and potential consequences of contacting the VCL. Key recommendations included letting veterans select the gender of the responder who takes their call, providing more information to potential callers about what to expect from VCL calls, and raising awareness about and maintaining options for caller anonymity. This study uniquely focused on women veterans' experiences and perspectives, in their own voices. Findings point to trauma-informed approaches supporting women veteran callers to the VCL and may also hold implications for other similar crisis hotline services. [ABSTRACT FROM AUTHOR]

Background: Little evidence exists about the comparative effects of first‐line antihypertensive medications (i.e., renin‐angiotensin‐aldosterone converting enzyme inhibitors (RAASi), amlodipine, or thiazide diuretics) in older adults with limited life expectancy. We compared the rates of injurious falls and short‐term cardiovascular events between different first‐line antihypertensive medication classes in adults receiving care in nursing homes (NH). Methods: This was a retrospective cohort of Medicare fee‐for‐service beneficiaries receiving care in NHs. Patients newly dispensed first‐line antihypertensive medications were identified using Part D claims (2015–2018) and linked with clinical assessments (i.e., Minimum Data Set). Fall‐related injuries (FRI), hip fractures, and major adverse cardiac events (MACE) outcomes were identified using hospitalization claims. Patients were followed from the date of antihypertensive dispensing until the occurrence of outcomes, death, disenrollment, or 6‐month follow‐up. Inverse‐probability‐of‐treatment‐weighted (IPTW) cause‐specific hazards regression models were used to compare outcomes between patients who were new users of RAASi, amlodipine, or thiazides. Results: Our cohort included 16,504 antihypertensive users (RAASi, n = 9574; amlodipine, n = 5049; thiazide, n = 1881). Mean age was 83.5 years (± 8.2), 70.6% were female, and 17.2% were non‐white race. During a mean follow‐up of 5.3 months, 326 patients (2.0%) experienced an injurious fall, 1590 (9.6%) experienced MACE, and 2123 patients (12.9%) died. The intention‐to‐treat IPTW hazard ratio (HR) for injurious falls for amlodipine (vs RAASi) use was 0.85 (95% confidence interval (CI) 0.66–1.08) and for thiazides (vs RAASi) was 1.22 (95% CI 0.88–1.66). The rates of MACE were similar between those taking anti‐hypertensive medications. Thiazides were discontinued more often than other classes; however, inferences were largely unchanged in as‐treated analyses. Subgroup analyses were generally consistent. Conclusions: Older adults with limited life expectancy experience similar rates of injurious falls and short‐term cardiovascular events after initiating any of the first‐line antihypertensive medications. [ABSTRACT FROM AUTHOR]

Promoting physical activity (PA) at the community level is a complex, multisector approach requiring researchers and practitioners to impact the individual, interpersonal, environment, and policy levels. One such strategy aiming to impact systems, policies, and environments is the Centers for Disease Control and Prevention's Activity Friendly Routes to Everyday Destinations (Routes to Destinations). This strategy specifically aims to connect pedestrian, bicycle, and public transportation systems with built environment and land use destinations. This article examines Black/African American transportation and land use experts' perspectives and concerns—across multiple mediums—around inequities that have discouraged PA among Black/African American persons specifically Routes to Destinations strategies. In March 2021, a multifaceted scoping review was conducted of peer-reviewed literature, gray literature, and social media authored by Black/African American transportation and land use experts focusing on policy, system, and environmental changes which promote or discourage equitable and inclusive access to physical activity. Themes from peer-reviewed and gray literature resources included: (1) Assessing Racism, Discrimination, and Segregation; (2) Addressing Equity and Inclusion Through Policy; (3) Community Engagement and Place-Based Interventions; (4) Infrastructure Changes; (5) Safety; and (6) Reporting Health Disparities. Twitter topic models suggested the main topics included elements of race/racism, equity, safety, infrastructure, and advancing social justice. Experts called for systemic and systematic change through new policies and implementation of existing policies as well as enhanced community inclusion in decision-making through ownership of policy and built environment change. Safety was discussed differently between peer-reviewed and gray literature and Twitter discussions indicating a publication bias. [ABSTRACT FROM AUTHOR]

High levels of burnout among healthcare providers (HCPs) have been a widely documented phenomenon, which have been exacerbated during the COVID-19 pandemic. In the United States, qualitative studies that are inclusive of HCPs in diverse professional roles have been limited. Therefore, we utilized a qualitative–quantitative design to examine professional quality of life in terms of compassion fatigue, burnout, and secondary traumatic stress among hospital-based HCPs, including social workers, hospitalists, residents, and palliative care team members during COVID-19. HCPs (n = 26) participated in virtual semi-structured focus groups or individual interviews and online surveys (n = 30) including the Professional Quality of Life (ProQOL) Scale. While ProQOL scores indicated low levels of compassion fatigue, burnout, and secondary traumatic stress, thematic analysis of our qualitative data included rich descriptions of compassion fatigue, burnout, and secondary traumatic stress. Safety concerns and value misalignment characterized structural stressors perceived to contribute to HCP compassion fatigue, burnout, and secondary traumatic stress. The discrepancy between our qualitative and quantitative findings may be indication that modifications to current screenings are warranted. These findings also suggest a need to identify and implement structural and policy changes that increase HCPs' physical and emotional safety and promote better alignment of institutional interests with HCP values. [ABSTRACT FROM AUTHOR]

Ensuring the safety and social well-being of rural populations, especially rural older adults living alone with complex medical conditions, is challenging, given large, sparsely populated communities and limited resources. Using qualitative data from surveys with 42 rural Meals on Wheels programs from across the U.S., we highlight particular challenges to meeting the social and safety needs of rural older adults living alone. Respondents described challenges, opportunities, and successes in meeting the needs of their clients. We describe these under four domains: main challenges, what can be done to address social isolation and loneliness, safety issues, improving safety, and current successes. We also identify cross-cutting themes related to programs' rural environment (long distances, inclement weather), infrastructure (housing quality, access to broadband Internet and technological connectivity, road conditions), funding and resource availability, and service provision (availability of health care and partner organizations.) We describe each of these in more detail and also share policy recommendations for improving health and safety of older adults living alone in rural areas, including funding nutrition programs as a health benefit and addressing aging, poor-quality housing stock. [ABSTRACT FROM AUTHOR]

Background Cleaning product use has been associated with adverse respiratory health effects such as asthma in cleaning staff and healthcare workers. Research in health effects from cleaning products has largely depended upon collecting exposure information by questionnaires which has limitations such as recall bias and underestimation of exposure. The aim of this study was to develop a Cleaning and Hazardous Products Exposure Logging (CHaPEL) app with a barcode scanner and to test the feasibility of this app with university cleaners. Methods The CHaPEL app was developed to collect information on demographics, individual product information, and exposure information. It also included an ease-of-use survey. A pilot study with university cleaning workers was undertaken in which cleaning workers scanned each product after use and answered the survey. Respiratory hazards of cleaning substances in the scanned cleaning products were screened by safety data sheets, a Quantitative Structure-Activity Relationship model and an asthmagen list established by an expert group in the US. Results Eighteen university cleaners participated in this study over a period of 5 weeks. In total, 77 survey responses and 6 cleaning products were collected and all reported that using the app was easy. The most frequently used product was a multi-surface cleaner followed by a disinfectant. Out of 14 substances in cleaning products, ethanolamine and Alkyl (C12-16) dimethyl benzyl ammonium chloride were found as respiratory hazardous substances. Conclusion The CHaPEL app is a user-friendly immediate way to successfully collect exposure information using the barcodes of cleaning products. This tool could be useful for future epidemiological studies focused on exposure assessment with less interruption to the workers. [ABSTRACT FROM AUTHOR]

Introduction: Identity threats, such as stereotype threat and microaggressions, impair learning and erode well‐being. In contrast to identity threat, less is known about how learners experience feelings of safety regarding their identity. This exploratory study aims to develop a theory of identity safety in the clinical learning environment. Methods: This multi‐institutional, qualitative interview study was informed by constructivist grounded theory and critical pedagogy. Participants were clinical students at three public medical schools in the United States in 2022. Investigators purposively sampled participants for interviews based on their responses to an 11‐item survey with an open‐ended question soliciting students' personal identities and responses to both the racial/ethnic and gender Stereotype Vulnerability Scales. The investigators interviewed, coded, constantly compared and continued sampling until the codes could be developed into categories, then concepts and finally into a theory. The team engaged in critical reflexivity throughout the analytic process to enrich data interpretations. Results: Sixteen diverse students were interviewed. We organised their identity‐salient experiences into identity threat, threat mitigation and identity safety. Participants experienced identity threat through unwelcoming learning environments, feeling compelled to change their behaviour in inauthentic ways or sociopolitical threat. Threat mitigation occurred when a participant or supervisor intervened against an identity threat, dampening but not eliminating the threat impact. Participants characterised identity safety as the ability to exist as their authentic selves without feeling the need to monitor how others perceive their identities. Identity safety manifested when participants demonstrated agency to leverage their identities for patient care, when others upheld their personhood and saw them as unique individuals and when they felt they belonged in the learning environment. Discussion Attending to identity safety may lead to educational practices that sustain and leverage team members' diverse identities. Identity safety and threat mitigation may work together to combat identity threats in the learning environment. In this edition of @medEd_journal, @jbullockruns et al. describe identity safety, where learning environments allow learners to exist as their authentic selves. The figure is worth 1000 words. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic exacerbated incidences of domestic violence (DV). The framing of DV within media sources contributes to the public's understanding of DV. Using critical discourse analysis (CDA), this paper explores representations of safety within newspapers' reporting of DV during the pandemic. The sample included newspaper articles (n = 31) from U.S. newspapers. The analysis involved multiple rounds of coding and employing "structured questions." These articles depicted limited courses of action for DV survivors and represented safety as unattainable. Safety was constructed in four ways: homes are unsafe, social services are overburdened, government failures, and the elusiveness of safety. These discursive formations provide insight regarding "idealized" social responses to DV. [ABSTRACT FROM AUTHOR]

Introduction: The routine use of heat-producing tools in the perioperative setting generates surgical smoke. Surgical smoke poses a known health hazard for perioperative staff working in the operating room. Objective: The objective of this best practice project was to promote evidence-based practices regarding surgical plume management in a pediatric operating room. Methods: This project was guided by the JBI Model of Evidence-Based Healthcare and used the JBI Practical Application of Clinical Evidence System and the Getting Research into Practice audit and feedback strategy to promote evidence-based practices regarding surgical smoke management in a pediatric operating room. Seven audit criteria representing best-practice recommendations were used. A baseline audit was conducted, followed by the implementation of multiple strategies developed by the key stakeholders. The project was finalized with a follow-up audit to determine any changes in compliance with best-practice recommendations. Results: Baseline audit data indicated an average of 41% compliance with best practices across all audit criteria, revealing the need for significant improvement in five of the seven criteria. Three barriers were identified and strategies were implemented, including the development and implementation of an educational module and a surgical smoke exposure risk assessment tool. Follow-up audits showed an overall improvement of 30% among five of the seven audit criteria. Conclusions: This project yielded improvements with best practices for surgical smoke management in the perioperative setting. However, additional work is required to ensure the sustainability of best practices in this setting. [ABSTRACT FROM AUTHOR]

• Youth ATV operators typically have a diminished field of vision compared to adults. • Limited vision in youth compromises control and perception, increasing crash risks. • Findings provide data to update ATV safety guidelines and prevention strategies. Problem: All-Terrain Vehicles (ATVs) cause a distressing number of fatalities and injuries among farm youth in the United States. The number of severe injuries caused by ATV crashes on farms, which stood at 25 children in 2019, is expected to rise due to increased ATV sales during the COVID-19 pandemic. Existing research into children's injuries has explored physical capabilities like anthropometry, strength, and visual acuity. Yet, studies assessing youths' physical ability to operate ATVs remain limited. This study tests the hypothesis that diminished vision field in young ATV operators raises crash risks. Methods: This study used SAMMIECAD digital human modeling system to simulate and compare the field of vision of youth and adult ATV operators. The simulations incorporated 3-D mockups of ATVs, humans, sprayer tanks, windshields, and obstacles. Ten utility ATVs and children of both genders across nine ages (8–16) and three height percentiles (5th, 50th, 95th) were evaluated. Results: Simulations showed that young ATV operators generally have a more restricted field of vision than adults, particularly those aged 6–11 years. Discussion: Visual limitations hinder riders' ability to see ATV controls, potentially leading to vehicle control loss. Moreover, they impair environmental perception during riding, compromising youths' ATV operation abilities and increasing crash risks. Practical Applications: These findings offer crucial data in support of modifying ATV safety guidelines. Additionally, they can guide youth occupational health professionals in preventing ATV-related incidents in agricultural settings. [ABSTRACT FROM AUTHOR]

Background: Current evidence on the safety of calcitonin gene–related peptide antagonists (CGRP-A) in pregnancy for the treatment of both episodic and chronic migraine is scarce and does not yet provide definitive information. By querying VigiBase®, the World Health Organization global pharmacovigilance database, this study aimed to detect differences in the reporting frequency between CGRP-A and triptans in relation to pregnancy. Methods: Disproportionality analyses on de-duplicated safety reports collected in VigiBase® as of 31.05.2023 reporting exposure to CGRP-A in pregnancy with or without pregnancy outcomes. A Reporting Odds Ratio (ROR) with a 95% confidence interval (CI) was used as a measure of disproportionality and the threshold for the detection of a signal of disproportionate reporting was set with a 95% CI lower limit > 1. Findings: Four hundred sixty-seven safety reports reported exposure to CGRP-A in pregnancy, mostly originating from the United States of America (360/467, 77%), more frequently reported by patients (225/467, 48%), who were mainly females (431/467, 92%), and more frequently reported exposure to CGRP-A during pregnancy (400/467, 86%). Compared to triptans, no signals of disproportionate reporting were detected with CGRP-A either for the overall reporting of pregnancy-related safety reports (ROR 0.91, 95% CI 0.78–1.06), for the reporting of pregnancy outcomes (maternal and/or foetal/neonatal, ROR 0.54, 95% CI 0.45–0.66), or for the reporting of foetal/neonatal outcomes (ROR 0.53, 95% CI 0.41–0.68). Conclusions: This study showed that, to date, there are no signals of increased reporting with CGRP-A compared to triptans in relation to pregnancy in VigiBase®. Future pharmacovigilance studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

A key motivation underlying topic avoidance is the belief that talk would be inappropriate. The current research teases apart the sources of this belief by testing family communication patterns (FCP) and perceived social norms as drivers of topic avoidance. Individuals planning to attend family holiday gatherings (N = 229) were surveyed in mid-December 2021 about family topic avoidance regarding COVID-19 holiday safety. Conformity orientation had an indirect, positive association with family topic avoidance via perceived social norms. Surprisingly, conversation orientation did not significantly affect perceived social norms or topic avoidance and did not significantly interact with conformity orientation. Theoretically, findings suggest that FCP influence perceptions of societal norms and values regarding communication. Practically, conformity orientation could increase health risks moving out of the COVID-19 pandemic by promoting silence around family health safety. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate which components or programs within the higher education environment have the greatest influence on college students' intention to engage in physical activity. Participants: Undergraduates enrolled in colleges and universities in the southcentral United States were issued a questionnaire via email. Methods: The use of structural equation modeling was used to assess the relationships among multiple variables and see what, if any, relationship exists. Results: Campus safety was the only influencer of all four known predictors of intention, attitude, perceived control, subjective norm, and self-efficacy toward physical activity while the accessibility of a wellness or fitness facility did not have a relationship with the intention to participate in physical activity. Conclusions: By increasing efforts toward the influences that offer the most return on investment, Higher Education can be another line of defence against chronic disease. [ABSTRACT FROM AUTHOR]

Previously reported estimates of vertebral artery injuries (VAIs) during cervical spine surgery relied on self-reported survey studies and retrospective cohorts, which may not be reflective of national averages. The largest study to date reports an incidence of 0.07%; however, significant variation exists between different cervical spine procedures. This study aimed to identify the incidence of VAIs in patients undergoing cervical spine procedures for degenerative pathologies. In this retrospective cohort study, a national insurance database was used to access data from the period 2010–2020 of patients who underwent anterior cervical discectomy and fusion, anterior corpectomy, posterior cervical fusion (C3-C7), or C1-C2 posterior fusion for degenerative pathologies. Patients who experienced a VAI were identified, and frequencies for the different procedures were compared. This study included 224,326 patients, and overall incidence of VAIs across all procedures was 0.03%. The highest incidence of VAIs was estimated in C1-C2 posterior fusion (0.12%–1.10%). The number of patients with VAIs after anterior corpectomy, anterior cervical discectomy and fusion, and posterior fusion was 14 (0.06%), 43 (0.02%), and 26 (0.01%), respectively. This is the largest study to date to our knowledge that provides frequencies of VAIs in patients undergoing cervical spine surgery in the United States. The overall incidence of 0.03% is lower than previously reported estimates, but significant variability exists between procedures, which is an important consideration when counseling patients about risks of surgery. [ABSTRACT FROM AUTHOR]

Purpose: When emergencies or disasters arise, individuals who use augmentative and alternative communication (AAC) are particularly vulnerable. It is critical that individuals who use AAC are supported to make decisions that impact their own lives and are able to communicate during such a crisis. Preparedness efforts that include a plan around communication needs and supports are necessary for ensuring that individuals who use AAC are able to understand options that ensure personal safety and express their needs during a time of crisis. Method: Qualitative methods were used to identify and describe the experiences of two young adults who use AAC and their caregivers when engaging in person-centered planning intervention sessions to complete the activities of the United States Society for Augmentative and Alternative Communication (USSAAC) emergency/disaster preparedness toolkit. Pre-intervention interviews and subjective, objective, assessment, and plan (SOAP) notes taken after each intervention session were done to describe their preparedness and experiences completing the toolkit. Themes were identified to describe participant experiences and change in their perceived preparedness. Results: Five themes and 18 subthemes emerged from the pre-intervention interviews and the SOAP notes across 14 intervention sessions that captured each participant and their caregiver's awareness of needs, barriers in emergency situations, challenges in completing the toolkit, and actions during person-centered planning with the toolkit (e.g., personalizing communication boards, making a go bag, and scheduling visits with local emergency agencies). Conclusions: This study highlights the need for preparedness activities that are person-centered and account for the communication support needs of individuals who use AAC if faced with an emergency/disaster. Outcomes suggest that these methods were feasible and supported positive change in perceived preparedness in the young adults who used AAC and their caregivers. [ABSTRACT FROM AUTHOR]

American football is associated with the largest number of emergency department visits for pediatric sport-related traumatic brain injury, including concussions. Tackling is responsible for almost two-thirds of football concussions. Some have recommended implementing age restrictions on tackling in youth football. To determine whether the public would support age restrictions and the factors that may drive such support. Cross-sectional study. Summer wave of Porter Novelli's 2020 US ConsumerStyles survey. A total of 4053 adults. Respondents answered questions about a good age for children to start playing tackle football, past football playing history, concerns about safety, and the benefits and risks of playing football. Most respondents believed that middle (32.8%) or high (27.8%) school was a good age to start playing tackle football. About 1 in 5 (19.8%) respondents reported that children should never play tackle football. Certain groups of individuals were more likely to support children starting to play tackle football at high school age or above or to say that they should never play tackle football, including those with a bachelor's degree or higher (rate ratio [RR]HS+ = 1.41, 95% CI = 1.14, 1.76; RRNEVER = 2.70, 95% CI = 1.93, 3.78), those who did not have children under 18 (RRHS+ = 1.54, 95% CI = 1.26, 1.90; RRNEVER = 1.54, 95% CI = 1.14, 2.07), those who were not football fans (RRNEVER = 3.07, 95% CI = 2.32, 4.06), and those who were very (RRHS+ = 3.94, 95% CI = 2.87, 5.42; RRNEVER = 11.52, 95% CI = 7.32, 18.15) or somewhat (RRHS+ = 1.88, 95% CI = 1.41, 2.52) concerned about the safety of children. Despite acknowledging the benefits of playing football, many adults expressed concern about safety and endorsed high school age and older or never as a good age to start playing tackle football, highlighting a disconnect with current football program practices regarding age. [ABSTRACT FROM AUTHOR]

Firearm-related injuries are the leading cause of death among youth in the United States, and rates of firearm-related suicide in rural youth are more than double those in urban youth. Although safe firearm storage has been shown to reduce firearm injuries, little is known about how to culturally tailor such interventions for rural families in the United States. Informed by community-based participatory methods, focus groups and key informant interviews were conducted to design a safe storage prevention strategy for rural families. Participants included a broad array of community stakeholders (n = 40; 60% male, 40% female; age 15–72, M = 36.9, SD = 18.9) who were asked to identify acceptable messengers, message content, and delivery mechanisms that were perceived as respectful to the strengths of rural culture. Independent coders analyzed qualitative data using an open coding technique. Emerging themes included (1) community norms, values, and beliefs about firearms; (2) reasons for ownership; (3) firearm safety; (4) storage practices; (5) barriers to safe storage; and (6) suggested intervention components. Firearms were described as a "way of life" and family tradition in rural areas. Owning firearms for hunting and protection influenced family storage decisions. Intervention strategies that use respected firearm experts as messengers, refer to locally derived data, and that reflect community pride in firearm safety and responsible ownership may improve the acceptability of prevention messages in rural areas. [ABSTRACT FROM AUTHOR]

Objective: Public health agencies have a critical role in providing effective messaging about mitigation strategies during a public health emergency. The objectives of this study were (1) to understand perceptions of COVID-19 vaccines, including concerns about side effects, safety, and effectiveness and how these perceptions influence vaccine decision-making among US adults and (2) to learn what messages might motivate vaccine uptake. Methods: In April and May 2021, we conducted 14 online focus groups with non-Hispanic English-speaking and English- and Spanish-speaking Hispanic adults (N = 99) not vaccinated against COVID-19. We oversampled adults aged 18-39 years and rural residents and systematically assessed 10 test messages. Researchers used a standardized guide and an a priori codebook for focus group discussions, coding transcripts, and thematic analysis. Results: Vaccine hesitancy factors included fear of the unknown; long-term side effects, including infertility; and beliefs that the vaccines were developed too quickly and were not sufficiently effective. Motivating factors for receiving vaccination included the ability to safely socialize and travel. Health care providers were considered important trusted messengers. Participants were critical of most messages tested. Messages that came across as "honest" about what is not yet known about COVID-19 vaccines were perceived more positively than other messages tested. Messages were seen as ineffective if perceived as vague or lacking in data and specificity. Conclusions: Messages that were simple and transparent about what is unknown about vaccines relative to emerging science were viewed most favorably. Health care providers, friends, and family were considered influential in vaccination decision-making. Findings underscore the benefits of research-informed strategies for developing and disseminating effective messages addressing critical issues in a public health emergency. [ABSTRACT FROM AUTHOR]

The article discusses an article by Lira and colleagues, published in 2021 which examined trends in cannabis involvement and risk of alcohol coinvolvement in motor vehicle fatalities over an 18-year-period in the U.S. Topics include the changing rate of crashes involving cannabis, the coinvolvement of cannabis and alcohol, and relevance of the interplay between cannabis and alcohol to health policy and criminal law.

The purpose of this study was to examine experiences and impacts from participating in an adult swim instruction program. We conducted 20 semi-structured interviews with adults aged 18 + who had participated in an adult learn to swim program. Participants were interviewed through a virtual platform using a semi-structured protocol. Data were coded individually by each member of the research team for emerging thematic outcomes with final consensus among all those involved in the analysis. Participants expressed adult learn to swim programs had an effect in three areas: (a) life affordance, (b) emotional affect, and (c) interpersonal relationships. Public health experts and aquatics leaders should consider targeting programs aimed at teaching adults to learn how to swim, especially to marginalized individuals and those who did not grow up in the United States. The authors highlight how these programs can create life affordances well beyond lap swimming and even water safety. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) and engage in sex work (MSW) frequently meet clients through dating/hookup apps. This provides an opportunity to discuss the parameters of the exchange prior to meeting and to learn things about the prospective client and the risks he might pose. Limited research has examined the specific issues or topics MSWs discuss with clients before agreeing to meet. We analyzed interview data from a sample of 180 MSWs from eight U.S. cities who engaged in exchange sex with clients they had primarily met through dating/hookup apps and websites. Participants typically asked about clients' sexual interests and expectations regarding what will transpire when they meet to make sure they were compatible with their own boundaries and limitations. Most participants inquired about clients' sexual health and often discussed condom use. Assertiveness and communication skills training might help MSWs negotiate encounters with clients that promote health and safety. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lockdown drills are mandated within many educational settings in the US; they may contribute to adverse mental health and there is little to suggest their effectiveness. We describe factors associated with post‐drill anxiety and perceived effectiveness of drills. METHODS: We surveyed youth‐caregiver dyads presenting to the pediatric emergency department. Nonparametric tests compared factors across groups of child anxiety and caregiver perceived effectiveness of drills. Kappa statistics (κ) measured child‐caregiver agreement on post‐drill anxiety and depression symptoms. RESULTS: 108 child‐caregiver dyads were included. Post‐lockdown drill anxiety was reported by 27% of children; those reporting anxiety were more likely to have histories of bullying or skipping school for safety (p = 0.0004). Of caregivers, 47% believed drills effectively prevent firearm injury. There was a significant disparity between child and caregiver report of post‐drill mental health symptomatology (κ anxiety = 0.19; κ depression = 0.30). Implications for School Health, Policy, Practice, and Equity: Understanding factors contributing to anxiety surrounding lockdown drills and perception of drill effectiveness may aid policy decisions and resource allocation. CONCLUSIONS: Lockdown drills may increase mental health symptoms in children, while caregivers may not recognize this occurrence. Studies to identify risk factors of acute and chronic post‐lockdown drill anxiety will help determine how to better serve youth. [ABSTRACT FROM AUTHOR]

Persons with HIV can receive mixed messages about the safety of breastfeeding. We sought to assess if they felt coerced to formula feed when counseled about practices to reduce HIV transmission. Persons with HIV who had given birth were eligible to complete a survey to describe their experiences with infant feeding counseling and if they felt coerced to formula feed. An Iowa Infant Feeding Attitude Scale (IIFAS) assessed attitudes towards breastfeeding. Qualitative analyses were performed on narrative responses. One hundred surveys were collected from sites in Georgia, North Carolina, Pennsylvania, and South Carolina. The mean IIFAS score (n, 85) was 47 (SD 9.2), suggesting relatively favorable attitudes toward breastfeeding. Thirteen persons reported feeling coerced to formula feed. When controlling for choosing to give any breast milk, persons with any college education were more likely to report feeling coerced (aOR 9.8 [95% CI 1.8–52.5]). Qualitative analyses revealed three themes: perceiving breastfeeding as unsafe, engaging in shared decision-making, and resisting advice to formula feed. Persons with HIV desire to be counseled about safe infant feeding practices and have their questions answered without judgement. We highlight experiences of persons with HIV that reflect a need for a nuanced approach to infant feeding counseling. [ABSTRACT FROM AUTHOR]

There has been little research on domestic violence (DV) within ethnic minority communities in high-income countries. This study reports on the findings of a meta-ethnography that examined the barriers and facilitators of help-seeking behaviors in South Asian women living in high-income countries who have experienced DV to inform practice, understand the limits of the evidence, and identify research gaps. Qualitative studies were identified which were available in English by electronic databases. After an initial search, 2,465 articles were reviewed by title and abstract and 135 articles were reviewed for full text. Thirty-five papers were included for this review and were synthesized using meta-ethnography. Key findings included barriers and facilitators of help-seeking behaviors: (1) Socio-cultural norms to prohibit help-seeking behaviors, (2) Fear of negative consequences, (3) Negative aspects of immigration status, (4) Insufficient support from statutory, and voluntary agencies, (5) Safety strategies and facilitators for surviving. Although this review investigated the perceptions of two different populations (survivors and service providers) both groups had similar views about the barriers and facilitators of help-seeking behaviors. It is crucial for the government and non-government organizations to understand the barriers for women who are DV survivors to seek help from their organizations and also from South Asian ethnicities. The awareness and understanding of these barriers and facilitators may help support the development of interventions to encourage effective help-seeking amongst South Asian women affected by DV. Suggestions for research, practice, and policies are discussed. [ABSTRACT FROM AUTHOR]

Objective: Although extreme heat can impact the health of anyone, certain groups are disproportionately affected. In urban settings, cooling centers are intended to reduce heat exposure by providing air-conditioned spaces to the public. We examined the characteristics of populations living near cooling centers and how well they serve areas with high social vulnerability. Methods: We identified 1402 cooling centers in 81 US cities from publicly available sources and analyzed markers of urban heat and social vulnerability in relation to their locations. Within each city, we developed cooling center access areas, defined as the geographic area within a 0.5-mile walk from a center, and compared sociodemographic characteristics of populations living within versus outside the access areas. We analyzed results by city and geographic region to evaluate climate-relevant regional differences. Results: Access to cooling centers differed among cities, ranging from 0.01% (Atlanta, Georgia) to 63.2% (Washington, DC) of the population living within an access area. On average, cooling centers were in areas that had higher levels of social vulnerability, as measured by the number of people living in urban heat islands, annual household income below poverty, racial and ethnic minority status, low educational attainment, and high unemployment rate. However, access areas were less inclusive of adult populations aged ≥65 years than among populations aged <65 years. Conclusion: Given the large percentage of individuals without access to cooling centers and the anticipated increase in frequency and severity of extreme heat events, the current distribution of centers in the urban areas that we examined may be insufficient to protect individuals from the adverse health effects of extreme heat, particularly in the absence of additional measures to reduce risk. [ABSTRACT FROM AUTHOR]

Heightened anti-Asian racism and hate crimes during the COVID-19 pandemic impacted older adults and the social workers who supported them. Yet, the experiences of Asian and Asian American (AAA) social workers are unknown. This study aimed to explore the perspectives and experiences of social workers focusing on the aging population during the anti-Asian racism climate and the COVID-19 pandemic. Guided by a qualitative approach, seventeen AAA social workers participated in semi-structured interviews. Based on thematic analysis, the following themes were identified: concerns about safety and discrimination, perceived service and support needs for older adults, and perceived generational gaps in advocacy. Social work practice, policy, and research implications are discussed. [ABSTRACT FROM AUTHOR]

The article presents the discussion on violence is an urgent public health concern affecting millions of individuals, families, and communities annually in the US. Topics include widespread community issue that can affect anyone in all life stages regardless of their gender, sexual orientation, race, socio-economic status; and violence can be reduced across communities over time and many individual acts of violence are preventable with effective intervention.

The purpose of the study was to compare United States and Polish university women in regard to demographics, victimization experiences, sensation seeking, fear of dangerous situations, perceived likelihood of victimization, and confidence about managing dangerous situations. A total of 520 women completed the online instruments, which consisted of Perceptions of Dangerous Situations Scale (PDSS), Brief Sensation-Seeking Scale (BSSS), and a demographic questionnaire. Overall, in regard to Fear, Likelihood, and Confidence about dangerous situations, Polish women scored significantly higher in Fear and Likelihood than U. S. women. Differences in Confidence between the two groups were not statistically significant. The two groups differed in the frequency of victimizations in terms of violent crimes, rape, and abusive relationships. The groups also differed in Likelihood scores depending on prior victimization. U. S. women made less of a distinction than Polish women between their emotional (Fear) and their cognitive (Likelihood) appraisals of dangerous situations. Neither group of women scored higher in Fear if they had been previously victimized. The researchers found differences between Polish and U.S. university women in Fear and Likelihood scores, some of which may be related to cultural differences. Sensation seeking did not differ between the two groups. Regardless of country membership, women did not acknowledge rape by a known person to be as likely as rape by a stranger, nor did they acknowledge the greater likelihood of being beaten up by a known person than by a stranger. It is clear that more education is still needed. Plain language summary: Fear of Crime, Perception of Risk, and Confidence About Dangerous Situations Among Women in the United States and Poland Security is a basic human need, connected with stability, freedom from fear, anxiety and chaos, and a feeling that there is no threat or risk of losing essential goods. A sense of security depends on numerous objective factors: scope of real danger, gender, age, and place of residence, but also on subjective perceptions– resources, social support, and individual personality features. Thus, it follows that a sense of safety and a sense of danger result from a way of thinking, as well as the temperament and personality of a particular individual. The purpose of our study was to compare United States and Polish university women regarding demographics, victimization experiences, sensation seeking, fear of dangerous situations, perceived likelihood of victimization, and confidence about managing hazardous situations. A total of 520 women from Poland and the United States completed the online instruments: the Perceptions of Dangerous Situations Scale (PDSS), a Brief Sensation-Seeking Scale (BSSS), and a demographic questionnaire. In our study, we found differences between the groups. Polish women scored significantly higher in Fear and Likelihood than U. S. women. Differences in Confidence between the two groups were not statistically significant. The two groups differed in the frequency of victimizations in terms of violent crimes, rape, and abusive relationships. Our results show that cultural diversity might affect the perception of dangerous situations. [ABSTRACT FROM AUTHOR]

We developed an opioid hazard awareness module for inclusion in required miner safety refresher training. The module was disseminated throughout the United States and post-training surveys showed improved knowledge and positive response to the training. Clinicians can improve care of high-risk worker patients by recommending employer support for such training. Objective: In response to elevated risk factors, an opioid hazard awareness training for the sand, stone, and gravel mining sector was developed and embedded in annual safety training. Methods: After positive results from a prior study among Massachusetts workers, a revised training was disseminated across the United States. Two hundred post-training surveys were obtained and compared with results from the Massachusetts cohort. Results: Participants' knowledge about opioid-based medications, confidence in talking to a doctor about opioids and/or to a coworker about their own use of opioids, and ability to refer struggling coworkers to resources improved. Massachusetts respondents had slightly more favorable responses. Both cohorts had strong positive views of the training. Conclusions: These results highlight the feasibility and effectiveness of opioid hazard prevention training for a high-risk worker population. [ABSTRACT FROM AUTHOR]

To foster retention of people living with HIV (PLWH) in HIV care in the Southern United States, we aimed to develop a stakeholder-driven mobile HIV clinic (MHC) model. From June 2019 to May 2021 we conducted a mixed-methods study: 50 surveys with out-of-care PLWH and 41 in-depth interviews with PLWH, HIV clinic staff, city officials, AIDS service organizations, and mobile clinics to examine preferences for MHC implementation. Survey data was analyzed descriptively, and interview transcripts were coded thematically. Participants recommended the MHC: (1) have nondescript exterior and HIV services nested in non-HIV care to foster confidentiality, (2) be located along public transportation and have extended hours to promote accessibility, (3) have established protocols addressing security, biosafety, and data safety; (4) provide comprehensive clinical and support services to address retention barriers; and (5) be integrated within the health system, use low-cost, diverse staffing, and establish appointment notification systems. By informing MHC design, these findings add to the toolbox of strategies that can render HIV care more accessible. [ABSTRACT FROM AUTHOR]

Background: Recently arriving to US schools, 405 immigrant adolescents in a large, urban high school shared backgrounds and perspectives on what variables and sociocultural factors contributed to their sense of belonging in their new school. This study occurred in 2019–2020 and examined belonging during a xenophobic socio-political climate. Objective: This study examines what predictors and experiences, if any, contributed to belonging for a large population of multilingual, newcomer youth. This research extends the body of literature to include a large, linguistically and culturally diverse, adolescent newcomer population to test hypotheses that gender, GPA, grade level, employment status, relationships, and family factors impact belonging. Methods: In this descriptive, single-site case study of newcomers enrolled in an International Academy (IA), semi-structured online interviews (N = 14) and a survey (N = 391) were utilized. Anchored with Goodenow's belonging definition and scale, quantitative data analysis included regression analysis to reveal three demographic belonging predictors. Qualitative data analysis leveraged emergent coding of newcomer comments to surface five belonging contributing factors. Results: Results indicated that females had higher sense of belonging scores, while students of smaller language groups and students paying rent had statistically significantly lower scores. Additionally, five sociocultural school factors emerged that contributed to belonging: support networks, language, participation opportunities, safety, and recognition. Conclusion: Conclusions resulted for improving secondary school structures, practices, and climate to cultivate belonging for newcomers. Directly from students, this study presents educators with opportunities to ensure newcomers feel included, accepted, and valued through peer support networks, post-secondary preparation, and linguistic, emotional, and physical safety. [ABSTRACT FROM AUTHOR]

The authors discuss the need for universal objective standards for DUIC, combined with consistent driving under the influence of cannabis (DUIC)-specific offenses and sanctions, to ensure highway safety. Topics include an increase in prevalence of DUIC and in fatal motor vehicle collisions in U.S. states and other countries following recreational cannabis legalization and challenges that underscore the complexities in developing clear, consistent and enforceable policies to limit DUIC.

The number of laws criminalizing homelessness is increasing in the United States. Simultaneously, more individuals are experiencing homelessness, and of those, an increasing number are experiencing vehicle homelessness. Safe parking lots, where people can legally shelter in their vehicles overnight, are one response to the criminalization of vehicle homelessness. Using a mixed-methods research design (n = 37), this study explores barriers to emergency shelters for people experiencing vehicle homelessness and the potential impact of safe parking lots. Our findings indicate that safety is a major concern for this population and safe parking lots have the potential to improve perceptions of safety. [ABSTRACT FROM AUTHOR]

The incidence of elder abuse has led to a growing trend of states taking various methods to regulate the use of electronic monitoring in institutional settings through programs, guidelines, regulations, and laws. This article attempts evaluate how the regulation of electronic monitoring has evolved and may be advanced in the future with the anticipated increase of elder abuse. [ABSTRACT FROM AUTHOR]

In the United States, approximately 2 million people live with limb loss and that number is expected to double by 2050. Although this is a significant figure, it still does not represent a substantial market size for the private sector to develop prosthetics for this population. Mobility is highly crucial for long-term health , , , , and prosthetic limbs are vital in restoring mobility. Undoubtedly, people with limb loss are among the most vulnerable segments of society. Therefore, we contend that their safety and care should be a high priority for the government. In this article, we recap the public policy landscape surrounding prosthetic limbs in the United States before proposing ways to increase access and adoption of prosthetic limbs. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe online prelicensure nursing students' experiences of incivility during COVID‐19. Design: Qualitative descriptive. Five optional open‐ended questions were presented to nursing students to share their experiences with incivility during the pandemic. Methods: Data were collected from September to October 2020 as a part of a larger multimethod study on stress, resilience and incivility with nursing students and faculty (n = 710) from a large public undergraduate nursing programme in the southwestern United States. Out of the initial 675 students who completed the survey, 260 individuals responded to three or more of the open‐ended questions which were reviewed and coded using reflexive thematic analysis. Results: Thirteen themes were organized into four analytical categories: (1) experiencing incivility, (2) causes and consequences of incivility, (3) the pandemic and academic incivility and (4) promoting civility in the academic setting. Conclusions: Prelicensure nursing students perceived unrealistic expectations, a lack of awareness and miscommunication hindered academic performance, as well as, created feelings of stress, discouragement and inadequacy. Implications for the Profession and/or Patient Care: Fostering academic civility during virtual educational experiences may require training in proper coping strategies when challenged with incivility. Impact: As the body of research emerges concerning the effects of COVID‐19 and undergraduate nursing education, understanding prelicensure students' experiences of academic incivility could prove to be beneficial to designing strategies co‐created with students to promote positive educational outcomes. Understanding students' viewpoints of uncivil experiences revealed prioritizing civility awareness is essential in creating healthy academic environments, improving clinical performance and providing safe patient care. Reporting Method: The COREQ (COnsolidated criteria for REporting Qualitative research) checklist was used. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

LGBTQIAþpeople, particularly those aging into end-of-life care decisions, need safety cues to identify safe spaces to access equitable death care. We conducted a website content analysis of 90 randomly selected funeral homes across the United States to evaluate the presence of LGBTQIAþsafety cues, such as inclusive language, symbols, imagery, and LGBTQIAþ-friendly collaborations. Results showed that none of the selected funeral homes displayed any kind of safety cues. A significant change in funeral home marketing strategies is warranted so sexual and gender minorities can easily locate inclusive and affirming death care services. [ABSTRACT FROM AUTHOR]