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Adequate sleep is crucial for elite athletes' recovery, performance readiness, and immune response. Establishing reference ranges for elite athletes enables appropriate contextualization for designing and targeting sleep interventions. Purpose: To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Methods: Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Results: Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P =.006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P <.001). Winter Games participants had later bedtime (P =.036) and sleep offset time (P =.028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P <.001). Individual-sport athletes were more likely to have low (P =.005) and mild (P =.045) risk for reduced sleep duration than team-sport athletes. Conclusion: These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions. [ABSTRACT FROM AUTHOR]

Asynchronous video interviews (AVIs) are a form of one‐way, technology‐mediated selection interview that can help streamline and increase flexibility in the hiring process and are used to hire millions of applicants per year. Although applicant reactions to AVIs in general tend to be more negative than with traditional interview modalities, AVIs can differ widely in how they are designed. For instance, applicants can be provided with more or less preparation time, response length, rerecording options, or rely on different question formats. This study examines how AVI design features impact applicant reactions, as well as the moderating role played by applicant age and gender. Data from 27,809 real job applicant's AVI experiences were collected in 11 countries (69.3% English‐speaking) from 33 companies and relating to 72 types of positions. Data were fitted with linear mixed‐effects models to account for nesting. Results showed that allowing more preparation time and offering the opportunity to rerecord responses were related to more favorable reactions, while including more questions was related to more negative reactions. Applicants above the age of 31 reacted especially negatively to AVIs with more questions while those below the age of 30 preferred being allocated longer maximum response lengths. Women reacted more positively to increased preparation time. These findings might help both AVI vendors and hiring organizations design AVIs that facilitate a positive applicant experience. Our research also expands knowledge on applicant reactions to interviews, highlights crucial differences from traditional formats, and calls for integrating applicant characteristics into current theoretical frameworks on applicant reactions to AVIs. [ABSTRACT FROM AUTHOR]

Background: Past studies have shown mixed results on how gender and living with a spouse or partner impact advance care planning (ACP). Few if any have tested for the interaction between these two variables. Objective: We examined how gender and couple status interact to impact the use of ACP practices including written instructions, designating a durable power of attorney for healthcare (DPOAHC), and discussing one's decisions with others. Design: We used cross-sectional data taken from the Health and Retirement Study, a longitudinal study of adults over the age of 50 in the United States. Methods: Data are from 632 respondents who died between the 2016 core survey and the 2018 exit survey. Participants had completed the 2016 survey and had a proxy informant complete the 2018 exit survey after their death. Generalized linear mixed models were used to test for main effects and interactions. Results: Women were more likely than men to designate a DPOAHC and to discuss their wishes with others. Women living without a partner were more likely than men living without a partner and coupled households to discuss their wishes with family or others. Conclusion: Both gender and couple status are important variables associated with ACP practices. Healthcare providers may want to reach out to women living within a coupled household and men living without a partner to ensure that they know the benefits of ACP. Plain language summary: Are men and women living with a partner less likely to make plans for the type of medical treatment they prefer at the end of life? Why was the study done? To see if men and women living alone or with a partner were more likely to make plans for the type of medical treatment they preferred at the end of life. We examined whether they had written plans, designated someone to make decisions for them, or discussed their wishes with other family members or healthcare providers before they died. What did the researchers do? The research team used survey data from the Health and Retirement Study in the United States on 632 people who had completed a survey in 2016 and died within two years. A family member or friend completed a survey after the person's death reporting on their preferences for end-of-life medical care. What did the researchers find? Women were more likely than men to designate another person to make medical decisions for them and to discuss their wishes with others. Single women were more likely than single men and people living with a partner to discuss their wishes with family or others. What do the findings mean? Women living alone may be more likely to see the benefits of making their end-of-life medical care wishes known to others. Men living alone were the least likely to make their wishes known. Healthcare providers may want to keep these differences in mind when reaching out to patients to explain the benefits of making plans for medical treatments in the future. [ABSTRACT FROM AUTHOR]

Introduction: The use of e-cigarettes or other electronic vaping products (EOEVP) has been on the rise since their introduction. Concurrently, Adverse Childhood Experiences (ACEs) have been linked to various negative behavioral health outcomes. We explore the association between ACEs and current EOEVP use, with a focus on variations across sex, race/ethnicity, and age. Methods: Utilizing data from the Behavioral Risk Factor Surveillance System (BRFSS) for 2020–2022, we analyzed responses from 202,126 adults in the United States in a cross-sectional study. Multivariable logistic regression models were used to evaluate the adjusted odds ratios (aORs) of current EOEVP use for different levels of ACEs. Stratified and interaction analyses were used to examine potential effect modification. Results: Among adults 54 years of age and younger, even a lower number of ACEs [1 (aOR 1.52), 2 (aOR 2.01), and 3 (aOR 1.51)] was associated with higher odds of current EOEVP use. Stratified analyses revealed significant differences in the odds of current EOEVP use among Non-Hispanic White adults between 1 ACE (95% CI 1.75–2.28) and 4 ACEs (2.34–3.17). Hispanic adults with ≥ 1 ACEs (p-value 0.001) and 8 ACEs (p-value 0.005) showed strong associations compared to Non-Hispanic White adults. The influence of ACEs on current EOEVP use was observed to decrease with age, particularly in older adults with fewer ACEs. The aORs did not very by sex. Conclusion: The findings emphasize the importance of considering any number of ACEs in public health strategies targeting current EOEVP use, especially among younger adults and specific minority groups. These insights are crucial for tailoring interventions and policies to address the nuanced impacts of early life adversities on health risk behaviors. [ABSTRACT FROM AUTHOR]

Introduction: In patients with cardiac sarcoidosis (CS), implantable cardioverter‐defibrillators (ICDs) are important for preventing sudden cardiac death. This study aimed to investigate sex disparities in CS patients undergoing ICD implantation. Methods: The 2016–2020 National Inpatient Sample (NIS) database compared the characteristics and outcomes of males and females with CS receiving ICDs. Results: Among 760 CS patients who underwent inpatient ICD implantation, 66.4% were male. Males were younger (55.0 vs. 56.9 years, p <.01), had higher rates of diabetes (31.7% vs. 21.6%, p <.01) and chronic kidney disease (CKD) (16.8% vs. 7.8%, p <.01) but lower prevalence of atrial fibrillation (AF) (11.9% vs. 23.5%, p <.01), sick sinus syndrome (4.0% vs. 7.8%, p =.024), ventricular fibrillation (VF) (9.9% vs. 15.7%, p =.02), and black ancestry (31.9% vs. 58.0%, p <.01). Unadjusted major adverse cardiovascular events (MACE), defined as a composite of in‐hospital death, myocardial infarction (MI), and ischemic stroke, was higher in females (11.8% vs. 6.9%, p =.024), but when adjusted for age and tCharlson Comorbidity Index (CCI), females demonstrated significantly lower odds of experiencing MACE (aOR: 0.048, 95% CI: 0.006–0.395, p =.005). Incidence of acute kidney injury (AKI) post‐ICD was significantly lower in females (15.7% vs. 23.8%, p =.01) as was the adjusted odds (aOR: 0.282, 95% CI: 0.146–0.546, p <.01). There was comparable mean length of stay and hospital charges. Conclusion: ICD utilization in CS patients is more common among males, who have a higher prevalence of diabetes and CKD but a lower prevalence of AF, sick sinus syndrome, and VF. Adjusted MACE and AKI were significantly lower in females. [ABSTRACT FROM AUTHOR]

Carefully standardized facial images of 591 participants were taken in the laboratory while controlling for self-presentation, facial expression, head orientation, and image properties. They were presented to human raters and a facial recognition algorithm: both humans (r =.21) and the algorithm (r =.22) could predict participants' scores on a political orientation scale (Cronbach's α =.94) decorrelated with age, gender, and ethnicity. These effects are on par with how well job interviews predict job success, or alcohol drives aggressiveness. The algorithm's predictive accuracy was even higher (r =.31) when it leveraged information on participants' age, gender, and ethnicity. Moreover, the associations between facial appearance and political orientation seem to generalize beyond our sample: The predictive model derived from standardized images (while controlling for age, gender, and ethnicity) could predict political orientation (r ≈.13) from naturalistic images of 3,401 politicians from the United States, the United Kingdom, and Canada. The analysis of facial features associated with political orientation revealed that conservatives tended to have larger lower faces. The predictability of political orientation from standardized images has critical implications for privacy, the regulation of facial recognition technology, and understanding the origins and consequences of political orientation. Public Significance Statement: We demonstrate that political orientation can be predicted from neutral facial images by both humans and algorithms, even when factors like age, gender, and ethnicity are accounted for. This indicates a connection between political leanings and inherent facial characteristics, which are largely beyond an individual's control. Our findings underscore the urgency for scholars, the public, and policymakers to recognize and address the potential risks of facial recognition technology to personal privacy. [ABSTRACT FROM AUTHOR]

Purpose: An official autism diagnosis is required to access timely intervention and is associated with better long-term wellbeing and mental health. Certain demographic characteristics, such as being female or a racially or ethnically minoritized youth, have been associated with significant diagnostic lag. However, it remains unclear how assigned sex, race, and ethnicity interact with each other in predicting the prevalence and age of autism diagnosis. Methods: To examine the interactions between assigned sex, race, and ethnicity, we used data from the National Survey of Children's Health (NSCH; 2016 > 2021). Results: One in 38 children had an autism diagnosis and 3.8 males were diagnosed per 1 female. Hierarchical linear regressions yielded diagnostic delays in some females, particularly those who were non-Hispanic white, Black, and Asian. Ethnic and racial minority children had significantly earlier diagnoses than white and non-Hispanic children when not accounting for sex. Conclusion: This study demonstrates slight increases in reported autism prevalence, a diagnostic lag in some autistic females that was strongly associated with ethnicity, and earlier diagnoses in racial and ethnic minority youth, a finding that may be explained by factors associated with phenotypic differences. This study has important implications for the diagnosis of minority autistic youth, particularly females and females who are non-Hispanic, who may experience a greater propensity for diagnostic delays. [ABSTRACT FROM AUTHOR]

The reported prevalence of autism spectrum disorder (ASD) has more than tripled in the past two decades in the United States, due in part to improved screening and diagnostic techniques. Epidemiologic data on ASD, however, are largely limited to population-based surveillance systems. We examined epidemiologic patterns in ASD diagnoses among inpatients aged 1–20 years, using data from the Kids' Inpatient Database (KID) from 1997 to 2019. ASD cases were identified using ICD-9-CM and ICD-10-CM codes. Of 9,267,881 hospital discharges studied, 110,090 (1.19%) had a diagnosis of ASD. The prevalence of ASD was higher among males compared to females (1.53% vs. 0.54%) and was highest among non-Hispanic Whites (1.28% vs. 0.95% in non-Hispanic Blacks, 0.94% in Hispanics, and 1.18% in Other races). ASD prevalence increased from 0.18% to 1997 to 3.36% in 2019 (Z= -273.40, p < 0.001). The absolute increase was higher among males compared to females (0.26–4.90% vs. 0.08–1.77%) and among non-Hispanic Whites (0.18–2.88%) compared to non-Hispanic Blacks (0.23–2.72%), Hispanics (0.14–2.60%), and Other races (0.19–2.97%). The epidemiologic patterns of ASD based on inpatient data are generally consistent with reports from the community-based autism surveillance system. Our findings indicate that KID and other health services data might play a complementary role in ASD surveillance. [ABSTRACT FROM AUTHOR]

Weightlifting has become an increasingly popular form of exercise that has been shown to have many health benefits but can be dangerous if performed improperly. The objective of this study was to describe the epidemiology of lower body weightlifting injuries in the United States. The National Electronic Injury Surveillance System database was queried from January 1, 2012, to December 31, 2021, for lower body injuries related to using weightlifting equipment. Demographics, diagnosis, disposition, and mechanism of injury (MOI) were analyzed. There were 7,773 lower extremity weightlifting injuries identified from 2012–2021, giving a national estimate of 311,842 injuries. The most common MOI was dropped weight (n=1785, 22.96%). Deadlifts were the most cited exercise that led to lower extremity injury (n=503, 6.47%). Males were more likely than females to be injured (76% males vs. 24% females; p<0.001), especially by compound movements with free weights including squats (79.63% males vs. 19.96% females, p<0.03) and deadlifts (83.89% males vs. 16.10% females, p<0.001). Nearly all injuries were treated as outpatient but those admitted to the hospital were significantly older than those treated as outpatients (38.0 years vs. 31.2 years, p<0.05). Weightlifting carries a high risk of injury due to the intensity and technique required for the different movements involved. [ABSTRACT FROM AUTHOR]

Racial/ethnic minoritized youth are underrepresented in autism research. Documented inequities in accessibility to and utilization of autism-specific services highlight the importance of better understanding for whom and under what conditions autism evidence-based practices (EBPs) work. This report examines the race, ethnicity, sex, and gender of school-based autism research participants (e.g. educators, students), given schools are the most common setting in which autistic youth receive services in the United States (US). Data across 14 years of research, for eight school-based studies in the US, showed that while most teachers identified as non-Hispanic White, over half of the youth sampled identified as being of a racial/ethnic minoritized background. Findings provide insights into who is being served in school-based autism research and how school partnerships may increase diversity among autism research participants and offer a means of reducing existing barriers. Researchers should continue to utilize schools to reach diverse populations and consider how demographic characteristics of school staff affect EBP effectiveness. Researchers should continue to better understand the impact of the EBP, provider, and setting on outcomes. Schools are the main provider of behavioral health services in the United States (US). Conducting research in schools may help increase access for autistic youth, but there is limited research about who participates in school-based autism research. The researchers examined data spanning 14 years of participation in school-based autism research. All data were collected in the US. Researchers found that in this sample, more than half of the youth identified as racial/ethnic minoritized (REM) youth. However, demographics of sampled youth were significantly different than expected, based on publicly available school-based population demographics. More youth identified as White non-Hispanic than would be expected in those schools. Majority of the sampled educators also identified as White non-Hispanic. High percentages of autistic REM youth suggest school-based autism research may be an effective way of providing services to more diverse populations. However, sampled schools were also not representative of a US national sample, with sampled schools having fewer White non-Hispanic youth than would be expected from US national statistics. Complexity around representation of schools sampled and demographics of service environments suggests a need for more research. [ABSTRACT FROM AUTHOR]

Objectives In recent decades, risk of job loss in America after age 50 has been high, potentially causing significant stress during the period preceding retirement. Yet no study has quantified the burden of clinically relevant depressive symptoms attributable to job loss in this age group over this period or identified the most vulnerable populations. Methods Participants aged 50+ in the Health and Retirement Study (recruited 1992–2016) who were employed and scored <5 on the Center for Epidemiologic Studies-Depression 8-item scale (CESD-8) at baseline (N  = 18,571) were followed for depressive symptoms until they first had CESD-8 ≥5 or died, or through the 2018 survey. Parametric g-formula analyses examined the difference in cumulative risk of having CESD-8 ≥5 if there had been no involuntary job loss compared to the observed scenario, adjusting for sex, race/ethnicity, age, and dynamic measures of recent marriage end (divorce or widowhood), having a working spouse, assets/debt, and health changes. Results We estimated that risk of CESD-8 ≥5 would have been 1.1% (95% confidence interval [0.55, 1.37]) lower if no involuntary job loss had occurred; job loss accounted for 11% of the total burden among those who lost a job. Stronger associations were observed for women (1.2% [0.7, 1.8] vs men 0.5% [0.2, 1.1]), White respondents (1.0% [0.6, 1.5] vs Black respondents 0.5% [−0.1, 1.4]), and those in the lowest quartile of baseline assets (1.1% [0.4, 1.9] vs wealthiest quartile 0.5% [−0.4, 0.9]). Discussion Involuntary job loss is associated with high depressive symptom burden in older persons, suggesting that screening and intervention soon after job loss may help mitigate depression. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the ways in which depression severity, gender, acculturation, and enculturation are associated with help-seeking attitudes among Arab/Middle Eastern North African (MENA) Americans. A hierarchical linear regression was conducted with a sample of 296 Arab/MENA participants (154 women and 142 men). After controlling for pertinent demographic variables, depression severity was negatively associated with help-seeking. Further, there was a significant three-way interaction between depression severity, gender, and enculturation on help-seeking attitudes. For women with higher levels of depression symptoms, higher levels of enculturation were associated with less positive help-seeking attitudes; conversely, higher levels of enculturation for men were associated with more positive help-seeking attitudes. These results have significant implications for clinicians working with Arab/MENA American populations. Practitioners should be aware of acculturation and enculturation processes as well as the ways in which depression symptom severity may influence engagement in treatment differentially for Arab/MENA women and men. Future research is needed to examine the mechanisms underlying these relationships. Public Significance Statement: This study suggests that depression severity and gender influence help-seeking attitudes among Arab/Middle Easter North African Americans. Further, enculturation affected this relationship so that higher levels of enculturation indicated less positive help-seeking attitudes for women and more positive help-seeking attitudes for men. These relationships have significant implications for practitioners providing culturally sensitive treatment when working with this population. [ABSTRACT FROM AUTHOR]

Objective: This cross‐sectional study evaluated de‐identified data from the National Collegiate Athletic Association—Department of Defense Grand Alliance from 2014 to 2020 to determine the prevalence of migraine and migraine medication and to describe differences in migraine prevalence by sex, race, and sport. Background: Epidemiological studies can help identify underdiagnosed and undertreated populations. Understanding migraine prevalence in collegiate student‐athletes is essential for positive healthcare outcomes including development of prevention and treatment plans. Methods: From a concussion baseline assessment, participant's self‐reported demographics (e.g., age, sex, sport), migraine diagnosis (i.e., yes/no), and migraine medication usage (e.g., yes/no, type) determined prevalence of migraine and medication use in collegiate student‐athletes. Results: Migraine was reported in 5.6% (2617/47,060; 95% confidence interval [CI] 5.4%–5.8%) of the student‐athletes, with higher prevalence in females, 7.5% (1319/17,628; 95% CI 7.1%–7.9%), than males, 4.6% (1298/28,116; 95% CI 4.4%–4.9%). Medication usage was reported by 36.2% (947/2617; 95% CI 34.3%–38.0%) of individuals with migraine. Migraine reporting differed by race, with Caucasian reporting highest (5.9%; 1990/33,913; 95% CI 5.6%–6.1%) and Asian the lowest (2.7%; 55/2027; 95% CI 2.1%–3.5%). Women's sports, including golf, gymnastics, and lacrosse, and men's diving and squash had higher migraine reporting than other sports. Conclusion: Caucasian females reported higher rates than other groups and sport influenced rates of migraine diagnosis. Plain Language Summary: Collegiate student‐athletes face unique circumstances that may influence migraine diagnosis and outcomes. From a de‐identified data set provided by the National Collegiate Athletic Association—Department of Defense Concussion Assessment, Research, and Education (CARE) Consortium, migraine was reported in 5.6% of collegiate student‐athletes and 36.2% of those also reported taking a medication. Migraine reporting differed by race and sport, with Caucasian females reporting higher rates of migraine than other groups. [ABSTRACT FROM AUTHOR]

Aims: To compare four a priori rival mediated pathways of frequent social media use, electronic nicotine delivery systems (ENDS) use and internalizing mental health (MH) problems across five waves of nationally representative data. Design, setting and participants: This was a longitudinal study using data drawn from waves 2–5 (October 2014–November 2019) of the Population Assessment of Tobacco and Health Study, a nationally representative cohort study spanning approximately 5 years, conducted in the United States. The analytical sample of participants included those who were aged 12–14 years at wave 2 and who provided data in subsequent waves until wave 4.5 (n = 4627, 69.7% were White and 51.4% were male). Measurements: Frequent social media use (several times a day), ENDS use (past 30‐day use) and internalizing MH problems (endorsed symptoms on four items in the past year) were dichotomized for analysis. Findings The weighted proportions of the three key variables increased over time. From wave 2 to wave 5, frequent social media use grew from 56.9 to 77.2%; internalizing MH problems from 18.9 to 29.0%; and ENDS use from 1.4 to 11.4%. In weighted logistic regressions using generalized linear mixed models with random effects, there was a significant within‐person association between frequent social media use at time t and greater ENDS use at t + 1 [adjusted odds ratio (aOR) = 1.87; 95% confidence interval (CI) = 1.47, 2.37] and worsened internalizing MH problems at t + 1 (aOR = 1.19; 95% CI = 1.04, 1.37). A model‐based causal mediation analysis and marginal structural models were fitted to estimate the average causal mediation effect. Among all four examined mediation pathways throughout the three constructs, partial mediation was observed, and all the pathways were significant for both boys and girls. Sex differences did not emerge in the examined prospective mediated pathways. Conclusions: Among youth in the United States, frequent social media use appears to mediate the prospective association between experiencing internalizing mental health problems and using electronic nicotine delivery systems. [ABSTRACT FROM AUTHOR]

Sudden infant death syndrome (SIDS) is the most common cause of death for infants between 1 month and 1 year of age in the United States. The objective was to examine recent trends in SIDS in the United States, over time and by sex and race. A population-based cross-sectional study was conducted on 80 710 348 live births using data from the Center for Disease Control and Prevention's (CDC) "Birth Data" and "Mortality Multiple Cause" files from 2000 to 2019. Logistic regression examined the effects of sex and race on the risk of SIDS and examined temporal changes in risk across sex and race over the study period. Incidence of SIDS decreased from 6.3 to 3.4/10 000 births from 2000 to 2019, with an overall incidence of 4.9/10 000 births (95% confidence interval [CI] = 4.4-5.3). Male infants were at the greatest risk of SIDS as were black and American Indian infants. Although SIDS incidence decreased by sex and race over time, the decline was smaller among Hispanic and American Indian infants. [ABSTRACT FROM AUTHOR]

This study analyzes different factors predicting both cohabitation and early marriage among emerging adults. Using a large (n = 1,510), national, longitudinal sample of emerging adults in the United States, predictors of cohabitation and early marriage were examined. Predictors included marital paradigms (marital salience and expected age of marriage) and sociodemographic characteristics (religious attendance, parents' marital status, parents' education, college attendance, income, gender, and race). We utilized a Cox proportional hazards model to run the analyses. Results showed that marital paradigms were the most consistent predictors of early marriage, while few sociodemographic factors were significant. On the other hand, cohabitation was most consistently predicted by sociodemographic factors, with no associations being significant with marital paradigms. These findings suggest that decisions to marry and cohabit may not be as closely interconnected as previously conceptualized. Future directions and limitations are also discussed. [ABSTRACT FROM AUTHOR]

During early and middle adolescence, individuals are at heightened risk of poor body image and subsequent negative mental health outcomes, and the highly visual nature of social media may play a role in this process. It remains unclear, however, if appearance preoccupation on social media—such as appearance-related social media consciousness (ASMC)—influences offline body image, or if preexisting body image concerns influence online appearance preoccupation. The present study investigated between-person differences and potential bidirectional within-person associations in these experiences among eighth grade adolescents in the United States (n = 1,582; ages 11–15 years old; Mage = 13; 47.5% girls, 45.9% boys, 6.5% another gender identity; 37% Latine, 32% White, 18% Black, 7% Asian, 6% another racial/ethnic identity). Participants completed a longitudinal study over three waves within one academic year. Results indicated that within-person increases in ASMC preceded within-person increases in appearance-contingent self-worth and were bidirectionally associated with worse appearance esteem, with no differences in these associations by gender. Among girls only, self-objectification was associated with subsequent within-person increases in ASMC, but not vice versa. Findings indicate that online appearance preoccupation may influence and be reinforced by general body image concerns. Public Significance Statement: Social media-specific appearance cognitions and behaviors and offline body image concerns may be mutually reinforcing and girls may be at higher risk than boys. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to analyze how farmworkers are represented in stock photos available in commercial libraries for use in agricultural health and safety education materials. Methods: We searched for images in five commercial stock photo libraries using the terms "farmworkers" and "women farmworkers" in April 2022. We used quantitative content analysis. We coded each image for containing a visible face, age, gender, skin tone, work activity, mechanization, presence of hazards, technology use, and protective equipment/clothing after establishing inter-coder reliability. We used descriptive statistics to characterize the available stock photos. Results: We identified stock photos (n = 127) in three databases (Adobe Stock Images, Canva, and Getty Images). Two databases (Microsoft Office Image Library and Pixabay) had no relevant images at the time of the search. Only half of the photos analyzed contained a face. Light skin tones and young or middle-aged adults were more common. A majority of farming activities represented in photos were manual tasks (e.g., harvesting) with few depictions of equipment, hazards, and protective equipment/clothing. Conclusions: Health and safety professionals tasked with developing materials for education in agricultural settings face a severe lack of imagery pertinent to the realistic conditions of farmworkers in the United States. In the databases we reviewed, photos displaying human faces, photos showing a range of skin tones and ages, and photos displaying an array of different farm hazards are likely not sufficient for material development. Health and safety professionals may benefit from sharing photos from their own work with other professionals and allocating resources for professional photo shoots in their material development projects. [ABSTRACT FROM AUTHOR]

Objective: US Hispanics have several health disparities, greater tobacco/nicotine-related illnesses, lower access to smoking cessation, and lower rates of cessation. Understanding cultural constructs linked to tobacco/nicotine use may provide a greater understanding of future cultural adaptations of cessation interventions. This study used a multidimensional acculturation framework, with cultural practices, identity, and values, to test links between measures of acculturation stress, multidimensional acculturation (language-based enculturation and acculturation, cultural identity, familism), and tobacco/nicotine use, and interactions with gender. Design: Participants were 391 adult Latin American immigrants (69% women); 12% self-reported tobacco/nicotine use in the past six months. Results: Path analysis showed acculturative stress, β =.16, and acculturation, β =.20, were positively related to tobacco/nicotine use. Enculturation, familism, and Hispanic cultural identity were not related to tobacco/nicotine use. There were no significant acculturation by enculturation or gender interactions, but women were less likely to use tobacco/nicotine than men, β = −.36. Conclusion: Findings suggest that tobacco/nicotine cessation interventions for Latino immigrants may be enhanced with an emphasis on the mitigation of acculturative stress, attention to the adoption of US cultural practices, and gender. Future research should examine specific sources of acculturative stress or social norms related to tobacco/nicotine use. [ABSTRACT FROM AUTHOR]

Online appearance preoccupation may put adolescents at risk of developing mental health challenges, perhaps especially during early-to-middle adolescence. A random intercept cross-lagged panel model assessed within-person associations between appearance-related social media consciousness and depressive symptoms over three time-points with three months between waves. The sample (n = 1594) included U.S. adolescents aged 11–15 (Mage = 13; 47% girls, 46% boys, 7% another gender; 37% Latine, 33% White, 18% Black, 7% Asian). Within-person increases in appearance-related social media consciousness were associated with subsequent increases in depressive symptoms, but not vice versa. There was no evidence of gender differences and results were robust to controlling for both time on social media and offline self-objectification. Thus, online appearance concerns precede mental health challenges during early and middle adolescence. [ABSTRACT FROM AUTHOR]

Following the U.S. military's departure from Afghanistan, a significant number of Afghan refugees have resettled in the United States, presenting complex mental health challenges exacerbated by extensive traumatic exposure. This demographic is particularly affected by collective trauma due to war, genocide, and the loss of homeland. However, detailed investigations into the correlations between collective trauma and mental health outcomes among Afghan refugees are limited. This study sought to explore the relationship between collective trauma and mental health outcomes within the Afghan refugee population in the United States, paying particular attention to the influence of sociodemographic factors. Identifying subgroups at greater risk allows for the development of more targeted mental health interventions. The study surveyed 173 Afghan refugees employing snowball sampling, utilizing a cross-sectional design. Data collection was facilitated through online and in-person surveys in English, Dari, and Pashto. Key measures included the Harvard Trauma Questionnaire for individual trauma experiences, the Historical Loss Scale for collective trauma, the Historical Loss Associated Symptoms Scale for collective trauma symptoms, the Afghan Symptom Checklist-22 for mental health symptoms, and the Post-Migration Living Difficulties Scale for post-migration stressors. Statistical analyses involved Pearson's correlation for variable associations, with nonparametric Mann–Whitney U and Kruskal–Wallis tests conducted to assess sociodemographic impacts due to data's non-normal distribution. The analysis revealed significant variations in collective trauma and mental health outcomes across subgroups. Afghan women, minoritized ethnic groups, those who experienced extended displacement, and refugees with uncertain visa statuses reported higher collective trauma levels and worse mental health outcomes. Statistical significance was noted in the correlations between collective trauma and mental health symptoms (r =.53, p <.01) and between post-migration difficulties and mental health (r =.33, p <.01). The disparities in mental health outcomes based on sociodemographic characteristics were significant, with nonparametric tests showing clear distinctions across different groups (Kruskal–Wallis H = 14.76, p <.05 for trauma experience by visa status). This study emphasizes the critical need for mental health interventions that account for the complex experiences of collective trauma among Afghan refugees, especially among identified subgroups. Tailoring mental health services to address the specific needs highlighted through disaggregated data can enhance support for Afghan refugees in the United States. This research contributes to a deeper understanding of the relationship between collective trauma and refugee mental health, advocating for nuanced care strategies in resettlement environments. [ABSTRACT FROM AUTHOR]

Many individuals with serious mental illness are at high risk for hospitalization or death due to inadequate treatment of medical conditions or unhealthy behaviors. The authors describe demographic and clinical characteristics associated with increased risk in this population. Electronic data were obtained for individuals in treatment at a large Veterans' healthcare system who were at high risk according to a validated model. A random sample of these individuals was assessed in person. Multivariable regressions estimated the effect of numerous demographic, health, and clinical characteristics on risk. Emergency visits and hospitalizations were common. Greater risk was associated with being male, not married, and having more diagnoses. While risk varied by race, this effect was no longer significant after controlling for other factors. Health-related quality of life worsened with increasing risk. Routine data identify a large population of high-risk individuals who may benefit from outreach to provide healthcare services. [ABSTRACT FROM AUTHOR]

Objective: Kratom use represents a growing risk for public health. The present study examined demographic and behavioral factors linked with kratom use. Participants: Participants were college students in the United States who participated in the 2019-2020 Healthy Minds Study. Methods: Participants completed survey-based assessment of kratom use and related demographic, behavioral, and mental health variables. Results: Kratom use was linked with being White, male or transgender/gender nonconforming, identifying as a sexual minority, use of alcohol or marijuana, and depressive symptoms. Kratom use was not uniquely linked to exercise or anxiety. Conclusions: The results of the present study can be used to inform initial targeting of efforts to reduce kratom use among college students. [ABSTRACT FROM AUTHOR]

This study examined associations between perceived discrimination, treatment adherence self-efficacy, and depressive symptoms among people living with HIV (PLHIV) in the Southern United States. Cross-sectional survey data were collected from 402 PLHIV who self-reported on interpersonal discrimination experiences based on HIV status, sexuality, gender, income, and living condition. Participants also reported on adherence self-efficacy and depressive symptoms. We employed K-means clustering to identify groups based on discrimination experiences, and logistic regressions to examine group differences on adherence self-efficacy and depressive symptoms. Results suggested three groups: a cluster with high perceived discrimination across all identities/conditions (n = 41; 11%; Cluster 1); a cluster with high perceived discrimination based on HIV status, income, and living condition (n = 49; 13%; Cluster 2); and a cluster with low perceived discrimination across all identities/conditions (n = 288; 76%; Cluster 3). Compared to Cluster 3, Cluster 1 and 2 had 2.22 times (p =.037) and 3.98 times (p<.001) greater odds of reporting depressive symptoms. Compared to Cluster 3, Cluster 2 had 3.40 times (p =.003) greater odds of reporting lower adherence self-efficacy. Findings demonstrate the need for individual-level support for PLHIV with discrimination histories, and broader efforts to end the stigma, discrimination, and marginalization of PLHIV based on HIV status and other characteristics. [ABSTRACT FROM AUTHOR]

Objectives: Dimensions of religion and spirituality are associated with better emotional, physical, and cognitive health. However, the underlying physiological mechanisms are not well known. We investigated the relationship between dimensions of religion and spirituality with levels of C-reactive protein (CRP), a biomarker of systematic inflammation, in middle-aged and older adults in the United States.Methods: In this descriptive longitudinal study using secondary data, we used proportional odds models of the generalized estimating equation (GEE) to assess the association between religious beliefs and values and religious service attendance with CRP levels from respondents (n = 2,385) aged 50 years and older in the Health and Retirement Study from 2006 to 2014.Results: Middle-aged to older adults who reported higher religious beliefs and values had lower levels of CRP, controlling for age, sex, education, marital status, race, household income, and health, such as hypertension, diabetes, cancer, and body mass index (BMI).Conclusion: Religious beliefs and values are associated with lower CRP levels among middle-aged and older adults in the U.S. This study adds to the understanding of biological processes underlying the relationship between dimensions of religion and spirituality with better cognitive and physical health, potentially through inflammation. [ABSTRACT FROM AUTHOR]

Introduction: The employment landscape for multiply marginalized people with disabilities presents significant challenges, exacerbated by intersecting identities such as race/ethnicity, sexual orientation, gender identity, poverty, and geography. Recent studies highlight the compounded employment disparities faced by this group, including discriminatory hiring practices, inadequate accommodations, and uneven gains in employment during the COVID-19 public health emergency. Methods: Our study employed a three-round Delphi process with 20 diverse experts across 14 states across the United States (U.S.) to formulate recommendations for improving employment experiences for multiply marginalized people with disabilities. The panel's insights were gathered through surveys administered online, with each round designed to refine the collective recommendations. This iterative process aimed to build a consensus on the most effective policy and practice recommendations for improving employment outcomes within this population. Results: The Delphi study identified key areas for strategic focus, including emergency preparedness, education and training, transportation, assistive technology, workplace accommodations, and combating discrimination and stigma. Notable recommendations included improving emergency preparedness training, enhancing employment education, increasing funding for accessible transportation and assistive technology, and promoting inclusive hiring practices. The study also emphasized the need for policies supporting telework and simplifying disability-related benefits. Discussion: The findings highlight the critical role of tailored strategies to address employment challenges faced by people with disabilities from marginalized communities. Meaningfully and fully implementing these recommendations would create a more inclusive environment that improves employment outcomes for multiply marginalized people with disabilities. [ABSTRACT FROM AUTHOR]

Simple Summary: The incidence and mortality rates of cancer in the Surveillance, Epidemiology, and End Results (SEER) Program for adolescent and young adult (AYA) patients show distinct patterns among early-onset cancers. For some cancers, AYA cancer rates varied by age group, sex, race, ethnicity and geography. Monitoring the rates and time trends of AYA cancer emphasizes the distinct health concern for this age group. (1) Background: The incidence rate of early onset-cancer (<50) has increased since 1995. Among younger people, cancers in AYAs (aged 15–39 y) are often biologically distinct tumors from those treated in the pediatric and older adult population. The current study describes trends in the United States for the most recent years including the first year of the COVID-19 epidemic. We aimed to describe the recent incidence and mortality trends of cancers in AYAs (aged 15–39 y). (2) Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER 22) from 1 January 2016 to 31 December 2021. Age-adjusted incidence and mortality rates were assessed by SEER*Stat 8.4.3 for major cancer types by sex, race/ethnicity, age, and metropolitan/nonmetropolitan status. Time trends of age-adjusted incidence and mortality rates were examined by sex and metropolitan/nonmetropolitan status. (3) Results: Age-adjusted overall cancer incidence and mortality rates were stable during this study period. The age-adjusted incidence rates declined significantly for ependymoma, melanoma, carcinomas of lung, bronchus, and trachea, unspecified malignant neoplasms, and non-Hodgkin's lymphoma. Significant increases were found for gastrointestinal tract cancers and non-Kaposi sarcomas. The age-adjusted mortality rate decreased for acute myeloid leukemia, melanoma, carcinomas of liver and intrahepatic bile ducts, kidney and, in women, leukemia. For some cancers, rates differed by sex, race, ethnicity, and geography. Monitoring the rates and time trends of AYA cancer emphasizes the distinct health concern for this age group. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis with pathological fractures is a significant public health issue, contributing to morbidity, disability, diminished quality of life, and increased mortality. Understanding mortality trends related to this condition is crucial for developing effective interventions to reduce mortality and improve healthcare outcomes. This study aimed to analyze trends and causes of death associated with osteoporosis and pathological fractures in the United States using a multi-cause approach. Methods: Annual death and age-standardized mortality rate (ASMR) data from 1999 to 2020 were obtained from the Centers for Disease Control and Prevention (CDC) mortality database. Death certificates listing ICD-10 M82 (osteoporosis with pathological fracture) as an underlying or related cause of death were analyzed. Epidemiological data were analyzed, and the ASMR data were calculated for each year, and trends were assessed using the Cochran-Armitage trend test. Results: From 1999 to 2020, there were 40,441 deaths related to osteoporosis with pathological fractures in the United States, with a female-to-male ratio of 5.6:1. Among these, 12,820 deaths (31.7%) listed osteoporosis with pathological fractures as the underlying cause of death (UCD), yielding a female-to-male ASMR ratio of approximately 5.0-7.7:1. When classified as a non-UCD, the ASMR ratio was approximately 4.8–6.2:1. At the same time, we found that the total number of deaths classified as UCD and multiple causes of death (MCD), but the trend ratio of the two groups in different years did not change statistically significant (P > 0.05), and the ASMR of both groups showed a downward trend. The UCD-to-MCD ratio increased between 1999 and 2007, then decreased from 2007 to 2020. As MCD, the number of female deaths was more than that of male, and both showed a decreasing trend, but there was no statistical significance in the change of trend ratio in different years (P > 0.05). Deaths were predominantly concentrated in individuals over 75 years of age, with those over 84 years being the most affected. The number of deaths in different age groups showed a decreasing trend, and the change of trend ratio in different years was statistically significant (P < 0.05). White individuals had the highest number of deaths. The leading causes of death were heart diseases, chronic lower respiratory diseases, and alzheimer's disease. In addition, the number of deaths of patients with prostate cancer and breast cancer showed a significant downward trend, and the change of trend ratio between the two groups in different years was statistically significant (P < 0.05). Conclusions: Although mortality from osteoporosis with pathological fractures is decreasing, anti-osteoporosis therapy remains essential for elderly patients. Healthcare providers should remain vigilant for potential complications, including malignant neoplasms, and ensure timely diagnosis and treatment to further reduce mortality in this population. [ABSTRACT FROM AUTHOR]

Background: Research on Qi Gong (QG) supports promising health benefits. Both interest and use of QG in U.S. adults has increased over the past decade. Shared Medical Appointments (SMAs) are a novel, cost-effective, and time efficient health care delivery approach associated with patient and clinician satisfaction. Objectives: A telehealth delivered QG SMA was pilot tested among a diverse demographic population within an integrative medicine practice at an academic medical center to assess feasibility and acceptability. Methods: This was a feasibility/acceptability pilot study conducted at a large New York City academic medical center's Integrative Health and Wellness center from January to July 2023. A QG instructor-acupuncturist and an integrative medicine physician-acupuncturist co-led 3 separate series (5 Element QG, Eight-Section Brocade, and Joint-Mobilizing/Sinew Strengthening exercises) of weekly 30-45-minute sessions of QG SMA on a weekday afternoon via telemedicine. The first session included an overview of QG and Traditional Chinese Medicine (TCM) research while follow-up sessions included a check-in, didactic demonstration followed by QG practice, and a debrief to answer questions. Video links were provided for home practice. Surveys assessing satisfaction were sent pre/post series. Results: 18 sessions of QG SMA were offered over a 6-month period. A total of 40 unique participants from diverse demographics (gender, race/ethnicity, primary residence) attended, for a total of 197 virtual visits. A total of 20 participants enrolled in Series 1 (8 weeks), 23 enrolled in Series 2 (7 weeks), and 16 enrolled in Series 3 (3cweeks). For each session, group attendance ranged from 8-16 with an average of 11 participants. Attendance was high with participants attending an average of 72% of the sessions. Participants attended 88% of the first 8-week series, 54% of the second 7-week series, and 60% of the third series. Participant interest persisted over time with 35% of the 40 participants attending more than 1 series, and 12.5% attending all 3 series. Participants' diagnoses and health symptoms included pain (62.5%), cancer (45%) anxiety/depression (40%), cardiovascular disease (CVD) or metabolic conditions (32.5%), gastrointestinal (GI) symptoms/diagnoses (27.5%), stress (22.5%), osteopenia/osteoporosis (17.5%), and insomnia (17.5%). Pre-series [n = 27] participants endorsed symptoms including sleep disturbances, fatigue, pain, stress, weakness, GI symptoms, psychological symptoms, hot flashes, and brain fog. Post-program survey results [n = 11] suggested QG program addressed common symptoms including fatigue, insomnia, anxiety, stress, pain, weakness, and gastrointestinal symptoms. Participants reported incorporating QG, breathing techniques, and meditation into their daily routine. All participants reported their goals were met and that they would recommend the program to others. Regarding delivery preferences, 73% preferred telehealth, 27% hybrid, and none preferred in-person. Participants appreciated the format, new skills, community, and instructors. Conclusion: While the Virtual QG SMA series provided to diverse demographic population with mixed diagnoses is feasible, acceptable, and shows promising positive impact in this pilot, caution in interpreting the data is advised due to the low response rate of the post-program survey. Robust studies with longer follow-ups are recommended. [ABSTRACT FROM AUTHOR]

Introduction: Adrenoleukodystrophy (ALD) patients exhibit three primary clinical phenotypes: primary adrenal insufficiency, adrenomyeloneuropathy, and cerebral demyelination due to the accumulation of saturated very long-chain fatty acids in the adrenal cortex and central nervous system white matter and axons. We investigated the diagnosis of adrenal insufficiency (AI) and the use of mineralocorticoid treatment in male ALD patients. Methods: A retrospective chart review of electronic medical records was conducted for all ALD patients at a single institution between January 1, 2011, and December 6, 2021. Results: Among the 437 ALD patients, 82% were male and 18% were female. Of the male ALD patients, 60% (213 out of 358) had a diagnosis of AI, and 39% (84 out of 213) of those with AI were prescribed mineralocorticoid replacement therapy. Conclusion: AI is highly prevalent among ALD patients, with approximately 40% of those with a diagnosis of AI undergoing mineralocorticoid replacement therapy. Further research is warranted to delineate the characteristics of patients predisposed to developing mineralocorticoid deficiency within the context of ALD and AI. [ABSTRACT FROM AUTHOR]

Objective: This investigation examines burden of comorbidity measured by the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) among inpatients based on age, sex, and race. Methods: Cross-sectional analysis of 2012-2018 US NIS datasets. Participants were inpatients 55y+. ICD-9/10 codes for admitting diagnoses were used to calculate disease burden using the CCI and ECI. Unweighted mean CCI and ECI scores were compared across demographic variables. Results: An increase in mean CCI and ECI scores across age, sex, and races (p<.001) was identified. Compared to the youngest age group (55-59y), all age groups had higher mean CCI and ECI adjusting for time (p<.001). Increases were greatest in older age groups until age 80-84 for CCI and 85-89 for ECI. The female group had lower CCI adjusting for time (p<.001) compared to males. There was no difference between sex groups in mean ECI (p=.409). Compared with the White group, all other race groups had higher mean CCI adjusting for time (p<.001). Black inpatients had the highest CCI followed by Native American inpatients. Findings were similar for ECI, but with no difference between Hispanic and White groups (p=.434). Conclusions: Growing multimorbidity burden among adult inpatients across age, sex, and race supports the continued need for programs for preventing and reducing multimorbidity, especially among communities that experience health inequity including older, Black, and Native American patients. [ABSTRACT FROM AUTHOR]

Background We aimed to analyse the differences in the risk of geriatric syndromes between older adults with and without coronavirus disease 2019 (COVID-19). Methods We conducted a retrospective cohort study of patients from the US Collaborative Network in the TriNetX between January 1, 2020, and December 31, 2022. We included individuals aged older than 65 years with at least 2 health care visits who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests during the study period. We excluded those with SARS-CoV-2 vaccination, diagnosis with neoplasm and geriatric syndromes before the index date, and death within 30 days after the index date. The index date was defined as the first date of the PCR test for SARS-CoV-2 during the study period. Hazard ratios (HRs) and 95% confidence intervals (CIs) for eight geriatric syndromes were estimated for propensity score-matched older adults with and without COVID-19. Subgroup analyses of sex and age were also performed. Results After propensity score matching, 315 826 patients were included (mean [standard deviation] age, 73.5 [6.4] years; 46.7% males and 51.7% females). The three greatest relative increases in the risk of geriatric syndromes in the COVID-19 cohort were cognitive impairment (HR: 3.13; 95% CI: 2.96–3.31), depressive disorder (HR: 2.72; 95% CI: 2.62–2.82) and pressure injury (HR: 2.52; 95% CI: 2.34–2.71). Conclusions The risk of developing geriatric syndromes is much higher in the COVID-19 cohort. It is imperative that clinicians endeavour to prevent or minimise the development of these syndromes in the post-COVID-19 era. [ABSTRACT FROM AUTHOR]

Participation in high school sports has physical, physiological, and social development benefits, while also increasing the risk of acute and overuse injuries. Risk of sport-related overuse injury differs between boys and girls. To investigate differences in overuse injuries among US high school athletes participating in the gender-comparable sports of soccer, basketball, and baseball/softball. Descriptive epidemiology study using a nationally representative sample from the High School Reporting Information Online (RIO) database. High schools. Athletes with overuse injuries during the 2006–2007 through 2018–2019 academic years. National estimates and rates of overuse injuries were extrapolated from weighted observed numbers with the following independent variables: sport, gender, academic year, class year, event type, body site, diagnosis, recurrence, activity, and position. Among an estimated 908 295 overuse injuries nationally, 43.9% (n = 398 419) occurred in boys' soccer, basketball, and baseball, whereas 56.1% (n = 509 876) occurred in girls' soccer, basketball, and softball. When comparing gender across sports, girls were more likely to sustain an overuse injury than boys (soccer, injury rate ratio [IRR]: 1.37, 95% CI = 1.20–1.57; basketball, IRR: 1.82, 95% CI = 1.56–2.14; baseball/softball, IRR: 1.21, 95% CI = 1.04–1.41). Most overuse injuries in soccer and basketball for both genders occurred to a lower extremity (soccer: 83.9% [175 369/209 071] for boys, 90.0% [243 879/271 092] for girls; basketball: 77.0% [59 239/76 884] for boys, 80.5% [81 826/101 709] for girls), whereas most overuse injuries in baseball and softball were to an upper extremity (72.5% [81 363/112 213] for boys, 53.7% [73 557/136 990] for girls). For boys' baseball, pitching (43.5% [47 007/107 984]) was the most common activity associated with an overuse injury, which differed from the most common activity of throwing (31.7% [39 921/126 104]) for girls' softball. Gender differences observed in this study can help guide future strategies that are more specific to gender and sport to reduce overuse injuries among high school athletes. [ABSTRACT FROM AUTHOR]

The objective of the study is to explore the associations of screen time, cyberbullying victimization, and suicidality during the COVID‐19 pandemic in female and male high school schools, especially the sex differences in the mediation effect of cyberbullying on the relation between screen time and suicidality. This study analysed the direct paths and mediation effects between variables among the 13,982 participants (female: 49%; male: 51%; age 15–17: 74%) in the Youth Risk Behaviour Survey 2021 (YRBS) using the Structural Equation Model and the Monte Carlo methods in Stata. Multiple‐group analysis was conducted to compare sex differences in the mediation effects. Elevated screen time increased the likelihood of suicide ideation (male: OR: 1.50, 95% CI: 1.26–1.79; female: OR: 1.47, 95% CI: 1.28–1.70), suicide plan (male: OR: 1.56, 95% CI: 1.29–1.89; female: OR: 1.45, 95% CI: 1.24–1.69), suicide attempts (female: OR: 1.23, 95% CI: 1.02–1.48). Cyberbully victims had higher odds of suicide ideation (female: OR: 3.69, 95% CI: 3.25–4.17; male: OR: 4.50; 95% CI: 3.80–5.34), suicide plan (female: OR: 3.74; 95% CI: 3.28–4.25; male: OR: 5.03; 95% CI: 4.22–6.01), and suicide attempt (female: OR: 4.24; 95% CI: 3.66–4.92; male: OR: 4.70; 95% CI: 3.81–5.79). Sex differences were revealed in the mediation effects on suicide ideations (χ2(2) = 8.72, p <.05), suicide attempts (χ2(2) = 8.80, p <.05), and suicide overall (χ2(2) = 6.42, p <.05), where the effects were stronger in female students than in males. Screen time and cyberbullying victimization were directly associated with suicide‐related behaviours in adolescents. Cyberbullying victimization in females had stronger mediation effects than in males. These findings emphasized the importance of understanding the new hybrid psychosocial dynamics and creating a healthy hybrid psychosocial environment, especially for female adolescents. [ABSTRACT FROM AUTHOR]

Goal: This research aimed to evaluate variations in perceived organizational support among physicians during the first year of the COVID-19 pandemic and the associations between perceived organizational support, physician burnout, and professional fulfillment. Methods: Between November 20, 2020, and March 23, 2021, 1,162 of 3,671 physicians (31.7%) responded to the study survey by mail, and 6,348 of 90,000 (7.1%) responded to an online version. Burnout was assessed using the Maslach Burnout Inventory, and perceived organizational support was assessed by questions developed and previously tested by the Stanford Medicine WellMD Center. Professional fulfillment was measured using the Stanford Professional Fulfillment Index. Principal Findings: Responses to organizational support questions were received from 5,933 physicians. The mean organizational support score (OSS) for male physicians was higher than the mean OSS for female physicians (5.99 vs. 5.41, respectively, on a 0-10 scale, higher score favorable; p < .001). On multivariable analysis controlling for demographic and professional factors, female physicians (odds ratio [OR] 0.66; 95% CI: 0.55-0.78) and physicians with children under 18 years of age (OR 0.72; 95% CI: 0.56-0.91) had lower odds of an OSS in the top quartile (i.e., a high OSS score). Specialty was also associated with perceived OSS in mean-variance analysis, with some specialties (e.g., pathology and dermatology) more likely to perceive significant organizational support relative to the reference specialty (i.e., internal medicine subspecialty) and others (e.g., anesthesiology and emergency medicine) less likely to perceive support. Physicians who worked more hours per week (OR for each additional hour/week 0.99; 95% CI: 0.99-1.00) were less likely to have an OSS in the top quartile. On multivariable analysis, adjusting for personal and professional factors, each one-point increase in OSS was associated with 21% lower odds of burnout (OR 0.79; 95% CI: 0.77-0.81) and 32% higher odds of professional fulfillment (OR 1.32; 95% CI: 1.28-1.36). Practical Applications: Perceived organizational support of physicians during the COVID-19 pandemic was associated with a lower risk of burnout and a higher likelihood of professional fulfillment. Women physicians, physicians with children under 18 years of age, physicians in certain specialties, and physicians working more hours reported lower perceived organizational support. These gaps must be addressed in conjunction with broad efforts to improve organizational support. [ABSTRACT FROM AUTHOR]

Objective: Attachment style and social support networks (SSN) are associated with suicide ideation (SI) and suicide attempt (SA). How these two factors interact is important to understanding the mechanisms of risk for suicidal behaviors and identifying interventions. Method: Using the Army Study to Assess Risk and Resilience in Servicemembers New Soldier Study (N = 38,507 soldiers), we examined how three attachment styles (preoccupied, fearful, and secure) and SSN (smaller vs larger) were associated with lifetime SI, SA, and SA among soldiers with SI. The interaction of each attachment style by SSN was examined. Results: All three attachment styles were associated with SI and SA in the total sample (for SA: preoccupied OR = 2.82, fearful OR = 2.84, and secure OR = 0.76). Preoccupied and fearful attachment were associated with SA among suicide ideators. Smaller SSN was associated with a higher risk for all three outcomes (range of ORs = 1.23–1.52). The association of SSN with SI and with SA among suicide ideators was significantly modified by the presence or absence of preoccupied attachment style. Among soldiers without preoccupied attachment, larger SSN was associated with lower risk of SI. Among suicide ideators with preoccupied attachment, a larger SSN was associated with lower risk of SA. Conclusion: This study highlights the need for increased understanding of the role of attachment style and social networks in suicide risk, in particular preoccupied attachment among soldiers with SI. A critical next step is to explore these relationships prospectively to guide intervention development. [ABSTRACT FROM AUTHOR]

Background: U.S. military veterans may be reluctant to disclose suicidal thoughts and behaviors. Suicide-specific cognitions, which generally avoid direct mention of suicide, may be reliable indicators of risk among those reluctant to disclose such thoughts and behaviors. Methods: Data from a population-based, cross-sectional study of 2,430 U.S. military veterans were analyzed to examine the associations between the Brief Suicide Cognitions Scale (B-SCS), suicidal ideation, and suicide planning. Results: After adjusting for age, sex, number of adverse childhood experiences, cumulative trauma burden, depressive symptom severity, and lifetime history of suicide attempt, total scores on the B-SCS (excluding the item mentioning suicide) were uniquely associated with suicidal ideation (odds ratio [OR] = 1.23, 95% confidence interval [CI] = 1.15–1.32) and suicide planning (OR = 1.27, 95%CI = 1.18–1.37). Exploratory post-hoc analyses revealed that difficulties with solving and coping with one's problems were uniquely linked to these outcomes. Conclusions: Assessment of suicide-specific cognitions may help to enhance suicide detection and prevention in veterans, especially in those who may not directly disclose thoughts of suicide. Intervention efforts to bolster perceived deficits in coping and problem-solving may help mitigate suicide risk in this population. [ABSTRACT FROM AUTHOR]

Background and Objectives Significant societal and technological changes in the 2010s called for an up-to-date understanding of the digital divide among older adults in the United States. This trend study aimed to examine the effects of race/ethnicity and the intersecting effects of race/ethnicity with other marginalized identities related to gender, income, education, and occupation on the first- and second-level digital divide. Research Design and Methods Utilizing a nationally representative sample of older community dwellers from the National Health and Aging Trends Study, we conducted weighted logistic regressions at 3 time points (2011/2013, 2015, and 2019). The first-level digital divide was measured by access to working phones or computers/laptops; the second-level divide was measured by 7 activities in personal task, social, and health-related Internet use. Results The first-level racial/ethnic digital divide became nonsignificant in 2019, whereas the disparities in all second-level measures persisted. The intersecting effects of race/ethnicity with low education and/or low income became nonsignificant in 2019 for personal-task use. However, the interactions with low education and/or low income became significant for social and health-related use in 2015 and/or 2019. Discussion and Implications This study highlights the persistence of the second-level racial/ethnic digital divide among older community dwellers in the United States, especially the exacerbated social and health-related digital divide for people of color with low socioeconomic status. By considering intersections of marginalized social identities, policymakers and stakeholders should develop targeted strategies to bridge the digital divide, promote health outcomes, and reduce health disparities. [ABSTRACT FROM AUTHOR]

Objective: To describe the epidemiology of hamstring tears in National Collegiate Athletic Association (NCAA) sports. Design: Descriptive epidemiology study. Athletic trainers from NCAA schools reported injuries to the NCAA Injury Surveillance Program. Setting: A convenience sample of NCAA hamstring tear injuries during the 2014/2015 through 2018/2019 academic years. Patients (or Participants): NCAA student-athletes. Independent Variables: Sport, sex, event type, season segment, injury history, and activity at the time of injury. Main Outcome Measures: Injury counts, rates, and proportions were used. Results: Two thousand ninety-six hamstring tears from 8 474 400 athlete-exposures (AEs) were reported (2.47 per 10 000 AEs). Rates were highest in Men's Soccer (5.97 per 10 000 AEs) and Women's Soccer (3.13 per 10 000 AEs), among all Men's and Women's sports, respectively. Competition-related rates in Men's and Women's sports were highest in 2015 to 2016 then followed a decreasing pattern across the remainder of the study period. Among sex-comparable sports, rates were higher in men's (compared with women's) Baseball/Softball, Soccer, and Track and Field. The prevalence of recurrent injuries was comparable among men's (14.8%) and women's (11.5%) sports. Time loss hamstring tears were more prevalent in Men's sports than Women's sports [injury proportion ratio 5 1.33; 95% confidence interval, (1.21, 1.47)]. Conclusions: Overall, hamstring tear rates were higher across all Men's sports compared with Women's sports. Rates across event type were comparable in several sports; and so, adjustments to practice are needed considering that practice environments are more modifiable than competitions. Indeed, improving hamstring tear prevention programs to reduce the burden of this injury in NCAA athletes remains critical. [ABSTRACT FROM AUTHOR]

Simple Summary: It is known that there are sex differences in adverse events experienced following cancer treatment. However, little is known about sex differences in adverse events experienced in individuals with metastatic cancer. Here, using SEER-Medicare data, we investigate sex differences in adverse events in lung cancer individuals with brain metastasis who are 66 years old and older. Sex differences in adverse events were observed and were dependent on lung cancer histology, age at diagnosis, year of diagnosis and treatment as well as potential interplay between these variables. Sex differences are evident in adverse events (AEs) related to brain tumors, yet sex differences in AEs specific to brain metastases (BrMs) are underexplored. Lung cancer BrMs dominate among BrM, comprising over half of cases. This study examined sex differences in AEs associated with lung cancer BrMs in individuals aged 66 or older using the SEER-Medicare dataset. Multivariable logistic regression, adjusted for demographic factors and comorbidities, stratified by histological subtype, treatment, age, and year of diagnosis were used to analyze AEs among those with BrMs from primary lung tumors. Year of diagnosis was grouped into prior/post-2013, to account for shifts in treatment paradigms. The results showed nuanced sex-specific AEs. Females diagnosed post-2013 with small-cell, squamous-cell, or other non-small-cell carcinoma BrMs had a higher headache likelihood than males. Males with adenocarcinoma post-2013 were more likely to experience brain herniation. Females aged 76 and older with small-cell BrM exhibited increased vision difficulty risk compared to males of the same age, with no significant difference in other age groups. Males treated for adenocarcinoma faced heightened hemorrhagic stroke risk. This study reveals sex-specific disparities in AEs among older individuals with lung cancer BrMs, varying by histological subtype, age, diagnosis year, and treatment. [ABSTRACT FROM AUTHOR]

Objectives IgG4-related disease (IgG4-RD) can affect nearly any organ and is often treated with glucocorticoids, which contribute to organ damage and toxicity. Comorbidities and healthcare utilization in IgG4-RD are poorly understood. Methods We conducted a cohort study using claims data from a US managed care organization. Incident IgG4-RD cases were identified using a validated algorithm; general population comparators were matched by age, sex, race/ethnicity and index date. The frequency of 21 expert-defined clinical outcomes associated with IgG4-RD or its treatment and healthcare-associated visits and costs were assessed 12 months before and 36 months after the index date (date of earliest IgG4-RD-related claim). Results There were 524 cases and 5240 comparators. Most cases received glucocorticoids prior to (64.0%) and after (85.1%) the index date. Nearly all outcomes, many being common glucocorticoid toxicities, occurred more frequently in cases vs comparators. During follow-up, the largest differences between cases and comparators were seen for gastroesophageal reflux disease (prevalence difference: +31.2%, P  < 0.001), infections (+17.3%, P  < 0.001), hypertension (+15.5%, P  < 0.01) and diabetes mellitus (+15.0%, P  < 0.001). The difference in malignancy increased during follow-up from +8.8% to +12.5% (P  < 0.001). Some 17.4% of cases used pancreatic enzyme replacement therapy during follow-up. Over follow-up, cases were more often hospitalized (57.3% vs 17.2%, P  < 0.01) and/or had an emergency room visit (72.0% vs 36.7%, P  < 0.01); all costs were greater in cases than comparators. Conclusions Patients with IgG4-RD are disproportionately affected by adverse outcomes, some of which may be preventable or modifiable with vigilant clinician monitoring. Glucocorticoid-sparing treatments may improve these outcomes. [ABSTRACT FROM AUTHOR]

Objective: To describe the work experience and respiratory health of women coal miners in the United States using Coal Workers' Health Surveillance Program (CWHSP) data. Methods: Analysis included CWHSP participants with self-reported sex of female between January 1, 1970, and December 31, 2022, and examined radiographic surveillance, demographics, and job history. National Institute for Occupational Safety and Health-certified physicians classified chest radiographs. Results: Among 8,182 women participants, most worked <10 years and a majority reported working in non-dusty jobs. Among 3,392 with ≥1 year of coal mining tenure, 18 (0.5%) had evidence of pneumoconiosis, with no cases of progressive massive fibrosis. Conclusion: Women coal miners participating in the CWSHP had short mining careers and low pneumoconiosis prevalence. Few worked in the most dusty jobs, indicating limited exposure to coal mine dust. This underscores the need to explore women's roles in mining, and for improved gender-specific employment reporting. Such changes can enhance health and work conditions for women in male-dominated industries. [ABSTRACT FROM AUTHOR]

Childhood physical maltreatment may contribute to the onset of borderline personality disorder (BPD) features in adolescence; however, the mechanisms explaining this association warrant investigation. This study focused on insecure attachment styles as mediators in this relationship among a sample of adolescents. Analyses were also conducted to determine whether gender moderated the association between physical maltreatment and BPD features. The sample consisted of 529 Italian adolescents between 14 and 18 years (Mage = 16.48, SD = 1.37). Participants completed a survey including three self-report questionnaires: CTQ-SF, ASQ, and BPI. Physical abuse was related to BPD features through insecure-anxious and insecure-avoidant attachment styles, whereas physical neglect was associated with BPD features only through insecure-avoidant attachment. Gender moderated the pathway between physical maltreatment and BPD features so that boys who experienced childhood physical abuse and neglect reported more BPD features than girls. This study expanded our knowledge of the role of insecure attachment styles in the onset of BPD features among adolescents with early experiences of childhood physical maltreatment. This study also advances our understanding of potential gender differences in the childhood maltreatment-BPD features link in adolescents. [ABSTRACT FROM AUTHOR]

Challenges for some women meeting the physical employment standards (PES) for ground close combat (GCC) roles stem from physical fitness and anthropometric characteristics. The purpose of this study was to identify the modifiable and nonmodifiable characteristics predictive of passing GCC‐based PES tasks and determine the modifiable characteristics suitable to overcome nonmodifiable limitations. 107 adults (46 women) underwent multiday testing assessing regional and total lean mass (LM), percent body fat (BF%), aerobic capacity (V̇O2peak), strength, power, and PES performance. Predictors with p‐value <0.200 were included in stepwise logistic regression analysis or binary logistic regression when outcomes among sexes were insufficient. Relative and absolute arm LM (OR: 4.617–8.522, p < 0.05), leg LM (OR: 2.463, p < 0.05), and upper body power (OR: 2.061, p < 0.05) predicted medicine ball chest throw success. Relative and absolute arm LM (OR: 3.734–11.694, p < 0.05), absolute trunk LM (OR: 2.576, p < 0.05), and leg LM (OR: 2.088, p < 0.05) predicted casualty drag success. Upper body power (OR: 3.910, p < 0.05), absolute trunk LM (OR: 2.387, p < 0.05), leg LM (OR: 2.290, p < 0.05), and total LM (OR: 1.830, p < 0.05) predicted maximum single lift success. Relative and absolute arm LM (OR: 3.488–7.377, p < 0.05), leg LM (OR: 1.965, p < 0.05), and upper body power (OR: 1.957, p < 0.05) predicted water can carry success. %BF (OR: 0.814, p = 0.007), V̇O2peak (OR: 1.160, p = 0.031), and lower body strength (OR: 1.059, p < 0.001) predicted repeated lift and carry success. V̇O2peak (OR: 1.540, p < 0.001) predicted 2‐km ruck march success. Modifiable characteristics were the strongest predictors for GCC‐based PES task success to warrant their improvement for enhancing PES performance for women. Highlights: Women in GCC roles require sufficient military‐specific physical fitness and anthropometric parameters, independent of sex, for successfully passing GCC‐based PES tasks as part of assessment testing and selection procedures for GCC roles.Passing GCC‐based PES tasks involving heavy lifting, dragging, pushing/throwing, and carrying may benefit from increased upper body (arm and trunk) and lower body lean mass and upper body power and maximal strength, whereas passing material handling tasks may benefit from lower percent body fat, greater lower body muscular strength, and higher aerobic capacity with the latter important for passing load carriage tasks.Military trainers should target modifiable characteristics, including upper body lean mass, power, and maximal strength to improve GCC‐based PES task performance in women. [ABSTRACT FROM AUTHOR]

Objectives Adult child socioeconomic status (SES) has been identified as a predictor of older parents' cognitive aging. However, studies have primarily relied on educational attainment as the sole measure of adult child SES. We evaluated the relationship between adult children's financial disadvantage and cognitive outcomes of older parents in the United States. Methods We used data from U.S. Health and Retirement Study (2000–2014, n = 15,053 respondents ≥51 years with at least 1 adult child). Adult child financial disadvantage was measured with 3 indicators of extremely low income, unemployment, and lack of homeownership. We used linear mixed models to estimate the association between adult child financial disadvantage and the rate of decline in verbal memory scores, controlling for respondents' sociodemographic characteristics. Results Having at least 1 adult child (vs no adult children) with extremely low income was found to be associated with lower verbal memory (b = −0.041, 95% confidence interval [CI]: −0.043, −0.039) at baseline. There was a small but significant association with the rate of decline in verbal memory z -scores (b = 0.004, 95% CI: 0.000, 0.008) and some evidence of heterogeneity by parent gender, marital status, and SES. Discussion Offspring financial disadvantage may be influential for older parents' initial level of memory function, although evidence of associations with memory decline was weak. Public policy interventions aimed at improving the economic conditions of adult children may indirectly benefit the cognitive performance of disadvantaged parents in their later life. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the voices of South Asian youth in the United States about gender norms and healthcare decision making. Ten focus group discussions were held with 36 students of South Asian origin at a university on the West Coast of the United States. Thematic analysis was performed on the focus group data. Three main themes emerged from the data: (1) intersectionality of gender with other factors that affect healthcare decision making, (2) impact of gender on health, and (3) coping strategies. Participants reported preferential treatment for boys versus girls, vesting decision-making control among males, worse health among females, and coping strategies. A few responses indicated that power differentials in some families were shifting to a more egalitarian balance between males and females. Aspects such as age, employment, and language barriers intersected with gender to create a complex web of influence on healthcare decision making. The study has implications for social workers to offer culturally responsive support to South Asian youth in the United States, paying attention to the intersectionalities when working with them. Further research is needed to explore the influence of gender on healthcare decision-making processes of South Asian youth in the United States. [ABSTRACT FROM AUTHOR]

We examined current levels of sexual prejudice among US college athletes and non-athletes (N = 451), accounting for the impact of traditional masculinity ideology and exclusivity of athletic identity. While no significant multivariate gender x athlete status interaction was found on sexual prejudice, significant main effects occurred for both gender (p < .001, ηp² = .10) and athlete status (p = .28, ηp² = .04). Men reported significantly greater sexual prejudice than women and athletes reported significantly greater sexual prejudice than non-athletes. When controlling for traditional masculinity ideology, gender differences were eliminated (p = .11, ηp² = .01). Similarly, when controlling for athletic identity, significant differences between athletes and non-athletes were no longer present (p = .13, ηp² = .01). [ABSTRACT FROM AUTHOR]

The twofold objective of this study was to examine the relationships between: (a) overall life skills and attitudes toward aggressive and violent behaviors outside of sport; and (b) specific life skills and attitudes toward aggressive and violent behaviors outside of sport. A sample of 84 university club sport athletes (Mage = 20.83, SD = 1.49) at a single mid-sized university in the United States completed an online survey. Data collection was conducted using the Life Skills Scale for Sport and Code of the Street scale (i.e., attitudes toward aggressive and violent behavior). A series of 2-stage hierarchical multiple regression analyses, with attitudes toward aggressive and violent behavior as the dependent variable, were performed for overall life skills and eight unique life skills. In stage one, gender and sport type served as covariates. In stage two, life skill(s) were added as the independent variable. Results indicate that overall life skills (β = -.329, p < .001) significantly and negatively predict club sport athletes' attitudes toward aggressive and violent behavior outside of sport (R² = 0.420, p < .001). Similarly, emotional skills (R²model = .421, β = -.333, p < .001), time management (R²model = .378, β = -.256, p = .005), problem solving R2model = .410, β = -.320, p = .001), social skills R²model = .392, β = -.284, p = .002), teamwork (R2model = .397, β = -.291, p = .001), leadership (R2model = .413, β = -.316, p < .001), each independently made a negative and significant contribution to attitudes toward aggressive and violent behavior outside of sport. However, goal setting (p = .094) and communication (p = .016) were not significant predictors. Considering the affinity between attitudes and behaviors, findings suggested that, for university club sport athletes, overall life skills and certain unique life skills may help inhibit aggressive and violent behaviors outside of sport. Such findings provide insight for administrators, coaches, and other stakeholders servicing the needs of university club sport athletes. [ABSTRACT FROM AUTHOR]

Gender differences in wage negotiations have been offered as a popular explanation for why the gender gap in pay persists in the United States. In this study, we use data from an artificial wage negotiation experiment (N = 307) to examine the relationship between gender and wage negotiations and to test whether gender-role attitudes moderate this relationship. We find that gender-role attitudes moderate how gender influences the decision to negotiate, but not the outcomes of negotiations, and that forced negotiations do not lead to additional gains for women regardless of their gender-role attitudes. We conclude with a discussion of implications and directions for future research. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the relationship among constructs of the Breastfeeding Relationship Scale and exclusive direct breastfeeding (EDBF) while controlling for covariates in US breastfeeding dyads in the first 3 months. Background: The Breastfeeding Relationship Scale was developed to measure mother-infant mutual responsiveness during breastfeeding in response to perceived insufficient milk, but there is no clear understanding about the relationships between the Breastfeeding Relationship Scale's constructs and EDBF. Methods: A cross-sectional design was used. The convenience sample of 589 directly breastfeeding mothers in the US whose infants were between 1 and 12 weeks of age were included for analysis using a structural equation model. Covariates for EDBF included mother's age, education, marital status, parity, prior breastfeeding experience, infant's age, weight, and sex. Results: Mother-Infant Breastfeeding Interaction and Breastfeeding Synchronicity were related (β = 0.33, p <.001), as were Breastfeeding Synchronicity and Perceived Adequate Milk Supply (β = 0.35, p <.001) and Mother-Infant Breastfeeding Interaction and Perceived Adequate Milk Supply (β = 0.08, p =.05). The relationship between Mother-Infant Breastfeeding Interaction and Breastfeeding Synchronicity with EDBF was fully mediated by Perceived Adequate Milk Supply, where the odds of EDBF was higher for mothers with higher scores on Perceived Adequate Milk Supply (OR = 1.61, p <.001) and prior breastfeeding experience (OR = 2.31, p =.006). Conclusions: Perceived Adequate Milk Supply and prior breastfeeding experience are major determinants of EDBF in the first 3 months. Breastfeeding Synchronicity can bolster Mother-Infant Breastfeeding Interaction and promote Perceived Adequate Milk. More attention should be paid to breastfeeding relationship to be the result of EDBF. [ABSTRACT FROM AUTHOR]