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Globalization has changed the landscape of higher education. The purpose of this study is to enhance understanding of how higher education leaders are engaging emerging questions about successful leadership, particularly when it comes to international student populations in times of crisis. Guided by the Intercultural Leadership framework, this comparative case study illuminates how university presidents from eight different countries were informed in their perceptions of international students and how they acted to support this vulnerable population. The results of this analysis highlight practical implications for higher education leaders to utilize when navigating global crises while protecting international student populations.

Purpose: Practice-based teacher education (PBTE) has been proposed as an approach to combat forms of teacher education that create prescriptive understandings of teaching that are disconnected from practice. In physical education, PBTE is becoming more prevalent. Some have argued that many of its elements have been in use for some time, whereas other elements have been refined or are new. In this study, we were motivated to examine the use of PBTE by physical education teacher educators and their perceptions of PBTE. Method: Participants were nine teacher educators from the United States (n = 6), Turkey (n = 2), and Belgium (n = 1). Surveys were used to gather data on the use of PBTE and the perceptions of teacher educators. Data describing the use of PBTE in their programs were descriptively analyzed. Our perceptions were interpreted using an intrinsic case study with PBTE serving as the case. Findings: Programs adopted similar and different elements of PBTE. Four themes emerged relative to the perceptions of teacher educators about PBTE: (a) how the context of the teacher educator influences their use of PBTE, (b) teacher educators' use of PBTE, (c) the advantages of using PBTE, and (d) a critical analysis of PBTE. Conclusion: Our approach to operationalizing PBTE may help encourage useful conversations in physical education teacher education.

Mexican American educational history has become a vibrant field of study since the late 1980s. In the last seven years, however, it is notable that this research has inspired community-based efforts to preserve and publicly commemorate challenges to unequal education. In this commentary, we discuss the archival recovery of the "Francisco Maestas et al. v. George Shone et al." case in Alamosa, Colorado; the excavation of El Colegio Altamirano in Hebbronville, Texas; the complexity of memorializing the "Mendez v. Westminster" case in Orange County, California; and the implications of archival and oral history research connected to the "Soria v. Oxnard School Board of Trustees" case in Oxnard, California. These examples illuminate the highly contested spaces that public schools held for Mexican Americans and the role scholars and communities can play in acknowledging those moments. We see public schooling as a place where liberation and hope can occur and where scholars and communities can engage together. This is a call to continue to create relationships that lead to the recognition of past struggles and acknowledge the enduring quest for educational equality.

In this article I review 83 empirical studies that provide insight into the secondary school experiences of trans youth. The studies show that while some trans youth have affirming experiences, the majority are exposed to institutionalized cisnormativity that makes them vulnerable to macroaggressions, microaggressions and violence within school settings. Trans youth's exposure to institutionalized cisnormativity was found to intersect with multiple vectors of social power, which subject some trans youth to multiple forms of disadvantage, while affording others degrees of privilege. In conclusion, the findings show that trans youth's educational experiences reflect broader structural inequalities yet defy essentialising explanations.

Background: Evidence on long COVID symptom clustering patterns among patients with COVID-19 is limited. We summarized long COVID symptoms in clusters defined by number of symptoms co-occurring together, and we assessed Health-Related Quality of Life (HQRoL), Work Productivity and Activity Impairment (WPAI) outcomes across these clusters over time. We assessed associations between the clusters and BNT162b2 vaccination status. Methods: A prospective longitudinal patient-reported outcomes (PRO) study recruited laboratory-confirmed symptomatic COVID-19 patients seeking testing from a national retail pharmacy. Long COVID-19 symptoms were self-reported by participants at 4-week, 3-month and 6-month surveys. Patient classes identified via latent class analysis (LCA) with long COVID-19 symptoms were simplified into clusters based on number of symptoms. HRQoL and WPAI outcomes were collected using EQ-ED-5L and WPAI: GH questionnaires. Mixed models for repeated measures analyses were conducted to examine associations between exposure groups and outcomes. Results: The study included 328 participants that were segmented into three groups of long COVID-19 symptoms based on LCA and then simplified by the number of symptoms (Cluster 1 low, <2; Cluster 2 moderate, 2–6; and Cluster 3 high, >6 symptoms). The number of long COVID-19 symptoms was negatively associated with HRQoL and WPAI, whereby participants with high symptom burden (>6 symptoms) had the lowest HRQoL and WPAI scores assessed by absenteeism, presenteeism, work productivity loss, activity impairment, and hours worked metrics. Compared with those unvaccinated and not up-to-date with COVID-19 vaccination, subjects boosted with BNT162b2 consistently reported less symptom burden during the follow-up, regardless of their symptom-based cluster. Conclusion: Three distinct patient clusters based on frequency of long COVID symptoms experienced different HRQoL and WPAI outcomes over 6 months. The cluster with more concomitant symptoms experienced greater burden than the others. Participants up-to-date with BNT162b2 reported lower symptom burden across all clusters and timeframes. Clinical trial registration: Clinicaltrials.gov NCT05160636. [ABSTRACT FROM AUTHOR]

Purpose: To measure the prevalence of speech-language pathologist (SLP) involvement and associated trends for critically ill children in United States (US) paediatric intensive care units (PICU) through secondary analysis of the Prevalence of Acute Rehab for Kids in the PICU (PARK-PICU) study data. Method: A secondary analysis of cross-sectional point prevalence study conducted over 1 day in 82 US PICUs. Data collected included SLP presence, patients' age, length of stay, medical interventions, aetiology, admission data, Glasgow Coma Scale scores, staffing involvement, and family presence. Result: Among 961 patients, 82 were visited by an SLP on the study day for a prevalence of 8.5%. Most visits were for children <3 years old. The odds of SLP involvement were lower for children who were 7–12 years old (vs. age 0–2; adjusted odds ratio [aOR] 0.28; 95% CI 0.1–0.8), were mechanically ventilated via endotracheal tube (vs. room air; aOR 0.02; 95% CI 0.005–0.11), or had mild or severe disability (mild vs. no disability; aOR 0.34; 95% CI 0.16–0.76 and severe vs. no disability; aOR 0.39; 95% CI 0.17–0.90). Concurrent physical and/or occupational therapy involvement was associated with higher odds of SLP involvement (aOR 3.6; 95% CI 2.1–6.4). Conclusion: SLP involvement is infrequent in US PICUs. PICU teams should be educated about the scope of SLP practice, to support communication and oral feeding needs during early recovery from critical illness. [ABSTRACT FROM AUTHOR]

This study describes medical interpreters' experiences with behavioral health (BH) services in a primary care clinic. Focus group data with medical interpreters representing multiple languages was analyzed using hybrid inductive-deductive thematic analysis. Themes related to interpreter roles were: (1) case management, (2) patient-interpreter relationship, and (3) patient-provider liaison. Themes related to barriers and facilitators to interpreter-mediated BH care were: (1) cultural factors, (2) patient-provider interactions, (3) BH-specific considerations, and (4) clinic factors. Results illustrate ways that interpreters directly (e.g. interpreter-mediated services) and indirectly (e.g. relationship building) support care. The interpreter-patient relationship reportedly helped improve patient attitudes and buy-in for BH. [ABSTRACT FROM AUTHOR]

Background: Teacher education is a complex endeavor designed to prepare preservice teachers for the task of teaching physical education to students in K–12 schools. Yet, there is widespread criticism of teacher education outcomes within the United States and around the world. Consequently, teacher educators have been increasingly called upon to use evidence-based approaches in teacher education. Purpose: In this article, we discuss a teacher education reform called practice-based teacher education from macro and micro perspectives. Discussion: Practice-based teacher education emphasizes a curriculum that is focused on relevance defined in terms of what a teacher needs to know and do to be able to teach physical education. Evidence for curricular changes to physical education teacher education and to the content and pedagogies of methods and content classes are presented. We conclude with a discussion of how practice-based teacher education can address social injustice. [ABSTRACT FROM AUTHOR]

This paper characterizes household spending in education using microdata from income and expenditure surveys for twelve Latin American and Caribbean countries and the United States. Bahamas, Chile, and Mexico have the highest household spending in education and Bolivia, Brazil, and Paraguay have the lowest. Tertiary education is the most important form of spending, and most educational spending is performed for 18- to 23-year-old individuals. More educated and wealthier household heads spend more in the education of household members. Households with both parents present and those with a female main income provider spend more than their counterparts. Urban households also spend more than rural households. On average, education in Latin America and the Caribbean is a luxury good, whereas it may be a necessity in the United States. No gender bias is found in primary education, but at secondary school age and up households invest more in females than in males.

Globalizing forces have both transformed the higher education sector and made it increasingly homogenous. Growing similarities among universities have been attributed to isomorphic pressures to ensure and/or enhance legitimacy by imitating higher education institutions that are perceived as successful internationally, particularly universities that are highly ranked globally (Cantwell & Kauppinen, 2014; DiMaggio and Powell, 1983). In this study, we compared the strategic plans of 78 high-ranked, low-ranked, and unranked universities in 33 countries in 9 regions of the world. In analyzing the plans of these 78 universities, the study explored patterns of similarity and difference in universities' strategic positioning according to Suchman's (1995) 3 types of legitimacy: cognitive, pragmatic, and moral. We found evidence of stratified university strategies in a global higher education landscape that varied by institutional status. In offering a corrective to neoinstitutional theory, we suggest that patterns of globalization are mediated by status-based differences in aspirational behavior (Riesman, 1958) and "old institutional" forces (Stinchcombe, 1997) that contribute to differently situated universities pursuing new paths in seeking to build external legitimacy.

Background: The field of robotic-assisted surgery is rapidly growing as many robotic surgical devices are in development and about to enter the market. Currently, there is no universally accepted language for labeling the different robotic systems. To facilitate this communication, we created what is, to our knowledge, the first classification of surgical robotic technologies that organizes and classifies surgical robots used for endoscopy, laparoscopy and thoracoscopy. Methods: We compiled a list of surgical robots intended to be used for endoscopy, laparoscopy, and/or thoracoscopy by searching United States, European, Hong Kong, Japan, and Korean databases for approved devices. Devices showcased at the 2023 Annual Meeting for the Society of Robotic Surgery were added. We also systematically reviewed the literature for any existing surgical robotic classifications or categorizations. We then created a multidisciplinary committee of 8 surgeons and 2 engineers to construct a proposed classification of the devices included in our search. Results: We identified 40 robotic surgery systems intended to be used for endoscopy, laparoscopy and/or thoracoscopy. The proposed classification organizes robotic devices with regard to architecture, port design, and configuration (modular carts, multi-arm integrated cart, table-attachable or arm-table integration). Conclusion: This 3-level classification of robotic surgical devices used for endoscopy, laparoscopy and/or thoracoscopy describes important characteristics of robotic devices systematically. [ABSTRACT FROM AUTHOR]

Working forests comprise a large proportion of forested landscapes in the southeastern United States and are important to the conservation of bats, which rely on forests for roosting and foraging. While relationships between bat ecology and forest management are well studied during summer, winter bat ecology remains understudied. Hence, we aimed to identify the diet composition of overwintering bats, compare the composition of prey consumed by bat species, and determine the potential role of forest bats as pest controllers in working forest landscapes of the southeastern U.S. Coastal Plain. During January to March 2021–2022, we captured 264 bats of eight species. We used DNA metabarcoding to obtain diet composition from 126 individuals of seven bat species identifying 22 orders and 174 families of arthropod prey. Although Coleoptera, Diptera, and Lepidoptera were the most consumed orders, we found that bats had a generalist diet but with significant differences among some species. We also documented the consumption of multiple insect pests (e.g., Rhyacionia frustrana) and disease vectors (e.g., Culex spp). Our results provide important information regarding the winter diet of bats in the southeastern U.S. Coastal Plain and their potential role in controlling economically relevant pest species and disease vectors. [ABSTRACT FROM AUTHOR]

This paper offers insights into the referencing of Singapore within the US Obama Administration educational discourse, underscoring the political-material-discursive nexus of international educational benchmarking. Using critical discourse analysis, we find that an objectified Singapore functions as a rhetorical tool of US policymaker agendas, with the Organization for Economic Cooperation and Development's (OECD) Programme for International Student Assessment (PISA) and other international assessments as basis for truth statements. US policy discourses on Singapore's education system perpetuate, rather than interrogate, PISA's questionable underlying "truths" around socio-economic development, equity, and excellence, and thus on student achievement and underachievement. Singapore's status as an "Asian Tiger" reference society intertwines with international assessments to form part of an emerging transnational regime of truth, homogenizing what to consider as factual or important, holding sway over views of reality by obscuring other more robust data, research, and lived experiences. In the process of constructing "high performance" around the role education plays in the international economic system, the notion of "low performance" is also discursively constituted and a schemata established for the disciplining of "low performing" bodies through neoliberal policy agendas.

This study examines the influence of cultural context on social distance and perceptions of stigma towards mental health conditions among Latino populations in Houston, TX, USA and Mexico City, Mexico. We employed a community-based experimental vignette survey to assess perceptions towards individuals experiencing symptoms of alcohol misuse, depression, and psychosis. Participants (n = 513) from Houston and Mexico City were asked about their willingness to accept community members experiencing mental health symptoms in various social roles, their perceptions of stigma related to these symptoms, anticipated danger, possible positive outcomes, and the community member's ability to change. Findings demonstrate significant differences in stigma perceptions between Latino respondents in the US and in Mexico. Houston participants reported lower public stigma and perceived dangerousness of someone with mental health concerns compared to respondents in Mexico City. Furthermore, the cultural context may influence the association between various dimensions of stigma, with some inverse relationships occurring based on location of data collection. Findings illuminate the complex interplay between cultural context, mental health symptoms, and stigma, and underscores the need for culturally nuanced interventions to reduce mental health stigma and promote service utilization in Latino communities. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus is a chronic disease that is increasing in global prevalence. An individualized approach to pharmacotherapy should consider costs, benefits beyond glucose control, and adverse events. Metformin is the first-line therapy due to its low cost and effectiveness. Sulfonylureas and thiazolidinediones are additional low-cost oral hypoglycemic classes available in the United States; however, evidence shows variability in weight gain and hypoglycemia. Thiazolidinediones increase fluid retention and are not recommended in patients with New York Heart Association class III or IV heart failure. Newer medications, including glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors, have demonstrated weight loss, reduced cardiovascular events, decreased renal disease, and improved all-cause morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors are recommended for people with known cardiovascular disease, heart failure, and chronic kidney disease but carry an increased risk of urinary tract and mycotic infections. Glucagon-like peptide-1 receptor agonists are contraindicated in patients with active multiple endocrine neoplasia type 2 or a personal or family history of medullary thyroid carcinoma; adverse effects include gastrointestinal upset and pancreatitis. Dipeptidyl-peptidase-4 inhibitors have a low risk of hypoglycemia but may increase the risk of pancreatitis and require a renal dose adjustment. Public and private programs to increase access to newer hypoglycemic medications are increasing; however, there are limitations to access, particularly for uninsured and underinsured people. (Am Fam Physician. 2024; 109(4): 333–342. Copyright © 2024 American Academy of Family Physicians.) Type 2 diabetes mellitus is a chronic disease that is increasing in global prevalence. An individualized approach to pharmacotherapy should consider costs, benefits beyond glucose control, and adverse events. Metformin is the first-line therapy due to its low cost and effectiveness. Sulfonylureas and thiazolidinediones are additional low-cost oral hypoglycemic classes available in the United States; however, evidence shows variability in weight gain and hypoglycemia. Thiazolidinediones increase fluid retention and are not recommended in patients with New York Heart Association class III or IV heart failure. Newer medications, including glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors, have demonstrated weight loss, reduced cardiovascular events, decreased renal disease, and improved all-cause morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors are recommended for people with known cardiovascular disease, heart failure, and chronic kidney disease but carry an increased risk of urinary tract and mycotic infections. Glucagon-like peptide-1 receptor agonists are contraindicated in patients with active multiple endocrine neoplasia type 2 or a personal or family history of medullary thyroid carcinoma; adverse effects include gastrointestinal upset and pancreatitis. Dipeptidyl-peptidase-4 inhibitors have a low risk of hypoglycemia but may increase the risk of pancreatitis and require a renal dose adjustment. Public and private programs to increase access to newer hypoglycemic medications are increasing; however, there are limitations to access, particularly for uninsured and underinsured people. [ABSTRACT FROM AUTHOR]

While smartphone apps for smoking cessation have shown promise for combustible cigarette smoking cessation, their efficacy in helping dual users of combustible and electronic cigarettes (e-cigarettes) to quit cigarettes remains unknown. This study utilized data from a randomized trial to determine if an Acceptance and Commitment Therapy (ACT)-based app (iCanQuit) was more efficacious than a US Clinical Practice Guidelines-based app (QuitGuide) for combustible cigarette smoking cessation among 575 dual users. The primary cessation outcome was self-reported, complete-case 30-day abstinence from combustible cigarettes at 12 months. Logistic regression assessed the interaction between dual use and treatment arm on the primary outcome in the full trial sample (N = 2,415). We then compared the primary outcome between arms among dual users (iCanQuit: n = 297; QuitGuide: n = 178). Mediation analyses were conducted to explore mechanisms of action of the intervention: acceptance of cues to smoke and app engagement. Results: There was an interaction between dual use of combustible and e-cigarettes and treatment arm on the primary outcome (p = 0.001). Among dual users, 12-month abstinence from cigarettes did not differ between arms (23% for iCanQuit vs. 27% for QuitGuide, p = 0.40). Mediation analysis revealed a significant positive indirect effect of the iCanQuit app on 12-month abstinence from cigarettes through acceptance of emotions that cue smoking (p = 0.004). Findings from this study of dual users of combustible and e-cigarettes showed no evidence of a difference in quit rates between arms. Acceptance of emotions that cue smoking is a potential mechanism contributing to cigarette smoking abstinence among dual users. [ABSTRACT FROM AUTHOR]

This qualitative study explored the experiences of people living with HIV (PLWH) in the San Francisco Bay Area, United States, during the COVID-19 pandemic and subsequent public health restrictions at a safety net HIV clinic. Patients (N = 30) were recruited for Spanish/English language semi-structured interviews (n = 30), translated when necessary, and analyzed thematically. The recurring theme of "pandemic expertise" emerged from the data: skills and attitudes developed through living with HIV helped PLWH cope with the COVID-19 pandemic, including effective strategies for dealing with anxiety and depression; appreciation for life; and practical experience of changing behavior to protect their health. A subset did not consider living with HIV helped them adapt to the COVID-19 pandemic, with some describing their lives as chaotic due to housing issues and/or ongoing substance use. Overall, interviewees reported finding trustworthy health information that helped them follow COVID-19 prevention strategies. Although living with HIV is associated with a higher prevalence of mental health concerns, substance use, and stigma, these challenges can also contribute to increased self-efficacy, adaptation, and resilience. Addressing structural issues such as housing appears to be key to responding to both pandemics. [ABSTRACT FROM AUTHOR]

Medication guides (MGs) provide patients with important information about certain prescription drugs to help them take these drugs safely. We surveyed US residents about their perceptions of MG readability and understandability. We randomly sampled 5204 US residents (age 18+) from Ipsos's KnowledgePanel to complete a two-part survey. Only respondents who reported receiving an MG with their prescription drugs (n  = 3852) completed part 2, which included two key items: How easy to [(1) read/ (2) understand ] are the MGs that you have received from a pharmacy along with your prescription medicines? (1 =  Very easy, 5 =  Very difficult ; reverse-coded). Health literacy (HL) and demographic data were also collected. After weighting our data, we found that 85% of respondents who reported receiving an MG perceived this information as 'very easy' (27.3%), 'somewhat easy' (28.3%) or 'about average' (29.3%) to read. Eighty-seven percent of respondents who reported receiving an MG perceived it as 'very easy' (27.6%), 'somewhat easy' (30.2%) or 'about average' (29.5%) to understand. ANOVAs revealed higher average perceived MG reading and comprehension ease scores among respondents presumed to have adequate versus inadequate HL (ps  ≤ 0.0006). Younger or less-educated respondents and non-Hispanic Blacks perceived MGs as easier to read and understand, on average, than their counterparts (p s ≤ 0.0001). Many of these relationships remained intact in models predicting perceived MG reading and comprehension ease (p s ≤ 0.001). Adjusted R 2 values across models were small, however (≤0.06). Our findings suggest most US residents (18+) who received MGs perceived them to be 'about average' to 'very easy' to read and understand. [ABSTRACT FROM AUTHOR]

This study examined mental health needs and risk factors associated with service use among Latinx high school students in two cities in the United States. We explored how socioeconomic characteristics, school location, youth and parental nativity, and self-perceived clinical needs were associated with the odds of youths seeing a mental health provider. Data were collected from 306 Latinx youths during the 2018–19 school year. Most youths (78%) self-reported symptoms of anxiety, trauma, or depression above the clinical range. None of these clinical needs predicted service utilization. Youth experiencing less economic hardship and having a mother from South America were almost five times more likely to use services than their counterparts. Similarly, males and older respondents were more likely to be underserved than females and younger respondents. Implications to ensure equitable access to services among older, low-income Latinx youth, particularly those from Central America, the Caribbean, and Mexico, are discussed. [ABSTRACT FROM AUTHOR]

Faith-based organizations (FBOs) are often "gatekeepers" to mental health care for congregants at risk of mental illness and suicide, especially U.S. military Veterans, but data to inform better collaboration are needed. We conducted focus groups with clergy in Los Angeles County to understand the mental health support FBOs provide and barriers to collaboration with the mental healthcare system. Clergy detailed strategies used to support the mental health of Veteran congregants. Barriers included stigma, limits in clergy training, and incomplete knowledge about community and VA mental health resources. Results suggest strategies to improve collaboration between FBOs and the mental healthcare system in Los Angeles County. [ABSTRACT FROM AUTHOR]

Co-infections are a poorly understood aspect of tick-borne diseases. In the United States alone, nineteen different tick-borne pathogens have been identified. The majority of these agents are transmitted by only two tick species, Ixodes scapularis and Amblyomma americanum. Surveillance studies have demonstrated the presence of multiple pathogens in individual ticks suggesting a risk of polymicrobial transmission to humans. However, relatively few studies have explored this relationship and its impact on human disease. One of the key factors for this deficiency are the intrinsic limitations associated with molecular and serologic assays employed for the diagnosis of tick-borne diseases. Limitations in the sensitivity, specificity and most importantly, the capacity for inclusion of multiple agents within a single assay represent the primary challenges for the accurate detection of polymicrobial tick-borne infections. This review will focus on outlining these limitations and discuss potential solutions for the enhanced diagnosis of tick-borne co-infections. [ABSTRACT FROM AUTHOR]

COVID-19 infection adversely impacts patients' wellbeing and daily lives. This survey-based study examined differences in patient-reported COVID-19 symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Activity Impairment (WPAI) among groups of patients defined based on age and symptom-based long COVID status. Symptomatic, COVID-19-positive US outpatients were recruited from 31 January–30 April 2022. Outcomes were collected via validated instruments at pre-COVID, Day 3, Week 1, Week 4, Month 3 and Month 6 following infection, with changes assessed from pre-COVID and between groups, adjusting for covariates. EQ-5D-5L HRQoL and WPAI scores declined in all groups, especially during the first week. Long COVID patients reported significantly higher symptoms burden and larger drops in HRQoL and WPAI scores than patients without long COVID. Their HRQoL and WPAI scores did not return to levels comparable to pre-COVID through Month 6, except for absenteeism. Patients without long COVID generally recovered between Week 4 and Month 3. Older (>50) and younger adults generally reported comparable symptoms burden and drops in HRQoL and WPAI scores. During the first week of infection, COVID-19-related health issues caused loss of 14 to 26 work hours across the groups. These data further knowledge regarding the differential impacts of COVID-19 on clinically relevant patient groups. [ABSTRACT FROM AUTHOR]

Objective: The Latinx/Hispanic (hereafter, Latinx) population in the United States (US) experiences significant tobacco-related health disparities. Extant work suggests social determinants of health (SDoH) such as perceived discrimination is an individual differences factor for cigarette smoking behavior among Latinx individuals who smoke cigarettes. Other research has suggested sensitivity to internal cues, referred to as anxiety sensitivity, is related to smoking among Latinx adults, but this work has not explored whether anxiety sensitivity may moderate the association between perceived discrimination and smoking behavior. Method: Therefore, the present investigation sought to explore the main and interactive association of perceived discrimination and anxiety sensitivity in relation to cigarettes smoked per day, severity of problems experienced when quitting, and perceived barriers for smoking cessation among 338 English-speaking Latinx individuals living in the US (Mage = 35.5 years; SD = 8.65; age range 18–61; 37.3% female) who smoke cigarettes. Results: Results supported statistically significant main effects for perceived discrimination and anxiety sensitivity in relation to increased severity of problems experienced when quitting and perceived barriers for smoking cessation. These associations were evident after adjusting for a sociodemographic covariates. Conclusion: Overall, the present investigation suggests that both perceived discrimination and anxiety sensitivity are important constructs relevant to understanding smoking processes among Latinx adults who smoke cigarettes and should be integrated in theoretical models of smoking among this population. [ABSTRACT FROM AUTHOR]

Background: Clinical Practice Guidelines for Gulf War Illness (GWI) recommend integrative health approaches such as yoga for relief from symptoms, yet little is known about the long-term efficacy of yoga in reducing symptoms of GWI. Here, we evaluated the long-term efficacy of yoga and cognitive-behavioral therapy (CBT) chronic pain treatment in a randomized controlled trial (RCT) of 75 Veterans (57 men, 42–71 ± 7.1 years of age) with Gulf War Illness (GWI). Methods: Participants received either 10 weeks of yoga or 10 weeks of CBT for chronic pain. The primary outcome measures were pain severity, and pain interference (Brief Pain Inventory-Short Form). The secondary outcome measures were fatigue, as indicated by a measure of functional exercise capacity (6-Minute Walk Test), depression, autonomic symptom severity, and quality of life. Piecewise linear mixed models were used to examine study hypotheses. Results: Compared to the CBT group, yoga was associated with greater reductions in pain severity during the 6-month follow-up period (group × time interaction: b = 0.036, se = 0.014, p =.011). Although we did not find between-group differences in the other primary or secondary outcome measures during follow-up (p's > 0.05), exploratory analyses revealed within-group improvements in pain interference, total pain (an experimental outcome variable which combines pain severity and interference), and fatigue in the yoga group (p's < 0.05) but not in the CBT group. Conclusions: This is the first study to report long-term follow-up results of yoga as a treatment for GWI. Our results suggest that yoga may offer long-term efficacy in reducing pain, which is a core symptom of GWI. Trial registration: Secondary analyses of ClinicalTrials.gov NCT02378025. [ABSTRACT FROM AUTHOR]

• The professionals who suffer most of the fatal accidents are carpenters and roofers. • The most cited fatal accidents were falling from the roof and the ladder. • The most frequent failure in accidents is linked to Organizational Influence. • An accident probability of 0.4% is a low, but not non-existent, chance of occurrence. Introduction : The civil construction industry (CCI) is one of the most dangerous sectors for occupational accidents. Studies conducted in several countries show that occupational accidents involving falls from height are the main cause of deaths in recent years. Method: This article analyzed the combinations of causal factors with the highest likelihood of accidents involving falls from height in construction to assist in decision-making. The methodology was divided into four stages: accident collection and sample definition; accident analysis; probability determination; and obtaining the theoretical curve of an accident probability distribution. The methodology was applied to reports of fatal fall-from-height accidents that occurred in the United States between 1997 and 2020. Results: The results show that among the accidents analyzed, the highest probability of fatality is when a roofer aged between 31 and 44 years performs their activity on a roof between 10:00 and 11:59 am. It is also noted that the three causal factors most present in the accidents were: organizational process (97.7%); poor management of worker resources (96.6%); and organizational climate (95.4%). From the probability distribution curve, 68% of the fatal accidents occurred after reaching between 18 and 34 causal factors present in the HFACS method categories. [ABSTRACT FROM AUTHOR]

Using the lens of Communication Privacy Management (CPM) theory, this article examines communication between health care providers in the southern United States emergency department (ED) and patients who have experienced IPV. We qualitatively examine communicative challenges that COVID-19 protocols have created, as well as routine difficulties that occur when communicating with survivors of violence. The participants described challenges including: (1) Feeling uncertainty, (2) Encountering patient resistance, (3) Managing apathy and frustration, and (4) Navigating time pressure. Furthermore, the providers explained how COVID-19 compounded those challenges through: (1) Minimizing contact, (2) Losing nonverbal behavior, (3) Encountering limited resources, and (4) Facing visitor complications. This article extends CPM theory by exploring disclosure challenges related to IPV in health care settings during the COVID-19 pandemic including permeability, linkages, and privacy rules. It offers practical suggestions for increasing patient disclosure of IPV experiences. [ABSTRACT FROM AUTHOR]

Introduction: Lichen planus (LP) is an inflammatory skin disorder that can present in various forms across the body, including lesions on the skin (cutaneous LP [CLP]), scalp (lichen planopilaris [LPP]), and mucosal regions (mucosal LP [MLP]). Qualitative exploration of the patient experience of LP, notably symptoms and impacts on health-related quality of life (HRQoL), is limited. A scarcity of research was also identified relating to emotional wellbeing impacts of CLP patients. Two qualitative studies were conducted with LP patients to address these gaps. Methods: Study 1 consisted of exit interviews conducted with a subset of adult patients with MLP (n = 5), CLP (n = 4), and LPP (n = 4) enrolled in an LP clinical study in the United States (US) to explore the patient experience. Study 2 consisted of independent qualitative interviews conducted with adult CLP patients (n = 13) from the US and Germany to further explore impacts on emotional wellbeing. Results: Exit interviews found that itch , pain, and skin lesions were most frequently reported as signs/symptoms of LP. Itch and skin lesions were experienced across all LP subtypes, while pain was only reported by CLP and MLP patients. These signs/symptoms impacted HRQoL including emotional wellbeing (frustration, embarrassment), daily activities (oral hygiene, clothing options), social functioning (intimacy, social activities), and physical functioning (chewing/swallowing, opening/moving mouth). Impacts on activities of daily living (ADL) and physical functioning were mostly experienced by MLP patients. Independent qualitative interviews, which further explored impacts of CLP on patients' emotional wellbeing, identified frustration, worry, sadness, embarrassment, and depression as the most frequently experienced. Conclusion: The findings contribute to the literature by providing qualitative insights into signs/symptoms and HRQoL impacts of LP, from the adult patient perspective. The findings also highlight the importance of considering assessment of HRQoL impacts in future clinical LP research, particularly impacts on emotional wellbeing when selecting instruments for assessment of HRQoL in the CLP population. Trial Registration: NCT04300296. [ABSTRACT FROM AUTHOR]

Purpose: The authors assessed common content knowledge of health-related fitness in a national representative sample of preservice physical education teachers in the United States. Methods: Six hundred and twenty-one preservice physical education teachers from 68 physical education teacher education (PETE) programs located in different regions in the United States completed the 40 multiple choice items health-related fitness knowledge test during the semester prior to their student teaching. In addition, each PETE program coordinator/department head completed the PETE Program Information Questionnaire. Results: The mean percentage correct on the test was 61.3% (M = 24.5, SD = 4.9). Analyses of variance and t-test analyses indicated that common content knowledge of health-related fitness was not a function of sex, program size, or region of the United States. Discussion/Conclusions: These data suggest that preservice physical education teachers in the United States lack common content knowledge of health-related fitness and warrant the attention of PETE programs. [ABSTRACT FROM AUTHOR]

Purpose: A substantial literature exists, documenting differences in access to quality health care among individuals of different racial/ethnic, residence, income, and disability groups. However, little attention has been given to disparate utilization among those who are deaf or hard of hearing (DHH). The purpose of this study was to evaluate differences between individuals with and without hearing-related issues using a nationally representative survey of health care access outcomes to quantify the magnitude of these differences. Method: Using data from the 2021 Centers for Disease Control Behavioral Risk Factor Surveillance System survey, we compared health care utilization between individuals who reported being DHH and those without hearing-related issues. Logistic regression models were used to explore differences in access to care between DHH and non-DHH individuals controlling for sociodemographic characteristics. Results: The total Behavioral Risk Factor Surveillance System survey sample consisted of 412,427 respondents. Among those were 36,532 (6.85%) who identified as DHH. Logistic models indicated that DHH adults were less likely to have a personal health care provider (odds ratio [OR] = 0.91, 95% CI [0.83-- 2.03]) and less likely to have received a routine checkup within the last 2 years (OR = 0.91, 95% CI [0.82--1.02]) but more likely to have forgone health care due to difficulty paying (OR = 1.90, 95% CI [1.71--2.06]) compared to those without hearing difficulties. Differences were robust to race, sex, and other demographic factors. Conclusions: Significant differences in health care utilization were observed between DHH and non-DHH individuals. This is concerning given that DHH adults have a higher prevalence of many chronic conditions that require clinical management. These results indicate that health care providers and systems must offer greater communication options to facilitate better health-related outcomes. [ABSTRACT FROM AUTHOR]

Concerns remain regarding the rare cardiovascular adverse events, myocarditis and pericarditis (myo/pericarditis), particularly in younger individuals following mRNA COVID-19 vaccination. Our study aimed to comprehensively assess potential safety signals related to these cardiac events following the primary and booster doses, with a specific focus on younger populations, including children as young as 6 months of age. Using the Vaccine Adverse Events Reporting System (VAERS), the United States national passive surveillance system, we conducted a retrospective pharmacovigilance study analyzing spontaneous reports of myo/pericarditis. We employed both frequentist and Bayesian methods and conducted subgroup analyses by age, sex, and vaccine dose. We observed a higher reporting rate of myo/pericarditis following the primary vaccine series, particularly in males and mainly after the second dose. However, booster doses demonstrated a lower number of reported cases, with no significant signals detected after the fourth or fifth doses. In children and young adults, we observed notable age and sex differences in the reporting of myo/pericarditis cases. Males in the 12–17 and 18–24-year-old age groups had the highest number of cases, with significant signals for both males and females after the second dose. We also identified an increased reporting for a spectrum of cardiovascular symptoms such as chest pain and dyspnea, which increased with age, and were reported more frequently than myo/pericarditis. The present study identified signals of myo/pericarditis and related cardiovascular symptoms after mRNA COVID-19 vaccination, especially among children and adolescents. These findings underline the importance for continued vaccine surveillance and the need for further studies to confirm these results and to determine their clinical implications in public health decision-making, especially for younger populations. [ABSTRACT FROM AUTHOR]

The occurrence and impact of antiatheist stigma appear to differ based on the geography and religiousness of the communities in which atheists live (Frazer et al., 2020; Frost et al., 2022). However, few studies have examined the potentially unique experiences of atheists living in parts of the United States (U.S.) designated as rural. Using a critical, grounded theory approach, the present study interviewed 18 rural-residing atheists about their experiences including antiatheist discrimination, outness, and their psychological well-being. Qualitative interviews resulted in five core categories of responses: (a) Harm to Atheists Living in Rural Communities; (b) Anti-Atheist Stigma Complicates Relationships in Rural Communities; (c) Hiding Atheism as a Primary Strategy for Safety in Rural Communities, (d) Personal Advantages that Promote Health and Safety, and (e) Atheism as a Part of a Healthy and Tolerant Worldview. Participants described a heightened danger to their physical safety, a preference for identity concealment, and barriers to access to health-promoting resources like non-religion-affirming health care and community, particularly in the rural Southern United States. However, conversely, participants also described the health benefits of their nonreligious worldview in the context of the challenges of living as an atheist in a rural community. Implications for future research and recommendations for clinical practice are provided. Public Significance Statement: The present study suggests the religiousness and political conservatism of rural communities are associated with risks to atheists' safety, lead them to hide their atheism, and create barriers to interpersonal connection. Importantly, nonreligiousness appears to support health through establishing a congruent worldview and offering some protection against experiences of antiatheist discrimination. [ABSTRACT FROM AUTHOR]

Background Dolichoectatic vertebrobasilar fusiform aneurysms (DVBFAs) have poor natural history when left untreated and high morbimortality when treated with microsurgery. Flow diversion (FD) with dual-antiplatelet therapy (DAPT) is feasible but carries high risk of perforator occlusion and progression of brainstem compression. Elaborate antithrombotic strategies are needed to preserve perforator patency while vessel remodeling occurs. We compared triple therapy (TT (DAPT plus oral anticoagulation)) and DAPT alone in patients with DVBFAs treated with FD. Methods Retrospective comparison of DAPT and TT in patients with DVBFAs treated with FD at eight US centers. Results The groups (DAPT=13, TT=14) were similar in age, sex, clinical presentation, baseline disability, and aneurysm characteristics. Radial access use was significantly higher in the TT group (71.4% vs 15.3%; P=0.006). Median number of flow diverters and adjunctive coiling use were non-different between groups. Acute ischemic stroke rate during the oral anticoagulation period was lower in the TT group than the DAPT group (7.1% vs 30.8%; P=0.167). Modified Rankin Scale score decline was significantly lower in the TT group (7.1% vs 69.2%; P=0.001). Overall rates of hemorrhagic complications (TT, 28.6% vs DAPT, 7.7%; P=0.162) and complete occlusion (TT, 25% vs DAPT, 54.4%; P=0.213) were non-different between the groups. Rate of moderate-to-severe disability at last follow-up was significantly lower in the TT group (21.4% vs 76.9%; P=0.007). Conclusions Patients with DVBFAs treated with FD in the TT group had fewer ischemic strokes, less symptom progression, and overall better outcomes at last follow-up than similar patients in the DAPT group. [ABSTRACT FROM AUTHOR]

This study examined each of the 192 Member States of the United Nations to address three important questions: (1) how many countries have professionals who provide school psychology services; (2) which countries do and do not have school psychologists; (3) what evidence of school psychology is available in each country. Of the 192 Member States of the United Nations there was evidence of school psychology in 83. Furthermore, this study revealed evidence of: regulations that require school psychologists to be licensed, registered or credentialed in 29 countries; professional associations specifically for school psychologists in 39 countries; university preparation programs for school psychologists in 56 countries and doctoral preparation programs in school psychology in 19 countries. This study advances our knowledge of the profession of school psychology as of 2007. (Contains 2 tables.)

Background and Purpose One of the best alternatives for the treatment of meniscal injuries in relation to surgical procedures, is exercise. This case report aimed to describe the effects of isokinetic training and a neuromuscular/proprioceptive exercise program on muscle performance and physical function in an individual after a rupture of the posterior horn of the medial meniscus. Study Design Case report. Case Description A 40-year-old man injured his right knee during a soccer match, with a partial lesion of the medial meniscus confirmed by magnetic resonance imaging. He completed an isokinetic training program in addition to exercises that targeted proprioception (22 sessions, 11 weeks) to improve physical function and performance, which were assessed before and after treatment and at a six-month follow-up. An individual with similar anthropometric characteristics was chosen to be used as a control for understanding the patient's assessment values. Outcomes Muscular performance of the knee flexors and extensors was evaluated isokinetically using the Biodex System-4 in a concentric mode at angular velocities of 60, 120, and 300 °/s. The main results indicated that after 11 weeks, the peak torque normalized to body mass (PT/BM), at 60 °/s of the knee extensors remained unchanged (2.54 N.m/kg) (below the control value - 3.06 N.m/kg), and at the six-month follow-up, increased by approximately 20% (3.08 N.m/kg). For the hamstrings, at 60 °/s, an increase of 18 % occurred after intervention (1.98 N.m/kg) and by approximately 30 % at the six-month follow-up (2.12 N.m/kg) - values much higher than the control 1.55 N.m/kg). This increase in the PT/BM was also reflected in the Hamstrings:Quadriceps ratio (78 %) after treatment which improved at follow-up (68 %). Discussion The results showed that the isokinetic training and neuromuscular/proprioceptive exercises improved the muscle performance of the knee flexors and extensors, after eleven weeks of intervention, and remained (or continued to improve) at the six-month follow-up. Level of evidence 5, single case report [ABSTRACT FROM AUTHOR]

Copyright of Review of Policy Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Using data from the Council on Social Work Education's Annual Survey, this study captures a baseline snapshot of policy practice education in U.S.-based bachelor of social work and master of social work programs. Results indicate that the nature of students' preparation to incorporate policy change into practice depends on which program they attended. This first study of policy practice education across U.S. BSW and MSW programs examines policy-related coursework, instruction, field-based learning, and hands-on educational experiences. The study finds substantial program variation, including the type of faculty teaching policy courses and their direct policy practice experience, as well as in the inclusion of field-based and hands-on policy learning opportunities. Implications for strengthening policy education in the United States are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Education Policy Analysis Archives / Archivos Analíticos de Políticas Educativas / Arquivos Analíticos de Políticas Educativas is the property of Educational Policy Analysis Archives & Education Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The COVID-19 pandemic has propelled the use of technology for health care services delivery. Because of inequities in health care and technology access, we investigated the use of telehealth services among racial and ethnic minority groups before and during the COVID-19 pandemic. Methods: For this retrospective study, we examined the electronic health records of privately insured patients in the Healthjump database, provided by the COVID-19 Research Database Consortium. We examined 17.98 million unique visit records of 2.93 million patients from March through December 2019 and 22.17 million records of 3.55 million patients from March through December 2020. We conducted a descriptive analysis and used multiple logistic regression to examine differences in the use of telehealth services among 3 racial and ethnic groups: non-Hispanic White, non-Hispanic Black, and Hispanic people. Results: Telehealth visits before and during COVID-19 accounted for 8.3% and 10.9% of total visits, respectively, with a peak of 15.5% in April 2020. Pre–COVID-19, Hispanic patients had a significantly lower monthly utilization rate (5.3%) than non-Hispanic White patients (8.4%, P <.001) and non-Hispanic Black patients (10.4%, P =.001). During the pandemic study period, Hispanic patients were 41% less likely than non-Hispanic White patients to have a telehealth visit, controlling for age and sex. Conclusions: The likelihood of using telehealth was lower among Hispanic patients than among non-Hispanic White and non-Hispanic Black patients during the pandemic. Culturally sensitive measures are needed to support telehealth use among the Hispanic population. [ABSTRACT FROM AUTHOR]

Background: Maternal mortality in the United States is a public health crisis and national emergency. Missed or delayed recognition of preventable life-threatening symptoms and untimely treatment of preventable high-risk medical conditions have been cited as key contributors to the nation's worsening mortality rates. Effective strategies are urgently needed to address this maternal health crisis, particularly for Black birthing populations. Morbidity and Mortality Assessment: Lifting Outcomes Via Education (MAMA LOVE) is a web-based platform that focuses on the identification of maternal morbidity and mortality risk factors. Objective: The purpose of this paper is to present the conceptualization, development, heuristics, and utility evaluation of the web-based maternal mortality risk assessment and educational tool MAMA LOVE. Methods: A user-centered design approach was used to gain feedback from clinical experts and potential end users to ensure that the tool would be effective among groups most at risk for maternal morbidity and mortality. A heuristic evaluation was conducted to evaluate usability and need within the current market. Algorithms describing key clinical, mental health, and social conditions were designed using digital canvas software (Miro) and incorporated into the final wireframes of the revised prototype. The completed version of MAMA LOVE was designed in Figma and built with the SurveyJS platform. Results: The creation of the MAMA LOVE tool followed three distinct phases: (1) the content development and creation of an initial prototype; (2) the feedback gathering and usability assessment of the prototype; and (3) the design, development, and testing of the final tool. The tool determines the corresponding course of action using the algorithm developed by the authors. A total of 38 issues were found in the heuristic evaluation of the web tool's initial prototype. Conclusions: Maternal morbidity and mortality is a public health crisis needing immediate effective interventions. In the current market, there are few digital resources available that focus specifically on the identification of dangerous symptoms and risk factors. MAMA LOVE is a tool that can address that need by increasing knowledge and providing resources and information that can be shared with health care professionals. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of death among women in the United States. A considerable number of young women already have risk factors for CVD. Awareness of CVD and its risk factors is critical to preventing CVD, yet younger women are less aware of CVD prevalence, its risk factors, and preventative behaviors compared to older women. Objective: The purpose of this study is to assess CVD awareness among adolescent and young adult women and develop a lifestyle-based cardiovascular risk assessment tool for the promotion of CVD awareness among this population. Methods: This study used a 3-phase iterative design process with young women and health care practitioners from primary care and reproductive care clinics in Atlanta, Georgia. In phase 1, we administered a modified version of the American Heart Association Women’s Health Survey to young women, aged 15-24 years (n=67), to assess their general CVD awareness. In phase 2, we interviewed young women, aged 13-21 years (n=10), and their health care practitioners (n=10), to solicit suggestions for adapting the Healthy Heart Score, an existing adult cardiovascular risk assessment tool, for use with this age group. We also aimed to learn more about the barriers and challenges to health behavior change within this population and the clinical practices that serve them. In phase 3, we used the findings from the first 2 phases to create a prototype of a new online cardiovascular risk assessment tool designed specifically for young women. We then used an iterative user-centered design process to collect feedback from approximately 105 young women, aged 13-21 years, as we adapted the tool. Results: Only 10.5% (7/67) of the young women surveyed correctly identified CVD as the leading cause of death among women in the United States. Few respondents reported having discussed their personal risk (4/67, 6%) or family history of CVD (8/67, 11.9%) with a health care provider. During the interviews, young women reported better CVD awareness and knowledge after completing the adult risk assessment tool and suggested making the tool more teen-friendly by incorporating relevant foods and activity options. Health care practitioners emphasized shortening the assessment for easier use within practice and discussed other barriers adolescents may face in adopting heart-healthy behaviors. The result of the iterative design process was a youth-friendly prototype of a cardiovascular risk assessment tool. Conclusions: Adolescent and young adult women demonstrate low awareness of CVD. This study illustrates the potential value of a cardiovascular risk assessment tool adapted for use with young women and showcases the importance of user-centered design when creating digital health interventions. [ABSTRACT FROM AUTHOR]

The article addresses unlearned lessons for Black, Latino, and other men with HIV who have sex with men about infectious diseases. Topics discussed include brief background of monkeypox (MPX), lessons from Covid-19 that have not been heeded in the MPX outbreak, and reason the lack of disaggregated data from the states and territories is hampering the response to the MPX outbreak.

Understanding the phytochemical landscapes of essential and nonessential chemical elements to plants provides an opportunity to better link biogeochemical cycles to trophic ecology. We investigated the formation and regulation of the cationic phytochemical landscapes of four key elements for biota: Ca, Mg, K, and Na. We collected aboveground tissues of plants in Atriplex, Helianthus, and Opuntia and adjacent soils from 51, 131, and 83 sites, respectively, across the southern United States. We determined the spatial variability of these cations in plants and soils. Also, we quantified the homeostasis coefficient for each cation and genus combination, by using mixed‐effect models, with spatially correlated random effects. Additionally, using random forest models, we modeled the influence of bioclimatic, soil, and spatial variables on plant cationic concentrations. Sodium variability and spatial autocorrelation were considerably greater than for Ca, Mg, or K. Calcium, Mg, and K exhibited strongly homeostatic patterns, in striking contrast to non‐homeostatic Na. Even so, climatic and soil variables explained a large proportion of plants' cationic concentrations. Essential elements (Ca, Mg, and K) appeared to be homeostatically regulated, which contrasted sharply with Na, a nonessential element for most plants. In addition, we provide evidence for the No‐Escape‐from‐Sodium hypothesis in real‐world ecosystems, indicating that plant Na concentrations tend to increase as substrate Na levels increase. [ABSTRACT FROM AUTHOR]

The purpose of this study was to create a valid and reliable volleyball common content knowledge (VB-CCK) test in secondary physical education contexts in the United States. Two physical education teacher educators served as content experts and developed test items for the VB-CCK test. We then established content validity with a group of in-service teachers and determined face validity with preservice teachers. The Rasch model was used in data analysis. The standardized residual contrasts for the items loaded in the range of-.4 to .4, confirming the test was unidimensional and measured VB-CCK. Both infit mean-square residuals and outfit mean-square residuals were within the criterion range of .5 to 1.5 (infit = .8 to 1.1; outfit = .8 to 1.5), which showed the range of the question difficulties matched the respondents' knowledge levels. The item separation index was 3.46 (reliability = .92; an excellent level) and the person separation index was 1.55 (reliability = .71; an acceptable level). The results provided evidence of the range of question difficulties and respondents' knowledge levels. The Wright Map added additional evidence that the 40 questions were well distributed from easy to difficult levels and could discriminate different knowledge levels of preservice teachers' VB-CCK. The study was successful in developing a valid and reliable instrument for PETE programs to assess secondary VB-CCK of their preservice teachers. We propose future CCK studies for both elementary content and secondary content. [ABSTRACT FROM AUTHOR]