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The aim of this study was to identify contextual factors that negatively affect activity and participation among powerchair football (PF) players. Thirty-seven semistructured interviews were conducted with PF players (Mage = 27.9 ± 8.2 years) in France (n = 18) and the United States (n = 19). Participants reported acute back and neck pain as the primary morbidities resulting from PF participation, with sustained atypical posture in the sport chair as the primary cause. Competition-related physical and mental stress were also identified as participation outcomes. Accompanying the many benefits of PF, participants recognized negative impacts of discomfort, physical fatigue, and mental fatigue. Interventions such as seating modifications, thermotherapy to combat pain, napping to combat acute physical stress, and mental preparation to manage state anxiety were all identified as prospective interventions. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Athletic identity (AI) can be defined as, "the degree to which an individual identifies with an athlete role, and the values, and social networks associated with that identity," and can pose a problem when athletes do not explore themselves outside of sport. This lack of identity development beyond athletics has the potential to lead to the development of a high AI. High AI in athletes can have positive effects in areas such as performance, however, high AI may also pose negative consequences. The development of such an identity can limit the adaptive responses to substantial life changes such as retirement from sport. This inability to adapt may thereby contribute to mental health problems during the transition. Therefore, the purpose of this study is to better understand the relationship between athletic identity and mental health symptoms so clinicians may provide support to enable positive outcomes after retirement from sport. Clinical Question: What is the influence of athletic identity on mental health symptoms in athletes retiring from sports? Summary of Key Findings: (1) High athletic identity contributes to increased mental health symptoms following retirement. (2) Athletic identity had no relationship to mental health symptoms during the preretirement phase of an athlete's career Clinical Bottom Line: The findings suggest that there is high-quality evidence to support that AI has no relationship with mental health symptoms during the preretirement phase and that athletes with high AI are more likely to experience mental health symptoms during their transition out of or retirement from sport. Strength of Recommendation: The grade of B is recommended by the Strength of Recommendation taxonomy for consistent, limited-quality, patient-oriented evidence that high AI has a strong relationship to mental health symptoms following retirement in athletes. [ABSTRACT FROM AUTHOR]

Para sport classification aims to minimize the impact of impairments on the outcome of competition. The International Paralympic Committee requires classification systems to be evidence based and sport specific, yet the sport of goalball uses a structure that is not supported by evidence demonstrating its legitimacy for competition. This study aimed to establish expert opinions on how a sport-specific system of classification should be structured in the sport of goalball. Using a three-round Delphi survey, 30 international experts expressed their views across topics linked to goalball classification. Participants were divided as to whether the current system fulfills the aim to minimize the impact of impairment on competition. Most felt that less impairment should be required to compete but that the one-class structure should remain. Experts identified measures of visual function that should be considered and 15 core components of individual goalball performance. Findings constitute a crucial first step toward evidence-based classification in goalball. [ABSTRACT FROM AUTHOR]

Research pertaining to the experiences and motives of Paralympic athletes who transfer between sports is scant. This study aimed to address this gap through semistructured interviews with Canadian Paralympic coaches (n = 35) and athletes (n = 12). Three higher-order themes of "alternative to retirement," "career extension," and "compatibility" were identified. The subthemes of "psychobehavioral" and "physical and physiological" (from the higher-order theme of alternative to retirement) captured reasons leading to transfer, which are similar to reasons athletes may consider retirement. The subthemes of career extension—"better opportunities" and "beneficial outcomes"—shed light on factors that contributed to the withdrawal of negative experiences and reinforcement of positive outcomes associated with transferring sports. Last, compatibility had three subthemes of "resources," "sport-specific," and "communication," which encapsulated factors athletes should consider prior to their transfer. In conclusion, the participants highlighted the importance of transparent and effective communication between athletes and sports to align and establish realistic expectations for everyone involved. [ABSTRACT FROM AUTHOR]

• Comparison of the nominal and quaternion attitude realisation of TOPEX/Poseidon. • Angular differences in roll, pitch, yaw, and the solar array rotation angle. • Influence on the radial position of the altimeter antenna due to mismodelling. • Similar results with slight improvements for the quaternion attitude realisation. • Change in the radial position up to 2.5 cm in case of mismodelling in roll/pitch. The altimetry mission TOPEX/Poseidon was operational between 1992 and 2005 and provided innovative insight into global and regional sea level changes and their variability. The correct modelling of the spacecraft orbit in precise orbit determination requires detailed information on the attitude of the spacecraft body and the solar array. Since the availability of attitude observations in form of quaternion data for this mission is limited, the nominal orientation model has to be used mainly. In this study, we compare the nominal and quaternion-based approaches of the TOPEX/Poseidon attitude realisation and validate the nominal model w.r.t. the observed attitude. We found good agreement between both approaches in the spacecraft-related roll, pitch, yaw, and solar array angles with slight differences of up to 0.31 ° on average. The best accordance is obtained in the yaw angles. A general angular offset of 0.12 ° and - 0.19 ° on average is found in the pitch and solar array angle differences, respectively. Parameters estimated in the orbit computation process also reflect the good agreement between both orientation models with slightly better results when using the observed attitude. However, in some intervals, the nominal model lacks detailed information about the correct attitude. These can be adjusted using the information from the quaternion data. Such intervals indicate off-nominal spacecraft attitude events like drifts or offsets. Purely geometrically analysed, mispointing in the roll and pitch components of about 0.25 ° results in a change of the altimeter phase centre position in the radial direction of about 7 mm, which directly impacts the sea-level heights determined from altimetry measurements. [ABSTRACT FROM AUTHOR]

To examine the applicability and process of change of Cognitive Functional Therapy (CFT) in the management of pain and disability in people with knee osteoarthritis who were offered knee replacement surgery and had risk factors for poor response to surgery. Single-case experimental design with a mixed-methods, repeated measures approach was used to investigate the process of change through CFT in four participants. Qualitative interviews investigated beliefs, behaviours and coping responses, and self-reported measures assessed pain, disability, psychological factors, and function at 25 timepoints. Study registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12619001491156). Qualitative data indicate that CFT promoted helpful changes in all participants, with two responses observed. One reflected a clear shift to a biopsychosocial conceptualisation of osteoarthritis, behavioural re-engagement and the view that a knee replacement was no longer necessary. The other response reflected a mixed conceptualisation with dissonant beliefs about osteoarthritis and its management. Psychological and social factors were identified as potential treatment barriers. Overall, quantitative measures supported the qualitative findings. The process of change varies between and within individuals over time. Psychological and social barriers to treatment have implications for future intervention studies for the management of knee osteoarthritis. Cognitive Functional Therapy is applicable in the management of knee osteoarthritis. Reconceptualisation of osteoarthritis reflected a helpful change. Psychological and social factors emerged as barriers to recovery. [ABSTRACT FROM AUTHOR]

Extant research on mental health within Muslim communities reveals inequalities, with religio-cultural beliefs viewed as influencing experience, access to care, and treatment outcomes. Additionally, religious affiliation is a prominent marker of social identity amongst Muslim migrant communities. This study examined whether acculturative approaches and identity influence perceptions of mental ill health within a Muslim migrant community. Semi-structured interviews were conducted with 11 Australian Muslim youth – six of whom were recent immigrants and five who were Australian-born/raised. Data was analysed using reflexive thematic analysis. Two main themes were identified: 1) making sense of mental health, and 2) the influence of social representations. Sub-themes included: 1a) defining mental health, 1b) perceived determinants, 2a) "emotional" vs "factual", and 2b) education through experience: personal encounters with mental illness. Overall, faith and religion played an important role in conceptualisations of mental health for young Australian Muslims – alluding to the necessity of faith-sensitive mental health services for ethnic and religious minority communities. What is already known about this topic: Cultural beliefs influence mental health understandings, access to care, and treatment for Muslims. For Muslims, conceptualisations of mental ill health are often based on cultural and pre-Islamic influences (e.g., the role of supernatural spirits). Cultural context affects access to, and experiences of, mental health services. What this topic adds: Muslim youth feel that faith and religion are vital for mental well-being and self-efficacy, highlighting the importance of adapting therapeutic modalities within a faith-sensitive paradigm. For recent immigrants, the influence of the supernatural on mental health is not necessarily negative. Personal experience impacts perceptions of mental illness and may play a role in reducing stigma. [ABSTRACT FROM AUTHOR]

This qualitative study explores the opportunities and challenges of collaboration experienced by social workers and police officers when dealing with cases of intimate partner violence (IPV) and stalking. The study aims to examine their collaborative approaches in risk assessment and risk management by identifying the structures, supports, and foundations crucial for effective collaboration. Our data, collected from twelve interviews and one focus group interview with social workers and police officers, reveals that collaboration was facilitated by assigning specific roles to involved parties, proximity, structure and professionalism. These key factors emerged as crucial and contributing to the effectiveness of the collaborative efforts. Practitioners should consider integrating these key elements into their practices to enhance and improve collaboration when addressing cases of IPV and stalking. The study underscores the need for a well-defined framework and support structures to optimise the collaborative response to such complex and sensitive issues. [ABSTRACT FROM AUTHOR]

The term topical steroid withdrawal (TSW) refers to a condition widely discussed on social media, but rarely mentioned in the medical literature. It typically involves a patient with chronic eczema who abruptly discontinues topical corticosteroids (TCS) believing they are ineffective and damaging. Symptoms include an acute eruption, worse than the previous eczema, of painful erythema followed by oozing, crusting, desquamation and sometimes prolonged systemic weakness. Patients self-diagnose and often avoid healthcare professionals who dismiss the diagnosis and persist in offering TCS, leaving them unsupported. We analysed 121 responses to a survey of UK dermatologists' attitudes to TSW. Views on aetiology included relapsed eczema, erythroderma and a social construct. A total of 88.4% (107/121) agreed that TSW needs better understanding and more research. Respondents earlier in their careers are more cautious than senior respondents about prescribing TCS long term because of TSW, suggesting a trend that might lead to better understanding, communication and management. [ABSTRACT FROM AUTHOR]

Background: Social isolation and loneliness are associated with living with a chronic condition particularly where stigma is a factor. Our study aimed to examine the lived experience of adolescents living with HIV in relation to isolation because of their diagnosis and consequences of disclosure. Giddens' structuration theory was used as an analytic framework to identify the potential mechanisms underlying adolescents living with HIV's experiences. Method: Longitudinal in-depth interviews were conducted with 20 adolescents living with HIV aged 15–24 years with each participant taking part in three interviews (total 60) between September 2020 and October 2021. Thematic analysis was performed using Braun and Clarke's steps for coding and analysing qualitative data and informed by the structuration theory framework. Results: The findings indicated that adolescents living with HIV have agency and make conscious choices about sharing their status. However, these choices are influenced by their experiences in their community. The discrimination and negative judgements they often experience prevent them from disclosing their status. Stigma, discrimination, and psychological distress contribute to the isolation that adolescents and young adults living with HIV experience. The limited disclosure itself can lead to them becoming isolated and lonely. Conclusion: The negative experiences which adolescents living with HIV face can have an impact not only on their psychological wellbeing but also on their decision to disclose and seek support. These experiences may lead to social isolation and loneliness, an unintended consequence of their action in protecting themselves from the conditions created by the structures/environment in which they live. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to explore whether a sense of collective or shared group identity was developed in one established online social support group for family caregivers and, if so, what did group identification mean for the group members and how was this cultivated in the group. Methods: Eighteen semi-structured interviews were carried out with members of a family caregiver online support group in Ireland. Inductive and deductive reflexive thematic analysis drawing on the social identity approach (SIA) generated four main themes and several related subthemes. Results: The first main theme generated was The group are a Tribe and the Tribe gets it, with subthemes: Invisibility as a common experience, my Tribe understands I am more than just a carer and Just being part of the Tribe can be enough. The second main theme generated was the Tribe is a lifeline and life-changing, with related subthemes: Our connection relieves experiences of loneliness and social isolation and Sharing knowledge, experience and support made me feel visible. The third and fourth main themes generated were The leadership of group moderators helped create the Tribe identity and Lessons that can be learnt. These findings are discussed in relation to the social identity approach, social isolation and loneliness. Conclusions: We concluded that group identity can be cultivated through considered, active and balanced moderation, creating a safe, welcoming and supportive space where family caregivers are able to have fun and seek information, advice and emotional support, which helps relieve loneliness and social isolation. [ABSTRACT FROM AUTHOR]

In this paper I will analyze the set of markers that have been associated with exclamative sentence-type and exclamations in Romance, like Catalan ma, mira, que , and si , Italian guarda and che , or Spanish mira, que, si , and vaya. The hypothesis I will defend is that the meaning encoded by each of these markers contribute to create an exclamation speech act. I will show that we must first distinguish mirative markers like ma, mira or guarda , which encode the surprise attitude of the speaker towards a proposition. A second class of elements are degree operators, like si , which create the necessary domain extension on which the attitude of the speaker is built. Finally, I will show that que / che is a marker of exclamative sentence-type. In the second part of the article I will show that these pragmatic differences have a transparent reflex in syntax: mirative markers occupy the Judge Phrase position in Krifka's Speech Act Layer, above ForceP and vocatives, so they may combine with different sentence-types, besides exclamatives. In ForceP we find degree operators (and exclamative wh -phrases) in its specifier, and the sentence-type marker que / che in its head. All in all, the paper aims at showing that a compositional approach to exclamativity can deal with the rich set of pragmatic and syntactic properties of exclamative markers in Romance. • Exclamativity and mirativity are two distinct pragmatic categories, with specialized markers. • Mirative markers are typically found with exclamative sentences, but they may appear with other sentence-types as well. • The set of pragmatic and syntactic properties of exclamative particles in Romance can be explained compositionally. • Data from exclamative markers support a rich syntax-pragmatics interface along the lines of the Cartographic Program. [ABSTRACT FROM AUTHOR]

Limited research has examined the active ingredients and mechanisms of change of naturalistic developmental behavioral interventions (NDBIs). The present study used an exploratory sequential mixed-methods design to develop a comprehensive Theory of Change of Project ImPACT, an empirically supported NDBI. We used qualitative data from interviews with intervention experts (n = 10), community providers (n = 22), and caregivers (n = 12) to develop a comprehensive causal model of the intervention process. We then tested select paths of the causal model using path analyses with an archival dataset (n = 92). The causal model described how developmental techniques aimed at supporting children's attention and engagement lay the foundation for more adult-directed learning opportunities and subsequent child skill growth. However, hypothesized causal relationships were not supported by our quantitative analyses. In the future, this research can be used to develop and prioritize nuanced research questions related to the timing, optimization, and mechanistic process underlying NDBIs. [ABSTRACT FROM AUTHOR]

Popular press and academic articles alike speculate that gender influences vaccine receipt, but they often disagree whether men or women are less likely to become vaccinated. In the current article, we further test the relation of gender and vaccination in four datasets, and we assess the mediating role of vaccine hesitancy dimensions. Our results demonstrate that: (1) gender has significant relations with several vaccine hesitancy dimensions, which are mixed between both women and men having negative perceptions regarding vaccination; (2) gender does not significantly relate to flu and COVID-19 vaccination willingness or receipt, but women were more likely to receive other vaccines; and (3) a significant indirect effect did emerge in the two datasets collected after widespread access to the COVID-19 vaccine, such that the perception that vaccines cause health risks mediates the relation of gender with flu vaccination willingness as well as COVID-19 vaccination willingness and receipt. Our discussion integrates these findings with models of preventative behaviors and identifies directions for future research. [ABSTRACT FROM AUTHOR]

In a globalised world, study and work options have become vast. The complexity of this for young people with an international upbringing can be considerable. This qualitative interview study aims to explore how different cultural experiences in childhood may influence career decision making behaviours, career preparedness and mental health in late adolescence, specifically within an international school setting. By considering the validity of these experiences, a better understanding of the psychological, social and cultural dynamics can be weighed up in order to identify suitable career guidance strategies to effectively support these young people. Using an IPA approach, in-depth semi-structured interviews were conducted with four diverse international school students aged 17–18. These young people demonstrated that career decision making was influenced by their cultural experiences, with cultural identity and sense of belonging having a significant impact on their career decision making and their perceived career adaptability in readiness for entering the globalised workforce. [ABSTRACT FROM AUTHOR]

Employment has been shown to be a strong predictor of recovery in individuals with serious mental illness (SMI) and is often amongst the foremost reported goals of this population. Yet individuals with SMI continue to face high levels of unemployment and employment marginalisation. This article aims to outline three major career barriers unique to this population: interrupted vocational development, symptoms of the illness itself, and stigma and discrimination. Three theoretical lenses, Social Cognitive Career Theory, Cochran's Narrative Career Theory, and Chaos Theory of Careers, will be utilised to frame these issues and to identify relevant and effective career interventions for individuals with SMI. [ABSTRACT FROM AUTHOR]

Long-term care facilities for older adults (LTCFs) were directly affected by the COVID-19 pandemic. This study aimed to discuss the perceptions of occupational therapists about deaths and other losses in LTCFs during the pandemic. This qualitative study is anchored in social phenomenology, and conducted in-depth interviews with eight occupational therapists who worked in LTCFs. Thus, two themes were generated after the Thematic Analyses: "The proximity of death" and "Losses associated with living and dying in a LTCF." In the first theme, the interviewees addressed the feeling of imminent death in the daily life of the LTCF, and feelings related to their own death, that of their family members and other older adults. In the second, the professionals highlighted three groups of losses: social, functional, and psychological/cognitive. These results highlighted the challenges faced by occupational therapists and can contribute to improve behavior and care for institutionalized older adults during the pandemic. [ABSTRACT FROM AUTHOR]

The aim of this project was to increase willingness to receive the influenza vaccine to the optimal rate of ≥ 70%. Low acuity adult patients who visited an Emergency Department (ED) were assessed regarding their willingness to receive the influenza vaccine before and after an educational intervention that included a provider recommendation and an educational handout. A total of seventy-six patients (n = 76) were assessed. Patients' willingness to receive the influenza vaccine rose from 29% pre-intervention to 72% post-intervention without disrupting the clinical flow in a busy ED. Similar vaccine educational strategies can be applied to influenza and other vaccines in EDs to increase vaccination willingness in patients, including those who use the ED as a primary point of contact for healthcare, decreasing the burden of influenza illness in the community. [ABSTRACT FROM AUTHOR]

The total consumption model (TCM) postulates a close link between total consumption and levels of harm within the population, which has important implications for prevention. This review aimed to explore evidence relating to the application of the TCM and theoretical elements associated with it (i.e. the distribution of harms; the concentration of consumption) to gambling by reviewing evidence pertaining to the distribution of harms across the population; the concentration of gambling consumption; and evidence of the validity of the TCM in gambling. Systematic literature searches were performed using MEDLINE, PsycINFO, and Web of Science databases, restricted to publications between January 1, 2010, and March 29, 2023. The search identified seven studies examining risk curves for gambling harm, of which only two employed continuous consumption measures. This nascent literature suggests mixed evidence for the relationship between gambling consumption (e.g. losses, frequency, expenditure, and expenditure as a percentage of income) and risk of harm. Five publications found that the concentration of gambling consumption was high among those experiencing gambling harms, with some evidence that spending is more concentrated for certain games (e.g. online casinos) than for others (e.g. lotteries). Finally, four studies assessed the TCM, suggesting close association between gambling consumption and problem gambling, lending empirical support to the validity of the TCM. However, robust evidence is nascent and further research is required to assess these relationships. [ABSTRACT FROM AUTHOR]

Since 2016, the Central African country of Cameroon has been experiencing the worst conflict and humanitarian crisis in its history over the systematic marginalization and discrimination of Anglophones and a change in the form of state. This study sets out to explore Anglophone's perception of discrimination, their attitudes towards the form of state (federation and independence), and the extent to which the perception of discrimination predicts attitudes towards the form of state. In a sample of 314 Anglophones, results showed that attitudes towards the form of state were mixed as there was no significant difference between support for independence and support for a federation. In addition, results indicated that the perception of discrimination among Anglophones was significantly high. Lastly, while controlling for the effect of age, level of education, and economic status, the results showed that the perception of discrimination was significantly related to support for independence but not support for a federation. Implications and avenues for further research are discussed as well. [ABSTRACT FROM AUTHOR]

The forced-choice response format is often considered superior to the standard Likert-type format for controlling social desirability in personality inventories. We performed simulations and found that the trait information based on the two formats converges when the number of items is high and forced-choice items are mixed with regard to positively and negatively keyed items. Given that forced-choice items extract the same personality information as Likert-type items do, including socially desirable responding, other means are needed to counteract social desirability. We propose using evaluatively neutralized items in personality measurement, as they can counteract social desirability regardless of response format. [ABSTRACT FROM AUTHOR]

This study surveyed the use of community-based resource facilitation (RF) services by ethnic minority survivors of traumatic brain injury (TBI) living in the Midwestern United States. Past records of RF use by survivors of TBI were reviewed. Demographics and patterns of RF use across 3 ethnic groups were documented. Reported barriers to community integration related to ethnic identity were identified using Chi-square test of independence. Ethnic minority survivors were less likely to use RF services than white survivors. Caucasian women and men utilized RF services at similar rates, whereas more African American men and Latina women used RF services. Caucasians received information about RF from a greater variety of sources than ethnic minority survivors. Ethnic identity was significantly associated with greater reported needs for TBI awareness. A pattern of differential RF use by survivors from ethnic minority groups was noted, suggesting potential socio-cultural influences on help-seeking behavior after TBI. These factors should be considered to develop more accessible and equitable strategies of RF service referral and support. Future investigations of cultural perspectives of TBI and injury-related services may improve understanding of the likelihood and necessity of community-based RF service use by diverse populations. [ABSTRACT FROM AUTHOR]

Despite the recommendations for COVID-19 preventive health behaviors, it continues to increase alarmingly. This study examined how media coverage, myths, political leaders, and community leaders influence the attitudes and misconceptions about COVID-19 and COVID-19 vaccination uptake in the Mississippi Delta region. This qualitative study employed focus group discussions (FDGs) with representatives from three rural counties in the Mississippi Delta. A thematic analysis approach was used for data analysis. Participants were aware of how COVID-19 is transmitted, the preventative measures that can be used to mitigate the spread of the virus, and misconceptions and beliefs that lingered in their communities. Participants were uncertain about the need for the COVID-19 vaccine in terms of perceived risks (e.g., side effects, efficacy, and safety) and its novelty. Participants also discussed a wide range of COVID-19 misinformation that resulted in distress and distrust of the vaccine and health behavior recommendations. There are varying misconceptions and beliefs about COVID-19 and COVID-19 vaccine among communities in the rural Mississippi Delta. Thus, multi-sectoral collaborations between agencies that can use risk communication frameworks to deliver accurate health information that can resolve misinformation about COVID-19 in rural communities are needed. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the knowledge and attitudes of a sample of Hispanics in Puerto Rico (PR) toward the transgender community. Methods: A cross‐sectional study addressing Hispanics, aged 21 years or older who lived in PR, was performed from March to September 2021. Participants were invited through online advertisement shared on social media pages. Data were collected via SurveyMonkey and analyzed with Stata 17. Descriptive statistics were employed to summarize findings. Results: A total of 404 participants were sampled. Most were female, 278 (68.8%), had completed at least a bachelor's degree, 292 (72.2%), and referred exposure to trans‐related topics during education, 237 (58.7%). Most correctly defined the terms sex, 257 (63.6%), sexual orientation, 334 (82.7%) and transgenderism, 297 (73.5%). The majority also agreed that transgender individuals should be able to change their name, 353 (93.6%) and undergo gender‐affirming procedures, 335 (88.9%). Most also believed trans individuals were a valuable part of society, 339 (89.9%) and should be allowed free gender expression, 358 (95.0%). Conclusions: PR is characterized by a patriarchal, religious, and conservative culture which could promote a negative attitude toward transgender people. Our findings challenged such assumption. The level of knowledge and positive attitude toward trans individuals identified in this study could counteract the existing violence and stigma affecting this community in PR. Synopsis: The adequate knowledge and positive attitude toward transgender individuals identified in this study could counteract the existing violence and stigma affecting this community in PR. [ABSTRACT FROM AUTHOR]

Background: A particular Theory of Care-Seeking Behavior was developed to explain care-seeking behavior with psychosocial concepts, external conditions, and clinical and demographic factors. Having a careful review of studies based on this theory could guide future research on care-seeking behaviors. Objectives: With a scoping review: describe characteristics of studies guided by a Theory of Care-Seeking Behavior, summarize support for the relationships of proposed, explanatory variables with care-seeking behaviors, and examine support for propositions in the theory. Method: Searching 5 electronic databases, we sought studies that were: full-text, peer-reviewed, in English, data-based, guided by the theory, and published from January 1, 1992, to January 1, 2022. Results: Across 18 identified articles, the behaviors studied included: symptomatic screening (n = 8), asymptomatic screening (n = 7), and care-seeking behaviors for either screening or symptoms (n = 3). A total of 3328 adults participated in the studies. In 16 studies, all participants were female. In 60% to 83% of studies, researchers had reported findings that supported the relationships of explanatory concepts with care-seeking behavior. Among the 7 studies that tested the 2 propositions of theory, all 7 tests failed to support the proposition that clinical and demographic factors influence care-seeking behavior indirectly through psychosocial variables. Six tests supported the proposition that psychosocial variables influence behavior conditionally, on external conditions. Conclusions: Relationships of these explanatory variables with care-seeking behaviors were supported, as was 1 of 2 propositions. The Theory of Care-Seeking Behavior can be applied to new clinical situations to continue to build knowledge of the theory and understanding of care-seeking behaviors. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an autoimmune condition managed by strict adherence to a gluten-free diet. Dietary choice has gendered connotations, and men with CD may face judgment from others when following a gluten-free diet. However, little is known about health-related stigma in men with CD. The study aim was to explore the health-related stigma and challenges faced by men with CD, and the influence of CD on their lives. Qualitative semistructured online interviews were conducted with men living with CD. Twenty adults (aged 18 years or older) identifying as men living in the United Kingdom, with self-reported CD, were recruited using social media and opportunistic sampling. Participants provided rich, detailed discussions about aspects of their experience of living with CD. Reflexive thematic analysis was used, with a critical-realist lens that enabled researchers to connect men's experiences within wider sociocultural constructs such as masculinity and social identity. Three themes were identified: CD threatens social inclusion; others' assumptions about CD and microaggressions have a psychological influence, and masculine norms, health-related stigma, and power dynamics influence men's health behaviors and everyday experience. Health-related stigma was found to be interconnected with these men's gendered social environment, suggesting that may be an important social and structural determinant of dietary, health-related, and health support-seeking behaviors in men diagnosed with CD. Contrary to prior assumptions, health-related stigma influences men with CD of all ages, particularly in social settings. The study unveils the complex interplay of individual beliefs, social norms, and power dynamics, in particular with other men, that influence individual beliefs and emphasize the performative aspect of food consumption. Internalized stigma and microaggressions influence men's well-being. To better support men with CD, health providers, charitable organizations, and the food industry should address the social influence of adherence to a gluten-free diet, in particular perceived threats to social status and inclusion, which may cause concern, influence food choice, and influence dietary adherence. [ABSTRACT FROM AUTHOR]

The study reported in this paper explores the experiences of 95 people with intersex variations constituting an international English-speaking sample who completed a mixed methods survey comprises questions designed by the authors to explore 1) genital variations and medical interventions (and pressures to undertake them), 2) experiences with sex education, and 3) experience of physical intimacy, including use of safer sex devices and sexually transmitted infections. Surgeries on minors were common and typically not consensual, often resulting in the need for revisions. Pressures for surgeries most commonly were made by doctors. Experiences of sex education often failed to be inclusive of intersex bodies, with information about menstruation and hygiene rarely provided, and many participants having to learn on their own. Participants had a diversity of experiences of physical intimacy beyond penetration. For those who had experienced penetration, vaginal intercourse was enjoyable for some, but many found it painful. Conversely, anal intercourse was enjoyed by many and rarely found to be painful. The paper concludes by highlighting the importance of an intersex-specific approach to sexual health for this population. [ABSTRACT FROM AUTHOR]

In the Philippines, rising incidences of harassment directed at Filipinos who identify as lesbian, gay, bisexual, trans, queer, and intersex (LGBTQI+) are part and parcel of the systemic prejudice and discrimination based on an individual's sexual orientation, gender identity, and expression (SOGIE). In the absence of a national anti-discrimination legislation, the burden to confront SOGIE-based harassment (SBH) rests upon the LGBTQI+ community and their allies. In-depth interviews with five (5) Filipino university students foreground how those with salient distinct identities from targets of harassment surfacedg hesitations and barriers to successfully intervening (e.g. cisgender and heterosexual bystanders vis-à-vis LGBTQI+ targets of harassment), while bystanders who associate with victims of SBH, either by acknowledging them as friends or as fellow human beings, articulated substantial motivation and greater ease in intervening. Taken together, the recognition of shared identities in others — or kapwa—fosters bystander intervention as it counteracts the inhumane treatment targeted at LGBTQI+ individuals whom the bystander considers equal and no different from them. [ABSTRACT FROM AUTHOR]

Background and objective:Breastfeeding has a significant impact on maternal and child health. Poor feeding practises increase the risk of infectious diseases such as diarrhoea and acute respiratory infection significantly. In view of the significance of breastfeeding, the current study was carried out to evaluate lactating mothers' knowledge, attitudes, and practises toward breastfeeding as well as to track their positioning and attachment. Material and methodology: this study wasconducted in Department of Pediatrics of tertiary care teaching hospital at Ahmedabad. This was cross sectional observational study; conducted over period of 2 years. All neonates who were qualified under inclusion criteria were enrolled in study. Demographic details of mothers were collected. All the answers were filled up according to pre designed questionnaires and all data were tabulated and analysed. Results: Total 300 mothers were included in this study. In our study 58% mothers had average and 39% mothers had excellent knowledge regarding breastfeeding; 83% mothers had excellent attitude. 55% mothers were having average and 45% mother were having poor practices regarding breastfeeding. There was a moderate positive correlation between attitude and practices, which was statistically significant. Conclusion:The present study concludes that despite having adequate knowledge, attitude, good practices towards breastfeeding, there were still myths prevailing in the community, certain malpractices and insufficient knowledge on certain aspects of breastfeeding. Proper education of mother and whole family is very important. [ABSTRACT FROM AUTHOR]

Objectives: Hearing voices is associated with public stigma and this can influence readiness to identify as a voice hearer (VH) and psychological wellbeing. In this study, we investigated the relationships between a VH social identity, the integration of that identity with other important social identities and wellbeing. Design: Cross‐sectional study, with a subset of longitudinal data across three time points. Methods: People who self‐identified as voice hearers completed questionnaires (VH social identity, identity integration, wellbeing and perceptions of in‐group and out‐group empathy) at three time points, spaced at 3‐monthly intervals. The final sample comprised 182 participants at T1, 91 at T2 and 75 at T3. Hierarchical linear multiple regression analyses were used to test all hypotheses. Results: The integration of a VH social identity was strongly associated with better psychological wellbeing at T1. Identity integration was also associated with static wellbeing scores at 6 months. Effects on wellbeing were not accounted for by either severity of voice‐hearing or paranoia. Whilst perceptions of in‐group empathy were associated with VH social identification, perceptions of outgroup empathy were important for identity integration. Conclusions: Integrating a VH social identity with other important identities into a coherent sense of self is important for wellbeing in voice hearers; perceived in‐group and outgroup empathy are important in this process. [ABSTRACT FROM AUTHOR]

The transition from school to adult life is challenging for young people with intellectual disability. The study aimed to explore how young people with intellectual disability themselves experience the transition from school to adult life. A co-designed, qualitative study. Thematic data analysis of qualitative survey responses, semi-structured interviews, and focus groups with 27 young people with intellectual disability in three Australian states. Participants found transition planning at school inconsistent or lacking and felt excluded from decision-making about their lives. Accessing meaningful services, training, and employment beyond volunteering was challenging and enduring, leaving participants in perpetual state of transition, feeling lost, and missing out of post-school adult milestones. Policy, system, and service gaps must be addressed with a nationally consistent and accountable approach that truly supports choice and control for young people with intellectual disability in transitioning from school into meaningful adult lives. [ABSTRACT FROM AUTHOR]

Parkinson's Disease (PD) is a neurodegenerative disease characterized by motor and non-motor features. Many people with PD struggle with mental health issues such as depression. Evidence shows that people with PD may have trouble adopting a hopeful or positive orientation given their diagnosis and symptoms. Psychological treatments for PD are scarce and even more scarce are treatments that specifically focus on promoting hope and well-being. The Strengths, Hope, and Resourcefulness Program for People with Parkinson's Disease was developed to begin to address this treatment gap. This qualitative study identifies seven processes group members found helpful during treatment: Accessing Hope, Comparing, Drawing Together, Reaching Out Beyond Self, Releasing Emotion, Sharing Skills and Picking Up Resources, and Self-Reflecting Leading to Personal Insight. The unique contributions of an intentional and explicit hope, strengths, and resources intervention are discussed with specific attention to therapeutic process and practice. Provides client-elicited information useful to the implementation of hope and strength-focused approaches to group work with those with Parkinson's Disease. The group treatment may reinforce the value of hope as a therapeutic group factor by facilitating its emergence and contribution to group cohesion. Affords an important precursor to hope through the expression of difficult emotions in a safe environment. Offers insights into the group leader's role as process facilitator rather than top-down content expert. [ABSTRACT FROM AUTHOR]

Context: Media messaging matters for public opinion and policy, and analyzing patterns of campaign strategy can provide important windows into policy priorities. Methods: The authors used content analysis supplemented with keyword-based text analysis to assess the volume, proportion, and distribution of media attention to race-related issues in comparison to gender-related issues during the general election period of the 2022 midterm campaigns for federal office in the United States. Findings: Race-related mentions in campaign advertising were overwhelmingly focused on crime and law and order, with very little attention to racism, racial injustice, and the structural barriers that lead to widespread inequities. In stark contrast to mentions of gender, racial appeals were less identity focused and were competitively contested between the parties in their messaging, but they were much more likely to be led by Republicans. Conclusions: The results suggest that discussions of race and gender were highly polarized, with consequences for public understanding of and belief in disparities and policies important to population health. [ABSTRACT FROM AUTHOR]

This article explores the multifaceted nature of the individual motivations behind engaging in competition. In doing so, we investigate the theoretical and empirical links between general trait competitiveness and the three competitive attitudes: personal development, hypercompetition, and competition avoidant, as moderated by core self-evaluation. Findings indicate that it is not merely the level of general trait competitiveness that influences an individuals attitude towards competing, but heightened levels of core self-evaluation decrease the neurotic and unhealthy competitive attitudes of hypercompetitive and competition avoidant individuals. We discuss the implications for these relationships. [ABSTRACT FROM AUTHOR]

Research centered on the socioemotional benefits of religion and religious congregations for young people has highlighted largely positive outcomes for both young people and religious congregations. However, fewer studies have explored whether transgender young people receive those same socioemotional benefits from being religiously affiliated. Using secondary quantitative data from the 2015 US Transgender Survey, this study examined the religious experiences of transgender young people (aged 18–24). The data indicate that individual demographics (e.g., race, gender identity, sexual orientation, religious affiliation) affected the religious experiences of transgender young people, including leaving their congregations due to the fear of being rejected. More research is needed on the socioemotional benefits of religious affiliation for transgender young people. [ABSTRACT FROM AUTHOR]

This study aimed to explore the experiences of older adults engaged in pickleball. In particular, we collected views from the USA Pickleball Association (USAPA) ambassadors to identify how their experiences facilitate successful aging. A qualitative case study was utilized to obtain naturalistic data. Purposive sampling was used to recruit a total of 15 USAPA ambassadors, all of whom were interviewed in person. Data were analyzed using interpretive thematic analysis, and four overarching themes were generated: (a) a new way to stay active, (b) pickleball is social, (c) an intergenerational pastime, and (d) reestablishing an identity through pickleball. The findings support the view that engaging in pickleball is a promising means of achieving a healthy life as a senior citizen. The participants maintained a physically and mentally active lifestyle through pickleball, and their commitment to this sport led to their engagement as ambassadors in their communities. [ABSTRACT FROM AUTHOR]

Status difference is prevalent within working groups, profoundly influencing employees' perceptions and behaviours towards coworkers and their groups. Despite this ubiquity, exploring the effects of status difference within groups remains relatively underexamined. Drawing on social identity theory, this study examined how and when horizontal status difference (i.e., status comparison between a focal employee and his/her peers) and vertical status difference (i.e., status comparison between a focal employee and his/her leader) influence employees' perceived insider status and proactive behaviour. Results from 421 employees across 113 working groups indicated that horizontal status difference was positively related to perceived insider status, but vertical status difference had a curvilinear effect on perceived insider status. Furthermore, perceived insider status significantly mediated the impact of horizontal and vertical status differences on proactive behaviour. We also demonstrated that promotion criteria significantly moderated the relationship between horizontal status difference and perceived insider status; in particular, this relationship was stronger when organizations used a relative rather than an absolute promotion criterion. [ABSTRACT FROM AUTHOR]

The current study examines the predictors and consequences of the ways coworkers react following sexual identity disclosure. We propose that employees may experience different reactions following disclosure depending on their social and sexual identities and that such reactions will impact their job attitudes, well‐being, and subsequent identity concealment. Data were collected from 308 lesbian, gay, bisexual, and pansexual employees using a two‐wave field survey design. Results for the predictors of coworker reactions indicate that employees who identified as Black, transgender/genderqueer, or bisexual/pansexual reported they experienced more unsupportive reactions from their coworkers following the disclosure of their sexual identity as compared to White, cisgender, and gay/lesbian employees. Supplemental analyses further indicate that Black bisexual/pansexual employees experienced the least positive reactions from coworkers as compared to the other referent groups. Results examining the outcomes of coworker reactions demonstrate that positive disclosure reactions are associated with decreased job satisfaction and increased turnover intentions, emotional exhaustion, and subsequent identity concealment, whereas negative disclosure reactions are associated with increased depressive symptoms and emotional exhaustion. Findings demonstrate a need to expand on conceptual and empirical work on identity disclosure to consider coworker reactions and underscore that the disclosure experiences of sexual minority employees are not uniform. [ABSTRACT FROM AUTHOR]

Ethnic minority youth show worse school adjustment than their ethnic majority peers. Yet, it remains unclear whether this gap can be explained by differences in family functioning and consequent identity commitments. This study examined (1) whether family functioning relates to identity commitments over time and (2) whether identity commitments impact later school value (3) among minority and majority adolescents. Minority (N = 205, Mage = 16.25 years, 31.1% girls) and majority adolescents (N = 480, Mage = 15.73 years, 47.9% girls) participated in this preregistered three-wave longitudinal study (T1: March-April 2012; T2: October 2012; T3: March-April 2013). Dynamic Panel Models revealed that most within-person cross-lagged associations were not significant in the total sample. Yet, multigroup analyses revealed differences between groups: Stronger identity commitments related to lower school value among minority adolescents, but were unrelated to school value among majority adolescents over time. Additionally, higher school value increased identity commitments among minority youth, yet it decreased identity commitments among majority youth over time. The findings highlight the differential interplay between identity commitments and school adjustment for minority and majority adolescents, with important implications for their future life chances. [ABSTRACT FROM AUTHOR]

A self-report instrument was created to measure stress, attitudes, and performance of domestic and family violence (DFV) first responders in an Australian state. DFV-related stress negatively impacted officers' attitudes and self-assessed performance. Higher DFV stress was predicted by the frequency and severity of DFV incidents, and the absence of lived experience. Negative attitudes were predicted by a shorter length of service and lower severity, and poorer performance by a longer length of service and lower perceived social support. Males reported higher stress and poorer performance than females. The findings reveal systemic issues that inhibit effective police response, emphasizing the need to address negative attitudes and "DV fatigue." [ABSTRACT FROM AUTHOR]

Domestic workers (DWs) are integral to the daily lives of a significant portion of India's urban population, with an estimated 3.9 million individuals employed in domestic roles in urban areas, mostly women. This article explores the perceptions of home, house, and safe spaces among migrant women DWs in Delhi. Through in-depth interviews, it delves into their lived experiences as both breadwinners and survivors of domestic violence, revealing that (a) house and home are differently conceptualized by these workers; (b) their homes are perceived as warzones, reinforcing patriarchy through incidents of domestic violence and gendered subordination; and (c) women DWs navigate the complexities of conflicting identities as breadwinners and survivors within unequal gendered relationships. [ABSTRACT FROM AUTHOR]

Purpose: To assess pharmacists' mental well-being, perceptions of safety, and willingness to administer vaccines before and during the COVID-19 pandemic. Methods: An electronic survey was administered to a convenient sample of practicing pharmacists working in Alabama, Tennessee and Texas. The 33-item survey examined pharmacists' beliefs about the pandemic's impact on their mental well-being, their perceptions of safety in vaccine administration, and their willingness to vaccinate. Responses were assessed on a 5-point Likert scale, ranging from strongly disagree (1) to strongly agree (5). A recruitment email with the survey link was sent to pharmacists, with periodic reminders over a 4-week period. Descriptive statistics and bivariate analyses were utilized to evaluate survey responses. Results: A total of 387 responses were analyzed, with an estimated response rate of 3.93%. Most respondents were women (65%) and had at least 6 to 10 years of practice experience (28%). Overall, participants felt that the pandemic worsened their mental well-being, with women reporting a more negative mental well-being compared with men (P <.001). They reported having less time during workflow to apply personal protective equipment (PPE) (P =.0074) compared to before the pandemic. They also reported a decrease in willingness to vaccinate adult patients during the pandemic (P <.0001), and that concern about contracting COVID-19 prevented them from giving vaccinations (P <.0001). Conclusions: Pharmacists felt their mental well-being and willingness to vaccinate patients suffered as a result of the COVID-19 pandemic. Future research and initiatives that focus on improving vaccination rates should also consider pharmacists' concerns and well-being. [ABSTRACT FROM AUTHOR]

Introduction: Cell population data (CPD) parameters may be putative biomarkers for the screening of various diseases including some infections and myelodysplastic syndrome. This study aimed to establish the age‐ and sex‐specific reference intervals (RIs) for the CPD parameters in the Korean population. Methods: The reference population for the RIs of CPD parameters comprised 124 856 subjects aged 20–99 years. CPD parameters were obtained from Sysmex XN‐2000 (Kobe, Japan) datasets from 17 health promotion centers in 13 South Korean cities. We determined significant partitions for age and sex, and calculated RIs according to Clinical and Laboratory Standards Institute C28‐A3 guidelines. Results: The side scattered light intensity in the neutrophil area and the lymphocyte area did not require sex‐related partitioning except in those over the age of 50, among whom the lower limit (LL) and upper limit (UL) were lower in females. However, the side scattered light distribution width in the lymphocyte area required age‐ and sex‐related partitioning, in which LL and UL were higher in females. The LL and UL of the fluorescent light distribution width were higher in males in the neutrophil area and higher in females in the lymphocyte area, but age‐related partitioning was not required. The forward scattered light intensity in the neutrophil area, lymphocyte area, and monocyte area did not require age‐related partitioning in males. Conclusion: This study has determined comprehensive age‐ and sex‐specific RIs for CPD parameters, which could help to prove the clinical significance of these parameters in the Sysmex XN‐2000. [ABSTRACT FROM AUTHOR]

Many studies have examined behavioral and social drivers of COVID-19 vaccination initiation, but few have examined these drivers longitudinally. We sought to identify the drivers of COVID-19 vaccination initiation using the Behavioral and Social Drivers of Vaccination (BeSD) Framework. Participants were a nationally-representative sample of 1,563 US adults who had not received a COVID-19 vaccine by baseline. Participants took surveys online at baseline (spring 2021) and follow-up (fall 2021). The surveys assessed variables from BeSD Framework domains (i.e., thinking and feeling, social processes, and practical issues), COVID-19 vaccination initiation, and demographics at baseline and follow-up. Between baseline and follow-up, 65% of respondents reported initiating COVID-19 vaccination. Vaccination intent increased from baseline to follow-up (p <.01). Higher vaccine confidence, more positive social norms towards vaccination, and receiving vaccine recommendations at baseline predicted subsequent COVID-19 vaccine initiation (all p <.01). Among factors assessed at follow-up, social responsibility and vaccine requirements had the greatest associations with vaccine initiation (all p <.01). Baseline vaccine confidence, social norms, and vaccination recommendations were associated with subsequent vaccine initiation, all of which could be useful targets for behavioral interventions. Furthermore, interventions that highlight social responsibility to vaccinate or promote vaccination requirements could also be beneficial. [ABSTRACT FROM AUTHOR]

Awareness and uptake of the meningitis vaccine remains low among marginalized groups, such as Latino men who have sex with men (LMSM), potentially due to structural and psychosocial barriers in accessing preventative healthcare. The current study explored awareness and uptake of meningitis vaccines among a group of LMSM (N = 99) living in South Florida. A three-pronged variable selection approach was utilized prior to conducting regression models (linear and logistic). Overall, 48.5% of the participants reported little to no knowledge about meningitis vaccines, and 20.2% reported being vaccinated. Living with HIV (OR = 10.48) and time since outbreak (OR = 1.03) were significant predictors of meningitis vaccine uptake. No significant correlates of meningitis vaccine awareness were identified. More research is needed to identify other important factors associated with meningitis vaccine awareness and uptake among LMSM, a multiple marginalized group. [ABSTRACT FROM AUTHOR]

Introduction: Betel quid (BQ) is globally the fourth most consumed psychoactive substance. It is consumed by an estimated 600 million people worldwide, accounting for nearly 8% of the world's population. There have been very few studies assessing chewers' motivation to quit. Objectives: In the current study, we sought to understand the relationship between several cessation-relevant variables and chewers' motivation to quit. Hypotheses: Based on analogous research on cigarette smoking, we hypothesized that the following cessation-relevant variables would be associated with motivation to quit: health risk perceptions, number of chews per day, cost, degree of BQ dependence, withdrawal symptoms, number of quit attempts, reasons for use, personal health improvement, and type of BQ chewed. Methods: A total of 351 adult BQ chewers from Guam participated in the survey and served as the sample for the analyses. Results: Majority of chewers want to quit and intend to quit. Chewers relatively high in motivation to quit evinced greater health risk perceptions of BQ chewing, greater perceived health benefits to quitting, and a greater number of past quit attempts, compared to those relatively low in motivation to quit. Conclusions: Understanding which factors are associated with chewers' motivation to quit can be helpful for designing BQ cessation programs. The results suggest that BQ cessation programs could be improved by an increased emphasis on information about the negative health effects of BQ chewing and relapse-prevention. [ABSTRACT FROM AUTHOR]

Background: Societal beliefs about the seriousness of different addictions were assessed in the United Kingdom (UK). Methods: An online panel, conducted in 2021 and sampled to be representative of the UK general population 18 years and over (N = 1499), was conducted and asked participants their views regarding the seriousness of different societal problems, including various addictive behaviors. Results: Cannabis was ranked as the least serious of the addictive behaviors. Other illicit drug use (cocaine, amphetamine, heroin) was rated as the most serious of addictive behaviors. None of the addictive behaviors were rated as being as serious a problem to society as environmental damage, violent crime, poverty, and the COVID-19 pandemic. Conclusions: Ratings of cannabis use were not as expected and stand in contrast to the current UK policy on cannabis use. In addition, the UK policy on alcohol consumption contrasts with societal concerns about alcohol use. [ABSTRACT FROM AUTHOR]

We responded to the need for replication in psychotherapy research by extending a prior naturalistic study documenting the effectiveness of long‐term psychodynamic treatment. We employed three novel analytic strategies and evaluated their influence on substantive interpretations offered in the prior study. The sample consisted of clients (N = 387; Mage = 31.61; SD = 11.13; 58.9% female; 79.1% Caucasian/White) receiving outpatient treatment at a psychodynamic training clinic. Results replicated the original two‐class solutions for social functioning, depression and life satisfaction. Novel to the replication analyses, each trajectory for social functioning and depression exhibited nonlinear change and results advanced research on a theorised mechanism of effective psychodynamic treatment. Results showed that change in experiential avoidance was a possible mechanism between early‐treatment change in social functioning and later‐treatment changes in depression symptoms and life satisfaction. Clinical implications focus on the influence that initial levels of symptoms and well‐being may have on early and later phases of treatment, monitoring progress throughout treatment, and how to promote symptom and well‐being improvement. [ABSTRACT FROM AUTHOR]

From the perspective of the health context paradox, this study examined the relationship between adolescent victimization and depression based on the diathesis-stress model and attribution theory using a nested model. A survey was conducted on 3743 Chinese adolescents using the Bullying & Victimization Scale, Rumination Scale, Beck Depression Inventory, and Bullying Attitude Scale. The results disclosed that victimization had a positive impact on depression, rumination played a mediating role between victimization and depression, and classroom anti-bullying attitudes heightened the correlation between victimization and developing depression as well as between victimization and engaging in rumination thinking. This study provides a new cross-level perspective to reduce the occurrence of depression among bullied adolescents and further validates the health context paradox, expanding its applicability range. It also provides new experimental research references for reducing depression among bullied adolescents from a more comprehensive, cross-level perspective in the future. • Study reveals classroom bullying attitudes mitigate the impact of victimization on teens' depression and rumination. • Study confirms and broadens the healthy context paradox scope with classroom bullying attitudes. • First study to examine how classroom bullying attitudes affect bullied teens' depression, offering a new research perspective. [ABSTRACT FROM AUTHOR]