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College-in-prison programs are positioned to expand substantially under the reinstatement of Pell Grant eligibility for people in prison. While this change will enable more students who have been systemically excluded from higher education to attend college, degree completion is rare during incarceration and post-release. Student perspectives can shed light on both the value of college-in-prison and the financial barriers to realizing its value. This study analyzes data from 12 focus groups with 105 total college-in-prison student participants, 114 student survey responses, and 45 stakeholder interviews. The data were collected between 2018-2022 during a process evaluation of the College-in-Prison Reentry Initiative, which provided funding to college-in-prison programs in New York State as part of the Manhattan District Attorney's Office Criminal Justice Investment Initiative. The findings demonstrate that students value college-in-prison, describing how it fostered self-reflection and personal growth and provided them with a skillset that may help them gain employment upon release. However, students also raised concerns about reenrolling and completing their degrees following release. Intentional, holistic reentry support could address the largely financial barriers to reenrollment. In so doing, students will be more likely to earn their college degrees after incarceration and experience the full value of a college education.

Pell eligibility for incarcerated people is a great rehabilitative opportunity, but several challenges remain. This article recaps five of the issues identified by the original research articles in this special issue. It also considers how solutions proposed in these studies may be beneficial across a variety of these issues and gathers recommendations together by which actor could implement them. Problems and solutions are corroborated by the author's personal experience with incarceration.

The violence of incarceration creates greater responsibility for higher education administrators in supporting students who are in prison. Using focus group data with incarcerated students and formerly incarcerated alumni who participated in or are actively participating in Second Chance Pell, we explore their perceptions and understandings of the Pell Grant and eligibility for the Pell Grant, including lifetime eligibility used limits. Through a lens of Witnessing, we argue that deprivation and censorship of information negatively influence students' access to accurate and timely information about federal student aid and their ability to fully participate in the process. Accordingly, college and university staff have a fiduciary duty to incarcerated applicants and students who are subjected to the information deprivation and censorship that characterizes imprisonment in the U.S.

This study addresses two areas of need in the literature. First, we recognize the impact of experiential-learning on student outcomes and fewer opportunities within the social sciences. Second, as academics in criminal justice and education, we are aware of educational needs of incarcerated persons. The current study blended together experiential-learning alongside a reading program within one state's women's correctional facility, targeting (grand)mothers. Two faculty and 40 students, spanning two academic departments, completed a research-based experiential-learning project with one community partner. This undergraduate project sought to benefit students, incarcerated (grand)mothers, and the (grand)children of incarcerated (grand)mothers through a read-aloud program. Through student observations, themed results found incarcerated (grand)mothers had negative school experiences regarding reading. Subsequently, they did not read with their (grand)children prior to incarceration but used reading as a means to escape their incarceration. Students' reflections demonstrated value to self, participants, and the community, through participation in research-based experiential-learning.

Because of the long history of anti-drug policing in the United States and the criminalization of substance use, clients who use substances are vulnerable to direct and vicarious experiences of police violence. Consequently, those who use substances may face a greater risk of experiencing symptoms of trauma that counselors should address in treatment. We recommend the use of a trauma-informed and abolitionist praxis in clinical and social justice practices as a framework to support clients who use substances and have histories of exposure to police violence.

In this article, I discuss how walking as mapping serves as a method for observing and disrupting spatial geopolitics, opening possibilities for alternative systems of living. I explore three theoretical perspectives--posthumanism, Indigenous and decolonializing theories of land, and Black geography--that, while distinct, nonetheless share some overlapping characteristics: the recognition and contestation of knowledge systems, the turn toward a relational ethics of living, and a call for critical and creative methods of mapping. intervention into existing systems. In the final half of the paper, I consider these orientations and their call for creative and critical methods of intervention as I review my scholarship on walking and how it has served as a form of counterstory mapping.

Background: The COVID-19 pandemic and subsequent school closures have had profound impacts on learners and their families globally, affecting their psychosocial wellbeing. However, the extent and nature of these effects, particularly in diverse socioeconomic contexts, remain largely under-explored. Aim: This study aimed to investigate the effects of school closures on the psychosocial wellbeing of children and parents in South Africa's Gauteng province. Setting: The research included families from various socioeconomic backgrounds in Gauteng province, South Africa. Methods: Using an ethnographic research approach, diary-style entries via the WhatsApp mobile app were collected from 43 families, and semi-structured telephonic interviews were conducted with 21 families. Results: The study found that children experienced adverse emotions, including loneliness, boredom, anxiety and isolation during school closures. Parents reported elevated stress levels and increased caregiving burden. The severity of impact was influenced by access to resources for online or home-schooling. Conclusion: The findings highlight the multi-dimensional implications of school closures on families and underscore the importance of providing adequate support during such disruptions, taking into account the varying effects across socioeconomic backgrounds. Contribution: This study fills a crucial gap in understanding the psychosocial impacts of school closures due to the COVID-19 pandemic on children and parents within diverse socioeconomic contexts. The findings call for equitable access to educational resources, evidence-based remediation efforts, and integrated mental health support services.

Afro Latinx immigrants are an underserved population in the United States and within counseling specifically. The counseling profession has been slow to address the unique needs of this population despite the increased visibility of this group in recent years. Consistent with the codes of ethics from the American Counseling Association and the National Board for Certified Counselors and the Multicultural and Social Justice Counseling Competencies (MSJCC), counselors must continue to expand their repertoire and use empirically supported tools to address these mandates and increase cultural responsiveness in clinical practice. Despite its alignment with the MSJCC, the counseling literature demonstrates that the Cultural Formulation Interview is an underutilized, empirically supported tool. The authors describe how counselors may use the Cultural Formulation Interview in their clinical practice with Afro Latinx immigrants while operating from a multicultural and social justice-oriented framework.

Black, school-aged youth may experience socioeconomic, psychological, and emotional difficulties that affect their mental health, leading to maladaptive ways of coping, such as cannabis use. Instead of getting treatment and support to help them manage their stressors in positive ways, Black youth often receive punitive school practices, including referrals to the juvenile justice system. Counselors who work with school-aged youth are likely to encounter many Black youth and can thus either be instrumental to their psychological development or inadvertently impede their well-being with over-pathologization and criminalization of their cannabis use. In this article, the author reflects on a particular experience he had working with a Black youth and how it influenced his cultural competency and development as a counselor. The author also discusses the socioeconomic landscape and psychological experience of Black youth and their rationale for cannabis use. The article concludes with implications for professional counselors.

Suicide, which is defined as an individual's intentionally attempting to end his or her life, is considered an important public health problem. In this study, it was aimed to examine the relationship between cognitive distortions and suicide probability in university students who are in age groups at risk for suicide, and to examine the mediating roles of the attachment dimensions of anxiety and avoidance, in this relationship. The study group consisted of 441 university students. In the study, Suicide Probability Scale, Experiences in Close Relationships Inventory, Cognitive Distortions in Relationships Scale and a personal information form were used as data collection tools. In accordance with the purpose of the study, a correlation analysis between variables and regression analyses were applied to examine the mediating roles of avoidance and anxiety in the relationship between cognitive distortions and suicide probability. The findings showed that there was a moderate positive correlational relationship between suicide probability scores and avoidance scores and there was a moderate positive correlational relationship between suicide probability scores and cognitive distortion scores. It was shown that there were low and moderate positive correlations between cognitive distortion scores, and avoidance and anxiety scores. The results of the mediation analyses showed that anxiety and avoidance had a partial mediating role in the relationship between cognitive distortion and suicide probability. The results were discussed in light of the literature.

This study investigated the digital existence of the food bank users in a university town in Texas, and subsequently, aligned with the research's pragmatic focus, the researchers designed a training model for these food bank users. Two research questions guided the study: What are the digital existence levels of the food bank users, and what training model would best serve these food bank users? Data were collected by means of a survey from 230 individual food bank users representing households. Additional data included observations and conversations with food bank staff, and documents and materials from the site which provided deeper insights. The study found that the food bank users (1) had little to no broadband connectivity; (2) possessed limited digital devices which revealed significant barriers to their digital existence; and (3) had feelings of desperation, vulnerability and isolation. Regarding training offered at no cost, the food bank users did not show much interest, which was attributed to the food bank users' insufficient digital knowledge. The three-level training model was designed with the following objectives: (1) Prepare participants for training; (2) introduce the concept of "digital;" and (3) teach basic computing and cybersecurity skills. To implement this training, an interactive learner-centric model was created demonstrating collaboration among university instructors, volunteer students and the food bank staff. The study concluded that to exist in digital societies affordable broadband connectivity, needs-based devices, and continual support and training were needed for such underserved groups.

Research shows that the vast majority of students who are diagnosed with learning disabilities in school are, in fact, dyslexic. Still, many students with dyslexia are not adequately identified, assessed, or supported with research-based interventions. Adults with dyslexia report struggling with reading difficulties from as early as kindergarten which impacts their learning experiences over the life span. Providing evidence-based instruction alongside supplementary digitally-mediated reading tools such as The Noah Text®--New Century program described in this article is critical for improving learning engagement and outcomes among adult learners with dyslexia, especially for the disproportionate number of learners with reading difficulties in incarcerated settings. Significant efforts are now underway to improve methods for diagnosing and treating dyslexia, including at the federal level. For example, in 2018, the First Step Act (FSA) was the first major criminal justice reform to recognize the need to identify and support adult learners with dyslexia as part of a broader effort to reduce recidivism by improving access to evidence-based educational and rehabilitative programming for justice-impacted individuals.

From James Baldwin's (1962) "A Letter to My Nephew," which laid bare the brutalities of being black in 1960s America, to Chanelle Miller's published victim impact statement addressed to her assailant, which provided vocabulary and was kindle for #MeToo, examples abound demonstrating the ways in which the open letter continuously surfaces during pivotal historical junctures. Although the contextual significance of this format of authorship is widely used in scholarly disciplines ranging from education to history, the structural significance of the open letter as a methodologic approach to academic writing has yet to be theorized, leaving questions that merit attention: Why is the open letter so often used by marginalized groups? What are the literary and rhetorical effects of the enclosed addressed between sender and receiver? Finally, how does this format of writing create and affect the positionality and subjectivity of authors? By writing a letter addressed to Academia/School, this essay makes the case for the open letter as something to be studied but also a methodology and study in and of itself. By drawing on literary theory, cultural studies, and research on writing in academia, this essay suggests that the open letter is an important form of authorship and argues for revisiting the open letter as a legitimate form of scholarship as well as an authentic form of academic writing in education.

Background: Children with intellectual and developmental disabilities are at a higher risk of developing dental caries. Few scoping reviews have been conducted in India to understand their issues. We aimed to summarise the distribution and risk factors of dental caries among children and adolescents with intellectual disabilities in India. Methods: A scoping review was conducted based on the Arksey O Malley framework. Quality assessment of studies, descriptive and thematic analyses were also conducted. Results: We charted, collated, and summarised from four databases. Thirty-one studies met the study criteria consisting of children and adolescents with intellectual disabilities. Median caries prevalence was 70%, decayed missing and fIlled permenant teeth (DMFT) was 2.4, decayed missing and filled decidous teeth (dmft) was 2.36, and DMFS was 3.7. Major determinants were the severity of disability, socioeconomic status and parents' education. Oral care and dental visits were inadequate. Conclusion: Further exploration is required to improve access and reduce caries experience and prevalence among children with intellectual and developmental disabilities in India.

Background: As a group, autistic children with high support needs (with adaptive functioning in the range of an intellectual disability) are at risk of significant literacy difficulties. We investigated the parent-reported home literacy environment of this group of children. Method: Sixty-two parents of autistic children (4.5 to 18.25 years) attending an autism-specific school completed a home literacy survey reporting on their child's: (1) alphabet knowledge, (2) interest in reading, (3) activities/interactions around books, (4) reading ability, and (5) writing ability. Results: We found significant positive correlations between parent-reported child interest in reading and literacy-related interactions and skills, but not with child age. Children using spoken words to communicate obtained significantly greater scores on four home-literacy subscales, but not on reading interest. Conclusions: A better understanding of the home literacy activities of autistic children with high-support needs is needed to inform educational practices aimed at promoting literacy development in this vulnerable population.

Background: Youth with intellectual disabilities experiencing homelessness are invisible within multiple service sectors. We know little about their experiences of homelessness, or the impacts of such on the social and physical health and well-being. Methods: We used quantitative and qualitative methods to measure prevalence and learn from key informants and homeless youth with intellectual disabilities about factors leading to and sustaining homelessness, and the implications of such on their social, physical, and mental health and well-being. The project involved seven co-researchers with intellectual disabilities and experience of youth homelessness in research design, data collection, analysis, and dissemination. We created Forum Theatre scenes that creatively represent the findings of the project. In this paper we share one of those scenes, as well as the recommendations three co-researchers with intellectual disabilities have for improving support to homeless youth with intellectual disabilities. Findings: Lack of awareness of and about homeless youth with intellectual disabilities, combined with siloed ways of working by involved sectors, results in significant disadvantage and health inequities for youth. Also revealed was the likelihood this would continue given existing obstacles to accessing appropriate housing and supports to exit homelessness. Conclusion: Services providers, policy makers and representatives of the involved sectors need to recognize and acknowledge homeless youth with intellectual disabilities and take responsibility for learning and working together to develop integrated and responsive approaches to effectively supporting them.

Background: People with learning disabilities experience health and social inequalities, and research that could improve health services may not be implemented in real-life settings. Building stakeholder networks that can share and implement research findings may address this. This paper presents a framework for building a stakeholder network that maximises the likelihood of research recommendations being implemented in practice. This was developed as part of the 'Making Positive Moves' (MPM) study, which explores the experiences of people with learning disabilities following discharge from a residential stay within a hospital inpatient setting. Methods: We reviewed the literature on existing theoretical frameworks to support the development of a model for dissemination of the MPM findings. Stakeholder categories were identified through consultation with the MPM researchers, experts by experience and the steering group and a hub and spoke model to represent all stakeholder categories was created. These categories include person moving; family of the person moving; specialist schools; social care; care providers; regulators; third sector organisations; policy organisations; academic community; and NHS professionals. After establishing the categories, we consulted with people with learning disabilities and other stakeholders and conducted online searches to create a stakeholder database. Through information gathering and direct contact with stakeholders, we assessed levels of interest, power and engagement to determine which stakeholders to prioritise in our dissemination activities. The Stakeholder Wheel was created to present the data captured within the database and engagement profiles in an illustrative way. Findings: We use two stakeholder sub-categories, user-led organisations and care providers, to demonstrate the methodological approach. The examples illustrate how a scoring system helped us to identify high-priority stakeholders who we then contacted to collaborate within developing our dissemination strategy to maximise the impact of the MPM research findings. Conclusions: We developed a framework to map stakeholders for the MPM study and enable targeted dissemination to increase the impact of the research. This approach has the potential to reduce health inequalities among people with learning disabilities by increasing the awareness of and ability to implement evidence-based recommendations in real-life settings. The stakeholder mapping framework could be applied to research projects associated with learning disabilities to bridge the gap between research and practice and reduce health inequalities.

The present study investigated whether distinct developmental patterns of externalizing behaviors (EBs: hyperactivity-impulsivity, noncompliance, physical aggression) based on parent reports were repeatedly and differentially associated with separate dimensions of internalizing problems such as general anxiety, separation anxiety, and depressive symptoms across the early, middle, and late preschool years in a population birth cohort (N = 2,057, 50.7% boys). Six high trajectory classes obtained by latent growth modeling were used as longitudinal indicators of single EB and co-occurrent EBs. Children following low or moderate trajectories for all EBs served as the reference class. Results revealed that children in trajectory classes reflecting high levels of co-occurring EBs showed higher levels of general anxiety, separation anxiety, and depressive symptoms across the preschool years. In contrast, children in trajectory classes reflecting single EB manifested higher levels of some, but not all, dimensions of internalizing problems. In addition, their scores varied from one period to another. No sex differences were observed in the above associations. These results underline the need for comprehensive assessments across distinct types of EBs and internalizing problems to better reflect the characteristics that distinguish individual children. Finally, results suggest that children showing early co-occurrent EBs and internalizing symptoms may be an important group to target for in-depth assessment and possibly preventive intervention.

The network scale-up method (NSUM) is a survey-based method for estimating the number of individuals in a hidden or hard-to-reach subgroup of a general population. In NSUM surveys, sampled individuals report how many others they know in the subpopulation of interest (e.g. "How many sex workers do you know?") and how many others they know in subpopulations of the general population (e.g. "How many bus drivers do you know?"). NSUM is widely used to estimate the size of important sociological and epidemiological risk groups, including men who have sex with men, sex workers, HIV+ individuals, and drug users. Unlike several other methods for population size estimation, NSUM requires only a single random sample and the estimator has a conveniently simple form. Despite its popularity, there are no published guidelines for the minimum sample size calculation to achieve a desired statistical precision. Here, we provide a sample size formula that can be employed in any NSUM survey. We show analytically and by simulation that the sample size controls error at the nominal rate and is robust to some forms of network model mis-specification. We apply this methodology to study the minimum sample size and relative error properties of several published NSUM surveys.

The dorsal stream vulnerability hypothesis posits that the dorsal stream, responsible for visual motion and visuo-motor processing, may be particularly vulnerable during neurodevelopment. Consistent with this, autism spectrum disorder (ASD) has been associated with deficits in global motion integration, though deficits in ventral stream tasks, such as form identification, have also been reported. In the current study, we examined whether a similar pattern of results is found in a cohort of 381 children born with neurodevelopmental risk factors and exhibiting a wide spectrum of caregiver-reported autistic traits. Methods: We examined the associations between global motion perception, global form perception, fine motor function, visual-motor integration, and autistic traits (autism spectrum quotient, AQ) using linear regression, accounting for possible interactions with sex and other factors relevant to neurodevelopment. Results: All assessments of dorsal stream function were significantly associated with AQ such that worse performance predicted higher AQ scores. We also observed a significant sex interaction, with worse global form perception associated with higher AQ in boys (n = 202) but not girls (n = 179). Conclusion: We found widespread associations between dorsal stream functions and autistic traits. These associations were observed in a large group of children with a range of AQ scores, demonstrating a range of visual function across the full spectrum of autistic traits. In addition, ventral function was associated with AQ in boys but not girls. Sex differences in the associations between visual processing and neurodevelopment should be considered in the designs of future studies.

This study examined the clinical utility of the Massachusetts Youth Screening Instrument--Second Version (MAYSI-2) among African American (AA) incarcerated youth and used White incarcerated youth as a comparison group. Data were analyzed for 314 incarcerated youth (193 AA offenders and 121 White offenders) of ages 13-17 years who were adjudicated delinquent from a southeastern United States medium security residential facility. Seven logistic regression and receiver operating characteristic curve (ROC) models were built to determine whether the MAYSI-2 subscales accurately identify committed AA male incarcerated youth who have a mental illness diagnosis on file. Analyses also examined how well the MAYSI-2 subscales identify specific mental illnesses among AA-committed male incarcerated youth. Results demonstrated that no MAYSI-2 subscales accurately identified and categorized AA-committed male incarcerated youth who have mental disorders, and only two subscales (Alcohol/Drug Use, Depressed/Anxious) identified and categorized White committed male incarcerated youth who have a mental disorder. Additional results and implications for research and practice are provided.

This research considers Pell grant restoration for incarcerated people for the field of higher education in prison. Using the original data, we outline the limits of Pell funding in the prison context by surfacing persistent funding challenges that the Pell grant alone cannot address and may exacerbate. By providing the necessary investments to support higher education in prison, Pell restoration could be an effective lever for advancing racial and economic justice. Using a lens of racial and socioeconomic justice, we identify gaps in prison program costs and argue that the long-term effects of Pell reinstatement will depend on whether the expansion is accompanied by investments in a range of institutional infrastructures and resources. Concluding are implications and recommendations to adequately and responsibly support the growth and infrastructure of higher education in prison programs.

Background: Historical trauma and cultural loss resulting from colonialism have contributed to educational and health disparities among Pacific youth. Recognizing the protective factors is essential for mitigating disparities and enhancing the overall well-being of these youth. Objective: This review provides evidence about the current state of youth development among Pacific youth. Methods: We conducted a systematic review of the literature published between 2010 and 2020, including the fields of education, social, psychological, and medical sciences. We employed qualitative data analysis of 35 peer-reviewed studies. Results: The majority (69%) of the studies focused on program interventions among 10-19-year-old youth at-risk primarily in New Zealand among Maori (51%) and in the U.S. among Native Hawaiians and Pacific Islanders (46%). Health interventions were common in Hawai'i, while the New Zealand studies focused more on measuring youth resilience. Among the three outcomes identified, health/well-being was the most studied area, followed by social-emotional, and cognitive development. The outcomes suggest mainly positive effects on health and well-being, socio-emotional, and cognitive development related to Pacific youth. Conclusions: While the last decade has seen a growth of culturally anchored programs, more research is needed to account for wider social, economic, and political dynamics that impact youth development, which was largely unaccounted for in the extant studies. There is a need for broader developmental frameworks that would, first, align with the context and culture of the youth's community, and second, expand our horizon of the developmental patterns as they occur in diverse sociocultural contexts.

Reservation-dwelling American Indian adolescents are at exceedingly high risk for cannabis use. Prevention initiatives to delay the onset and escalation of use are needed. The risk and promotive factors approach to substance use prevention is a well-established framework for identifying the timing and targets for prevention initiatives. This study aimed to develop predictive models for the usage of cannabis using 22 salient risk and promotive factors. Models were developed using data from a cross-sectional study and further validated using data from a separate longitudinal study with three measurement occasions (baseline, 6-month follow-up, 1-year follow-up). Application of the model to longitudinal data showed an acceptable performance contemporaneously but waning prospective predictive utility over time. Despite the model's high specificity, the sensitivity was low, indicating an effective prediction of non-users but poor performance in correctly identifying users, particularly at the 1-year follow-up. This divergence can have significant implications. For example, a model that misclassifies future adolescent cannabis use could fail to provide necessary intervention for those at risk, leading to negative health and social consequences. Moreover, supplementary analysis points to the importance of considering change in risk and promotive factors over time.

School-based mental health professionals consistently report that they are either not prepared to support grieving students, or do not have time to integrate crisis intervention support into their hectic schedule. Given that inadequate school mental health services can increase a bereaved student's risk of developing emotional problems, it is critical that school psychologists increase their comfort in grief. This study surveyed 75 school psychologists in the Northwestern United States regarding their training and experience in grief support. A reflexive thematic analysis identified four themes related to the challenges and recommendations in grief support: lack of training, limited role of the school psychologist, lack of formalized grief response system, and lack of school and community resources. Furthermore, only 3% of participants reported taking the lead in providing grief support and 64% provide grief support fewer than five times a year. The majority (81%) reported that they had zero courses devoted to grief support during their graduate degree, with more participants (67%) obtaining grief training postdegree. Study limitations, areas for further research, and implications for schools and school psychologists are also discussed.

Being looked at is an important communicative signal, and attenuated responses to such direct gaze have been suggested as an early sign of autism. Using live eye tracking, we examined whether direct gaze elicits different gaze responses in infants at ages 10, 14 and 18 months with and without later autism in real-life interaction. The sample consisted of 169 infants: 35 with elevated likelihood of autism and subsequent diagnosis, 94 without subsequent diagnosis and 40 with typical likelihood of autism. Infants in all groups tended to look more towards the adult's face shortly after the direct gaze occurred. Neither how much nor how quickly the infants responded to the direct gaze differentiated the without elevated likelihood of autism and subsequent diagnosis and with elevated likelihood of autism and subsequent diagnosis groups. Infants in the typical likelihood group looked more at the face after the direct-gaze event than infants in the two elevated likelihood groups, but this result is tentative. In an exploratory analysis, infants in the elevated likelihood of autism and subsequent diagnosis group looked away quicker from faces with direct gaze than infants in the typical likelihood group, but this measure did not correlate with dimensional autism or differentiate between the two elevated likelihood groups. The current results suggest that attenuated behavioural responses to direct gaze in infancy are neither strong nor specific early markers of autism.

Aim: Evidence shows that 20%-30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration. Materials and methods: We conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 -- neurological diseases (n = 93), G2 -- head and neck surgery (n = 200), G3 -- gastroenterological diseases (n = 94) and G4 -- other patients (n = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered. Results: There is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (p < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (p < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (p = 0.020 for cranial nerve paresis; p = 0.004 for radiotherapy; p < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX-X). Conclusions: Patients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery.

Introduction: Dysphagia affects up to 70% of care home residents, increasing morbidity and hospital admissions. Speech and language therapists make recommendations to support safe nutrition but have limited capacity to offer ongoing guidance. This study aimed to understand if recommendations made to support safe and effective care are implemented and how these relate to the actual care delivered. Methods: Eleven mealtimes with residents with dysphagia were observed during 2020 using a tool capturing 12 elements of expected practice. Staff actions during mealtimes were compared with adherence to residents' care plans and speech and language therapist recommendations. Results: Written recommendations predominantly focused on food and fluid modification. Observations (n = 66) revealed food texture, posture, and alertness were adhered to on 90% of occasions, but alternating food and drink, prompting and ensuring swallow completed adherence was less than 60%. Thickened fluids frequently did not align with required International Dysphagia Diet Standardisation Initiative levels. Nutrition care provided in the dining room was less safe due to a lack of designated supervision. Conclusion: Care homes need to be supported to establish a safe swallowing culture to improve residents' safety and care experience.

Background: More than 20 million children in the United States lack access to primary health care. Practice Learning: Research shows that students with regular access to physical and mental health services have fewer absences, are more social, less likely to participate in risky behaviors, have improved focus and higher test scores. Implication For School Health Policy, Practice, And Equity: School-based health centers (SBHCs) can be an important, valuable and viable health care delivery option to meet the full-range of primary health care needs of students where they spend the majority of their wake hours, ie, in school. Children in rural and other underserved communities, as well as those underinsured, non-insured, economically challenged, underserved, and the most vulnerable among us are especially at risk. Conclusions: This paper discusses the history, value, and importance of SBHCs from myriad perspectives, including physical and emotional wellbeing, academic and social success, and the promotion of a positive transition to adulthood. In addition, the authors' experiences that resulted in building the first SBHC in the Mid-Hudson Valley Region of New York State are shared. These experiences form the foundation for creating an important roadmap for individuals and school leaders that are interested in bringing a SBHC to their school and district.

Preschoolers who display extremely inhibited behavior are at risk for the development of anxiety disorders. However, behavioral inhibition (BI) is a multifaceted characteristic. Some children with BI are fearful when confronted by unfamiliar adults, peers, and objects; others are fearful when separated from their parents. In the present study, we examined specific features of BI that predicted observed friendship formation among preschoolers who are behaviorally inhibited. We also examined whether teacher ratings of classroom behaviors predicted friendship formation. Sixty highly inhibited children (35 female, M[subscript age] = 52.57 months) were observed during eight weekly free-play sessions with initially unfamiliar inhibited peers. Free-play periods occurred before weekly intervention sessions for children with BI and their parents. An observational protocol was developed to identify children who made a friend during the eight weekly sessions. Before the first session, different subtypes of BI were assessed by parents; preschool teachers assessed the children's classroom behaviors with familiar peers. Twenty-six children met the criteria for having made and kept a friend. Probit regression analyses revealed that parent ratings of BI among unfamiliar peers and teacher ratings of children's social anxiety before the intervention were associated with a decreased probability of making a friend. No evidence was found linking children's responses to the intervention and friendship formation. Results suggest that extremely inhibited preschoolers are capable of making friends. Implications for future research and intervention efforts that focus on individual differences of children with BI are discussed.

Young people with developmental language disorder (DLD) often have poorer mental health compared to those without DLD. However, not all young people with DLD experience such difficulties. Two hundred and eighty-one young people at risk of DLD (45% Female; 53% White British) were identified from a UK based population-cohort. Main caregivers completed questionnaires about their early life (<5 years) and their mental health (at 14 years). Parent-child conflict was revealed to be an early risk factor for all mental health outcomes, at age 14. Additionally, harsh discipline and second-hand smoke predicted worse externalising problems, and gender differences predicted worse internalising problems. Further findings demonstrated that, as the number of risk factors increased, so did the severity of mental health difficulties.

Children with chronic illnesses present unique health, psychosocial, and learning challenges. Due to the complexities surrounding their needs, these children and their families often encounter multilayered barriers when accessing educational services and health care management. Medical-family-school interprofessional interagency collaborations (IIC) are needed to facilitate information sharing across institutions, treatment alignment among care partners, and equitable and high-quality school-based service delivery. This article presents a novel hospital-based school consultative liaison service, the Educational Achievement Partnership Program (EAPP), which conducts IIC with the families, schools, hospitals, and community care partners of children with chronic illnesses. We explore disproportionalities in IIC services among low-income and racially/ethnically minoritized children and examine ways to increase IIC service access and utilization. Results demonstrate that systematic changes targeting in-person communication with families significantly increased minoritized and low-income children's EAPP participation. Despite this increase, differences occurred between minoritized and White children's utilization through all stages of EAPP service delivery. These results underscore the importance of ongoing IIC service evaluation to examine the effectiveness of implementation components. We discuss implications and highlight opportunities for similar medical-family-school IIC under a school psychologist-led medical liaison consultative approach. We conclude that IIC is best fostered through innovations in communication models, graduate training, practice, and research.

This study used a longitudinal probability sample survey, "Understanding Society: COVID-19," to examine trajectories in adolescents' mental health, via the Strengths and Difficulties Questionnaire, at three timepoints during COVID-19 with a particular emphasis on vulnerable groups (i.e., young carers, adolescent girls, BAME--Black, Asian and minority ethnic, and adolescents in financially strained households). Generally, self-reports of emotional and total difficulties remained stable during the pandemic, although adolescents who had limited social support were far more likely to report severe emotional and total difficulties. Young people with pre-existing mental and physical health conditions appeared more resilient, whereas vulnerable young people were hit the hardest during the pandemic. Compared to their less vulnerable peers, young carers, adolescent girls, Black or mixed-race young people and adolescents in financially strained households were more likely to report reduced mental health during the pandemic. It is hoped that the findings will contribute to debates about the pandemic unveiling existing mental health inequalities in society, and to public policy in an era of perma-crises as we currently face a cost of living crisis where public services are under enormous strain to reach those who need them most.

Objective: The goal of this study was to report on the development and early usability of a new interactive mHealth app for reducing cardiovascular risk in primary care patients of low socioeconomic status attending clinics in Chile. Design: Mixed-methods design with qualitative and quantitative components. Setting: Three Chilean primary care clinics located in one urban (Santiago) and two rural areas (San Clemente and Chiguayante). Each clinic serves a population of about 24,000 people of generally low socioeconomic status with an average of 8.5 years of education. Methods: A qualitative co-design participatory framework was used to develop the "Mi Salud-APS" mHealth app. Three iterations of virtual workshops were held with healthcare providers and patient participants to develop the new app. Once developed, the usability phase identified, invited and followed up for 3 months a sample of primary care patients with moderate (N = 119) or high (N = 329) cardiovascular risk. Results: A total of 24 healthcare providers and 24 patients participated in the developmental workshops. Three emergent categories represented the core attributes for the mHealth app design: 'Friendly', 'Interactive' and 'Pertinent'. In the usability phase of the sample of 448 patients, 98% downloaded the app, and 64.6% of them logged in and used it for an average of 1.46 (0.5-10) times weekly. Conclusion: Findings suggest that patient and healthcare provider contributions to the development of the mHealth app accurately reflect the interests and experiences of both groups and together helped achieve the high usability levels observed among primary care patients enrolled in clinics in underserved communities.

This study builds on existing literature on autism spectrum disorder (autism) and sexual and gender minority (SGM) identities and is the first to examine self-declared frequency rates, associated functional impairments, and treatment engagement levels for sexual minority (SM) and non-SM populations with and without autism cross-sectionally via a large nationwide college-student sample across 3 years. Using data from the American College Health Association-National College Health Assessment (ACHA-NCHA) III, we analyzed data from 81,286 college students (ages 18-25 years old) randomly selected from 75 U.S. colleges and universities. Included ACHA-NCHA-III measures consisted of self-reported demographics, SM and gender minority (GM) identities, autism diagnosis, stress, academic impairment, mental health symptoms, and treatment engagement. We found a 2.8% self-declared frequency of autism in the SM group, compared with 0.9% self-declared frequency among the non-SM sample. Autistic college students with both SM and GM identities had the greatest levels of reported adverse stress and the most negative academic and mental health outcomes (i.e., suicidality), followed by college students with two minority identities (i.e., Autism and SM, SM and GM), across all groups. These findings emphasize the need for mental healthcare providers to consider SM and GM identities in non-autistic and, especially, in autistic college students to assess suicide risk and inform treatment.

This intervention study aimed to assess mothers' knowledge of iron-deficiency anemia (IDA). It also measured the impact of a health education program on their level of knowledge and their infants' IDA rates in rural areas of Nablus Governorate. Using a randomized pretest--posttest control group design, the efficacy of 3 months' education program was examined against control group. Assessments were made at baseline and after 3 months of conducting the intervention. A structured interviewing questionnaire was used to assess the knowledge about IDA, and blood samples were collected from infants in both groups. Only 1.9% of mothers in the intervention group and 3.5% of mothers in the control group had good level of knowledge at baseline. After the educational intervention, a significant statistical difference was observed in the mean total knowledge score between the intervention and control groups (33.68 + 5.366 versus 26.12 + 5.243), and the intervention group was seven times more likely to have good knowledge (relative risk = 7.332). Regarding IDA rate, there was a decrease in the infants with IDA in the intervention group (relative risk = 0.671) compared to infants in the control group. The planned health education program was effective in improving mothers' knowledge and reducing the risk of IDA among their infants.

Limited research has explored the experiences of nonbinary college students. Using a national sample of college students from the American College Health Association-National College Health Assessment (ACHA-NCHA), we compared experiences of college students in terms of their campus safety, mental health, and involvement in extracurricular activities. Results reveal complexities of nonbinary students' experiences. Nonbinary students reported feeling less safe on and around campus and were more likely to be verbally threatened, stalked, and sexually assaulted than their peers. In terms of mental health indicators, nonbinary students reported significantly worse outcomes than their peers. Nonbinary students were also significantly less likely to be involved in extracurricular activities. Among nonbinary students, Black nonbinary students reported less safety, higher stress, and greater suicidality than White nonbinary students, and multiracial nonbinary students were more likely to be stalked than their White nonbinary peers. In terms of campus involvement, multiracial nonbinary students were more likely to volunteer than White nonbinary students. On the whole, this study suggests that nonbinary college students' experiences differ from their peers' in terms of greater reports of victimization, poorer mental health, and less involvement on campus, with important racial differences. Those who work with college students should ensure that their services support and affirm nonbinary identities and should work to push back on superficial changes that do not address the racist, cis-heteropatriarchal conditions that give rise to such outcomes.

Sexual and gender minorities (SGM) frequently experience depression and health care-related stigma. Health care satisfaction is important for seeking care, but little is known about SGM health care satisfaction, and especially as it relates to depression among rural SGM. From May 25 to July 2, 2021, we surveyed rural Illinois (IL) individuals aged [greater than or equal to] 18 years on the topics of demographics, depression, health care satisfaction, past health care experiences, internalized stigma, and victimization. Among the 398 respondents, the gender identity distribution included cisgender males and females (171 and 203, respectively) and transgender males and females (8 and 7, respectively), while sexual orientation included heterosexuals (114), gay/lesbians (143), and other orientations (141). Analyses were conducted with respect to both identity and orientation (and their interaction). In univariate analysis, transgender individuals were more likely than cisgender to screen positive for depression and less likely to report feeling accepted by their medical provider. Compared to heterosexual respondents, gay/lesbians and other orientations were more likely to screen positive for depression. In logistic regression, factors associated with increased risk of depression included nonheterosexual orientation and past poor health care experiences. In linear regression, factors most commonly associated with the seven satisfaction subscales include: sexual orientation, past poor experiences, and employment. There were significant differences in depression across both sexual orientation and gender identity, and in health care satisfaction by sexual orientation. Rural SGMs are more vulnerable to depression and less likely to report satisfactory care. As health care engagement is critical for screening and care adherence, engaging rural SGM in a routine and satisfactory fashion is needed.