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This study analyzes the intersection of media and the law in the People’s Republic of China from qualitative and quantitative empirical linguistics perspectives. Institutional interaction in court trials broadcast online, televised confessions that are directed, scripted, and broadcast on state television, and news and academic articles about these two phenomena are all systematically examined to determine how media becomes part of the law and law becomes part of media.Conversation analysis of a corpus of 20 criminal trials streamed on the China Court Trial Online website (CCTO) reveals that defendants construct resistance to ascriptions of guilt in exclusively covert ways, while judges respond to these efforts in turns that reassert guilt and seek explicit affiliation from defendants. Multimodal critical discourse analysis of three televised confession news segments shows the ways in which state ideology about nationality and the law is conveyed to mass media audiences through lexico-grammatical structure, gaze, and other semiotic resources. I also show, through corpus-assisted critical discourse analysis of four corpora in two different genres – two news corpora and two academic corpora including articles about trial streaming and televised confessions – that institutional and individual discourses surrounding these phenomena diverge sharply in terms of factual interpretation and normative evaluation.The consideration of these findings together reveals the way that the media is being mobilized as a part of the legal process, in order to further discipline the immediate participants and communicate the institutional stance toward law-breakers and the ideologically deviant to a mass media audience. This study also shows how corpus linguistics may be incorporated into qualitative research, e.g. conversation analysis and critical discourse analysis, to reveal subtle patterns, guide the refining of research questions, and enhance the systematic nature of the analytic approach.

BackgroundAdvance care planning is considered best practice for children and young people with life-limiting conditions but there is limited evidence how parents’ perceive, understand and engage with the process.AimTo understand parents’ experience of advance care planning for a child or young person with a life-limiting condition.DesignScoping review, theoretically informed by Family Sense of Coherence. Parents’ experience was conceptualised in terms of meaningfulness, comprehensibility and manageability.Data sourcesElectronic databases Medline, CINAHL and PyschINFO were searched for studies published between 1990 and 2021, using MeSH and broad-base terms.Results150 citations were identified and screened; 15 studies were included: qualitative (n=10), survey (n=3) and participatory research (n=2). Parents’ experience of advance care planning was contextualised by their family values and beliefs, needs and goals and the day-to-day impact of caring for their child and family. They valued conversations, which helped them to maximise their child’s quality of life and minimise their suffering. They preferred flexible, rather than definitive decisions about end-of-life care and treatment.ConclusionsAdvance care planning which solely focuses on treatment decisions is at odds with parents’ concerns about the current and future impact of illness on their child and family. Parents want advance care planning for their child to reflect what matters to them as a family. Future longitudinal and comparative studies are needed to understand the influence of advance care planning on parental decision-making over time and how social, cultural and contextual nuances influence parental experience.

ObjectiveTo qualitatively assess surgeons decision making for lip surgery in patients with cleft lip/palate (CL/P).DesignProspective, non-randomized, clinical trial.SettingClinical data institutional laboratory setting.Patients, ParticipantsThe study included both patient and surgeon participants recruited from four craniofacial centers. The patient participants were babies with a CL/P requiring primary lip repair surgery (n=16) and adolescents with repaired CL/P who may require secondary lip revision surgery (n=32). The surgeon participants (n=8) were experienced in cleft care. Facial imaging data that included 2D images, 3D images, videos, and objective 3D visual modelling of facial movements were collected from each patient, and compiled as a collage termed the Standardized Assessment for Facial Surgery (SAFS) for systematic viewing by the surgeons.InterventionsThe SAFS served as the intervention. Each surgeon viewed the SAFS for six distinct patients (two babies and four adolescents) and provided a list of surgical problems and goals. Then an in-depth-interview (IDI) was conducted with each surgeon to explore their decision-making processes. IDIs were conducted either in person or virtually, recorded, and then transcribed for qualitative statistical analyses using the Grounded Theory Method.ResultsRich narratives/themes emerged that included timing of the surgery; risks/limitations and benefits of surgery; patient/family goals; planning for muscle repair and scarring; multiplicity of surgeries and their impact; and availability of resources. For diagnoses/treatments, surgeons agreed, and level of surgical experience was not a factor.ConclusionsThe themes provided important information to populate a checklist of considerations to serve as a guide for clinicians.

The seductive allure of neuroscience explanations (SANE) is controversial. Irrelevant neuroscience information in the form of text or imagery has been found to improve ratings of quality of, and agreement with, scientific explanations, and to possibly affect jury decisions in court. On the other hand, several studies have yielded little to no effect. To establish the magnitude of this effect, we conducted a random-effects meta-analysis on all studies that compared neuroscience to non-neuroscience information for impact on ratings or judgment, including mock juror decisions. This analysis used 60 experiments from 28 publications comprising 13,088 participants, and yielded a mild but highly significant effect of neuroscience information (Hedges’ g = .25, CI = [0.18, 0.31]). There was evidence of publication bias and heterogeneity (PI = [-0.22, 0.72], I2 = 87.2%). After removing outliers, we conducted planned subgroup analyses, which revealed that within-subjects studies, in which participants compare neuroscience to non-neuroscience, have significantly stronger effects than between-subjects designs, and studies using text yield a stronger average effect than those using brain images. We also serendipitously found that effect sizes were stronger in studies where participants evaluate satisfaction or metacomprehension, compared with jury verdicts or assessments of convincingness. Overall, the heterogeneity indicates there is more than one type of SANE effect, having more to do with stimuli used and outcomes assessed, than with participant characteristics, such as dualistic beliefs. Irrelevant neuroscience does appear to have a seductive allure, especially on self-appraised satisfaction and understanding, and when presented as text.

Many firms engage in activities aimed at making prices less transparent – tactics that may be referred to collectively as price obfuscation. Existing theory does not explain the substantial heterogeneity that exists both within and across industries with respect to the prevalence of these practices. The essays herein thus seek to shed further light on this phenomenon. In particular, I address several interrelated questions: what incentives drive firms to obfuscate in the first place, what are the potential consequences (if any) of doing so, and how do these tradeoffs vary depending on firm characteristics and market conditions? Novel empirical results are drawn from U.S. hotel industry data in Chapters 1 and 2; in Chapter 3, I synthesize existing price obfuscation literature from a range of disciplines and provide several illustrative case studies. Taken together, these three essays build toward a more comprehensive theoretical framework for understanding why, in practice, some firms utilize obfuscation (and deceptive tactics more broadly) while others do not.

OBJECTIVE The aims of this study were to describe firearm storage practices in homes of patients evaluated for mental health (MH) complaints at a tertiary care children's hospital and to describe storage practice changes after treatment. METHODS We surveyed families of children with MH complaints presenting to the emergency department or psychiatry unit who stored firearms in their homes between February 12, 2016, and January 14, 2017. Patients and families received standard care, including routine counseling on limiting access to methods of suicide. Participants completed surveys at baseline, 7, and 30 days after discharge. The primary outcome was triple safe firearm storage-storage of firearms unloaded, locked, and with ammunition stored and locked separately. RESULTS Ninety-one household members of MH patients who stated they had firearms were enrolled at baseline. Seventy-seven (85%) completed at least 1 follow-up survey, and 63 (69%) completed both. At baseline, 21% (19/91) of participants reported engaging in triple safe firearm storage, 26% had an unlocked firearm, 23% had a loaded firearm, and 65% stored ammunition either unlocked or with their firearm. Triple safe storage rates increased to 31% at both 7 days and 30 days. Ten (17%) of 59 (P < 0.01) participants who did not report triple safe storage at baseline and completed a follow-up survey changed to reporting triple safe storage on follow-up. CONCLUSIONS The majority of firearm-storing family members of children with MH complaints do not follow triple safe storage practices. Storage practices modestly improved after an emergent MH visit, but over two thirds of participants reported unsecured or partially secured firearms 7 and 30 days later.

BackgroundAlthough most persons over 5 years of age drown in open water, few laws have sought to regulate open water swim sites. We examined the association between regulations for designated open water swim sites and open water drowning death rates by state.MethodsUsing International Classification of Disease (ICD)-10 codes in the CDC Web-based Injury Statistics Query and Reporting System (WISQARS), we identified and calculated open water drowning deaths involving all ages from 2012 to 2017 for 50 states and calculated open water drowning death rates. We then identified and categorised types of state regulations (lifeguards, water quality, rescue equipment, tracking/planning/reporting and signage) for open water swim sites in place in 2017 for a sample of 30 states (20 high-drowning, 10 low-drowning). Analyses evaluated associations between open water drowning rates in three groups (overall, youth and non-white) and the total number and types of state regulations.ResultsSwim site regulations and open water drowning death rates for 10 839 victims were associated in all regression models. States with more types of regulations had lower open water drowning death rates in a dose-response relationship. States lacking regulations compared with states with all five types of regulations had open water drowning death rates 3.02 times higher among youth (95% CI 1.82 to 4.99) and 4.16 times higher among non-white residents (95% CI 2.46 to 7.05). Lifeguard and tracking/planning/reporting regulations were associated with a 33% and 45% reduction in open water drowning rates overall and among those aged 0–17 years.ConclusionStates’ open water swim area regulations, especially addressing tracking/planning/reporting and lifeguards, were associated with lower open water drowning death rates.

While poetic inquiry has been used to explore many aspects of motherhood, there has been less attention given to pregnant, birthing, and immediately postpartum/fourth trimester embodiment. Here, we utilize poetry to explore a topic that is understudied and embodied experiences in the transition from pregnancy to early motherhood. The poems we present in this article are part of a larger project exploring experiences of embodied transition into motherhood. In the context of this larger project, 14 women were interviewed about their experiences of pregnancy, birth, and postpartum. In order to maintain focus on the embodied transition to new motherhood, only participants within 6 months of their first birth at the time of the interview are included in this article. The full data set was analyzed using a feminist-informed qualitative method centered on voice (The Listening Guide), and the poems we present here are derived from the second listening, which focuses on participants’ use of “I” in their narratives.

BackgroundHistory of psychiatric disorders, particularly depression, is the strongest risk factor for perinatal depression (PND). Yet many women without such history experience their first depression episode perinatally, whilst other women with depression history do not experience any episodes during the perinatal period. PND may itself be heterogenous, according to differences in psychiatric history. However, a comprehensive investigation of characteristics of women with PND, with and without a prior psychiatric history, has not been attempted.MethodsIn a large sample of parous women with depression, we sought to identify risk factors associated with PND after previous depression episodes, or as first-onset depression. Using data from the Australian Genetics of Depression Study, we identified two subgroups of PND cases (Edinburgh Postnatal Depression Scale score >= 13) with and without prior depression history. For both subgroups, we investigated lifetime prevalence, length and severity of PND. Logistic regression compared a range of characteristics of cases to those of a comparison group with major depression without any perinatal episodes. ResultsCriteria for PND was met by 5,058 (70%) of 7,182 parous women who met criteria for major depression. Of women reporting depression onset before first pregnancy, 2,261 (77%) PND cases were compared to 672 (23%) without PND. Among women reporting their first depression episode during or after their first pregnancy, 878 women for whom this first episode was PND were compared to 2,124 parous women who had experienced depression but never perinatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.1 per additional depression episode, CI=[1.1-1.1], P=1.3E-13), non-European ancestry (OR=1.8, CI=[1.3-2.5], P=1.2E-03), severe nausea during pregnancy (OR=1.3, CI=[1.1-1.6], P=6.6E-03) and emotional abuse (OR=1.4, CI=[1.1-1.7], P=2.0E-03). Women without any depression before their first perinatal episode were significantly more likely to report emotional abuse (OR=1.3, CI=[1.1-1.6], P=1.1E-02) than women with depression without PND.ConclusionsThe majority of parous women in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.

Drowning is a public health concern that disproportionally affects children and minorities in Washington State. Community health educators from Seattle Children’s Hospital designed a Water Safety Education and Lifejacket Giveaway Program for low-income parents of preschool-aged children from culturally and linguistically diverse backgrounds. The program was interpreted into multiple languages and parents and children in attendance received free lifejackets. The mixed-methods pilot evaluation of this program found statistically significant relationships between language and self-reported parent swim skill level (English-speaker OR 4.6; 95%CI: 1.84 – 11.54); and confidence of keeping one’s child safe (English-speaker OR 3.34; 95%CI: 1.10 – 10.4). Additionally, parents who self-reported that they could swim had four times the odds of feeling confident in keeping their children safe around the water (95% CI: 1.21 - 13.28). Qualitative data from follow-up interviews identified that the program boosted parent knowledge and confidence in safe water practices. Multi-lingual delivery and the role of partner preschools was critical to this program’s success. Specific programmatic focus on adult parent/caregiver skills and knowledge that reduce risk around the water should be a priority for future efforts to reduce drowning.

Background Weight management is complex for people even in times of stability. Supporting individuals to develop strategies to maintain a healthier weight when there are additional life challenges may prevent relapse. This mixed-methods study describes the impact the COVID-19 restrictions had on adults engaged in weight management before and during the pandemic in order to determine helpful strategies. Methods Longitudinal data was captured from online surveys completed by Slimming World (SW) members 0–4 weeks after joining, October/November 2019, providing pre-joining and baseline (T0&T1), 3- (T2) and 6- month (T3-during COVID-19) data. Representatives from the general population, not attending a weight management service, completed the same questionnaires providing cross-sectional control data. All weights are self-reported. For this study, questions assessing the impact of the COVID-19 challenges on health-related behaviours and well-being are included comparing responses at T0/T1, T2 & T3. Longitudinal data were analysed using repeated measures ANOVA and cross-sectional data, one-way independent ANOVAs to compare means. Comparisons between SW members and controls were determined using z-proportion tests. Qualitative data generated was thematically analysed using a six-step approach to produce the key emerging themes. Results 222 SW members completed all three surveys, achieving a weight loss of 7.7 ± 7.5%. They maintained positive health-related behaviour changes made since joining, including increased fruit and vegetables (p p p p Conclusions The findings highlight the value of peer, group and online support and guidance for individuals to develop sustainable behaviour changes and a level of resilience. These strategies can then be drawn upon enabling maintenance of lifestyle changes and management of weight even in challenging times.

Individuals with Turner syndrome (TS) are at risk for a constellation of neurocognitive and psychosocial differences, although there is significant individual variability in these features. TS is associated with an increased risk for difficulties with visual-spatial reasoning, visual-spatial memory, attention, executive functioning, motor, and math skills. Additionally, increased rates of social difficulties, anxiety, and depression are observed. There can be significant interplay between all of these factors contributing to the behavioral phenotype. Neuropsychological features and previous research are reviewed. Clinical considerations and recommendations for evaluation and treatment of psychological and behavioral difficulties are provided, including consideration of medical features in TS, as well as therapies, educational supports, and medication treatment. Future research is needed to evaluate effectiveness of different treatments for neuropsychological and psychosocial features of TS, including modification and validation of existing evidence-based treatments and new approaches to care.

ObjectivesThis study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression.Design and settingThe Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms.ParticipantsIn a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively).Primary and secondary outcome measuresThe primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures.ResultsThe prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, pConclusionsThe majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.

Background Novel adjuvant strategies are needed to optimise outcomes after complete surgical resection in patients with early-stage non-small-cell lung cancer (NSCLC). We aimed to evaluate adjuvant atezolizumab versus best supportive care after adjuvant platinum-based chemotherapy in these patients. Methods IMpower010 was a randomised, multicentre, open-label, phase 3 study done at 227 sites in 22 countries and regions. Eligible patients were 18 years or older with completely resected stage IB (tumours ≥4 cm) to IIIA NSCLC per the Union Internationale Contre le Cancer and American Joint Committee on Cancer staging system (7th edition). Patients were randomly assigned (1:1) by a permuted-block method (block size of four) to receive adjuvant atezolizumab (1200 mg every 21 days; for 16 cycles or 1 year) or best supportive care (observation and regular scans for disease recurrence) after adjuvant platinum-based chemotherapy (one to four cycles). The primary endpoint, investigator-assessed disease-free survival, was tested hierarchically first in the stage II-IIIA population subgroup whose tumours expressed PD-L1 on 1% or more of tumour cells (SP263), then all patients in the stage II-IIIA population, and finally the intention-to-treat (ITT) population (stage IB-IIIA). Safety was evaluated in all patients who were randomly assigned and received atezolizumab or best supportive care. IMpower010 is registered with ClinicalTrials.gov, NCT02486718 (active, not recruiting). Findings Between Oct 7, 2015, and Sept 19, 2018, 1280 patients were enrolled after complete resection. 1269 received adjuvant chemotherapy, of whom 1005 patients were eligible for randomisation to atezolizumab (n=507) or best supportive care (n=498); 495 in each group received treatment. After a median follow-up of 32·2 months (IQR 27·4-38·3) in the stage II-IIIA population, atezolizumab treatment improved disease-free survival compared with best supportive care in patients in the stage II-IIIA population whose tumours expressed PD-L1 on 1% or more of tumour cells (HR 0·66; 95% CI 0·50-0·88; p=0·0039) and in all patients in the stage II-IIIA population (0·79; 0·64-0·96; p=0·020). In the ITT population, HR for disease-free survival was 0·81 (0·67-0·99; p=0·040). Atezolizumab-related grade 3 and 4 adverse events occurred in 53 (11%) of 495 patients and grade 5 events in four patients (1%). Interpretation IMpower010 showed a disease-free survival benefit with atezolizumab versus best supportive care after adjuvant chemotherapy in patients with resected stage II-IIIA NSCLC, with pronounced benefit in the subgroup whose tumours expressed PD-L1 on 1% or more of tumour cells, and no new safety signals. Atezolizumab after adjuvant chemotherapy offers a promising treatment option for patients with resected early-stage NSCLC. Funding F Hoffmann-La Roche and Genentech.

Background: Drowning remains the third leading cause of unintentional injury death for adolescents in the United States. Aims: This study described adolescent swimming lessons, behaviors (life jacket wear while boating) and comfort (swimming in deep water) and their association with protective and risk factors and risk-taking behaviors reported by Washington State students in Grades 8, 10, 12, primarily comprised of youth ages 13 to 18 years. Methods: This study used the 2014 Washington State Healthy Youth Survey (HYS), a publicly available dataset. Results: Most students reported having had swimming lessons, using life jackets, and comfort in deep water. Differences reflected racial, ethnic and socioeconomic disparities: being White or Caucasian, speaking English at home and higher maternal education. Lowest rates of comfort in deep water were among Hispanics or Latino/Latinas followed by Blacks or African Americans. Greater life jacket wear while boating was reported by females, those in lower grades and negatively associated with alcohol consumption, sexual activity and texting while driving. Having had swimming lessons was associated with fewer risk-taking behaviors. Conclusions: The HYS was useful to benchmark and identify factors associated with drowning risk among adolescents. It suggests a need to reframe approaches to promote water safety to adolescents and their families. Multivariate analysis of this data could identify the key determinants amongst the racial, ethnic, and socioeconomic disparities noted and provide stronger estimation of risk-taking and protective behaviors.

Objective To determine if providing firearm storage devices with training during clinical care improves safe storage practices in household members of children who present to a pediatric hospital with an emergent mental health complaint. Methods Prospective, pre-post study. Enrollment occurred in the emergency department or the inpatient psychiatric unit. Participants in the observation phase received usual care. Participants in the intervention phase were randomized to be offered a firearm storage device at either no or low ($5) cost and trained in its use. We surveyed participants at enrollment, 7, & 30 days post visit. Our primary outcome was triple-safe storage (TSS) - storing firearms unloaded, locked, and with ammunition stored and locked separately. Results About 256 participants enrolled. In the observation phase TSS increased from 21% (95% confidence interval [CI] 14%–30%) at baseline to 31% (95% CI 21%–42%) at 7 and 31% (95% CI 21%–43%) at 30 days. In the intervention phase, TSS increased from 32% (95% CI 25%–39%) at baseline to 56% (95% CI 48%–64%) at 7 and 56% (95% CI 47%–64%) at 30 days. Among those not practicing TSS at baseline, 7-day TSS was higher in the intervention (38%) versus the observation phase (14%, P = .001). Conclusions Distribution and training in the use of firearm storage devices increased TSS in the study population, improves pediatric safety and should be part of the routine care of these high-risk patients.

BACKGROUND Childhood and adolescent firearm injury and death rates have increased over the past decade and remain major public health concerns in the United States. Safe firearm storage has proven to be an effective measure to prevent firearm injury and death among youth. Social media has been used as an avenue to promote safe firearm storage, but perceptions of this tool remain unknown. OBJECTIVE The aim of this study was to determine receptiveness and responsiveness in promoting firearm lock box and trigger lock giveaway events on social media, and to describe the characteristics of participants who learned of these events through social media. METHODS We performed a mixed methods study combining a content analysis of Facebook event post comments, quantitative analysis of positive and negative feedback on social media, and a descriptive analysis of event participant characteristics. Through a qualitative content analysis approach, we thematically coded comments from each event’s social media page posting. Interrater reliability and κ statistics were calculated. We calculated the prevalence of positive and negative feedback data. Further, we calculated descriptive statistics for demographic characteristics gathered from day-of-event intake surveys. Differences between collected measures were analyzed with χ2 and t tests according to how the participant found out about the event (social media vs other means). Using concurrent analysis, we synthesized the results from both the qualitative and quantitative aims. RESULTS Through qualitative content analysis, 414 comments from 13 events were coded. Seven themes emerged through the comment coding process with the most common being “positive receptiveness” (294/414, 71.0%). From quantitative analysis of the social media content, we found higher levels of positive feedback compared to negative feedback. The average number of event post “likes” was 1271.3 per event, whereas the average count in which “hide post” was clicked was 72.3 times per event. Overall, 35.9% (1457/4054) of participants found out about the event through social media. The participants who learned about the event through social media were on average significantly younger than those who learned about the event through other means (–6.4 years, 95% CI –5.5 to –7.3). Among the group that learned of the event through social media, 43.9% (629/1433) identified as female, whereas 35.5% (860/2420) identified as female among the group that learned of the event through other means. CONCLUSIONS There was overall positive receptiveness and responsiveness toward firearm lock box and trigger lock giveaway events when promoted on social media. Compared with other promotional tools, social media has the ability to reach those who are younger and those who identify as female. Future studies should extend this research to determine whether there is a difference between rural and urban settings, and consider other social media platforms in the analysis. CLINICALTRIAL

The Hill District of Pittsburgh, Pennsylvania (USA) is a once vibrant community that experienced socioeconomic decline through urban renewal polices and related factors. This article presents poems constructed from interviews with women who considered the Hill District to be their home. Interviews were completed as part of an undergraduate-level community-engaged learning course in collaboration with a local agency. One component of the course was a public reading, during which the poems were shared with members of the community and the University. The poems were created through use of the Listening Guide, a feminist relational method. These emotionally resonant poems, known as I poems, attend to the subjective experience of each participant by focusing on her use of “I” throughout the interview transcripts. While individual in nature, these poems are inseparable from the historical trauma the Hill District has experienced. Seen through the lens of root shock, interpersonal and intergenerational traumas are also the trauma of the Hill District. Poetic inquiry provides an avenue for connecting individual experience with the larger community story.

BackgroundSafe firearm storage practices are associated with a lower risk of unintentional and self-inflicted firearm injuries among household members, though many firearms remain unlocked and/or loaded.ObjectivesConduct a preliminary evaluation of a community-based firearm safety intervention and assess participants’ preferences for firearm locking devices and their comfort with potential firearm safety counsellors.Design/MethodsBaseline event and follow-up surveys among adult participants to assess changes in firearm storage practices, including whether all household firearms were stored locked, all were unloaded, all ammunition was locked, and a composite measure assessing whether all firearms were locked and unloaded and all ammunition was stored locked.ResultsA total of 206 out of 415 participants completed both surveys and were included. Nearly 9 in 10 respondents preferred the firearm lock box rather than a trigger lock. At follow-up, a significantly greater proportion reported that all household firearms were locked (+13.7%) and unloaded (+8.5%) and a non-significantly greater proportion reported that all ammunition was locked (+6.3%). A significantly greater proportion reported practising all three safe firearm and ammunition storage practices at follow-up (+12.6%). A majority reported they would becomfortableorvery comfortablediscussing firearm safety with various safety counsellors, though women were less likely to do so than men.ConclusionThis intervention that included distribution of a free, participant-selected locking device improved safe firearm storage practices among participants. Differences in participant preferences for devices and safety counsellors suggest that a ‘one size fits all’ approach may be inadequate in affecting population-level storage practices.

Introduction A deeper and more thorough characterization of why patients do or do not seek orthodontic treatment is needed for effective shared decision making about receiving treatment. Previous orthodontic qualitative research has identified important dimensions that influence treatment decisions, but our understanding of patients’ decisions and how they interpret benefits and barriers of treatment are lacking. The objectives of this study were to expand our current list of decision-making dimensions and to create a conceptual framework to describe the decision-making process. Methods Discussion boards, rich in orthodontic decision-making data, were identified and analyzed with qualitative methods. An iterative process of data collection, dimension identification, and dimension refinement were performed to saturation. A conceptual framework was created to describe the decision-making process. Results Fifty-four dimensions captured the ideas discussed in regard to a patient's decision to receive orthodontic treatment. Ten domains were identified: function, esthetics, psychosocial benefits, diagnosis, finances, inconveniences, risks of treatment, individual aspects, societal attitudes, and child-specific influences, each containing specific descriptive and conceptual dimensions. A person's desires, self-perceptions, and viewpoints, the public's views on esthetics and orthodontics, and parenting philosophies impacted perceptions of benefits and barriers associated with orthodontic treatment. Conclusions We identified an expanded list of dimensions, created a conceptual framework describing the orthodontic patient's decision-making process, and identified dimensions associated with yes and no decisions, giving doctors a better understanding of patient attitudes and expectations.

Childhood obesity is a serious health issue, associated with medical comorbidity and psychosocial impairment that can persist into adulthood. In the United States, youth with intellectual and developmental disabilities are more likely to be obese than youth without disabilities. A large body of evidence supports the efficacy of family-based treatment of childhood obesity, including diet, physical activity, and behavior modification, but few interventions have been developed and evaluated specifically for this population. We highlight studies on treatment of obesity among youth with intellectual and developmental disabilities, including both residential/educational settings as well as outpatient/hospital settings. All interventions were delivered in-person, and further development of promising approaches and delivery via telenursing may increase access by youth and families. Nursing scientists can assume an important role in overcoming barriers to care for this vulnerable and underserved population.

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