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Support Over Silence for KIDS is a training program that equips bystanders with confidence and skills to defuse challenging moments between caregivers and their children in public. The purpose of this study was to assess the satisfaction with and effectiveness of Support Over Silence for KIDS within three training settings: a community organization, university, and children's hospital. Participants completed pre-program and follow-up assessments to capture demographic characteristics and change in behaviors, attitudes, self-efficacy, and perceived barriers related to bystander intervention. Participants completed an immediate post-program questionnaire to assess program satisfaction and post-program intentions. Univariate statistics were used to describe the demographic characteristics of the sample, bystander behaviors, and program satisfaction. Wilcoxon signed-rank tests were used to assess change between pre-program and follow-up. Sixty-six adults participated in the training program. Favorable outcomes were demonstrated at post-program for satisfaction with the program, future bystander intentions, and self-efficacy for bystander intervention. At follow-up, participants reported more favorable attitudes toward bystander intervention and significantly increased self-efficacy for intervention despite acknowledged barriers. Participants reported increased bystander intervention; at follow-up, none of the participants reported avoiding a challenging moment between a caregiver and their child in public. Support Over Silence for KIDS was effective in promoting supportive bystander intervention with caregivers navigating challenging interactions with their children in public. A bystander training program may help community members, university students, and hospital personnel respond in a positive way to caregiver struggles and create an environment where caregivers and their children feel supported., Author(s): Meghan E. Taylor [sup.1] , Nancy L. Weaver [sup.1] , Terri L. Weaver [sup.2] , Travis M. Loux [sup.3] , Timothy J. Kutz [sup.4] Author Affiliations: (1) grid.262962.b, 0000 [...]

Purpose: Auditory perceptual judgments are commonly used to diagnose dysarthria and assess treatment progress. The purpose of the study was to examine the acoustic underpinnings of perceptual speech abnormalities in individuals with Parkinson's disease (PD). Method: Auditory perceptual judgments were obtained from sentences produced by 13 speakers with PD and five healthy older adults. Twenty young listeners rated overall ease of understanding, articulatory precision, voice quality, and prosodic adequacy on a visual analog scale. Acoustic measures associated with the speech subsystems of articulation, phonation, and prosody were obtained, including second formant transitions, articulation rate, cepstral and spectral measures of voice, and pitch variations. Regression analyses were performed to assess the relationships between perceptual judgments and acoustic variables. Results: Perceptual impressions of Parkinsonian speech were related to combinations of several acoustic variables. Approximately 36%-49% of the variance in the perceptual ratings were explained by the acoustic measures indicating a modest acoustic perceptual relationship. Conclusions: The relationships between perceptual ratings and acoustic signals in Parkinsonian speech are multifactorial and involve a variety of acoustic features simultaneously. The modest acoustic perceptual relationships, however, suggest that future work is needed to further examine the acoustic bases of perceptual judgments in dysarthria.

Uses of the propensity score to obtain estimates of causal effect have been investigated thoroughly under assumptions of linearity and additivity of exposure effect. When the outcome variable is binary relationships such as collapsibility, valid for the linear model, do not always hold. This article examines uses of the propensity score when both exposure and outcome are binary variables and the parameter of interest is the marginal odds ratio. We review stratification and matching by the propensity score when calculating the Mantel-Haenszel estimator and show that it is consistent for neither the marginal nor conditional odds ratio. We also investigate a marginal odds ratio estimator based on doubly robust estimators and summarize its performance relative to other recently proposed estimators under various conditions, including low exposure prevalence and model misspecification. Finally, we apply all estimators to a case study estimating the effect of Medicare plan type on the quality of care received by African-American breast cancer patients.

Although the use of real-world data sets is encouraged when teaching statistics, it can be difficult for instructors to find meaningful data for introducing students to univariate descriptive statistics such as the mean, median, and percentiles. The recent lead contamination of the water supply in Flint, Michigan, provides a real-life data set with important implications hinging on basic statistics such as these. The data set can also be used as a starting point for discussions on sampling design, data collection, and ethical data practices.

This study compares characteristics and outcomes of 70 defendants with and 1,122 without intellectual and developmental disabilities (IDD) participating in a mental health court. Demographic and clinical characteristics differed, but criminal justice or program characteristics did not. Age, race, marital status, living situation, court location, health insurance status, and likelihood of mental illness or substance abuse diagnosis differed between the two groups. When controlling for other factors, a diagnosis of IDD did not affect the odds of negative termination from the court but did reduce the odds of rearrest within 1 year of leaving the court. Some mental health courts exclude people with IDD; the study concludes inclusion is appropriate.

Flipped classrooms have become an interesting alternative to traditional lecture-based courses throughout the undergraduate curriculum. In this article, we compare a flipped classroom approach to the traditional lecture-based approach to teaching introductory biostatistics to first-year graduate students in public health. The traditional course was redesigned to include video lectures and online quizzes which the students were expected to complete before coming to class, followed by a short in-class lecture and time working on applied statistics problems in class. We compared the opinions of the biostatistics field and confidence applying biostatistics methods of 46 students who took the flipped course to 52 students who took the traditional, lectured-based course offering. We found similar end-of-semester opinions and levels of confidence between students in the flipped classes and those in the traditional, lecture-focused classes, though students in the flipped course reported very high satisfaction with the model.

Introduction Little is known about childcare staff's and parents' uptake of and attitudes towards pertussis vaccine. Methods Questionnaires were distributed to St. Louis parents and childcare staff in fall, 2014. Parents versus staff and vaccinated versus unvaccinated individuals' beliefs regarding pertussis vaccine were compared using chi square tests. Multivariate logistic regressions were run to develop predictive models for staff's and parents' vaccine uptake. Results Overall, 351 parents and staff from 23 agencies participated (response rate = 32%). Parents were more likely than staff to have received pertussis vaccine (66.5 vs. 45.8%, X.sup.2 = 12.5, p < .001). Predictors for staff vaccination included willingness to get vaccinated even if there was a cost (OR 6.6; CI 1.8-24.6; p < .01), awareness of vaccination recommendations (OR 5.2; CI 1.2-22.8; p < .05), and healthcare provider recommendation (OR 4.2; CI 1.2-15.1; p < .05). Parents' predictors of vaccination included perceived importance of vaccination (OR 9.9; CI 4.1-23.8; p < .001), healthcare provider recommendation (OR 4.6; CI 1.7-12.6; p < .01), believing vaccination is effective (OR 4.4; CI 1.1-18.0; p < .05), and knowing where to get vaccine (OR 3.5; CI 1.5-8.1; p < .01). Among unvaccinated staff (n = 52), 74.5% (n = 38) and 70.0% (n = 35) would receive pertussis vaccine if it were offered free of charge and onsite, respectively. Conclusions for Practice Childcare staff's and parents' pertussis vaccine uptake was higher than overall U.S. rates, though significantly lower than the Global Pertussis Initiative target. Implementing an education campaign and providing free vaccine on-site are likely to result in increased vaccine uptake., Author(s): Terri Rebmann [sup.1] [sup.3] , Travis M. Loux [sup.2] , Daphne Lew [sup.2] , Mary Wakefield [sup.1] Author Affiliations: (1) Institute for Biosecurity, Epidemiology & Biostatistics, College for Public [...]

Summary: Background: Adolescent obesity can lead to long‐term health problems and is a topic of major concern in pediatric and broader medical and public health spheres. Numerous national and state‐wide initiatives aimed at increasing physical activity and/or improving nutrition in this age group have assumed the goal of reducing the prevalence adolescent obesity. Objectives: We assess trends in U.S. adolescent physical activity and body mass index between 1999 and 2019. Methods: Using data from the U.S. Youth Risk Behaviour Surveillance System, we analyse data from 144 544 14‐to‐18‐year‐old respondents. We use multilevel linear and logistic regression to perform age‐period‐cohort analyses attributing changes in physical activity and body mass index over time to these three sources. Results: Age and period effects are strong in all outcomes studied. Physical activity consistently decreases with age across the study period. Age trends in obesity have reversed in recent years, with older adolescents now more likely to be have obesity than younger adolescents. Both female and Asian adolescents report less physical activity but lower rates of obesity than their male and non‐Asian counterparts. Conclusions: The reversal of obesity trends by age with little change in physical activity over the study period suggests other lifestyle factors have changed over the study period to increase the prevalence of obesity in older adolescents. [ABSTRACT FROM AUTHOR]

There is a paucity of research on antisocial personality disorder (ASPD) in the geriatric population and the majority of knowledge on the disorder is drawn from young adult samples. Researchers posit that the prevalence of ASPD as well as other personality disorders (PDs) is underestimated among older adults. Using a nationally representative sample, the present study examines the prevalence and correlates of ASPD in adults ages 50 and older. We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions Waves I and III. Multivariate logistic regression analyses were employed to investigate associations between ASPD and sociodemographic characteristics. A series of logistic regression analyses were also conducted to study associations between ASPD and medical conditions (liver and cardiovascular disease, arthritis, and stomach ulcer), major psychiatric disorders (lifetime major depressive disorder, mania, and generalized anxiety disorder), and substance use disorders (lifetime alcohol, marijuana, cocaine, heroin, and nicotine use disorders). Findings indicated that the prevalence of ASPD increases through early adulthood, with a peak at 3.91% in younger adults and decline to 0.78% in adults ages ≥65. Older adults with ASPD are more likely to be diagnosed with a substance use disorder, major depression, mania, and generalized anxiety disorder as well as each medical condition. Older adults with ASPD experience increased rates of medical and psychiatric comorbidities. These conditions exacerbate the existing challenges associated with diagnosing and treating this population and may have serious consequences for the patient, their caregivers and society. [ABSTRACT FROM AUTHOR]