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PurposeTo conduct a post-Americans with Disabilities Act Amendments Act of 2008 multisite, multicohort study called the Pathways Project to assess the performance and trajectory of medical students with disabilities (SWDs).MethodFrom June to December 2020, the authors conducted a matched cohort study of SWDs and nondisabled controls from 2 graduating cohorts (2018 and 2019) across 11 U.S. MD-granting medical schools. Each SWD was matched with 2 controls, one from their institution and, whenever possible, one from their cohort for Medical College Admission Test score and self-reported gender. Outcome measures included final attempt Step 1 and Step 2 Clinical Knowledge scores, time to graduation, leave of absence, matching on first attempt, and matching to primary care.ResultsA total of 171 SWDs and 341 controls were included; the majority of SWDs had cognitive/learning disabilities (118/171, 69.0%). Compared with controls, SWDs with physical/sensory disabilities had similar times to graduation (88.6%, 95% confidence interval [CI]: 77.0, 100.0 vs 95.1%, 95% CI: 90.3, 99.8; P = .20), Step 1 scores (229.6 vs 233.4; P = .118), and match on first attempt (93.9%, 95% CI: 86.9, 100.0 vs 94.6%, 95% CI: 91.8, 97.4; P = .842), while SWDs with cognitive/learning disabilities had lower Step 1 scores (219.4; P < .001) and were less likely to graduate on time (81.2%, 95% CI: 69.2, 93.2; P = .003) and match on first attempt (85.3%, 95% CI: 78.0, 92.7; P = .009). Accommodated SWDs had Step 1 scores that were 5.9 points higher than nonaccommodated SWDs (95% CI: -0.7, 12.5; P = .08).ConclusionsStructural barriers remain for SWDs with cognitive/learning disabilities, which could be partially mitigated by accommodations on high-stakes exams.

Mothers' empathic understanding of their children's motives, thoughts, and feelings is thought to guide parenting behaviors and shape the mother-child relationship. However, little is known about the relation between empathic understanding and parenting behaviors during developmental shifts that may be emotionally challenging for mothers, such as the transition from infancy to the toddler years, or how it may relate to maternal depressive symptoms. We assessed relations between maternal empathic understanding, depression, and sensitivity. We developed a coding system, the Empathic Understanding Assessment (EUA), to measure this construct in the mothers of 30-month old children. One hundred twenty eight mother-child pairs participated in a series of lab-based tasks designed to be challenging for the children. Mothers then watched these videotaped interactions and responded to questions regarding their children's experiences. Interview content was coded using the EUA. Results indicated that mothers higher in empathic understanding and more intensely emotional were rated as more sensitive. Maternal depression was negatively related to empathic understanding. The importance of considering the role of maternal empathic understanding in parenting behavior is discussed, as are potential implications for child outcomes.

Children's vulnerability to jealousy surrounding their best friends was explored in 2 studies. Study 1 involved 94 adolescents who reported on their friendship jealousy on a newly created measure. Results indicated that the jealousy measure had sound psychometric properties and produced individual differences that were robust over time and free from socially desirable responding. As expected, girls and adolescents with low self-worth reported the greatest friendship jealousy. Study 2 involved 399 young adolescents and extended the measurement of self-report jealousy to a broader age range. In addition, Study 2 included assessments of jealousy provided by friends and other peers. Self- and peer-reported jealousy were only modestly associated and had somewhat distinct correlates. Structural modeling revealed that young adolescents' reputation for friendship jealousy was linked to behaving aggressively and to broader peer adjustment difficulties. Both self- and peer-reported jealousy contributed to loneliness.

Background: In order to provide responsive, individualised and personalised care, there is now greater engagement with patients, families and carers in designing health services. Out-of-hours care is an essential component of community palliative care. However, little is known about how patients, families and carers have been involved in the planning and design of these services. Aim: To systematically search and review the research literature that reports on how out-of-hours palliative care services are provided in the community and to identify the extent to which the principles of co-design have been used to inform the planning and design of these services. Design: Systematic literature search and review. Data sources: A systematic search for published research papers from seven databases was conducted in MEDLINE, PsycINFO, Embase, Emcare, PubMed, CINAHL and Web of Science, from January 2010 and December 2021. Reference list searches of included papers were undertaken to source additional relevant literature. A manifest content analysis was used to analyse the data. Results: A total of 77 papers were included. The majority of out-of-hours services in the community were provided by primary care services. The review found little evidence that patients, families or carers were involved in the planning or development of out-of-hours services. Conclusion: Incorporating patients, families and carers priorities and preferences in the planning and designing of out-of-hours palliative care service is needed for service providers to deliver care that is more patient-centred. Adopting the principles of co-design may improve how out-of-hours care scan be delivered. [ABSTRACT FROM AUTHOR]

Children's vulnerability to jealousy surrounding their best friends was explored in 2 studies. Study 1 involved 94 adolescents who reported on their friendship jealousy on a newly created measure. Results indicated that the jealousy measure had sound psychometric properties and produced individual differences that were robust over time and free from socially desirable responding. As expected, girls and adolescents with low self-worth reported the greatest friendship jealousy. Study 2 involved 399 young adolescents and extended the measurement of self-report jealousy to a broader age range. In addition, Study 2 included assessments of jealousy provided by friends and other peers. Self-and peer-reported jealousy were only modestly associated and had distinct correlates. Structural modeling revealed that young adolescents' reputation for friendship jealousy was linked to behaving aggressively and to broader peer adjustment difficulties. Both self-and peer-reported jealousy contributed to loneliness.

This review discusses the forensic medical and psychological assessments of children and adolescents suspected of being victims of sexual or physical abuse/neglect. Evaluation of the whole child and the need to minimize trauma during the investigative and assessment processes are stressed. The forensic medical examination is reviewed, including the specifics of the pediatric anogenital examination. The key components of the forensic medical examination in sexual assault cases are also reviewed, with particular attention to maintaining the integrity of the process. Special emphasis is placed on the forensic interview in child sexual abuse cases, the best evidence available and areas in need of further research. [ABSTRACT FROM AUTHOR]