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Despite their prevalence, workplace diversity and inclusion (D&I) practices continue to produce inconsistent effects on employee attitudes and behaviors. This shines a light on the need for evidence‐based approaches in understanding how employees enact D&I goals. Drawing on self‐determination theory, we argue that employee D&I motivation is an untapped pathway for understanding how inclusion‐supportive employee outcomes (i.e., more inclusion and less exclusion) emerge. In addition, we leverage attribution theory to inform when employee motivation can be shaped, demonstrating that employee attributions of the intentions behind their organization's D&I practices play an important role in shaping their subsequent D&I motivation. Across two studies, latent profile analysis identified five distinct profiles of D&I motivation, which were differentially related to inclusion and exclusion (Study 1) and predicted by D&I attributions (Studies 1 and 2). Combined, these findings highlight the importance of understanding employee motivations and attributions within the context of D&I. Such knowledge can inform how employees enact inclusion goals, which has the potential to help organizations realize the desired benefits of diversity. [ABSTRACT FROM AUTHOR]

Membership-based free shipping (MFS) has been increasingly adopted by online retailers. However, its effectiveness is understudied. This study leverages a consumer transaction data set provided by an online retailer and uses a stacked difference-in-differences approach to quantify the enrollment effect of MFS on consumers' purchase behaviors and their net revenue contribution to the retailer. Interestingly, MFS enrollment does not lift average consumers' spending at the beginning of the enrollment, as they break large orders into smaller ones. Retailers do not gain incremental net revenue due to the increased shipping costs during this period. However, the free shipping benefit may build a switching barrier that motivates consumers to purchase more often with larger order sizes over time. It eventually leads to increased spending and revenue contribution. MFS also increases members' purchase variety and impulse purchases. In addition, the authors find that there is a greater increase in net revenue contribution after enrollment for light buyers, variety seekers, and those who are willing to pay shipping fees before enrollment. Surprisingly, MFS has a negative impact on the revenue contribution of heavy buyers, the conventional best-value consumers. Moreover, MFS can effectively strengthen consumer–retailer relationships by reducing customer churn. [ABSTRACT FROM AUTHOR]

Introduction: Laparoscopic cholecystectomy is performed very commonly but laparoscopic common bile duct exploration (LCBDE) is performed infrequently. We aimed to determine the most significant barriers to performing LCBDE and to identify the highest yield interventions to facilitate adoption. Methods and procedures: A national survey was designed by content experts, who regularly perform LCBDE. The survey was distributed by email to the Society of American Gastrointestinal and Endoscopic Surgeons and the American Association for the Surgery of Trauma memberships. Non-U.S. surgeon responses were excluded. Descriptive statistics were used to analyze the results. Results: Seven hundred twenty six practicing surgeons responded to the survey, 543 of which were US surgeons who perform laparoscopic cholecystectomy. Only 27% of respondents preferred to manage choledocholithiasis with LCBDE. Their technique of choice was choledochoscopy (70%). Despite this, 36% of surgeons did not have access to a choledochoscope or were unsure if they did. Seventy percent of surgeons who performed LCBDE did not have supplies readily available in a central stocking location. Only 8.5% of surgeons agreed that routine LCBDE would impact their referral relationship with gastroenterology. About half the respondents (47%) considered LCBDE worth the time, but only 25% knew about reimbursement for the procedure. Almost all (85%) of surgeons understood that LCBDE results in shorter length of stay compared to ERCP. Conclusions: Only a quarter of the surgeons performing cholecystectomy perform LCBDE. Multiple barriers contribute to low LCBDE utilization. Increasing availability of appropriate equipment, a dedicated supply cart, and teaching fluoroscopic LCBDE interventions may address limitations and increase adoption. These efforts may also increase efficiency, minimizing perceived time and skill restraints. Although many surgeons understand LCBDE decreases length of stay, they are unaware of surgeon-specific LCBDE financial benefits. Systematically addressing these barriers may increase LCBDE adoption, improve patient care, and decrease healthcare costs. [ABSTRACT FROM AUTHOR]

The article foregrounds two protagonists with Tourette Syndrome (TS) from contemporary Young Adult (YA) novels written by authors with TS. Grounded in the interdisciplinary field of cultural disability studies in education (CDSE), each protagonist is analyzed for (1) physical manifestations of TS (external depiction), (2) emotional reactions about having TS (internal depiction), and (3) the response of parents and family members, friends, acquaintances, and strangers (societal depiction). Both main characters navigate a world in which they are viewed as abnormal, frequently working through internalized feelings of freakery as they struggle to become more self-accepting during their adolescent years. Such depictions "engage with disability as an isolating, hurtful, and joyful experience" (Bolt 11), allowing for the complexities, tensions, contradictions, and general messiness of embodying TS. These depictions suggest that the authors seek to provide readers with an empathetic understanding of TS, while allowing the simultaneous contemplation of ways in which the embodiment of TS informs us about our culture. [ABSTRACT FROM AUTHOR]

Taken together these essays reveal both synergies and contradictions between and within immigration and welfare policies. Several common themes emerge. Firstly, while access to the welfare state is an important signifier of membership, in practice claiming certain state benefits is accompanied by suspicion, surveillance and stigma. The good citizen is a worker citizen. Secondly, the importance of the welfare state in putting the nation into the nation-state: the normative national community imagined as the rightful subject of welfare states is racialised and classed. Thirdly, deservingness functions in both welfare states and immigration regimes to prioritise victimhood rather than rights and redistribution. [ABSTRACT FROM AUTHOR]

In recent years, social campaigns and high-profile cases have brought increased attention to violence against women. Athletes can be role models, shaping both prosocial and antisocial attitudes. Their engagement in violence prevention could be an effective tool to tackle violence against women through bystander intervention. This part of a mixed-method feasibility study reports on the quantitative evaluation of an evidence-led bystander program, Football Onside, implemented at a football club in South West England in June 2018 to February 2020. The study employed a quasi-experimental design with intervention and control groups. Football coaches and club members (n = 50) completed measures of rape and domestic abuse myths, bystander intent and efficacy, self-reported bystander behaviors, readiness for change, perceptions of peer helping and myth acceptance, law knowledge, and program evaluation. Fidelity was also assessed. The analysis compared between- and within-group differences in mean changes over time using mixed-effects models. Participant ratings of learning outcomes were high, and fidelity was maintained throughout the intervention. Between-group comparison revealed mixed results, with greater improvements in the intervention group for bystander intent and efficacy at post-test and follow-up, domestic abuse myths at post-test, and rape myth acceptance at follow-up. Model contrasts for within intervention group revealed improvements in rape and domestic abuse myth acceptance, bystander intent and efficacy, perceived law knowledge at both time points, and perceived peer myths and helping at post-test. At follow-up, intervention participants reported significantly higher engagement in bystander behaviors. No significant effects were found for perceived importance of legal knowledge. Our research highlights the potential efficacy of a bystander program tailored for football club members. Cluster-randomized control trials are now required to examine bystander attitudes and behavior change processes among professional athletes. [ABSTRACT FROM AUTHOR]

The idea(l) of 'legitimate peripheral participation' remains at the heart of debates over the nature and potential of communities of practice. Yet the question of how the legitimacy or otherwise of participation is actually established is seldom addressed. In this article, we focus on 'legitimacy' as figure instead of ground. We attend to the 'displays of competence', and their associated 'labours of division', by means of which 'practitioners' claim recognition and are made recognisable to each other as members, or non-members, of an 'us'. We seek to understand how members come to recognise particular 'doings' and forms of knowledge as belonging (or not belonging) to a particular practice. How is the common 'domain' (communis) of practice settled (or un-settled) in the course of specific performances of membership? Empirically, the article draws upon a 2-year investigation of how community of practice boundaries and participation were negotiated in 'UltraGlass Plc', a multinational manufacturing company, and specifically of the failure of 'community' to cohere around practices. [ABSTRACT FROM AUTHOR]

The paper extends the Framework for Service Driven-driven Social Community by the inclusion of value co-creation, taken from the Service-Dominant Logic, and test the corresponding hypotheses. We, following a quantitative approach, surveyed members of two social communities, one in Africa, another in South America. We applied Structural Equation Modelling. The results validate almost all the Modified Model in the two samples and reinforce its potential to increase both self and collective wellbeing. Within the Framework, there are just a few relationships of different magnitude between one and the other community. [ABSTRACT FROM AUTHOR]

We investigate organizational members' crisis sensemaking and construction of responsibility at the peak of a corporate scandal. We focus on those organizational members, who are not directly involved in the scandal but are still affected by it, as they are questioned about their collective and moral responsibility for being members of an organization that has engaged in wrongdoing. Our study is based on interviews with and observations of frontline employees and their managers at Danske Banke—a bank involved in a money laundering scandal of historical magnitude. We propose an antenarrative crisis sensemaking framework that enables us to contribute to the literature on crisis sensemaking in two significant ways. First, we advance existing knowledge on crisis sensemaking by focusing on the less visible, unfinished, fragmented, and polyphonic sensemaking of organizational members during a corporate scandal. Second, we demonstrate that organizational members at the peak of a scandal place responsibility in different timespaces as they construct others' and their own responsibility both retrospectively and prospectively. [ABSTRACT FROM AUTHOR]

Communities of practice in health settings often serve to address contemporary public health issues by sharing knowledge and experiences about accelerating implementations and innovative solutions. Because there are gaps between the practical application of communities of practice and the scientific knowledge about their effectiveness, this realist synthesis aimed to identify how and why members of communities of practice translate the shared knowledge and apply it in their daily practice. In a six‐step process, this realist synthesis included a scoping review that led to an initial theory map (Step 1), followed by searches (Step 2), appraisal (Step 3), extracts and organisation (Step 4), and analysis and synthesis (Step 5). These steps organised the literature into context–mechanism–outcome configurations that guided the development of a realist framework that can support research and practice (Step 6). We identified three key ways in which knowledge translation may occur: (1) Members bring (new) knowledge to their parent organisation; (2) members change the (daily) practice in their parent organisation; and (3) members improve health outcomes through systemic changes. We found that an initial outcome of knowledge sharing within the community of practice is conditional to achieving outcomes of knowledge translation outside the community of practice. This knowledge sharing within the community of practice is more likely to occur in a structured and trusted environment where members feel safe, as well as where members recognise individual and organisational benefits from participation. To achieve knowledge translation outside the community of practice, support from the parent organisation becomes important, alongside learning and developing confidence to implement the knowledge. The synthesis of the different contexts that potentially trigger mechanisms that lead to desired outcomes provides insight into how best to inform community of practice initiators and facilitators about supporting effective public health responses. [ABSTRACT FROM AUTHOR]

Background: In recent years, the United States (US) has witnessed a rise in political violence. Prior research has found that an individual's social network is associated with their likelihood of engaging in various forms of violence, but research on social networks and political violence in the US context is limited. This study examined associations between social network size and endorsement of political violence in a recent nationally representative survey and explored how the relationship varied by use of social media as a major news source, perceptions of the government as an enemy, and membership in a marginalized or privileged racial or ethnic group. Methods: This was a nationally representative cross-sectional survey study of adults aged 18 and older in the US, administered from May 13-June 2, 2022. The exposure was social network size, defined by the number of strong social connections. We examined three violence-related outcomes: support for non-political violence, support for political violence, and personal willingness to engage in political violence. We estimated prevalence ratios for associations using survey-weighted Poisson regression with robust standard errors, adjusting for hypothesized confounders and including interaction terms to examine effect measure modification. Results: The sample included 8,620 respondents. Median age was 48.4 years (95% CI = 47.9–48.8), 51.5% were female (95% CI = 50.4–52.7%), and 62.7% self-identified as non-Hispanic White (95% CI = 61.4–65.9%). In adjusted models, those with zero strong connections were more likely than those with 1–4 strong social connections to consider political violence usually/always justified in general (PR = 2.43, 95% CI = 1.47–4.01). Those with 50 + strong connections were more likely than those with 1–4 strong social connections to consider political violence usually/always justified in at least one situation (PR = 1.19, 95% CI = 1.03–1.37) and were more likely to report being willing to personally use political violence (PR = 1.52, 95% CI = 1.13–2.04). Associations varied somewhat by social media use, perceptions of the government as an enemy, and racialized identity. Conclusions: Individuals who reported very few and very many strong social connections were more likely than others to support political violence or be personally willing to engage in it in one form or another. Findings point toward potential intervention and prevention opportunities. [ABSTRACT FROM AUTHOR]

In this paper, we re-estimate the astrometric and photometric parameters of the young open star cluster King 18 based on Gaia Data Release 3 (DR3), Two Micron All-sky Survey (2MASS) and VRI CCD observations using the f/4.9 Newtonian focus of 74-inch telescope at Kottamia Astronomical Observatory (KAO) in Egypt. King 18 is a poorly studied open star cluster, for which new results are found in the current study. In order to estimate the membership and determine all the astrophysical parameters of the cluster, we have used data from Gaia DR3 and KAO. The center, cluster radius, radial density distribution, color-magnitude diagrams, distance, age, and reddening of King 18 are calculated. Also, the luminosity and mass functions, the total mass and the relaxation time of the cluster are estimated. The slope value of the mass function (α ) of King 18 is found to be 2.27± 0.17, which is comparable with Salpeter value. Our estimates for the average cluster age and the relaxation time are 224 ± 6.3 and 28.92 Myrs, respectively. This indicates that King 18 is dynamically stable and a relaxed cluster. The cluster distance modulus from Gaia, 2Mass and VRI observations has been determined to be 12.380 ± 1.320, 12.320 ± 0.107 and 12.280 ± 0.290 mag respectively, which corresponds to distances of 2992.26, 2910.72 and 2857.59 pc, respectively. These results are in good agreement within the error. Moreover the color excesses E(V–I), E(J– K s ) and E( G BP – G RP ) are 0.850 ± 0.087, 0.380 ± 0.091 and 0.980 ± 0.130 respectively. Finally, the proper motions ( μ α cos δ , μ δ ), and parallaxes (ϖ ) are - 2.603 ± 0.018 , - 2.106 ± 0.013 and 0.324 ± 0.040, respectively. [ABSTRACT FROM AUTHOR]

This article questions the justification for restricting political party membership as a condition for receiving political service retirement benefits in Ethiopia (a restriction first imposed through the Administration of the President of the Federal Democratic Republic of Ethiopia Proclamation and endorsed in the Rights and Benefits of Outgoing Heads of State and Government, Senior Government Officials, Members of Parliament and Judges Proclamation). After reviewing relevant law, literature and comparative experience from Kenya and Tanzania, the article argues that prohibiting political party membership without a pressing need for non-partisan service is an unjust restriction on the right to freedom of political party membership. Benefits for retiring high-ranking government officials are part of the right to social security and should not be disallowed based on political party membership. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of research on and a limited understanding of patient and public involvement (PPI) in the context of research in homelessness and, in particular, direct involvement of people with lived and living experience of homelessness (PEH) as expert advisors. We aim to report on outcomes and reflections from lived experience advisory panel (LEAP) meetings and PPI activities, held throughout the study lifecycle of a pilot randomised‐controlled trial (RCT) focused on evaluating integrated health and practical support for PEH. Methods: Community Pharmacy Homeless Outreach Engagement Non‐medical Independent prescribing Rx (PHOENIx Community Pharmacy RCT) is an integrated health and social care intervention for people experiencing homelessness who present to community pharmacy. Intervention includes weekly support from a pharmacist prescriber and a third sector support worker for up to 6 months. PPI activities undertaken throughout the study were documented, including outcomes of LEAP meetings. Outcome reporting followed Guidance for Reporting Involvement of Patients and the Public 2 Short Form (GRIPP2‐SF). Results: In total, 17 members were recruited into the LEAP; six meetings (three in two study sites) were held. PPI input was also received through representation from homelessness third sector organisation staff as study co‐applicants and core membership in the trial steering committee. Together, the PPI activities helped shape the study proposal, design of study materials, data analysis and dissemination materials. LEAP panel members offered valuable input via their experience and expertise into the delivery and refinement of interventions. Although longitudinal input was received from some LEAP members, ensuring repeat attendance in the pre‐planned meetings was challenging. Conclusion: People who face social exclusion and marginalisation can provide highly valuable input as equal partners in co‐design and delivery of interventions seeking to improve their health and well‐being. Fluid membership and flexible methods of seeking and incorporating advice can offer pragmatic approaches to minimising barriers to continued involvement in research. Patient or Public Contribution: This study reports findings and learning relevant to involvement of people with lived and living experience of homelessness as advisors in a research study. It is important for researchers to offer fluid memberships and use diverse methods to receive input from lived experience members, as traditional PPI methodology may be insufficient to ensure inclusivity. Staff and volunteers from third sector organisations were important PPI partners who bring their experience based on frontline service provision, often as the first port of call for people experiencing severe and multiple disadvantage. Trial Registration: ISRCTN88146807. [ABSTRACT FROM AUTHOR]

This analysis aimed to (1) identify longitudinal joint trajectories of participation in organized and unorganized physical activity contexts, and level of daily moderate‐to‐vigorous physical activity (MVPA) and (2) assess whether basic psychological need satisfaction during adolescence differentiates between membership in different physical activity trajectories. Participants (n = 888; 56% girls) reported their involvement in 36 different physical activities, level of MVPA, and their perceived satisfaction of competence, autonomy, and relatedness satisfaction in physical activity up to three times per year, over 8 years (from ages 10 to 17 years). Group‐based multi‐trajectory models were used to identify longitudinal joint trajectories of physical activity participation. We estimated a multinomial logistic regression model for membership in a physical activity trajectory by including individual‐level intercepts and slopes for each psychological need obtained using mixed models over the 24 cycles modelized as natural cubic splines. Five longitudinal trajectory groups emerged: Non‐participants, Dropouts, Active in unorganized physical activities, Active in organized physical activities, and Active through a variety of activities. Relative to Non‐participants, we identify a dose–response relationship in baseline competence and membership in the higher active trajectory groups. In addition, a positive change in competence in early adolescence predicted membership in all three Active trajectory groups. [ABSTRACT FROM AUTHOR]

Evidence suggests that social identities, which provide purpose and a sense of belonging, enhance resilience against psychological strain and safeguard well‐being. This applies to first‐generation migrant populations facing adverse experiences, including prejudice and disconnection from previous identities during host country integration, negatively impacting their well‐being. The importance of social identity also extends to first‐generation migrant descendants, confronting dual‐identity challenges and experiencing exclusion and discrimination despite being native born. Building on the social identity approach to mental health, 20 semi‐structured interviews were conducted to investigate how migrants construct their social identities, their perspective on the challenges and changes they experience in relation to group memberships and ultimately, the influence this has on their psychological well‐being. Findings emphasize the significance of social identity continuity and gain pathways in first‐generation migrants' successful adjustment and psychological well‐being. For second‐generation migrants, dual‐identity development is especially difficult during adolescence due to social exclusion and discrimination in schools. Even in early adulthood, pressure to maintain heritage identity can lead to negative mental health outcomes over time. The current study contributes to and strengthens the social identity approach to migrant mental health and has wider implications for psychological interventions and policy. [ABSTRACT FROM AUTHOR]

Whether and how NATO might pull Ukraine closer attracted a great deal of attention at the 2024 Washington summit, with the Alliance settling on the formulation of an 'irreversible path' towards Kyiv's membership and pledging to further institutionalise the NATO–Ukraine relationship. There has been comparatively little analysis of what should happen once Ukraine actually becomes a member. Much like major Alliance expansions of the past – including the addition of West Germany in 1955 and Finland in 2023 – adding Ukraine would require a substantial revision of NATO's collective defence. Although the outcome of the Russia–Ukraine war remains highly contingent, it is clear that the Alliance will need to reconsider its approach in four main areas: defending Ukrainian territory, beefing up security in the Black Sea, strengthening the 'flanks' and sharpening the responses to intensified Russian hybrid attacks. [ABSTRACT FROM AUTHOR]

Background and Objectives Family conflict is a stressor for dementia family caregivers, yet its impact may differ based on the relationship between caregivers and their recipients. This study's objectives were to categorize caregivers into groups based on family conflict, examine whether the relationship to the recipient influences group membership, and determine whether these groups are associated with engaging in abusive and neglectful behaviors. Research Design and Methods This national, cross-sectional study of 453 dementia family caregivers used latent class analysis to generate groups based on family conflict and abuse accusations. A multinomial logistic regression determined if relationship type (i.e. being a spouse, child, or grandchild to the care recipient or having a nontraditional relationship) predicted group membership. Groups were examined as predictors of abusive and neglectful behaviors using analysis of variance. Results A 4-class solution emerged as the best fit: 3 groups with varying probabilities of family conflict and 1 group with elevated probabilities of abuse and neglect accusations. Relationship typed predicted membership in these classes. Group membership predicted abusive and neglectful behaviors. Discussion and Implications Adult children were more likely to experience high amounts of family conflict, whereas nontraditional caregivers were less likely to experience abuse and neglect accusations. Membership in the accusations group was a unique risk factor for abusive and neglectful behaviors. These findings support the need for continued investigation of family conflict in dementia caregivers. They also call to examine how family relationship types, including nontraditional family structures, influence caregiving outcomes. [ABSTRACT FROM AUTHOR]

The article presents the benefits and lessons learned by the Parent Council for a pediatric stroke rehabilitation and how to provide a framework for researchers. Topics discussed include background and need for parent partnership, formation of the Parent Council, and description and activities of the Parent Council.

Summary: Key predictors of three trajectory group membership of potentially preventable hospitalisations were age, the number of comorbidities, the presence of chronic obstructive pulmonary disease and congestive heart failure, and frailty risk at the occurrence of hip fracture. These predictors of their trajectory group could be used in targeting prevention strategies. Purpose: Although older adults with hip fracture have a higher risk of multiple readmissions after index hospitalisation, little is known about potentially preventable hospitalisations (PPH) after discharge. This study examined group-based trajectories of PPH during a five-year period after a hip fracture among older adults and identified factors predictive of their trajectory group membership. Methods: This retrospective cohort study was conducted using linked hospitalisation and mortality data in New South Wales, Australia, between 2013 and 2021. Patients aged ≥ 65 years who were admitted after a hip fracture and discharged between 2014 and 2016 were identified. Group-based trajectory models were derived based on the number of subsequent PPH following the index hospitalisation. Multinominal logistic regression examined factors predictive of trajectory group membership. Results: Three PPH trajectory groups were revealed among 17,591 patients: no PPH (89.5%), low PPH (10.0%), and high PPH (0.4%). Key predictors of PPH trajectory group membership were age, number of comorbidities, dementia, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), frailty risk, place of incident, surgery, rehabilitation, and length of hospital stay. The high PPH had a higher proportion of patients with ≥ 2 comorbidities (OR: 1.86, 95% confidence interval (CI): 1.04–3.32) and COPD (OR: 2.97, 95%CIs: 1.76–5.04) than the low PPH, and the low and high PPHs were more likely to have CHF and high frailty risk as well as ≥ 2 comorbidities and COPD than the no PPH. Conclusions: Identifying trajectories of PPH after a hip fracture and factors predictive of trajectory group membership could be used to target strategies to reduce multiple readmissions. [ABSTRACT FROM AUTHOR]

Organisations of Persons with Disabilities (OPDs) are critical to promoting and protecting the rights of people with disabilities. However, little is known about the extent to which people with disabilities are aware and members of OPDs. This study uses data from nine population-based surveys in low- and middle-income countries to explore OPD awareness and membership. Across settings, about a third of people with disabilities were aware of OPDs and fewer than 15% were members. Awareness and membership were lower amongst older adults, women, people with difficulties communicating, remembering and with self-care, people with less education, in poverty and in rural areas. Underrepresentation of certain groups may indicate a need to seek out the voices of people less likely to be associated with OPDs. Further, low total membership may be a cause for concern in settings where OPDs are relied upon to deliver essential services in the absence of state structures. Points of interest: Organisations of Persons with Disabilities can serve many roles, including advocacy, policymaking and service provision. The increasing involvement of Organisations of Persons with Disabilities in direct provision of essential services, particularly in low- and middle-income countries, is often a result of poor availability and quality of inclusive public services. This study explores awareness and membership of people with disabilities across nine low- and middle-income countries using population-based surveys. About a third of people with disabilities were aware of Organisations of Persons with Disabilities across settings, ranging from 12% in Lesotho to 73% in the Maldives. Fewer than 15% of people with disabilities were members across settings, ranging from 3.5% in Zambia to 14% in Vietnam (Cam Le district). Awareness and membership were generally lower amongst older adults, women, people with difficulties communicating, remembering and with self-care, people with less education, in poverty and in rural areas. Given the increased role of Organisations of Persons with Disabilities in direct service delivery, low total membership may indicate that many people with disabilities – particularly the most marginalised or experiencing the greatest need – are not being reached. Additional efforts may also be needed to seek out the voices of groups underrepresented in Organisations of Persons with Disabilities, particularly for advocacy and policymaking. [ABSTRACT FROM AUTHOR]

The Communities Organizing to Promote Equity (COPE) Project was implemented in 20 counties across Kansas to build capacity to address health equity by forming local health equity action teams (LHEATS), hiring and training community health workers, facilitating state-wide learning collaboratives, and tailoring communication strategies. We conducted interviews and focus groups with project stakeholders who identified pragmatic recommendations related to LHEAT formation and leadership, establishing trust, nurturing autonomy, and optimizing impact. Insights can improve future community-based health equity efforts. (Am J Public Health. 2024;114(S7):S570–S574. https://doi.org/10.2105/AJPH.2024.307802) [ABSTRACT FROM AUTHOR]

The article outlines the transformative goals for the American Dental Association (ADA) as it navigates evolving challenges in the dental field. Topics include the need for innovative leadership, enhancing member engagement, addressing mental health concerns among dentists, and the importance of adapting to technological advancements in practice.

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy and Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433. [ABSTRACT FROM AUTHOR]

Clinical ethics consultation services (CECS) can be particularly complex in oncology, and widespread misconceptions exist about their nature. As a result, visibility and accessibility of information regarding CECS is critical. We investigated the availability and content of information regarding CECS on websites of NCI-designated comprehensive cancer centers and cancer centers (CCs). Each website was reviewed for information on CECS and reviewed for benchmarks partially derived from the American Society of Bioethics and Humanities recommendations for CECS. Our analysis revealed that of 70 NCI-designated center websites, 38 had information on CECS, and 17 were found directly on these sites. When CECS information was available, most websites provided a mission statement (71%) and an explanation of what constitutes an ethics consult (74%). Few provided a description of the consult process (45%) or service membership (39%). Our findings reveal a significant gap in CECS visibility on the websites of NCI-designated CCs. [ABSTRACT FROM AUTHOR]

Background: Research on alcohol-related problems often examines individual problem types in isolation or uses scales that provide a single cumulative severity score for alcohol-related harms. This study aims to assess the patterns of seventeen distinct alcohol-related problems and how they co-occur. Methods: The East Bay Neighborhood Study surveyed a community sample of 864 adults who drank in the past year in Alameda County, California. Participants reported if they experienced each of seventeen alcohol-related problems in the last year. Latent class analysis assessed subgroups of problems. Logistic regression models examined associations between class membership, sociodemographics, and alcohol use. Results: A two-class model best fit the data. The multiple problems class (18% of respondents) was characterized by experiencing problems of all types and almost all experiences of legal, violence, and risky sex-related problems. The none/few problems class (82%) was characterized by a low prevalence of all problem types, with only a small proportion experiencing hangovers. In adjusted models, only older age (AOR = 0.90, 95% CI = 0.88–0.92) had lower odds of multiple problems class membership. Conclusions: Numerous alcohol-related problems co-occurred within a small subgroup of people who drank in the last year, while the majority experienced few problems. Results suggest that focusing on singular alcohol-related problems may overlook patterns of concurrent problems in high-risk groups. [ABSTRACT FROM AUTHOR]

This study explores the complex nature of female genital mutilation/cutting (FGM/C) by juxtaposing the mental and sexual health of women who had undergone FGM/C as part of initiation/membership into a traditional women's society (TWS) with those who were also cut but not initiated into a TWS. While considerable differences emerged between TWS members and nonmembers, there was no evidence that TWS membership was protective against the physical and psychological trauma typically ascribed to FGM/C. In fact, the pattern of results would tend to suggest the opposite. Possible explanations for and implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

This study aims to identify the effect of spiritual leadership on organizational Virtuousness in government institutions in Dhofar Governorate. This study was applied to five government institutions represented in (Dhofar Municipality, Consumer Protection Authority, General Directorate of Health Services, General Directorate of Awqaf and Religious Affairs, and the General Directorate of Education). The size of the study population consisted of (2360) employees, a simple random sample of individuals working in these institutions was selected, amounting to (327) employees, and questionnaires were distributed to them. A number of (297) questionnaires were retrieved and valid for statistical analysis. An electronic questionnaire was relied upon as a source for data collection. The analytical descriptive approach was adopted to achieve the objectives of the study, and structural equation modeling was used to analyze the data through the AMOS program. One of the most important findings of the study is that the degree of availability of spiritual leadership in the institutions of the study sample came at a high level of relative importance, and likewise with regard to organizational Virtuousness. The results also revealed that there was a statistically significant positive effect of the two dimensions of spiritual leadership (altruism and membership) on organizational virtuousness, and that there was no positive effect of the dimensions (vision, hope, and meaning) on organizational virtuousness. [ABSTRACT FROM AUTHOR]

BACKGROUND: A substantial gap in employment rates has been documented between people with and without visual impairments, but most employment-related research for people with visual impairments has focused on employment at one time point. OBJECTIVE: The purpose of this study was to examine longitudinal employment trajectories by visual impairment and investigate factors associated with trajectories for people with visual impairments. METHODS: The data source was the 2014 Panel of the Survey of Income and Program Participation. Participants were 816 adults with visual impairments and a matched comparison group of 816 adults without visual impairments. We used group-based trajectory modeling to estimate employment trajectories, identify predictors of trajectory group membership, and explore the impact of health on employment trajectories. RESULTS: Visual impairment was associated with a lower probability of membership in the Rising, Declining, and High employment trajectory groups compared to the Low group. Predictors of trajectory group membership included disability benefit receipt, non-visual disabilities, gender, race, age, and education. Fair or poor health was associated with decreases in all four trajectories over time. CONCLUSION: Visual impairment is a risk factor for not working across multiple years. Disability benefit receipt was the strongest predictor of trajectory group membership for this population. [ABSTRACT FROM AUTHOR]

Objective: This article explores the ideological dilemmas of decision making identified in members' and staff's talk in Clubhouse communities. Method: The data are drawn from a corpus of 10 video-recorded focus group interviews with Clubhouse members and staff, which were collected at five Finnish Clubhouses in 2020. The method used is discursive psychology, and the analysis identifies interpretative repertoires and ideological dilemmas. Results: Clubhouse members and staff express diverse opinions regarding decision making at the Clubhouse. We identified six interpretative repertoires and three ideological dilemmas between these repertoires. The first dilemma deals with participation and efficiency, advancing the idea that everybody should be allowed to participate in decision making, but the decision making should be efficient. The second dilemma regards the passivity or activity of the participants, suggesting that decision-makers should be allowed to be themselves, but participation in decision making requires activity. The third dilemma is associated with power structures in decision making, proposing that joint decision making requires active resistance against power structures, but these structures are both inexorable and partially necessary. Conclusions and Implications for Practice: In introducing a discursive perspective to joint decision making in the Clubhouse community, this study makes visible the conflicting ideals of decision making. The acknowledgment of these dilemmas can guide interventions aiming at improving genuinely participatory joint decision-making practices at the Clubhouse. Impact and Implications: The study shows that Clubhouse members and staff have conflicting ideals about joint decision making at the Clubhouse. The staff's views constitute a potential risk, as they highlight the active role of members and associate efficient decision making with the inexorability of power structures. By making the conflicting ideals visible, the study can inform interventions to improve joint decision making in the Clubhouse community. [ABSTRACT FROM AUTHOR]

Objective: The Clubhouse model of psychosocial rehabilitation supports the personal recovery of individuals with severe mental health challenges. To date, there has never been a multisite, longitudinal study examining the outcomes of Clubhouse members in Canada. Therefore, the purpose of the present study was to longitudinally assess the psychosocial outcomes and hospitalization rates of Clubhouse members from six Clubhouses across Canada. An exploratory aim of this study was to assess the psychosocial impact of the COVID-19 pandemic on Clubhouse members. Method: The present study used a participatory approach with six accredited Clubhouses across Canada. A total of 462 Clubhouse members consented to participate in the study. Members completed a questionnaire battery every 6 months over a 2-year period (five data points total). The last three data points were collected during the COVID-19 pandemic. Primary outcomes included community functioning, measured by the Multnomah Community Ability Scale, and self-reported hospitalization rates. Data were analyzed using multilevel growth models. Results: The results of the analysis indicated stability over the study period in community functioning and rates of hospitalization. Subscales of community functioning, including interference in functioning and behavioral problems improved over the course of the study, while adjustment to the community and social competence remained stable. Conclusions and Implications for Practice: The consistency in outcomes across the study is notable, due to the worldwide impact of COVID-19 on mental health. Clubhouses may have had a buffering effect for members, in that membership diminished the impact of the pandemic on mental health. Impact and Implications: The present study longitudinally assessed the psychosocial outcomes of Clubhouse members from six Clubhouses across Canada. Data collection occurred prior to and during the pandemic, making an exploratory aim of this study to assess the psychosocial impact of the pandemic on Clubhouse members. The results indicate that Clubhouse member's outcomes remained stable hospitalization over the course of the study. Clubhouses' ability to adapt their programming to virtual formats during the pandemic appears to have been successful in tempering the psychosocial impact of social distancing and lockdowns in Canada. [ABSTRACT FROM AUTHOR]

A medium-to-high level of physical activity (PA) may have at least a short-term positive effect on psychopathology in children and adolescents. Hence, the objective of this study was to investigate the long-term effects of PA in non-adult age groups on their general mental health problems and/or ADHD symptoms, using trajectories of concurrent development over a period of 10 years. This study employed data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected at three time points (baseline, Wave 1, Wave 2, over 10 years) from 17,640 children and adolescents. Using parent-reported data from the Strengths and Difficulties Questionnaire (SDQ), different developmental trajectories of general mental health problems (SDQ-total) and ADHD symptoms (SDQ-H/I) were identified with latent class mixed models (LCMM) statistics. This was also applied to parent- and self-reported data of three levels of PA. The latter was assessed according to WHO recommendations. The joint probability of class membership for SDQ-total as well as ADHD symptoms with PA was calculated to generate the concurrent developmental trajectories between variables. Results showed a 4-class trajectory model for both SDQ-total and ADHD symptoms among boys and girls. The majority of children and adolescents showed "low general difficulties" and "low ADHD symptoms" over the period of 10 years. Three distinct trajectories in boys and four distinct trajectories in girls were found for PA. Most of the participants showed an "increasing–decreasing activity" trajectory. No statistically significant correlations were found between the different SDQ-total or ADHD symptom trajectories and the trajectories of PA in the two genders. Taken together, our findings did not indicate any significant relationship between waxing and waning PA course over 10 years and various classes of mental health problems for children and adolescents. In contrast to our cross-sectional findings, no steady long-term medium/high-level of PA was present, which could (at least partly) explain the non-significant findings. [ABSTRACT FROM AUTHOR]

Autistic adults experience high rates of unemployment, yet research investigating what predicts employment success produces inconsistent results. By utilising longitudinal person-oriented analyses, this study aimed to identify employment trajectories of autistic adults to better understand what may predict stable autistic employment. Participants were 2449 autistic adults (1077 men, 1352 women, 20 non-binary, M = 42.25 years, SD = 14.24), recruited via the Netherlands Autism Register. Latent class analysis utilising employment status across eight annual waves was used to identify longitudinal employment profiles. Fit indices and the interpretability of results indicated a four-class model best fit the data, with profiles reflecting stable unemployment (n = 1189), stable employment (n = 801), early unemployment increasing in probability of employment (n = 183) and high probability of employment reducing across time to low employment (n = 134). Multinominal analyses suggested that compared to the 'stable unemployment' group, membership in the 'stable employment' profile was predicted by fewer autistic traits, lower age, male gender, higher education and diagnosis age, and fewer co-occurring conditions. Higher education predicted both other profiles, with lower age and fewer co-occurring conditions predicting membership in the increasing employment class. Taken together, findings highlight the utility of person-oriented approaches in understanding the longitudinal challenges autistic adults experience maintaining employment and identifies key areas of support. Autistic adults experience difficulties finding and keeping employment. However, research investigating reasons that might explain this difficulty produce mixed results. We gave a survey to 2449 autistic adults and used a statistic method to group them based on their employment status over 8 years. We identified four employment groups that best captured the experiences of autistic adults; this included a group that experienced stable unemployment, a group that experienced stable employment, a group that had high employment that reduced over time, and a group whose employment increased over the 8 years. Further analysis showed that those with fewer autistic traits, younger age, male gender, higher education, later diagnosis age and no co-occurring conditions were more likely to have stable employment. People whose employment changed over time were more likely to have a higher level of education than the stable unemployment group, and those in the increasing employment group were younger age and had no co-occurring conditions. These findings help us better understand that not all autistic adults' experiences of employment are the same, which helps focus where employment programmes and support may be most needed, for example, people who identify as women or have a co-occurring condition. [ABSTRACT FROM AUTHOR]

Goal: The U.S. hospital sector is experiencing record levels of integration, with more than half of U.S. physicians and nearly three quarters of all hospitals affiliated with one of slightly more than 630 health systems. However, there is growing evidence to suggest that health system integration is associated with more expensive and lower quality care. The goal of this research is to explore the associations between forms of health system integration and hospital patient experience scores. Methods: Across-section of data for the year 2019 was assembled and analyzed from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience survey. Data from the Compendium of US Health Systems, published by the Agency for Healthcare Research and Quality (AHRQ), and the American Hospital Association (AHA) Annual Survey were used to obtain independent variables and hospital-level covariates. A series of multivariable regressions was used to explore the associations between forms of health system integration and hospital patient experience scores across three domains: overall impression of the hospital; experiences with staff; and the hospital environment. Forms of both horizontal integration (i.e., number of hospitals owned by hospital-based health systems) and vertical integration (i.e., physician-hospital integration, nursing home ownership, accountable care organization [ACO] participation, group purchasing, contract management, offering insurance products, and investor ownership) were explored. Principal Findings: Although horizontal integration was not associated with any meaningful differences in patient experience scores, health systems with physician--hospital integration were associated with overall impression scores that were 2 percentage points higher than systems without physician integration. Similarly, contract management and membership in a group purchasing organization were associated with overall impression and environment scores that were 2 to 3 percentage points higher than hospitals that did not engage in those forms of integration. By contrast, investor ownership was associated with a 5% lower score for overall patient experience compared with other forms of ownership. Practical Applications: The findings of this study suggest that hospitals in more vertically integrated systems may have higher patient experience scores than independent hospitals and those that belong exclusively to horizontally integrated systems. Thus, there are elements of vertical integration that could benefit patients and be worth pursuing. Conversely, higher degrees of horizontal integration in the form of multihospital ownership may not be of any benefit to patients and should be pursued with caution. [ABSTRACT FROM AUTHOR]

Background: Gender representation trends at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Annual Meetings and the effect of the 2018 'We R SAGES' initiatives are unknown. We assessed gender trends in oral presentations at the SAGES Annual Meeting between 2012 and 2022 with a focus on assessing the impact of the 2018 initiatives. Methods: Abstracts selected for oral presentations from 2012 to 2022 were reviewed for presenter and first, second, and senior author gender. Gender was categorized as woman, man, or unknown using public professional profiles. Subsequent publications were identified using search engines. The primary outcome was the temporal trend of proportion of women in each role using interrupted time series analysis. Secondary outcomes included publication rates based on first and senior author genders in 2012–2018 versus 2019–2022. Results: 1605 abstracts were reviewed. The proportion of women increased linearly in all categories: presenter (2.4%/year, R2 = 0.91), first author (2.4%/year, R2 = 0.90), senior author (2%/year, R2 = 0.65), and overall (2.2%, R2 = 0.91), (p < 0.01 for all). Prior to 2018, the proportion of women increased annually for presenters (coefficient: 0.026, 95% CI [0.016, 0.037], p = 0.002) and first authors (coefficient: 0.026, 95% CI [0.016, 0.037], p = 0.002), but there was no significant increase after 2018 (p > 0.05). Female second author proportion increased annually prior to 2018 (coefficient: 0.012, 95% CI [0.003, 0.021], p = 0.042) and increased by 0.139 (95% CI [0.070, 0.208], p = 0.006) in 2018. Annual female senior author proportion did not significantly change after 2018 (p > 0.05). 1198 (75.2%) abstracts led to publications. Women were as likely as men to be first (79% vs 77%, p = 0.284) or senior author (79% vs 77%, p = 0.702) in abstracts culminating in publications. There was no difference in woman first author publication rate before and after 2018 (80% vs 79%, p = 1.000), but woman senior author publication rate increased after 2018 (71% vs 83%, p = 0.032). Conclusion: There was an upward trend in women surgeons' presentations and associated publications in the SAGES Annual Meetings over the last decade. [ABSTRACT FROM AUTHOR]

While victim numbers are frequently estimated for past events of genocide and authoritarian rule, there has so far been less discussion of perpetrator numbers. This is surprising considering the recent interest in perpetrators, their motivations and their trajectories. In the case of Cambodia, this is primarily due to a lack of archival documentation. While these are indeed not insignificant, this article seeks to contribute to the historical record on the Khmer Rouge by drawing together what we do know about the Khmer Rouge and its organizational structure and providing reasoned estimations where data does not exist. Altogether, we enumerate the number of men and women who were part of the regime as Khmer Rouge and suggest this number to be around half a million individuals: 526,297 (our estimates range from no lower than 386,000 and no higher than 646,000). [ABSTRACT FROM AUTHOR]

The article focuses on the deficiencies in ethics committee education and orientation processes in hospitals. Topics include the lack of formal orientation and ongoing education for committee members, the need for comprehensive orientation programs to ensure effective ethics consultation, and the role of ethics committees in improving clinical ethics knowledge among members.

Objectives: Identify how the American Headache Society (AHS) membership manages status migrainosus (SM) among outpatients. Background: SM is defined as a debilitating migraine attack lasting more than 72 h. There is no standard of care for SM, including whether a 72‐h duration is required before the attack can be treated as SM. Methods: The Refractory Headache Special Interest Group from AHS developed a four‐question survey distributed to AHS members enquiring (1) whether they treat severe refractory migraine attacks the same as SM regardless of duration, (2) what their first step in SM management is, (3) what the top three medications they use for SM are, and (4) whether they are United Council for Neurologic Subspecialties (UCNS) certified. The survey was conducted in January 2022. Descriptive statistical analyses were performed. Results: Responses were received from 196 of 1859 (10.5%) AHS members; 64.3% were UCNS certified in headache management. Respondents treated 69.4% (136/196) of patients with a severe refractory migraine attack as SM before the 72‐h period had elapsed. Most (76.0%, 149/196) chose "treat remotely using outpatient medications at home" as the first step, 11.2% (22/196) preferred procedures, 6.1% (12/196) favored an infusion center, 6.1% (12/196) sent patients to the emergency department (ED) or urgent care, and 0.5% (1/196) preferred direct hospital admission. The top five preferred medications were as follows: (1) corticosteroids (71.4%, 140/196), (2) nonsteroidal anti‐inflammatory drugs (NSAIDs) (50.1%, 99/196), (3) neuroleptics (46.9%, 92/196), (4) triptans (30.6%, 60/196), and (5) dihydroergotamine (DHE) (21.4%, 42/196). Conclusions: Healthcare professionals with expertise in headache medicine typically treated severe migraine attacks early and did not wait 72 h to fulfill the diagnostic criteria for SM. Outpatient management with one or more medications for home use was preferred by most respondents; few opted for ED referrals. Finally, corticosteroids, NSAIDs, neuroleptics, triptans, and DHE were the top five preferred treatments for home SM management. Plain Language Summary: In this research study, we asked members of the American Headache Society how they treat status migrainosus, a very severe migraine attack lasting more than 3 days. Out of the 196 people who answered the survey, most used stronger treatments before the headache lasted 72 h, and the majority preferred to use home‐based treatments to avoid the hospital. The five most common treatments they use are corticosteroids (like dexamethasone), nonsteroidal anti‐inflammatory drugs (like ketorolac), neuroleptics (like prochlorperazine), triptans (like naratriptan), and dihydroergotamine. [ABSTRACT FROM AUTHOR]

Clinical trials investigating novel or high-risk interventions often use data monitoring committees (DMCs) to ensure that the participants' best interests are safeguarded. The typical DMC charter describes procedures by which the DMC operates, including important details concerning organizational structure, membership, meeting frequency, statistical monitoring guidelines, and contents of DMC reports for interim review. These charters, however, are not routinely publicly available; in some cases, their access could be important to the interpretation of trial results. We recommend including DMC charters for such trials in ClinicalTrials.gov at the time of trial completion; trial protocols, informed consent documents, and statistical analysis plans are already available in this repository. [ABSTRACT FROM AUTHOR]

Background: The new EU Medical Device Regulation (MDR) places greater importance on the role of clinical evidence to establish safety and performance. Article 54 of the MDR calls for expert committees to independently review the scientific, technical, and clinical evidence supporting the market authorization of certain novel devices independently from the established process of Notified Body reviews. These experts provide a review and opinion that ultimately is taken into consideration alongside the information reviewed by the Notified Body during the review process. Four expert committees (General and Plastic Surgery and Dentistry; Orthopaedics, Traumatology, Rehabilitation, Rheumatology; Circulatory System; and Neurology) have published at least one Scientific Opinion (SO) under the Clinical Evaluation Consultation Procedure (CECP) in 2021–2022. Methods: The four expert committees with published CECP opinions were reviewed to assess the academic backgrounds and professional expertise of each member with respect to clinical, technical, and biological domains on a 0–2 scale for each domain. A content review was conducted on the 10 CECP opinions published by these committees to assess their consistency with the goals and outcome expectations set by the MDR. The extent of content related to each of the clinical, technical, and biological domains was also assessed on a 0–2 scale. Results: All committees were composed primarily by members with strong clinical expertise, but only a few had strong technical and biological expertise. Across committees, the average scores of members related to academic background and professional expertise both ranged from 1.64 to 2.00 in the clinical domain, but only 0–0.15 and 0.15–0.69, respectively, in the biological domain, and 0.12–0.55 and 0.23–0.73, respectively, in the technical domain. A content review for the 10 SOs showed that all opinions focused exclusively or primarily on the clinical evidence. Three contained a modest amount of additional text directed at technical/engineering issues and five at biological issues. Conclusion: Expert committees are composed predominantly of expert clinical reviewers but have many fewer members with significant technical or biological expertise. This may limit the ability of the committees to evaluate the significant technical and biological risks that are often best understood by preclinical testing. Broadening the expertise across the committees may improve the depth of their benefit/risk critiques. [ABSTRACT FROM AUTHOR]

This article explores the significance of gender in understanding the formation of Indian collections in European museums, and how the activities of a single collector sheds light on the role of the individual and wider society. It focuses on Annie Marion Rivett-Carnac's (1843–1935) contribution to multiple European museums over a period of over forty years. She amassed a personal collection of 6,000 to 8,000 items, brought together during her life in India alongside her husband. Her assemblage consisted of Indian body ornaments, jewellery, and items used in religious and daily practices, which she used to form networks with eminent figures in anthropology and ethnography in Europe, some outside of Britain's traditional networks of British imperial collectors. While her husband has a prominent presence through his donations to museums, membership of learned societies and publications, little is known about her. Her contributions to museum collections in Britain, Germany and Sweden have largely gone unstudied, which this article seeks to address. It argues that Rivett-Carnac used her collections and the emergence of ethnography in Europe and British India as a way to position herself as a serious and respected scholar. [ABSTRACT FROM AUTHOR]

Research question: The number of adults participating in physical activity and sport is in decline; nine of the top 15 daily sports experienced a decrease in participation in recent years. For sport organizations that provide participation programming, retaining members is critical to their success and longevity. The purpose of this research is to empirically determine factors that explain member retention in a masters-level sport. Research method: A relationship marketing-based model was developed and tested using survey data from over 6000 current and former members of United States Masters Swimming. Results and findings: Enjoyment and fitness, community, and competition are motivational factors that support membership continuation. Membership renewal is also influenced by identification with the organization, improved fitness and ability, and positive perceptions of service quality and coaching. Implications: Leaders of non-profit sport organizations can apply the findings to increase member retention and fulfill the mission of providing health benefits to adults. Organizations can improve sport experiences through community-building and challenge; creating positive interactions with the coach and service organization can contribute to retention. This research contributes to theory-building regarding relationship marketing in member-based sport organizations. [ABSTRACT FROM AUTHOR]

Autocrats must redistribute to survive, but redistribution is limited and selective. Who is entitled to redistribution underlying the authoritarian bargain? I argue redistribution is a question of citizenship. Autocrats use citizenship institutions, especially particularistic membership, to strategically limit and extend socio-economic rights to ensure both security and economic development. I apply this framework to China, where control over particularistic membership decentralized in conjunction with development strategies. Drawing on semi-structured interviews, government policies, and a database of local citizenship policies in China, I trace how local citizenship creates closure while economic development incentivizes strategic inclusion. By evaluating how authoritarian citizenship functions, this framework increases our understanding of individual-staterelations in autocratic contexts.