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Research suggests that school climate can have a great impact on student, teacher, and school outcomes. However, it is often assessed as a summary measure, without taking into account multiple perspectives (student, teacher, parent) or examining subdimensions within the broader construct. In this study, we assessed school climate from the perspective of students, staff, and parents within a large, urban school district using multilevel modeling techniques to examine within- and between-school variance. After adjusting for school-level demographic characteristics, students reported worse perceptions of "safety" and "connectedness" compared to both parent and staff ratings (all p < 0.05). Parents gave the lowest ratings of "parental involvement," and staff gave the lowest ratings of "academic emphasis" (ps < 0.05). Findings demonstrate the importance of considering the type of informant when evaluating climate ratings within a school. Understanding how perceptions differ between informants can inform interventions to improve perceptions and prevent adverse outcomes.

Introduction Understanding the interrelationships between co-occurring chronic health conditions and health behaviors is critical to developing interventions to successfully change multiple health behaviors and related comorbidities. The objective of the present study was to examine the effects of depression, insomnia, and their co-occurrence on risk of obesity and to examine the role of health risk behaviors as potential confounders of these relationships with an emphasis on eating pathologies. Methods Iraq and Afghanistan conflict era veterans (n  = 1,094, 51.2% women) who participated in the Women Veterans Cohort Study between July 2014 and September 2019 were categorized as having depression, insomnia, both, or neither condition. Logistic regression models were used to examine group differences in the risk of obesity. Health risk behaviors (i.e. eating pathology, physical activity, smoking, and hazardous drinking) were then assessed as potential confounders of the effects of depression and insomnia on the likelihood of obesity. Results Obesity was most prevalent in individuals with co-occurring insomnia and depression (53.2%), followed by depression only (44.6%), insomnia only (38.5%), and neither condition (30.1%). Importantly, maladaptive eating behaviors confounded the depression–obesity association but not the insomnia–obesity association. There was no evidence that insufficient physical activity, smoking, or hazardous drinking confounded the effects of insomnia or depression on obesity. Conclusions These findings exemplify the complex relationships between multiple health conditions and behaviors that contribute to obesity. Elucidating these associations can enhance the precision with which interventions are tailored to efficiently allocate resources and reduce the severe health impact of obesity among veterans. [ABSTRACT FROM AUTHOR]

Federally Qualified Health Centers (FQHCs) provide primary care to older adults, yet most FQHC providers do not have formal training in geriatrics. A geriatric educational program for interprofessional health care providers was established at a community health center called Fair Haven Community Health Care (FHCHC). Providers' self-reported confidence in caring for older adults, and access to and satisfaction with professional development at the workplace were surveyed after 14 sessions. Thirty-two of 48 participants (67%) completed the survey. FHCHC health care providers had high baseline confidence in caring for older adults and demonstrated a trend towards increased confidence after 14 sessions. Participants' access to and satisfaction with professional development at the workplace increased significantly from 65% vs 96%, (P = 0.005) and 62% vs 96%, (P = 0.003), respectively. Establishment of an onsite geriatric education program improved FHCHC health care providers access to, and satisfaction with, professional development at the workplace. [ABSTRACT FROM AUTHOR]

Introduction: Potentially inappropriate medication (PIM) use in older adults with dementia is an understudied area. We assessed longitudinal changes in PIM exposure by dementia type following dementia diagnosis., Methods: We followed 2448 participants aged ≥65 years (52% women, 85.5% Caucasian, mean age 80.9 ± 7.5 years) diagnosed with dementia after enrollment in the National Alzheimer's Coordinating Center (2005-2014). We estimated the association between dementia type and PIM annually for 2 years after diagnosis, using Generalized Estimating Equations., Results: Participants with Lewy body dementia had more PIM use, and participants with frontotemporal dementia had less PIM use than participants with Alzheimer's disease. In the first year following diagnosis, total number of medications increased, on average, by 10% for Alzheimer's disease and 15% for Lewy body dementia ( P  < .05 for both)., Discussion: A tailored approach aimed at optimizing drug therapy is needed to mitigate PIM exposure to improve medical care for individuals with dementia.