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Background: Recruitment of cancer clinical trial (CCT) participants, especially participants representing the diversity of the US population, is necessary to create successful medications and a continual challenge. These challenges are amplified in Phase I cancer trials that focus on evaluating the safety of new treatments and are the gateway to treatment development. In preparation for recruitment to a Phase I recurrent head and neck cancer (HNC) trial, we assessed perceived barriers to participation or referral and suggestions for recruitment among people with HNC and community physicians (oncologist, otolaryngologist or surgeon). Methods: Between December 2020 and February 2022, we conducted a qualitative needs assessment via semistructured interviews with a race and ethnicity‐stratified sample of people with HNC (n = 30: 12 non‐Hispanic White, 9 non‐Hispanic African American, 8 Hispanic and 1 non‐Hispanic Pacific Islander) and community physicians (n = 16) within the University of Florida Health Cancer Center catchment area. Interviews were analyzed using a qualitative content analysis approach to describe perspectives and identify relevant themes. Results: People with HNC reported thematic barriers included: concerns about side effects, safety and efficacy; lack of knowledge and systemic and environmental obstacles. Physicians identified thematic barriers of limited physician knowledge; clinic and physician barriers and structural barriers. People with HNC and physicians recommended themes included: improved patient education, dissemination of trial information and interpersonal communication between community physicians and CCT staff. Conclusions: The themes identified by people with HNC and community physicians are consistent with research efforts and recommendations on how to increase the participation of people from minoritized populations in CCTs. This community needs assessment provides direction on the selection of strategies to increase CCT participation and referral. Patient or Public Contribution: This study focused on people with HNC and community physicians' lived experience and their interpretations of how they would consider a future Phase I clinical trial. In addition to our qualitative data reflecting community voices, a community member reviewed the draft interview guide before data collection and both people with HNC and physicians aided interpretation of the findings. [ABSTRACT FROM AUTHOR]

Families involved with child welfare services often experience a range of stressors in addition to maltreatment, including intimate partner violence, substance abuse, and mental health problems. Children in these families are at risk for developing a myriad of problems. Although parenting education programs are among the most routine interventions for families involved with child welfare services, there is relatively little data available about these programs for families with multiple stressors. This study sought to explore the family stressors in parents involved in the child welfare system who have been referred to an intensive therapeutic parenting program, and the relationship of those stressors to change in parenting attitudes. Quantitative abstraction of parenting program files was conducted. Analyses included descriptive and bivariate statistics, and related samples "t" tests to examine change in parenting attitudes. Qualitative interviews were conducted with a sub-sample of this population. File abstraction revealed that parents in this population experiencing multiple co-occurring stressors ranged from 23 to 39%. Significant improvements in parenting attitudes were found for most groups of participants, including those with violence, mental health, and substance abuse problems. Qualitative interviews indicated that parents felt that they were learning from the parenting program and were supported by the facilitators. Parents facing multiple stressors are unlikely to be able to parent effectively, and may need significant support and intervention. Additional understanding of the types of issues they face and whether particular interventions are effective for those groups would allow for the development of more targeted interventions.

Purpose: Neglect of older adults accounts for 60% to 70% of all elder-mistreatment reports made to adult protective services. The purpose of this article is to report data from research, using a risk-and-vulnerability model, that captures the independent contributions of both the elder and the caregiver as they relate to the outcome of neglect. Methods: Between February 2001 and September 2003, older adults were screened and recruited through four emergency departments in New York and Tampa. The diagnosis of neglect was made by an expert neglect-assessment team. Elders and their caregivers were then scheduled for separate face-to-face interviews after discharge. Results: Constructs within the risk-and vulnerability model were examined for scale-score significance based on the outcome diagnosis of neglect. In the risk domain, caregivers' functional status, childhood trauma, and personality were statistically significant. In the vulnerability domain, the elders' cognitive status, functional status, depression, social support, childhood trauma, and personality were significant. Implications: Findings from this study underscore the value of interdisciplinary assessment teams in emergency departments for screening elder neglect, with attention given to risk factors related to the caregiver and elder vulnerability factors, including reports of childhood trauma. The risk-and vulnerability model may provide a link between the caregiving and neglect research. Data should be collected independently from both members of the elder-caregiver dyad in order for clinicians to understand factors related to elders who receive the diagnosis of neglect from interdisciplinary teams.

This study evaluated whether the use of a multilevel system of intervention based on batterer assessment resulted in lowered risk of re-arrests for both domestic violence and other crimes. The study conducted analysis of data from 1995 to 2004, including initial arrest and program placement information and re-arrest rates for 17,999 individual batterers. The study found that recidivism rates were substantially lower for participants who completed the programs when compared to those who did not and that the re-arrest rates were substantially lower than are generally found in the literature on batterer recidivism. The study provides guidance to batterers intervention programs in approaches to designing countywide programs that are most effective in reducing recidivism in domestic violence batterers. Keywords: characteristics; family violence; intimate partner violence; treatment; cognitive-behavioral

Background. Elder neglect accounts for over 70% of all adult protective services reports in the nation annually, and it has been estimated that there are over 70,000 new cases each year. The purpose of this study was to conduct elder neglect research in the emergency department (ED). using a dyadic vulnerabilily/risk-profiling framework for elder neglect. Methods. Patients were recruited through four EDs in New York and Tampa from the beginning of February 2001 through the end of September 2003. Demographics, a Mini-Mental Status Examination score, and all initial elder assessment screen were collected. The diagnosis of neglect was then made by n Neglect Assessment Team (NAT) comprising a nurse, physician, and social worker, with extensive clinical experience in elder neglect. Results. Of the 3664 ED screens of adults 70 years and older, 405 (11%) met the inclusion criteria and agreed to participate. Neglect was diagnosed by the NAT in 86 of the 405 cases reviewed. Demographic differences between neglect versus no neglect cases were examined using Fisher's exact test, and differences emerged between the 2 groups. Conclusion. This study documents the underreporting of cases of neglect as evidenced by differences in diagnoses by screeners versus experts. The research assistants screened positive for neglect in 5% (N = 22) of the 405 cases. The NAT made the diagnosis of neglect in 22% (86/389) of the cases. This markedly different rate of neglect may mean that ED screens are important but many underestimate the true number of cases. Conversely, an NAT may make the diagnosis of neglect in an older adult more often given a higher sensitivity and a more robust knowledge base of the problem.

Purpose. This study examined verbal aggression in a sample of community dwelling older adults with Alzheimer's Disease (AD) using the Risk and Vulnerability model as a means for identifying factors associated with verbal mistreatment in caregiver/patient dyads. Design and Methods. Subjects were recruited in the State of Florida through their association with state-funded memory disorder clinics or with local chapters of the Alzheimer's Association. The sample for this analysis consisted of 254 caregivers who completed both a questionnaire and an in-home interview between the years 1998 and 2002. Verbal mistreatment was measured using the verbal aggression sub-scale of the Conflict Tactics Scale and logistic regression analysis was used to examine factors associated with increased risk. Results. Verbal aggression as a conflict resolution style was self reported by 60.1% of caregivers, and was reported as a technique used against them by 74.8% of family members with AD. Logistic regression analysis suggests that factors associated with increased risk for verbal aggression by caregivers included being female, providing care to verbally aggressive elders, caregiver's diminished cognitive status, high levels of psychiatric symptoms, depression, or experiencing a high degree of caregiver hassle. Additionally, a significant interaction effect was found between levels of depression in caregivers and dementia symptoms in elders, as well as between levels of psychiatric symptoms in caregivers, feelings of caregiver hassle, and depression in care recipients and risk for verbal mistreatment. Implications. This study highlights the importance of both risks and vulnerabilities in the outcome of verbal mistreatment, and identifies that in many cases verbal mistreatment may be a reciprocal phenomenain dyads of caregivers and persons with AD. [Article copies available for a fee from The Haworth Document Delivery, Service: 1-800-HAWORTH. E-mail address: Website: [C] 2005 by The Haworth Press, Inc. All rights reserved.] KEYWORDS. Psychological, emotional, abuse, aged, dementia

The purpose of this paper is to describe how elder mistreatment (EM) assessment has been conducted in emergency departments in an ongoing study on elder neglect and to present profiles of older adults who are assessed as neglected by domestic caregivers. Data from 334 patients, which include 22 neglect cases, are presented in order to examine the demographic profile of the sample and the differences between the neglect and non-neglect groups. Results suggest that, although there are no differences in the basic demographic variables of the two groups, differences exist in regards to the type of caregiver, the reason for the patient's emergency department visit, and the elder's functional and dependency status. KEYWORDS. Elder mistreatment, elder neglect, emergency department screening, emergency care, geriatric assessment

Understanding human mobility in outdoor environments is critical for many applications including traffic modeling, urban planning, and epidemic modeling. Using data collected from mobile devices, researchers have studied human mobility in outdoor environments and found that human mobility is highly regular and predictable. In this study, we focus on human mobility in private homes. Understanding this type of human mobility is essential as smart-homes and their assistive applications become ubiquitous. We model the movement of a resident using ambient motion sensor data and construct a chronological symbol sequence that represents the resident’s movement trajectory. Entropy rate is used to quantify the regularity of the resident’s mobility patterns, and an upper bound of predictability is estimated. However, the presence of visitors and malfunctioning sensors result in data that is not representative of the resident’s mobility patterns. We apply a change-point detection algorithm based on penalized contrast function to detect these changes, and to identify the time periods when the data do not completely reflect the resident’s activities. Experimental results using the data collected from 10 private homes over periods of 178 to 713 days show that human mobility at home is also highly predictable in the range of 70% independent of variations in floor plans and individual daily routines. [ABSTRACT FROM AUTHOR]

Objective: In this paper, we describe high school coaches' beliefs and knowledge pertaining to sports injury and their readiness for the practice of high school injury prevention. Methods: A mixed-methods approach was used to assess 111 Florida high school coaches' beliefs and knowledge related to sports injury, readiness for injury prevention practice, and the relationship between coaches' beliefs, knowledge and readiness. Results: Whereas only 22% of respondents exhibited high injury susceptibility beliefs, levels of self-efficacy were strongly related to particular injury prevention behaviors. Coaches who employed medical staff were 4 times more likely to implement prevention programs and have emergency plans. Conclusion: This research supports coaches having access to evidence-based injury prevention programs and policies should be developed on the need for coaches to execute prevention programs. [ABSTRACT FROM AUTHOR]

Objectives: Research indicates increasing trends among older adults toward heavy and abusive drinking, often associated with depressive symptoms. Possible exceptions are residents of planned retirement communities, whose drinking may be associated with social activities. To better understand these relationships, this study examined the relationship of depressive symptoms and drinking in a large retirement community.Methods: The Villages, a retirement community in central Florida with a focus on healthy, active living, has almost 90,000 residents. In 2012, a population-based needs assessment was conducted in partnership with University of South Florida Health. In the present study, 11,102 surveys were completed and returned. A structural equation model was utilized to analyze the relationship between depressive symptoms and alcohol use as measured by the three-item Alcohol Use Disorders Identification Test (AUDIT-C).Results: Hazardous drinking was reported in 15.4% of respondents, somewhat higher than the general population of older adults (around 10%). Variables of depressive symptoms, physical activity, total health problems, and poor general health loaded significantly into the factor of depression indicators, which was shown to have a significant, negative correlation with risk of hazardous drinking (λ = 0.16, p < 0.000, R(2) = 0.02).Conclusions: Results suggest at-risk drinking among respondents was not associated with depression, in contrast to studies of older adults living alone where alcohol abuse was often associated with depression. Implications for successful aging are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study examined verbal aggression in a sample of community dwelling older adults with Alzheimer's Disease (AD) using the Risk and Vulnerability model as a means for identifying factors associated with verbal mistreatment in caregiver/patient dyads., Design and Methods: Subjects were recruited in the State of Florida through their association with state-funded memory disorder clinics or with local chapters of the Alzheimer's Association. The sample for this analysis consisted of 254 caregivers who completed both a questionnaire and an in-home interview between the years 1998 and 2002. Verbal mistreatment was measured using the verbal aggression sub-scale of the Conflict Tactics Scale and logistic regression analysis was used to examine factors associated with increased risk., Results: Verbal aggression as a conflict resolution style was self reported by 60.1% of caregivers, and was reported as a technique used against them by 74.8% of family members with AD. Logistic regression analysis suggests that factors associated with increased risk for verbal aggression by caregivers included being female, providing care to verbally aggressive elders, caregiver's diminished cognitive status, high levels of psychiatric symptoms, depression, or experiencing a high degree of caregiver hassle. Additionally, a significant interaction effect was found between levels of depression in caregivers and dementia symptoms in elders, as well as between levels of psychiatric symptoms in caregivers, feelings of caregiver hassle, and depression in care recipients and risk for verbal mistreatment., Implications: This study highlights the importance of both risks and vulnerabilities in the outcome of verbal mistreatment, and identifies that in many cases verbal mistreatment may be a reciprocal phenomenain dyads of caregivers and persons with AD.