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Objective: To characterize the experience of people with epilepsy and aligned healthcare workers (HCWs) during the first 18 months of the COVID‐19 pandemic and compare experiences in high‐income countries (HICs) with non‐HICs. Methods: Separate surveys for people with epilepsy and HCWs were distributed online in April 2020. Responses were collected to September 2021. Data were collected for COVID‐19 infections, the effect of COVID‐related restrictions, access to specialist help for epilepsy (people with epilepsy), and the impact of the pandemic on work productivity (HCWs). The frequency of responses for non‐HICs and HICs were compared using non‐parametric Chi‐square tests. Results: Two thousand one hundred and five individuals with epilepsy from 53 countries and 392 HCWs from 26 countries provided data. The same proportion of people with epilepsy in non‐HICs and HICs reported COVID‐19 infection (7%). Those in HICs were more likely to report that COVID‐19 measures had affected their health (32% vs. 23%; p < 0.001). There was no difference between non‐HICs and HICs in the proportion who reported difficulty in obtaining help for epilepsy. HCWs in non‐HICs were more likely to report COVID‐19 infection than those in HICs (18% vs 6%; p = 0.001) and that their clinical work had been affected by concerns about contracting COVID‐19, lack of personal protective equipment, and the impact of the pandemic on mental health (all p < 0.001). Compared to pre‐pandemic practices, there was a significant shift to remote consultations in both non‐HICs and HICs (p < 0.001). Significance: While the frequency of COVID‐19 infection was relatively low in these data from early in the pandemic, our findings suggest broader health consequences and an increased psychosocial burden, particularly among HCWs in non‐HICs. Planning for future pandemics should prioritize mental healthcare alongside ensuring access to essential epilepsy services and expanding and enhancing access to remote consultations. Plain Language Summary: We asked people with epilepsy about the effects of COVID‐19 on their health and healthcare. We wanted to compare responses from people in high‐income countries and other countries. We found that people in high‐income countries and other countries had similar levels of difficulty in getting help for their epilepsy. People in high‐income countries were more likely to say that their general health had been affected. Healthcare workers in non‐high‐income settings were more likely to have contracted COVID‐19 and have the care they deliver affected by the pandemic. Across all settings, COVID‐19 associated with a large shift to remote consultations. [ABSTRACT FROM AUTHOR]

A principal components analysis of the Teacher Rating Scale-Child (TRS-C) of the Behavior Assessment System for Children was conducted with a cross-sectional cohort of 659 children in Grades 1 to 5. A predictive validity study was then conducted with a 2-year longitudinal sample of 206 children. The results suggested that scores from the resulting 23-item screener had strong initial reliability and validity evidence. Predictive validity coefficients for the screener scores were acceptable for both behavioral and academic outcomes and equal to or better than those for the full TRS-C, comprised of 148 items. The practicality of the screener was documented by teachers' experiences. Administration time was less than 5 minutes per child, and no specialized teacher training was necessary. These results provide preliminary evidence that routine school screening via a brief teacher rating scale can increase the probability that children with behavioral and emotional problems may be validly identified for diagnostic and treatment services. (Contains 4 tables.)

Objectives: As part of the COVID‐19 and Epilepsy (COV‐E) global study, we aimed to understand the impact of COVID‐19 on the medical care and well‐being of people with epilepsy (PWE) in the United States, based on their perspectives and those of their caregivers. Methods: Separate surveys designed for PWE and their caregivers were circulated from April 2020 to July 2021; modifications in March 2021 included a question about COVID‐19 vaccination status. Results: We received 788 responses, 71% from PWE (n = 559) and 29% (n = 229) from caregivers of persons with epilepsy. A third (n = 308) of respondents reported a change in their health or in the health of the person they care for. Twenty‐seven percent (n = 210) reported issues related to worsening mental health. Of respondents taking ASMs (n = 769), 10% (n = 78) reported difficulty taking medications on time, mostly due to stress causing forgetfulness. Less than half of respondents received counseling on mental health and stress. Less than half of the PWE reported having discussions with their healthcare providers about sleep, ASMs, and potential side effects, while a larger proportion of caregivers (81%) reported having had discussions with their healthcare providers on the same topics. More PWE and caregivers reported that COVID‐19‐related measures caused adverse impact on their health in the post‐vaccine period than during the pre‐vaccine period, citing mental health issues as the primary reason. Significance: Our findings indicate that the impact of the COVID‐19 pandemic in the US on PWE is multifaceted. Apart from the increased risk of poor COVID‐19 outcomes, the pandemic has also had negative effects on mental health and self‐management. Healthcare providers must be vigilant for increased emotional distress in PWE during the pandemic and consider the importance of effective counseling to diminish risks related to exacerbated treatment gaps. [ABSTRACT FROM AUTHOR]

The Star Excursion Balance Test (SEBT) is a unilateral balance task designed to evaluate dynamic postural control. This investigation explored the relationship between limb preference, strength, and performance on the SEBT in NCAA Division I, female collegiate soccer athletes (nonsoccer, n = 11 ; soccer, n = 12). Each participant completed maximal, concentric test efforts at a velocity of 90[degrees]*[s.sup.-1] for supine ankle dorsiflexion (ADF) and plantarflexion (APF) and at 60[degrees]*[s.sup.-1] for the seated leg extension (LE) and flexion (LF) and supine hip extension (HE) and flexion (HF). In addition, participants performed maximal SEBT reaches in the anterior, medial, and posterior directions. All testing was completed on both limbs. These results indicate that SEBT performance is similar for both limbs in both groups. The soccer group, however, reached significantly farther than the nonsoccer group, suggesting that the SEBT may be sensitive to training status and/or sport-related adaptations. The concentric strength results indicate that despite group differences in all strength tests, strength in general was not highly correlated to SEBT performance. Thus, neuromuscular factors above and beyond strength may have accounted for the group differences in SEBT performance. The SEBT may be a useful tool for determining the relative effectiveness of an intervention designed to improve postural control. KEY WORDS stregth, limb preference, postural control

Consumers often desire to become better versions of themselves. Reflecting this interest in self-improvement, the marketplace offers consumers a wide range of products and services that promise to improve or better the consumer in some way. But, in a world with unlimited opportunities to spend one's time and money, what influences whether consumers will invest in products that enable self-improvement? We demonstrate that the degree to which God is salient has a negative effect on individuals' preferences for consumption choices with self-improvement features compared to equally attractive options that do not include such features. We propose that this is because thoughts of God activate a greater sense of being loved for who you are ("loved 'as-is'"), making self-improvement a lower priority. We demonstrate this basic effect across several experiments as well as archival data, provide process evidence through mediation and moderation, and address alternative explanations. We also identify important boundary conditions: God salience is less likely to decrease interest in self-improvement products when consumers do not believe in God, and when God is considered to be a punishing (vs. loving) entity. [ABSTRACT FROM AUTHOR]

Healthcare delivery and access, both in the United States and globally, were negatively affected during the entirety of the COVID-19 pandemic. This was particularly true during the first year when countries grappled with high rates of illness and implemented non-pharmaceutical interventions such as stay-at-home orders. Among children with special healthcare needs, research from the United Kingdom (U.K.) has shown that the pandemic response uniquely impacted various aspects of their care, including decreased access to care, delays in diagnosis, and poorer chronic disease control. In response to these findings, and to begin to comprehend whether the concerning findings from the nationalized system of healthcare in the U.K. extend to the highly dissimilar United States (U.S.) healthcare context, we reviewed the literature on alterations in access to and delivery of care during the early stages of the COVID-19 pandemic for children with special healthcare needs in the U.S. We then utilize these findings to consider the ethical and policy considerations of alterations in healthcare provision during pandemics and crisis events in the U.K. and U.S. and make recommendations regarding how the needs of CSHCN should be considered during future responses., Competing Interests: Declarations. Conflict of interest: The authors have no conflict of interest., (© 2024. The Author(s) under exclusive licence to Monash University.)

The article expresses gratitude for the invaluable contributions of peer reviewers in 2023, emphasizing the crucial role of peer review in the foundation of scientific publication.

Rationale, Aims and Objectives: A learning health system model can be used to efficiently evaluate and incorporate evidence‐based care into practice. However, there is a paucity of evidence describing key organizational attributes needed to ensure a successful learning health system within primary care. We interviewed stakeholders for a primary care learning health system in Ontario, Canada (the Alliance for Healthier Communities) to identify strengths and areas for improvement. Method: We conducted a qualitative descriptive study using individual semistructured interviews with Alliance stakeholders between December 2019 and March 2020. The Alliance delivers community‐governed primary healthcare through 109 organizations including Community Health Centres (CHCs). All CHC staff within the Alliance were invited to participate. Interviews were audio‐recorded and transcribed verbatim. We performed a thematic analysis using a team approach. Results: We interviewed 29 participants across six CHCs, including Executive Directors, managers, healthcare providers and data support staff. We observed three foundational elements necessary for a successful learning health system within primary care: shared organizational goals and culture, data quality and resources. Building on this foundation, people are needed to drive the learning health system, and this is conditional on their level of engagement. The main factors motivating staff member's engagement with the learning health system included their drive to help improve patient care, focusing on initiatives of personal interest and understanding the purpose of different initiatives. Areas for improvement were identified such as the ability to extract and use data to inform changes in real‐time, better engagement and protected time for providers to do improvement work, and more staff dedicated to data extraction and analysis. Conclusions: We identified key components needed to establish a learning health system in primary care. Similar primary care organizations in Canada and elsewhere can use these insights to guide their development as learning health systems. [ABSTRACT FROM AUTHOR]

Background: Benzodiazepines, opioids, proton-pump inhibitors (PPIs), and antibiotics are frequently prescribed inappropriately by primary care physicians (PCPs), without sufficient consideration of alternative options or adverse effects. We hypothesized that distinct groups of PCPs could be identified based on their propensity to prescribe these medications.Objective: To identify PCP groups based on their propensity to prescribe benzodiazepines, opioids, PPIs, and antibiotics, and patient and PCP characteristics associated with identified prescribing patterns.Design: Retrospective cohort study using VA data and latent class regression analyses to identify prescribing patterns among PCPs and examine the association of patient and PCP characteristics with class membership.Participants: A total of 2524 full-time PCPs and their patient panels (n = 2,939,636 patients), from January 1, 2017, to December 31, 2018.Main Measures: We categorized PCPs based on prescribing volume quartiles for the four drug classes, based on total days' supply dispensed of each medication by the PCP to their patients (expressed as days' supply per 1000 panel patient-days). We used latent class analysis to group PCPs based on prescribing and used multinomial logistic regression to examine patient and PCP characteristics associated with latent class membership.Key Results: PCPs were categorized into four groups (latent classes): low intensity (23% of cohort), medium-intensity overall/high-intensity PPI (36%), medium-intensity overall/high-intensity opioid (20%), and high intensity (21%). PCPs in the high-intensity group were predominantly in the highest quartile of prescribers for all four drugs (68% in the highest quartile for benzodiazepine, 86% opioids, 64% PPIs, 62% antibiotics). High-intensity PCPs (vs. low intensity) were substantially less likely to be female (OR: 0.30, 95% CI: 0.21-0.42) or practice in the northeast versus other census regions (OR: 0.10, 95% CI: 0.06-0.17).Conclusions: VA PCPs can be classified into four clearly differentiated groups based on their prescribing of benzodiazepines, opioids, PPIs, and antibiotics, suggesting an underlying typology of prescribing. High-intensity PCPs were more likely to be male. [ABSTRACT FROM AUTHOR]

Grounded in the theoretical framework of ecological feminism, this study explores the tension between constraint and empowerment that often marks women's participation in outdoor recreation. Drawing on ethnographic fieldwork and thirteen semi-structured interviews, this study examines how women in a co-ed community hiking group in the Midwest region of the United States experience the gendered space of outdoor recreation. Analysis of the observational and interview data resulted in five themes: Empowerment, Being Healthy, Cultural Expectations of Age, Vulnerability, and Navigation. Focusing on the latter three, we suggest that women's experiences are impacted by gendered assumptions (such as a lack of navigational skill) and socialized beliefs (such as the fear of being alone) that temper the potential for expected outcomes of personal empowerment and improved physical and mental health. [ABSTRACT FROM AUTHOR]

Several philosophers, known as situationists, have argued that evidence in social psychology threatens to undermine Aristotelian virtue ethics. An impressively large amount of empirical evidence suggests that most people do not consistently act virtuously and lack the ability to exercise rational control over their behavior. Since possessing moral virtues requires these features, situationists have argued that Aristotelianism does not accurately describe the character traits possessed by most people, and so the theory cannot lay claim to various theoretical advantages such as explanatory power and egalitarian character education. In contrast to previous defenses which either downplay the relevance of psychological evidence or revise philosophical conceptions of virtue to fit the data, this paper appeals to previously neglected psychological evidence on self-efficacy and mental contrasting in combination with "non-idealized" interpretations of Aristotelian moral virtue to support the view that the available empirical evidence is compatible with widespread possession of virtuous character. These "non-idealized" interpretations of virtuous character allow for serious deviations from virtuous conduct, especially in the contexts described by the psychology experiments. Furthermore, decades of research on mental contrasting and self-efficacy suggest that subjects in the psychology experiments acted for reasons and possessed the ability to exercise rational control over their behavior. Hence, situationists are mistaken in thinking that, based on the empirical data, Aristotelianism is deprived of various theoretical advantages. [ABSTRACT FROM AUTHOR]

Jim Thorpe – All American by Michael Curtiz (1951), with Burt Lancaster as main actor, is an interesting example of a sports biopic for all historians seeking both to build ties between reality and fiction, and decipher the construction and/or diffusion of certain collective representations. As such, it constitutes a 'trace' of time which contributes a posteriori to a 'realization'. For the interest of the film lies less in the reconstitution or mere duplication of the sporting past than in its 'reconstruction'. By placing this film in the context of the United States in the 1950s, and considering it from the contemporary angle of visual studies, it is easier to understand the place of American Indian sportsmen in North American society. In fact, even when reconstructed by the Hollywood machine, Thorpe's sporting prowess led to indictment by a society that could not, and did not want to, really integrate its minorities. Behind this happy-end story and the rehabilitation of the champion, a reflection of deeply rooted racism in fine reared its head, driven by a self-righteous white community towards American Indians. [ABSTRACT FROM AUTHOR]

The empirical relationship between total phosphorus and chlorophyll has guided lake management decisions for decades, but imprecision in this relationship in individual lakes limits the utility of these models. Many environmental factors that potentially affect the total phosphorus‐chlorophyll relationship have been studied, but here we hypothesize that imprecision can be reduced by considering differences in the proportions of phosphorus bound to three different "compartments" in the water column: phosphorus bound in phytoplankton, phosphorus bound to suspended sediment that is not associated with phytoplankton, and dissolved phosphorus. We specify a hierarchical Bayesian network model that estimates phosphorus associated with each compartment using field measurements of chlorophyll, total suspended solids, and total phosphorus collected from reservoirs in Missouri, United States. We then demonstrate that accounting for these different compartments yields accurate predictions of total phosphorus in individual lakes. Results from this model also yield insights into the mechanisms by which lake morphometric and watershed characteristics affect observed relationships between total phosphorus and chlorophyll. [ABSTRACT FROM AUTHOR]

Placenta percreta is the abnormal invasion of the placenta through the myometrium and serosa of the uterus. It is the most invasive of the placenta accreta spectrum followed by placenta increta. This paper presents a case of a maternal and fetal death in the second trimester due to rupture of the uterus at the site of placenta percreta in a C-section scar. Postmortem MRI showed a large hemoperitoneum and thinning of the anterolateral uterine wall. Internal examination revealed two liters of blood in the abdomen and rupture of the anterolateral uterine wall at the site of placenta percreta in a previous C-section scar. Placenta percreta is a rare complication of pregnancy, however, it is becoming more common with the increasing rate of C-section, the most common and significant risk factor. [ABSTRACT FROM AUTHOR]

Depression is responsible for a large burden of disability in the USA. We estimated the prevalence of depression in the New York City (NYC) adult population in 2013-14 and examined associations with demographics, health behaviors, and employment status. Data from the 2013-14 New York City Health and Nutrition Examination Survey, a population-based examination study, were analyzed, and 1459 participants met the inclusion criteria for this analysis. We defined current symptomatic depression by a Patient Health Questionnaire (PHQ-9) score ≥ 10. Overall, 8.3% of NYC adults had current symptomatic depression. New Yorkers with current symptomatic depression were significantly more likely to be female, Latino, and unemployed yet not looking for work; they were also significantly more likely to have less than a high school education and to live in a high-poverty neighborhood. Socioeconomic inequalities in mental health persist in NYC and highlight the need for better diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: The Department of Veterans Affairs (VA) has implemented robust strategies to monitor prescription opioid dispensing, but these strategies have not accounted for opioids prescribed by non-VA providers. State-based prescription drug monitoring programs (PDMPs) are a potential tool to identify VA patients' receipt of opioids from non-VA prescribers, and recent legislation requires their use within VA.Objective: To evaluate VA physicians' perspectives and experiences regarding use of PDMPs to monitor Veterans' receipt of opioids from non-VA prescribers.Design: Qualitative study using semi-structured interviews.Participants: Forty-two VA primary care physicians who prescribed opioids to 15 or more Veterans in 2015. We sampled physicians from two states with PDMPs (Massachusetts and Illinois) and one without prescriber access to a PDMP at the time of the interviews (Pennsylvania).Approach: From February to August 2016, we conducted semi-structured telephone interviews that addressed the following topics regarding PDMPs: overall experiences, barriers to optimal use, and facilitators to improve use.Key Results: VA physicians broadly supported use of PDMPs or desired access to one, while exhibiting varying patterns of PDMP use dictated by state laws and their clinical judgment. Physicians noted administrative burdens and incomplete or unavailable prescribing data as key barriers to PDMP use. To facilitate use, physicians endorsed (1) linking PDMPs with the VA electronic health record, (2) using templated notes to document PDMP use, and (3) delegating routine PDMP queries to ancillary staff.Conclusions: Despite the time and administrative burdens associated with their use, VA physicians in our study broadly supported PDMPs. The application of our findings to ongoing PDMP implementation efforts may strengthen PDMP use both within and outside VA and improve the safe prescribing of opioids. [ABSTRACT FROM AUTHOR]

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The table of contents for the Volume 38, 2008 issue of "Canadian Journal of Forest Research" is presented.

Copyright of Canadian Journal of Forest Research is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)