Physical attractiveness and cardiometabolic risk

OBJECTIVES

There is only limited evidence suggesting that physical attractiveness and individuals' actual health are causally linked. Past studies demonstrate that characteristics related to physical attractiveness are more likely to be present in healthy individuals, including those with better cardiovascular and metabolic health, yet many of these studies do not account for individuals' initial health and socioeconomic characteristics, which are related to both physical attractiveness and later life health.

METHODS

We use panel survey data from the National Longitudinal Study of Adolescent to Adult Health in the United States to examine the relationship between interviewer-rated in-person physical attractiveness and actual cardiometabolic risk (CMR) based on a set of relevant biomarkers: LDL cholesterol, glucose mg/dL, C-reactive protein, systolic and diastolic blood pressure, and resting heart rate.

RESULTS

We identify a robust relationship between individuals' physical attractiveness and 10-year follow up actual health measured by the levels of CMR. Individuals of above-average attractiveness appear to be noticeably healthier than those who are described as having average attractiveness. We find that individuals' gender and race/ethnicity do not have a major effect on the described relationship. The link between physical attractiveness and health is affected by interviewers' main demographic characteristics. We carefully address the possibility of confounders affecting our results including sociodemographic and socioeconomic characteristics, cognitive and personality traits, initial health problems and BMI.

CONCLUSION

Our findings are largely in line with the evolutionary perspective which assumes that physical attractiveness is linked to individuals' biological health. Being perceived as physically attractive might also imply, among other aspects, high levels of satisfaction with life, self-confidence and ease of finding intimate partners, all of which can positively affect individuals' health.

Parental Interference in Offspring's Mate Choice: Sets of Actions and Counteractions Based on Both Perspectives

Mate choice in humans is specific by the involvement of kin both in partner choice and in the functioning of the relationship. The influence of relatives ranges from providing advice all the way to arranged marriages. Existing research so far tended to map neither the actual parental interventions and further reactions (counteractions) nor the independently pursued behavior (actions) by which the offspring or their partners assert their interests. This study identified such sets of behaviors through semi-structured individual interviews with members of 20 dyads of adult offspring and their biological parents (five son-mother, five son-father, five daughter-mother, and five daughter-father dyads). Thematic analysis revealed sets of parental actions aimed at the offspring, their partners, and the couple as a whole, as well as further counteractions (reactions to parental interference) and independently pursued behavior (actions) of the offspring and their partners aimed at the parents in the context of the offspring's previous or current relationship. Our findings showed that parental interference differed depending on the recipient: toward the couple were applied mainly indirect and supportive parental actions, whereas when facing their offspring or offspring's partner, parents' actions were more direct and disruptive. Our results thus indicate the importance of reporting about actual interactions which differ from the hypothetical settings used in prior studies by lower intensity. Moreover, by interviewing both members of dyads, we expanded the sets of actions and counteractions identified by prior studies and managed to limit self-reporting bias.

How Older White Gay Men and Lesbians Leverage Advantages to Navigate Healthcare

A lifetime of disadvantages shapes how lesbians and gay men navigate healthcare as they age and their fears about end-of-life care. This paper investigates how a localized group of older white, college educated, and economically privileged gay men and lesbians conceptualize their approach to healthcare. Analyzing 23 in-depth interviews with gay men and lesbians over the age of 60 I consider how they utilize their advantages when aging and facing declining health. I pay particular attention to how discriminatory social and legal contexts shaped elders' current situations and ability to be "out" and engage with healthcare professionals. I utilize the theory of cumulative advantages and disadvantages as another way to understand literature on health inequalities and LGBTQ health work, finding that despite systemic inequalities some gay men and lesbian elders use their resources to find gay-friendly primary care physicians, age at home, and build social supports for caregiving as their health declines.

Effectiveness of a training program for a patient with non-cardiac chest pain that combines intervention to improve quality of life, psychological state, and functional capacity: a case report

BACKGROUND

Noncardiac chest pain (NCCP) is persistent angina-like chest pain without cardiac origin that affects the patient's health related quality of life (HrQoL), although it does not affect mortality. The effect of a comprehensive training program for NCCP focused on quality of life, psychological state, peripheral muscle strength, physical activity, and quality of life has not been previously established or published. Therefore, this study aimed to show the effectiveness of our combined training program that focuses on functional capacity, physical activity, pulmonary function, respiratory and peripheral muscle strength, dyspnea, fatigue, anxiety, and depression perception in NCCP patients with dyspnea.

CASE PRESENTATION

A 38-year-old man with shortness of breath and NCCP was referred to to us for cardiopulmonary rehabilitation. Respiratory muscle strength (mouth pressure device), functional capacity (6 min walking test, 6-MWT), peripheral muscle strength (dynamometer), pulmonary function (spirometry), fatigue (fatigue severity scale), shortness of breath (MMRC, Modified Medical Council Research, Modified Borg Scale-MBS), physical activity (International Physical Activity Questionnaire, IPAQ), health related quality of life (SF-36, Short Form-36), and depression and anxiety (Hospital Depression and Anxiety scale, HADs) were assessed. Aerobic training combined with inspiratory muscle training (loading 30% maximal inspiratory pressure (MIP)) was administered at least 5 days/week for 6 weeks. Functional capacity, physical activity, pulmonary function, and respiratory and peripheral muscle strength improved, and dyspnea, fatigue, anxiety, and depression perception were decreased after the management.

CONCLUSIONS

This combined training program was effective for patients with NCCP and shortness of breath. Future studies should be conducted to find the most effective biopsychosocial training protocol for NCCP patients.

Influencing recommendation algorithms to reduce the spread of unreliable news by encouraging humans to fact-check articles, in a field experiment

Society often relies on social algorithms that adapt to human behavior. Yet scientists struggle to generalize the combined behavior of mutually-adapting humans and algorithms. This scientific challenge is a governance problem when algorithms amplify human responses to falsehoods. Could attempts to influence humans have second-order effects on algorithms? Using a large-scale field experiment, I test if influencing readers to fact-check unreliable sources causes news aggregation algorithms to promote or lessen the visibility of those sources. Interventions encouraged readers to fact-check articles or fact-check and provide votes to the algorithm. Across 1104 discussions, these encouragements increased human fact-checking and reduced vote scores on average. The fact-checking condition also caused the algorithm to reduce the promotion of articles over time by as much as -25 rank positions on average, enough to remove an article from the front page. Overall, this study offers a path for the science of human-algorithm behavior by experimentally demonstrating how influencing collective human behavior can also influence algorithm behavior.

A Web-Based Instrument for Infantile Atopic Dermatitis Identification (Electronic Version of the Modified Child Eczema Questionnaire): Development and Implementation

BACKGROUND

Atopic dermatitis (AD) is a chronic inflammatory cutaneous disease that affects 30.48% of young children; thus, there is a need for epidemiological studies in community settings. Web-based questionnaires (WBQs) are more convenient, time-saving, and efficient than traditional surveys, but the reliability of identifying AD through WBQs and whether AD can be identified without the attendance of doctors, especially in community or similar settings, remains unknown.

OBJECTIVE

This study aimed to develop and validate a web-based instrument for infantile AD identification (electronic version of the modified Child Eczema Questionnaire [eCEQ]) and to clarify the possibility of conducting WBQs to identify infantile AD without the attendance of doctors in a community-representative population.

METHODS

This study was divided into 2 phases. Phase 1 investigated 205 children younger than 2 years to develop and validate the eCEQ by comparison with the diagnoses of dermatologists. Phase 2 recruited 1375 children younger than 2 years to implement the eCEQ and verify the obtained prevalence by comparison with the previously published prevalence.

RESULTS

In phase 1, a total of 195 questionnaires were analyzed from children with a median age of 8.8 (IQR 4.5-15.0) months. The identification values of the eCEQ according to the appropriate rules were acceptable (logic rule: sensitivity 89.2%, specificity 91.5%, positive predictive value 97.1%, and negative predictive value 72.9%; statistic rule: sensitivity 90.5%, specificity 89.4%, positive predictive value 96.4%, and negative predictive value 75%). In phase 2, a total of 837 questionnaires were analyzed from children with a median age of 8.4 (IQR 5.2-14.6) months. The prevalence of infantile AD obtained by the eCEQ (logic rule) was 31.9% (267/837), which was close to the published prevalence (30.48%). Based on the results of phase 2, only 20.2% (54/267) of the participants identified by the eCEQ had previously received a diagnosis from doctors. Additionally, among the participants who were not diagnosed by doctors but were identified by the eCEQ, only 6.1% (13/213) were actually aware of the possible presence of AD.

CONCLUSIONS

Infantile AD can be identified without the attendance of doctors by using the eCEQ, which can be easily applied to community-based epidemiological studies and provide acceptable identification reliability. In addition, the eCEQ can also be applied to the field of public health to improve the health awareness of the general population.

Beyond borders: A commentary on the benefit of promoting immigrant populations in genome-wide association studies

Immigrants are an important part of many high-income nations, in that they contribute to the sociocultural tapestry, economic well-being, and demographic diversity of their receiving countries and communities. Yet, genomic studies to date have generally focused on non-immigrant, European-ancestry populations. Although this approach has proven fruitful in discovering and validating genomic loci, within the context of racially/ethnically diverse countries like the United States-wherein half of immigrants hail from Latin America and another quarter from Asia-this approach is insufficient. There is a persistent diversity gap in genomic research in terms of both current samples and genome-wide association studies, meaning that the field's understanding of genetic architecture and gene-environmental interactions is being hampered. In this commentary, I provide motivating examples of recent research developments related to the following: (1) how the increased ancestral diversity, such as seen among Latin American immigrants, improves power to discover and document genomic loci, (2) informs how environmental factors, such as immigration-related exposures, interact with genotypes to influence phenotypes, and (3) how inclusion can be promoted through community-engaged research programs and policies. I conclude that greater inclusion of immigrants in genomic research can move the field forward toward novel discoveries and interventions to address racial/ethnic health disparities.

Conflict experience and resolution underlying obedience to authority

Definitions of obedience require the experience of conflict in response to an authority's demands. Nevertheless, we know little about this conflict and its resolution. Two experiments tested the suitability of the 'object-destruction paradigm' for the study of conflict in obedience. An experimenter instructed participants to shred bugs (among other objects) in a manipulated coffee grinder. In contrast to the demand condition, participants in the control condition were reminded of their free choice. Both received several prods if they defied the experimenter. Results show that participants were more willing to kill bugs in the demand condition. Self-reported negative affect was increased after instructions to destroy bugs relative to other objects (Experiments 1 and 2). In Experiment 2, compliant participants additionally showed an increase in tonic skin conductance and, crucially, self-reported more agency and responsibility after alleged bug-destruction. These findings elucidate the conflict experience and resolution underlying obedience. Implications for prominent explanations (agentic shift, engaged followership) are discussed.

Exploring the Impact of a Global Pandemic (COVID-19) on Factors Impacting the Resilience of Top-Tier London Hockey Players

Introduction

The cessation of all professional and amateur sport due to the COVID-19 pandemic had a dramatic effect on the mental and physical capacity of the United Kingdom populace, but its impact was arguably felt more deeply by the athletic population. Thus, this research explored which limiting factors were experienced by team hockey players during the national lockdowns (1.0-3.0) with the objective of enabling coaches and team management to better support and protect players' physiological and psychological resilience in return to play.

Methods

Data were collected over 12 weeks during the 3rd UK lockdown (March 2021) from two top-tier London clubs. Hockey players (n = 63) completed an online questionnaire that included validated tests for self-compassion, sport motivation, and a custom open-ended style qualitative questionnaire on nutrition and lifestyle behaviour. Mean self-compassion, motivation scores, and common indicative limiting factors were evaluated and ranked according to significance.

Results

High "rebound resilience" was found with low amotivation scores (m = 8.33) and strong affinity for their sport identifying with the statement "because participation in my sport is an integral part of my life" with correspondingly high integrated regulation scores (m = 21.43). Participants' self-compassion showed the highest scores in mindfulness (m = 3.66) and lowest in self-kindness (m = 2.84) indicating a common trait in athletes for self-criticism. The highest limiting factor was cited as "no social outlets, social interactions, or seeing friends and family".

Conclusion

This study revealed the critical role that social connectedness plays in promoting resilience and enhancing motivation in return to play during extremely challenging circumstances. When the social outlet is absent, enhancing resilience factors with mindfulness, self-compassion, and the creation of a more facilitative environment where player welfare takes priority are potential strategies to support players when they are unable to participate in their sport.

Individuals reciprocate negative actions revealing negative upstream reciprocity

Indirect reciprocity is widely recognized as a mechanism for explaining cooperation and can be divided into two sub-concepts: downstream and upstream reciprocity. Downstream reciprocity is supported by reputation; if someone sees you helping someone else, the person who sees this will think higher of you, and you will be more likely to be helped. Upstream reciprocity is helping someone because you are being helped by somebody else, which often happens in everyday life and experimental games. This paper focuses on the behavior of "take" and examines negative upstream reciprocity using an upstream reciprocity framework. The term "take" is defined as "to steal rather than give resources to others." "If something is taken from you, do you take from others?" is an important extension for indirect reciprocity research; subsequently, this paper discusses experiments conducted on whether negative upstream reciprocity is chained and what causes it. The results demonstrated differences between positive and negative upstream reciprocity. In analyzing the data of nearly 600 participants to determine the extent to which negative upstream reciprocity is observed and the causes of negative upstream reciprocity, the study found that If individual A takes resources from individual B, then B is more likely to take resources from a third-party, individual C. Notably, some causes of positive upstream reciprocity were found to have no effect or the opposite effect on negative upstream reciprocity. The results also demonstrate that the first person to take can cause a chain reaction. This paper demonstrates the importance of the first person not taking from someone else and suggests the need to consider various behavioral options for future research on cooperation.

Enhancing long-term smoking abstinence among individuals with a history of cervical intraepithelial neoplasia or cervical cancer (Project ACCESS): protocol for a randomized clinical trial

BACKGROUND

The prevalence of smoking among cervical cancer survivors is high and evidence-based smoking cessation interventions are critically needed. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial (RCT) designed to evaluate the efficacy of a novel, personally tailored SMS-delivered text-based digital treatment adjuvant designed to enhance the long-term efficacy of a "Motivation And Problem-Solving" (MAPS) approach for smoking cessation among individuals with a history of cervical intraepithelial neoplasia (CIN) or cervical cancer. MAPS is a phone counseling approach designed to facilitate long-term abstinence that comprises 6 counseling calls over 12 months. The current trial is evaluating the efficacy of MAPS+, which comprises all MAPS components plus a 24-month digital treatment adjuvant. This trial represents a logical extension of our previous RCT, which compared the efficacy of MAPS to a quitline control condition and found that MAPS resulted in greater than a 2-fold increase in smoking abstinence at 12 months (i.e., 26.4% vs. 11.9%). This treatment effect was no longer significant at 18 months, suggesting that efficacy dissipated as time from the end of treatment increased. The primary aim of the current trial is to compare the efficacy of MAPS + and ST in facilitating long-term abstinence.

METHODS

Individuals who smoke and have a history of cervical cancer or CIN (N = 340) are recruited throughout Florida and randomly assigned to Standard Treatment [ST] or MAPS+. ST participants are electronically connected with the Florida Quitline. MAPS + consists of 6 proactive MAPS-based counseling calls over 12 months plus the novel, personally tailored, text message-based treatment adjuvant delivered over 24 months. All participants receive 12 weeks of combination nicotine replacement therapy (patch and lozenge) and are followed for 24 months. Participant recruitment commenced in December 2022 and is ongoing.

DISCUSSION

This study builds on promising results from our recent trial which found that MAPS was associated with substantially higher abstinence from smoking at the end of the 12-month treatment period. Finding that this low-burden, personally tailored digital treatment adjuvant improves the long-term efficacy of MAPS would have important clinical and public health implications.

TRIAL REGISTRATION

Clinical Trials Registry NCT05645146; https://clinicaltrials.gov/ct2/show/NCT05645146 ; Registered on December 9, 2022.

Union Status and Disability Pension

A lot is known about the association between marital status and mortality, and some of these studies have included data on cohabitation. Studies on the association with health problems, rather than mortality, are often based on self-reported health outcomes, and results from these studies are mixed. As cohabitation is now widespread, more studies that include data on cohabitation are needed. We use Norwegian register data that include detailed information about union status and all cases of disability pensioning from 2005 to 2016. We employ Cox regression analysis and a within-family design in order to control for hard to measure childhood characteristics. Compared to the married, the cohabiting have a somewhat higher risk of receiving disability pension due to mental disorders, and for men also due to physical disorders. Receipt of disability pension is most common among the never married, especially for men. The association between union status and disability pensioning is stronger for mental than for physical disorders.

Uncertainty in complex healthcare settings - The need for a comprehensive approach

Uncertainty is increasingly recognized as a crucial phenomenon throughout medical practice. Research on uncertainty so far has been scattered across disciplines, leading to a lack of consensus about what uncertainty represents and minimal integration of knowledge obtained within isolated disciplines. Currently, a comprehensive view of uncertainty which does justice to normatively or interactionally challenging healthcare settings is lacking. This impedes research teasing apart when and how uncertainty manifests, how all stakeholders experience and value it, and how it affects medical communication and decision-making. In this paper, we argue that we need a more integrated understanding of uncertainty. We illustrate our argument using the context of adolescent transgender care, in which uncertainty occurs in myriad ways. We first sketch how theories of uncertainty have emerged from isolated disciplines, leading to a lack of conceptual integration. Subsequently, we emphasize why it is problematic that no comprehensive approach to uncertainty has yet been developed, using examples from adolescent transgender care. Finally, we advocate an integrated approach of uncertainty to further advance empirical research and to ultimately benefit clinical practice.

Identity leadership and cohesion in elite sport: The mediating role of intra-team communication

One perspective on leadership that has recently gained increased attention in sport is identity leadership; however, research on elite sport teams is still in its infancy. Thus, the main purpose of this research is to investigate identity leadership in elite team sports in relation to task cohesion, and subsequently to explore the mediating role of the intra-team communication dimensions of acceptance and distinctiveness. A cross-sectional design was employed and 441 elite athletes from division 1 and division 2 in handball and ice hockey participated in the present study. Structural equation modeling was used to assess relationships between identity leadership and task cohesion, and the mediating role of acceptance and distinctiveness. Results revealed that identity leadership positively predicted task cohesion, and that this relationship was mediated by intra-team communication acceptance. In conclusion, findings in the present study expand our understanding of performance-related benefits of identity leadership in elite sport.

Associations of Surgical Team Communication With the Layout of Physical Space: A Network Analysis of the Operating Room in a Military Medical Center

AIM

To examine how the spatial topology of the operating room (OR) within the medical center impacts surgical team communication.

BACKGROUND

Understanding the complex association between surgical team communication and the OR's spatial network location is critical to patient safety. Effective surgical communication is associated with fewer adverse events and medical errors.

METHODS

We employed a cross-sectional, quantitative, case study, and network-centric study design. We studied the population of 204 clinicians in a large military medical center (36 perioperative nurses, 34 surgical technicians, 62 anesthesia providers, and 72 surgeons), focusing on surgical teams with cases completed within duty hours. Data were collected from December 2020 to June 2021 using an electronic survey. Spatial network analysis was done using electronic floor plans. Statistical analysis was done with descriptive statistics and linear regressions. The outcomes were general and task-specific communication, and team-level variables were aggregated from scores for all team members. Spatial effects were assessed with network centrality (degree, Laplacian, and betweenness).

RESULTS

The individual-level survey response rate was 77% (157 of 204). Data were collected on 137 surgical teams. On a 5-point scale, general and task-specific communication ranged from 3.4 to 5.0 and 3.5 to 5.0, respectively (for both, median = 4.7). Team size ranged from 4 to 6 individuals (median = 4). Surgical suites with higher network centralities were associated with significantly lower communication scores.

CONCLUSIONS

The OR's spatial network location has important impacts on surgical team communication. Our findings have design and workflow implications for ORs and even surgical care in combat zones.

"Everyone Saw Me Differently Like It Was My Fault or I Wanted It": Acquaintance Stalking Victim Experiences of Sexual Assault, Sexual Harassment, and Sexual Autonomy

Although the stalking research literature has grown over time, there is more limited research focused on acquaintance stalking victim experiences and harms. The current study used online surveys with women stalked by acquaintances who had (n = 193), and who had not (n = 144), been sexually assaulted by the stalker to examine differences in stalking course of conduct (including jealousy and control, sexual harassment) and victim harms (resource losses, social identity perceptions, sexual autonomy, sexual difficulties, and safety efficacy). Results found that many of the acquaintance stalking victims in the current study experienced all three types of sexual harassment (verbal harassment, unwanted sexual advances, sexual coercion) and had negative social identity perceptions (e.g., how they felt about themselves, how they felt about their ability to be a good partner). More women who were sexually assaulted, compared to those who were not, experienced threats, jealous and controlling behavior, severe physical violence, stalking-related fear, sexual harassment, negative social identity perceptions, and lower sexual autonomy. Multivariate analysis found that sexual assault, more unwanted sexual attention, increased sexual coercion, lower safety efficacy, and more negative social identity perceptions were associated with sexual difficulties while sexual assault, higher safety efficacy, fewer resource losses, and fewer negative social identity perceptions were associated with increased sexual autonomy. Sexual assault, verbal sexual harassment, and resource losses were associated with more negative social identity perceptions. Understanding the full scope of stalking victimization and the negative impacts can inform the recovery journey and safety planning interventions.

Do supportive work environments matter for minority aging? Work stress and subjective cognitive impairment among middle-age and older lesbian, gay, bisexual, transgender, and queer adults

Research has documented how people's experiences at work affect their cognitive health outcomes, but how these processes unfold for minority groups, particularly lesbian, gay, bisexual, transgender, and queer (LGBTQ+) populations, is unclear. This study builds on the nascent literature by employing generalized structural equation models to test how experiencing major problems at work and working with LGBTQ+ supportive coworkers affect subjective cognitive impairment among middle-age and older LGBTQ+ adults. We also test for mediated and indirect effects of support and problems at work operating via vascular disease, sleep problems, and depression symptoms. Experiencing major problems at work is associated with a higher likelihood of reporting cognitive symptoms consistent with mild cognitive impairment, but this relationship is mediated by depression symptoms and sleep problems. Having LGBTQ+ supportive coworkers does not have direct effects on mild cognitive impairment, but does operate indirectly by decreasing problems at work and, in turn, decreases the likelihood of reporting cognitive symptoms consistent with mild cognitive impairment. Overall, we find that workplace stressors contribute to cognitive health directly and through mediated and indirect pathways and that supportive contexts reduce exposure to problems at work. We conclude with suggested possibilities to reorganize workplaces to improve long-term cognitive health outcomes for older adults, especially those who are LGBTQ+-identified.

Meaning Making Mechanisms in Women Survivors of Childhood Sexual Abuse: A Scoping Review

Childhood sexual abuse (CSA) is a complex and prevalent problem with devastating long-term consequences for survivors. Despite these consequences, some survivors seem to find a source of meaning and fulfillment throughout their recovery process, which may facilitate resilience and posttraumatic growth (PTG). However, little is known from the literature about the specific meaning making mechanisms that CSA survivors experience. A scoping review was conducted by searching relevant journals and several online databases such as EbscoHost, Scopus, ProQuest, ScienceDirect, and Google Scholar. Studies published in English and that discussed meaning making as a topic of recovery from CSA in the context of women survivors' experiences were included, where a total of 57 articles were selected including qualitative (n = 32), quantitative (n = 9), mixed method (n = 9), and review (n = 7) articles. Using thematic analysis, the results of the scoping review found four mechanisms of meaning making and seven sources of meaning describing the meaning making processes of women survivors of CSA. The mechanisms were identified as being benevolent; restoring and empowering the inner self; mobilizing external and social resources; and lastly actively integrating the trauma narrative. This study contributes toward the global knowledge base on meaning making mechanisms of women survivors of CSA by providing the first known summary of studies to date. Future research is recommended to further confirm these findings to inform treatment interventions for women survivors of CSA.

Factors associated with patient perceived suboptimal dosing of in-hospital opioid agonist therapy among people who use illicit drugs in Vancouver, Canada

Optimal dosing of opioid agonist therapy (OAT) is essential for treatment success. However, initiation and maintenance of OAT in hospital settings can be challenging given differing levels of opioid tolerance, withdrawal, and intoxication among patients.

The objective of this study was to characterize the prevalence and factors associated with in-hospital patient perceived suboptimal OAT dosing among people who use illicit drugs (PWUD) in Vancouver, Canada.

Data were derived from three prospective cohorts of PWUD in Vancouver, Canada. Bivariable and multivariable logistic regression models were used to examine factors associated with patient perceived suboptimal in-hospital OAT dose.

273 study participants were prescribed OAT while in hospital: 83 (30.4%) participants perceived their OAT dose to be suboptimal. In a multivariable model, factors positively associated with a perceived suboptimal OAT dose included: homelessness (adjusted odds ratio [AOR] = 2.85; 95% CI: 1.53-5.28), daily stimulant use (AOR = 2.03; 95% CI: 1.14-3.63) and illicit drug use while in hospital (AOR = 2.33; 95% CI: 1.31-4.16).

Almost one third of participants perceived receiving a suboptimal OAT dose while in hospital. These observed correlations indicate that a patient's perception of suboptimal OAT dosing in hospital may be more prevalent for patients who are homeless, report polysubstance use with stimulants and opioids and who obtain illicit drugs while hospitalized. While cautious prescribing of OAT in patients experiencing hospitalization is important, these findings demonstrate a high prevalence of and apparent risk factors for perceived suboptimal OAT dosing.

A Developmental Model of the Sexual Minority Closet: Structural Sensitization, Psychological Adaptations, and Post-closet Growth

Across the lifespan, most sexual minority individuals experience the closet-a typically prolonged period in which no significant others know their sexual identity. This paper positions the closet as distinct from stigma concealment given its typical duration in years and absolute removal from sources of support for an often-central identity typically during a developmentally sensitive period. The Developmental Model of the Closet proposed here delineates the vicarious learning that takes place before sexual orientation awareness to shape one's eventual experience of the closet; the stressors that take place after one has become aware of their sexual orientation but has not yet disclosed it, which often takes place during adolescence; and potential lifespan-persistent mental health effects of the closet, as moderated by the structural, interpersonal, cultural, and temporal context of disclosure. The paper outlines the ways in which the model both draws upon and is distinct from earlier models of sexual minority identity formation and proposes several testable hypotheses and future research directions, including tests of multilevel interventions.

Investigation of the Causes of Negative Attitudes towards Women Incompatible with Gender Stereotypes within the Context of Social Identity Theory

The primary gender stereotypes accepted in mainstream social psychology describe women as low in competence and high in warmth, men as having low warmth and high competence. Women who are incompatible with stereotypes are exposed to negative attitudes. Exposure to negative attitudes damages the psychological well-being of these group members. Stereotypes and negative attitudes towards members of social groups contribute to the persistence of their low status. Explaining the causes of gender stereotypes and negative attitudes towards women incompatible with stereotypes is an overlooked topic in mainstream social psychology. In order to change the ongoing gender system, where women have a disadvantageous status compared to men, it is necessary to understand the reasons for negative attitudes towards women who are incompatible with stereotypes. Based on the suggestions and findings of Social Identity Theory, explanations about negative attitudes towards women who are incompatible with gender stereotypes are presented in this study. It is concluded that most men reveal negative attitudes towards these women because women with high competency threaten men who can affirm their social identity through competency. Most men define their social identity through status-related traits such as competency. Due to the threat to men's social identity by women with high competence, it is concluded that negative attitudes towards these women are revealed by most of the men, based on theoretical suggestions. It is necessary to understand the identity management strategies to explain women's negative attitudes towards their fellows who are incompatible with stereotypes. According to the theoretical suggestions and related studies, it is concluded that the adoption of individual mobility and social creativity strategies reveal negative attitudes toward fellows who are incompatible with stereotypes. Although it is expected that women who adopt the social competition strategy have positive attitudes towards their fellows who are inconsistent with gender stereotypes, the level of adoption of this strategy is low. When theoretical suggestions and study findings are brought together, it is possible to understand the reasons for the negative attitudes towards women who are incompatible with gender stereotypes.

The intersectionality of professional and personal identity formation in a virtual pre-health pathway program

BACKGROUND AND PURPOSE

To describe the development and implementation of professional and personal identity formation content in a virtual pre-health pathway program.

EDUCATIONAL ACTIVITY AND SETTING

Content within a six-week pre-health program for underrepresented and/or disadvantaged college students was redesigned to a virtual format with enhanced focus on professional and personal identity formation. Sessions on personal identity formation were also enhanced through a partnership with local mental health clinicians specializing in trauma-informed care and culturally relevant practices and strategies.

FINDINGS

The 2020 and 2021 programs were restructured to include pharmacy professional identity formation content around the following weekly themes: Roadmap to Pharmacy, What Does it Mean to be a Pharmacist?, Expanding Knowledge of Pharmacy, Gaining Insight and Dispelling Myths, Practicing Knowledge and Exploration, and Moving Forward. These pre-pharmacy components emphasized diversity of career paths, pharmacy-based clinical services, and the pharmacist's role in promoting health equity. Overarching components of interprofessional collaboration coupled with health policy applications further emphasized the professional identity of a pharmacist in the collaborative design and delivery of health care. New personal identity formation sessions were implemented in tandem with this content and centering around the following themes: Supporting Scholars in Self-Authorship, Building a Community among Peers, and Strategies for Coping in Times of Challenge.

SUMMARY

This project has the potential to serve as a model for the implementation of both personal and professional identity formation initiatives at other programs to promote pharmacy as a desirable and attainable career to pre-health students.

Capturing the impact employees have on their coworkers and leaders: a holistic approach on health-specific support behavior from employees

Support is a valuable resource for ensuring employee health in the workplace. However, research on health-specific support behavior (i.e., support specifically targeting concrete health aspects) has only concentrated on either leader behavior (e.g., healthy leadership styles) or support provided by employees for specific health issues (e.g., healthy eating or smoking cessation). Although the importance of employee health has been well established, the examination of a wider range of potential health-specific support behaviors from employees provided for their colleagues and leaders has been neglected. To understand employee health-specific support behavior, we adapted an existing health-oriented leadership questionnaire to cover support for colleagues (PeerCare) and their leaders (LeaderCare). Capturing the employee perspective with a sample of 347 employees, the results confirmed a delineation of health-oriented scales (factor, convergent, and discriminant validity). By testing health-specific support behavior processes at work, the positive effects of PeerCare on general health were demonstrated. Contrary to expectations, existing health effects are outweighed when leaders provide health-specific support behavior to their employees (StaffCare). However, the results imply that the health-specific support behavior practices of different actors reinforce each other: the effects of StaffCare and PeerCare enhance each other, and StaffCare has a strong influence on LeaderCare. Remarkably, SelfCare has a key role in this process. The open questions and implications regarding the effects of the different health-specific support behavior measurements are discussed.

Global social identity predicts cooperation at local, national, and global levels: Results from international experiments

Individuals who identify themselves with humanity as a whole tend to be more prosocial in a number of different domains, from giving to international charities to volunteering for humanitarian causes. In this paper, we show that global identity is "inclusive" in character. That is, rather than neglecting or diminishing attachments to local and national groups, identification with all of humanity encourages individuals to embrace local and national goals at no lesser intensity than they embrace global goals. We have done so using experimental data on social dilemmas at the local level and nested social dilemmas at the local and national level, as well as at the local and world levels. Experiments were conducted with adult samples in the United States, Italy, Russia, Argentina, South Africa, and Iran. We show that the higher the identification with global collectives, net of identification with local and national collectives, the higher the cooperation at the local, national, and world levels. Conversely, local social identity is not significantly associated with cooperation at any level of interaction, while national social identity, net of local and global identification, tends overall to have a negative correlation with cooperation, particularly at the local level. We also show that individuals with strong global identity are significantly more optimistic of others' contributions than individuals with lower levels of global identification, but they are as accurate as others in predicting others' cooperation at the local and national levels. Their forecast error is instead systematically larger than that of all others for cooperation at the world level.

Conversation Analysis of Clients' Active Resistance to Veterinarians' Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada

The impact of nutrition on animal health requires effective diet-related treatment recommendations in veterinary medicine. Despite low reported rates of veterinary clients' adherence with dietary recommendations, little is known about how clients' resistance to nutritional proposals is managed in the talk of veterinary consultations. This conversation-analytic study investigated clients' active resistance to veterinarians' proposals for long-term changes to cats' and dogs' diets in 23 segments from 21 videotaped appointments in Ontario, Canada. Clients' accounts suggested the proposals themselves or nutritional modifications were unnecessary, inappropriate, or unfeasible, most often based on patients' food preferences, multi-pet feeding issues, current use of equivalent strategies, or current enactment of the proposed changes. Resistance arose when veterinarians constructed proposals without first gathering relevant diet- and patient-related information, soliciting clients' perspectives, or educating them about the benefits of recommended changes. Veterinarians subsequently accommodated clients' concerns more often when resistance involved patient- or client-related issues rather than clients' lack of medical knowledge. The design of subsequent proposals accepted by clients frequently replaced dietary changes in the initial proposals with nutritional or non-nutritional alternatives and oriented to uncertainty about adherence. This study provides evidence-based findings for developing effective communication training and practice guidelines in nutritional assessment and shared decision-making.

The metacognitive experience of time passing in Chinese college students: scale development, structure verification, and influencing factors

The experience of time passing (ETP) is also the consciousness of the progress of life. ETP contributes to time regulation and life management, which basically conforms to the metacognitive theory. Also, the traditional Chinese cultural approach to time emphasizes ETP. It is an indispensable part of Chinese education and culture to strengthen one's appreciation of time by emphasizing the passage of time. In combination with the above two points, ETP equals metacognitive experience of time passing (METP) to a certain extent. However, we currently know little about the connotations of METP. To better understand traditional Chinese time culture, and referring to the concept of metacognition and model of time experience as proposed by Western scholars, the current study combined the results of open and semi-structured interviews, to explore the structure of METP in Chinese college students and developed a questionnaire with which to measure it. Using convenience sampling, 2,876 college students were recruited, the interview, and the reliability and validity tests were carried out. Five hundred and seventy-nine college students were tested a second time to investigate the correlation validity between METP and Ruminative Responses, time attitude, and meaning in life. The results led to the development of the METP Scale which contains 15 items and assesses two factors: ruminative and emotional experience of time passing. The two-factor model was well fitted, and invariable in measurements across gender, grade, and major. The internal consistency coefficients of the scale and its two factors ranged from 0.82 to 0.89, the half-point reliability between 0.76 and 0.88, and the retest reliability ranged from 0.77 to 0.78. METP Scale has good correlation validity, meanwhile, the results of regression analysis showed that symptom rumination, positive past, negative present, positive future, and searching for meaning in life significantly predict the intensity of METP.

Friendship habits questionnaire: A measure of group- versus dyadic-oriented socializing styles

Friendships are central to our social lives, yet little is known about individual differences associated with the number of friends people enjoy spending time with. Here we present the Friendship Habits Questionnaire (FHQ), a new scale of group versus dyadic-oriented friendship styles. Three studies investigated the psychometric properties of group-oriented friendships and the relevant individual differences. The initially developed questionnaire measured individual differences in extraversion as well as desire for intimacy, competitiveness, and group identification, traits that previous research links with socializing in groups versus one-to-one friendships. In three validation studies involving more than 800 participants (353 men, age M = 25.76) and using principal and confirmatory factor analyses, we found that the structure of the FHQ is best described with four dimensions: extraversion, intimacy, positive group identification, and negative group identification. Therefore, competitiveness was dropped from the final version of the FHQ. Moreover, FHQ scores reliably predicted the size of friendship groups in which people enjoy socializing, suggesting good construct validity. Together, our results document individual differences in pursuing group versus dyadic-oriented friendships and provide a new tool for measuring such differences.

Hair Cortisol and Testosterone Concentrations in Relation to Maturity and Breeding Status of Male Feral Horses

Steroid-hormone concentrations from non-invasively obtained biomarkers, like hair, can provide a representation of circulating hormones diffused over relatively long time periods (e.g., weeks or months). The hormone cortisol is often associated with physiological or even psychological stress, while testosterone is strongly associated with male development and reproductive success. Increasingly, studies are using hormone levels derived from hair to make inferences among both domestic animals and wildlife. For horses, all previous hair hormone analysis has been done on companion or working animals. We evaluated the levels of hair cortisol (n = 153) and testosterone (n = 48) from 136 feral horses living on Sable Island, Canada that have been part of a long-term individual-based study since 2008. This population has been undisturbed and unmanaged for over 50 years, and exhibits the natural social organization for horses, harem defense polygyny. Hair samples were collected in mid to late summer and the segment analyzed corresponds with hair grown during, and following, the peak of the reproductive season. Social position was determined based on the male's role as either a dominant breeding Stallion (Stallion), a non-breeding subordinate male (tag), adult Bachelor (5 years old or older), or Immature male (2-4 years of age). While there was no difference in hair-cortisol concentration among any class of adult males (i.e., Stallion, tag, or Bachelor), Immature males had significantly lower hair cortisol concentrations than the other groups (p = 0.001). Hair testosterone levels among the four social positions were significantly higher among Stallions (p = 0.04). Hair testosterone concentration was also significantly related to the probability of a male being either a Bachelor or Stallion and was the only variable remaining in AICc model selection (p = 0.016, AICc = 32.3, Null AICc = 38.8). While not a significant relationship, Stallions had a negative correlation between hair cortisol concentrations and testosterone (R2 = -0.20, p = 0.383), and Bachelors, conversely, had a positive association (R2 = 0.43, p = 0.246). Our observations of hormone concentrations in relation to physiological, social, or reproductive parameters in this population suggest trends that are similar to what has been established using blood or other matrices.

Relationship between psychological adaptability and work engagement of college teachers within smart teaching environments: the mediating role of digital information literacy self-efficacy

Introduction

Integrating the Internet and traditional teaching has enriched teaching resources and methods and introduced many advanced digital media. The smart teaching process is influenced by teachers' psychological adaptability, which can be affected by teachers' work engagement. However, the relationship between the two has not received sufficient attention in the literature. This study aims to analyze the relationship between college teachers' psychological adaptability and work engagement in a smart teaching environment.

Methods

Applying structural equation modeling (SEM) to a sample of 373 front-line teachers, this study focuses on the mediating effect of digital information literacy self-efficacy on the relationship between teachers' psychological adaptability and work engagement.

Results

The results show that the four dimensions of college teachers' psychological adaptability strongly influence work engagement and digital information literacy self-efficacy. In particular, teachers' psychological adaptability and work engagement are positively correlated; teachers' self-efficacy can positively affect the three dimensions of their work engagement, and teachers' psychological adaptability can positively affect their digital information literacy self-efficacy.

Conclusion

The above results can serve as a basis for the development and improvement of the training of college teachers and the implementation of smart teaching. The study findings highlight the importance of training teachers on information technology teaching and implementing measures to enhance teachers' digital information literacy self-efficacy. Training should focus on the knowledge and skills of teachers using information technology teaching and increase the practical links of teachers using information technology teaching.

The Effects of Pubertal Timing on Academic Performance in Adolescence and Career Success in Adulthood: Evidence from a 16-year Longitudinal Study

Previous research showed inconsistent effects of pubertal timing on adolescent academic performance and adult career success. Moreover, the relative importance of biological vs. perceived pubertal timing has not been examined. This study examined effects of biological and perceived pubertal timing on academic performance throughout adolescence and career success in adulthood together with sex differences in an understudied population of pre-dominantly Black youth from lower income families. The sample included 704 youth (52% male, 76% Black, 22% White) interviewed at four time points (Mean ages: 11.8, 13.2, 17.6, and 27.7 years). The results from a mediation path model showed that among males, perceived off-time pubertal timing uniquely predicted lower concurrent academic performance as well as lower objective career success in adulthood; this effect was mediated by lower academic performance throughout adolescence. Additionally, results from bivariate correlation analyses showed associations between early biological pubertal timing and lower concurrent academic performance in males and early perceived pubertal timing and lower concurrent academic performance among females. These findings contribute to the understanding of more nuanced links between pubertal timing, academic performance and subsequent career success in an understudied population of pre-dominantly Black youth from lower income families.

Help others-be happy? The effect of altruistic behavior on happiness across cultures

Research has established that altruistic behavior increases happiness. We examined this phenomenon across cultures, differentiating between individualistic and collectivist cultures. We propose that cultural variations in the notion of altruism lead to different effects of helping on the helper's happiness. For individualists, altruism is linked to self-interest ("impure" altruism), and helping others results in increased happiness for the helper. For collectivists, altruism is focused on the recipient ("pure" altruism), and helping others is less likely to enhance the helper's happiness. Four studies support our predictions. Study 1 measured the dispositions toward altruism among people with various cultural orientations. Consistent with our predictions, the findings showed that individualism (collectivism) was positively associated with tendencies reflecting more "impure" ("pure") altruism. Two experimental studies then examined the moderating role of cultural orientation on the effect of spending money on oneself versus others (Study 2) or of doing a kind action (making tea for oneself versus others; Study 3). Both experimental studies demonstrated that altruistic behavior had a positive effect on happiness for individualists but not for collectivists. Finally, Study 4, which utilized data from the World Values Survey to examine the altruism-happiness link in various countries, displayed a stronger link between altruistic behavior and happiness in individualistic (vs. collectivist) cultures. Altogether, this research sheds light on cultural differences in the display of altruism, revealing different motivations for and consequences of altruistic behaviors.

"They want you to know who they really are inside of the old visage"-biographical storytelling as a methodological tool to explore emotional challenges in old age

BACKGROUND

Growing older is often associated with resilience, contentedness and inner growth. Older people however are also at risk of confronting unique emotional challenges as a result of varied ageing-related experiences. By employing a biographical lens, we aim to introduce storytelling as a methodological tool to more holistically explore older people's emotional challenges and to improve their wellbeing.

METHODS

Building upon theoretical understandings about the narrative construction of identity across the life span, we draw upon a qualitative study about older people's loneliness as an example to showcase the methodological value and feasibility of biographical storytelling. We aim to better understand the nuanced and sometimes painful emotional experiences that can be encountered alongside ageing.

RESULTS

Findings from the qualitative study we showcase, highlight that unique emotional pains and the (in)ability to deal with such in old age could be deeply rooted in older people's earlier lives. These findings contextualise people's emotional challenges and needs within their identity, as a narrative thread that links their past, present and expected future. As such, our example study shows that emotional challenges in old age are not only ageing-related, but can be more fundamentally connected to disruptions to the ongoing flow of narrative identity construction.

CONCLUSION

The highly retrospective and reflexive nature of these findings illustrates the methodological merit of biographical storytelling. We argue that the impact of biographical storytelling can go further than both conventional semi-structured narrative interviews and existing interventional tools. Instead, it is a particularly useful research methodology to explore human experiences and needs in the unique context of ageing. This methodological development thus provides an insightful analytical lens to explore how older people's earlier life experiences may be carried forward and confronted to shape their emotional stability in the present and future stages of their ageing lives. Beyond the methodological significance, we further demonstrate the benefits of empowering older people to reconstruct their ageing lives in the context of their biography.

Exploring the Presence of Implicit Bias Amongst Healthcare Professionals Who Refer Individuals Living with COPD to Pulmonary Rehabilitation with a Specific Focus Upon Smoking and Exercise

Background

We are developing a shared decision-making intervention for individuals with COPD who are deciding between Pulmonary Rehabilitation (PR) programme options. Previously, we identified Healthcare Professional (HCP) beliefs about the characteristics of COPD individuals as a barrier to PR conversations. Beliefs can lead to implicit biases which influence behaviour. To inform our shared decision-making intervention, we aimed to measure the presence of implicit bias amongst HCPs who refer individuals with COPD to PR.

Methods

We utilised the Implicit Association Test to measure HCPs response times when categorising words related to smoking or exercise (eg stub, run) to matching concepts or evaluations of concepts (eg "smoking, unpleasant" or "exercise, pleasant") and unmatching concepts or evaluations of concepts (eg "smoking, pleasant" or "exercise, unpleasant"). We approached HCPs across the UK. Following consent, we collected demographic data and then administered the test. The primary outcome was the standardised mean difference in response times from the matching and unmatching categorisations (D4-score), measured using a one-sample Wilcoxon Signed Rank Test. We explored the relationship between HCP demographics and their D4-scores using Spearman Rho correlation analysis and logistic regression.

Results

Of 124 HCPs screened, 104 (83.9%) consented. Demographic data were available for 88 (84.6%). About 68.2% were female and most (28.4%) were in the 45-54 years age category. Test data were available for 69 (66.3%) participants. D4-scores ranged from 0.99 to 2.64 indicating implicit favouring of matching categorisation (MD-score = 1.69, SDD-score = 0.38, 95% CID-score 1.60-1.78, p < 0.05). This was significantly different from zero, z = -7.20, p < 0.05, with a large effect size (r = 0.61, (28)). No demographic predictors of implicit bias were identifiable.

Conclusion

HCPs demonstrated negative bias towards smoking and positive bias towards exercising. Since implicit bias impacts behaviour, we plan to develop intervention components (eg decision coaching training) to enable HCPs to fully and impartially support shared decision-making for a menu of PR options.

Decrease in Overall Vaccine Hesitancy in College Students during the COVID-19 Pandemic

The COVID-19 pandemic changed our world as we know it and continues to be a global problem three years since the pandemic began. Several vaccines were produced, but there was a considerable amount of societal turmoil surrounding them that has affected the way people view not only COVID-19 vaccines but all vaccines. We used a survey to compare how attitudes towards vaccination have changed in college students during the pandemic. An initial survey was administered in 2021, then a follow-up in 2022. Out of 316 respondents who answered the first survey, 192 completed the follow-up. The survey was designed to measure trends in changes to vaccine attitudes since the COVID-19 pandemic began. By comparing the first survey in 2021 and the follow-up, we found that roughly 55% of respondents' vaccine attitudes did not change, roughly 44% of respondents' attitudes towards vaccines became more positive, and only about 1% of the respondents' vaccine attitudes became more negative. Improved view of vaccines was associated with political views and increased trust in medicine and the healthcare system. Worsened opinions of vaccines were associated with a belief that the COVID-19 vaccine affected fertility.

Accurately predicting hit songs using neurophysiology and machine learning

Identifying hit songs is notoriously difficult. Traditionally, song elements have been measured from large databases to identify the lyrical aspects of hits. We took a different methodological approach, measuring neurophysiologic responses to a set of songs provided by a streaming music service that identified hits and flops. We compared several statistical approaches to examine the predictive accuracy of each technique. A linear statistical model using two neural measures identified hits with 69% accuracy. Then, we created a synthetic set data and applied ensemble machine learning to capture inherent non-linearities in neural data. This model classified hit songs with 97% accuracy. Applying machine learning to the neural response to 1st min of songs accurately classified hits 82% of the time showing that the brain rapidly identifies hit music. Our results demonstrate that applying machine learning to neural data can substantially increase classification accuracy for difficult to predict market outcomes.

Why people engage in corrupt collaboration: an observation at the multi-brain level

Recent studies suggest that corrupt collaboration (i.e. acquiring private benefits with joint immoral acts) represents a dilemma between the honesty and reciprocity norms. In this study, we asked pairs of participants (labeled as A and B) to individually toss a coin and report their outcomes; their collective benefit could be maximized by dishonestly reporting (a corrupt behavior). As expected, the likelihood of corrupt behavior was high; this probability was negatively correlated with player A's moral judgment ability but positively correlated with player B's empathic concern (EC). Functional near-infrared spectroscopy data revealed that the brain-to-brain synchronization in the right dorsolateral prefrontal cortex was associated with fewer corrupt behaviors, and that it mediated the relationship between player A's moral judgment ability and corrupt collaboration. Meanwhile, the right temporal-parietal junction synchronization was associated with more corrupt behaviors, and that it mediated the relationship between player B's EC and corrupt collaboration. The roles of these 2 regions are interpreted according to the influence of the honesty and reciprocity norms on corrupt collaboration. In our opinion, these findings provide insight into the underlying mechanisms and modulating factors of corrupt collaboration.

Development and Validation of the Military Minority Stress Scale

Despite affecting nearly 3% of active-duty service members, little is known about how LGBT-related stress experiences may relate to health outcomes. Thus, the present study sought to create a Military Minority Stress Scale and assess its initial reliability and construct validity in a cross-sectional study of active-duty LGBT service members (N = 248). Associations between 47 candidate items and health outcomes of interest were analyzed to retain those with substantial betas. Item response theory analyzes, reliability testing, invariance testing, and exploratory factor analysis were performed. Construct validity of the final measure was assessed through associations between the sum score of the final measure and the health outcomes. The final 13-item measure demonstrated an excellent reliability (ω = 0.95). Bivariate linear regressions showed significant associations between the sum score of the measure and overall health (β = -0.26, p < 0.001), overall mental health (β = -0.34, p < 0.001), physical health (β = 0.45, p < 0.001), life satisfaction (β = -0.24, p < 0.001), anxiety (β = 0.34, p < 0.001), depressive symptoms (β = 0.37, p < 0.001), suicidality (β = 0.26, p < 0.001), and PTSD (β = 0.42, p < 0.001), respectively. This study provides the first evidence that minority stressors in the military setting can be operationalized and measured. They appear to have a role in the health of LGBT service members and may explain the continued health disparities experienced by this population. Little is known regarding the experiences of LGBT active-duty service members, including experiences of discrimination. Understanding these experiences and their associated health outcomes during military service may therefore help and guide further etiological studies and intervention development.

Modeling the Conversation with Digital Health Assistants in Adherence Apps: Some Considerations on the Similarities and Differences with Familiar Medical Encounters

Digital health assistants (DHAs) are conversational agents incorporated into health systems' interfaces, exploiting an intuitive interaction format appreciated by the users. At the same time, however, their conversational format can evoke interactional practices typical of health encounters with human doctors that might misguide the users. Awareness of the similarities and differences between novel mediated encounters and more familiar ones helps designers avoid unintended expectations and leverage suitable ones. Focusing on adherence apps, we analytically discuss the structure of DHA-patient encounters against the literature on physician-patient encounters and the specific affordances of DHAs. We synthesize our discussion into a design checklist and add some considerations about DHA with unconstrained natural language interfaces.

Children's Transitions to Adulthood and Midlife Parents' Depressive Symptoms and Activities of Daily Living Conditions in the United States

BACKGROUND

Parents and children are close over the life course. However, these relationships often change as parents age and children enter adulthood. Today, the entrance into adulthood for children has become delayed and increasingly unstable. Such changes may interrupt the child's acquisition of resources used to support themselves and their midlife parents, having implications for parents' mental and physical health. The purpose of this study is to examine the role of adult children's transitions to adulthood on parents' mental and physical health.

METHODS

Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) and the Add Health Parent Study (AHPS), we investigated how certain transitions to adulthood (e.g., education, marriage, residential independence, employment, parenthood, and incarceration) for children were linked to the mental and physical health of their midlife parents.

RESULTS

In sum, we found that children's educational attainment was linked to fewer activities of daily living (ADL) limitations and depressive symptoms among parents. Children's marriage and employment were also associated with fewer ADL limitations among parents.

CONCLUSIONS

Our findings reveal that adult children's circumstances are associated with the mental and physical health of their midlife parents.

Student athlete well-being framework: an empirical examination of elite college student athletes

The current study proposes a multidimensional student athlete well-being framework (SAWBF). The authors used 12 items to capture SAWBF comprised of four well-being dimensions (i.e., physical, hedonic, psychological, and social well-being). To empirically assess the reliability and validity of the framework, data from elite collegiate student athletes in Japan (N = 546) were procured. The results indicated sufficient convergent and discriminant validities of SAWBF. The authors also assessed predictive validity correlations of the framework by focusing on the oft-supported well-being outcome-organizational citizenship behavior, which were also found to be associated with SAWBF. The findings indicated the usefulness of SAWBF; and coaches and staff members can utilize the framework to multi-dimensionally understand well-being status of their student athletes, potentially boosting adaptive behaviors.

Effect of Weight Self-Stigma on Quality of Life and Dietary Habits among Adult Students in Riyadh, Saudi Arabia

Weight self-stigma (WSS) is a personal experience of negative self-evaluations, perceived discrimination, and shame about body weight. Studies suggested that WSS could negatively affect quality of life, eating behavior, and psychological outcomes. WSS has been linked with a number of obesogenic health outcomes that complicate weight loss interventions. Thus, this study aimed to examine the effect of WSS on the quality of life and dietary habits among adult students. A sample of 385 students from Riyadh universities participated in this cross-sectional study and completed three online questionnaires: the WSS questionnaire, the WHO quality of life questionnaire, and a dietary habit questionnaire. The average age of participants was 24 ± 6.74, and the majority were female (78.4%). Results demonstrated a negative association between all QOL domains and WSS (p < 0.001). Moreover, higher BMI is associated with increased self-devaluation and fear of enacted stigma (p < 0.001). There was also a negative link between both quality and quantity of food with WSS (p < 0.01). No significant difference was seen in study outcomes concerning gender. The findings of this study suggest the importance of increasing awareness about the negative impact of WSS and developing social policies to prevent or decrease it. Additionally, multidisciplinary teams, especially dietitians, should be more aware of WSS when dealing with overweight and obese individuals.

A survey of social well-being among employees, retirees, and nursing students: a descriptive-analytical study

BACKGROUND

Social well-being is one of the essential dimensions of individual health. Nursing is one of the occupations that can affect a person's well-being. This study aimed to determine social well-being among employees, retirees, and nursing students.

METHODS

This is a cross-sectional descriptive study. 321 samples participated in this study. Convenience sampling method was used to collect samples. Two questionnaires of demographic characteristics and the Keyes Social Well-being Questionnaire were used to collect data. Descriptive statistics, independent t-test, one-way analysis of variance (ANOVA), and Linear regression analysis by the Backward Elimination method were applied using SPSS 14.0.

RESULTS

The mean total social well-being score of this study's participants was 100 ± 16.43. The mean social well-being score among nursing employees was 109.58 ± 15.98, among nursing retirees was 95.67 ± 12.55, and among nursing students was 93.14 ± 14.81. Nursing students had lower social well-being scores than nursing employees and retirees (p < 0.001). Linear regression analysis showed a significant relationship between the number of children (p = 0.04) (β = -0.11), marital status (p = 0.04) (β = 2.95), and employment status (p < 0/001) (β = 0.451) and social well-being and predicted 25% of the total variance of social well-being.

CONCLUSION

According to the results of this study, the social well-being of retirees and nursing students was significantly lower than nursing employees. Therefore, the educational and healthcare systems of the countries must take the necessary measures to improve the Social well-being of this group of people.

Psychiatric disorders and caregiver burden in children with transfusion dependent β-thalassaemia and their caregivers

BACKGROUND

Children with thalassemia need care from the first years of life owing to the physical and psychological effects of their disorder. Thalassemia is a concern not only for the children’s physical health but also the mental health of themselves and their caregivers.

AIM

To screen the psychosocial problems and assessment of psychiatric morbidities among thalassaemic children and their caretakers, along with an assessment of caregiver burden in them.

METHODS

In this observational cross-sectional study, children with transfusion-dependent thalassemia, were included and were assessed for psychiatric morbidity and global functioning. Their parents were assessed for psychiatric morbidity and the caregiver burden they faced. All the parents completed two different questionnaires to assess their knowledge about the psycho-social functioning [using Pediatric Symptom Checklist-35 (PSC-35)] of their children and the level of the burden faced by them by Caregiver Burden Scale (CBS).

RESULTS

A total of 46 children (28 boys and 18 girls) with transfusion-dependent thalassemia with a mean age of 8.83 ± 2.70 years and 46 parents (12 fathers and 34 mothers) were included in this study. More than 32 children had some psychosocial problems on screening by PSC-35. On assessment by CBS moderate caregiver burden was perceived in domains of general strain, isolation, disappointment, emotional involvement, and environment. A total of 65.3% of children and 62.7% of parents were diagnosed with psychiatric problems.

CONCLUSION

Thalassemia affects not only the persons with the disorder but also their caregivers in several aspects, including their psychosocial well-being. This study emphasizes the role of a supportive group in the psychological well-being of caregivers, which could be used to prevent the pathological effects of caregiver burden and enhance their psychological well-being through counselling.

Distress, Social Support, and Self-Compassion: Relationships With Mental Health Among College Students

This study investigated how distress, conceptualized as an interaction between hassles and stress perceptions, related to mental health, whether the type of distress (social or nonsocial) was consequential, and whether perceived support and self-compassion attenuated these relationships. Students (N = 185) from a mid-sized university in the southeast completed a survey. Survey questions pertained to hassles and stress perceptions, mental health (i.e., anxiety, depression, happiness, and love of life), perceived social support, and self-compassion. As predicted, students reporting more hassles and stress (both social and nonsocial) as well as those reporting less support and self-compassion, were worse off regarding mental illness and mental wellness. This was observed for both social and nonsocial distress. Although we did not support our hypotheses regarding buffering effects, we found perceived support and self-compassion are beneficial, regardless of hassles and stress levels. We discuss implications for students' mental health and ideas for future research.

The Effect of Follower Identity on Followership: The Mediating Role of Self-Efficacy

Followership is as crucial as leadership for organizational success. Significant efforts have been made by numerous researchers to examine how leadership influences followership; however, not enough attention has been paid to the influence of internal factors of followers on followership from the followers' perspective. This study relies on identity theory to understand the relationship between the influence of followers' perceived self-following traits (FTP) and followership prototype (FP) on followership, and the mediation role of self-efficacy in the relationship between FTP-FP consistency and followership. In order to avoid common method bias and ensure good discriminant validity of the variables, a two-wave time-lagged data collection design was used to collect 276 valid questionnaires from front-line business staff and junior supervisors in private and public sector organizations of China. Polynomial regression and response surface analysis were used to investigate the effect of FTP-FP consistency on followership. The empirical findings indicated that (1) the more consistent FTP-FP, the stronger the followership; (2) compared to the 'low FTP-low FP', employees with 'high FTP-high FP' had stronger followership; (3) employees with 'high FTP-low FP' had stronger followership than 'low FTP-high FP'; (4) self-efficacy played a mediating role between FTP-FP consistency and followership. These findings contribute to management practice by revealing antecedents to followership from the perspective follower identity and the effect of follower identity on followership.

Conversation analysis and power: examining the descendants and antecedents of social action

Conversation Analysis (CA) tends to adopt an ambivalent attitude to the concept of power. The concept is fundamental in sociology but secondary or even disregarded in CA. A closer look at research and the conceptual foundations of CA however demonstrate significant contributions to theories of power. In this paper we aim to demonstrate and discuss these contributions, however, also arguing for an expansion of the CA approach in dialogue with sociological theories to engage in the sociological analysis of power as an essential feature of social relationships and social organization. Based on a general definition of power, as the transformative capacities of social agents in virtue of their social relationships, we discuss how power is interactionally achieved and negotiated, but also conditioned by social institutions and structures that extend beyond the contexts of situated encounters. The paper is divided into two main sections. The first section presents central contributions of CA in relation to the distinctions between power over and power to, authority as a legitimate form of power, and deontics as a key concept in the analysis of power. The second section critically considers the tendency in CA to localize power solely to actions in interaction, and to conflate structure and action, which constraints the analysis and explanations of power. We present examples of how analyses of power, grounded in CA, can be extended to account for the dynamics of social structures and realities beyond the interactional encounters.

Predictors of self-reported research productivity amongst medical students in the United Kingdom: a national cross-sectional survey

BACKGROUND

The number of academic clinicians in the UK is declining and there are demographic inequalities in the clinical-academic workforce. Increased research productivity by medical students is believed to reduce future attrition in the clinical-academic workforce. Thus, this study investigated the association between student demographics and research productivity amongst UK medical students.

METHODS

This is a national multicentre cross-sectional study of UK medical students in the 2020/21 academic year. We appointed one student representative per medical school, and they disseminated a 42-item online questionnaire over nine weeks, through departmental emails and social media advertisements. The outcome measures were: (i) publications (yes/no) (ii) number of publications (iii) number of first-authored publications (iv) abstract presentation (yes/no). We utilised multiple logistic and zero-inflated Poisson regression analyses to test for associations between the outcome measures and predictor variables at a 5% significance level.

RESULTS

There are 41 medical schools in the UK. We received 1573 responses from 36 UK medical schools. We failed to recruit student representatives from three newly formed medical schools, whilst two medical schools prohibited us from sending the survey to their students. Women had lower odds of having a publication (OR: 0.53, 95% CI: 0.33-0.85) and on average had fewer first-author publications than men (IRR: 0.57, 95% CI: 0.37-0.89). Compared to white students, mixed-ethnicity students had greater odds of having a publication (OR: 3.06, 95% CI: 1.67-5.59), an abstract presentation (OR: 2.12, 95% CI: 1.37-3.26), and on average had a greater number of publications (IRR: 1.87, 95% CI: 1.02-3.43). On average, students who attended independent UK secondary schools had a higher rate of first-author publications compared to those that attended state secondary schools (IRR: 1.97, 95% CI: 1.23-3.15).

CONCLUSION

Our data suggest that there are gender, ethnic and socioeconomic inequalities in research productivity among UK medical students. To tackle this, and potentially improve diversity in clinical academia, we recommend that medical schools should facilitate targeted high quality research mentorship, funding and training, especially for under-represented-in-medicine students.

Volunteering and Changes in Cardiovascular Biomarkers: Longitudinal Evidence From the Health and Retirement Study

Background and Objectives

Growing body of research shows that volunteering is beneficial for those served, the volunteers, and the larger communities. However, major challenges remain that hinder the practical implications for volunteer activity as a public health intervention, including potential selection effects, lack of longitudinal studies that adjust for baseline characteristics, and a paucity of studies that consider multiple physical health outcomes in a single model.

Research Design and Methods

Data from 2006 to 2016 waves of the Health and Retirement Study (2006-2016) were used (N = 18,847). Outcome-wide analyses were utilized to evaluate if changes in volunteering between 2006/2008 (t0) and 2010/2012 (t1) were associated with 7 cardiovascular disease biomarkers 4 years later (2014/2016, t2). These models were adjusted for demographic factors, socioeconomic status, health behaviors, chronic conditions, baseline biomarkers, and volunteering. Additionally, selection into volunteering and attrition were taken into account.

Results

Compared with nonvolunteers, volunteering more than 200 hr a year was associated with a lower risk for clinically high diastolic blood pressure. In addition, increased volunteering effort (change from 1 to 99 hr at t0 to >100 hr at t1) was associated with a lower likelihood of clinically high systolic and diastolic blood pressure levels. Sustained high volunteering (>100 hr at both t0 and t1) was associated with lower diastolic blood pressure.

Discussion and Implications

The current study adds to the evidence on the health benefits of volunteering for adults 50 and older by inferring a potential causal link between high-intensity volunteering and reduced blood pressure.

Multimodal interaction analysis of non-lexical vocalisations in low-verbal autistic children

This article analyses non-lexical vocalisations produced by low-verbal autistic children. Seven dyads of naturalistic interactions between non-autistic adults and low-verbal autistic children over five years old were analysed from a multimodal conversation analysis perspective. Data were extracted from an audio-visual corpus of interactions in institutional (school) and non-institutional settings (home). The data are in Brazilian Portuguese. The videos are visualised using the ELAN tool and transcribed. The analyses showed that in some cases participants did not reach a mutual understanding of the semantic meaning of non-lexical vocalisations, while in other cases, the meanings of vocalisations emerged between the participants in the multimodal process of sense-making in their embodied context. A microanalysis of where these vocalisations occurred and their multimodal aspects (linguistics, bodily, material, and spatial) suggests that: a) such occurrences are both initiated by the autistic child and responsive to the non-autistic interlocutor's turn; b) some vocalisations play an important role in the sequential organisation of the interaction, promoting the maintenance of intersubjective of low verbal children; and c) non-autistic adult interlocutors perform a varied set of actions, recycling, incorporating, retaking, assigning meaning, and repairing the non-lexical vocalisations produced by autistic children. The indexical analysis shows how communicative ecologies create meaning. This study thus contributes to our understanding of the interactional behaviour of these children and their interlocutors.

Patterns of the Satisfaction and Frustration of Psychological Needs and Their Associations with Adolescent Students' School Affect, Burnout, and Achievement

Based on self-determination theory and adopting a person-oriented approach, we aimed to investigate the latent profiles of adolescent students' basic psychological needs and their associations with personal characteristics (gender, socioeconomic status) as well as school functioning (school affect, burnout, academic achievement). Latent profile analyses based on a group of 1521 Chinese high school students identified four need profiles: low satisfaction/moderate frustration, high satisfaction/low frustration, average all, and moderate satisfaction/high frustration. Furthermore, there were significant differences in students' school functioning among the four latent profiles. Specifically, students with moderate to high levels of need frustration were most likely to experience maladaptive school functioning, regardless of their need satisfaction level. Additionally, gender and socioeconomic status were significant predictors of profile membership. The findings of this study can assist educators in gaining a better understanding of the diverse patterns of psychological needs among students and help them to implement targeted interventions.