Retrospective Survey Data Research Articles

Can survey design reduce anchoring bias in recall data? Evidence from smallholder farmers in Malawi

Abstract Recall biases in retrospective self-reported survey data have important implications for empirical research. We leverage the survey design literature and test three strategies to attenuate mental anchoring in retrospective data collection: question ordering, retrieval cues and aggregate (community) anchoring. We focus on maize production and happiness reports among smallholder farmers in Malawi. Asking for retrospective before concurrent data on average reduces recall bias (i.e. the deviation of the recalled versus the concurrent outcome reported in the previous period) by 34 per cent for maize production, a meaningful improvement with no increase in data collection costs. Retrieval cues are less successful and community anchors can exacerbate the bias. None of the strategies help to ease the recall bias for happiness reports.

Necessity of Analyzing the Korea Community Health Survey Using 7 Local Government Types.

This study examined the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size as a more effective tool to address local health problems and deduce practical implications. Retrospective survey data from 2023 KCHS were obtained. Frequency analyses were performed for self-rated good health status, current smoking status, and unmet medical needs as proxies for health status, as well as healthcare utilization and health behavior, utilizing individual weights to represent national community residents. We established a new classification of local governments into 7 types to facilitate regional comparisons. These local government types are presumably composed of populations showing statistically significant differences in demographic characteristics. There were evident differences in health status, health behavior, and healthcare utilization in comparisons of groups categorized by local government types. This study suggests that regional disparities can be analyzed using a new typology of local governments. This practically effective approach could be used in decision-making for community-centered health projects in terms of community health planning. Future research should conduct analyses of KCHS data that use these 7 local government types to comprehensively reflect regional characteristics.

COVID-19 Impacts on Physical Activity Among Community-Dwelling Older Adults With Memory Problems: The Moderating Role of Walkable Neighborhood Destinations.

The number of people with memory problems who desire or are forced to age in place has been growing rapidly. Coronavirus disease 2019 (COVID-19) has brought significant challenges to the ability of those with memory problems to stay active and age in place. This study investigated the roles of neighborhood environments in helping community-dwelling people with memory problems maintain physical activity during the COVID-19 pandemic. We used retrospective online survey data from 75 caregivers who responded on behalf of their care recipients with memory problems living in Texas communities. We used difference-in-difference (DID) estimations based on zero-inflated negative binomial regression models to examine the changes in recreational walking and moderate-to-strenuous exercise before and during the COVID-19 pandemic and whether such changes vary by diversity of walkable neighborhood destinations. In the total sample, there was a significant reduction in both recreational walking (Δ change = -45.16 min/week, p < .001) and exercise (Δ change = -36.28 min/week, p = .03) after the COVID-19 outbreak. The pandemic's impact on exercise varied by diversity of neighborhood destinations (DID = 0.81, p = .03). Those living in neighborhoods with diverse walkable destinations experienced less decline in physical activity compared to those living in areas with limited destinations. These findings suggest that the impact of the COVID-19 pandemic on physical activity among people with memory problems may be partially explained by neighborhood land-use characteristics. Destination-rich, mixed-use neighborhood environments can help people with memory problems stay active even during pandemics such as COVID-19 in the United States and potentially elsewhere.

Trends in COVID-19 testing, infection, vaccination, and housing assistance among people who inject drugs in Los Angeles and Denver

ABSTRACTIntroductionWe examined COVID-19 trends and the socio-structural correlates of infections and vaccinations among people who inject drugs (PWID).MethodsWe collected retrospective survey data from PWID (n = 472). We examined changes in COVID-19 testing, infection, and housing assistance for the first year of the pandemic, and then used multivariate logistic regression to examine factors with ever having an infection and receiving at least one vaccination from April 2020-March 2021.ResultsThe sample was mostly male, White and Latinx, and unhoused. Testing by quarter ranged from 46% to 33%. Housing assistance declined from 10% to 7% by the last quarter, while infections ranged from 6% to 4%. Ever being COVID-19 positive was associated with being male, having an income source, and being arrested in the last 3 months. Almost half of participants reported vaccination (47%). Receiving a vaccination was associated with prior U.S. armed forces service, older age, receiving substance use disorder treatment, and having ever received COVID-19 testing.DiscussionEfforts to vaccinate PWID fell short and housing assistance declined. Receiving targeted assistance, including better access to housing and medication treatments for opioid use disorder, could be important efforts to mitigate the heightened risks of COVID-19 and the ongoing harms PWID face that predate the pandemic.

Social Health Insurance and Healthcare Seeking Behavior in Urban Ethiopia.

After years of planning, in 2024 the government of Ethiopia proposes to introduce a compulsory Social Health Insurance (SHI) program for formal sector employees. The proposed scheme will provide access to contracted healthcare facilities at a premium of 3% of the gross monthly income of employees with another 3% coming from the employer. Several studies have examined the willingness to pay (WTP) this premium, however, little is known about the healthcare seeking behavior (HSB) of formal sector employees. This paper investigates both - the determinants of healthcare seeking behavior and among other aspects, WTP the premium. Through these explorations, the paper sheds light on the potential challenges for implementation of SHI. Descriptive statistics, logit, and multinomial logit (MNL) models are used to analyze retrospective survey data (2,749 formal sector employees) which covers the major regions of the country. Regarding outpatient care, a majority of the visits (55.9%) were to private healthcare providers. In the case of inpatient care, it was the opposite with a majority of healthcare seekers visiting public sector hospitals (62.5%). A majority of the sample (67%) supported the introduction of SHI but only 24% were willing to pay the proposed SHI premium. The average WTP was 1.6% of gross monthly income. Respondents in the two richest income quintiles were more likely to oppose SHI and consider it unfair. The prominent role of the private sector and the resistance to SHI amongst the two richest income quintiles, suggests that the SHI program needs to actively include private healthcare facilities within its ambit. Additionally, concerted efforts at enhancing the quality of care available at public health facilities, both, in terms of perception and patient-centered care and addressing drug and equipment availability bottlenecks, are needed, if SHI is to garner wider support.

A life course perspective on determinants of discontinuance of active participation in sports activities

Physical inactivity remains a global public health challenge today. Determining why people stop regularly participating in sports is significant to develop targeted intervention strategies for sports promotion and healthy living. As sports participation is dynamic throughout life, a life-course perspective is needed to provide a more comprehensive understanding. This study adopts a life-course perspective to explore the determinants of the change from active participation in sports to becoming inactive. Based on online retrospective survey data collected in the Netherlands, a two-level binary logistic regression model is estimated to capture the effects of socio-demographics, sports motivations, life transitions, and neighborhood characteristics on sports dropout over the lifespan. Results show that dropout from sports is age-specific, and that people are less likely to discontinue sports participation when they have health and weight loss goals. Life transitions have different effects. The cessation of living with physically active people appears to be the most important event to make people stop sporting, followed by having a baby, and then owning the first car. Compared with education-related events, work-related events are more likely to cause people to stop sporting. Moreover, the probability of sports discontinuance may increase when residents feel unsafe doing physical activities in their neighborhoods or when the neighborhood has sufficient greenspace for walking. The findings have implications for supporting sports participants to continue exercising by addressing the barriers.

How I Do It: Suicidal Ideation During Surgical Training: Is an Innovative Surgical Trainee Check Ins Program a Part of the Solution?

Mental health distress and suicidal ideation are leading contributors to the silent epidemic of physician suicide leading to approximately 300 to 400 physician deaths per year. The Second Trial has illuminated the alarming fact that several of our residents have experienced suicidal thoughts within the last year. Unfortunately, our institution is not an outlier. Suicidal ideation and under- or untreated mental health disorders are increasingly prevalent in the surgical trainee population. Given the major concern for our residents' well-being, our department consulted a licensed mental health professional familiar with resident training and the GME to develop a program to provide access to a mental health professional that is free of cost for trainees, safe and confidential. Implementation of a 30 minute opt-out resident check-in program with a licensed mental health professional and a post-session survey that provided retrospective survey data for analysis. This program was implemented at the University of Virginia Health System in Charlottesville, VA. General surgery categorical and preliminary residents participated in this program. Thirty residents participated in the program and an overwhelming majority would like to continue this program at regular intervals. Sessions were 25 minutes on average and 27.7% of participants requested additional sessions. Implementation of this program for our surgical trainees was favorably perceived with request for continuation of the program and provided access to a safe space with a familiar provider.

Phytanic Acid Intake and Lifestyle Modifications on Quality of Life in Individuals with Adult Refsum Disease: A Retrospective Survey Analysis.

Adult Refsum disease (ARD) is a rare peroxisomal biogenesis disorder inherited in an autosomal recessive fashion and is often characterized by retinitis pigmentosa, cerebellar ataxia, and polyneuropathy. Many patients with ARD require diet modification, psychosocial support, and various specialist visits to manage their symptoms. In this study, we explored the quality of life in individuals with ARD by analyzing retrospective survey data collected by the Coordination of Rare Diseases at Sanford (CoRDS) Registry and Global Defeat Adult Refsum Everywhere (DARE) Foundation. Statistical tests used were frequencies, mean, and median. There were 32 respondents, ranging between 11 and 32 responses for each question. The mean age at diagnosis was 35.5 ± 14.5 years (range 6-64) with 36.4% male and 63.6% female respondents. The average age for retinitis pigmentosa diagnosis was 22.8 ± 15.7 years (range 2-61). Dieticians were the most frequently seen (41.7%) for management of low-phytanic-acid diets. Most participants exercise at least once per week (92.5%). Depression symptoms were reported in 86.2% of the participants. Early diagnosis of ARD is important for managing symptoms and preventing progression of visual impairment due to phytanic acid buildup. Interdisciplinary approach should be used for patients to address physical and psychosocial impairments of ARD.

How accurate are retrospective survey data? Evidence from rural Ethiopia

ABSTRACT Development actors are always seeking reliable and cost-effective methods to assess the impact of their programmes. In particular, there are frequently calls to evaluate programmes for which no pre-intervention (or ‘baseline’) data are available. In these cases, evaluators often rely on retrospective survey questions to reconstruct the baseline situation. This article explores the accuracy of such retrospective survey data, using data from two surveys carried out nearly six years apart among women in rural Ethiopia. We find that the proportion of survey items for which baseline data and retrospective data do not agree is 22%. Responses to the retrospective questions are more closely associated with respondents’ situation at the time of the survey than with their situation at the time they were being asked to recall. Consequently, 72% of respondents were allocated to different quintiles of household wealth, depending on whether the true baseline or the retrospective baseline data were used. We show that controlling for retrospective baseline data can considerably underestimate the impact of the intervention being evaluated. This suggests that there is a need for caution in interpreting the findings of evaluations based on such data and in drawing policy conclusions from them.

Hearing Healthcare Professionals' Views about Over-The-Counter (OTC) Hearing Aids: Analysis of Retrospective Survey Data.

Over-the-counter hearing aids have been available to consumers in the US since 17 October 2022 following a ruling by the Food and Drug Administration. However, their reception by hearing healthcare professionals (HHP) has been mixed, and concerns have been expressed by many HHPs. The aim of this study was to examine the concerns that HHPs have towards over-the-counter (OTC) hearing aids. The study used a retrospective survey design. The survey data of HHPs (n = 730) was obtained from Hearing Tracker. A 22-item structured questionnaire was administered using a Question Scout platform. Descriptive analyses examined reported areas of concern and a Fisher's exact test examined the relationship between demographics and responses. A cluster analysis with partitioning around medoids (PAM) was used to identify a sub-group of participants based on responses. Nearly half of HHPs who participated reported that they will support patients with OTC hearing aids purchased elsewhere, whereas a quarter reported that they will sell OTC hearing aids in their clinic or website. HHPs expressed over 70% agreement in 'concern' statements in 14 of the 17 items. Issues about safety, counseling, and audiological care were the key concerns expressed by HHPs about OTC hearing aids. Some demographics (i.e., profession, primary position) were associated with responses to some statements. Two groups were identified based on the responses to concern statements. The HHPs in the first cluster 'OTC averse' (51%) agreed on all the 17 concern statements, whereas the second cluster 'OTC apprehensive' (49%) had some items rated as disagree (i.e., consumers will give up on amplification) and neither agree nor disagree (i.e., do not provide good value, warranties and return periods will be worse), and remaining items were rated as agree. OTC hearing aids were initiated to improve affordability, accessibility, and hearing aid uptake and are currently a rapidly emerging category of hearing devices. Overall, the results of the current study indicate that HHPs have serious concerns about OTC hearing aids. HHP concerns cited in this study provide useful feedback to stakeholders (e.g., HHP professional agencies, FDA, industry, and insurance payers) involved in improving OTC hearing aid implementation.

Hapū Wānanga: A Kaupapa Māori childbirth education class for Māori and non-Māori māmā hapū and whānau

Global studies attest that early engagement with childbirth education (CBE) classes enhances maternal and infant health outcomes. In Aotearoa New Zealand, Māori participation rates in CBE classes are lower than those of their non-Māori counterparts. Current CBE classes are designed and delivered using a predominantly Western medicalised approach that negates Māori birthing knowledge, expertise, and values. However, sporadically, Kaupapa Māori CBE classes are being delivered. This article draws on a wider study that explores the Hapū Wānanga (HW) CBE programme, a by Māori, for Māori pregnancy and parenting initiative. This mixed-method interpretive study used retrospective post-course survey data of 1,152 participants over a three-year period from the HW based in the Waikato District Health Board region. Data explored the programme’s quality, the impact on levels of knowledge and understanding, and the overall experiences and views of participants. This artice interrogates the factors that shaped participation, engagement and acceptability of the HW for participants.

Use of An Ophthalmology Tutorial to Improve Resident Comfort with the Emergency Eye Exam.

This tutorial should be utilized for emergency medicine (EM) interns and junior residents. Ophthalmology is characteristically a weak area in both medical school and resident education. Medical students are rarely given formal didactic education on the use of the slit lamp or a systematic approach to examining the eye. For EM residents, this leads to inefficient and uncomfortable encounters with patients with eye complaints. We sought to develop a comprehensive emergency ophthalmology tutorial utilizing asynchronous learning followed by a hands-on skill session that would address this need. By the end of this small group didactic, learners will be able to: 1) demonstrate ability to focus on the various components of the slit lamp exam 2) demonstrate understanding of a systematic approach to the eye exam 3) demonstrate appropriate use of the Diaton, iCare, and Tonopen tonometers. This two-hour small group didactic combines hands-on learning sessions to learn the slit lamp exam and tonometry measurement, with a systematic review of the eye exam to help learners better organize their exams and understand the use of necessary tools. The emergency ophthalmology tutorial was initially designed as an education project in which we collected pre- and post-participation surveys regarding resident comfort with various components of the emergency eye exam. After the course residents received a post-course survey to complete. Given the positive feedback we received from our residents regarding the tutorial, we applied for Institutional Review Board (IRB) approval to publish our retrospective survey data. Our IRB waived the need for participant consent. Twelve emergency medicine residents including 11 interns and one post-graduate year (PGY) 2 resident participated in the emergency ophthalmology tutorial as part of our intern boot camp in July of 2021. Twelve PGY-1 residents initially signed up for the course and filled out the pre-participation survey but one of them was not able to attend their scheduled class, so a PGY-2 resident requested to attend.Prior to the course, we used a Likert scale from 1-7, finding that 61.5% (8/13) of participants felt very uncomfortable with performing slit lamp exams, 84.6% (11/13) felt very uncomfortable with using the Diaton tonometer, 76.9% (10/13) felt very uncomfortable with using the iCare tonometer, and 69.3% (9/13) felt uncomfortable or very uncomfortable with using a systematic approach to examining the eye. After the course, 75% (9/12) of participants felt that the course exceeded expectations in ensuring their ability to perform the subcomponents of the slit lamp exam, 75% (9/12) and 83.3% (10/12) of participants felt that the course exceeded expectations in ensuring their ability to use the Diaton and iCare tonometers, respectively, and 91.7% (11/12) felt that the course exceeded expectations in ensuring their ability to perform a systematic eye exam. Participation in a 2-hour emergency ophthalmology tutorial with assigned asynchronous pre-course work improved emergency medicine resident comfort with various components of the eye exam. Emergency ophthalmology, eye exam, slit lamp, tonometry.

The use of patient experience feedback in rehabilitation quality improvement and codesign activities: Scoping review of the literature

Objective To characterize the literature, reported enablers, and gaps on the use of patient experience feedback for person-centered rehabilitation quality improvement and codesign activities. Design Scoping Review. Data sources Scientific databases (PubMed, CINAHL, Rehabdata, Scopus, Web of Science, ProQuest), website searches (e.g. Beryl Institute), snowballing, and key-informant recommendations. Methods Two independent reviewers performed title and abstract screenings and full-text reviews. Eligibility focused on English-language, peer-reviewed (all time) and gray literature (last five years) that used patient experience feedback in rehabilitation improvement activities. The aims, settings, methods, findings, implications, and reported limitations were extracted, followed by content analyses identifying reported enablers and gaps. Results Among the 901 unique references and 52 full texts reviewed, ten were included: four used patient experience surveys for improving patient experiences; six used codesign methodologies to engage patient feedback in service improvement activities. Implementation enablers included securing managerial support, having a structured methodology and facilitator, using efficient processes, engaging staff experiences, and using appreciative inquiry. Reported study gaps included limited follow-up, low sample sizes, analytical limitations, lack of reported limitations, or narrow range of perspectives (e.g. not from people with severe impairments). Conclusion Few examples of the use of patient experience feedback in quality improvement or codesign activities were found in the rehabilitation literature. Patient experience improvement activities relied exclusively on retrospective survey data, which were not combined with often more actionable forms (e.g. qualitative, real time) of patient experience feedback. Further research might consider design of activities that collect and use patient experience feedback for rehabilitation service improvements.

Socio-demographics, neighborhood characteristics, time use, and leisure-time physical activity engagement patterns over the life course

Physical inactivity remains a major public health challenge today. Understanding the determinants of changes in habitual leisure-time physical activity patterns by type across the life course is important for developing targeted interventions. This study presents a multiple discrete-continuous extreme value model to examine the determinants of habitual participation in and time allocation to multiple leisure-time physical activities over the life course. A comprehensive set of socio-demographics, life transitions, neighborhood characteristics, and time-related factors are considered as determinants of each activity type, including sports, recreational walking, cycling, outdoor playing, and dog walking. Results estimated on retrospective survey data collected in the Netherlands show significant differences in the determinants of the different types of leisure-time physical activity. Social-demographic factors have a strong influence on sports participation, followed by recreational walking, cycling, outdoor playing, and then dog walking. Life transitions have different effects. A change in marital status appears to be the most important life event for sports participation while changing jobs is the most important event for the other two activities. Neighborhood characteristics primarily affect participation in recreational walking, cycling, outdoor playing, and dog walking. As for time-related factors, they mainly impact sports engagement. The findings of this study could help develop effective interventions to promote leisure-time physical activity participation during life transitions and encourage healthy living.

Supervised models to predict the Stunting in East Aceh

Nowadays, Undernutrition is the main cause of child death in developing countries. There are many people and organizations try to mitigate or minimize case of child death. Thus, this paper aimed to has excellent method to handle undernutrition case by exploring the efficacy of machine learning (ML) approaches to predict Stunting in East Aceh administrative zones of Indonesia and to identify the most important predictors. The study employed ML techniques using retrospective cross-sectional survey data from East Aceh, a national-representative data is collected from government by using 2019 about stunting data. We explored Random forest commonly used ML algorithms. Random Forest (RF) as an extension of bagging that in addition for taking random sample of data and also uses random subset of features which mitigates over fitting. Our results showed that the considered machine learning classification algorithms by random forest can effectively predict the stunting status in East Aceh administrative zones. Persistent stunting status was found in the east part of Aceh. The identification of high-risk zones can provide more useful information and data to decision-makers for trying to reduce child undernutrition.

Residents Are Coming: A Faculty Development Curriculum to Prepare a Community Site For New Learners.

This curriculum is designed for emergency medicine attendings in varying years of community practice to prepare them for Emergency Medicine (EM) residents. 15 months. Emergency medicine is a growing field with new residencies approved every year. A strong, competent cadre of clinical educators is essential to the success of any residency, and new programs have the challenge of developing their clinical faculty into outstanding teachers. There is minimal literature guidance for navigating this transition. Our site is a community tertiary care center in the process of applying for an EM residency. We focus on our experience designing a faculty development curriculum to accommodate the needs of a diverse group of physicians in all stages of their careers. We will demonstrate that a curriculum satisfying all stakeholders can easily be implemented in a way that allows for robust participation without excessive additional administrative burden. Our goal is to prepare community-based EM attendings to be outstanding educators to future residents by augmenting their knowledge of current educational practice and adult learning theory, literature review, and biostatistics. The educational strategies used in this curriculum included lectures, guided discussion, small group discussion, and asynchronous learning. This curriculum was implemented in the Geisinger Wyoming Valley Medical center targeted at staff physicians. This educational study was deemed exempt by the institutional review board (IRB). We electronically collected retrospective survey data using a 5-point Likert scale as well as free text responses. The primary measure was agreement with the statement, "Faculty development time makes me feel more prepared to be a clinical educator." We also surveyed whether this was felt to be an appropriate use of time, self-reported growth in key educational and biostatistical domains, and likeliness to change practice based on the material. Responses collected from core faculty after the sessions indicated a uniformly positive review of the series itself with the primary outcome receiving a 4.6 rating on a 5-point Likert scale (strong agreement). Faculty reported that these brief sessions improved the quality of the departmental staff meetings (average rating 4.7/5). Journal club sessions were rated as positive (4.7/5) and attendees self-reported growth in statistical literacy and security in clinical practice. We demonstrated successful implementation of a faculty development curriculum that was favorably assessed by all key stakeholders. Faculty self-reported growth in all educational and clinical domains evaluated. It was successfully implemented without substantially increasing the time burden for physicians with robust clinical and administrative schedules. We feel this is generalizable to other sites seeking to start an EM residency and is useful for sites with existing residencies to efficiently deliver content to junior faculty. Emergency medicine, faculty development, journal club, virtual learning.

Evaluation of opioid disposal process for home hospice patients.

Context: Considering the national opioid epidemic and its impact on thousands of lives, the importance of appropriate management of controlled substances in the home hospice setting is paramount. Family members tend to be the primary caregivers for home hospice patients, and hospice nurses are the front line for providing education on opioid disposal. As such, the importance of effective and consistent education is essential in minimizing the risks of misuse and diversion. Objectives: To evaluate the use of a standardized opioid disposal policy through the implementation of three steps: (1) opioid education at enrollment in hospice program; (2) the use of the Medication Diversion or Misuse checklist; and (3) a review of the standards for safe opioid disposal. We also evaluated the current knowledge and understanding of the standard processes of opioid education and disposal among home hospice nurses. Study Design: Mixed methods. Setting or Dataset: Retrospective data and survey data, Milwaukee, WI; 07-12/2019. Population Study: Home hospice patients, home hospice registered nurses. Outcome Measures: The fidelity of our institution's opioid medication disposal policy and knowledge of the policy. Basic descriptive statistics were used to describe the patients and survey responses. Results: A total of 160 patients met inclusion criteria. We found that 108 (67.9%) patients/families received education on admission, 11 (6.9%) families received education on opioid disposal at the time of death, and 152 (95.6%) of families had an opioid disposal discussion at the death certification visit. Of the 16 nursing survey respondents, only 3 (18.8%) consistently provided all of the necessary education to new patients. However, when education is provided, 14 (87.5%) respondents did provide all the appropriate instructions regarding dosing, administration, side effects, and storage. On death calls/visits, 13 (81.2%) reported consistently providing the appropriate education regarding opioid disposal. Conclusion: Our results suggests that nursing staff do provide the appropriate education regarding the use and administration of opioids, as well as appropriate disposal practices, but do not do so consistently. The project highlighted the importance of continued nursing education regarding safe opioid use, disposal, and awareness of drug diversions.

Long-term effects of childhood adversity on the subjective well-being of older adults in urban China: the mediating effect of elder abuse

Objectives Adverse childhood experiences (ACEs) have negative impacts on individuals’ subjective well-being (SWB) in later life. This article investigates the relationships between the ACEs and SWB of Chinese older adults and examines how elder abuse victimization mediates the pathways in these relationships. Method We used retrospective cross-sectional survey data collected in Beijing, China, in 2019. The study sample consists of 1002 older adults aged 65 years and over. The survey measured individual types, number, and various categories of ACEs of older adults and their elder abuse victimization experiences, along with their SWB (i.e. depression and life satisfaction). We tested the potential mediating role of elder abuse victimization in the relationships between ACEs and SWB. Results After controlling for socio-demographic factors and self-rated health, the results suggest a full mediating effect of elder abuse on the relationship between both several individual types and multiple categories of ACEs (i.e. childhood victimization, the family’s economic difficulties, and a family member’s episodes of illness) and depression, in addition to a partial mediating effect of elder abuse between number of ACEs and depression. A full mediating effect of elder abuse was found in regard to the relationship between a family’s economic difficulties and life satisfaction. Conclusion This study provides evidence for a long-term impact of ACEs on the SWB of older adults in China. In analyzing and understanding elder abuse victimization as a pathway linking ACEs and SWB, we stress the importance of the prevention of interpersonal violence across the life course. Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2022.2040427 .

Use of healthcare services during the COVID-19 pandemic in urban Ethiopia: evidence from retrospective health facility survey data

ObjectivesIn recent years, Ethiopia has made enormous strides in enhancing access to healthcare, especially, maternal and child healthcare. With the onset and spread of COVID-19, the attention of the healthcare...

Diverse predictors of early attrition in an elite Marine training school

ABSTRACT Reconnaissance Marine training is deliberately difficult, to assure that graduates have the capabilities required to function successfully in the high-risk military occupational specialty. The majority of training attrition is due to voluntary withdrawal and previous research has identified certain predictive factors such as demographics, mental status, and physical performance. While some characteristics of training attrition have been identified, there is still a lack of understanding related to an individual’s profile that is more apt to complete Recon training. Retrospective survey data was analyzed from 3,438 trainees within the Reconnaissance Training Company. Surveys were related to trainees’ military recruitment history and other military experience, prior life experience, athletic experience, self-identified personality characteristics and motivations, and reasons for voluntary withdrawal if applicable, as well as physical performance metrics. Various demographic factors, self-reported hobbies, motivations, aquatic experience, and physical performance were associated with success in Recon Marine training courses. Subjects who voluntarily withdrew from training most commonly cited mental stress and aquatic rigor as the reason and less commonly cited reasons were physical and family reasons. These results could potentially increase training success, but more research is needed to understand the relationships between the observed trainee characteristics and success in elite warfighter training.