US Study Research Articles

Individual differences in peace of mind reflect adaptive emotion regulation

Well-being consists of several different dimensions, such as hedonic and eudaimonic well-being. However, peace of mind (PoM)—an aspect of well-being characterized by internal peace and harmony—has only recently begun to receive attention. It has been shown that PoM predicts important outcomes, such as depression and anxiety. An open question is what underlies individual differences in PoM. One important factor may be emotion regulation. However, to date, no studies have been conducted on PoM and emotion regulation. Here, we investigated the relationship between individual differences in PoM and trait emotion regulation. In two studies, participants from Finland (Study 1, N = 417) and the US (Study 2, N = 303) completed measures of PoM, trait emotion regulation, and other aspects of well-being and ill-being. Results showed that people with higher levels of PoM displayed a greater tendency to use cognitive reappraisal and a lesser tendency to use expressive suppression. Our findings suggest that adaptive emotion regulation may play an important role in explaining PoM and may serve as a promising target for interventions designed to enhance PoM.

Positive life experiences and mortality: Examination of psychobiological pathways

Introduction and rationalePositive life experiences are potentially-rewarding events and behaviors, such as social and romantic interactions, experiences of relaxation and physical comfort, time spent in nature, and other leisure activities. To date, there is limited evidence linking positive life experiences to long-term health outcomes. Objective and methodsThe current study used data from N = 1243 participants in the Midlife Development in the US Study Biomarker Project to examine whether greater frequency of a range of different positive experiences and greater level of enjoyment of these experiences was linked to survival over a 12- to-16-year period in Cox proportional hazards models. The potential mediating roles of positive affect, depression, perceived stress, and an allostatic load index of physiological dysregulation in these associations were also examined. ResultsGreater frequency of positive experiences and greater enjoyment of positive experiences were both associated with a reduced hazard of mortality over the 12- to 16-year period. Models assessing a single mediator showed that both associations were mediated by decreased depression and decreased perceived stress, but not by positive affect or allostatic load. In supplementary multi-mediation models, depression was the only significant mediator of the frequency-survival and enjoyment-survival associations. ConclusionsPositive life experiences may confer long-term survival benefits, partially through lessening depressive symptomatology.

Cardiovascular variability, sociodemographics, and biomarkers of disease: the MIDUS study.

Introduction: Like heart rate, blood pressure (BP) is not steady but varies over intervals as long as months to as short as consecutive cardiac cycles. This blood pressure variability (BPV) consists of regularly occurring oscillations as well as less well-organized changes and typically is computed as the standard deviation of multiple clinic visit-to-visit (VVV-BP) measures or from 24-h ambulatory BP recordings (ABPV). BP also varies on a beat-to-beat basis, quantified by methods that parse variation into discrete bins, e.g., low frequency (0.04-0.15Hz, LF). However, beat-to-beat BPV requires continuous recordings that are not easily acquired. As a result, we know little about the relationship between LF-BPV and basic sociodemographic characteristics such as age, sex, and race and clinical conditions. Methods: We computed LF-BPV during an 11-min resting period in 2,118 participants in the Midlife in the US (MIDUS) study. Results: LF-BPV was negatively associated with age, greater in men than women, and unrelated to race or socioeconomic status. It was greater in participants with hypertension but unrelated to hyperlipidemia, hypertriglyceridemia, diabetes, elevated CRP, or obesity. LF-diastolic BPV (DBPV), but not-systolic BPV (SBPV), was negatively correlated with IL-6 and s-ICAM and positively correlated with urinary epinephrine and cortisol. Finally, LF-DBPV was negatively associated with mortality, an effect was rendered nonsignificant by adjustment by age but not other sociodemographic characteristics. Discussion: These findings, the first from a large, national sample, suggest that LF-BPV differs significantly from VVV-BP and ABPV. Confirming its relationship to sociodemographic risk factors and clinical outcomes requires further study with large and representative samples.

Comparing the influence of intellectual humility, religiosity, and political conservatism on vaccine attitudes in the United States, Canada, and the United Kingdom.

Three studies of US, Canada, and UK respondents examined pro-vaccine attitudes as predicted by intellectual humility, belief in science, religiosity, and political attitudes. Intellectual humility refers to the capacity to understand limits of one's own beliefs and showed strong relationship to pro-vaccine attitudes across samples. Pro-vaccine attitudes were correlated with intellectual humility and negatively correlated with political conservatism and religiosity. Regression models compared overlapping influences of belief predictors on vaccine attitudes. Across countries, intellectual humility was the most consistent predictor of pro-vaccine attitudes when controlling for other beliefs and thinking styles (political conservatism, belief in science, religiosity). In comparison, political conservatism was a significant predictor of vaccine attitudes in regression models on US and Canadian respondents, and religiosity only held as a predictor in regression models in the US sample. We conclude with a discussion of intellectual humility as a predictor of vaccine attitudes and implications for research and persuasion.

Excessive Altruism and Its Underlying Motivation: Effects on Likability in Japan and the US

The present study examined whether there is a difference in the liking for the actor depending on whether the motivation for excessive altruistic behavior is selfish or altruistic. Two experiments were conducted via a Web-based survey. Participants in the experiments responded with their liking toward an altruistic actor, assuming a situation in which the actor responded about his/her motivations. The results showed no effect of individual differences in caution (Study 1), but did show differences between Japan and the US (Study 2). In Japan, actions with altruistic motivations may be evaluated more favorably because selfish motivations were judged to be normatively unfavorable, whereas in the US, where people are tolerant of deviation from the norm, excessively altruistic behavior with selfish motivation may be evaluated as favorably as that with altruistic motivation.

Poverty among same-sex couple families in the United States: Is there a premium for married couples?

AbstractThis paper explores the monetary poverty of families headed by same-sex couples, a group understudied in the poverty literature. This research contributes to the literature by documenting how same-sex couples rank with respect to different-sex couples when (a) employing poverty indicators that allow us to move beyond the poverty incidence; (b) measuring not only absolute poverty, which is the usual approach in US studies, but also relative poverty; and (c) distinguishing between married and cohabiting same-sex couples to determine whether they have the same marriage premium as different-sex couples do. Using a reweighting procedure to account for differences in basic characteristics, we document that married/cohabiting male same-sex couples have conditional poverty levels similar to those of married different-sex couples with some indicators, although when using other indicators, they have more poverty. The disadvantage of married male same-sex couples with respect to married different-sex couples increases when moving beyond poverty incidence. Female same-sex couples have more conditional poverty than married different-sex couples regardless of the poverty measure and marital status of the couple. We also find that the marriage premium is unclear for families headed by same-sex couples. Married same-sex couples tend to have more poverty than their cohabiting peers when we move beyond the poverty incidence, with differences among these two groups in the very low tail of their income distributions. Far from the stereotype that married same-sex couples are well off, our results suggest the existence of higher extreme poverty among married female same-sex couples.

Fluidity in Gender Identity and Sexual Orientation Identity in Transgender and Nonbinary Youth

ABSTRACT Changes in sexual orientation identity (SOI) and gender identity (GI) have rarely been studied in transgender and/or nonbinary youth (TNBY), but documenting such changes is important for understanding identity development and gender transition and supporting the needs of TNBY. This study examined the frequency and patterning of changes in GI and SOI across 3 months (T1-T2) and 1.5 years (T1-T4) among 183 TNBY (baseline age 14–17 years; 83.6% White, 16.9% Hispanic/Latinx) who participated in a longitudinal US study. Participants completed online surveys including measures of GI and SOI. The most common gender identity selected at T1 (with or without another gender identity) was nonbinary (56.3%), and more than half (57.4%) of youth identified with a plurisexual identity (e.g., bisexual, pansexual). GI fluidity from T1-T2 was 13.2% and from T1-T4 was 28.9%. It was equally common to move toward a nonbinary gender identity as toward a binary gender identity. SOI fluidity was more common (30.6% from T1-T2; 55.8% from T1-T4) than GI fluidity. Shifts toward plurisexual identities were more common than shifts toward monosexual identities (e.g., straight, gay). Findings highlight the need to assess changes in GI and SOI in research and clinical practice to address the unique needs of TNBY accurately and effectively.

Circulating 27-hydroxycholesterol, lipids, and steroid hormones in breast cancer risk: a nested case–control study of the Multiethnic Cohort Study

BackgroundLaboratory studies have indicated that a cholesterol metabolite and selective estrogen receptor modulator, 27-hydroxycholesterol (27HC), may be important in breast cancer etiology and explain associations between obesity and postmenopausal breast cancer risk. Epidemiologic evidence for 27HC in breast cancer risk is limited, particularly in multiethnic populations.MethodsIn a nested case–control study of 1470 breast cancer cases and 1470 matched controls within the Multiethnic Cohort Study, we examined associations of pre-diagnostic circulating 27HC with breast cancer risk among African American, Japanese American, Native Hawaiian, Latino, and non-Latino White postmenopausal females. We used multivariable logistic regression adjusted for age, education, parity, body mass index, and smoking status. Stratified analyses were conducted across racial and ethnic groups, hormone receptor (HR) status, and use of lipid-lowering drugs. We assessed interactions of 27HC with steroid hormones.Results27HC levels were inversely related to breast cancer risk (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.58, 1.12), but the association was not statistically significant in the full model. Directions of associations differed by racial and ethnic group. Results suggested an inverse association with HR-negative breast cancer (OR 0.46; 95% CI 0.20, 1.06). 27HC interacted with testosterone, but not estrone, on risk of breast cancer; 27HC was only inversely associated with risk among those with the highest levels of testosterone (OR 0.46; 95% CI 0.24, 0.86).ConclusionThis is the first US study to examine circulating 27HC and breast cancer risk and reports a weak inverse association that varies across racial and ethnic groups and testosterone level.

Parallel incorporation and public law

Abstract Over the past fifty years, domestic regulators have turned to standards developed by private organizations as a means of complying with international law commitments to eliminate barriers to trade. What impact does this phenomenon of parallel incorporation, in which regulators in different countries incorporate the same private standards, have on domestic administrative law and public law? Through a case study of US and Australian regulators’ adoption of the same standards in aviation, the article exposes how parallel incorporation exacerbates existing accountability deficits of administration, contributes to the hollowing out of public capacity to review these incorporations, defies conventional understandings of delegation, and breaches basic understanding of rulemaking processes in both the United States and Australia. Using conventional administrative processes to implement solutions compelled by international commitments strains and transforms these processes. In this context, trade law imperatives result in accommodations from domestic public law not the reverse.

Patient perspectives on community pharmacy administered and dispensing of methadone treatment for opioid use disorder: a qualitative study in the U.S.

BackgroundPharmacy administration and dispensing of methadone treatment for opioid use disorder (PADMOUD) may address inadequate capability of opioid treatment programs (OTPs) in the US by expanding access to methadone at community pharmacies nationally. PADMOUD is vastly underutilized in the US. There is no published US study on OUD patients’ perspectives on PADMOUD. Data are timely and needed to inform the implementation of PADMOUD in the US to address its serious opioid overdose crisis.MethodsPatient participants of the first completed US trial on PADMOUD through electronic prescribing for methadone (parent study) were interviewed to explore implementation-related factors for PADMOUD. All 20 participants of the parent study were invited to participate in this interview study. Each interview was recorded and transcribed verbatim. Thematic analysis was conducted to identify emergent themes.ResultsSeventeen participants completed the interview. Patients’ perspectives on PADMOUD were grouped into five areas. Participants reported feasibility of taking the tablet formulation of methadone at the pharmacy and identified benefits from PADMOUD (e.g., better access, efficiency, convenience) compared with usual care at the OTP. Participants perceived support for PADMOUD from their family/friends, OTP staff, and pharmacy staff. PADMOUD was perceived to be a great option for stable patients with take-home doses and those with transportation barriers. The distance (convenience), office hours, and the cost were considered factors most influencing their decision to receive methadone from a pharmacy. Nonjudgmental communication, pharmacists’ training on methadone treatment, selection of patients (stable status), workflow of PADMOUD, and protection of privacy were considered key factors for improving operations of PADMOUD.ConclusionThis study presents the first findings on patient perspectives on PADMOUD. Participants considered pharmacies more accessible than OTPs, which could encourage more people to receive methadone treatment earlier and help transition stable patients from an OTP into a local pharmacy. The findings have timely implications for informing implementation strategies of PADMOUD that consider patients’ views and needs.

Effects of chronic workplace harassment on mental health and alcohol misuse: a long-term follow-up

BackgroundResearch on the impacts of exposure to workplace harassment (WH) is largely cross-sectional, and existing prospective studies generally are between two and five years of follow-up, with the longest US study being 10 years. However, the effects of exposure to WH may persist longer, particularly if exposure has been chronic. This study fills this gap by examining effects of prior exposure to chronic sexual and generalized WH on psychological distress and alcohol misuse over an approximately 25 year study period.MethodsIndividuals originally recruited from a university-employed sample in the United States were surveyed at 8 time points from 1996–2007 and again in 2020–2021. A series of hybrid path analyses were tested on a sample of 2352 individuals, regressing recent outcomes on latent classes of harassment derived from earlier survey waves, controlling baseline outcomes and demographics. Model fit was assessed using a variety of fit statistics, and standardized regression coefficients were used to assess significance of individual pathways.ResultsPrior exposure to chronic sexual harassment had significant direct associations with psychological distress, alcohol misuse, and recent stressors at follow-up. Prior exposure to chronic generalized harassment had significant direct associations with lower income and alcohol misuse. Both forms of WH were significantly indirectly associated with psychological distress through recent stressors at follow-up.ConclusionsExposure to chronic WH is associated with long-term effects on psychological distress and alcohol misuse in a sample representing a wide variety of job types and racial/ethnic identities. Enforcement of anti-sexual harassment law and policies and enactment of policies and laws to prevent generalized harassment/workplace bullying are imperative for the protection of worker health.

Risk Factors for SARS-CoV-2 Infection and Severe Outcomes Among People With Human Immunodeficiency Virus: Cohort Study.

Studies on COVID-19 in people with HIV (PWH) have had limitations. Further investigations on risk factors and outcomes of SARS-CoV-2 infection among PWH are needed. This retrospective cohort study leveraged the national OPTUM COVID-19 data set to investigate factors associated with SARS-CoV-2 positivity among PWH and risk factors for severe outcomes, including hospitalization, intensive care unit stays, and death. A subset analysis was conducted to examine HIV-specific variables. Multiple variable logistic regression was used to adjust for covariates. Of 43 173 PWH included in this study, 6472 had a positive SARS-CoV-2 result based on a polymerase chain reaction test or antigen test. For PWH with SARS-CoV-2 positivity, higher odds were found for those who were younger (18-49 years), Hispanic White, African American, from the US South, uninsured, and a noncurrent smoker and had a higher body mass index and higher Charlson Comorbidity Index. For PWH with severe outcomes, higher odds were identified for those who were SARS-CoV-2 positive, older, from the US South, receiving Medicaid/Medicare or uninsured, a current smoker, and underweight and had a higher Charlson Comorbidity Index. In a subset analysis including PWH with HIV care variables (n = 5098), those with unsuppressed HIV viral load, a low CD4 count, and no antiretroviral therapy had higher odds of severe outcomes. This large US study found significant ethnic, racial, and geographic differences in SARS-CoV-2 infection among PWH. Chronic comorbidities, older age, lower body mass index, and smoking were associated with severe outcomes among PWH during the COVID-19 pandemic. SARS-CoV-2 infection was associated with severe outcomes, but once we adjusted for HIV care variables, SARS-CoV-2 was no longer significant; however, low CD4 count, high viral load, and lack of antiretroviral therapy had higher odds of severe outcomes.

Learning important common data elements from shared study data: The All of Us program analysis.

There are many initiatives attempting to harmonize data collection across human clinical studies using common data elements (CDEs). The increased use of CDEs in large prior studies can guide researchers planning new studies. For that purpose, we analyzed the All of Us (AoU) program, an ongoing US study intending to enroll one million participants and serve as a platform for numerous observational analyses. AoU adopted the OMOP Common Data Model to standardize both research (Case Report Form [CRF]) and real-world (imported from Electronic Health Records [EHRs]) data. AoU standardized specific data elements and values by including CDEs from terminologies such as LOINC and SNOMED CT. For this study, we defined all elements from established terminologies as CDEs and all custom concepts created in the Participant Provided Information (PPI) terminology as unique data elements (UDEs). We found 1 033 research elements, 4 592 element-value combinations and 932 distinct values. Most elements were UDEs (869, 84.1%), while most CDEs were from LOINC (103 elements, 10.0%) or SNOMED CT (60, 5.8%). Of the LOINC CDEs, 87 (53.1% of 164 CDEs) originated from previous data collection initiatives, such as PhenX (17 CDEs) and PROMIS (15 CDEs). On a CRF level, The Basics (12 of 21 elements, 57.1%) and Lifestyle (10 of 14, 71.4%) were the only CRFs with multiple CDEs. On a value level, 61.7% of distinct values are from an established terminology. AoU demonstrates the use of the OMOP model for integrating research and routine healthcare data (64 elements in both contexts), which allows for monitoring lifestyle and health changes outside the research setting. The increased inclusion of CDEs in large studies (like AoU) is important in facilitating the use of existing tools and improving the ease of understanding and analyzing the data collected, which is more challenging when using study specific formats.

A comprehensive literature review of the impact of child tax credit/child allowance in the United States and South Korea

PurposeThe America Rescue Plan (ARP) transformed the Child Tax Credit (CTC) into a more generous, inclusive monthly payment from July through December 2021. However, the expansion has been terminated and the annual CTC has been reinstated. The United States is one of the few OECD countries that do not have a child allowance system and South Korea has recently adopted child allowance in 2018. This study aims to comprehensively review the existing literature and evidence on ARP-CTC in the United States and Universal Child Allowance (CA) in Korea.Design/methodology/approachThe researchers completed a database search between July 1, 2022 and July 20, 2022. For the United States, the search keywords were child tax credit OR expanded child tax credit OR CTC OR child allowance. For Korea, the search keyword was child allowance. Searches were conducted using 79 databases. A total of 36 US studies and 7 Korean studies met all the inclusion criteria and proceeded to the extraction process. A narrative thematic synthesis approach was employed to identify themes in the findings. The results were organized based on the characteristics of the studies and the post-intervention outcomes.FindingsStudies in the United States focused primarily on economic outcomes, including poverty and material hardship, reflecting the concern policymakers and researchers have about child poverty. On the other hand, Korean studies examined employment, economic well-being, psychological well-being and expenditures in a relatively balanced share. Overall, studies found that both ARP-Child Tax Credits and Universal Child Allowance reduced child poverty and improved material hardship. Also, studies in both countries suggested that both policies had positive impacts on parental psychological well-being.Originality/valueTo the authors knowledge, this paper is the first to comprehensively review the impact of the US ARP-CTC in comparison with the Korean child allowance. Two studies reviewed and updated the literature on US ARP-CTC as a round-up paper. Moreover, the authors conduct cross-national comparative analyses between the United States and Korea. The contexts of the child allowance system in the two nations have both similarities and differences, thereby offering a unique opportunity for a comparative study.

DS19 Characterizing ergonomics in dermatology surgical practice: results of an online questionnaire distributed by the British Society for Dermatological Surgery

Abstract Ergonomics is the study of the interaction between humans and their working environment. By evaluating workplace ergonomics, we can reduce the potential for injury and ill health and improve performance and productivity. Poor postures can contribute to surgical fatigue and introduce errors due to impaired psychomotor performance. Furthermore, it reduces physician wellbeing and career longevity. A US study in 2010 reported that > 90% of Mohs surgeons suffered from musculoskeletal injury at work. No study of ergonomics in dermatological surgery has been undertaken outside of the USA. We aimed to characterize the incidence of musculoskeletal injuries and ergonomic practices among dermatological surgeons in the UK and Ireland. An online questionnaire consisting of 17 questions was circulated via the British Society for Dermatological Surgery in January 2023. There were 74 responders from the UK and Ireland. Forty per cent were consultant dermatologists and Mohs surgeons, 27% were consultant dermatologists, 15% were registrars, 7% were Mohs fellows, and 11% were of other groups. The mode age range was 45–49 years (23%) followed closely by 40–44 years (22%). Forty-seven per cent were female and 51% were male. The mode number of hours operating per week was ∼4–8 h (28%; range from ∼4 h or less to ∼40 h or more). Seventy-six per cent operated standing, while 22% shifted between sitting and standing. Regarding pain directly related to undertaking surgery, 34% experienced neck pain ‘sometimes’, with 16% reporting pain ‘often’ and ‘always’. Forty-three per cent experienced lower back pain ‘sometimes’, with 11% reporting lower back pain ‘often’ and 22% reporting back pain ‘never’. Thirty-eight per cent reported stiffness related to undertaking surgery ‘often’ or ‘sometimes’, while 43% reported ‘never’ experiencing stiffness. Nineteen per cent wore loupes while operating, with 71% of this group reporting that loupes made their posture ‘much better or better’. Most respondents began to have symptoms after 5 years of operating. Over a third of respondents had physiotherapy for their pain. Forty-nine per cent of respondents felt more pain on days they operated. Seventy-eight per cent of respondents had no formal education on ergonomics at their institution. These results highlight that chronic pain is prevalent among dermatological surgeons in the UK and Ireland. Modification of footwear, table height, operating position, lighting and surgical instruments may all improve ergonomics. Surgeons should also be mindful of their posture, hold instruments lightly, take microbreaks, stretch during their surgical day and aim to maintain fitness outside of work. Ergonomics training should be incorporated formally into educational meeting updates, and consideration of formal guidelines from associated physician bodies should be prioritized in order to protect the health and wellbeing of dermatological surgeons and prevent musculoskeletal injury, early burnout and retirement.

System for Observing Play and Leisure Activity in Youth: A Systematic Review of US and Canadian Studies.

The System of Observing Play and Leisure Activity in Youth (SOPLAY) has assisted in providing valid and reliable data of youth physical activity and characteristics specific to environmental contexts. The review aimed to examine empirical research that employed the SOPLAY instrument to measure physical activity in leisure-based activity environments in North American countries. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A systematic search was conducted with an exhaustive process using 10 electronic databases to locate peer-reviewed studies implementing SOPLAY that were published between 2000 and 2021. A total of 60 studies were included in the review. Most studies (n = 35) reported physical activity findings related to contextual characteristics measured using SOPLAY. Interestingly, a few of the studies (n = 8) found the provision of equipment and supervision, particularly adult supervision, significantly increased child physical activity observed. This review provides information relative to the group-level physical activity observed across multiple contexts (ie, playgrounds, parks, recreation centers) using a validated direct observation instrument.

Traumatic Brain Injury and Long-Term Risk of Stroke Among US Military Veterans.

Traumatic brain injury (TBI) is associated with significant morbidity, but the association of TBI with long-term stroke risk in diverse populations remains less clear. Our objective was to examine the long-term associations of TBI with stroke and to investigate potential differences by age, sex, race and ethnicity, and time since TBI diagnosis. Retrospective cohort study of US military veterans aged 18+ years receiving healthcare in the Veterans Health Administration system between October 1, 2002 and September 30, 2019. Veterans with TBI were matched 1:1 to veterans without TBI on age, sex, race and ethnicity, and index date, yielding 306 796 veterans with TBI and 306 796 veterans without TBI included in the study. In primary analyses, Fine-Gray proportional hazards models adjusted for sociodemographics and medical/psychiatric comorbidities were used to estimate the association between TBI and stroke risk, accounting for the competing risk of mortality. Participants were a mean age of 50 years, 9% were female, and 25% were of non-White race and ethnicity. Overall, 4.7% of veterans developed a stroke over a median follow-up of 5.2 years. Veterans with TBI had 1.69 times (95% CI, 1.64-1.73) increased risk of any stroke (ischemic or hemorrhagic) compared to veterans without TBI. This increased risk was highest in the first-year post-TBI diagnosis (hazard ratio [HR], 2.16 [95% CI, 2.03-2.29]) but remained elevated for 10+ years. Similar patterns were observed for secondary outcomes, with associations of TBI with hemorrhagic stroke (HR, 3.92 [95% CI, 3.59-4.29]) being stronger than with ischemic stroke (HR, 1.56 [95% CI, 1.52-1.61]). Veterans with both mild (HR, 1.47 [95% CI, 1.43-1.52]) and moderate/severe/penetrating injury (HR, 2.02 [95% CI, 1.96-2.09]) had increased risk of stroke compared to veterans without TBI. Associations of TBI with stroke were stronger among older compared to younger individuals (P interaction-by-age<0.001) and were weaker among Black veterans compared to other race and ethnicities (P interaction-by-race<0.001). Veterans with prior TBI are at increased long-term risk for stroke, suggesting they may be an important population to target for primary stroke prevention measures.

Prenatal Ultrasound Findings of Circumvallate Placenta and Pregnancy Outcomes.

Circumvallate placenta has a suggested association with adverse pregnancy outcomes (antenatal bleeding, placental abruption, preterm birth, emergency cesarean, small for gestational age infants, and stillbirth). The aim was to determine if prenatal diagnosis of circumvallate placenta is associated with these adverse pregnancy outcomes. Pregnancies with a singleton gestation prenatally diagnosed with circumvallate placenta between January 1, 2012 and March 31, 2021 were identified. Adverse pregnancy outcomes were obtained. Rates of adverse pregnancy outcomes were compared among those with prenatally diagnosed circumvallate placentas to those without this prenatal diagnosis with a 4:1 control matched group. Pregnancies with known fetal anomalies or other placental abnormalities were excluded. Statistical analyses included Student's t-test and Χ 2 with p < 0.05 considered significant. Prenatal ultrasound findings of circumvallate placenta were seen in 179 pregnant people (0.20% of all anatomic US studies and 0.17% of all deliveries). Diagnosis was made at a mean gestational age of 19.8 ± 2.4 weeks. Adverse pregnancy outcomes were similar between groups. Prenatal ultrasound findings of circumvallate placenta do not correlate with adverse pregnancy outcomes. Given overall good prognosis, prenatal diagnosis of circumvallate placenta may not warrant additional surveillance during pregnancy. · The risk of prenatally diagnosed circumvallate placenta was previously unclear.. · Prenatally diagnosed circumvallate placenta is not associated with adverse pregnancy outcomes.. · No change in management may be necessary with prenatally diagnosed circumvallate placenta..

The sound of misogyny: sexual harassment and sexual violence in the music industry

The cultural and creative industries are the fastest growing industries in the UK (Webster et al, 2018). Stakeholder engagement, media reporting, anecdotal evidence and emerging research suggests that there are endemic levels of sexual harassment and sexualised violence within the music industry that can be described as widespread, systemic and normalised. This article reviews the literature on sexual harassment and sexualised violence in the music industry, examining gender stratifications and inequalities within the music industry with a focus on UK, Australian and US studies. The music industry is not a singular entity but instead, is an agglomeration of many different sub-sectors predominantly consisting of three interconnected spheres of music recording and distribution, music publishing and licensing, and live performance. This paper references Kelly’s (1988; 2007; 2016) theorisations on conducive contexts and the continuum of violence to argue that historical and entrenched misogyny and sexism along with the lack of regulation, process and governing frameworks create conditions for both the maintenance of gender inequality and the perpetuation of sexual harassment and sexualised violence within the music industry. Consequently, both the cultural context and the practice of misogyny (in this case sexual harassment and sexualised violence) within the music industry are mutually supporting and reinforcing.

The FOR US (Fostering Opportunities in Research Using Marketing Strategies) study.

e18577 Background: Black patients are less likely to be enrolled in clinical trials compared with White patients, resulting in reduced access to breakthrough treatments and limited understanding of treatment effect in diverse populations. Ineffective dissemination of cancer research, education, and interventions among the public contributes to cancer inequities. Dissemination rarely involves engagement with non-research audiences and end-users. Efforts to promote equity in clinical trial participation may benefit from business marketing strategies traditionally applied in the business sector. Our team is conducting community-engaged research using focus groups with Black community members and family members of cancer survivors, facilitated by a professional marketing agency to create a culturally responsive public service announcement (PSA) video to increase awareness of clinical trials among Black audiences. Methods: We will conduct 6 focus groups over two phases with: 1) social support networks of Black cancer survivors (n = 20, 2 focus groups) and 2) Black community members (n = 40, 4 focus groups) to inform the content and design of a 60 second PSA to be disseminated through media and public health outlets. Phase 1 focus groups will inform content for the PSA. Data will be triangulated with qualitative data from Black patients diagnosed with breast cancer, oncologists, clinical trial staff, and community advocates from a concurrent study. Phase 2 focus groups will garner feedback on video script and style prior to development. Content and thematic analysis approaches will identify themes and PSA recommendations. Results: Phase 1 focus groups (n = 3) are completed. We used maximum variation sampling techniques to recruit Black participants (n = 30) varied in age, geographic location, education, and gender. Themes identified include: 1) mistrust about clinical trials due to past and current experiences of racism persists but diminishes with younger respondents or those with clinical trials; 2) clinical trial trust-building was associated with transparency from medical experts, information from someone in the Black community, and stories from clinical trial participants; 3) invasive procedures (i.e., ingesting or injecting a treatment) are a big factor in weighing the costs and benefits of clinical trial participation; 4) messages that are not coercive, yet support decision-making are more credible; and 5) sharing the PSA on social media with links to primary resources was a favorable dissemination strategy. Next steps are to develop and focus group test creative content and then PSA video production. Conclusions: Applying marketing communication strategies to expand awareness about clinical trial participation among general Black audiences may directly and indirectly facilitate clinical trial participation decision-making processes among Black patients diagnosed with cancer and their support systems.