Fathers' contributions to attachment in adolescence and adulthood: the moderating role of race, gender, income, and residential status.

Fathers play a critical yet underappreciated role in adolescent development. To examine contributions of fathers' parenting to attachment in adolescence and adulthood, this longitudinal study followed 184 adolescents from ages 13-24. At age 13, adolescents reported on their fathers' parenting behavior and were observed in a father-teen conflict task; at ages 14 and 24, they completed the Adult Attachment Interview. Adolescents who lived with their father showed higher attachment security at age 14 (Cohen's d = .72), compared to those with non-residential fathers. Fathers' positive relatedness and support for teens' psychological autonomy predicted attachment security at age 14. Fathers' physical aggression predicted attachment insecurity in adolescence, whereas fathers' verbal aggression predicted insecurity in adulthood, illuminating developmental shifts. Pathways to security were moderated by father residential status, adolescent gender, and race. Findings underscore the importance of fathers' presence, autonomy support, and non-aggression in predicting adolescents' state of mind in close relationships.

Gartland classification concordance of supracondylar fractures among pediatric emergency medicine physicians, radiologists, and orthopedic surgeons.

BACKGROUND: The modified Gartland classification is the most widely accepted grading method of supracondylar humeral fractures among orthopedic surgeons and is relevant to identifying fractures that may require surgery. OBJECTIVE: To assess the interobserver reliability of the modified Gartland classification among pediatric radiologists, pediatric orthopedic surgeons, and pediatric emergency medicine physicians. MATERIALS AND METHODS: Elbow radiographs for 100 children with supracondylar humeral fractures were retrospectively independently graded by two pediatric radiologists, two pediatric orthopedic surgeons, and two pediatric emergency medicine physicians using the modified Gartland classification. A third grader of the same subspecialty served as a tie-breaker as needed to reach consensus. Readers were blinded to one another and to the medical record. The modified Gartland grade documented in the medical record by the treating orthopedic provider was used as the reference standard. Interobserver agreement was assessed using kappa statistics. RESULTS: There was substantial interobserver agreement (kappa = 0.77 [95% CI, 0.69-0.85]) on consensus fracture grade between the three subspecialties. Similarly, when discriminating between Gartland type I and higher fracture grades, there was substantial interobserver agreement between specialties (kappa = 0.77 [95% CI, 0.66-0.89]). The grade assigned by pediatric radiologists differed from the reference standard on 15 occasions, pediatric emergency medicine differed on 19 occasions, and pediatric orthopedics differed on 9 occasions. CONCLUSION: The modified Gartland classification for supracondylar humeral fractures is reproducible among pediatric emergency medicine physicians, radiologists, and orthopedic surgeons.

Rethinking peer influence and risk taking: A strengths-based approach to adolescence in a new era.

The ways that psychopathology manifests in adolescence have shifted dramatically over the past twenty-five years, with rates of many externalizing behaviors declining substantially while rates of anxiety and depressive disorders have skyrocketed. This paper argues that understanding these changes requires rethinking the field's historically somewhat negative views of intense peer connections, peer influences, and adolescent risk-taking behavior. It is argued that intense peer connections are critical to development, and that peer influence and risk taking have important, often overlooked, adaptive components. The shift in observed manifestations of adolescent psychopathology over this period can be viewed at least partly in terms of a shift away from strong peer connections and toward greater risk aversion. Implications for research and intervention based on a focus on the adaptive aspects of peer influences and risk taking are discussed.

Empathy across three generations: From maternal and peer support in adolescence to adult parenting and child outcomes.

This study examined the development of empathic care across three generations in a sample of 184 adolescents in the United States (99 female, 85 male; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other groups), followed from their family of origin at age 13 into their parenting years (through their mid-30s). Mothers' empathic support toward adolescents at age 13 predicted teens' empathy for close friends across adolescence (13-19 years). Participants' empathic support for friends in late adolescence predicted more supportive parenting behavior in adulthood, which in turn was associated with their children's empathy at age 3-8 years. Results suggest that individuals "pay forward" the empathic care they receive from parents, and that skills developed in adolescent friendships may inform later parenting.

An updated analysis of safety climate and downstream outcomes in two convenience samples of U.S. fire departments (FOCUS 1.0 and 2.0 survey waves).

BACKGROUND: The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service. METHODS: This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling (n1.0 = 275; n2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments (n1.0 = 22,719; n2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer). RESULTS: Our analysis indicated that a majority of respondents were males (90.7%FOCUS 1.0; 90.4%FOCUS 2.0), non-officers (68.4%FOCUS 1.0; 66.4%FOCUS 2.0), and non-Hispanic Whites (70.8%FOCUS 1.0; 69.5%FOCUS 2.0). For both samples there was a higher prevalence of injuries among individuals in career departments (nFOCUS 1.0 = 3778 [17.5%]; nFOCUS 2.0 = 3072 [18.7%]) than volunteer departments (nFOCUS 1.0 = 103 [8.8%]; nFOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR1.0 overall: 0.98, 95% CI 0.97-0.99; OR2.0 volunteer: 0.90, 95% CI 0.85-0.95) and Supervisor Support for Safety (OR1.0 overall: 0.95, 95% CI 0.93-0.97; OR1.0 career: 0.95, 95% CI 0.92-0.98). CONCLUSIONS: From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety.

Adolescent responses to paternal verbal aggression: Assessing spillover and compensatory processes using random intercept cross-lagged panel models.

INTRODUCTION: Prior research suggests several pathways through which verbal aggression manifests across adolescent relationship contexts, including spillover (continuity of aggression across different relationships) and compensation (offsetting an aggressive relationship with less aggression in other relationships). These pathways vary across timescales in ways that between-person analytic approaches are unlikely to adequately capture. The current study used random intercept cross-lagged panel modeling (RI-CLPM) to examine adolescents' spillover and compensatory responses to paternal verbal aggression. METHODS: Participants were 184 adolescents (53.2% female) from a United States community sample participating in a longitudinal study. Annually from ages 13-17, participants reported on their experiences of verbal aggression in their paternal and maternal relationships and participated in observed interactions with a close peer that were coded for aggressive behavior. RESULTS: Spillover was observed from father-adolescent to mother-adolescent and adolescent-peer contexts in analyses at the between-person level, likely capturing long-term, cumulative effects of paternal aggression. Conversely, compensation was observed in analyses at the within-person level, likely capturing medium-term (i.e., year-to-year) adaptations to paternal aggression: Adolescents who experienced more aggression from their father than expected at a specific time point were less likely to both perpetrate and experience aggression in maternal and peer relationships the following year. Several findings differed across teen gender, with compensation more likely to occur in males than females. CONCLUSIONS: These findings highlight the multiple pathways by which father-adolescent aggression may be linked to behavior in other relationships in the medium- and long-term. They also support the value of RI-CLPM in decomposing these effects.

Adolescent social learning within supportive friendships: Self-disclosure and relationship quality from adolescence to adulthood.

This study examines links between self-disclosure and relationship quality with close friends from adolescence to adulthood. A diverse community sample of adolescents (N = 184) participated in survey and observational measures annually from ages 13 through 29, along with their close friends and romantic partners. Random intercept cross-lagged panel modeling (RICLPM) was used to parse markers of within-individual change from age 13 to 18. Long-term longitudinal path models also investigated cascading associations among self-disclosure and relationship quality, on aggregate, from adolescence to adulthood. Adolescents who reported a higher-quality friendship in a given year demonstrated greater-than-expected increases in self-disclosure the following year, and an adolescent demonstrated high self-disclosure one year reported greater-than-expected increases in friendship quality the following year. Higher mean self-disclosure in adolescence predicted higher mean self-disclosure in adulthood. Results are interpreted as identifying high-quality adolescent friendships as key contexts for developing intimacy-building capacities (i.e. self-disclosure), which sets the stage for satisfying close relationships in adulthood.

Mandating indoor air quality for public buildings.

If some countries lead by example, standards may increasingly become normalized.

Pathways from adolescent close friendship struggles to adult negative affectivity.

This 19-year prospective study applied a social development lens to the challenge of identifying long-term predictors of adult negative affectivity. A diverse community sample of 169 individuals was repeatedly assessed from age 13 to age 32 using self-, parent-, and peer-reports. As hypothesized, lack of competence establishing and maintaining close friendships in adolescence had a substantial long-term predictive relation to negative affectivity at ages 27-32, even after accounting for prior depressive, anxious, and externalizing symptoms. Predictions also remained robust after accounting for concurrent levels of depressive symptoms, indicating that findings were not simply an artifact of previously established links between relationship quality and depressive symptoms. Predictions also emerged from poor peer relationships within young adulthood to future relative increases in negative affectivity by ages 27-32. Implications for early identification of risk as well as for potential preventive interventions are discussed.

Unique roles of adolescents' friends and fathers in predicting verbal aggression in future adult romantic relationships.

This 20-year prospective study examined verbal aggression and intense conflict within the family of origin and between adolescents and their close friends as predictors of future verbal aggression in adult romantic relationships. A diverse community sample of 154 individuals was assessed repeatedly from age 13 to 34 years using self-, parent, peer, and romantic partner reports. As hypothesized, verbal aggression in adult romantic relationships was best predicted by both paternal verbal aggression toward mothers and by intense conflict within adolescent close friendships, with each factor contributing unique variance to explaining adult romantic verbal aggression. These factors also interacted, such that paternal verbal aggression was predictive of future romantic verbal aggression only in the context of co-occurring intense conflict between an adolescent and their closest friend. Predictions remained robust even after accounting for levels of parental abusive behavior toward the adolescent, levels of physical violence between parents, and the overall quality of the adolescent's close friendship. Results indicate the critical importance of exposure to aggression and conflict within key horizontal relationships in adolescence. Implications for early identification of risk as well as for potential preventive interventions are discussed.

Debriefing Methods for Simulation in Healthcare: A Systematic Review.

ABSTRACT: Debriefing is a critical component in most simulation experiences. With the growing number of debriefing concepts, approaches, and tools, we need to understand how to debrief most effectively because there is little empiric evidence to guide us in their use. This systematic review explores the current literature on debriefing in healthcare simulation education to understand the evidence behind practice and clarify gaps in the literature. The PICO question for this review was defined as "In healthcare providers [P], does the use of one debriefing or feedback intervention [I], compared to a different debriefing or feedback intervention [C], improve educational and clinical outcomes [O] in simulation-based education?" We included 70 studies in our final review and found that our current debriefing strategies, frameworks, and techniques are not based on robust empirical evidence. Based on this, we highlight future research needs.

Social Media Posts from Friends during Late Adolescence as Predictors of Young Adult Physical Health.

Although an increasing body of literature has linked social experiences to physical health, research has yet to consider how specific aspects of social experiences taking place on social media during late adolescence may predict future physical health outcomes. This study thus examined qualities of social media posts received from peers at age 21 as predictors of participants' physical health (e.g., Interleukin-6 (inflammation), sleep problems, problems with physical functioning, and BMI) at age 28. Participants included 138 youth (59 men and 79 women); 57% of participants identified as White, 30% as Black/African American, and 13% as from other or mixed racial/ethnic groups. Posts from friends and participants at age 21 characterized by social ties predicted lower levels of future physical health problems, whereas socially inappropriate "faux pas" posts that deviated from peer norms by friends predicted higher levels of physical health problems at age 28. These associations were found after accounting for factors typically associated with physical health outcomes, including participants' baseline social competence, internalizing and externalizing symptoms, alcohol use, observed physical attractiveness, and history of prior hospitalizations. The results of this study suggest the importance of both achieving social integration with peers online and adhering to peer norms in the online domain as key predictors of future physical health.

Immune response, phenotyping and molecular graft surveillance in kidney transplant recipients following severe acute respiratory syndrome coronavirus 2 vaccination.

BACKGROUND: Understanding immunogenicity and alloimmune risk following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in kidney transplant recipients is imperative to understanding the correlates of protection and to inform clinical guidelines. METHODS: We studied 50 kidney transplant recipients following SARS-CoV-2 vaccination and quantified their anti-spike protein antibody, donor-derived cell-free DNA (dd-cfDNA), gene expression profiling (GEP), and alloantibody formation. RESULTS: Participants were stratified using nucleocapsid testing as either SARS-CoV-2-naïve or experienced prior to vaccination. One of 34 (3%) SARS-CoV-2 naïve participants developed anti-spike protein antibodies. In contrast, the odds ratio for the association of a prior history of SARS-CoV-2 infection with vaccine response was 18.3 (95% confidence interval 3.2, 105.0, p < 0.01). Pre- and post-vaccination levels did not change for median dd-cfDNA (0.23% vs. 0.21% respectively, p = 0.13), GEP scores (9.85 vs. 10.4 respectively, p = 0.45), calculated panel reactive antibody, de-novo donor specific antibody status, or estimated glomerular filtration rate. CONCLUSIONS: SARS-CoV-2 vaccines do not appear to trigger alloimmunity in kidney transplant recipients. The degree of vaccine immunogenicity was associated most strongly with a prior history of SARS-CoV-2 infection.

Nurses' Experience Implementing an Automated Video Monitoring System to Decrease the Risk of Patient Falls during a Global Pandemic.

Healthcare is a complex sociotechnical system where information systems (IS) and information technology (IT) intersect to solve problems experienced by patients and providers alike. One example of IS/IT in hospitals is the Ocuvera automated video monitoring system (AVMS), which has been implemented in more than 30 hospitals. The purpose of this study was to evaluate nurses' attitudes toward AVMS implementation over time as they received the training program developed for this intervention. Consistent with the job demands-resources (JDR) model, we found that perceptions of AVMS usefulness increased over time and were positively associated with perceptions of social influence and behavioral control. These results were consistent with our finding that there was a significant decrease in the risk of unassisted falls from the bed from baseline to intervention. Leaders in hospital systems and healthcare organizations may want to consider implementing an AVMS as researchers continue to test, verify, and demonstrate the effectiveness of these interventions for improving patient well-being.

Social Regulation of the Neural Threat Response Predicts Subsequent Markers of Physical Health.

OBJECTIVE: Social support has been linked to a vast range of beneficial health outcomes. However, the physiological mechanisms of social support are not well characterized. Drawing on functional magnetic resonance imaging and health-related outcome data, this study aimed to understand how neural measures of "yielding"-the reduction of brain activity during social support-moderate the link between social support and health. METHODS: We used a data set where 78 participants around the age of 24 years were exposed to the threat of shock when holding the hand of a partner. At ages 28 to 30 years, participants returned for a health visit where inflammatory activity and heart rate variability were recorded. RESULTS: Findings showed a significant interaction between dorsal anterior cingulate cortex-related yielding and perceived social support on C-reactive protein levels ( ß = -0.95, SE = 0.42, z = -2.24, p = .025, 95% confidence interval = -1.77 to -0.12). We also found a significant interaction between hypothalamus-related yielding and perceived social support on baseline heart rate variability ( ß = 0.51, SE = 0.23, z = 2.19, p = .028, 95% confidence interval = 0.05 to 0.97). CONCLUSIONS: Greater perceived social support was associated with lower C-reactive protein levels and greater baseline heart rate variability among individuals who were more likely to yield to social support in the dorsal anterior cingulate cortex and hypothalamus years earlier. The current study highlights the construct of yielding in the link between social support and physical health.

Impact of presenting stroke severity and thrombolysis on outcomes following urgent carotid interventions.

BACKGROUND: Carotid interventions are increasingly performed in select patients following acute stroke. We aimed to determine the effects of presenting stroke severity (National Institutes of Health Stroke Scale [NIHSS]) and use of systemic thrombolysis (tissue plasminogen activator [tPA]) on discharge neurological outcomes (modified Rankin scale [mRS]) after urgent carotid endarterectomy (uCEA) and urgent carotid artery stenting (uCAS). METHODS: Patients undergoing uCEA/uCAS at a tertiary Comprehensive Stroke Center (January 2015 to May 2022) were divided into two cohorts: (1) no thrombolysis (uCEA/uCAS only) and (2) use of thrombolysis before the carotid intervention (tPA + uCEA/uCAS). Outcomes were discharge mRS and 30-day complications. Regression models were used to determine an association between tPA use and presenting stroke severity (NIHSS) and discharge neurological outcomes (mRS). RESULTS: Two hundred thirty-eight patients underwent uCEA/uCAS (uCEA/uCAS only, n = 186; tPA + uCEA/uCAS, n = 52) over 7 years. In the thrombolysis cohort compared with the uCEA/uCAS only cohort, the mean presenting stroke severity was higher (NIHSS = 7.6 vs 3.8; P = .001), and more patients presented with moderate to severe strokes (57.7% vs 30.2% with NIHSS >4). The 30-day stroke, death, and myocardial infarction rates in the uCEA/uCAS only vs tPA + uCEA/uCAS were 8.1% vs 11.5% (P = .416), 0% vs 9.6% (P < .001), and 0.5% vs 1.9% (P = .39), respectively. The 30-day stroke/hemorrhagic conversion and myocardial infarction rates did not differ with tPA use; however, the difference in deaths was significantly higher in the tPA + uCEA/uCAS cohort (P < .001). There was no difference in neurological functional outcome with or without thrombolysis use (mean mRS, 2.1 vs 1.7; P = .061). For both minor strokes (NIHSS ≤4 vs NIHSS >4: relative risk, 1.58 vs 1.58, tPA vs no tPA, respectively, P = .997) and moderate strokes (NIHSS ≤10 vs NIHSS >10: relative risk, 1.94 vs 2.08, tPA vs no tPA, respectively; P = .891), the likelihood of discharge functional independence (mRS score of ≤2) was not influenced by tPA. CONCLUSIONS: Patients with a higher presenting stroke severity (NIHSS) had worse neurological functional outcomes (mRS). Patients presenting with minor and moderate strokes were more likely to have discharge neurological functional independence (mRS of ≤2), regardless of whether they received tPA or not. Overall, presenting NIHSS is predictive of discharge neurological functional autonomy and is not influenced by the use of thrombolysis.

Adolescent caregiving success as a predictor of social functioning from ages 13 to 33.

Adolescent success providing satisfying support in response to a close friend's call in a caregiving task was examined as a potentially fundamental developmental competence likely to predict future social functioning, adult caregiving security, and physical health. Adolescents (86 males, 98 females; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other) were followed from ages 13 to 33 (1998-2021) using multiple methods and reporters. Early caregiving success was found to predict greater self- and partner-reported caregiving security, lower negativity in adult relationships, and higher adult vagal tone. Results are interpreted as advancing our understanding beyond simply recognizing that adolescent friendships have long-term import, to now identifying specific capacities within friendships that are linked to longer-term outcomes.

"If you have light, your heart will be at peace": A qualitative study of household lighting and social integration in southwestern Uganda.

Background: Expanding electrification and access to other clean and affordable energy, such as solar energy, is a critical component of the Sustainable Development Goals, particularly in sub-Saharan Africa where 70% of people are energy insecure. Intervention trials related to access or less polluting household energy alternatives have typically focused on air quality and biological outcomes rather than on how an intervention affects the end user's lived experiences, a key determinant of uptake and adoption outside of a research setting. We explored perceptions of and experiences with a household solar lighting intervention in rural Uganda. Methods: In 2019, we completed a one-year parallel group, randomized wait-list controlled trial of indoor solar lighting systems (ClinicalTrials.gov NCT03351504) in rural Uganda where participants are largely relying on kerosene and other fuel-based lighting received household indoor solar lighting systems. In this qualitative sub-study, we conducted one-on-one, in-depth qualitative interviews with all 80 female participants enrolled in the trial. Interviews explored how solar lighting and illumination impacted participants' lives. We applied a theoretical model linking social integration and health to analyse dynamic interactions across aspects of study participants' lived experiences. Sensors were used to measure daily lighting use before and after receipt of the intervention solar lighting system. Results: Introduction of the solar lighting system increased daily household lighting use by 6.02 (95% confidence intervals (CI) = 4.05-8.00) hours a day. The solar lighting intervention had far-reaching social implications with improved social integration and, consequently, social health. Participants felt that lighting improved their social status, mitigated the stigma of poverty, and increased the duration and frequency of social interactions. Household relationships improved with access to lighting because of reduced conflicts over light rationing. Participants also described a communal benefit of lighting due to improved feelings of safety. At the individual-level, many reported improved self-esteem, sense of well-being, and reduced stress. Conclusion: Improved access to lighting and illumination had far reaching implications for participants, including improved social integration. More empirical research, particularly in the light and household energy field, is needed that emphasizes the impacts of interventions on social health. Registration: ClinicalTrials.gov No. NCT03351504.

Workflow enabling deepscale immunopeptidome, proteome, ubiquitylome, phosphoproteome, and acetylome analyses of sample-limited tissues.

Serial multi-omic analysis of proteome, phosphoproteome, and acetylome provides insights into changes in protein expression, cell signaling, cross-talk and epigenetic pathways involved in disease pathology and treatment. However, ubiquitylome and HLA peptidome data collection used to understand protein degradation and antigen presentation have not together been serialized, and instead require separate samples for parallel processing using distinct protocols. Here we present MONTE, a highly sensitive multi-omic native tissue enrichment workflow, that enables serial, deep-scale analysis of HLA-I and HLA-II immunopeptidome, ubiquitylome, proteome, phosphoproteome, and acetylome from the same tissue sample. We demonstrate that the depth of coverage and quantitative precision of each 'ome is not compromised by serialization, and the addition of HLA immunopeptidomics enables the identification of peptides derived from cancer/testis antigens and patient specific neoantigens. We evaluate the technical feasibility of the MONTE workflow using a small cohort of patient lung adenocarcinoma tumors.