Telehealth mindful exercise for people with knee osteoarthritis: A decentralized feasibility randomized controlled trial.

Objective: Negative psychological beliefs like fear avoidance and catastrophizing can interfere with exercise engagement in people with knee osteoarthritis (OA). Mindfulness, when integrated with exercise, could potentially address both psychological and physical impairments. Our objectives were to optimize and assess the feasibility of a novel telehealth, group-based mindful exercise intervention for people with knee OA. Methods: We conducted a decentralized randomized controlled trial where participants (n â€‹= â€‹40) with symptomatic knee OA were randomized into mindful exercise (n â€‹= â€‹21) or exercise-only (n â€‹= â€‹19) groups. Both groups received supervised group-based interventions weekly for 8-weeks via Zoom. Primary outcomes were safety, fidelity, and feasibility of the mindful exercise intervention. Participants completed patient-reported outcomes (PRO) for pain, function, and psychological measures at baseline, week-8, and week-14. Results: Participants were from 21 US states; >90% identified as having White race, 16% were from rural areas, and approximately 40% had an annual income < $50,000. At 8-weeks, mindful exercise and exercise groups had retention rates of 86% (18/21) and 100% (19/19), and attendance was 54% (11.4/21) and 68% (13/19) respectively. There were no adverse events in the mindful exercise group and four in the exercise group related to exacerbation of knee pain. Preliminary findings showed numerically larger improvements in several PROs for the mindful exercise group. Conclusion: An 8-week telehealth, group-based, mindful exercise intervention was safe for people with knee OA. Our decentralized approach was feasible in terms of recruitment and retention. Further refinement is needed to improve intervention attendance and participant diversity.

Describing Outcomes in Autistic Young Adults One Year After High School Graduation.

PURPOSE: Research documents poor outcomes for autistic adults in the domains of employment, independent living, and social relationships. Measurement and sample limitations in prior studies may have amplified past estimates of poor outcomes. The goal of the current study was to improve upon past approaches and to create and describe a measurement approach to capture adult outcomes that reflected the context of young adulthood and the perspectives of autistic individuals, pairing objective outcome indicators with subjective satisfaction indicators. METHODS: Thirty-six autistic young adults (mean age 19.8 years) and a parent completed self-report surveys. Using these data, we defined an objective and subjective (i.e., satisfaction) outcome indicator in each of three domains: productivity (employment or post-secondary education), social well-being (frequency of contact with friends), and living situation (autonomy). RESULTS: Three-quarters of young adults experienced at least 5 out of 6 positive outcomes. Over 90% were engaged in school, work, or a structured transition program, and an equal percentage were satisfied with their productivity activity. Over three-quarters of adults had a good amount of contact with friends and were satisfied with their social life. Most young adults had a moderate level of autonomy in their daily lives, and all were satisfied with their living situation. CONCLUSION: Tailoring outcome measurement approaches specifically for autistic young adults provided a more optimistic portrayal of outcomes than previously noted in the literature. The approach used better reflects a neurodiversity approach and may be useful for evaluating the effectiveness of transition services or interventions.

Racial differences in legal socialization models across adolescence and emerging adulthood.

OBJECTIVE: White and non-White adolescents report different experiences in the legal system. This disparity impacts their evaluations of, and attitudes toward, legal authorities such that non-White and older adolescents tend to perceive the legal system more negatively. Yet, many researchers assume that the process of legal socialization, which involves internalizing norms and information about the law and the legal system, is universal for all ages and races. HYPOTHESES: We hypothesized that legal socialization models would change over the course of adolescent development and would differ by race. METHOD: We used data from two longitudinal studies to examine racial differences in the integrated legal socialization model in early, middle, and late adolescence. Study 1 included 140 young adolescents (59% White, 41% non-White), and Study 2 included 296 midadolescents (82% White, 18% non-White) followed into late adolescence/emerging adulthood. RESULTS: Study 1 identified differences in the integrated legal socialization model for young White and non-White adolescents. Normative status predicted rule-violating behavior for White participants, whereas no predictors or mediators related to rule-violating behavior for non-White participants. In Study 2, legal and moral reasoning during midadolescence became relevant in the model for both groups. Enforcement status predicted rule-violating behavior for non-White youth, whereas normative status continued to predict rule-violating behavior for White youth. In late adolescence/emerging adulthood, differences in the model shifted toward the relation between reasoning and legal attitudes. CONCLUSIONS: Our findings suggest that legal socialization is a developmental process occurring and changing throughout adolescence and that this developmental process differs for White and non-White youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Breaking rules for moral reasons: Development and validation of the Prosocial and Antisocial Rule-Breaking (PARB) scale.

OBJECTIVES: To determine whether prosocial rule-breaking exists as a separate construct from antisocial rule-breaking and to develop a valid rule-breaking scale with prosocial and antisocial subscales. HYPOTHESES: We hypothesized that (a) rule-breaking would have prosocial and antisocial subfactors; (b) the prosocial rule-breaking subscale would positively associate with prosocial intentions, empathy, moral identity, and guilt proneness, whereas the antisocial rule-breaking subscale would negatively associate with these same factors; and (c) the two subscales would predict prosocial and antisocial cheating behaviors, respectively. METHOD: We developed the Prosocial and Antisocial Rule-Breaking (PARB) scale using a sample of 497 undergraduates (Study 1) and 257 Amazon Mechanical Turk workers (Study 2). Participants completed all surveys (Studies 1 and 2) and took part in a between-subjects experiment (Study 2) in which cheating behavior was measured in two conditions-when cheating helps others (prosocial) or oneself (antisocial). RESULTS: The final PARB scale demonstrated the expected factor structure (comparative fit index = .96, Tucker-Lewis index = .93, root-mean-square error of approximation = .064; χ² = 177, df = 88, p < .001), with the prosocial (α = .81) and antisocial (α = .93) subscales showing good reliability. Prosocial rule-breaking was positively associated with prosocial intentions, empathy, and guilt proneness, whereas antisocial rule-breaking was negatively associated with these same factors. Each additional point in prosocial rule-breaking PARB score predicted a 37% increased likelihood of participating in protest behavior in an exploratory investigation (p = .025) and predicted a 268% increase in actual prosocial cheating behavior (p < .001) but did not predict antisocial cheating behavior (p = .293). Conversely, each additional point in antisocial rule-breaking PARB score did not predict protest participation (p = .410) but did predict a 69% increase in actual antisocial cheating behavior (p = .025). CONCLUSIONS: These findings suggest that our current understanding of rule-breaking is limited, as many types of rule-breaking are prosocially motivated and are not necessarily antisocial. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Survey of surgical critical care applicant and program director views on virtual interviews for fellowship training: a Surgical Critical Care Program Directors Society sponsored study.

Background: The COVID-19 pandemic forced postgraduate interview processes to move to a virtual platform. There are no studies on the opinions of faculty and applicants regarding this format. The aim of this study was to assess the opinions of surgical critical care (SCC) applicants and program directors regarding the virtual versus in-person interview process. Methods: An anonymous survey of the SCC Program Director's Society members and applicants to the 2019 (in-person) and 2020 (virtual) interview cycles was done. Demographic data and Likert scale based responses were collected using Research Electronic Data Capture. Results: Fellowship and program director responses rates were 25% (137/550) and 58% (83/143), respectively. Applicants in the 2020 application cycle attended more interviews. The majority of applicants (57%) and program faculty (67%) strongly liked/liked the virtual interview format but felt an in-person format allows better assessment of the curriculum and culture of the program. Both groups felt that an in-person format allows applicants and faculty to establish rapport better. Only 9% and 16% of SCC program directors wanted a purely virtual or purely in-person interview process, respectively. Applicants were nearly evenly split between preferring a purely in-person versus virtual interviews in the future. Discussion: The virtual interview format allows applicants and program directors to screen a larger number of programs and applications. However, the virtual format is less useful than an in-person interview format for describing unique aspects of a training program and for allowing faculty and applicants to establish rapport. Future strategies using both formats may be optimal, but such an approach requires further study. Level of evidence: Epidemiologic level IV.

Errata.

[This corrects the article DOI: 10.5195/ijt.2021.6371.].

Errata.

[This corrects the article DOI: 10.5195/ijt.2020.6328.].

Preparation for Adulthood: Shifting Responsibility for Management of Daily Tasks From Parents to Their Children.

IMPORTANCE: Limited research has described the timing of acquisition of the broad range of skills required for the transition to adulthood. OBJECTIVE: To describe the timing of the shift of responsibility for daily tasks from parent to child. DESIGN: This study used an existing data set of parent responses to 49 items in the Responsibility domain of the Pediatric Evaluation of Disability Inventory Computer Adaptive Tests. PARTICIPANTS: A U.S. nationally representative sample of 2,205 typically developing children and youth ages 0 to 20 yr. OUTCOMES AND MEASURES: Descriptive analyses focused on two ages: (1) starting age (when >50% of parents reported their child was taking at least some responsibility for a task) and (2) full responsibility age (when >50% of parents reported their child was taking full responsibility for the task). RESULTS: The process of shifting responsibility for daily life tasks from parent to child typically occurred over a long period. Many task items had an interval of 5 yr from starting age to full responsibility age; the longest interval was 15 yr. Youth began assuming responsibility for more complex tasks and tasks that involved more risk at ages 10 to 15. CONCLUSIONS AND RELEVANCE: Results can serve as a reference for the timing of the transition to greater self-management of daily life tasks across childhood and adolescence. Timing of responsibility shifts may reflect a combination of development of underlying capacities and social transitions. Executive functioning may be especially relevant for management of the more complex tasks required in daily life in adulthood. WHAT THIS ARTICLE ADDS: The transfer of responsibility for managing tasks of daily life from parents to children often extends over a period of many years. Clinicians may find the results helpful when discussing the future with parents of young people with disabilities and other chronic conditions and the tasks that their children must learn to manage for independent living as an adult.

Identifying School-Based Factors that Predict Employment Outcomes for Transition-Age Youth with Autism Spectrum Disorder.

There is a growing need to provide appropriate services to help students with autism spectrum disorder (ASD) transition to employment. Limited research has investigated what aspects of support should be prioritized when preparing youth with ASD for employment. By conducting structural equation modeling using a nationally-representative dataset on high school students receiving special education services (NLTS-2), this study examined the malleable predictors of employment during the transition and developed a model to examine the relationships between predictors and employment outcomes. The findings suggested two pathways for youth with ASD. For youth with higher daily functioning skills (DFS), academic performance mediated the relationship between parent participation and employment. For youth with lower DFS, school-based transition supports was the key mediator.

Predictive Extrinsic Factors in Multiple Victim Shootings.

Although researchers have found support for a relationship between temperature and violence and evidence of temporal patterns in violent crime, research on homicide shows less consistent results and no research on mass murder has been conducted. We address this by examining predictive factors in multi-victim shootings (those with four or more victims, including injured), a more general crime category than mass murder, but one with likely similar predictive factors. We used data from the Gun Violence Archive to understand the relationship between multi-victim shootings and temperature as well as other extrinsic factors. To avoid the confound between season and temperature, we employed temperature anomaly (the difference between actual and expected temperature) as a predictor of daily shooting rate. Using a generalized linear model for the daily count of multi-victim shootings in the U.S., we found that these events are significantly more frequent on weekends, some major holidays, hotter seasons, and when the temperature is higher than usual. Like other crimes, rates of multi-victim shooting vary systematically.

Variables Associated With Shift of Responsibility for Daily Tasks From Parents to Children With and Without Disabilities.

IMPORTANCE: No study has directly investigated which variables are associated with the shift of responsibility for managing daily tasks from parent to child in the transition to adulthood. OBJECTIVE: To examine characteristics associated with responsibility for managing daily life tasks in youth with and without disabilities. DESIGN: A secondary data analysis of parent-report data on typically developing (TD) youth and youth with disabilities. SETTING: An online panel that has regularly participated in online surveys. PARTICIPANTS: A nationally representative sample of 2,205 TD U.S. children and youth, ages 0 to 20 yr, 11 mo (about 100 children per age year) and a sample of 617 children and youth with disabilities, ages 0 to 20 yr, 11 mo. OUTCOMES AND MEASURES: The dependent variable was the Responsibility domain scaled score (from the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test), which reflects the extent to which responsibility for daily tasks has shifted from parent to youth. RESULTS: Youth with higher levels of responsibility were older in age, reported to be more focused, and youngest in birth order (TD, R 2 = .79; disability, R 2 = .35). Youth with developmental delay, intellectual disability, autism spectrum disorder, or orthopedic or movement impairments had assumed less responsibility. CONCLUSIONS AND RELEVANCE: Other personal characteristics in addition to disability may have important influences on parents' decision making as they prepare their children to manage daily life tasks. WHAT THIS ARTICLE ADDS: Clinicians who work with adolescents in the process of transition to adulthood need to consider the potential influence of the personal characteristics, such as birth order and child temperament, on preparation for adulthood.