Does Point-of-Care Ultrasound Affect Fluid Resuscitation Volume in Patients with Septic Shock: A Retrospective Review.

Background: Fixed, large volume resuscitation with intravenous fluids (IVFs) in septic shock can cause inadvertent hypervolemia, increased medical interventions, and death when unguided by point-of-care ultrasound (POCUS). The primary study objective was to evaluate whether total IVF volume differs for emergency department (ED) septic shock patients receiving POCUS versus no POCUS. Methods: We conducted a retrospective observational cohort study from 7/1/2018 to 8/31/2021 of atraumatic adult ED patients with septic shock. We agreed upon a priori variables and defined septic shock as lactate ≥4 and hypotension (SBP <90 or MAP <65). A sample size of 300 patients would provide 85% power to detect an IVF difference of 500 milliliters between POCUS and non-POCUS cohorts. Data are reported as frequencies, median (IQR), and associations from bivariate logistic models. Results: 304 patients met criteria and 26% (78/304) underwent POCUS. Cardiac POCUS demonstrated reduced ejection fraction in 15.4% of patients. Lung ultrasound showed normal findings in 53% of patients. The POCUS vs. non-POCUS cohorts had statistically significant differences for the following variables: higher median lactate (6.7 [IQR 5.2-8.7] vs. 5.6], p = 0.003), lower systolic blood pressure (77.5 [IQR 61-86] vs. 85.0, p < 0.001), more vasopressor use (51% vs. 34%, p = 0.006), and more positive pressure ventilation (38% vs. 24%, p = 0.017). However, there were no statistically significant differences between POCUS and non-POCUS cohorts in total IVF volume ml/kg (33.02 vs. 32.1, p = 0.47), new oxygen requirement (68% vs. 59%, p = 0.16), ED death (3% vs. 4%, p = 0.15), or hospital death (31% vs. 27%, p = 0.48). There were similar distributions of lactate, total fluids, and vasopressors in patients with CHF and severe renal failure. Conclusions: Among ED patients with septic shock, POCUS was more likely to be used in sicker patients. Patients who had POCUS were given similar volume of crystalloids although these patients were more critically ill. There were no differences in new oxygen requirement or mortality in the POCUS group compared to the non-POCUS group.

Celebrating organizational history triggers social identity threat among Black Americans.

Many mainstream organizations celebrate their historical successes. In their history, however, they often marginalized racial minorities, women, and other underrepresented groups. We suggest that when organizations celebrate their histories, even without mentioning historical marginalization, they can undermine belonging and intentions to join the organization among historically marginalized groups. Four experiments demonstrate that Black participants who were exposed to an organization that celebrated their history versus the present showed reduced belonging and intentions to participate in the organization. These effects were mediated by expectations of biased treatment in the organization. Further, when organizations had a history of Black people in power, celebrating history was no longer threatening, highlighting that the negative effects of celebrating history are most likely when organizations are or are assumed to be majority-White and have treated Black Americans poorly. Taken together, these findings suggest that emphasizing organizational history can be a source of social identity threat among Black Americans.

Effects of Message-Sidedness on Perceived Source Bias: When Presenting Two Sides Does Versus Does Not Alleviate Concerns About Bias.

Communicators commonly present two-sided messages to avoid being perceived as biased. This approach equates bias with one-sidedness rather than divergence from the position supported by available data. Messages often concern topics with mixed qualities: a product is exceptional but expensive; a politician is inexperienced but ethical. For these topics, providing a two-sided message should reduce perceived bias according to both views of bias as one-sidedness and divergence from available data. However, if perceived bias follows divergence from available data, for topics viewed as one-sided (univalent), a two-sided message should not reduce perceived bias. Across five studies, acknowledging two sides reduced perceived bias for novel topics. In two of the studies, two-sidedness no longer reduced perceived bias for topics viewed as univalent. This work clarifies that people conceptualize bias as a divergence from available data, not simply one-sidedness. It also clarifies when and how to leverage message-sidedness to reduce perceived bias.

Hospitalizations, Emergency Department Visits, and Home Health Use Among Older Adults With Sensory Loss.

Objectives: This study examines healthcare resource use (hospitalizations, emergency department [ED] visits, and home health episodes) among adults 65 and older diagnosed with hearing, vision, or dual sensory loss (SL) seen in the primary care setting of an academic health system. Methods: Multivariable logistic regression models were used to examine the relationship between SL (identified using ICD-10 codes) and healthcare resource use for 45,000 primary care patients. Results: The sample included 5.5% (N = 2479) with hearing loss, 10.4% (N = 4697) with vision loss, and 1.0% with dual SL (N = 469). Hearing loss increased the likelihood of having an ED visit (OR = 1.22, CI: 1.07-1.39), and home health services (OR = 1.27, CI: 1.07-1.51) compared to older adults without any SL. Vision loss reduced the likelihood of having a hospitalization (OR = .81, CI: .73-.91). Discussion: Findings support research into the drivers of healthcare use among older adults with sensory loss.

Effects of matching personal and organizational mindsets on belonging and organizational interest.

Growth mindsets are beliefs that abilities, like intelligence, are mutable. Although most prior work has focused on people's personal mindset beliefs, a burgeoning literature has identified that organizations also vary in the extent to which they communicate and endorse growth mindsets. Organizational growth mindsets have powerful effects on belonging and interest in joining organizations, suggesting that they may be a productive way to intervene to improve individual and societal outcomes. Yet, little is known about for whom organizational mindset interventions might be more or less effective, a critical question for effective implementation and theory. We examine whether people's personal mindset beliefs might determine the effect of organizational growth mindsets, and if so, whether this moderation reflects a matching or mismatching pattern. Three experiments manipulated the espoused mindset of an organization and found that organizational growth mindsets primarily increased belonging and interest in joining among participants who personally endorsed matching growth mindset beliefs. An additional field study provided ecological validity to these findings, replicating them with students' experiences of belonging in classrooms. This study also revealed a divergent mismatching pattern on grades: rather than bolstering the grades of students with growth mindsets, growth mindset classroom contexts primarily enhanced the grades of students with more fixed mindsets. By clarifying for whom organizational growth mindsets are beneficial and in what manner, the current work provides theoretical and practical insight into the psychological dynamics of organizational growth mindsets. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Disruption, Not an Interruption: The Impact of COVID-19 on Child Care in Iowa.

Background: In March 2020, when public health stay home orders began in order to halt the spread of COVID-19, child care as an industry was drastically and abruptly impacted. This public health emergency highlighted the weaknesses in the child care system in the United States. Objective: This study investigated the changes in operations cost, child enrollment and attendance, and state and federal support that occurred during the first year of the COVID-19 pandemic among both center-based and home-based child care programs. Methods: A total of 196 licensed centers and 283 home-based programs across Iowa participated in an online survey as a part of the 2020 Iowa Narrow Costs Analysis. This mixed method study utilizes qualitative analysis of response as well as descriptive statistics and pre- post comparison testing. Results: Analysis of qualitative and quantitative data revealed that the COVID-19 pandemic had a marked impact on child care enrollment, the operational cost of child care, the availability of child care, and a variety of other areas including staff workload and mental health. In many instances, participants shared that state and federal COVID-19 relief funds were critical. Conclusion: Although state and federal COVID-19 relief funds were critical for child care providers in Iowa during the pandemic, results suggest similar financial support will be necessary beyond the pandemic to sustain the workforce. Policy suggestions are made for how to continue to support the child care workforce in the future.

Correction to: A Disruption, Not an Interruption: The Impact of COVID-19 on Child Care in Iowa.

[This corrects the article DOI: 10.1007/s10566-023-09739-8.].

Social support as a resilience factor for parent-infant dyads experiencing homelessness.

Despite the considerable prevalence of homelessness among very young children in the United States, there is a notable lack of research on risk, resilience, and developmental well-being of infants who experience family homelessness. In the present study, we considered social support as a resilience factor for quality of parent-infant relationships and parent depression among a sample of 106 parents and their infants (ages birth to 12 months) residing in emergency shelters for families experiencing homelessness. We assessed social support, parent histories of adverse experiences during childhood and adulthood, and parent current depression symptoms via structured interview measures, and we assessed quality of the parent-infant relationship with an observational approach. Results showed different patterns for the roles of adversity the parents had experienced during childhood compared to adversity experienced more recently, as adults. Childhood adversity predicted parent-infant responsiveness, with a positive association that was moderated by level of perceived social support. Parents with more childhood adversity showed more responsiveness with their infants only when they had access to high levels of social support. Adulthood adversity predicted higher scores for parent depression, while social support predicted lower parent depression scores. This work contributes to the very limited literature on the functioning of families with infants in shelters. Our discussion includes implications for research, policy, and prevention and intervention efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Ultralow frictional healing explains recurring slow slip events.

Plate motion on shallow subduction megathrusts is accommodated by a spectrum of tectonic slip modes. However, the frictional properties and conditions that sustain these diverse slip behaviors remain enigmatic. Frictional healing is one such property, which describes the degree of fault restrengthening between earthquakes. We show that the frictional healing rate of materials entrained along the megathrust at the northern Hikurangi margin, which hosts well-characterized recurring shallow slow slip events (SSEs), is nearly zero (<0.0001 per decade). These low healing rates provide a mechanism for the low stress drops (<50 kilopascals) and short recurrence times (1 to 2 years) characteristic of shallow SSEs at Hikurangi and other subduction margins. We suggest that near-zero frictional healing rates, associated with weak phyllosilicates that are common in subduction zones, may promote frequent, small-stress-drop, slow ruptures near the trench.

When Objective Ambivalence Predicts Subjective Ambivalence: An Affect-Cognition Matching Perspective.

Understanding when people are likely to feel ambivalent is important, as ambivalence is associated with key attitude outcomes, such as attitude-behavior consistency. Interestingly, the presence of conflicting positive and negative reactions (objective ambivalence) is weakly related to feeling conflicted (subjective ambivalence). We tested a novel situation that can influence the correspondence between objective and subjective ambivalence: whether a message and a recipient's topic match in affective versus cognitive orientation. When a person encounters a message with an affective or cognitive match to the topic, conflicting reactions may be more accessible, increasing feelings of ambivalence. Across five studies, greater objective-subjective ambivalence correspondence occurred with an affective-cognitive match between message and topic orientation. Studies 4 and 5 also demonstrated that this primarily occurred when the message was counterattitudinal. This work contributes to the literature explaining the gap between measures of objective and subjective ambivalence as well as how messages can influence attitude strength properties.

Segmentation of Shallow Slow Slip Events at the Hikurangi Subduction Zone Explained by Along-Strike Changes in Fault Geometry and Plate Convergence Rates.

Over the last two decades, geodetic and seismic observations have revealed a spectrum of slow earthquakes along the Hikurangi subduction zone in New Zealand. Of those, shallow slow slip events (SSEs) that occur at depths of less than 15 km along the plate interface show a strong along-strike segmentation in their recurrence intervals, which vary from ∼1 yr from offshore Tolaga Bay in the northeast to ∼5 yr offshore Cape Turnagain ∼300 km to the southwest. To understand the factors that control this segmentation, we conduct numerical simulations of SSEs incorporating laboratory-derived rate-and-state friction laws with both planar and non-planar fault geometries. We find that a relatively simple model assuming a realistic non-planar fault geometry reproduces the characteristics of shallow SSEs as constrained by geodetic observations. Our preferred model captures the magnitudes and durations of SSEs, as well as the northward decrease of their recurrence intervals. Our results indicate that the segmentation of SSE recurrence intervals is favored by along-strike changes in both the plate convergence rate and the downdip width of the SSE source region. Modeled SSEs with longer recurrence intervals concentrate in the southern part of the fault (offshore Cape Turnagain), where the plate convergence rate is lowest and the source region of SSEs is widest due to the shallower slab dip angle. Notably, the observed segmentation of shallow SSEs cannot be reproduced with a simple planar fault model, which indicates that a realistic plate interface is an important factor to account for in modeling SSEs.

The relationship between sensory loss and health literacy in older adults: A systematic review.

OBJECTIVES: As sensory loss may impact the ability to receive and apply health information, a relationship between sensory loss and health literacy may exist. The purpose of this systematic review was to explore the relationship between hearing, vision and dual sensory loss and health literacy in older adults. METHODS: Studies examining the relationship between sensory loss and health literacy in older adult populations using a validated health literacy instrument were included. The search was conducted in the CINAHL, PubMed, Scopus, AgeLine and REHABdata databases in May-June 2021. RESULTS: Nine studies were included. Findings revealed a positive association between hearing and vision loss and low health literacy. DISCUSSION: This review highlights a relationship between hearing and vision loss and low health literacy. The small number of studies and overall heterogeneity of study methods limits strength of this evidence. Individuals with sensory loss may benefit from additional clinician support in receiving and applying health information.

Healthcare Resource Utilization and Related Costs in Chronic Fibrosing Interstitial Lung Diseases with a Progressive Phenotype: A US Claims Database Analysis.

INTRODUCTION: We aimed to describe healthcare resource utilization (HCRU) patterns and costs in patients with fibrosing interstitial lung disease (ILD) and those with a progressive phenotype of fibrosing ILD in a US claims database. METHODS: Data from the IBM® MarketScan® databases (1 October 2011-30 September 2015) were used. Diagnosis codes documented on medical claims on two occasions (without any claims during the 12 months prior) identified patients with incident fibrosing ILD. Patients with chronic fibrosing ILD with a progressive phenotype were identified by proxies for progression. Patients aged ≥ 18 years with 365 days of continuous coverage before the index date were eligible for inclusion. Data were analyzed for 12 months prior to identification of fibrosing ILD/progressive phenotype (baseline) and 12 months after (follow-up). Outcomes included treatment patterns, outpatient and inpatient claims, and costs. RESULTS: We identified 23,577 patients with incident fibrosing ILD and 14,722 with the progressive phenotype. Follow-up data were available for 9986 and 5840 patients, respectively. The most frequent ILD-related medications during baseline were corticosteroids (49.4% and 56.6%). Mean (± standard deviation [SD]) annualized number of outpatient claims was 30.0 (± 26.4) and 34.1 (± 27.7) in the baseline period and 36.2 (± 28.6) and 41.9 (± 30.2) in the follow-up in fibrosing ILD and with a progressive phenotype, respectively. Mean (SD) number of all-cause hospitalizations was 0.5 (± 1.1) and 0.7 (± 1.2) during baseline and 0.6 (± 1.1) and 0.7 (± 1.2) during follow-up. Mean (SD) total costs were $40,907 (± 92,496) and $49,561 (± 98,647) during baseline and $46,157 (± 102,858) and $54,215 (± 116,833) during follow-up. Inpatient mortality during follow-up was 53.50 and 77.44 per 1000 patient-years. CONCLUSION: HCRU and costs were high in patients with chronic fibrosing ILD with a progressive phenotype, likely reflecting the disease severity and the need for close monitoring and acute care. Outpatient claims accounted for a substantial proportion of the total costs.

Some patients with lung diseases have inflammation or scarring of the lung tissues (interstitial lung diseases, or ILDs). In some patients with lung scarring, the scarring may become progressive (i.e., it worsens over time). In this study, we looked at these patients identified in US health insurance records. We counted how many times patients visited a doctor, were admitted to hospital, or needed medications or tests. We also looked at the total cost of all this medical care. Overall, we concluded that patients with ILDs with progressive lung scarring had a high number of visits to the doctor, and the total costs of their medical care were high.

Point-of-care Ultrasound-guided Central Venous Catheter Confirmation in Ultrasound Nonexperts.

OBJECTIVE: Emerging evidence suggests that chest radiography (CXR) following central venous catheter (CVC) placement is unnecessary when point-of-care ultrasound (POCUS) is used to confirm catheter position and exclude pneumothorax. However, few providers have adopted this practice, and it is unknown what contributing factors may play a role in this lack of adoption, such as ultrasound experience. The objective of this study was to evaluate the diagnostic accuracy of POCUS to confirm CVC position and exclude a pneumothorax after brief education and training of nonexperts. METHODS: We performed a prospective cohort study in a single academic medical center to determine the diagnostic characteristics of a POCUS-guided CVC confirmation protocol after brief training performed by POCUS nonexperts. POCUS nonexperts (emergency medicine senior residents and critical care fellows) independently performed a POCUS-guided CVC confirmation protocol after a 30-minute didactic training. The primary outcome was the diagnostic accuracy of the POCUS-guided CVC confirmation protocol for malposition and pneumothorax detection. Secondary outcomes were efficiency and feasibility of adequate image acquisition, adjudicated by POCUS experts. RESULTS: Twenty-six POCUS nonexperts collected data on 190 patients in the final analysis. There were five (2.5%) CVC malpositions and six (3%) pneumothoraxes on CXR. The positive likelihood ratios of POCUS for malposition detection and pneumothorax were 12.33 (95% confidence interval [CI] = 3.26 to 46.69) and 3.41 (95% CI = 0.51 to 22.76), respectively. The accuracy of POCUS for pneumothorax detection compared to CXR was 0.93 (95% CI = 0.88 to 0.96) and the sensitivity was 0.17 (95% CI = 0.00 to 0.64). The median (interquartile range) time for CVC confirmation was lower for POCUS (9 minutes [8.5-9.5 minutes]) compared to CXR (29 minutes [1-269 minutes]; Mann-Whitney U, p < 0.01). Adequate protocol image acquisition was achieved in 76% of the patients. CONCLUSION: Thirty-minute training of POCUS in nonexperts demonstrates adequate diagnostic accuracy, efficiency, and feasibility of POCUS-guided CVC position confirmation, but not exclusion of pneumothorax.

Prevalence and Incidence of Chronic Fibrosing Interstitial Lung Diseases with a Progressive Phenotype in the United States Estimated in a Large Claims Database Analysis.

INTRODUCTION: Many fibrosing interstitial lung diseases (ILDs) develop a chronic progressive phenotype. While idiopathic pulmonary fibrosis, which is always progressive, is well characterized with established treatment options, the epidemiology of other chronic fibrosing ILDs with a progressive phenotype has not been widely investigated. Treatment options are limited, with a high unmet need. This claims database study estimates the incidence and prevalence of these diseases in the USA. METHODS: Diagnosis, procedure and resource utilization codes from insurance claims were used to identify patients with fibrosing ILD and those with a chronic progressive phenotype among 37,565,644 adult patients in the IBM® MarketScan® Research Database 2012-2015. Two eligible ILD claims were required for a fibrosing ILD diagnosis. Progression was defined using a novel algorithm constituted by criteria considered proxies for progression. Patients were defined as having incident (new) or existing diagnoses based on claims during a 365-day period before study entry. RESULTS: The estimated age- and sex-adjusted prevalence per 100,000 persons of fibrosing ILD (95% confidence interval) was 117.82 (116.56, 119.08) and of chronic fibrosing ILDs with a progressive phenotype was 70.30 (69.32, 71.27). The estimated adjusted incidence per 100,000 patient-years of fibrosing ILD was 51.56 (50.88, 52.24) and of chronic fibrosing ILDs with a progressive phenotype was 32.55 (32.01, 33.09). Among incident fibrosing ILD patients, 57.3% experienced progression over a median of 117 days (interquartile range 63-224), with largely comparable rates of progression among different diseases. CONCLUSIONS: Chronic fibrosing ILDs with a progressive phenotype comprise a relatively new disease construct requiring varied approaches to obtain reliable estimates of prevalence and incidence. This is the first large claims database study using real-world data to provide estimates of the prevalence and incidence of these diseases among a very large segment of the US population and could form the groundwork for future studies.

Progressive lung fibrosis occurs in idiopathic pulmonary fibrosis; however, interstitial lung fibrosis may occur in other diseases such as rheumatoid arthritis, chronic hypersensitivity pneumonitis and sarcoidosis, and may or may not be progressive in these diseases. Little is known about the frequency of lung fibrosis among patients with these diseases or how often such fibrosis is progressive. This study used information from a large insurance claims database (IBM^® MarketScan^®) to estimate the frequency and progression of lung fibrosis associated with different diseases.

A Proactive Curriculum With Remediation Intervention Tool for Nursing Education Success.

ABSTRACT: Mastering the Content is a proactive curriculum whose At-Risk Student Identification Criteria-Based Remediation Interventions Tool leads to nursing student success. The curriculum integrates active learning strategies and problem-solving activities throughout the nursing program to develop clinical judgment. Remediation includes guided metacognitive learning tool construction, individualized student support, and study plans to increase learning and decrease attrition. The curriculum and interventions tool were developed based on evidence gathered from a meta-analysis of research on best practices in basic RN prelicensure program remediation success and one nursing program's successful implementation of best practices.

Effectiveness and Safety of COPD Maintenance Therapy with Tiotropium/Olodaterol versus LABA/ICS in a US Claims Database.

INTRODUCTION: In patients with chronic obstructive pulmonary disease (COPD), treatment with long-acting muscarinic antagonist (LAMA)/long-acting ß2-agonist (LABA) combination therapy significantly improves lung function versus LABA/inhaled corticosteroid (ICS). To investigate whether LAMA/LABA could provide better clinical outcomes than LABA/ICS, this non-interventional database study assessed the risk of COPD exacerbations, pneumonia, and escalation to triple therapy in patients with COPD initiating maintenance therapy with tiotropium/olodaterol versus any LABA/ICS combination. METHODS: Administrative healthcare claims and laboratory results data from the US HealthCore Integrated Research Databasesm were evaluated for patients with COPD initiating tiotropium/olodaterol versus LABA/ICS treatment (January 2013-March 2019). Patients were aged at least 40 years with a diagnosis of COPD (but not asthma) at cohort entry. A Cox proportional hazard regression model was used (as-treated analysis) to assess risk of COPD exacerbation, community-acquired pneumonia, and escalation to triple therapy, both individually and as a combined risk of any one of these events. Potential imbalance of confounding factors between cohorts was handled using fine stratification, reweighting, and trimming by exposure propensity score (high-dimensional); subgroup analyses were conducted on the basis of blood eosinophil levels and exacerbation history. RESULTS: The total population consisted of 61,985 patients (tiotropium/olodaterol n = 2684; LABA/ICS n = 59,301); after reweighting, the total was 42,953 patients (tiotropium/olodaterol n = 2600; LABA/ICS n = 40,353; mean age 65 years; female 54.5%). Patients treated with tiotropium/olodaterol versus LABA/ICS experienced a reduction in the risk of COPD exacerbations (adjusted hazard ratio 0.76 [95% confidence interval 0.68, 0.85]), pneumonia (0.74 [0.57, 0.97]), escalation to triple therapy (0.22 [0.19, 0.26]), and any one of these events (0.45 [0.41, 0.49]); the combined risk was similar irrespective of baseline eosinophils and exacerbation history. CONCLUSIONS: In patients with COPD, tiotropium/olodaterol was associated with a lower risk of COPD exacerbations, pneumonia, and escalation to triple therapy versus LABA/ICS, both individually and in combination; the combined risk was reduced irrespective of baseline eosinophils or exacerbation history. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT04138758 (registered 23 October 2019).

Integration of teaming therapy and mixed-reality simulation as remote learning modality for couple and family therapy graduate training programs.

In response to COVID-19, a couple and family therapy (CFT) graduate training program integrated a teaming therapy model with virtual technology using mixed-reality simulation software. By utilizing teaming therapy--a model with strong roots in systemic theory and practice-- combined with cutting-edge simulation technology, this distance learning modality provides distinctly relational therapy supervision and training for students at a time when their internships sites are struggling to offer remote clinical services due to the pandemic. This integrative framework offers a high degree of both realism and safety, allowing experiential learning to be appropriately scaffolded for optimum creativity and engagement in an online setting. This paper describes the conceptual, systemic basis for the learning modality, steps for implementation, benefits of the model, and the authors plan for further evaluation.

Estimation of the Prevalence of Progressive Fibrosing Interstitial Lung Diseases: Systematic Literature Review and Data from a Physician Survey.

Some patients with interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis exhibit a progressive clinical phenotype. These chronic progressive fibrosing ILDs have a variety of underlying diseases, and their prevalence is currently unknown. Here we carry out the first systematic review of literature on the prevalence of fibrosing ILDs and progressive fibrosing ILDs using data from physician surveys to estimate frequency of progression among different ILDs. We searched MEDLINE and Embase for studies assessing prevalence of ILD, individual ILDs associated with fibrosis and progressive fibrosing ILDs. These were combined with data from previously published physician surveys to obtain prevalence estimates of each chronic fibrosing ILD with a progressive phenotype and of progressive fibrosing ILDs overall. We identified 16 publications, including five reporting overall ILD prevalence, estimated at 6.3-76.0 per 100,000 people in Europe (four studies) and 74.3 per 100,000 in the USA (one study). In total, 13-40% of ILDs were estimated to develop a progressive fibrosing phenotype, with overall prevalence estimates for progressive fibrosing ILDs of 2.2-20.0 per 100,000 in Europe and 28.0 per 100,000 in the USA. Prevalence estimates for individual progressive fibrosing ILDs varied up to 16.7 per 100,000 people. These conditions represent a sizeable fraction of chronic respiratory disorders and have a high unmet need.

Lay concepts of source likeability, trustworthiness, expertise, and power: A prototype analysis.

Previous research on persuasion has used researcher-generated exemplars to manipulate source characteristics such as likeability, trustworthiness, expertise, or power. This approach has been fruitful, but it relies to some degree on an overlap between researcher understanding of these variables and lay understanding of these variables. Additionally, these exemplar manipulations may have unintentionally affected multiple characteristics and may be limited to certain topics or time periods. In the current work, we sought to provide persuasion researchers with a methodological tool to increase construct and potentially external validity by conducting a prototype analysis of the four traditional source characteristics: likeability, trustworthiness, expertise, and power. This bottom-up approach provided insight into the ways in which recipients perceive sources and allowed us to examine relations between the characteristics. Moving forward, a bottom-up understanding of source characteristics will allow researchers to more effectively develop manipulations that might transcend time and topic as well as isolate their effects to the intended source characteristic.