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From strategy to sentiment: examining the role of partisan news in fostering white racial consciousness and shaping attitudes toward critical race theory
Get PDFFox News has dedicated considerable attention to Critical Race Theory (CRT), recoding it as indicative of anti-white racism. This study examined whether exposure to these narratives is associated with white audiences’ racial consciousness: white identity, perceptions of anti-white discrimination, and white racial mobilization, as well as attitudes toward CRT-related education policies. Using the 2020 Collaborative Multi-racial Post-election Survey, we examine relationships between white Americans’ (N = 2917) use of Fox News, racial consciousness, and opposition to CRT-related educational policies. We find a positive association between Fox News use and perceptions of anti-white discrimination, with this relationship strengthening during periods of heightened news coverage of CRT. Furthermore, the relationship between Fox News use and opposition to diversity and fairness instruction in K–12 education is mediated by perceptions of anti-white discrimination across ideological groups. We discuss these findings in consideration of conservative media’s recoding of CRT and its implications for accessible white racial consciousness and opposition to equity initiatives
Comparative outcomes of synthetic and biological mesh use in laparoscopic inguinal hernia repair: a systematic review and meta-analysis
Get PDFBackground Inguinal hernias occur when abdominal contents protrude through the inguinal canal. Laparoscopic repair is often preferred due to reduced postoperative pain, quicker recovery, and better cosmetic results. While synthetic mesh remains the standard, concerns about complications have prompted interest in biological meshes, which may integrate better with tissue but are more expensive and lack long-term data. Methods We conducted a meta-analysis of studies published between 2015 and 2025 that compared biological versus synthetic mesh in laparoscopic inguinal hernia repair among adults. Only randomized controlled trials and cohort studies published in English were included. The primary and secondary outcomes were hernia recurrence and postoperative complications. Results Out of 6017 records, three studies involving 1372 participants met the inclusion criteria. All compared porcine small intestinal submucosa (SIS) biological mesh with synthetic mesh. SIS mesh was associated with longer operating times (SMD 0.45; 95% CI: 0.02–0.87; p = 0.039). However, there were not a statistically significant differences in recurrence (RR 12.73; p = 0.15), complications (RR 3.06; p = 0.55), or adverse events (RR 5.38; p = 0.21). Heterogeneity was high, and funnel plots suggested possible publication bias. Conclusion Biological mesh did not show a clear benefit over synthetic mesh in laparoscopic inguinal hernia repair. While it may reduce chronic pain, it requires longer operative time and raises concerns about cost and long-term outcomes. Larger, high-quality studies are needed to clarify their role in clinical practice
Separate and Cumulative Impacts of Trauma-Informed Practices and a Housing Intervention on the Safety, Housing Stability and Mental Health of Domestic Violence Survivors Over Two Years
Get PDFPurpose Trauma-informed practices (TIP) with intimate partner violence (IPV) survivors contributes to short-term improvements in their mental health. However, less is known about TIP’s long-term value for mental health and whether TIP’s value extends to other life domains, such as housing. Focused on the outcomes of housing stability, mental health, and violence experiences, this longitudinal study examined the contributions of TIP and Domestic Violence Housing First (DVHF), which is a novel intervention that engages survivors in housing-inclusive advocacy and flexible financial assistance. Methods The community-based, quasi-experimental study included homeless and unstably housed survivors (n = 351) who sought services for IPV. Survivors were interviewed across five timepoints over two years, assessing the services they received, including experiences with TIP. Participants also reported their housing stability, violence experiences, and mental health symptoms, including depression, anxiety, and post-traumatic stress. Based on the services they received, survivors were categorized as either receiving only services-as-usual (e.g., counseling, safety planning, shelter) or DVHF (i.e., housing-inclusive advocacy, flexible financial assistance, plus usual services). Data were analyzed using conditional random intercept models. Results Survivors who received DVHF and/or reported their services to be trauma-informed also reported greater housing stability, less violence, and better mental health over time. Those who both received DVHF and reported their services to be highly trauma-informed reported the most improvements in housing, mental health, and violence. Conclusions Study results suggest that DVHF and TIP can work in tandem over time to produce positive outcomes for survivors seeking housing stability, improved mental health, and safety
Associations Between Parent–Child Attachment and Psychosocial- and Health-Related Symptoms in Children with Functional Abdominal Pain Disorders
Get PDFBackground and Objectives: The attachment-diathesis model of chronic pain, which associates insecure attachment with pain catastrophizing and worse pain-related outcomes, is well-supported in adults. Although Functional Abdominal Pain Disorders (FAPDs) are common in youth, with symptoms influenced by the parent–child dynamic, an attachment-diathesis model of FAPDs is unexplored. The aim of this study was to investigate if insecure parental attachment is associated with pain catastrophizing and pain-related variables in youth with FAPDs. Methods: Baseline questionnaire data from an RCT of cognitive behavioral therapy for children with FAPDs (n = 200, 73% girls, 93% White, and a mean age of 11.2 years old) were used to examine relationships between parental attachment (subscales include Alienation, Trust, and Communication), catastrophizing, and pain-related variables (depression, disability, and gastrointestinal (GI) symptom severity). Results: Alienation was significantly correlated with depression (r = 0.39), GI symptom severity (r = 0.30), and disability (r = 0.22; ps < 0.05). Trust was also correlated with depression (r = −0.39), GI symptom severity (r = −0.19), and disability (r = −0.19; ps < 0.05). Communication was associated with depression (r = −0.30, p < 0.01). Catastrophizing mediated these associations, accounting for 22–89% of the relationship between attachment and pain-related variables. Conclusions: Children who report a less secure attachment to their parents report more physical and psychological symptomatology than children who describe their attachment as more secure. This association is partly explained by child catastrophizing. Results suggest that parent–child attachment and catastrophizing may be important treatment targets in children with FAPDs
Accelerating birth equity using collaborative systems mapping
Get PDFBackground Recognizing the complexity of cross-sector collaboration, holistic and innovative approaches are required to achieve birth equity. This project applied systems thinking and the Remove, Repair, Remediate, Restructure, and Provide (R4P) framework to understand and address systemic barriers to birth equity. This paper describes the systems thinking activities used to identify system actors and critical actions they can take to advance birth equity. Methods We applied systems thinking tools through the R4P lens in a series of collaborative and iterative activities. We conducted an environmental scan and synthesis of reports with recommendations to improve birth equity. In addition, we engaged a diverse group of birth equity actors, including those from federal agencies, state and local health departments, community-based organizations, funders, academic institutions, health systems and national nonprofits, through systems mapping workshops to co-create a series of birth equity tools. Results Our collaborative efforts produced an innovative Birth Equity Ecosystem Map, Birth Equity Iceberg, and interactive Birth Equity Action Map. The Birth Equity Ecosystem Map is a comprehensive synthesis of recommendations defining an equitable ecosystem, while the Birth Equity Iceberg summarizes insights on systemic barriers to achieving birth equity most critical to address in the next 5 years. The Birth Equity Action Map is an interactive and strategic tool, synthesized from diverse system actors’ experiences and perspectives, that describes needed actions and responsible actors for each systemic barrier identified. We probed for and organized actions by the five dimensions of the R4P framework to encourage comprehensive action to achieve equity. The Birth Equity Action Map and connected resources developed through this project help actors identify actions they can work on to overcome identified systemic barriers to birth equity in their community and key partners for each. Conclusions The tools we developed demonstrate how systems thinking and R4P can offer a more holistic and effective approach to tackling issues of birth equity and lead to more actionable insights, thereby contributing significantly to the public health goal of achieving equity. These tools can be used by birth equity advocates to assess and leverage their strengths, resources and unique context to identify priorities and collectively advance birth equity
Pseudomonas aeruginosa keratitis in a tertiary referral center: a decade of clinical insights and therapeutic challenges
Get PDFPurpose To evaluate the clinical characteristics, risk factors, antimicrobial resistance patterns, and outcomes of Pseudomonas aeruginosa keratitis in patients referred to a tertiary eye care center over a ten-year period. Methods In this retrospective study, medical records of patients with culture-confirmed Pseudomonas aeruginosa keratitis between 2012 and 2022 at Farabi Eye Hospital, Tehran, were reviewed. Data collected included demographic and clinical features, antimicrobial susceptibility results, treatment modalities, and outcomes up to six months of follow-up. Results A total of 172 patients were included. The mean age was 52.33 ± 22.01 years, with a nearly balanced gender distribution (49.42% male, 50.58% female). Trauma was the most common predisposing factor (30.23%). Corneal perforation occurred in 23.84% and endophthalmitis in 13.95% of patients. Surgical intervention was required in 68.6% of patients, with penetrating keratoplasty (PKP) performed in 35.5%. Advanced age, worse baseline best corrected visual acuity (BCVA), diabetes mellites, and corneal perforation were significantly associated with poorer visual outcomes. Antimicrobial susceptibility testing revealed preserved sensitivity to amikacin (95.93%), ciprofloxacin (95.93%), ceftazidime (95.35%), and gentamicin (92.44%), while high resistance rates were noted for chloramphenicol (48.26%) and cefazolin (59.30%). Conclusion Pseudomonas aeruginosa keratitis remains a severe, sight-threatening condition associated with significant surgical burden and suboptimal visual outcomes. Despite retained sensitivity to key antibiotics, high rates of corneal perforation and endophthalmitis emphasize the need for timely diagnosis and aggressive management. Future prospective, multicenter studies with longer follow-up are warranted to better define long-term outcomes and guide treatment strategies
Building capacity for HIV and implementation science among students in the United States: the stimulating training and access to HIV research experiences (STAR) program
Get PDFExpanding HIV research capacity among the global majority (individuals identifying as Black/African American, American Indian and Alaska Native, Asian, Native Hawaiian and Other Pacific Islander, Multiracial, and Hispanic/Latino) is important. However, achieving national goals to increase the pool of implementation science and HIV early-stage investigators from underrepresented backgrounds remains elusive, largely due to limited investment in training and mentoring these individuals. To address this issue, we launched the Stimulating Training and Access to HIV Research Experiences (STAR) program, a partnership led by Saint Louis University and the University of North Carolina at Chapel Hill in collaboration with Georgia State University and Texas A&M University. The STAR program aims to establish a pathway for Underrepresented minority (UREM) students to engage in HIV and implementation science research. We launched a crowdsourcing open call from November 30, 2022, to January 22, 2023, to identify potential trainees at the four participating institutions (Prompt: “How might we promote HIV prevention among youth aged 13–24 years in your community?”). The finalists from the crowdsourcing call participated in a 2-day designathon, which included didactic introductory lectures on HIV, dissemination and implementation science. The finalists participated in a 6-week innovation bootcamp, including modules on HIV research, implementation science, research ethics, and fieldwork experience with community partners. We assessed the acceptability of the STAR program through participant self-reported surveys on their experience and evaluation of the lectures. Twenty-four individuals applied to the STAR program by completing the crowdsourcing open call, 12 were selected for the designathon, and 10 completed the fellowship. The first cohort of STAR trainees (10 students—6 undergraduate and 4 graduate students) successfully completed the STAR innovation bootcamp. The innovation bootcamp culminated in seven proposals that the trainees implemented and evaluated over 12 months, with support from the research team, mentors, and participatory learning community. The implementation strategies proposed by the trainees include the use of peer engagement, storytelling, digital engagement tools, and artificial intelligence to promote awareness of HIV and increase the uptake of HIV testing. All the participants were satisfied with the STAR program (90% very satisfied and 10% satisfied) and indicated enthusiasm for pursuing academic and research careers in HIV and/or implementation science. Building a pathway for UREM investigators is crucial to ending the HIV epidemic. The STAR program may enhance interest, build research capacity, and increase the UREM talent pool retained in this field
Evaluating trustworthiness in AI-Based diabetic retinopathy screening: addressing transparency, consent, and privacy challenges
Get PDFBackground Artificial intelligence (AI) offers significant potential to drive advancements in healthcare; however, the development and implementation of AI models present complex ethical, legal, social, and technical challenges, as data practices often undermine regulatory frameworks in various regions worldwide. This study explores stakeholder perspectives on the development and deployment of AI algorithms for diabetic retinopathy (DR) screening, with a focus on ethical risks, data practices, governance, and emerging shortcomings in the Global South AI discourse. Methods Fifteen semi-structured interviews were conducted with ophthalmologists, program officers, AI developers, bioethics experts, and legal professionals. Thematic analysis was guided by OECD principles for responsible AI stewardship. Interviews were analyzed using MAXQDA software to identify themes related to AI trustworthiness and ethical governance. Results Six key themes emerged regarding the perceived trustworthiness of AI: algorithmic effectiveness, responsible data collection, ethical approval processes, explainability, implementation challenges, and accountability. Participants reported critical shortcomings in AI companies’ data collection practices, including a lack of transparency, inadequate consent processes, and limited patient awareness about data ownership. These findings highlight how unchecked data collection and curation practices may reinforce data colonialism in low and middle-income healthcare systems. Conclusion Ensuring trustworthy AI requires transparent and accountable data practices, robust patient consent mechanisms, and regulatory frameworks aligned with ethical and privacy standards. Addressing these issues is vital to safeguarding patient rights, preventing data misuse, and fostering responsible AI ecosystems in the Global South. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-025-01265-7
Operationalizing Inclusion of Diverse Older Adults in Aging Services Information
Get PDFAs the United States’ population ages, it is also becoming more diverse. The country’s Older Americans Act requires county-level offices on aging to be both service and information providers. But it is unclear to what extent offices on aging can identify gaps within the aging services information they provide and improve efforts to meet the information needs of diverse older adults. Utilizing an action research methodology, this study describes a partnership with an office on aging which ultimately resulted in the development and deployment of a diversity audit which is used to increase diverse representation in the aging services information their organization provides. The results reinforce the importance of designing resources with diversity in mind. By implementing the diversity audit and its recommendations, other aging services providers worldwide can ensure they are prepared to serve all older adults who may benefit from the services and information they have to offer
Neurogenic Thoracic Outlet Syndrome: A Current Literature Review.
Get PDFNeurogenic Thoracic Outlet Syndrome (nTOS), the most prevalent type of thoracic outlet syndrome, results from compression of the compression of the brachial plexus as it traverses the scalene triangle and rectopectoralis minor space. It typically presents with upper extremity pain, hand weakness, paresthesia, and muscle atrophy that is often exacerbated by arm elevation or overhead activity. Etiology commonly includes congenital anatomical variants, trauma, and repetitive overhead activity. Diagnosis remains challenging as a result of significant symptom overlap with cervical radiculopathy, brachial plexopathies, and entrapment neuropathies. Work up involves a combination of thorough history and physical with electrophysiologic testing, diagnostic injections and imaging such as MRI or duplex ultrasonography. Initial therapy indicates physical therapy with a focus on decompression and postural correction. In patients with persistent symptoms, motor deficits or failed conservative management, surgical decompression using transaxillary, supraclavicular or minimally invasive techniques is indicated. Rib-sparing surgical decompression is increasingly favored given lower complication rates. Postoperative rehabilitation focuses on restoring range of motion and shoulder girdle strength. This review serves to outline clinical presentation, diagnostic strategies and operative options for nTOS while emphasizing an individualized, stepwise approach to optimize outcomes and minimize risk