Assumptions Not Often Assessed or Satisfied in Published Mediation Analyses in Psychology and Psychiatry.

Mediation analysis aims to investigate the mechanisms of action behind the effects of interventions or treatments. Given the history and common use of mediation in mental health research, we conducted this review to understand how mediation analysis is implemented in psychology and psychiatry and whether analyses adhere to, address, or justify the key underlying assumptions of their approaches. All articles (n = 206) were from top academic psychiatry or psychology journals in the PsycInfo database and were published in English from 2013 to 2018. Information extracted from each article related to study design, covariates adjusted for in the analysis, temporal ordering of variables, and the specific method used to perform the mediation analysis. In most studies, underlying assumptions were not adhered to. Only approximately 20% of articles had full temporal ordering of exposure, mediator, and outcome. Confounding of the exposure-mediator and/or mediator-outcome relationships was controlled for in fewer than half of the studies. In almost none of the articles were the underlying assumptions of their approaches discussed or causal mediation methods used. These results provide insights to how methodologists should aim to communicate methods, and motivation for more outreach to the research community on best practices for mediation analysis.

Humans peeing: Justice-involved women's access to toilets in public spaces.

Justice-involved women face myriad challenges as they negotiate the terms of community supervision and manage the long-term implications and stigma of living with a criminal record. Major tasks that women juggle include securing safe, affordable housing, finding and retaining employment, accessing physical and mental health care (including substance use treatment), and handling relationships with family, friends, children, and intimate partners. In addition to these responsibilities, women must meet their basic physiological needs to eat, sleep, and use the toilet. Women's ability to safely meet their personal care needs may impact their capacity to manage their criminal-legal challenges. This study uses qualitative methods to understand justice-involved women's lived experiences related to urination. Specifically, the study reports on a thematic analysis of 8 focus groups conducted with justice-involved women (n = 58) and the results of a toilet audit conducted in the downtown areas of the small city in the United States where the focus group participants were living. Findings suggest that women had limited access to restrooms and reported urinating outside. Lack of restroom access impacted their engagement with social services support and employment and their ability to travel through public spaces. Women perceived their public toilet options as unsafe, increasing their sense of vulnerability and reinforcing the idea that they did not have full access to citizenship in the community because of their criminal-legal involvement. The exclusion and denial of women's humanity that is perpetuated by a lack of public toilet access impacts women's psychosocial outcomes. City governments, social service agencies, and employers are encouraged to consider how lack of toilet access may impact their public safety and criminal-legal objectives and expand opportunities for people to access safe restroom facilities.

Characterizing Measurement Error in Dietary Sodium in Longitudinal Intervention Studies.

Background: Previous measurement error work that investigates the relationship between a nutritional biomarker and self-reported intake levels has typically been at a single time point, in a single treatment group, or with respect to basic patient demographics. Few studies have examined the measurement error structure in longitudinal randomized trials, and whether the error varies across time or group. This structure is crucial to understand, however, in order to correct for measurement error in self-reported outcomes and properly interpret the longitudinal effects of dietary interventions. Methods: Using two longitudinal randomized controlled trials with internal longitudinal validation data (urinary biomarkers and self-reported values), we examine the relationship between urinary sodium and self-reported sodium and whether this relationship changes as a function of time and/or treatment condition. We do this by building a mixed effects regression model, allowing for a flexible error variance-covariance structure, and testing all possible interactions between time, treatment condition, and self-reported intake. Results: Using a backward selection approach, we arrived at the same final model for both validation data sets. We found no evidence that measurement error changes as a function of self-reported sodium. However, we did find evidence that urinary sodium can differ by time or treatment condition even when conditioning on self-reported values. Conclusion: In longitudinal nutritional intervention trials it is possible that measurement error differs across time and treatment groups. It is important for researchers to consider this possibility and not just assume non-differential measurement error. Future studies should consider data collection strategies to account for the potential dynamic nature of measurement error, such as collecting internal validation data across time and treatment groups when possible.