Longitudinal Associations between Different Types of Sexting, Adolescent Mental Health, and Sexual Risk Behaviors: Moderating Effects of Gender, Ethnicity, Disability Status, and Sexual Minority Status.

The present study investigated the moderating effect of adolescent demographic variables in the longitudinal associations among different types of sexting, mental health (i.e., depression, self-harm, subjective health complaints), and sexual risk behaviors. There were 1113 adolescents (ages 14-17 years; Mage = 16.36; SDage = .81; 50% female) from six high schools located in the United States included in this study. Adolescents completed questionnaires on their sexting behaviors, mental health, and sexual risk behaviors during the ninth grade; in tenth grade, they completed questionnaires on mental health and sexual risk behaviors. Non-consensual sexting and pressured sexting were both related positively to each of the mental health variables and sexual risk behaviors. The relationship between non-consensual sexting and depressive symptoms was stronger for girls, ethnic minorities, those adolescents with disabilities, and sexual minorities. Similar patterns were found for pressured sexting, non-suicidal self-harm, and subjective health complaints. The relationships between pressured sexting and sexual risk behaviors were stronger for girls, ethnic minorities, those adolescents with disabilities, and those who identified as sexual minorities. Research focused on the relationships among different types of sexting, mental health, and sexual risk behaviors is important as such research facilitates the development of evidence-based recommendations for sexting harm prevention and sexual education programs.

Individual and Contextual Correlates of Latent Bystander Profiles toward Racist Hate Speech: A Multilevel Person-centered Approach.

Prior research into bystander responses to hate speech has utilized variable-centered analyses - such approaches risk simplifying the complex nature of bystander behaviors. Hence, the present study used a person-centered analysis to investigate latent hate speech bystander profiles. In addition, individual and classroom-level correlates associated with the various profiles were studied. The sample included 3225 students in grades 7-9 (51.7% self-identified as female; 37.2% with immigrant background) from 215 classrooms in Germany and Switzerland. The latent profile analysis revealed that four distinct profiles could be distinguished: Passive Bystanders (34.2%), Defenders (47.3%), Revengers (9.8%), and Contributors (8.6%). Multilevel logistic regression models showed common and distinct correlates. For example, students who believed that certain social groups are superior were more likely to be Revengers and Contributors than Passive Bystanders, students who felt more connected with teachers were more likely to be Defenders, and students who were more open to diversity were less likely to be Contributors than Passive Bystanders. Students were less likely Defenders and more likely Revengers and Contributors than Passive Bystanders in classrooms with high rates of hate speech perpetration. Further, in classrooms with high hate speech intervention, students were more likely to be Defenders and less likely to be Contributors than Passive Bystanders. In classrooms with stronger cohesion, students were more likely to be Defenders and less likely to be Contributors than Passive Bystanders. In conclusion, the findings add to our understanding of bystander profiles concerning racist hate speech and the relevance of individual and classroom-level factors in explaining various profiles of bystander behavior.

RPGR isoform imbalance causes ciliary defects due to exon ORF15 mutations in X-linked retinitis pigmentosa (XLRP).

Mutations in retinitis pigmentosa GTPase regulator (RPGR) cause severe retinal ciliopathy, X-linked retinitis pigmentosa. Although two major alternatively spliced isoforms, RPGRex1-19 and RPGRORF15, are expressed, the relative importance of these isoforms in disease pathogenesis is unclear. Here, we analyzed fibroblast samples from eight patients and found that all of them form longer cilia than normal controls, albeit to different degrees. Although all mutant RPGRORF15 messenger RNAs (mRNAs) are unstable, their steady-state levels were similar or higher than those in the control cells, suggesting there may be increased transcription. Three of the fibroblasts that had higher levels of mutant RPGRORF15 mRNA also exhibited significantly higher levels of RPGRex1-19 mRNA. Four samples with unaltered RPGRex1-19 levels carried mutations in RPGRORF15 that resulted in this isoform being relatively less stable. Thus, in all cases, the RPGRex1-19/RPGRORF15 isoform ratio was increased, and this was highly correlative to the cilia extension defect. Moreover, overexpression of RPGRex1-19 (mimicking the increase in RPGRex1-19 to RPGRORF15 isoform ratio) or RPGRORF15 (mimicking reduction of the ratio) resulted in significantly longer or shorter cilia, respectively. Notably, the cilia length defect appears to be attributable to both the loss of the wild-type RPGRORF15 protein and to the higher levels of the RPGRex1-19 isoform, indicating that the observed defect is due to the altered isoform ratios. These results suggest that maintaining the optimal RPGRex1-9 to RPGRORF15 ratio is critical for cilia growth and that designing strategies that focus on the best ways to restore the RPGRex1-19/RPGRORF15 ratio may lead to better therapeutic outcomes.

Retinal organoids: a window into human retinal development.

Retinal development and maturation are orchestrated by a series of interacting signalling networks that drive the morphogenetic transformation of the anterior developing brain. Studies in model organisms continue to elucidate these complex series of events. However, the human retina shows many differences from that of other organisms and the investigation of human eye development now benefits from stem cell-derived organoids. Retinal differentiation methods have progressed from simple 2D adherent cultures to self-organising micro-physiological systems. As models of development, these have collectively offered new insights into the previously unexplored early development of the human retina and informed our knowledge of the key cell fate decisions that govern the specification of light-sensitive photoreceptors. Although the developmental trajectories of other retinal cell types remain more elusive, the collation of omics datasets, combined with advanced culture methodology, will enable modelling of the intricate process of human retinogenesis and retinal disease in vitro.

ART Praxis: Evidence-Based Strategies for Antiracist Teaching in Nursing.

AIM: This integrative review seeks to provide effective teaching and learning strategies for teaching about racism and advancing health equity. BACKGROUND: Most faculty preparation remains devoid of an exploration of racism and the skills to critique how historical events and socialization create and reinforce the biases that influence how we teach and provide care. It is difficult to teach what we do not know. METHOD: Using Whittmore and Knafl's approach, we conducted an integrative review of multidisciplinary literature from 2009 to 2021 to uncover best practices for teaching about racism. Seven databases yielded 55 relevant articles from 18 disciplines. RESULTS: Four themes emerged illuminating effective strategies for teaching and learning about systemic racism: encounter education, reflection, discussion, and activism. CONCLUSION: Findings of this review align with Mezirow's transformative learning theory and highlight the importance of not just "doing" antiracist activities in a course but "becoming" an antiracist educator.

Effects of the Prevention Program "HateLess. Together against Hatred" on Adolescents' Empathy, Self-efficacy, and Countering Hate Speech.

Currently, there is a lack of empirically evaluated prevention programs targeting hate speech among adolescents. This is problematic because hate speech jeopardizes adolescents' well-being and social integration. To this end, this study aims to evaluate the short-term effects of the newly developed anti-hate speech prevention program, "HateLess. Together against Hatred", on adolescents' empathy, self-efficacy, and counter-speech. Eight hundred and twenty adolescents between 12 and 16 (M = 13.27, SD = 1.04) from 11 German schools participated in this study. More specifically, 567 adolescents participated in the one-week prevention program, and 253 participants were assigned to the control group. Repeated measures ANOVAs showed that HateLess was successful, as there was a significant increase in empathy, self-efficacy, and counter-speech in the intervention group from the pretest (T1) to the posttest (T2) one month after the intervention. In contrast, no changes were found among adolescents in the control group. A multilevel mediation model revealed that the effect of being a member of the intervention group on counter-speech was partially mediated via empathy and self-efficacy. The findings indicate that HateLess is an effective, cost-efficient approach to enhance adolescents' counter-speech directly and indirectly by altering the skills they need to become informed citizens in democratic societies.

Climate change and the adverse impact on the health and well-being of women and girls from the Women's Health Expert Panel of the American Academy of Nursing.

Climate change has measurable adverse impact on the general and reproductive health of women and girls. Multinational government organizations, private foundations, and consumer groups identify anthropogenic disruptions in social and ecological environments as the primary threats to human health this century. Drought, micronutrient shortage, famine, mass migration, conflict over resources, and effects on mental health resulting from displacement and war are challenging effects to manage. The most severe effects will be felt by those with the least resources to prepare for and adapt to changes. Climate change is a phenomenon of interest to women's health professionals because women and girls are more vulnerable to the effects due to a combination of physiologic, biologic, cultural, and socioeconomic risk factors. Nurses, with our scientific foundation, human-centered approach, and position of trust in societies can be leaders in efforts at mitigation, adaptation, and building resilience in response to changes in our planetary health.

A roadmap for social determinants of health and biological nursing research in the National Institute of Nursing Research 2022-2026 Strategic Plan: Optimizing health and advancing health equity using antiracist framing.

BACKGROUND: Health equity is essential for improving the well-being of all individuals and groups, and research remains a critical element for understanding barriers to health equity. While considering how to best support research that acknowledges current health challenges, it is crucial to understand the role of social justice frameworks within health equity research and the contributions of minoritized researchers. Additionally, there should be an increased understanding of the influence of social determinants of health on biological mechanisms. PURPOSE: Biological health equity research seeks to understand and address health disparities among historically excluded populations. DISCUSSION: While there are examples of studies in this area led by minoritized researchers, some individuals and groups remain understudied due to underfunding. Research within minoritized populations must be prioritized to authentically achieve health equity. Furthermore, there should be increased funding from National Institutes of Health to support minoritized researchers working in this area.

A telehealth intervention to increase patient preparedness for surgery: a randomized trial.

INTRODUCTION AND HYPOTHESIS: Methods to increase surgical preparedness in urogynecology are lacking. Our objective was to evaluate the impact of a preoperative provider-initiated telehealth call on surgical preparedness. METHODS: This was a multicenter randomized controlled trial. Women undergoing surgery for pelvic organ prolapse and/or stress urinary incontinence were randomized to either a telehealth call 3 (± 2) days before surgery plus usual preoperative counseling versus usual preoperative counseling alone. Our primary outcome was surgical preparedness, as measured by the Preoperative Prepardeness Questionnaire. The Modified Surgical Pain Scale, Pelvic Floor Distress Inventory-20, Patient Global Impressions of Improvement, Patient Global Impressions of Severity, Satisfaction with Decision Scale, Decision Regret Scale, and Clavien-Dindo scores were obtained at 4-8 weeks postoperatively and comparisons were made between groups. RESULTS: Mean telehealth call time was 11.1 ± 4.11 min. Women who received a preoperative telehealth call (n = 63) were significantly more prepared for surgery than those who received usual preoperative counseling alone (n = 69); 82.5 vs 59.4%, p < 0.01). A preoperative telehealth call was associated with greater understanding of surgical alternatives (77.8 vs 59.4%, p = 0.03), complications (69.8 vs 47.8%, p = 0.01), hospital-based catheter care (54 vs 34.8%, p = 0.04) and patient perception that nurses and doctors had spent enough time preparing them for their upcoming surgery (84.1 vs 60.9%, p < 0.01). At 4-8 weeks, no differences in postoperative and patient reported outcomes were observed between groups (all p > 0.05). CONCLUSIONS: A short preoperative telehealth call improves patient preparedness for urogynecological surgery.

Doula Support Challenges and Coping Strategies during the COVID-19 Pandemic: Implications for Maternal Health Inequities.

The COVID-19 pandemic has made birthing more stressful and isolating, which has raised particular concern for populations of birthing people affected by maternal health inequities. Doulas have been proposed as one means of improving health outcomes by providing emotional, physical, and informational support to patients and their families before, during, or after labor. However, the social and economic conditions of the COVID-19 pandemic have posed new challenges for doula care. We conducted thematic analysis on 25 semi-structured interviews with practicing doulas in the United States to explore changes to doula care during the pandemic. Although doulas have faced many challenges in providing virtual and socially-distanced support during the pandemic, the rising use of telehealth among doulas has revealed new coping strategies and opportunities for virtual communication with the doula community. Our findings indicate that doula experiences during the pandemic can inform future doula care practices, particularly for birthing people of color and low-income birthing people.

Assessing image-based sexual abuse: Measurement, prevalence, and temporal stability of sextortion and nonconsensual sexting ("revenge porn") among adolescents.

INTRODUCTION: The aim of this study is to develop a new measure of victimization and perpetration of two frequent forms of image-based sexual abuse, namely sextortion (i.e., the threat of distributing sexual images to pressure the victim into doing something) and nonconsensual sexting (i.e., distributing sexual images of someone without the consent of the victim). Additional aims were to analyze the prevalence of these forms of victimization and perpetration and to examine their temporal stability over a 1-year period. METHODS: The sample was made up of 1820 Spanish adolescents (mean age = 13.38, SD = 1.42; 929 girls, 878 boys, 3 nonbinary, and 10 did not indicate gender) who completed self-report instruments on image-based sexual abuse and related variables (e.g., cyberbullying victimization). RESULTS: Confirmatory factor analysis supported a structure composed of the four hypothesized factors: sextortion victimization and perpetration, and nonconsensual sexting victimization and perpetration. Higher sexting, cyberbullying victimization, and symptoms of depression and anxiety had stronger associations with image-based sexual victimization than with perpetration, which showed evidence of concurrent validity. Prevalence was 2.6% and 0.7% for sextortion victimization and perpetration, respectively, and 3.4% and 4.9% for nonconsensual sexting victimization and perpetration, respectively. Temporal stability over 1 year was .26 for sextortion victimization, .19 for nonconsensual sexting victimization, .33 for nonconsensual sexting perpetration (all ps < .001), and nonsignificant for sextortion perpetration. The stability of nonconsensual sexting victimization was significantly higher for girls compared to boys, whereas nonconsensual sexting perpetration was more stable over 1 year for boys. CONCLUSIONS: Future studies must advance the analysis of the predictors and consequences of image-based sexual abuse among adolescents to better prevent this problem. Prevalence of sextortion and nonconsensual sexting is not negligible, and these problems should be particularly addressed in prevention programs.

The Role of Perceived Gay-Straight Alliance Social Support in the Longitudinal Association Between Homophobic Cyberbullying and LGBTQIA Adolescents' Depressive and Anxiety Symptoms.

There has been little research attention given to how Gay-Straight Alliances might mitigate mental health consequences associated with experiencing homophobic cyberbullying. To address this gap in knowledge, the purpose of this one-year longitudinal study was to investigate the moderating effect of perceived social support from Gay-Straight Alliances in the relationships among homophobic cyberbullying victimization and bystanding and depressive and anxiety symptoms among 466 LGBTQIA adolescents (Mage = 15.76; 52% female). The findings revealed that perceived social support was related negatively to homophobic cyberbullying involvement and depressive and anxiety symptoms. Homophobic cyberbullying involvement was related positively to depressive and anxiety symptoms. High perceived social support buffered against the depressive and anxiety symptoms resulting from homophobic victimization and bystanding among LGBTQIA adolescents but low levels and average levels did not moderate these associations. These findings highlight the importance of expanding Gay-Straight Alliances in schools.

Does social support moderate the relationship between racial discrimination and aggression among Latinx adolescents? A longitudinal study.

INTRODUCTION: This study examined the relationship between racial discrimination by peers and aggression (i.e., self-reported and peer-nominated relational aggression and physical aggression) across one year through the moderation of social support from parents, friends, and teachers. METHODS: Participants were 606 Latinx adolescents from the United States (60% girls; M = 14.36, SD = 0.46). They completed self-report questionnaires on their perceived racial discrimination by peers, and self-reported and peer-nominated relational and physical aggression. RESULTS & CONCLUSIONS: Racial discrimination by peers was negatively associated with social support from parents, friends, and teachers, as well as positively related to all forms of Time 2 (1 year) self-reported and peer-nominated relational aggression and physical aggression. Social support from parents, friends, and teachers were negatively related to all forms of Time 2 aggressive behaviors. Increases in social support from parents, friends, and teachers weakened the positive association between racial discrimination by peers and Time 2 self-reported and peer-nominated relational aggression, while lower levels of social support strengthened this association. There were no significant moderating effects of social support from parents, social support, and close friends found for Time 2 self-reported and peer-nominated physical aggression. These findings indicate that high social support from parents, friends, and teachers impacts Latinx adolescents reduces the impact of racial discrimination by peers on adolescents' relational aggression.

Association of Obesity with DNA Methylation Age Acceleration in African American Mothers from the InterGEN Study.

African American women are affected by earlier onset of age-associated health deteriorations and obesity disproportionally, but little is known about the mechanism linking body mass index (BMI) and biological aging among this population. DNA methylation age acceleration (DNAm AA), measuring the difference between DNA methylation age and chronological age, is a novel biomarker of the biological aging process, and predicts aging-related disease outcomes. The present study estimated cross-tissue DNA methylation age acceleration using saliva samples from 232 African American mothers. Cross-sectional regression analyses were performed to assess the association of BMI with DNAm AA. The average chronological age and DNA methylation age were 31.67 years, and 28.79 years, respectively. After adjusting for smoking, hypertension diagnosis history, and socioeconomic factors (education, marital status, household income), a 1 kg/m2 increase in BMI is associated with 0.14 years increment of DNAm AA (95% CI: (0.08, 0.21)). The conclusion: in African American women, high BMI is independently associated with saliva-based DNA methylation age acceleration, after adjusting for smoking, hypertension, and socioeconomic status. This finding supports that high BMI accelerates biological aging, and plays a key role in age-related disease outcomes among African American women.

Understanding the overlap between cyberbullying and cyberhate perpetration: Moderating effects of toxic online disinhibition.

BACKGROUND: Problem behaviour theory postulates that different forms of norm violations cluster and can be explained by similar antecedents. One such cluster may include cyberbullying and cyberhate perpetration. A potential explanatory mechanism includes toxic online disinhibition, characterised by anonymity, an inability to empathise and to recognise and interpret social cues. The current study to develop a better understanding of the relationship between cyberhate and cyberbullying to inform effective intervention and prevention efforts. AIMS: To test the link between cyberbullying and cyberhate and whether this relationship was moderated by toxic online disinhibition. METHODS: Self-report questionnaires on cyberbullying, cyberhate, and toxic online disinhibition were completed by 1,480 adolescents between 12 and 17 years old (M = 14.21 years; SD = 1.68). RESULTS: Increases in cyberbullying perpetration and toxic online disinhibition were positively related to cyberhate perpetration. Furthermore, cyberbullies reported more cyberhate perpetration when they reported higher levels of toxic online disinhibition and less frequent cyberhate perpetration when they reported lower levels of toxic online disinhibition. CONCLUSION: The current study provides evidence of a possible link between cyberbullying and cyberhate perpetration, moderated by toxic online disinhibition. This suggests that, to be effective, prevention and intervention programmes should (i) consider the co-occurrence of varying forms of cyberaggression and (ii) consider potential effects of the online environment on aggressive online behaviour among young people.

Children's Experiences and Awareness about Impact of Digital Media on Health.

Previous research has focused on the associations between technology use and children's health, using mainly quantitative designs. This qualitative study describes technology's impact on physical and mental health from children's perspectives. The differences between children's experiences and awareness of the health-related consequences associated with digital media use were examined. Focus groups and interviews were conducted with children between the ages of 9 and 16 in nine European countries (N = 368). Results of this study indicate that children's experiences of health-related technology impacts are different from their awareness of these impacts. Children's direct experiences with media were less extreme in contrast to their awareness of health problems, which typically involved extreme examples of possible consequences, such as killing people, kidnapping, blindness, and developing learning or psychological disorders. The results are discussed in the context of the "media panic" and "third person effect" theories.

Bullying and alexithymia: Are there differences between traditional, cyber, combined bullies, and nonbullies in reading their own emotions?

BACKGROUND: Few studies have examined alexithymia, the inability to identify or describe one's emotions, as a possible correlate of bullying. AIMS: To investigate whether there are differences among 12-18 year-olds in capacity for identifying and/or describing own emotions between traditional bullies, cyber bullies, combined bullies, and nonbullies. METHODS: Data from self-report questionnaires completed by 897 female and 652 male 12-18 year-olds (mean 14.5 years, standard deviation 1.68) from Germany and Thailand were analysed using analysis of covariance. RESULTS: Young people who reported never having bullied others scored lower on the alexithymia scale than traditional, cyber, or combined bullies. There were no differences between traditional and cyber bullies on this measure, but those who operated in both ways had significantly higher alexithymia scores compared with those who bullied in just one modality. CONCLUSION: Alexithymia is thus likely to be an important factor to consider in prevention and treatment of bullying. We recommend that prevention programmes include elements to help identify and describe one's own emotions, providing additional support, and "training" if alexithymia is identified. When young people use cyber techniques and traditional bullying methods, it seems likely that they will have greatest need in this respect.

Relationships among psychoneurological symptoms and levels of C-reactive protein over 2 years in women with early-stage breast cancer.

PURPOSE: The aim of the present study was to explore clusters of psychoneurological symptoms and inflammation (levels of C-reactive protein) over time in a cohort of women with early-stage breast cancer. Specifically, we examined the relationships among affective symptoms (depression, anxiety, fatigue, sleep disturbances, pain, and perceived stress), domains of cognitive performance, and levels of peripheral C-reactive over a period of 2 years. METHODS: This was a prospective, longitudinal study of 77 women diagnosed with early-stage breast cancer. Data collection, including symptom questionnaires, performance-based cognitive testing, and blood draws, took place at 5 time points: prior to initiating adjuvant chemotherapy, prior to the fourth chemotherapy treatment, and at 6, 12, and 24 months after the initiation of chemotherapy. RESULTS: Exploratory factor analysis with varimax orthogonal rotation was used to examine the covariance among symptoms at each visit. Using the factor scores and weighted sums, three clusters were identified: global cognition, affective symptoms, and cognitive efficiency. Peripheral levels of C-reactive protein were inversely correlated with the cognitive efficiency factor across time. CONCLUSIONS: The findings suggest that objectively measured domains of cognitive function occur independently of other affective symptoms that are commonly reported by women with breast cancer in long-term survivorship. The cognitive efficiency symptom cluster may be amenable to interventions targeted to biological influences that reduce levels of C-reactive protein.

Genome Sequencing Technologies and Nursing: What Are the Roles of Nurses and Nurse Scientists?

BACKGROUND: Advances in DNA sequencing technology have resulted in an abundance of personalized data with challenging clinical utility and meaning for clinicians. This wealth of data has potential to dramatically impact the quality of healthcare. Nurses are at the focal point in educating patients regarding relevant healthcare needs; therefore, an understanding of sequencing technology and utilizing these data are critical. AIM: The objective of this study was to explicate the role of nurses and nurse scientists as integral members of healthcare teams in improving understanding of DNA sequencing data and translational genomics for patients. APPROACH: A history of the nurse role in newborn screening is used as an exemplar. DISCUSSION: This study serves as an exemplar on how genome sequencing has been utilized in nursing science and incorporates linkages of other omics approaches used by nurses that are included in this special issue. This special issue showcased nurse scientists conducting multi-omic research from various methods, including targeted candidate genes, pharmacogenomics, proteomics, epigenomics, and the microbiome. From this vantage point, we provide an overview of the roles of nurse scientists in genome sequencing research and provide recommendations for the best utilization of nurses and nurse scientists related to genome sequencing.

Changes in vaginal community state types reflect major shifts in the microbiome.

Background: Recent studies of various human microbiome habitats have revealed thousands of bacterial species and the existence of large variation in communities of microorganisms in the same habitats across individual human subjects. Previous efforts to summarize this diversity, notably in the human gut and vagina, have categorized microbiome profiles by clustering them into community state types (CSTs). The functional relevance of specific CSTs has not been established. Objective: We investigate whether CSTs can be used to assess dynamics in the microbiome. Design: We conduct a re-analysis of five sequencing-based microbiome surveys derived from vaginal samples with repeated measures. Results: We observe that detection of a CST transition is largely insensitive to choices in methods for normalization or clustering. We find that healthy subjects persist in a CST for two to three weeks or more on average, while those with evidence of dysbiosis tend to change more often. Changes in CST can be gradual or occur over less than one day. Upcoming CST changes and switches to high-risk CSTs can be predicted with high accuracy in certain scenarios. Finally, we observe that presence of Gardnerella vaginalis is a strong predictor of an upcoming CST change. Conclusion: Overall, our results show that the CST concept is useful for studying microbiome dynamics.