Measuring the Effect of Off-Balancing Vectors on the Delivery of High-Quality CPR during Ambulance Transport: A Proof of Concept Study.

AIM: This study aims to demonstrate the feasibility of quantifying the off-balancing vectors experienced during ambulance transport and comparing them to high-quality cardiopulmonary resuscitation (HQ-CPR) metrics. METHODS: Ten participants completed a total of 20 evolutions of compression-only HQ-CPR in an ambulance driven in a manner that minimized or increased linear and angular off-balancing vectors. Linear and angular velocity, linear and angular acceleration, and linear jerk were recorded. HQ-CPR variables measured were compression fraction and proportion of compressions with depth >5 cm (depth%), rate 100-120 (rate%), full chest recoil (recoil%), and hand position (hand%). A composite score was calculated: [(depth% + rate% + recoil% + hand%)/4) * compression fraction]. Difficulty of HQ-CPR performance was measured with the Borg rating of perceived exertion (RPE) Scale. A series of mixed effects models were fitted regressing each HQ-CPR metric on each off-balancing vector. RESULTS: HQ-CPR data and vector quantity data were successfully recorded in all evolutions. Rate% was negatively associated with increasing linear velocity (slope = -3.82, standard error [SE] 1.12, p = 0.005), linear acceleration (slope = -5.52, SE 1.93, p = 0.013), linear jerk (slope = -17.60, SE 5.78, p = 0.007), angular velocity (slope = -75.74, SE 22.72, p = 0.004), and angular acceleration (slope = -152.53, SE 59.60, p = 0.022). Compression fraction was negatively associated with increasing linear velocity (slope = -1.35, SE 0.37, p = 0.004), linear acceleration (slope = -1.67, SE 0.48, p = 0.003), linear jerk (slope = -4.90, SE 1.86, p = 0.018), angular velocity (slope = -25.66, SE 6.49, p = 0.001), and angular acceleration (slope = -45.35, SE 18.91, p = 0.031). Recoil% was negatively associated with increasing linear velocity (slope = -5.80, SE 2.21, p = 0.023) and angular velocity (slope = -116.96, SE 44.24, p = 0.019)). Composite score was negatively associated with increasing linear velocity (slope = -4.49, SE 1.45, p = 0.009) and angular velocity (slope = -86.13, SE 31.24, p = 0.014) and approached a negative association with increasing magnitudes of linear acceleration (slope -5.54, SE 2.93, p = 0.075), linear jerk (slope = -17.43, SE 8.80, p = 0.064), and angular acceleration (slope = -170.43, SE 80.73, p = 0.051). Borg RPE scale was positively associated with all off-balancing vectors. Depth%, hand%, mean compression depth, and mean compression rate were not correlated with any off-balancing vector. CONCLUSION: Off-balancing vector data can be successfully quantified during ambulance transport and compared with HQ-CPR performance parameters. Increasing off-balancing vectors experienced during ambulance transport are associated with worse HQ-CPR metrics and increased perceived physical exertion. These data may help guide future drive styles, ambulance design, or use of mechanical CPR devices to improve HQ-CPR delivery during selected patient transport scenarios.

The Role of Agreeableness, Neuroticism, and Relationship-Specific Features in Self- and Other-Perceptions of Conflict Frequency in Adolescent Relationships with Parents and Peers.

Conflict frequency in adolescence has been linked to personality and relationship-specific features. However, an integrative investigation of both aspects is lacking. To address this gap, this study used data from 571 individuals in middle adolescence (Study 1; Mage = 15.86, SD = 1.23; 75.8% female) and 233 individuals in late adolescence (Study 2; Mage = 17.17, SD = 1.01; 75.5% female) in Germany, including participants' self-reports on conflict frequency and other-reports provided by parents and peers. Across studies, multigroup models revealed that adolescents' level of neuroticism predicted self- and other-perceived conflict frequency in parent and peer relationships more consistently than agreeableness, while providing no evidence for an interplay between both personality traits. Furthermore, relationship-specific features differentially accounted for individual differences in conflict frequency across relationship types, such that in adolescents' relationships with parents, lower relationship quality related to more frequent conflicts. In peer relationships, higher contact frequency was linked to more frequent conflicts. The present findings highlight the contributions of both personality and relationship-specific features to conflict frequency in adolescence and offer practical guidance for the improvement of adolescents' and their relationship partners' social skills and experiences. All research questions, hypotheses, and analyses of this research were preregistered at the OSF and can be retrieved from: https://osf.io/xmvqd/ .

Routes to momentary self-esteem in adolescence: Links with interpersonal perceptions of liking and personality metaperceptions within social interactions.

OBJECTIVE: This study provides insights into the perceptual processes contributing to positive social experiences and momentary self-esteem in adolescents' initial social interactions. BACKGROUND: A person's self-esteem is shaped by their social experiences. However, little is known about which interpersonal perceptions are linked to momentary self-esteem within social interactions. Identifying two key interpersonal perceptions, we examined differential associations between an individual's meta-liking and other-perceptions of liking by interaction partners with momentary self-esteem. Further, we investigated how preceding personality metaperceptions (i.e., meta-accuracy and meta-positivity) extended these sociometer processes. METHOD: The current study used round-robin data from N = 296 adolescents participating in a virtual group interaction. Social accuracy modeling was used to estimate meta-accuracy and meta-positivity of personality metaperceptions, and path models were used to test associations with interpersonal perceptions of liking and momentary self-esteem. RESULTS: Two main findings emerged: First, meta-liking was consistently related to higher momentary self-esteem, whereas other-perceptions of liking were not. Second, meta-positivity of personality metaperceptions was linked to higher meta-liking and indirectly contributed to higher momentary self-esteem through meta-liking. CONCLUSION: These findings highlight the importance of considering different interpersonal perceptions to understand social interaction experiences.

Beyond Big Five trait domains: Stability and change in personality facets across midlife and old age.

OBJECTIVE: Accumulated evidence indicates both stable and malleable parts of inter-individual differences in the broad Big Five domains. Less is known, however, about stability and change at the more diversified facet level. With the current study, we fill this gap by investigating personality stability and change across midlife and old age. METHOD: We apply local structural equation measurement models and second-order growth curve models to four waves of data obtained with the full NEO Personality Inventory (NEO-PI-R) collected over 11 years from 1667 adults (Mage  = 62.69 years, SDage  = 15.62, 55% female) who participated in the Seattle Longitudinal Study. RESULTS: Measurement invariance analyses indicated that the psychometric properties of the NEO-PI-R facets are comparable across time and age. Results revealed substantial rank-order stabilities across all facets, yet the exact pattern varied strongly between facets of the same trait and across traits. Mean-level change of facets from midlife to old age largely mirrored the mean-level change observed for the broader traits. CONCLUSION: We discuss conceptual implications and argue that in the face of overall stability across midlife and old age, changes in the rank-ordering of people reveals a much more complex and diverse pattern of development than analyses at the trait level suggest.

Acting Like a Baby Boomer? Birth-Cohort Differences in Adults' Personality Trajectories During the Last Half a Century.

Society and developmental theory generally assume that there are wide generational differences in personality. Yet evidence showing historical change in the levels of adult Big Five traits is scarce and particularly so for developmental change. We tracked adult trajectories of personality in 4,732 participants (age: M = 52.93 years, SD = 16.69; 53% female) from the Seattle Longitudinal Study (born 1883-1976) across 50 years. Multilevel models revealed evidence for historical change in personality: At age 56, later-born cohorts exhibited lower levels of maturity-related traits (agreeableness and neuroticism) and higher levels of agency-related traits (extraversion and openness) than earlier-born cohorts. Historical changes in agreeableness and neuroticism were more pronounced among young adults, but changes in openness were less pronounced. Cohort differences in change were rare and were observed only for agreeableness; within-person increases were more pronounced among later-born cohorts. Our results yield the first evidence for historical change in the Big Five across adulthood and point to the roles of delayed social-investment and maturity effects.

Moving beyond referrals to strengthen late-life depression care: a qualitative examination of primary care clinic and community-based organization partnerships.

BACKGROUND: National guidelines have called for greater integration of primary care and behavioral health services, with more recent attention to social care and community-based services. Under growing resource constraints healthcare organizations have tended to rely on referrals to external entities to address social care needs. Traditional referral models, however, may not be equipped to provide for the complex needs of older adults with depression. The Care Partners Project was designed to strengthen late-life depression care through integrated partnerships between primary care clinics and community-based organizations. We sought to understand how these integrated partnerships, with shared tasks and accountability across organizations, changed the nature of depression care for older adults. METHODS: We conducted 65 in-depth, semi-structured interviews and six focus groups with service providers involved in the project, including care managers, primary care providers, and psychiatric consultants, and applied inductive and deductive qualitative thematic analysis to develop themes around participants' experiences with the partnered initiative. RESULTS: We found the partnerships established by the Care Partners Project reshaped late-life depression care in two ways: (1) bidirectional communication across organizations facilitated greater recognition among providers of intersecting medical and social needs associated with late-life depression; and (2) depression care became more coordinated and effective as care teams established or strengthened relationships across organizations. CONCLUSIONS: These findings highlight the ways cross-organizational health and social care partnerships that move beyond traditional referrals can strengthen late-life depression care and enhance organizational capacities.

Gloomy and out of control? Consequences of the COVID-19 pandemic on momentary optimism in daily live of adolescents.

In the global COVID-19 pandemic, adolescents are regarded as especially burdened due to school closures and leisure activities being banned, often reducing peer contacts to zero. Experiencing restrictions while being uninvolved in decision-making processes left them with little control over their daily lives. Meanwhile, research highlights that optimism can act as a buffer against the impact of daily hassles and is considered an important resource for mental health. To understand the implications of the COVID-19 pandemic for adolescents' lives, this study examined how momentary perceived control and perceived personal and societal consequences of the COVID-19 pandemic relate to momentary optimism. Using experience-sampling data from N = 242 (M age = 15.89; 86% female) adolescents assessed during the second pandemic wave in Germany, multilevel modeling revealed positive associations between adolescents' momentary perceived control and their momentary optimism at both the within- and between-person level. Additionally, perceived consequences of the COVID-19 pandemic showed specific associations with momentary optimism: Whereas perceived societal consequences were directly related to lower momentary optimism, perceived personal consequences strengthened the relationship between momentary perceived control and optimism. These findings highlight the role of perceived control as an important resource for optimism both as a general tendency and within specific situations in daily life. This way, our results may shed light on how to support adolescent optimism during states of emergency, such as a worldwide pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-03313-6.

Beware of Stereotypes: Are Classmates' Stereotypes Associated With Students' Reading Outcomes?

This study examined the associations between classmates' reading-related gender stereotypes and students' reading self-efficacy, self-concept, motivation, and achievement. Our sample consisted of 1,508 fifth-grade students (49% girls; age: 10.89 years); data were collected at two time points. Multilevel analyses yielded two main results: First, there was a relation between students' individual reading-related gender stereotypes and their reading self-concept, self-efficacy, and motivation with boys experiencing negative and girls experiencing positive effects. Second, a contextual effect was found: after controlling for students' individual reading-related gender stereotypes, classmates' gender stereotypes were negatively related to all of the boys' reading outcomes. The results provide evidence for the assumption that classmates are important communicators of gender stereotypes and that they reinforce conforming behaviors.

Ulipristal acetate and pregnancy outcome-an observational study.

STUDY QUESTION: Is the failure of the selective progesterone receptor modulator ulipristal acetate (UPA) as emergency contraception (EC; 30 mg, single) or inadvertent exposure for myoma treatment (5 mg/d) in pregnancy associated with a higher risk of birth defects, spontaneous abortion (SAB) or elective termination of pregnancy (ETOP)? SUMMARY ANSWER: We did not find an increased risk for birth defects, SABs or ETOPs after UPA exposure during implantation and early embryogenesis. WHAT IS KNOWN ALREADY: Pregnancy outcome data after exposure to UPA are very limited. In cases of EC failure or unplanned pregnancy during myoma treatment, women need well-grounded risk assessment to minimize anxiety and prevent unjustified termination of pregnancy. STUDY DESIGN, SIZE, DURATION: Observational study of prospectively ascertained pregnancies from the German Embryotox institute with UPA exposure (EC, n = 95; myoma, n = 7). Four retrospectively reported pregnancy outcomes were evaluated separately. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 226 requests on ulipristal were directed to the German Embryotox institute during the study period 2010-2018. Outcomes of pregnancies exposed-(i) precycle, (ii) preconceptional or (iii) first trimester-were ascertained using standardized questionnaires. Descriptive statistics were applied. MAIN RESULTS AND THE ROLE OF CHANCE: Failed EC with UPA resulted in 95 prospectively ascertained pregnancies, of which 56 had completed follow-up: 37 live births, 7 SABs and 12 ETOPs. There was no major birth defect. Just 34% of women had taken UPA during the fertile window. Seven prospectively enrolled pregnancies were treated for myoma and had known pregnancy outcomes: five healthy live births and two SABs. Among the four retrospectively reported pregnancies after EC, there was one child diagnosed with Beckwith-Wiedemann syndrome (BWS). LIMITATIONS, REASONS FOR CAUTION: Our limited sample size does not allow concluding safety of UPA use in pregnancy. WIDER IMPLICATIONS OF THE FINDINGS: We provide a preliminary basis for reassuring women who wish to carry their pregnancy to term after EC or myoma treatment with UPA. However, because of the report of a BWS after UPA exposure, a possible epigenetic effect could not be excluded and requires further evaluation. STUDY FUNDING/COMPETING INTEREST(S): This work was performed with financial support from the German Federal Institute for Drugs and Medical Devices (BfArM). All authors declare that they have no conflicts of interest. TRIAL REGISTRATION NUMBER: Registered with the German Clinical Trial Register (DRKS00015155).

Perioperative management of positioning in gynecological cancersurgery: a national NOGGO-AGO intergroup survey.

INTRODUCTION: The daily clinical routine in the operating room includes patient positioning. The number of perioperative positioning-related complications is growing, along with the legal proceedings concerning this topic, and only a few guidelines exist to provide specific recommendations. The aim of this survey was to assess perioperative positioning and associated adverse events during gynecological cancer surgery in Germany. METHODS: A total of 633 gynecological departments of primary, secondary, and maximum healthcare hospitals in Germany were invited to participate in this multiple-choice online questionnaire. The survey was conducted anonymously for a period of six months. The survey was divided into five different sections: descriptive information about the respondent department, pre- and postoperative management, management of positioning in the operating room based on two fictional case examples, and quality management. RESULTS: The response rate of our survey was 29.1 % (184/633). Nearly half of the departments (46.7 %) reported to have had one to five patients with positioning-related complications during the prior 12 months, and 29.1 % had experienced a legal dispute due to positioning-related complications. Departments with more than 50 gynecologic-oncological surgeries per year more often reported positioning-related complications (p=0.003). Standard operating procedures exist in almost every department for laparoscopic (97 %) and open surgery (95.1 %), respectively. DISCUSSION: The high number of positioning-related complications throughout all departments of different healthcare levels underlines the relevance of this issue and supports the need for a prospective European registry for further analysis. Training and education for all staff members should be routinely implemented to reduce and prevent positioning-related complications.

Similarity of vocational interest profiles within families: A person-centered approach for examining associations between circumplex profiles.

OBJECTIVE: Our study addressed three questions concerning the similarity of vocational interests within families: (a) How similar are vocational interests of mothers and fathers? (b) How similar are vocational interests of parents and their children? (c) Is the inference about parent-child profile similarity affected by mother-father profile similarity? METHOD: Data from N=1,624 tenth graders and their parents were used to analyze interest profile similarity by means of a pseudo-coupling approach. Similarity was assessed on the level of observed profiles and model-based circumplex profiles. RESULTS: Interest profiles of mother-father and parent-child dyads were more similar to each other than those of corresponding arbitrarily paired dyads. However, when the similarity between the parents' interest profiles was accounted for, only same-sex parent-child dyads were more similar to each other than would be expected by chance. All findings were mirrored on the level of observed profiles and model-based circumplex profiles. CONCLUSIONS: In sum, our findings support the validity of the circumplex model of vocational interests and emphasize the benefits of explicitly considering its implications when analyzing profile similarity. Moreover, we were able to show that the statistical evaluation of profile similarities must account for normative profile components.

Self-esteem development in the school context: The roles of intrapersonal and interpersonal social predictors.

OBJECTIVE: When considering that social inclusion is a basic human need, it makes sense that self-esteem is fueled by social feedback and the sense of being liked by others. This is particularly true with respect to early adolescence, when peers become increasingly important. In the current article, we tested which components of social inclusion are particularly beneficial for the development of self-esteem by differentiating between intrapersonal components (i.e., self-perceptions of social inclusion) and interpersonal components (i.e., perceiver and target effects of liking). METHOD: Using longitudinal data from 2,281 fifth graders and 1,766 eighth graders (TRAIN; Jonkmann et al., 2013), we tested mean-level self-esteem development and the role of intrapersonal components in this development. Using classroom round-robin data on liking from subsamples of 846 (689) fifth-(eighth-)grade students nested in 46 (39) classes, we tested effects of interpersonal relationship components on self-esteem development in the classroom context. RESULTS: The three major findings demonstrated, first, no consistent trends in mean levels of self-esteem in early to middle adolescence; second, constant positive effects of intrapersonal components between students and within students across time; and third, no stable effects of interpersonal components. CONCLUSIONS: The discussion highlights the role of intrapersonal components and the methodological challenges of our study.

Self-esteem Is Mostly Stable Across Young Adulthood: Evidence from Latent STARTS Models.

How stable is self-esteem? This long-standing debate has led to different conclusions across different areas of psychology. Longitudinal data and up-to-date statistical models have recently indicated that self-esteem has stable and autoregressive trait-like components and state-like components. We applied latent STARTS models with the goal of replicating previous findings in a longitudinal sample of young adults (N = 4,532; Mage = 19.60, SD = 0.85; 55% female). In addition, we applied multigroup models to extend previous findings on different patterns of stability for men versus women and for people with high versus low levels of depressive symptoms. We found evidence for the general pattern of a major proportion of stable and autoregressive trait variance and a smaller yet substantial amount of state variance in self-esteem across 10 years. Furthermore, multigroup models suggested substantial differences in the variance components: Females showed more state variability than males. Individuals with higher levels of depressive symptoms showed more state and less autoregressive trait variance in self-esteem. Results are discussed with respect to the ongoing trait-state debate and possible implications of the group differences that we found in the stability of self-esteem.

Parental Involvement with College Students in Germany, Hong Kong, Korea, and the United States.

Rates of college attendance have increased throughout the world. This study asked whether students across nations experience high involvement with parents (frequent contact and support) and how satisfied they are with parental involvement. College students from four major Western and Asian economies participated: Germany (n = 458), Hong Kong (n = 276), Korea (n = 257), and the United States (n = 310). Consistent with solidarity theory, students across nations reported frequent contact with parents and receiving several forms of social support (e.g., practical, emotional, and advice) every month. Multilevel models revealed Asian students received more frequent parental support than German or US students, but were less satisfied with that support. Students in Hong Kong resided with parents more often and gave more support to parents than students in other cultures. Discussion focuses on cultural (i.e., filial obligation) and structural (i.e., coresidence) factors explaining parental involvement.

Boosting yourself? Associations between momentary self-esteem, daily social interactions, and self-esteem development in late adolescence and late adulthood.

Research over the past 2 decades has repeatedly shown that the evaluation of one's own worth-trait self-esteem-is closely linked to the quality of social relationships and perceptions of social inclusion. However, there is limited evidence on the dynamics between momentary self-esteem and perceptions of social inclusion in everyday life, as well as on their possible long-term (bottom-up) effects on the development of trait self-esteem. We addressed this research gap using longitudinal data from a German multimethodological study (N = 324) in which N = 235 late adolescents (Mage = 17.7; 76% female) and N = 89 older adults (Mage = 63.8; 64% female) were followed over 1 year. Based on three trait questionnaires with 6-month intervals and a 7-day experience-sampling burst at the first measurement point, we investigated momentary dynamics in self-esteem and longitudinal change by using multilevel and latent growth modeling. Results confirmed the positive association between momentary self-esteem and perceptions of social inclusion in everyday life, that is, self-esteem reactivity in both age groups. In addition, both self- and other-reports showed a consistent increase in trait self-esteem over 1 year. However, because the slope parameters did not indicate substantial interindividual variance, we were unable to test for bottom-up effects of self-esteem reactivity. We discuss the importance of daily social experiences for momentary self-esteem in late adolescence and late adulthood but also point to the need for further multimethodological research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Popularity at first sight: Dominant behaviours mediate the link between extraversion and popularity in face-to-face and virtual group interactions.

Although there is robust evidence that being more extraverted is related to higher popularity, only few studies have examined which actual behaviours (e.g., verbal content, body language) might explain this association. The current study examined whether observer-rated dominant behaviours (nonverbal, paraverbal, verbal, and general cues) mediate the relationship between self-rated extraversion and its facets (assertiveness, sociability, and activity) and other-rated popularity in zero-acquaintance settings. In two studies, we analysed data from face-to-face (Study 1, N = 124) and virtual (Study 2, N = 291) group interactions where participants were videotaped while performing a task and subsequently rated each other on popularity. Across studies, extraversion and the facets assertiveness and sociability were consistently associated with higher popularity, while the role of dominant behaviours differed. In Study 1, only two nonverbal behaviours, dominant gestures and upright posture, mediated the association between extraversion and popularity. In Study 2, all four types of behavioural cues mediated the association between extraversion (facets) and popularity. We discuss how these findings provide insights into the mechanisms of attaining popularity at zero acquaintance in diverse social settings.

I think you might like me: Emergence and change of meta-liking in initial social interactions.

Feeling accepted by others is a fundamental human motive and an important marker of successful social interactions. This interpersonal perception, known as meta-liking, is especially relevant during adolescence, when peer relationships deepen and expand. However, knowledge is limited regarding meta-liking formation in initial social interactions. This study investigated whether adolescents (N = 293, Mage = 15.48, 61.10% female) have default expectations for meta-liking at zero acquaintance and how these judgments are updated during initial group interactions. Specifically, we used latent change models to examine how personality traits predicted initial meta-liking and whether personality and social interaction experiences were linked to changes in meta-liking judgments throughout an interaction. Our findings revealed three key insights: First, meta-liking increased gradually over the course of the interaction, with substantial individual differences in both default meta-liking and change scores. Second, extraversion, neuroticism, and self-esteem predicted initial meta-liking. Third, liking others was also linked to initial meta-liking and early changes, while meta-liking changes toward the end of the interaction occurred independent of all these features and were not predicted by expressive behaviors of interaction partners. This study represents a first empirical test of default expectations and updates in meta-liking based on personality characteristics and social interaction experiences in initial social interactions. We discuss our results in terms of a broader framework for understanding how metaperceptions are formed and updated early in the acquaintance process. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Missing link: a qualitative analysis of community-based organisations' contributions to partnered collaborative care to treat late-life depression.

OBJECTIVE: Extending collaborative care, a model integrating mental health services into primary care, to include community-based organisations (CBOs) may improve older patient health outcomes by increasing access to care and addressing patients' social needs; however, little is known about how CBOs contribute to such partnered depression care. We explored how six primary care clinic and CBO partnerships came together to provide late-life depression care through the Care Partners funded in 2014. DESIGN: 43 key informant interviews and 15 focus groups were conducted with care managers, administrators and primary care providers partnering to provide late-life depression care. Data were coded and analysed iteratively using qualitative thematic analysis. SETTING: Six primary care clinic-CBO sites across California. PARTICIPANTS: Care managers, administrators and primary care providers participated in this study. RESULTS: Three unique contributions of CBOs to depression care in these clinic-CBO partnerships were identified: (1) CBOs added new services that focus on social needs and enhanced depression care; (2) CBOs strengthened core aspects of collaborative care for depression; (3) CBOs provided new avenues for building connections and trust with underserved patients. CONCLUSIONS: CBOs, when partnered with clinics, enhanced both medical and social aspects of depression treatment for older adults. CBOs are well positioned to assist primary care clinics in treating the complex health needs of older adults by providing new and strengthening existing aspects of partnered depression care while building patient trust among culturally diverse populations.

Sexually Transmitted Infection Co-testing in a Large Urban Emergency Department.

Introduction: The incidence of sexually transmitted infections (STI) increased in the United States between 2017-2021. There is limited data describing STI co-testing practices and the prevalence of STI co-infections in emergency departments (ED). In this study, we aimed to describe the prevalence of co-testing and co-infection of HIV, hepatitis C virus (HCV), syphilis, gonorrhea, and chlamydia, in a large, academic ED. Methods: This was a single-center, retrospective cross-sectional study of ED patients tested for HIV, HCV, syphilis, gonorrhea or chlamydia between November 27, 2018-May 26, 2019. In 2018, the study institution implemented an ED-based infectious diseases screening program in which any patient being tested for gonorrhea/chlamydia was eligible for opt-out syphilis screening, and any patient 18-64 years who was having blood drawn for any clinical purpose was eligible for opt-out HIV and HCV screening. We analyzed data from all ED patients ≥13 years who had undergone STI testing. The outcomes of interest included prevalence of STI testing/co-testing and the prevalence of STI infection/co-infection. We describe data with simple descriptive statistics. Results: During the study period there were 30,767 ED encounters for patients ≥13 years (mean age: 43 ± 14 years, 52% female), and 7,866 (26%) were tested for at least one of HIV, HCV, syphilis, gonorrhea, or chlamydia. We observed the following testing frequencies (and prevalence of infection): HCV, 7,539 (5.0%); HIV, 7,359 (0.9%); gonorrhea, 574 (6.1%); chlamydia, 574 (9.8%); and syphilis, 420 (10.5%). Infectious etiologies with universal testing protocols (HIV and HCV) made up the majority of STI testing. In patients with syphilis, co-infection with chlamydia (21%, 9/44) and HIV (9%, 4/44) was high. In patients with gonorrhea, co-infection with chlamydia (23%, 8/35) and syphilis (9%, 3/35) was high, and in patients with chlamydia, co-infection with syphilis (16%, 9/56) and gonorrhea (14%, 8/56) was high. Patients with HCV had low co-infection proportions (<2%). Conclusion: Prevalence of STI co-testing was low among patients with clinical suspicion for STIs; however, co-infection prevalence was high in several co-infection pairings. Future efforts are needed to improve STI co-testing rates among high-risk individuals.

Agency-communion and self-esteem relations are moderated by culture, religiosity, age, and sex: evidence for the "self-centrality breeds self-enhancement" principle.

OBJECTIVE: Who has high self-esteem? Is it ambitious, competitive, outgoing people-agentic personalities? Or is it caring, honest, understanding people-communal personalities? The literature on agency-communion and self-esteem is sparse, indirect, and inconsistent. Based on William James's theorizing, we propose the "self-centrality breeds self-enhancement" principle. Accordingly, agency will be linked to self-esteem, if agency is self-central. Conversely, communion will be linked to self-esteem, if communion is self-central. But what determines the self-centrality of agency and communion? The literature suggests that agency is self-central in agentic cultures, as well as among nonreligious individuals, men, and younger adults. Communion is self-central in communal cultures, as well as among religious individuals, women, and older adults. METHOD: This study examined 187,957 people (47% female; mean age = 37.49 years, SD = 12.22) from 11 cultures. The large sample size afforded us the opportunity to test simultaneously the effect of all four moderators in a single two-level model (participants nested in cultures). RESULTS: Results supported the unique moderating effect of culture, religiosity, age, and sex on the relation between agency-communion and self-esteem. CONCLUSIONS: Agentic and communal people can both have high self-esteem, depending on self-centrality of agency and communion.