Factors associated with usage frequency and pricing of temporary anchorage devices among orthodontists.

Background/purpose: Temporary anchorage devices (TADs) are widely used in contemporary orthodontic treatments for anchorage purposes. This research aimed to investigate orthodontists' attitude toward temporary anchorage devices (TADs) by surveying their TAD usage frequency and pricing and to identify factors influencing TAD usage frequency and pricing. Materials and methods: A structured, self-administered questionnaire with a total of 26 questions was randomly distributed to members of the Taiwanese Association of Orthodontics at the annual orthodontic meeting. The questionnaire comprised 6 questions on demographics, 10 questions on work patterns and patient type, and 10 questions on orthodontic technique. Responses were analyzed using a Pearson chi-Square test to identify factors of interest. Results: Factors associated with TAD usage frequency included degree of income satisfaction, number of working hours per week, and proportion of extraction-based treatments in treatment plans. Factors associated with TAD pricing included orthodontist age, geographic region of practice, and adult treatment fee. Conclusion: More Taiwanese orthodontists use TADs compared with orthodontists in other countries. TADs have become universally accepted, but practitioners use them selectively. The main factor influencing TAD usage frequency was the proportion of extraction-based treatments in treatment plans, and those influencing TAD were orthodontist age, geographic region of practice, and adult treatment fee. These findings may be applicable to other parts of the world and should be investigated at an international level.

Listen Before You Auscultate: An Active-Learning Approach to Bedside Cardiac Assessment.

Introduction: Bedside cardiac assessment (BCA) is deficient across a spectrum of noncardiology trainees. Learners not taught BCA well may become instructors who do not teach well, creating a self-perpetuating problem. To improve BCA teaching and learning, we developed a high-quality, patient-centered curriculum for medicine clerkship students that could be flexibly implemented and accessible to other health professions learners. Methods: With a constructivist perspective, we aligned learning goals, activities, and assessments. The curriculum used a "listen before you auscultate" framework, capturing patient history as context for a six-step, systematic approach. In the flipped classroom, short videos and practice questions preceded two 1-hour class activities that integrated diagnostic reasoning, pathophysiology, physical diagnosis, and reflection. Activities included case discussions, jugular venous pressure evaluation, heart sound competitions, and simulated conversations with patients. Two hundred sixty-eight students at four US and international medical schools participated. We incorporated feedback, performed thematic analysis, and assessed learners' confidence and knowledge. Results: Low posttest data capture limited quantitative results. Students reported increased confidence in BCA ability. Knowledge increased in both BCA and control groups. Thematic analysis suggested instructional design strategies were effective and peer encounters, skills practice, and encounters with educators were meaningful. Discussion: The curriculum supported active learning of day-to-day clinical competencies and promoted professional identity formation alongside BCA ability. Feedback and increased confidence on the late-clerkship posttest suggested durable learning. We recommend approaches to confirm this and other elements of knowledge, skill acquisition, or behaviors and are surveying impacts on professional identity formation-related constructs.

Assessment of mechanical characteristics of polyetheretherketone as orthodontic fixed lingual retainers.

Background/purpose: Polyetheretherketone (PEEK) is known for its strength, flexibility, biocompatibility, and potential as a replacement for metals in dental appliances; however, uncertainty remains about the mechanical characteristics and dimensions of PEEK-made orthodontic fixed lingual retainers (FLRs). This study aimed to determine the optimal shape of PEEK-made orthodontic FLRs using the finite element method (FEM) and the three-point bending test (TPBT). Materials and methods: Seventy-five three-dimensional PEEK rod-shaped models were created, which included five thicknesses (0.4, 0.6, 0.8, 1.0, and 1.2 mm), five widths (0.7, 0.9, 1.1, 1.3, and 1.5 mm), and three cross-sectional shapes (rectangular, oval, and hemielliptical). A 0.9-mm (0.036-inch) stainless steel wire (SSW) was used as a control and the FEM was used to determine six optimal dimensions among the PEEK models. The selected models were then fabricated and subjected, along with the SSW, to the experimental TPBT to assess their mechanical responses against lingual and biting pressures. Results: The FEM analysis revealed that Von Mises stresses on the PEEK models decreased with an increase in width and thickness. Six optimal shapes of PEEK models were chosen based on acceptable lingual and biting stresses as well as patient comfort compared to the SSW. Furthermore, PEEK models showed significantly lower deformation during the 3.1-mm deflection test than did the SSW, while no notable differences were observed among different sizes of PEEK models. The hemielliptical PEEK model with a thickness of 1.0 mm and width of 1.5 mm was found to be mechanically robust enough to withstand lingual forces, while none of the PEEK models, including the SSW, were able to resist biting forces. Conclusion: Within the limitations of this in vitro study, PEEK-made orthodontic FLRs with a hemielliptical cross-sectional shape and a thickness-to-width ratio of 1.0:1.5 would be suitable for use as orthodontic FLRs.

Eliciting social stressors, supports, and determinants of health through the DSM-5 cultural formulation interview.

Objective: As recognition of the importance of social determinants of mental health has increased, the limitations of clinical competence-enhancing interventions that do not emphasize this approach have emerged. The Cultural Formulation Interview (CFI) is a cultural competence intervention that emerges from a confluence of social medicine and medical anthropology traditions. Limited research has examined how patients respond to CFI questions on social-structural aspects of illness and care to assess whether the CFI adequately elicits information on social determinants of mental health. Methods: Patients' responses during a first intake appointment to three CFI questions on social stressors, supports, or barriers to care from 27 patient-clinician dyads are analyzed through qualitative content analysis. The data come from a hyper-diverse clinical setting in Queens, New York, where no ethnoracial group has a majority and all patient-clinician dyads reflect cross-cultural interactions. Results: At least one social determinant was coded in 89 of all cases, and nearly 44% included themes related to multiple determinants of health. The most-commonly coded theme was social relationships (n = 21), followed by financial instability (n = 7), stigma (n = 5), housing instability (n = 2), and poor access to healthcare, involvement in the criminal justice system, employment instability, area-level poverty, and immigration policies (n = 1 each). Conclusion: Our work shows that social determinants of mental health can be elicited through the CFI. Future work should examine how this information is included in clinicians' formulations and whether the cultural formulation approach would benefit from additional revision to facilitate assessment of socio-structural factors.

Perceptions and reasons for quitting and transitioning between smoking and smokeless tobacco products: Findings from four waves of the ITC Bangladesh survey.

INTRODUCTION: Transitions between different tobacco products are frequent among tobacco users in Bangladesh; however, the reasons leading to such transitions and why they quit are not well researched. The aim of the study is to examine perceptions and reasons reported by tobacco users in Bangladesh to transition to other products or quit. METHODS: Data from four waves (2009-2015) of the International Tobacco Control (ITC) Bangladesh Survey were used. Repeated data on perceptions and reasons for exclusive cigarette (n=520), bidi (n=130), and SLT users (n=308) to either start using other products or quit were analyzed with sampling weights. The percentages of responses across waves were used to calculate the pooled proportion data using a meta-analysis approach. RESULTS: Common reasonsig for respondents switching to other tobacco products were influence of friends/family (73.8-86.0%), and curiosity (44.4-71.3%). The perceived calming effect of smoking cigarettes and bidis (43.2-56.9%), and the impression that bidis were less harmful (52.3%) and taste better (71.2%) were major reasons for exclusive SLT users to switch products. Health concerns (16.5-62.7%) and disapproval from friends/family (29.8-56.4%) were generally the main reasons for quitting. For smoked tobacco users, doctor's advice (41.6%), package warning labels (32.3%), and price (32.4%) seemed to be the major driving factors to quit. CONCLUSIONS: Results highlight that the reasons for switching between tobacco products and quitting include social factors (e.g. friends/family) and (mis) perceptions regarding the products. Tobacco control policy could emphasize cessation support, increased price and education campaigns as key policies to reduce overall tobacco use in Bangladesh. Data from four waves (2009-2015) of the International Tobacco Control (ITC) Bangladesh Survey were used. Repeated data on perceptions and reasons for exclusive cigarette (n=520), bidi (n=130), and SLT users (n=308) to either start using other products or quit were analyzed with sampling weights. The percentages of responses across waves were used to calculate the pooled proportion data using a meta-analysis approach.

Explicitly Solvable Continuous-time Inference for Partially Observed Markov Processes.

Many natural and engineered systems can be modeled as discrete state Markov processes. Often, only a subset of states are directly observable. Inferring the conditional probability that a system occupies a particular hidden state, given the partial observation, is a problem with broad application. In this paper, we introduce a continuous-time formulation of the sum-product algorithm, which is a well-known discrete-time method for finding the hidden states' conditional probabilities, given a set of finite, discrete-time observations. From our new formulation, we can explicitly solve for the conditional probability of occupying any state, given the transition rates and observations within a finite time window. We apply our algorithm to a realistic model of the cystic fibrosis transmembrane conductance regulator (CFTR) protein for exact inference of the conditional occupancy probability, given a finite time series of partial observations.

Derivation and Validation of a Clinical Risk Assessment Model for Cancer-Associated Thrombosis in Two Unique US Health Care Systems.

PURPOSE: Venous thromboembolism (VTE), especially pulmonary embolism (PE) and lower extremity deep vein thrombosis (LE-DVT), is a serious and potentially preventable complication for patients with cancer undergoing systemic therapy. METHODS: Using retrospective data from patients diagnosed with incident cancer from 2011-2020, we derived a parsimonious risk assessment model (RAM) using least absolute shrinkage and selection operator regression from the Harris Health System (HHS, n = 9,769) and externally validated it using the Veterans Affairs (VA) health care system (n = 79,517). Bootstrapped c statistics and calibration curves were used to assess external model discrimination and fit. Dichotomized risk strata using integer scores were created and compared against the Khorana score (KS). RESULTS: Incident VTE and PE/LE-DVT at 6 months occurred in 590 (6.2%) and 437 (4.6%) patients in HHS and 4,027 (5.1%) and 3,331 (4.2%) patients in the VA health care system. Assessed at the time of systemic therapy initiation, the new RAM included components of the KS with the modified cancer subtype, cancer staging, systemic therapy class, history of VTE, history of paralysis/immobility, recent hospitalization, and Asian/Pacific Islander race. The c statistic was 0.71 in HHS and 0.68 in the VA health care system (compared with 0.65 and 0.60, respectively, for KS). Furthermore, the new RAM appropriately reclassified 28% of patients and increased the proportion of VTEs in the high-risk group from 37% to 68% in the validation data set. CONCLUSION: The novel RAM stratified patients with cancer into a high-risk group with 8%-10% cumulative incidence of VTE and 7% PE/LE-DVT at 6 months (v 3% and 2%, respectively, in the low-risk group). The model had improved performance over the original KS and doubled the number of VTE events in the high-risk stratum. We encourage additional external validation from prospective studies.[Media: see text].

Tobacco control measures in COVID-19 recovery: an opportune time to restore equity and planetary health.

Tobacco intersects with the COVID-19 pandemic not only in terms of health consequences, but also environmental change and planetary health. Tobacco use exacerbates inequalities, causes catastrophic environmental degradation and climate change and adds burdens to COVID-19-related mortality, which are major challenges to recovery from the COVID-19 pandemic. However, the pandemic has provided a chance to combat tobacco use and accelerate efforts to alleviate these challenges in response. The MPOWER measures introduced by the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) can play a crucial role in COVID-19 recovery to fight tobacco use and contribute to sustainable and equitable development. To accelerate recovery, it is critical to call for actions for governments and policy-makers to strengthen synergies and coordinate policy actions emphasising tobacco control and cessation across equity, public health, and climate actions as global authorities pledge to achieve the Sustainable Development Goals (SDGs) and net zero emissions targets as part of the Climate Change Conference 2021 (COP26).

Implementing the Cultural Formulation Interview in a Community Clinic to Improve Appointment Retention: A Pilot Study.

Despite consensus that clinicians should receive cultural competence training to reduce mental health disparities among racial-ethnic minority groups, few studies have evaluated training in community settings. This column delineates implementation of the DSM-5 Cultural Formulation Interview (CFI) at a community hospital. Participating clinicians were able to implement the CFI after a single training session and offer administrative support and instructions on customizing care with lower- and middle-income, racially and ethnically diverse patients.

COVID-19 within families amplifies the prosociality gap between adolescents of high and low socioeconomic status.

COVID-19 has had worse health, education, and labor market effects on groups with low socioeconomic status (SES) than on those with high SES. Little is known, however, about whether COVID-19 has also had differential effects on noncognitive skills that are important for life outcomes. Using panel data from before and during the pandemic, we show that COVID-19 affects one key noncognitive skill, that is, prosociality. While prosociality is already lower for low-SES students prior to the pandemic, we show that COVID-19 infections within families amplify the prosociality gap between French high school students of high and low SES by almost tripling its size in comparison to pre-COVID-19 levels.

Carceral-community epidemiology, structural racism, and COVID-19 disparities.

Black and Hispanic communities are disproportionately affected by both incarceration and COVID-19. The epidemiological relationship between carceral facilities and community health during the COVID-19 pandemic, however, remains largely unexamined. Using data from Cook County Jail, we examine temporal patterns in the relationship between jail cycling (i.e., arrest and processing of individuals through jails before release) and community cases of COVID-19 in Chicago ZIP codes. We use multivariate regression analyses and a machine-learning tool, elastic regression, with 1,706 demographic control variables. We find that for each arrested individual cycled through Cook County Jail in March 2020, five additional cases of COVID-19 in their ZIP code of residence are independently attributable to the jail as of August. A total 86% of this additional disease burden is borne by majority-Black and/or -Hispanic ZIPs, accounting for 17% of cumulative COVID-19 cases in these ZIPs, 6% in majority-White ZIPs, and 13% across all ZIPs. Jail cycling in March alone can independently account for 21% of racial COVID-19 disparities in Chicago as of August 2020. Relative to all demographic variables in our analysis, jail cycling is the strongest predictor of COVID-19 rates, considerably exceeding poverty, race, and population density, for example. Arrest and incarceration policies appear to be increasing COVID-19 incidence in communities. Our data suggest that jails function as infectious disease multipliers and epidemiological pumps that are especially affecting marginalized communities. Given disproportionate policing and incarceration of racialized residents nationally, the criminal punishment system may explain a large proportion of racial COVID-19 disparities noted across the United States.

A Survey of Current Preferences of Plastic Surgeons Regarding the Assessment and Reduction of Preoperative Patient Anxiety.

BACKGROUND: Preoperative anxiety is a common phenomenon in plastic surgery that has been associated with numerous negative patient outcomes. Little is known about the preferences of plastic surgeons regarding management of patient preoperative anxiety OBJECTIVE: To determine the preferences of plastic surgeons regarding the assessment and reduction of adult preoperative patient anxiety in their primary practice setting. METHODS: The membership of the American Council of Academic Plastic Surgeons (ACAPS) was surveyed using an anonymous, online questionnaire from April to June of 2020. RESULTS: A total of 100 participants from a membership of 532 responded (19%). The majority of respondents (63%) did not formally assess patient anxiety but supported the use of standardized scales to measure anxiety (57%). Most plastic surgeons preferred patient education (81%), family member presence (69%), and visit from the anesthesiologist (54%) to reduce patient anxiety. Plastic surgeons also allocated the most responsibility to anesthesiologists (63%) and plastic surgeons (62%) to reduce preoperative anxiety. DISCUSSION: Most plastic surgeon members of ACAPS did not assess their patients' anxieties preoperatively but appeared willing to use anxiety scales. Plastic surgeons also supported several measures to reduce anxiety, especially patient education, family member preferences, and anesthesiologist visits. Although plastic surgeons appeared to hold multiple parties responsible to manage preoperative anxiety, they held themselves and anesthesiologists most responsible. Future studies are needed to determine whether these views cohere with those of other healthcare providers and whether these preferences change for pediatric patients. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Inequality-Related Health and Social Factors and Their Impact on Well-Being during the COVID-19 Pandemic: Findings from a National Survey in the UK.

Background: Lower socioeconomic groups and disadvantaged populations across the world suffer disproportionately from the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to examine the impact of health- and social-inequality-related factors on well-being in order to further distinguish each of their effects during the pandemic. Methods: A nationally-representative sample of 5077 UK respondents aged 18 years or older was recruited through an online survey panel during the COVID-19 pandemic. Their subjective well-being was measured using the 11-point Cantril Ladder of Life Scale. The impact of inequality-related health and social factors (pre-existing medical conditions, household size and occupation), as well as COVID-19-related risk factors (symptoms, confirmed infections, and social distancing behaviours) on well-being were analysed using multiple linear regression models. The associations between the COVID-19-related risk factors and well-being according to the respondents' household size and occupation were modelled in order to test the differences by their socioeconomic profile. Results: We identified inverted V-shaped associations between household size and subjective well-being during the COVID-19 pandemic. Compared to single-person households, respondents from households of two to four persons showed better well-being (ß = 0.57; CI (0.44, 0.72)), whereas living in crowded households of five persons or more was associated with decreased well-being (ß = -0.48; CI (-0.71, -0.25)). Furthermore, lower-skilled occupations (elementary occupations: ß = -0.31; CI (-0.58, -0.03); logistics and transport services: ß = -0.37; CI (-0.74, -0.01)) and chronic medical conditions (cardiometabolic or respiratory diseases: ß = -0.25; CI (-0.41, -0.1); and mental health conditions: ß = -1.12; CI (-1.28, -0.96)) were factors associated with reduced well-being during the pandemic. Interactions between a positive COVID-19 diagnosis, symptoms, and crowded households were identified (ß = -0.95; CI (-1.76, -0.14) and ß = -4.74; CI (-9.87, -1.61), respectively). Conclusions: In a national sample, the levels of general subjective well-being during the COVID-19 pandemic and lockdowns were disproportionately distributed across different groups within society. Preventive policies should explicitly focus on reaching lower socioeconomic groups; more emphasis should be placed on the coordination of multisectoral support in order to tackle existing health and social inequalities.

Carbon emissions embodied in product value chains and the role of Life Cycle Assessment in curbing them.

Life cycle-based analyses are considered crucial for designing product value chains towards lower carbon emissions. We have used data reported by companies to CDP for public disclosure to build a database of 866 product carbon footprints (PCFs), from 145 companies, 30 industries, and 28 countries. We used this database to elucidate the breakdown of embodied carbon emissions across products' value chains, how this breakdown varies by industry, and whether the reported emission reductions vary with the granularity of the PCF. For the 866 products, on average 45% of total value chain emissions arise upstream in the supply chain, 23% during the company's direct operations, and 32% downstream. This breakdown varies strongly by industry. Across their lifecycle, the 866 products caused average total emissions of 6 times their own weight, with large variation within and across industries. Reported achievements to reduce emissions varied depending on whether a company had reported a PCF's breakdown to life cycle stages or only the total emissions (10.9% average reduction with breakdown versus 3.7% without). We conclude that a sector-level understanding of emissions, absent of individual PCFs, is insufficient to reliably quantify carbon emissions, and that higher reported emission reductions go hand in hand with more granular PCFs.

Assessment of Elastic-Plastic Fracture Behavior of Cortical Bone Using a Small Punch Testing Technique.

The fracture properties of cortical bone are directly coupled to its complex hierarchical structure. The limited availability of bone material from many anatomic locations creates challenges for assessing the effect of bone heterogeneity and anisotropy on fracture properties. The small punch technique was employed to examine the fracture behavior of cortical bone in terms of area under the curve values obtained from load-load point displacement behavior. Fracture toughness of cortical bone was also determined in terms of J-toughness values obtained using a compact tension (CT) test. Area under the curve values obtained from the small punch test were correlated with the J-toughness values of cortical bone. The effects of bone density and compositional parameters on area under the curve and Jtoughness values were also analyzed using linear and multiple regression analysis. Area under the curve and J-toughness values are strongly and positively correlated. Bone density and %mineral content are positively correlated with both area under the curve and J-toughness values. The multiple regression analysis outcomes support these results. Overall, the findings support the hypothesis that area under the curve values obtained from small punch tests can be used to assess the fracture behavior of cortical bone.

Demographics, perceptions, and socioeconomic factors affecting influenza vaccination among adults in the United States.

OBJECTIVE: The study objective is to analyze influenza vaccination status by demographic factors, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance status, and barriers to influenza vaccination among adults 18 years and older in the United States. BACKGROUND: Influenza vaccination coverage among adults 18 years and older was 41% during 2010-2011 and has increased and plateaued at 43% during 2016-2017. This is below the target of 70% influenza vaccination coverage among adults, which is an objective of the Healthy People 2020 initiative. METHODS: We conducted a survey of a nationally representative sample of adults 18 years and older in the United States on factors affecting influenza vaccination. We conducted bivariate analysis using Rao-Scott chi-square test and multivariate analysis using weighted multinomial logistic regression of this survey data to determine the effect of demographics, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance, and barriers associated with influenza vaccination uptake among adults in the United States. RESULTS: Influenza vaccination rates are relatively high among adults in older age groups (73.3% among 75 + year old), adults with education levels of bachelor's degree or higher (45.1%), non-Hispanic Whites (41.8%), adults with higher incomes (52.8% among adults with income of over $150,000), partnered adults (43.2%), non-working adults (46.2%), and adults with internet access (39.9%). Influenza vaccine is taken every year by 76% of adults who perceive that the vaccine is very effective, 64.2% of adults who are socially influenced by others, and 41.8% of adults with health insurance, while 72.3% of adults without health insurance never get vaccinated. Facilitators for adults getting vaccinated every year in comparison to only some years include older age, perception of high vaccine effectiveness, higher income and no out-of-pocket payments. Barriers for adults never getting vaccinated in comparison to only some years include lack of health insurance, disliking of shots, perception of low vaccine effectiveness, low perception of risk for influenza infection, and perception of risky side effects. CONCLUSION: Influenza vaccination rates among adults in the United States can be improved towards the Healthy People 2020 target of 70% by increasing awareness of the safety, efficacy and need for influenza vaccination, leveraging the practices and principles of commercial and social marketing to improve vaccine trust, confidence and acceptance, and lowering out-of-pocket expenses and covering influenza vaccination costs through health insurance.

Logo-autobiography and its effectiveness on depressed Korean immigrant women.

This study aimed to explore the effectiveness of logo-autobiography (LA) as a therapeutic modality for Korean immigrant women suffering from depression and perceiving their lives as meaningless. A nonrandomized quasi-experimental study was conducted with pretest, posttest, and a 4-week follow-up test. Forty subjects--20 with antidepressants and 20 without--were divided quarterly and assigned to the experimental group and the control group. The experimental group reported a significant lower score on depressive symptoms (F = 6.832, p = .013; F = 19.800, p ≤ .001) and a higher score on meaning of life (F = 12.294, p = .001; F = 12.232, p = .001) than did the control group immediately after completing the LA and a 4-week follow-up. The LA was more effective for the subjects in the nonmedication group than in the medication group. In conclusion, LA is effective in reducing depressive symptoms and increasing a sense of meaning in life among Korean immigrant women suffering from depression.

Characterizing changes in student empathy throughout medical school.

BACKGROUND: Empathy is important in the physician-patient relationship. Prior studies suggest that medical student empathy declines with clinical training. AIMS: We examined the trend of empathy longitudinally; determined differences in empathy according to gender and medical specialty preferences; and determined empathy and career preference differences among students admitted through different medical school admission pathways. METHOD: The data for this study were collected using a longitudinal cohort design and included 2652 observations nested within 1162 individuals. Participants were medical students at a university-based medical school surveyed yearly from 2007 through 2010. Empathy was measured by the Jefferson Scale of Physician Empathy-Student Version (JSPE-S), a validated, 20-item self-administered questionnaire. Predictors of JSPE-S scores included gender, age, anticipated financial debt upon graduation and future career interest. RESULTS: Empathy scores of students in preclinical years were higher than in clinical years. Gender was a significant predictor of empathy, with women having higher empathy scores than men. Students preferring technology-oriented specialties had lower empathy scores. When career preference was controlled, higher levels of debt were significantly associated with greater empathy. Students with high baseline empathy decreased less than students with low baseline empathy during medical school. Students in traditional four-year medical school programs had higher baseline empathy than those in early pathway programs. CONCLUSIONS: Self-reported empathy for patients, a possibly critical factor in high-quality patient-centered care, wanes as students advance in clinical training, particularly among those entering technology-oriented specialties. In the era of new health care policy and primary care shortages, our research may have implications for the medical education system and admission policy.

The perceived ethnic discrimination questionnaire--community version: validation in a multiethnic Asian sample.

This study evaluated the validity and reliability of the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV) Lifetime Exposure scale in a multiethnic Asian sample (N = 509). The 34-item scale measures perceived interpersonal racial/ethnic discrimination and includes four subscales assessing different types of discrimination: Social Exclusion, Stigmatization, Discrimination at Work/School, and Threat/Aggression. The Lifetime Exposure scale demonstrated excellent reliability across the full group and in all major subgroups. Subscales displayed good reliability across the full group and moderate-to-good reliability in each subgroup. The Lifetime Exposure scale was significantly correlated with the depression and anxiety subscales of the SCL-90-R, providing preliminary evidence of construct validity. The data suggest the Lifetime Exposure scale, previously validated in Black and Latino adults, is also appropriate for use with Asian samples, and can be used to examine both within-group and between-groups differences in discrimination.