STI self-testing: ensuring representation and outreach to teens and adolescents in expanded approaches.

In our correspondence, we describe the results from a quality improvement survey in a sexual health clinic in North Carolina regarding attitudes and perceptions among adolescents and providers regarding specimen self-collection. We find that adolescents have high levels of acceptability for self-collection and confidence in their ability to self-collection; however, providers expressed hesitation regarding the ability of adolescents to self-collection. Our study shows that while self-collection may provide a way to expand testing access to difficult-to-reach populations, we must ensure that providers are confident in the corresponding results.

To trust or not to trust: social decision-making in post-institutionalized, internationally adopted youth.

Chronic parental maltreatment has been associated with lower levels of interpersonal trust, and depriving environments have been shown to predict short-sighted, risk-averse decision-making. The present study examined whether a circumscribed period of adverse care occurring only early in life was associated with biases in trust behavior. Fifty-three post-institutionalized (PI) youth, adopted internationally on average by 1 year of age, and 33 never-institutionalized, non-adopted youth (Mage  = 12.9 years) played a trust game. Participants decided whether or not to share coins with a different anonymous peer in each trial with the potential to receive a larger number of coins in return. Trials were presented in blocks that varied in the degree to which the peers behaved in a trustworthy (reciprocal) or untrustworthy (non-reciprocal) manner. A comparison condition consisted of a computerized lottery with the same choices and probabilistic risk as the peer trials. Non-adopted comparison youth showed a tendency to share more with peers than to invest in the lottery and tended to maintain their level of sharing across trials despite experiencing trials in which peers failed to reciprocate. In contrast, PI children, particularly those who were adopted over 1 year of age, shared less with peers than they invested in the lottery and quickly adapted their sharing behavior to peers' responses. These results suggest that PI youth were more mistrusting, more sensitive to both defection and reciprocation, and potentially more accurate in their trusting decisions than comparison youth. Results support the presence of a sensitive period for the development of trust in others, whereby conditions early in life may set long-term biases in decision-making.

Predictors of Prosocial Behavior: Differences in Middle Aged and Older Adults.

Generativity, contributing to the next generation, is important for well-being throughout middle and late life. Therefore, it is crucial to understand what contributes to generativity during these life stages. Parenting and work are common, but not the only, ways people engage generatively; prosocial behavior is another. A community connection may encourage generative contributions in adults. However, older adults may face obstacles to being generative, and may need an additional drive to engage in these behaviors. Given this, it was expected that community cohesion would predict prosocial behavior despite age, and that grit would provide motivation for older adults, so the current study examined whether age moderated the relation between grit and prosocial behavior. Data were used from 188 upper-Midwest adults (aged 37-89). Multiple regression analyses showed that age moderated the relation between grit and prosocial behavior such that grit predicted prosocial behavior in older adults but not middle age adults. A sense of community cohesion was predictive of prosocial behavior despite age. While grit may promote generative acts in different ways depending on age, a sense of community cohesion may foster community contributions despite age. The discussion focuses on future directions and ways to promote generativity using this research.

Reducing CAUTI in patients with acute urinary retention in the critical care setting: A pilot study with electronic medical record analytics.

BACKGROUND: This study implemented and evaluated an algorithm protocol for management of indwelling urinary catheters (IUCs) among patients treated for acute urinary retention (AUR) in an intensive care unit. The algorithm protocol (1) instituted in and out catheterization before placing an IUC for retention; (2) encouraged more consistent use of medications for AUR; and (3) provided for prompt removal of IUCs placed for AUR. METHODS: An uncontrolled pre- and post-test intervention approach was used to assess the impact of the algorithm on the treatment of AUR. Bivariate and multivariate analyses assessed data collected using 2 approaches: (1) electronic extracts from the electronic medical record (EMR) vs (2) manual chart reviews. RESULTS: Findings suggest that the intervention decreased indwelling IUC days by 1.93 average days and increased medication prescription rates. An EMR extract identified fewer catheters per patient pre-intervention than a manual chart review, but otherwise the differences observed in the EMR extract and manual chart review were insignificant. CONCLUSIONS: Implications for practitioners and administrators are that the algorithm protocol may reduce CAUTI risk and - provided consistent EMR documentation - EMR extracts may represent an efficient and effective approach for monitoring data when spreading the intervention.

The brain-derived neurotrophic factor Val66Met polymorphism moderates early deprivation effects on attention problems.

Adverse early care is associated with attention regulatory problems, but not all so exposed develop attention problems. In a sample of 612 youth (girls = 432, M = 11.82 years, SD = 1.5) adopted from institutions (e.g., orphanages) in 25 countries, we examined whether the Val66Met polymorphism of the brain-derived neurotrophic factor gene moderates attention problems associated with the duration of institutional care. Parent-reported attention problem symptoms were collected using the MacArthur Health and Behavior Questionnaire. DNA was genotyped for the brain-derived neurotrophic factor Val66Met (rs6265) single nucleotide polymorphism. Among youth from Southeast (SE) Asia, the predominant genotype was valine/methionine (Val/Met), whereas among youth from Russia/Europe and Caribbean/South America, the predominant genotype was Val/Val. For analysis, youth were grouped as carrying Val/Val or Met/Met alleles. Being female, being from SE Asia, and being younger when adopted were associated with fewer attention regulatory problem symptoms. Youth carrying at least one copy of the Met allele were more sensitive to the duration of deprivation, yielding an interaction that followed a differential susceptibility pattern. Thus, youth with Val/Met or Met/Met genotypes exhibited fewer symptoms than Val/Val genotypes when adoption was very early and more symptoms when adoption occurred later in development. Similar patterns were observed when SE Asian youth and youth from other parts of the world were analyzed separately.

Becoming a teller of tales: associations between children's fictional narratives and parent-child reminiscence narratives.

Previous research has revealed a connection between the contributions parents make while reminiscing and their children's narratives for personally experienced events. The current research expands the literature by focusing on the connection between parental reminiscing and children's production of fictional narratives. After 4- to 9-year-olds and their parents reminisced about past shared events, the children (with an experimenter) produced narratives based on wordless picture books. The results revealed that the overall quality of the fictional narratives was correlated with parents' provision statements that emphasized orientation and evaluation in the reminiscence narrative. For younger children, correlations held for reminiscence narratives about recent events. For older children, correlations held for reminiscence narratives about events from the distant past. The results are consistent with the suggestion that children learn general storytelling skills from adult models.

Preschoolers' comprehension of goal structure in narratives.

Preschool children's understanding and use of goals were studied in two experiments. Children heard stories in the presence of pictures or props. The stories were varied by goal success occurring early or late in the story, with late goal success resulting in more causal connections in the narrative. The results showed that children recalled goals spontaneously and that their recall benefited from goal structure of the stories. Pictures benefited the children when the stories were short. Enactment of the props versus static displays of the props did not enhance recall in the second experiment. Preschool children thus demonstrated ability to infer and use goal and causal information in stories for both picture and object support.