Letters from Queer Elders: Transmitting Intergenerational Wisdom in LGBTQ+ Communities.

Intergenerational relationships have been established as a critical locus of psychosocial development, meeting needs of identity development for youth, generativity for elders, and connection and belonging for both. However, intergenerational relationships are both rare in the LGBTQ+ community and sorely needed as a buffer to the discrimination and harm that those within the community experience from systemic and structural oppression. Focusing on sexual identity, and employing a letter writing paradigm, we investigated the content of wisdom that LGB elders have to share with youth. In a descriptive, exploratory, mixed-methods, and pre-registered study, 94 adults ranging in age 50 to 79 years (M = 55.98; SD = 6.30) wrote letters to a fictional youth, Sam, as well as completed surveys of psychosocial development and well-being. Letters were content coded for themes, as well as for emotional tone and subjective perspective. The most common themes of wisdom shared included knowing and celebrating oneself, negotiating an oppressive society, and finding one's community. Those who wrote more emotionally positive letters scored higher on measures of wisdom and generativity, and lower on embitterment. Results are discussed in terms of the importance of cultivating opportunities for wisdom-sharing within LGBTQ+ communities to promote flourishing across the lifespan.

Electroanatomical Adaptations in the Guinea Pig Heart from Neonatal to Adulthood.

Background: Electroanatomical adaptations during the neonatal to adult phase have not been comprehensively studied in preclinical animal models. To explore the impact of age as a biological variable on cardiac electrophysiology, we employed neonatal and adult guinea pigs, which are a recognized animal model for developmental research. Methods: Healthy guinea pigs were categorized into three age groups (neonates, n=10; younger adults, n=13; and older adults, n=26). Electrocardiogram (ECG) recordings were collected in vivo from anesthetized animals (2-3% isoflurane). A Langendorff-perfusion system was employed for optical assessment of epicardial action potentials and calcium transients, using intact excised heart preparations. Optical data sets were analyzed and metric maps were constructed using Kairosight 3.0. Results: The allometric relationship between heart weight and body weight diminishes with age, as it is strongest at the neonatal stage (R 2 = 0.84) and completely abolished in older adults (R 2 = 1E-06). Neonatal hearts exhibit circular activation waveforms, while adults show prototypical elliptical shapes. Neonatal conduction velocity (40.6±4.0 cm/s) is slower than adults (younger adults: 61.6±9.3 cm/s; older adults: 53.6±9.2 cm/s). Neonatal hearts have a longer action potential duration (APD) and exhibit regional heterogeneity (left apex; APD30: 68.6±5.6 ms, left basal; APD30: 62.8±3.6), which was absent in adult epicardium. With dynamic pacing, neonatal hearts exhibit a flatter APD restitution slope (APD70: 0.29±0.04) compared to older adults (0.49±0.04). Similar restitution characteristics are observed with extrasystolic pacing, with a flatter slope in neonatal hearts (APD70: 0.54±0.1) compared to adults (Younger adults: 0.85±0.4; Older adults: 0.95±0.7). Finally, neonatal hearts display unidirectional excitation-contraction coupling, while adults exhibit bidirectionality. Conclusion: The transition from neonatal to adulthood in guinea pig hearts is characterized by transient changes in electroanatomic properties. Age-specific patterns can influence cardiac physiology, pathology, and therapies for cardiovascular diseases. Understanding postnatal heart development is crucial to evaluating therapeutic eligibility, safety, and efficacy. What is Known: Age-specific cardiac electroanatomical characteristics have been documented in humans and some preclinical animal models. These age-specific patterns can influence cardiac physiology, pathology, and therapies for cardiovascular diseases. What the Study Adds: Cardiac electroanatomical characteristics are age-specific in guinea pigs, a well-known preclinical model for developmental studies. Age-dependent adaptations in cardiac electrophysiology are readily observed in the electrocardiogram recordings and via optical mapping of epicardial action potentials and calcium transients. Our findings reveal unique activation and repolarization characteristics between neonatal and adult animals.

Registry-derived stage (RD-Stage) for capturing stage at diagnosis for pancreatic carcinoma in Australia.

INTRODUCTION: Stage of pancreatic carcinoma at diagnosis is a strong prognostic indicator of morbidity and mortality, yet is poorly notified to population-based cancer registries ("cancer registries"). Registry-derived stage (RD-Stage) provides a method for cancer registries to use available data sources to compile and record stage in a consistent way. This project describes the development and validation of rules to capture RD-Stage (pancreatic carcinoma) and applies the rules to data currently captured in each Australian cancer registry. MATERIALS AND METHODS: Rules for deriving RD-stage (pancreatic carcinoma) were developed using the American Joint Commission on Cancer (AJCC) Staging Manual 8th edition and endorsed by an Expert Working Group comprising specialists responsible for delivering care to patients diagnosed with pancreatic carcinoma, cancer registry epidemiologists and medical coders. Completeness of data fields required to calculate RD-Stage (pancreatic carcinoma) and an overall proportion of cases for whom RD stage could be assigned was assessed using data collected by each Australian cancer registry, for period 2018-2019. A validation study compared RD-Stage (pancreatic carcinoma) calculated by the Victorian Cancer Registry with clinical stage captured by the Upper Gastro-intestinal Cancer Registry (UGICR). RESULTS: RD-Stage (pancreatic carcinoma) could not be calculated in 4/8 (50%) of cancer registries; one did not collect the required data elements while three used a staging system not compatible with RD-Stage requirements. Of the four cancer registries able to calculate RD-Stage, baseline completeness ranged from 9% to 76%. Validation of RD-Stage (pancreatic carcinoma) with UGICR data indicated that there was insufficient data available in VCR to stage 174/457 (38%) cases and that stage was unknown in 189/457 (41%) cases in the UGICR. Yet, where it could be derived, there was very good concordance at stage level (I, II, III, IV) between the two datasets. (95.2% concordance], Kendall's coefficient = 0.92). CONCLUSION: There is a lack of standardisation of data elements and data sources available to cancer registries at a national level, resulting in poor capacity to currently capture RD-Stage (pancreatic carcinoma). RD-Stage provides an excellent tool to cancer registries to capture stage when data elements required to calculate it are available to cancer registries.

Intergenerational Storytelling as a Developmental Resource in LGBTQ+ Communities.

LGBTQ+ people continue to be threatened by systemic censorship and erasure in public spaces and discourses, making community-based resources for positive development crucial. In this study, we examined one such developmental resource-LGBTQ+ intergenerational storytelling about cultural-historical events. LGBTQ+ adults (N = 495) ranging in age from 17 to 80 years (M = 39.22, SD = 19.89) responded to an online survey about LGBTQ+ intergenerational storytelling and relationships. Results showed that although LGBTQ+ intergenerational storytelling was reported to occur infrequently, sharing stories across generations was considered important, and LGBTQ+ people desired even greater intergenerational connection. Intergenerational narratives reported by participants were primarily about cultural-historical events involving adversity and oppression (e.g. AIDS crisis), policy and legislation (e.g. marriage equality), and protest, resistance, and activism (e.g. Stonewall uprising). Stories were mostly told by older friends in private or social settings for the purpose of passing on LGBTQ+ history. Lessons learned through storytelling were diverse but tended to focus on appreciation and affirmation. Valuing intergenerational storytelling was associated with positive psychosocial identity. This study suggests that intergenerational storytelling may be an important developmental resource for LGBTQ+ people and other marginalized communities.

Testing exploratory narrative processing as a mechanism of change in identity status processes over 4 years in college-going emerging adults.

We examined the critical task of emerging adulthood-identity development-via analyses of trajectories of identity exploration and commitment over the college years, as well as whether narrative processing of important events during this period served as a mechanism of identity exploration and commitment. We took advantage of a unique and comprehensive longitudinal design, which included 12 waves of data, both quantitative and qualitative assessments, collected over 4 years, on two distinct college campuses in the Northwestern and Northeastern regions of the United States (Wave 1, n = 639; growth models using all waves, n = 251). Analyses for this study were preregistered after data collection was complete. We first examined trajectories of exploration and commitment via the dual-cycle identity model. Second, we examined whether exploratory processing in the narration of future self-defining memories at specific waves predicted changes in exploration and commitment in subsequent waves. Findings indicated that exploration and commitment showed trajectories typically viewed as normative (e.g., increasing adaptive forms of exploration and commitment), although trajectories for those at higher socioeconomic statuses differed by showing more exploration and less commitment. We failed to find evidence that exploratory processing predicted changes in exploration and commitment. Implications include distinctions in measurement and theoretical approaches to the study of identity development, the need for greater understanding of what is developing before theorizing how it develops, and the limitations of what is considered normative without attention to structural constraints, such as social class. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Expanding midwifery care in the United States: Implications for clinical outcomes and cost.

BACKGROUND: This study compared clinical and financial outcomes for low-risk birthing people between those attended by midwives and those attended by obstetricians during hospital births. METHODS: We conducted a retrospective cohort analysis of births from January 1, 2016 to December 31, 2020 at hospitals participating in a perinatal quality improvement collaborative, Obstetrical Care Outcomes Assessment Program (OB COAP), in the Northwest region of the United States and estimated risk ratios using a multivariate regression approach with a modified Poisson binomial for mode of delivery, labor interventions, and newborn outcomes comparing midwife-led to obstetrician-led care. Using publicly available data on average costs of vaginal and cesarean births, we then extrapolated the cost differences in care between midwives and obstetricians. RESULTS: Births in the midwife group were less likely to be associated with induction (17.6% vs. 20.3% RR 0.74; 95% CI 0.70-0.78), epidural use (58.9% vs. 76.3% RR 0.78; 95% CI 0.77-0.80), and episiotomy (2.2% vs. 3.4% RR 0.68; 95% CI 0.58-0.81). Cesarean birth was also lower in the midwifery group (7.8% vs. 12.3% RR 0.68, 95% CI 0.62-0.73), without a corresponding increase in risk in adverse neonatal outcomes. We estimated that expanding midwifery care to 100% of low-risk births across the United States could save as much as $340 million per year. CONCLUSIONS: Midwifery care is associated with a lower risk of cesarean birth and other interventions versus care provided by obstetricians and is therefore likely lower-cost.

Effects of the ARRIVE (A Randomized Trial of Induction Versus Expectant Management) Trial on Elective Induction and Obstetric Outcomes in Term Nulliparous Patients.

OBJECTIVE: To evaluate the effect of publication of the ARRIVE (A Randomized Trial of Induction Versus Expectant Management) trial on perinatal outcomes in singleton, term, nulliparous patients. METHODS: An interrupted time series analysis was performed using clinical data for nulliparous singleton births at 39 weeks of gestation or later at 13 hospitals in the Northwest region of the United States (January 2016-December 2020). A modified Poisson regression was used to model time trends and changes after the ARRIVE trial (August 9, 2018). Outcomes of interest were elective induction, unplanned cesarean births, hypertensive disorders of pregnancy, a composite of perinatal adverse outcomes, and neonatal intensive care unit admissions. RESULTS: The analysis included 28,256 births (15,208 pre-ARRIVE and 13,048 post-ARRIVE). The rate of elective labor induction was 3.6% during the pre-ARRIVE period (January 2016-July 2018) and 10.8% post-ARRIVE (August 2018-December 2020). In the interrupted time series analysis, elective induction increased by 42% (relative risk [RR] 1.42; 95% CI 1.18-1.71) immediately after the ARRIVE trial publication. Thereafter, the trend was unchanged compared with the pre-ARRIVE period. There was no statistically significant change in cesarean birth (RR 0.96; 95% CI 0.89-1.04) or hypertensive disorders of pregnancy (RR 0.91; 95% CI 0.79-1.06) immediately after the trial, and no change in trend. After the ARRIVE trial, there was no immediate change in adverse perinatal outcomes, but a statistically significant increase in trend of adverse perinatal events (1.03; 95% CI 1.01-1.05) when compared with a declining trend observed in the pre-ARRIVE period. CONCLUSION: Publication of the ARRIVE trial was associated with an increase in elective induction, and no change in cesarean birth or hypertensive disorders of pregnancy in singleton nulliparous patients giving birth at 39 weeks or later. There was a flattening of the pre-ARRIVE decreasing trend in perinatal adverse events.

Cognitive scripts and narrative identity are shaped by structures of power.

Constructing a narrative identity involves developing an understanding of oneself as integrated through time and across contexts, a task critical to psychosocial development and functioning. However, research has primarily focused on the individual in isolation or in highly localized contexts. This is problematic because narrative identity is profoundly shaped by structures of power; thus, we cannot understand how individuals understand themselves through time, across contexts, and as a member of a particular community without attention to the structure of society. We propose a structural-psychological framework for the study of autobiographical memory, narrative, and context that examines how structures of power are maintained, and potentially changed, through the narration of autobiographical events, as guided by cognitive scripts, or master narratives.

Creating something new from past experiences-The meaning of change in repeated narratives.

OBJECTIVE: Narrative identity is an essential level of personality, and to develop, the life narrative should entail both stability and change. In this study, we examine the meaning of change in repeated narratives about occupational experiences. METHOD: Fifty-nine individuals were interviewed at age 25, 29, and 33. In these interviews 544 narratives and 142 sets of repeated narratives were identified, of these 39 sets of repeated narratives had changed between interviews. A thematic narrative analysis was conducted focusing on the meaning of change in repeated narratives. RESULTS: The analysis resulted in five narrative themes: Gaining insights about one's identity, transforming views of past challenges, increasing agency, increasing motivation for occupational commitments, and accentuating competence and importance. In the context of occupational experiences, the results from the narrative themes illuminate how narrators repeatedly engage with the same narrative to elaborate their narrative identity. CONCLUSION: This study presents a novel method for capturing identity development, which show that changes in repeated narratives can entail important information about identity growth as well as the way narrators create new stories of their previous experiences in order to continue to make sense of their lives.

"You gotta give them hope": A structural psychobiography of Harvey Milk (1930-1978).

OBJECTIVE: In this psychobiographical study, we examined the life and times of social change agent Harvey Milk, one of the first openly gay public officials in the United States. Milk is remembered as a gay hero who fought for the rights of marginalized people, often by invoking the importance of hope. Milk was assassinated less than 1 year after his election. METHOD: We adopt a structural psychobiographical approach, foregrounding social, cultural, political, and historical forces that intersect with personal factors to explain Milk's ascension to the status of social change agent. RESULTS: This psychobiography tells the story of a man not destined to become a social change agent but who became one anyway because of shifting tides in the political climate of San Francisco in the 1970s, because of a series of catalytic events that started him down this path, because of a history of persecution as a gay Jew, and because of his enduring need for a stage upon which he could express his generative concern. CONCLUSIONS: Our analysis raises questions about the story that "belongs" to the agent of social change, and the story that "belongs" to the rest of us, as we remember him.

Master narrative methodology: A primer for conducting structural-psychological research.

OBJECTIVE: The emphasis placed on individual-level analysis throughout psychological science in general, and diversity science in particular, has left the role of structural factors undertheorized. Moreover, the field suffers from a lack of research methods that fully investigate structural-individual relations. This article outlines one structural-psychological approach, the master narrative framework, and details various methods for taking social structures into account while still maintaining the focus on the individual. CONCLUSION: These methods, including event narratives, in-depth interviews, life-script analysis, focus groups, experiments, and conversation analysis, allow for an understanding of both the nature and substance of the structures and how individuals interact with them. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Early Impacts of College, Interrupted: Considering First-Year Students' Narratives About COVID and Reports of Adjustment During College Shutdowns.

The COVID-19 pandemic has threatened lives and livelihoods, imperiled families and communities, and disrupted developmental milestones globally. Among the critical developmental disruptions experienced is the transition to college, which is common and foundational for personal and social exploration. During college shutdowns (spring 2020), we recruited 633 first-year U.S. students (mean age = 18.83 years, 71.3% cisgender women) to provide narratives about the impacts of the pandemic. We tested the ways narrative features were associated with concurrent and longitudinal COVID stressors, psychosocial adjustment, and identity development. Narrative growth expressed in spring 2020 was positively associated with psychosocial adjustment and global identity development and was negatively associated with mental health concerns. Associations were supported concurrently and at 1-year follow-up. Growth partly explained associations between COVID stressors and students' adjustment. Our findings reinforce the importance of growth for resilience and underscore the importance of connective reasoning as people navigate a chronic stress.

Disentangling paradigm and method can help bring qualitative research to post-positivist psychology and address the generalizability crisis.

For decades, psychological research has heavily favored quantitative over qualitative methods. One reason for this imbalance is the perception that quantitative methods follow from a post-positivist paradigm, which guides mainstream psychology, whereas qualitative methods follow from a constructivist paradigm. However, methods and paradigms are independent, and embracing qualitative methods within mainstream psychology is one way of addressing the generalizability crisis.

Stability and change in autobiographical reasoning: A 4-year longitudinal study of narrative identity development.

OBJECTIVE: Research on personality development has traditionally focused on rank-order stability and mean-level change in the context of personality traits. The present study expands this approach to the examination of change and stability at another level of personality-narrative identity-by focusing on autobiographical reasoning. Drawing from theory in personality and developmental science, we examine stability and change in exploratory processing and positive and negative self-event connections. METHOD: We take advantage of a longitudinal study of emerging adult personality and identity development, which includes four waves of data across 4 years, examining reasoning in two domains of identity, academics, and romance (n = 1520 narratives; n = 176-638 participants, depending on the analysis). RESULTS: We found moderate rank-order stability in autobiographical reasoning, but more so for exploratory processing than self-event connections. We found mean-level increases for exploratory processing in the context of romance and stability in the context of academics. For self-event connections, we saw a decrease for positive connections, and for negative connections about romance, with stability for negative connections about academics. CONCLUSIONS: Implications include developmental differences in types of reasoning as well as the sensitivity of narrative identity to revealing the contextual nature of personality development.

College, Interrupted: Profiles in First-Year College Students Responses to the COVID-19 Pandemic Across One Year.

First-year college students in the 2019-2020 academic year are at risk of having their mental health, identity work, and college careers derailed as a result of the COVID-19 pandemic. To assess emerging and evolving impacts of the pandemic on mental health/well-being, identity development, and academic resilience, we collected data from a racially, ethnically, geographically, and economically diverse group of 629 students at four universities across the US within weeks of lockdown, and then followed up on these students' self-reported mental health, identity, and academic resilience three times over the following year. Our findings suggest that: 1) students' mental health, identity development, and academic resilience were largely negatively impacted compared to pre-pandemic samples; 2) these alterations persisted and, in some cases, worsened as the pandemic wore on; and 3) patterns of change were often worse for students indicating more baseline COVID-related stressors.

Recent Advances in Smellscape Research for the Built Environment.

The interrelationships between humans, smells and the built environment have been the focus of increasing numbers of research studies in the past ten years. This paper reviews these trends and identifies the challenges in smellscape research from three aspects: methodological approaches, artistic design interventions and museum practices, and odour policy making. In response to the gaps and challenges identified, three areas of future research have also been identified for this field: smell archives and databases, social justice within odour control and management, and research into advanced building materials.

The inter- and intrarater reliability and feasibility of dietetic assessment of sarcopenia and frailty in potential liver transplant recipients: A mixed-methods study.

Sarcopenia and frailty are associated with poorer outcomes in potential liver transplant (LT) recipients. We examined the reliability and feasibility of dietitians assessing sarcopenia and frailty. Seventy-five adults referred for LT underwent assessments of muscle mass (abdominal CTs), physical function (handgrip strength; HGS, short physical performance battery; SPPB), and frailty (Liver Frailty Index; LFI). Inter- and intrarater reliability and agreement were assessed in subsets of patients using intraclass correlation coefficients (ICCs) and Bland-Altman plots. CTs were analyzed by a dietitian and two independent experts, two dietitians assessed function and frailty. Feasibility assessed system, patient, and profession factors (staff survey). Inter- and intrarater reliability for CT-defined low muscle were excellent (ICCs > 0.97). Reliability between dietitians was excellent for HGS (0.968, 95% CI, 0.928-0.986), SPPB (0.932, 95% CI, 0.798-0.973), and LFI (0.938, 95% CI 0.861-0.973). Bland-Altman analysis indicated excellent agreement for HGS. All transplant clinicians valued sarcopenia and frailty in LT assessments and considered the dietitian appropriate to perform them. Seven saw no barriers to implementation into practice, while five queried test standardization, learning from repeat testing, and resource cost. Dietetic assessments of sarcopenia and frailty are reliable, feasible, and valued measures in the assessment of potential LT recipients.

Post-traumatic growth as positive personality change: Challenges, opportunities, and recommendations.

OBJECTIVE: Post-traumatic growth typically refers to enduring positive psychological change experienced as a result of adversity, trauma, or highly challenging life circumstances. Critics have challenged insights from much of the prior research on this topic, pinpointing its significant methodological limitations. In response to these critiques, we propose that post-traumatic growth can be more accurately captured in terms of personality change-an approach that affords a more rigorous examination of the phenomenon. METHOD: We outline a set of conceptual and methodological questions and considerations for future work on the topic of post-traumatic growth. RESULTS: We provide a series of recommendations for researchers from across the disciplines of clinical/counseling, developmental, health, personality, and social psychology and beyond, who are interested in improving the quality of research examining resilience and growth in the context of adversity. CONCLUSION: We are hopeful that these recommendations will pave the way for a more accurate understanding of the ubiquity, durability, and causal processes underlying post-traumatic growth.

Who has to tell their trauma story and how hard will it be? Influence of cultural stigma and narrative redemption on the storying of sexual violence.

Although survivors of sexual violence have shared their stories with the public on social media and mass media platforms in growing numbers, less is known about how general audiences perceive such trauma stories. These perceptions can have profound consequences for survivor mental health. In the present experimental, vignette-based studies, we anticipated that cultural stigma surrounding sexual violence and cultural preference for positive (redemptive) endings to adversity in the United States (U.S.) would shape perceptions. Four samples of U.S. adults (N = 1872) rated first-person narratives of 6 more stigmatizing (i.e., sexual violence) or less stigmatizing (e.g., natural disaster) traumatic events. Confirming pre-registered hypotheses, sexual violence trauma (versus other types of trauma) stories were perceived as more difficult to tell, and their storytellers less likeable, even when they had redemptive endings. Disconfirming other pre-registered hypotheses, redemptive (versus negative) story endings did not boost the perceived likelihood or obligation to share a sexual violence trauma story. Rather, redemptive (versus negative) story endings only boosted the perceived likelihood, obligation, and ease of telling other, less stigmatizing types of trauma stories. Findings suggest that sexual violence survivors do not benefit, to the same degree as other survivors, from telling their stories with the culturally valued narrative template of redemption. Clinical and societal implications of the less receptive climate for sexual violence stories are discussed.

The empirical structure of narrative identity: The initial Big Three.

A robust empirical literature suggests that individual differences in the thematic and structural aspects of life narratives are associated with and predictive of psychological well-being. However, 1 limitation of the current field is the multitude of ways of capturing these narrative features, with little attention to overarching dimensions or latent factors of narrative that are responsible for these associations with well-being. In the present study we uncovered a reliable structure that accommodates commonly studied features of life narratives in a large-scale, multi-university collaborative effort. Across 3 large samples of emerging and midlife adults responding to various narrative prompts (N = 855 participants, N = 2,565 narratives), we found support for 3 factors of life narratives: motivational and affective themes, autobiographical reasoning, and structural aspects. We also identified a "functional" model of these 3 factors that reveals a reduced set of narrative features that adequately captures each factor. Additionally, motivational and affective themes was the factor most reliably related to well-being. Finally, associations with personality traits were variable by narrative prompt. Overall, the present findings provide a comprehensive and robust model for understanding the empirical structure of narrative identity as it relates to well-being, which offers meaningful theoretical contributions to the literature, and facilitates practical decision making for researchers endeavoring to capture and quantify life narratives. (PsycInfo Database Record (c) 2020 APA, all rights reserved).