A Virtual Multi-institution Pediatric Radiology Peer Teaching Conference Improves Knowledge of Educators.

RATIONALE AND OBJECTIVES: Medical education led by peers and near-peers has been shown to benefit both teachers and learners and can be successfully incorporated into radiology education. The authors created a virtual, multi-institution pediatric radiology conference employing peer and near-peer teaching with the goals of improving radiology knowledge and enhancing the educational experience of radiology trainees. MATERIALS AND METHODS: Two radiology residency programs implemented a common pediatric radiology curriculum and joint quarterly virtual peer teaching conference. Conferences featured short teaching sessions led by six to ten radiology trainees and were facilitated by attending pediatric radiologists. Knowledge assessments (KA) consisting of multiple-choice questions inspired by conference learning objectives were sent to peer educators before the conference (pre-conference), directly after the conference (immediate post-conference), and three months after the conference (delayed post-conference). Surveys were distributed to peer educators immediately after conferences to assess conference reception and solicit feedback. Quantitative data was analyzed using ANOVA, Kruskal-Wallis test, and post-hoc Tukey HSD test. RESULTS: Four conferences featured 33 peer educators consisting primarily of first-year (60.6 %), second-year (18.2 %), and third-year (15.2 %) radiology residents. Compared to pre-conference scores, immediate post-conference scores were significantly increased (HSD 13, p = 0.02) and delayed post-conference scores were increased without statistical significance (HSD 5.8, p = 0.29). Almost all survey respondents perceived the conferences as helpful, well-organized, and effective in teaching pediatric radiology. A majority of participants expressed interest in participating in future peer teaching radiology conferences. CONCLUSION: A virtual pediatric radiology peer and near-peer teaching conference held between two radiology residencies improved short-term radiology knowledge of educators and was highly received.

To teach is to learn twice, revisited: a qualitative study of how residents learn through teaching in clinical environments.

BACKGROUND: Teaching helps the teacher's own learning as a professional-as the saying goes, 'to teach is to learn twice'. Near-peer teaching in clinical practice has been shown to contribute to the development of both teaching skills and necessary competencies for doctors. Research on how near-peer teachers learn through their teaching roles has mainly focused on classroom learning. However, understanding how the phenomenon of 'teaching is learning twice' occurs in clinical settings and its influencing factors is important for the development of a quality workplace learning environment. Therefore, this study investigated how residents learn through teaching in clinical practice and the factors influencing this process. METHODS: This study's methodology is based on the constructivist grounded theory from a social constructivist perspective. Several teaching hospitals in Japan were included, and the study participants were post-graduate year 2 residents (PGY2s) from these hospitals. The interviews were recorded, transcribed into text, and analysed by the first author. RESULTS: From January 2016 to July 2022, 13 interviews were conducted with 11 PGY2s from nine educational hospitals. The PGY2s played diverse educational roles in clinical settings and learned competencies as physicians in almost all areas through such roles. We found that knowledge transfer and serving as role models stimulated PGY2s' intrinsic motivation, encouraged reflection on their own experiences, and promoted self-regulated learning. Further, educating about procedural skills and clinical reasoning prompted reflection on their own procedural skills and thought processes. Supporting post-graduate year 1 residents' reflections led to the refinement of PGY2s' knowledge and thought processes through the verbal expression of their learning experiences. Such processes required the formation of a community of practice. Thus, education promoted learning through reflection and clarified the expert images of themselves that PGY2s envisaged. CONCLUSIONS: The study found that residents acquire various physician competencies through multiple processes by teaching as near-peer teachers in clinical settings, that a community of practice must be formed for near-peer teaching to occur in a clinical setting, and that teaching brings learning to those who teach by promoting reflection and helping them envision the professionals they aim to be.

Cancer health disparities in minority communities: peer support networks can bridge the gap.

PURPOSE: Peer support networks have been suggested to have significant utility in the care of patients with cancer, especially among racial minorities. This article proposes an approach to integrate peer support networks into the care of racial minorities with cancer. METHODS: Methods to integrate peer support groups across racial minorities with cancer include utilizing language and religion in strategic recruitment of peer supporters, recruiting minority peer supporters in online oncology peer support groups, and emphasizing relationship & trust building for participant retention. RESULTS: Language concordance among peer support groups may enhance patient understandability, emotional expression, and create a sense of community and safety. Religious integration may also promote support group accessibility, particularly among Blacks, who tend to depend on their religious communities for cancer care guidance to a greater extent. In addition to providing knowledge, online opportunities may also decrease cancer-related stress, depression, and trauma. Trust between individuals and their sociocultural environment and healthcare system, as well as between the community and the healthcare system, is necessary, particularly for racial minorities who may harbor a historical mistrust of the healthcare system. CONCLUSIONS: To close the racial cancer care gap, a multi-pronged approach is crucial. This includes establishing tailored peer support networks within minority communities that account for language, religion, and cultural factors to build trust and meet psycho-social needs. However, peer support is just one tool. Other critical tools such as holding healthcare institutions accountable for providing equitable care to racial minorities is equally vital in reducing disparities and improving survival outcomes.

Curriculum reform and stereotype threat in medical education: Implications for student well-being.

PURPOSE: Altering the curriculum of a program can have negative repercussions for the student experience, including peer mentorships and interclass relationships. This study investigated the effect of curriculum reform on students' emotional and social well-being in a predoctoral dental program. We explored if any of these consequences could be related to stereotype threat. METHODS: We utilized a quasi-experimental design with two different treatments, New Curriculum Treatment (New-CT, n = 44) and Past Curriculum Treatment (Past-CT, n = 43). Quantitative data were collected through surveys to assess students' perceptions of curriculum changes and their impacts on anxiety, confidence, and clinical performance. Qualitative data were gathered via semi-structured interviews to explore personal experiences of stereotype threat and its implications on peer relationships and mentorship dynamics. RESULTS: The findings suggest significant effects of curriculum changes on interpersonal relationships. Past-CT viewed New-CT as overconfident, while New-CT felt heightened performance pressure. Thematic and interview analyses revealed deep-rooted tensions, with New-CT feeling mistrusted and Past-CT resenting New-CT's perceived accelerated competence. Stereotype threat was identified as a key factor worsening these inter-group tensions and affecting clinical performance and relationships. CONCLUSIONS: Curriculum changes in dental education can significantly affect students' well-being, with stereotype threat playing a critical role in these dynamics. When making changes to the structure, sequencing, or content of a program, administrators need to be aware of the potential ramifications these changes could have on students' relationships with their peers.

Does a peer review group consensus process for MR-Linac patients affect clinical care? Evaluation of impact and feasibility.

Background and purpose: Peer review is an important component of quality assurance in radiotherapy. To our knowledge, there are no studies reporting on the feasibility and outcomes of the peer review process for magnetic resonance (MR) guided radiotherapy (MRgRT) on the MR linear accelerator (MR-Linac) despite the planning complexity involved and its evolving clinical indications. This study aimed to quantify the rate of change in treatment plans post-peer review and the time and resources required. Materials and methods: Fifty-five cases presented at weekly MR-Linac peer review meetings across two centres from 8 June to 21 September 2023 were prospectively collected. Cases were analysed to determine the rate and extent of plan changes based on the Peer Review Audit Tool for radiation oncology (PRAT) developed by the Royal Australian and New Zealand College of Radiologists (RANZCR). Results: Peer review resulted in changes to 36.4 % of treatment plans (n = 20), with 3.6 % (n = 2) having major changes requiring deferment of treatment. The most frequent changes were to organs at risk (OAR) volumes involving both delineation and increased OAR sparing (16.4 %, n = 9), total dose and fractionation (10.9 %, n = 6) and target volume dose coverage (5.5 %, n = 3). Patients with SBRT plans (39.1 % cf 22.2 %), oligometastatic/oligoprogressive sites (38.1 % cf 30.7 %) and reirradiation cases (41.2 % cf 34.2 %) had higher rates of change. Cases took a mean of 7 min (range 2-15 minutes) to discuss. Conclusion: The high rates of plan changes support the value of peer review in MRgRT. We recommend, where possible that all MRgRT cases, particularly those involving SBRT plans, oligometastatic/oligoprogressive sites, and/or reirradiation, be subject to peer review.

Predictors of academic engagement of high school students: academic socialization and motivational beliefs.

The potential of academic engagement to enhance academic outcomes and well-being has been empirically supported, yet studies addressing its predictors are too limited. Hence, the current study collected self-report cross-sectional data from randomly selected 614 (male = 323) high school students in Ethiopia and examined the relations of academic socialization (parental and peer), self-efficacy, and outcome expectations in explaining variance in academic engagement, guided by an integrative model of engagement. Structural equation modeling with the maximum likelihood method indicated that (a) the hypothesized model fit the data well, (b) direct paths from parental and peer academic socialization to self-efficacy, outcome expectations, and academic engagement were positive and significant, (c) the relationships of the constructs in the model explained a significant portion of the variance in academic engagement, and (d) self-efficacy and outcome expectations significantly and positively but partially mediated the pathway from academic socialization to academic engagement. The findings' implications for boosting student academic engagement were forwarded.

Illness experience and (unmet) needs of women with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH): a qualitative analysis of an online forum.

OBJECTIVE: Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a congenital condition characterized by the underdevelopment or complete absence of the uterus and the upper part of the vagina. Diagnosis is commonly made during adolescence, a sensitive period for psychophysical development, following the absence of menstruation. Having MRKH syndrome can have a profound and multifaceted psychosocial impact that characterizes these women's subjective experiences, although it continues to be qualitatively understudied. This article explores the lived experience of women with MRKH spontaneously recounted on an online support forum. The aim was to gain insight into the features of the syndrome experience to understand deeply the emotional and social impact of the condition and the individual needs expressed online. METHODS: Using a naturalistic observation stance, data was collected from an online support forum for MRKH women and systematically analyzed using thematic analysis. RESULTS: Four main interconnected themes are identified: the impact of being diagnosed with MRKH, the difficult interaction with the medical environment, challenging social relationships, and the unmet needs of MRKH women. CONCLUSION: A multidisciplinary and person-centered approach that provides effective and sensitive management of the condition and its psychosocial implications, is essential. Recommendations for future research and practical clinical implications for healthcare professionals are proposed.

Maternal Immunization Decision-Making Among Pregnant and Lactating People in Kenya: A Qualitative Exploration of Peer Influences on Vaccine Decision-Making for a Future RSV Vaccine.

INTRODUCTION: Respiratory syncytial virus (RSV) is a leading cause of respiratory illness in infants globally, with new maternal RSV vaccines on the horizon. Vaccine decision-making during pregnancy is shaped by individual, interpersonal, community, and societal factors. This study explored key interpersonal influences on maternal vaccine decision-making among pregnant and lactating people (PLP) and community members in Kenya. METHODS: This qualitative study conducted in-depth interviews with six pregnant people, 18 lactating people, and 10 community members in one rural and one urban county in Kenya. Data were analyzed using a grounded theory approach. RESULTS: Participants identified the pregnant person themself, male partners, other family members, peers, and healthcare providers (HCPs) as key influences on the maternal immunization decision-making process. The majority of interviewed PLP believed that decision-making during pregnancy should be left to themselves due to autonomy and their role as the primary caregiver. Community members, including male partners, also identified pregnant people as the key decision-maker. While some PLP said they deferred to male partners to make vaccine decisions, more felt that men were not as informed on maternal and child issues as themselves or other female peers and relatives. HCPs emerged as important influences and information sources for PLP during decision-making. DISCUSSION: Understanding who influences vaccine-decision making during pregnancy will help inform demand generation strategies, and in turn, uptake of future maternal vaccines, including RSV vaccines. Given the strong role HCPs and peers have in the decision-making process, targeting key potential influences is essential to improve vaccine acceptance.

Can you be a peer if you don't share the same health or social conditions? A qualitative study on peer integration in a primary care setting.

BACKGROUND: Peer support has been extensively studied in specific areas of community-based primary care such as mental health, substance use, HIV, homelessness, and Indigenous health. These programs are often built on the assumption that peers must share similar social identities or lived experiences of disease to be effective. However, it remains unclear how peers can be integrated in general primary care setting that serves people with a diversity of health conditions and social backgrounds. METHODS: A participatory qualitative study was conducted between 2020 and 2022 to explore the feasibility, acceptability, and perceived effects of the integration of a peer support worker in a primary care setting in Montreal, Canada. A thematic analysis was performed based on semi-structured interviews (n = 18) with patients, relatives, clinicians, and a peer support worker. FINDINGS: Findings show that peers connect with patients through sharing their own hardships and how they overcame them, rather than sharing similar health or social conditions. Peers provide social support and coaching beyond the care trajectory and link identified needs with available resources in the community, bridging the gap between health and social care. Primary care clinicians benefit from peer support work, as it helps overcome therapeutic impasses and facilitates communication of patient needs. However, integrating a peer into a primary care team can be challenging due to clinicians' understanding of the nature and limits of peer support work, financial compensation, and the absence of a formal status within healthcare system. CONCLUSION: Our results show that to establish a relationship of trust, a peer does not need to share similar health or social conditions. Instead, they leverage their experiential knowledge, strengths, and abilities to create meaningful relationships and reliable connections that bridge the gap between health and social care. This, in turn, instills patients with hope for a better life, empowers them to take an active role in their own care, and helps them achieve life goals beyond healthcare. Finally, integrating peers in primary care contributes in overcoming obstacles to prevention and care, reduce distrust of institutions, prioritize needs, and help patients navigate the complexities of healthcare services.

Peer review of the pesticide risk assessment of the active substance triclopyr (variant triclopyr-butotyl).

The conclusions of the European Food Safety Authority (EFSA) following the peer review of the initial risk assessments carried out by the competent authorities of the rapporteur Member State Poland and co-rapporteur Member State Hungary for the pesticide active substance triclopyr (variant triclopyr-butotyl) and the assessment of applications for maximum residue levels (MRLs) are reported. The context of the peer review was that required by Commission Implementing Regulation (EU) No 844/2012, as amended by Commission Implementing Regulation (EU) No 2018/1659. The conclusions were reached on the basis of the evaluation of the representative uses of triclopyr (variant triclopyr-butotyl) as a herbicide on established pasture and non-recreational amenity grassland (field use). MRLs were assessed in rice. The reliable end points, appropriate for use in regulatory risk assessment and the proposed MRLs, are presented. Missing information identified as being required by the regulatory framework is listed. Concerns are reported where identified.

Development and Implementation of a Peer-Teaching Curriculum for Student Assistants.

We have developed a peer-teaching program for student assistants involved in medical education. The offer comprises (1) an inventory of potentially relevant courses offered by other institutions at our university and (2) our own peer-teaching curriculum on pedagogy and teaching methodology. We describe a pilot scheme to implement the curriculum.

One-to-one peer-coaching for patients with cancer - results of a pilot study.

PURPOSE: Cancer is a life threatening disease with negative impact on quality of life and psychological well-being. In international studies, one-to-one peer support and counseling have been shown to improve the psychological well-being of cancer patients. In the study presented, we developed and evaluated an innovative program of peer-coaching. In this program at the University Hospital of Freiburg, cancer survivors were trained to support peers by sharing experience. METHODS: In the project, N = 25 cancer survivors were trained to conduct supportive one-to-one conversations with acute patients or patients in aftercare. Based on a prospective observational study, patients were interviewed using questionnaires before and after the conversations. We assessed expectations and experiences with the peer-coaching as well as psychosocial parameters (PHQ9, GAD7, SSUK, NCCN-distress thermometer). RESULTS: A total of 52 patients had at least one contact with a peer-coach. Most of the patients attended 1-3 sessions. In total, 85 contacts pairing peer-coaches with patients were conducted. Patients showed on average a high level of distress but a low rate of psychiatric comorbidity. The supportive conversations met the patients` needs. Sharing experiences and empowerment were the most relevant benefits for the patients. Both patients and trained peers showed high satisfaction levels with the program. CONCLUSION: Our findings support the feasibility and utility of a peer-coaching program in which trained cancer survivors, acting as peer-coaches, support other patients during or after their oncological treatment. In a further study, the efficacy of peer-coaching should be investigated based on a randomized-controlled trial. TRIAL REGISTRATION: The trial was registered in the German Clinical Trials Register (No. DRKS DRKS00017500) on 12.12.2019.

The relationship between peer support and sleep quality among Chinese college students: the mediating role of physical exercise atmosphere and the moderating effect of eHealth literacy.

Background: Poor sleep quality has emerged as a prevalent health issue among college students. This study aims to explore the mechanism of sleep quality among college students by constructing a moderated mediation model. Methods: The Peer Support Scale, Physical Exercise Atmosphere Scale, eHealth Literacy Scale and Pittsburgh Sleep Quality Index were used to conduct a survey and analysis on 1,085 questionnaires, which were distributed among students from four universities in the northwest, northeast and central regions of China. Results: (1) A significant pairwise correlation exists between peer support, physical exercise atmosphere, eHealth literacy and sleep quality (P < 0.001); (2) Physical exercise atmosphere plays a mediating role between peer support and sleep quality, with a mediating effect accounting for 28.08%; (3) eHealth literacy can significantly moderate the strength of the relationships between peer support and exercise atmosphere, between peer support and sleep quality, and between physical exercise atmosphere and sleep quality. This study revealed the relationship between peer support and sleep quality among college students and its influencing mechanism, and provided theoretical and practical basis for improving college students' sleep quality from the perspectives of peer support, physical exercise atmosphere, and eHealth literacy.

Evaluation of a specialist nurse-led structured self-management training for peer supporters with type 2 diabetes mellitus with or without comorbid hypertension in Slovenia.

BACKGROUND: The training of peer supporters is critical because the success of the entire peer support intervention depends on the knowledge and experience that peer supporters can share with other patients. The objective of this study was to evaluate the pilot implementation of a specialist nurse-led self-management training programme for peer supporters with type 2 diabetes mellitus (T2DM) with or without comorbid hypertension (HTN) at the primary healthcare level in Slovenia, in terms of feasibility, acceptability, and effectiveness. METHODS: A prospective pre-post interventional pilot study was conducted in two Community Health Centres (CHC) in Slovenia from May 2021 to August 2022. Purposive sampling was employed to recruit approximately 40 eligible volunteers to become trained peer supporters. A specialist nurse-led structured training lasting 15 h over a 2-month period was delivered, comprising four group and two individual sessions. The comprehensive curriculum was based on interactive verbal and visual learning experience, utilising the Diabetes Conversation Maps™. Data were collected from medical records, by clinical measurements, and using questionnaires on sociodemographic and clinical data, the Theoretical Framework of Acceptability, knowledge of T2DM and HTN, and the Appraisal of Diabetes Scale, and evaluation forms. RESULTS: Of the 36 participants, 31 became trained peer supporters (retention rate of 86.1%). Among them, 21 (67.7%) were women, with a mean age of 63.9 years (SD 8.9). The training was evaluated as satisfactory and highly acceptable. There was a significant improvement in knowledge of T2DM (p < 0.001) and HTN (p = 0.024) among peer supporters compared to baseline. Six months post-training, there was no significant improvement in the quality of life (p = 0.066), but there was a significant decrease in body mass index (BMI) (p = 0.020) from 30.4 (SD 6.2) at baseline to 29.8 (SD 6.2). CONCLUSION: The pilot implementation of a specialist nurse-led self-management training for peer supporters was found to be feasible, acceptable, and effective (in the study group). It led to improvements in knowledge, maintained disease control, and promoted positive self-management behaviours among peer supporters, as evidenced by a decrease in their BMI over six months. The study emphasises the need for effective recruitment, training, and retention strategies. TRIAL REGISTRATION: The research is part of the international research project SCUBY: Scale up diabetes and hypertension care for vulnerable people in Cambodia, Slovenia and Belgium, which is registered in ISRCTN registry ( https://www.isrctn.com/ISRCTN41932064 ).

Peer mentor contributions to an early intervention vocational rehabilitation specialist service following trauma: A qualitative study.

BACKGROUND: Peer mentors have a role in facilitating the participation, health and well-being of people who have had a traumatic injury. Few studies have explored the involvement of peer mentors in an early intervention vocational rehabilitation (EIVR) service following trauma. OBJECTIVE: This study aimed to explore the experience of implementing peer support within the context of an EIVR service from the perspectives of the peer mentors themselves, the vocational therapists supervising them, and the patients that received peer mentoring. METHODS: Semi-structured interviews were conducted with twenty participants from three groups: peer mentors (n = 4); vocational therapists (n = 3); and patients who received the EIVR intervention (n = 24). Data were thematically analysed. RESULTS: Three themes were identified: The value of peer input in an EIVR service, The facilitators impacting the value of peer involvement as part of the EIVR service, The challenges impacting peer input as part of an EIVR service. CONCLUSIONS: The inclusion of peer mentors early after major traumatic injury was a unique and valuable addition to the EIVR service. Offering peer support early on in rehabilitation enabled patients to gain a sense of hope for their future, and the expectation that returning to work was a realistic option. The careful selection of peer mentors, and ensuring they receive adequate preparation and ongoing supervision are vital to support their well-being during the intervention. Aiming to match peer mentors with similar injuries and work backgrounds to patients is an important contributor to the likely ongoing engagement of the mentee with the mentor.

Protocol for a pilot cluster randomised controlled trial of PRoGRAM-A (preventing gambling-related harm in adolescents): a secondary school-based social network intervention.

BACKGROUND: In the UK, recent evidence of young people and gambling indicates a higher prevalence of gambling in comparison to other addictive behaviours. Engaging in gambling-related behaviour at a young age is associated with short and long-term consequences, including financial, emotional, academic, interpersonal, and physical and mental health detriments; otherwise known as gambling-related harms (GRH). Given the unique vulnerability of this younger group, early interventions aimed at delaying or preventing gambling are critical. PRoGRAM-A (Preventing Gambling-Related Harm in Adolescents) is a school-based, social network intervention to protect young people from future GRH, by delaying or preventing gambling experimentation. METHODS: Pilot cluster RCT with an embedded process evaluation and health economic scoping study. PARTICIPANTS: PRoGRAM-A will be delivered in four schools, with two control schools acting as a comparator. All are secondary schools in Scotland. Baseline surveys were conducted with students in S3 (ages 13-14). Follow-up surveys were conducted with the same cohort, six months post-baseline. INTERVENTION: PRoGRAM-A trainers will deliver a 2-day, out-of-school training workshop to Peer supporters. Peer supporters will be nominated by peers among their school year group (S3, age 13-14). Workshops will provide peer supporters with information on four gambling-related topics: (1) what is gambling? (2) gambling and gaming, (3) gambling marketing, (4) identifying harm and reducing risk. Peer supporters will disseminate the information (message diffusion) they have learned among their friends and family over a 10-week period. After the 2-day workshop, PRoGRAM-A trainers will conduct × 3 in-school follow-up sessions with peer supporters to offer support, encouragement, and advice to Peer Supporters as well as monitor and explore the extent of their message diffusion. PRIMARY OUTCOME: The primary outcome of the pilot cluster RCT (cRCT) will be whether progression to a phase III RCT is justified. DISCUSSION: This will be the first pilot cluster RCT (cRCT) of an intervention to prevent gambling-related harms among young people within the UK. If findings indicate feasibility and acceptability, funding will be sought for a phase III RCT of effectiveness. TRIAL REGISTRATION: Researchregistry8699. Registered 21st February 2023.

Peer review of the pesticide risk assessment of the active substance Phthorimaea operculella granulovirus.

The conclusions of the European Food Safety Authority (EFSA) following the peer review of the initial risk assessments carried out by the competent authority of the rapporteur Member State, The Netherlands for the pesticide active substance Phthorimaea operculella granulovirus are reported. The context of the peer review was that required by Regulation (EC) No 1107/2009 of the European Parliament and of the Council. The conclusions were reached on the basis of the evaluation of the representative uses of Phthorimaea operculella granulovirus as an insecticide on tomato (field and greenhouse uses) and on potato (field use) via spraying (tractor drawn or knapsack sprayers) or overhead irrigation. The reliable endpoints, appropriate for use in regulatory risk assessment are presented. Missing information identified as being required by the regulatory framework is listed.

Relationship Between Father-Child Attachment and Adolescents' Anxiety: The Bidirectional Chain Mediating Roles of Neuroticism and Peer Attachment.

Background: Adolescent anxiety is closely associated with the quality of parent-child attachment. However, previous studies have predominantly focused on the impact of mother-child attachment. Little is known about the direct and indirect associations of father-child attachment on adolescent anxiety. Purpose: This study aims to investigate the association and underlying mechanisms that link father-child attachment and adolescent anxiety. A bidirectional chain mediating model was constructed to test whether neuroticism and peer attachment play bidirectional mediating roles in father-child attachment and adolescent anxiety. Methods: The proposed model was examined among 763 adolescents aged 11-16 years (male 53.1%) from four middle schools in Central China. Students completed questionnaires on father-child attachment, anxiety, neuroticism and peer attachment. The correlation and bidirectional chain mediating effect analyses were conducted using SPSS Process. Results: (1) Father-child attachment negatively correlated with adolescent anxiety and neuroticism, and positively correlated with peer attachment; (2) Father-child attachment had an indirect association on adolescent anxiety through three pathways: a partial mediating effect on neuroticism, a partial mediating effect on peer attachment, and a bidirectional chain mediating effect involving both neuroticism and peer attachment. Conclusion: This study revealed father-child attachment has an indirect association with adolescent anxiety through the bidirectional chain mediation of neuroticism and peer attachment. These empirical findings shed light on the intricate dynamic between father-child attachment and anxiety among Chinese adolescents, highlighting the crucial role of fathers in the prevention and reduction of adolescent anxiety from the perspectives of father-child dynamics, personal traits, and interpersonal relationships.

Violence against children and later substance use in low- and middle-income countries.

BACKGROUND: Globally, one in two children experience violence; experiences which may lead to later risky behaviors such as substance use. In low- and middle-income countries (LMICs), however, the association between childhood violence and substance use remains underexplored. OBJECTIVE: This study assessed the association between childhood violence and substance use among LMIC youth. PARTICIPANTS: Data from the Violence Against Children and Youth Surveys (VACS) in eight LMICs (2017-2019) were analyzed, comprising 33,408 children and young adults (ages 13-24). METHODS: Exposure variables included the experience of childhood violence (physical, sexual, emotional) and polyvictimization (experience of two or more types). Outcomes were current smoking and past-month alcohol and drug use. Multivariable logistic regressions with country-fixed effects were estimated. Stratified analyses were performed based on participant's sex and age, and effect modification analyses examined whether associations differ by the presence of peer support. RESULTS: Childhood physical violence was the most prevalent type of violence (40.7 %), and about 10 % of the participants experienced polyvictimization. All types of violence increased the odds of smoking, binge drinking, and drug use, and polyvictimization elevated the risk substantially. Stronger associations were observed in young women with a history of childhood sexual violence (current smoking aOR: 1.5, 95 % CI: 1.2-1.9; binge-drinking aOR: 2.1, 95 % CI: 1.7-2.5; and drug-use aOR: 2.3, 95 % CI: 1.5-3.5) compared to young men. Additionally, the associations between childhood sexual violence and substance use were more pronounced among adolescents (current smoking aOR: 1.7, 95 % CI: 1.2-2.2; binge-drinking aOR: 2.3, 95 % CI: 1.8-2.9; and drug-use aOR: 2.4, 95 % CI: 1.5-3.9), relative to young adults. Lack of peer support significantly increased the likelihood of drug use. CONCLUSION: Childhood violence prevention programs can reduce substance use in LMICs, and they should take into account the survivor's sex and age. Our findings suggest that peer support can mitigate risky behaviors among the survivors of childhood violence.

Enhancing infection preventionist certification success through a structured training program.

BACKGROUND: Certification in infection control (CIC) is a standardized indicator of the knowledge and competencies essential for effective infection prevention practice. Evidence measuring success of training programs for certfication in infection control is limited. METHODS: From 2017 through 2023, 51 novice infection preventionists (IPs) were enrolled in a training program that combined didactic learning, application of knowledge in practice, and mentorship from advanced-practice and near-peer IPs. Participants were tracked through completion of certification examination and pass rates were compared with rates for 2023 CIC candidates. RESULTS: All participants engaged in the training program attempted the CIC examination. The training group had a pass rate of 98%. This is 27% higher than the most recent rate published by Certification Board of Infection Control and Epidemiology (CBIC) of 71%. DISCUSSION: Participants were significantly more likely to pass the CIC exam on the first try, showing that a supported, competency-based training program can be successful in supporting novice IPs in certification success. CONCLUSIONS: Building foundational knowledge on key concepts in infection prevention and control and enhancing learning through supervised, direct application of skills improves CIC certification exam pass rates and supports progression of early career IPs to more independent practice.