U.S. parents' intentions to use anti-bullying apps: Insights from a comprehensive model.

Cyberbullying has become a prominent risk for youth and an increasing concern for parents. To help parents reduce their child's cyberbullying risk, anti-bullying apps (ABAs)-mobile applications for identifying and preventing instances of cyberbullying-have been developed in recent years. Given that ABAs are an emerging technology, limited research has been conducted to understand the factors predicting parents' intentions to use them. Drawing on three interdisciplinary theoretical frameworks, a sample of parents in the U.S. recruited through Amazon Mechanical Turk completed an online survey to assess parents' knowledge of, attitudes about, and intentions to use ABAs. Participants also rated the importance of a range of ABA functions and provided information about their child's social media use and bullying history. A series of path analyses revealed that the importance parents placed on an app's ability to provide information about their child's cyberbullying risk predicted more positive attitudes toward ABAs and greater perceived usefulness of them. Stronger intentions to use ABAs were predicted by greater cyberbullying concern, greater importance of social recommendations, greater perceived usefulness, more positive attitudes toward the apps, and lower ratings of the importance of ease of use. These findings shed light on the factors predicting parents' intentions to use ABAs and the app features they view as most important. Crucial directions for future research and implications for anti-bullying efforts are discussed.

An Analysis of Temporal Trends in Anti-Asian Hate and Counter-Hate on Twitter During the COVID-19 Pandemic.

Recent studies have documented increases in anti-Asian hate throughout the COVID-19 pandemic. Yet relatively little is known about how anti-Asian content on social media, as well as positive messages to combat the hate, have varied over time. In this study, we investigated temporal changes in the frequency of anti-Asian and counter-hate messages on Twitter during the first 16 months of the COVID-19 pandemic. Using the Twitter Data Collection Application Programming Interface, we queried all tweets from January 30, 2020 to April 30, 2021 that contained specific anti-Asian (e.g., #chinavirus, #kungflu) and counter-hate (e.g., #hateisavirus) keywords. From this initial data set, we extracted a random subset of 1,000 Twitter users who had used one or more anti-Asian or counter-hate keywords. For each of these users, we calculated the total number of anti-Asian and counter-hate keywords posted each month. Latent growth curve analysis revealed that the frequency of anti-Asian keywords fluctuated over time in a curvilinear pattern, increasing steadily in the early months and then decreasing in the later months of our data collection. In contrast, the frequency of counter-hate keywords remained low for several months and then increased in a linear manner. Significant between-user variability in both anti-Asian and counter-hate content was observed, highlighting individual differences in the generation of hate and counter-hate messages within our sample. Together, these findings begin to shed light on longitudinal patterns of hate and counter-hate on social media during the COVID-19 pandemic.

Cyberbullying and Mental Health in Adults: The Moderating Role of Social Media Use and Gender.

Previous research has identified a link between mental health and cyberbullying, primarily in studies of youth. Fewer studies have examined cyberbullying in adults or how the relation between mental health and cyberbullying might vary based on an individual's social media use. The present research examined how three indicators of mental health-depression, anxiety, and substance use-interact with social media use and gender to predict cyberbullying in adults. In Study 1, U.S. adults recruited through Amazon Mechanical Turk (N = 525) completed an online survey that included measures of mental health and cyberbullying. Multiple regression analyses revealed significant three-way interactions between mental health, degree of social media use, and gender in models predicting cyberbullying victimization and perpetration. Specifically, for men, depression and anxiety predicted greater cyberbullying victimization and perpetration, particularly among men with relatively higher levels of social media use. In contrast, depression and anxiety were uncorrelated with cyberbullying for women, regardless of level of social media use. Study 2 largely replicated these findings using well-validated measures of mental health (e.g., Center for Epidemiological Studies-Depression scale, Beck Anxiety Inventory, Global Appraisal of Individual Needs Substance Use scale) in U.S. adults recruited through Prolific.co (N = 482). Together, these results underscore the importance of examining mental health correlates of cyberbullying within the context of social media use and gender and shed light on conditions in which indicators of mental health may be especially beneficial for predicting cyberbullying in adults.

Living Through COVID-19: Social Distancing, Computer-Mediated Communication, and Well-Being in Sexual Minority and Heterosexual Adults.

COVID-19 has had far-reaching effects on people's lives, with evidence of a disproportionate impact on marginalized groups. Given existing health disparities and research on minority stress, COVID-19 may have uniquely impacted psychological well-being among sexual minorities. In an online survey of adults in the U.S. (N = 1,007) conducted in April 2020, we examined differences between sexual minority and heterosexual participants in psychological well-being, social distancing, computer-mediated communication, and COVID-19-related worry and experiences. Sexual minorities reported lower thriving and greater psychological distress, social distancing, computer-mediated communication, and COVID-19 worry and experiences than heterosexual participants. Social distancing and distress were positively correlated among sexual minorities and more frequent computer-mediated communication predicted greater thriving across groups. Path analyses showed sexual minorities' poorer psychological well-being was mediated by their greater COVID-19 worry and social distancing, in particular. These findings shed light on the distinct impact of COVID-19 on sexual minorities.

Upper Gastrointestinal Bleeding in Adults: Evaluation and Management.

Upper gastrointestinal (GI) bleeding is defined as hemorrhage from the mouth to the ligament of Treitz. Common risk factors for upper GI bleeding include prior upper GI bleeding, anticoagulant use, high-dose nonsteroidal anti-inflammatory drug use, and older age. Causes of upper GI bleeding include peptic ulcer bleeding, gastritis, esophagitis, variceal bleeding, Mallory-Weiss syndrome, and cancer. Signs and symptoms of upper GI bleeding may include abdominal pain, lightheadedness, dizziness, syncope, hematemesis, and melena. Physical examination includes assessment of hemodynamic stability, presence of abdominal pain or rebound tenderness, and examination of stool color. Laboratory tests should include a complete blood count, basic metabolic panel, coagulation panel, liver tests, and type and crossmatch. A bolus of normal saline or lactated Ringer solution should be rapidly infused to correct hypovolemia and to maintain blood pressure, and blood should be transfused when hemoglobin is less than 7 g per dL. Clinical prediction guides (e.g., Glasgow-Blatchford bleeding score) are necessary for upper GI bleeding risk stratification and to determine therapy. Patients with hemodynamic instability and signs of upper GI bleeding should be offered urgent endoscopy, performed within 24 hours of presentation. A common strategy in patients with failed endoscopic hemostasis is to attempt transcatheter arterial embolization, then proceed to surgery if hemostasis is not obtained. Proton pump inhibitors should be initiated upon presentation with upper GI bleeding. Guidelines recommend high-dose proton pump inhibitor treatment for the first 72 hours post-endoscopy because this is when rebleeding risk is highest. Deciding when to restart antithrombotic therapy after upper GI bleeding is difficult because of lack of sufficient data.

Improving Resident Feedback on Diagnostic Reasoning after Handovers: The LOOP Project.

Appropriate calibration of clinical reasoning is critical to becoming a competent physician. Lack of follow-up after transitions of care can present a barrier to calibration. This study aimed to implement structured feedback about clinical reasoning for residents performing overnight admissions, measure the frequency of diagnostic changes, and determine how feedback impacts learners' self-efficacy. Trainees shared feedback via a structured form within their electronic health record's secure messaging system. Forms were analyzed for diagnostic changes. Surveys evaluated comfort with sharing feedback, self-efficacy in identifying and mitigating cognitive biases' negative effects, and perceived educational value of night admissions-all of which improved after implementation. Analysis of 544 forms revealed a 43.7% diagnostic change rate spanning the transition from night-shift to day-shift providers; of the changes made, 29% (12.7% of cases overall) were major changes. This study suggests that structured feedback on clinical reasoning for overnight admissions is a promising approach to improve residents' diagnostic calibration, particularly given how often diagnostic changes occur.