Fielding Graduate University

Several forms of police misconduct exist, including the inappropriate use of a weapon, sexual misconduct, and racially offensive behaviors, and deserve more attention in the literature. More recent literature suggests that there may be personality predictors of misconduct. Specifically, aggression, having unstable relationships, a lack of empathy, thrill-seeking behavior , and poor impulse control, may contribute to officer misconduct. The current study examined a group of 642 first-year police officers through a series of mostly logistic regression analyses to determine if antisocial or borderline personality traits predict inappropriate use of a weapon, sexual misconduct, and racially offensive behavior using scales from the Min-nesota Multiphasic Personality Inventory, Second Edition (MMPI-2; the antisocial practices and the psychopathic deviance scales) and the Personality Assessment Inventory (PAI; the borderline and antisocial scales). Most of the hypotheses were not supported by the findings. Participants who had more antisocial traits, as assessed by MMPI-2, were less likely to be accused of racially offensive behavior. Officers who had more borderline characteristics, as assessed by the MMPI-2, were less likely to be accused of engagement in any misconduct, specifically sexual misconduct. However, participants who had more borderline traits, as assessed by the PAI, were more likely to engage in sexual misconduct, but less likely to engage in any misconduct overall. Demographic covariates also were found to be related to all three forms of misconduct.

Narrative research deals in the stories people tell about themselves and their experiences. More specifically, narrative analysis looks for the truths of the storytellers. This chapter explores context, subjectivity, and positionality of the person or group of interest instead of a singular objective truth, which are integral facets of narrative inquiry and qualitative research more generally. The author discusses how narrative analysis can effectively highlight the lived experiences and context of AuDHD individuals in a largely neurotypical world. The chapter further examines how, although the narrative usually does not include the researcher as an explicit character, the researcher plays an integral role in shaping the narrative and in co-constructing meaning from the stories with the narrators. Additionally, this chapter grapples with the question of what happens when there is a mismatch between researchers and narrators, particularly regarding communication, context, and experience of the world? This chapter explores the challenges, benefits, and structure of using narrative analysis and research to uplift the stories of AuDHD experiences and attends to the role of researcher reflexivity and co-construction of meaning.

Cannabis use among women who experience chronic pain is on the rise in the United States. However, little is known about women's motives and preferences for cannabis administration. The purpose of this study was to characterize cannabis use among women with chronic pain. This study examined self‐reported forms of cannabis administration and preferred source of cannabis, frequency and quantity of use, and self‐reported side effects, and type, level, and intensity of chronic pain among adult women in the United States. This study also compared women who use cannabis for chronic pain and those who do not across the level of chronic pain, length of chronic pain, and the number of types of chronic pain experienced. Participants showed a significant preference (60%) for using recreational cannabis to treat chronic pain but reported that medical cannabis was more effective. For participants who preferred medical cannabis 24.3% reported daily use, as compared to only 7.8% of recreational cannabis users. Smoking was the most common form of administration (62.1%), followed by edibles (25.3%), vaporizing in any form (7.4%), tinctures and concentrates (3.2%), and topicals (2.1%). Participants reported using 1–6 different forms of cannabis administration. Those who preferred smoking were significantly likely to use all other forms of administration. However, those who preferred alternatives to smoking were significantly likely to use all forms of administration except for smoking. Medical cannabis users preferred to obtain cannabis from a dispensary, while recreational users preferred to obtain cannabis from unlicensed sources. Additionally, participants who used cannabis for chronic pain reported a 74% reduction in past 30‐day opioid use. Future research is needed to investigate the health effects associated with single and combined forms of cannabis administration for women with chronic pain. Results can inform educational and intervention programs, treatment development, content regulation of products, policy formation, women's health research, and public health guidelines.

The present study investigated the effects of long-term knowledge on backward masking interference in visual working memory (VWM) by varying the similarity of mask stimuli along categorical dimensions. To-be-remembered items and masks were taken from categories controlled for perceptual distinctiveness and distinctiveness in kinds (e.g., there are many kinds of cars and few kinds of coffee mugs). Participants completed a change-detection task in which the memory array consisted of exemplars from either a similar or distinctive category, followed by a mask array of items from the same category (conceptually similar versus conceptually distinct categories), a different category, or no mask. The results over two experiments showed greater interference from conceptually similar masks as compared with the other conditions across stimulus onset asynchrony (SOA) conditions, suggesting masking with conceptually similar categories leads to more interference even when masks are shown well after the stimulus. These results have important implications for both the nature and time course of long-term conceptual knowledge influencing VWM, particularly when using complex real-world objects.

Purpose To assess gender differences in COVID-19 related changes in home and work responsibilities longitudinally, and determine whether these differences, together with other potential risk and protective factors, are associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptomatology. Method Symptoms of depression, anxiety, and PTSD were measured using an online survey instrument, between May 2020 and April 2021, in four waves completed at 3-monthly intervals. Analyses were based on data from the COvid MEntal healTh (COMET) survey which investigated the mental health effects of the COVID-19 outbreak spanning 13 countries on five continents in N = 7,909 participants. Results From the first to the last wave, women reported a greater increase in home and work responsibilities, and had higher depression, anxiety and PTSD scores compared to men. Women who reported a reduction in income due to the pandemic had higher depression scores. Working harder and experiencing a reduction in income were also associated with higher anxiety scores in women but not in men. Women were more likely to score above the cut-off for depression (32.5% vs 23.6%, p < .001), anxiety (21.2% vs 14.4%, p < .001) and PTSD (21.2% vs 14.4%, p < .001) than men during the first wave. Stronger reliance on socially supported coping mechanisms was a risk factor for depression, anxiety and PTSD in men and women. Conclusion Women were more likely to report mental health problems which may be related to the gender disproportionate increase in home and work responsibilities but not necessarily due to COVID-19 stressors.

Background: Enhancing care integration and coordination to improve patient outcomes in opioid use disorder treatment is a growing focus in the field. Understanding of how the treatment system implements coordination and integration, particularly in the aftermath of the COVID-19 pandemic, remains limited. In this study, we explored the implementation of medications for opioid use disorder (MOUD) and the evolution of service delivery toward a more comprehensive approach. We examined providers’ perspectives from high-achieving programs in Los Angeles County, the largest and most diverse U.S. county, including barriers to integrating and coordinating care and strategies for integrating MOUD service delivery. Methods: We gathered qualitative interview data from 30 high-performing programs in Los Angeles County, each represented by a manager or supervisor. High performance was defined by empirical indicators of access, retention, and program completion. Our data collection and analysis followed the constructivist grounded theory approach, explicating the social processes used by participating managers during the pandemic and subsequent organizational shifts. This approach yielded 14 major and six minor codes. Interrater reliability tests yielded a pooled Cohen’s kappa statistic of 93%. Results: Expert providers exhibited a strong commitment to destigmatizing MOUD and worked to overcome obstacles in delivering care to clients by advocating its efficacy to fellow health care providers. Along with their endorsement of MOUD, they identified challenges in integrating and coordinating MOUD care. Barriers included stigma at both patient and provider levels, inadequate education about MOUD, limited access to MOUD, and the complexities of operating in a fragmented health care framework. Despite these challenges, high-performing providers used strategies to harmonize and align MOUD service delivery with health and social services. These included establishing service colocation, adopting a multidisciplinary team-based approach, forming partnerships with the community, offering telehealth services, integrating and sharing data, and embracing a harm reduction philosophy. Discussion: Through the adoption of these strategies, providers enhanced care accessibility, boosted patient engagement, sustained retention in treatment, and enhanced treatment outcomes. Even among highly skilled treatment providers in Los Angeles County, barriers to integrating and coordinating care using MOUD remain intricate and multifaceted. Addressing these challenges necessitates a comprehensive strategy involving provider education and training, increased availability of MOUD, enhanced coordination and communication among health care providers, resolution of regulatory hurdles, and addressing patient hesitancy toward MOUD.

Introduction: Perinatal depression affects 5–15% of childbearing women. However, literature suggests that Latina women are twice as likely to experience depression during pregnancy. Group telehealth-based interventions are a promising approach to increasing access and reducing barriers to mental health. However, little is known about the experience that Latinas have with navigating this approach. This paper aimed to explore Latina mothers’ perspectives and recommendations in using telehealth to deliver a mindfulness-based cognitive behavioral therapy (MBCBT) group intervention. Methods: Fourteen pregnant or postpartum women participated in focus groups and individual interviews. Interview topics included perinatal depression, knowledge and content of interventions, and the feasibility and acceptability of the telehealth approach. Data were recorded, transcribed, and analyzed using a grounded theory approach. Results: Three broad themes emerged; (1) accessibility to telehealth, (2) relational connection through technology, and (3) technological issues affecting access (i.e., level of familiarity with portal, video quality, etc.). Enhancers promoting participation in the telehealth intervention included reduced scheduling concerns and no need for childcare. Barriers included mistrust of providers’ engagement, concerns about privacy, and potential for lack of relational connection through technology. Conclusion: Specific recommendations were provided to increase participation and effectiveness of telehealth groups among Latinas.

PURPOSE A cost-effective, prebiotic gel (PreBioGyn) is being developed to prevent genital cancers by reducing biological risk factors for women including vaginal infections, mucosal inflammation, and plastic contaminant exposure. PreBioGyn is packaged in a reduced-plastic system, using a Kraft-paper vaginal applicator. Vaginal mucosa has high absorption and permeability putting women at risk to contaminants in feminine-care products. Specifically, cell toxic levels of phthalates and bisphenols are found in 90% of these products with increased serum levels (e.g. 5X) occurring in some users. Short-term exposure to plastics used in these products results in over 5,000 leachable chemicals migrating into water samples. Plastic chemical burdens are amplified for women in low-resource settings, women who also have increased genital cancer risks. These studies evaluated the dosing accuracy, user acceptance, and cytotoxicity of the paper PreBioGyn applicator. METHODS (1) Dosing accuracy of the paper applicator was compared to that of plastic applicators used with existing vaginal gels (Trimosan and RepHresh; modified ISO11608-1:2014). (2) Table-top acceptability of the paper applicator was scored by 42 HPV-positive women in two locations (BWH and UPRMSC). Women were not educated about any benefits of plastic-free vaginal applicators. (3) Cytotoxicity of the paper applicator was tested (ISO 10993-1:2018, 10993-5:2009, 10993-12:2012) with 48 hr extract exposure to L929 cells. Latex glove extracts served as positive controls. RESULTS For the PreBioGyn paper applicator: (1) 90% of gel doses fell within target levels (+10%) which was significantly more accurate as compared to the two plastic applicators. (2) The proportion of women who scored the applicator in Likert responses as neutral or better (vs a negative acceptance score) was >50% for appearance, feel, and dose-preparation; and >64% for use with vaginal medications as part of a cancer prevention program. (3) No cytotoxicity or biological reactivity was seen in applicator extracts. Latex extracts resulted in severe destruction of cells. CONCLUSION The novel paper applicator was safe, effective and acceptable in these studies. Acceptability was equal to published ratings for many plastic applicators used in existing vaginal products. The reduced-plastic PreBioGyn delivery system is designed to minimize plastic contaminant exposure in the vagina and the environment, further supporting its adoption as a cancer prevention gel.

Few patient engagement tools incorporate the complex patient experiences, contexts, and workflows that limit depression treatment implementation. Describe a user-centered design (UCD) process for operationalizing a preference-driven patient activation tool. Informed by UCD and behavior change/implementation science principles, we designed a preference-driven patient activation prototype for engaging patients in depression treatment. We conducted three usability cycles using different recruitment/implementation approaches: near live/live testing in primary care waiting rooms (V1–2) and lab-based think aloud testing (V3) oversampling older, low-literacy, and Spanish-speaking patients in the community and via EHR algorithms. We elicited clinician and “heuristic” expert input. We administered the system usability scale (SUS) all three cycles and pre-post V3, the patient activation measure, decisional conflict scale, and depression treatment barriers. We employed descriptive statistics and thematically analyzed observer notes and transcripts for usability constructs. Overall, 43 patients, 3 clinicians, and 5 heuristic (a usability engineering method for identifying usability problems) experts participated. Among patients, 41.9% were ≥ 65 years old, 79.1% female, 23.3% Black, 62.8% Hispanic, and 55.8% Spanish-speaking and 46.5% had ≤ high school education. We described V1–3 usability (67.2, 77.3, 81.8), treatment seeking (92.3%, 87.5%, 92.9%), likelihood/comfort discussing with clinician (76.9%, 87.5%, 100.0%), and pre vs. post decisional conflict (23.7 vs. 15.2), treatment awareness (71.4% vs. 92.9%), interest in antidepressants (7.1% vs. 14.3%), and patient activation (66.8 vs. 70.9), with fewer barriers pertaining to cost/insurance, access/coordination, and self-efficacy/stigma/treatment efficacy. Key themes included digital literacy, understandability, high acceptability for aesthetics, high usefulness of patient/clinician videos, and workflow limitations. We adapted manual entry/visibility/content; added patient activation and a personalized algorithm; and proposed flexible, care manager delivery leveraging clinic screening protocols. We provide an example of leveraging UCD to design/adapt a real-world, patient experience and workflow-aligned patient activation tool in diverse populations.

Masking experiments, using vertical and horizontal sinusoidal depth corrugations, have suggested the existence of more than two spatial‐frequency disparity mechanisms. This result was confirmed through an individual differences approach. Here, using factor analytic techniques, we want to investigate the existence of independent temporal mechanisms in frontoparallel stereoscopic (cyclopean) motion. To construct stereomotion, we used sinusoidal depth corrugations obtained with dynamic random‐dot stereograms. Thus, no luminance motion was present monocularly. We measured disparity thresholds for drifting vertical (up‐down) and horizontal (left‐right) sinusoidal corrugations of 0.4 cyc/deg at 0.25, 0.5, 1, 2, 4, 6, and 8 Hz. In total, we tested 34 participants. Results showed a small orientation anisotropy with lower thresholds for horizontal corrugations. Disparity thresholds as a function of temporal frequency were almost constant from 0.25 up to 1 Hz, and then they increased monotonically. Principal component analysis uncovered two significant factors for vertical and two for horizontal corrugations. Varimax rotation showed that one factor loaded from 0.25 to 1–2 Hz and a second factor from 2 to 4 to 8 Hz. Direct Oblimin rotation indicated a moderate intercorrelation of both factors. Our results suggest the possible existence of two somewhat interdependent temporal mechanisms involved in frontoparallel stereomotion.

The term living on a hyphen denotes a hybrid identity that seeks to integrate two distinct roles, knowledge sets, and value systems. We share practitioner experience of an attempt to live on the coaching-consultant hyphen in a program for women entrepreneurs. The program was designed for intentional shifts between coaching and consulting and for these helping modes to remain clear and distinct across the 6-month engagement. This kind of practice contrasts with much professional guidance, especially on the coaching side, which maintains the importance of staying in the coaching lane. We explain our reasons for the hybrid approach in relation to this client group. This hybrid practice was more involving and demanding than single-mode work, requiring the development of more complex and authentic relationships with clients. We share our learning and call for research to clarify the conditions and capacities necessary to work effectively on the coaching-consulting hyphen.