Description: Theory and research suggest that narcissism plays an important role in perpetration of sexual aggression. As narcissism is a multidimensional construct, our objective was to clarify the relation between perpetration and three aspects of narcissism. College men (N = 234) completed the Narcissistic Personality Inventory (NPI), Narcissistic Personality Disorder (NPD) subscale of the Structured Clinical Interview for DSM Disorders–II (SCID-N) Personality Questionnaire, and Hypersensitive Narcissism Scale (HSNS). Perpetrators had higher scores on NPD traits, which were also associated with frequent perpetration. HSNS scores were only associated with perpetration via alcohol and/or drugs. Only the maladaptive facets of NPI narcissism correlated with perpetration. Narcissism seems to have been understudied in nonincarcerated perpetrators.

Description: Allergies and asthma have long been considered diseases of children and young adults. They are, however, prevalent among older patients also. This article summarizes findings on the diagnosis and treatment of allergies and asthma in the older population. Allergies and asthma occur with fair frequency in older patients. Remembering to look and test for these problems enables better treatment and symptom control for these patients. Immunotherapy works well in this population. Regardless of the patient's age, the differential diagnosis for sinonasal and dyspnea complaints should include allergies and asthma. Diagnosis is straightforward, and appropriate treatment improves quality of life.

Description: The inclusion of Persistent Complex Bereavement Disorder (PCBD) in the DSM‐5 appendix signifies a call for research regarding the distinguishing features and clinical utility of proposed PCBD criteria. Rigorously constructed tools for assessing PCBD are lacking, especially for youth. This study evaluated the validity and clinical utility of the PCBD Checklist, a 39‐item measure designed to assess PCBD criteria in youth aged 8 to18 years. Test construction procedures involved: (a) reviewing the literature regarding developmental manifestations of proposed criteria, (b) creating a developmentally informed item pool, (c) surveying an expert panel to evaluate the clarity and developmental appropriateness of candidate items, (d) conducting focus groups to evaluate the comprehensibility and acceptability of items, and (e) evaluating psychometric properties in 367 bereaved youth (Mage = 13.49, 55.0% female). The panel, clinicians, and youth provided favorable content validity and comprehensibility ratings for candidate items. As hypothesized, youth who met full PCBD criteria, Criterion B (e.g., preoccupation with the deceased and/or circumstances of the death), or Criterion C (e.g., reactive distress and/or social/identity disruption) reported higher posttraumatic stress and depressive symptoms than youth who did not meet these criteria, ηp2 = .07–.16. Youth who met Criterion C reported greater functional impairment than youth who did not, ηp2 = .08–.12. Youth who qualified for the “traumatic bereavement specifier” reported more frequent posttraumatic stress symptoms than youth who did not, ηp2 = .04. Findings support the convergent, discriminant, and discriminant‐groups validity, developmental appropriateness, and clinical utility of the PCBD Checklist. Resumen Spanish s by the Asociación Chilena de Estrés Traumático (ACET) Validación de Lista de verificación del Trastorno por Duelo Complejo Persistente (TDCP): Un informe del desarrollo de herramientas de medición para duelo en jóvenes LISTA DE CHEQUEO DE TRASTORNO DE DUELO COMPLEJO PERSISTENTE La inclusión del trastorno de duelo complejo persistente (TDCP en su sigla en español; PCBD en sus siglas en inglés) en el apéndice del DSM‐5 significa un llamado para investigar en relación a las características distintivas y la utilidad clínica de los criterios propuestos para el TDCP. Se carece de herramientas rigurosamente construidas para evaluar TDCP, especialmente para jóvenes. Este estudio evalúa la validez y utilidad clínica de la lista de verificación de TPCP, una medida con 39 ítems diseñada para medir el criterio de TDCP en jóvenes de edades entre 8 a 18 años. El procedimiento de construcción del test involucró: (a) revisión de la literatura relacionada con manifestaciones desarrolladas del criterio propuesto; (b) creación de un pool de ítems informados para el desarrollo; (c) encuesta a un panel experto para evaluar la claridad y desarrollo apropiado de los ítems; (d) conducir grupos focales para evaluar la compresibilidad y aceptabilidad de los ítems; y (e) evaluación de propiedades psicométricas en 367 jóvenes en proceso de duelo (M edad = 13.49, 55.0% femenino). El panel, los clínicos y los jóvenes en proceso de duelo proveyeron una validez de contenido favorable y rangos de comprensibilidad para los ítems candidatos. Como se hipotetizó, los jóvenes que cumplieron el criterio completo de TDCP, criterio B (ej., preocupación por el fallecido y/o las circunstancias de la muerte) o el criterio C (ej., estrés reactivo y/o perturbación social/identidad) reportaron alto estrés postraumático y síntomas depresivos que los jóvenes que no cumplen este criterio, ηp2 = .07 a .16. Los jóvenes que no cumplieron el criterio C reportaron mayor deterioro funcional que los jóvenes que no lo cumplieron ηp2 = .08 a .12. Los jóvenes que calificaron para el “duelo traumático especifico” reportaron mayor frecuencia de síntomas de estrés postraumático que jóvenes que no calificaron ηp2 = .04. Los resultados apoyan la validez convergente, discriminante y de grupos discriminante; y el apropiado desarrollo y utilidad clínica de la lista de verificación de TDCP para jóvenes con duelo. 抽象 Traditional and Simplified Chinese s by AsianSTSS Validation of the Persistent Complex Bereavement Disorder (PCBD) Checklist: A Developmentally‐Informed Assessment Tool for Bereaved Youth Traditional Chinese 標題: 驗證「持續性複雜哀慟障礙症(PCBD)檢查表」:一個針對哀慟青少年、具發展適切性的評估工具 撮要: DSM‐5在附錄裡包含了持續性複雜哀慟障礙症(PCBD), 反映我們有需要研究其提出的PCBD標準獨特的特徵和臨床效用。特別是針對青少年的PCBD, 我們目前仍欠缺嚴格設計的評估工具。本研究檢視「PCBD檢查表」的效度和臨床效用。它具備39個測量項目, 用以評估年齡介乎8至18歲的青少年的PCBD。編制評估的過程包括: (一) 審視所提出的標準在過往研究的發展數據; (二) 因應發展數據建立一個項目庫; (三) 訪問一群專業人士, 檢視我們建立的評估項目的清楚性和發展適切性; (四) 以焦點小組的形式, 檢視評估項目的可理解性和可接受度; (五) 檢視367名哀慟青少年 (Mage = 13.49, 55.0% 為女性)的心理測量特質。專業團隊、臨床治療師和受檢視的哀慟青少年, 都對評估項目的內容效度和可理解性作出良好評分。一如假設, 完全符合PCBD標準, 或符合標準B (如對死者和/或其死亡情況長期擔憂) 、或標準C (如反應性悲痛和/或社交/身份認同受擾) 的青少年, 比不符的青少年有較高水平的創傷後壓力和抑鬱症狀(ηp2 = .07 至 .16)。符合標準C的青少年比不符的青少年有較高水平的功能受損(ηp2 = .08 至 .12)。符合有「創傷性哀慟特徵」的青少年, 比不符的青少年有較頻繁的創傷後壓力症狀(ηp2 = .04)。結果證明用以評估哀慟青少年的「PCBD檢查表」有匯聚效度、判別效度、組別判別效度, 亦有發展適切性和臨床效用。 Simplified Chinese 标题: 验证「持续性复杂哀恸障碍症(PCBD)检查表」:一个针对哀恸青少年、具发展适切性的评估工具 撮要: DSM‐5在附录里包含了持续性复杂哀恸障碍症(PCBD), 反映我们有需要研究其提出的PCBD标准独特的特征和临床效用。特别是针对青少年的PCBD, 我们目前仍欠缺严格设计的评估工具。本研究检视「PCBD检查表」的效度和临床效用。它具备39个测量项目, 用以评估年龄介乎8至18岁的青少年的PCBD。编制评估的过程包括: (一) 审视所提出的标准在过往研究的发展数据; (二) 因应发展数据建立一个项目库; (三) 访问一群专业人士, 检视我们建立的评估项目的清楚性和发展适切性; (四) 以焦点小组的形式, 检视评估项目的可理解性和可接受度; (五) 检视367名哀恸青少年 (Mage = 13.49, 55.0% 为女性)的心理测量特质。专业团队、临床治疗师和受检视的哀恸青少年, 都对评估项目的内容效度和可理解性作出良好评分。一如假设, 完全符合PCBD标准, 或符合标准B (如对死者和/或其死亡情况长期担忧) 、或标准C (如反应性悲痛和/或社交/身份认同受扰) 的青少年, 比不符的青少年有较高水平的创伤后压力和抑郁症状(ηp2 = .07 至 .16)。符合标准C的青少年比不符的青少年有较高水平的功能受损(ηp2 = .08 至 .12)。符合有「创伤性哀恸特征」的青少年, 比不符的青少年有较频繁的创伤后压力症状(ηp2 = .04)。结果证明用以评估哀恸青少年的「PCBD检查表」有汇聚效度、判别效度、组别判别效度, 亦有发展适切性和临床效用。

Description: BackgroundActive tobacco smoking is a well-known risk factor for head and neck malignancy, and strong evidence has associated tobacco as the main carcinogenic factor in squamous cell cancers of this region. Evidence supporting a carcinogenic effect of second-hand smoke (SHS) on head and neck organs in non-smokers was also demonstrated with results consistent with those for active smokers. There is little data on the effects of SHS in patients previously treated for squamous cell carcinomas of the head and neck.ObjectiveThe purpose of this study was to prospectively evaluate the role of SHS on recurrence and survival in treated head and neck cancer patients.MethodsWe conducted a prospective cohort study to examine the association between self-reported SHS exposure and the risk of recurrence and mortality in patients treated for squamous cell cancers of the head and neck in a longitudinal fashion. Patients filled out an exhaustive smoking questionnaire on presentation and abbreviated questionnaires at each follow-up visit, which occurred every 6months. Primary outcome measures were recurrence, development of a second primary malignancy, and recurrence-free survival. Chi square analysis was used to assess the association between SHS and the primary outcomes. A multivariate binary logistic regression analysis was applied to determine the independent predictors of recurrence. Cox proportional hazards and Kaplan Meier modeling were employed to assess the possible relationships between SHS exposure and time to develop the primary outcomes.ResultsUntreated new patients with a histologically confirmed diagnosis of first primary SCC of the UADT (defined as cancer of the oral cavity, the oropharynx, the hypopharynx, and the larynx) were recruited. Patients seen at The University of Texas Medical Branch (UTMB) Head and Neck oncology clinic from 1988 to 1996 were considered as cases in this study. One hundred and thirty-five patients were enrolled in the study. The median follow-up time for the sample was 54months (3.92years). Complete records were achieved for 92% of patients, thus 124 patients were included in the final analysis. SHS significantly correlated with recurrence and recurrence-free survival. The rate of recurrence was 46% in the group exposed to SHS and 22% in the non-exposed group. Based on multivariate binary logistic regression analysis, SHS exposure was detected as a significant independent predictor for recurrence (HR=3.00 [95% CI 1.18-7.63]). Kaplan-Meier analysis demonstrated that patients who were not exposed to SHS had a statistically significant longer recurrence-free survival (log-rank P=0.029). The mean survival for non SHS-exposed patients was 76 [63-89] months versus 54 [45-63] months for those exposed to SHS.ConclusionsSHS exposure is an independent predictor of recurrence and survival after head and neck cancer treatment. These results support the importance and efforts of reducing smoking at home in in the work-place.

Description: Context: A major contributor to health disparities is the relative lack of resources—including resources for science—allocated to address the health problems of those with disproportionately greater needs. Engaging and involving underrepresented communities in setting research priorities could make the scientific research agenda more equitable, more just, and more responsive to their needs and values. We engaged minority and underserved communities in informed deliberations and report here their priorities for health research. Methods: Academic-community partnerships adapted the simulation exercise CHAT for setting health research priorities. We had participants from minority and medically underserved communities (47 groups, n = 519) throughout Michigan deliberate about health research priorities, and we used surveys and CHAT software to collect the demographic characteristics and priorities selected by individuals and groups. Findings: The participants ranged in age (18 to 88), included more women than men, and were overrepresented by minority groups. Nearly all the deliberating groups selected child health and mental health research (93.6% and 95.7%), and most invested at the highest level. Aging, access, promote health, healthy environment, and what causes disease were also prioritized by groups. Research on mental health and child health were high priorities for individuals both before and after group deliberations. Access was the only category more likely to be selected by individuals after group deliberation (77.0 vs 84.0%, OR = 1.63, p = .005), while improve research, health policy, and culture and beliefs were less likely to be selected after group deliberations (all, p 〈 .001). However, the level of investment in many categories changed after the group deliberations. Participants identifying as Black/African American were less likely to prioritize mental health research, and those of Other race were more likely to prioritize culture and beliefs research. Conclusions: Minority and medically underserved communities overwhelmingly prioritized mental health and child health research in informed deliberations about spending priorities.

Description: The current study prospectively examined the longitudinal relationships between binge drinking behavior and rape experiences among a multisite sample of college women with a history of prior attempted or completed rape (N = 228). Rates of binge drinking among this high-risk sample were high. Prospective analyses indicated that binge drinking significantly increased risk for subsequent rape. Monthly binge drinkers were significantly more likely to experience alcohol-involved rape than forcible rape at follow-up. Only prior binge drinking, and not type of rape experience, predicted subsequent binge drinking. Findings have direct implications for targeted programming addressing combined risks for binge drinking and rape among college women.

Description: The purpose of this review is to improve otolaryngologists' antibiotic stewardship by detailing current approaches to penicillin allergy. Although up to 15% of hospitalized patients in the United States have a penicillin allergy recorded on their charts, fewer than 10% of these have a true penicillin allergy. Using a combination of a detailed allergy history, skin testing and graded-dose administration, many patients whose charts say 'penicillin-allergic' can safely be treated with penicillin and cross-reacting antibiotics. This permits use of narrower-spectrum antibiotics and saves money.

Description: A landmark textbook on digital libraries for LIS students, educators and practising information professionals throughout the world. Exploring Digital Libraries is a highly readable, thought-provoking authorative and in-depth treatment of the digital library arena that provides an up-to-date overview of the progress, nature and future impact of digital libraries, from their collections and technology-centred foundations over two decades ago to their emergent, community-centred engagement with the social web.

Description: OBJECTIVES/SPECIFIC AIMS: As the sole Clinical and Translational Science Award (CTSA) site in Michigan, the Michigan Institute for Clinical & Health Research (MICHR) at the University of Michigan (UM) is working to develop community networks that drive clinical and translational research on community-identified health priorities. METHODS/STUDY POPULATION: These CBRNs will be modeled from successful work that has been accomplished in Jackson, MI where stakeholders from the local healthcare community, County Health Department, Health Improvement Organization, and grassroots community members created a Community of Solution to address the unmet behavioral health and social needs of community members. The CBRN’s will focus on identifying community health priorities by receiving input from community members in underserved communities using deliberative software called Choosing All Together (CHAT). RESULTS/ANTICIPATED RESULTS: In the fall of 2017, 3 focus groups were held in Northern Michigan to identify community health priorities. The top 5 community health priorities include; (1) mental wellness, (2) long-term illness, (3) alcohol and drugs, (4) air, water, and land, and (5) affording care. Additional focus groups are scheduled for the winter in 2 additional geographic areas. DISCUSSION/SIGNIFICANCE OF IMPACT: Future work for the creation of CBRNs includes building leadership groups comprised of clinicians, community leaders, public health leaders, health system leaders and researchers to inform the leadership groups of community-identified health priorities. In addition, the team is working to identify a platform to connect academic investigators across UM and community partners on shared research priorities in real time. In order to measure and map relationships within the networks, we are planning to utilize Social Network Analysis as an evaluation tool.

Description: OBJECTIVES/SPECIFIC AIMS: Facilitate relationships and partnership development to address the opioid crisis in Detroit and Wayne County Contribute to real-time conversations on opioid epidemic policy and practice to identify and build consensus on research questions Apply findings from each learning community session to policy briefs to better inform policymakers, providers and consumers; and advocate for institutional responsiveness METHODS/STUDY POPULATION: The study population utilizes a purposive sampling approach to intentionally organize relationships and partnership development. For example, participants registered for the December 2018 session, “Detroit/Wayne County Opioid Crisis Learning Community Series: Data Session,” include representation from school-based health clinics, community and faith-based organizations, health systems, city and county level public health, addiction/recovery organizations, law enforcement, academia and citizens. The team feels this approach ensures and builds diverse, team science perspectives and regional collaboration. The Detroit Area Mental Health Leadership Team formed in 2015 at a retreat held by the University of Michigan’s Clinical and Translational Science Initiative attended by nearly 100 community-academic partners. Mental health, stigma and suicide were identified as community priorities by participants who attended the summit. A mental health workgroup formed and later expanded its membership to strengthen diverse perspectives. The team immediately designed and administered a survey amongst its partners creating the following priorities and focus: substance abuse interventions, healthcare access, and consumer awareness of mental health issues/available resources. Since data, policy and service are common threads to design interventions, the partnership decided to facilitate dialogue and discussion from the community on special topics related to the crisis, and share the community’s recommendations on how to address them. The learning community series was designed as a bi-lingual format for sharing and expression. Deliberative democracy encourages inclusion of voices, interests and opinions often not heard or included in decision-making processes; driving the project’s purposive sampling approach. Institutional responsiveness and advocacy for adoption of the community’s recommendations will occur through strategic policy briefs summarizing each learning community session and the entire series. A dissemination plan will be utilized to encourage the policy briefs reach appropriate audiences for capacity building and institutional responsiveness. The learning community series will provide 5 sessions on data (impacting adolescents, emerging adults, and 20-mid 30 year-old adults), recovery/law enforcement, prescribing, and marijuana. The session topics arose from earlier assessment conducted by the Detroit Area Mental Health Leadership Team. RESULTS/ANTICIPATED RESULTS: A response to the opioid crisis should address community priorities identified through data, research and community input. Community providers should have access to real-time data and research to develop appropriate interventions and institutional responsiveness. Equally important is the need for legislators and others impacting resource allocation to hear from the community on priorities they feel should be addressed, and to better understand the need for new types of data and information to drive service delivery, policy and resources to address the crisis. The learning community series will focus on describing the epidemic and building infrastructure to collaborate, and share data and information to strengthen advocacy and responsiveness to address the crisis. We feel this will enable more efficient programming to strengthen service delivery that captures life experiences from those who directly interface with individuals impacted by the crisis. DISCUSSION/SIGNIFICANCE OF IMPACT: There is limited knowledge and consensus on types of data and information to effectively describe the opioid crisis. For example, data and information connecting gateway drugs such as marijuana with more hardcore drugs (i.e., opioids and heroin) is not available; community-based providers have limited access to what research says about the crisis; and local public and community providers are dependent upon the state for surveillance data. Individuals dealing with addiction and recovery often need immediate attention. A gap in access to services exists depending on types of insurance. For example, Medicaid and some HMOs require an assessment before clients can seek treatment, resulting in uncompensated care among providers to immediately address patients need. Access to healthcare is a longstanding issue in medically underserved communities. The impact of the crisis varies geographically in communities and regions due to cultural and ethnic differences, yet data and information on these differences is not readily available. Cultural competency and sensitivity is often an issue in medically underserved areas because stakeholders may feel professionals providing services do not relate to them effectively. Finally, the community does not understand the economic impact of the crisis. These issues make it difficult for community advocates and providers to work with elected officials, providers and others on the opioid crisis because they do not have the data and informed required to effectively flush out a hypothesis and form solutions. Information captured in the learning community series (i.e., presentations by experts, facilitated discussion and personal testimony) will be summarized in a policy brief after each session and the entire series. Recommendations and priorities from the community will be shared with providers, policymakers, the business community, consumers and others to provide community input on problem solving approaches, new interventions, types of data not currently available that should be captured, and other important strategies and information to address the crisis. This information will also encourage designing research questions to guide developing new community engaged and community based participatory research to address the crisis. Finally, utilizing a purposive approach in participant recruitment will encourage partnership development from a team science and capacity building perspective.