Parents with intellectual disabilities (ID) are overrepresented in the child welfare system. Valid instruments are needed to assess parenting skills in this population. This research evaluates the psychometric properties of the Skills Assessment for Parents with Intellectual Disability (SAPID), an observational instrument completed to assess parents with ID with child welfare involvement. All clients enrolled in a prevention program for parents with ID were included in the sample (N=133). Confirmatory factor analysis was conducted to understand the validity of the SAPID. Predictive validity was assessed by examining change over time with two outcomes out-of-home placement and program completion. The validated SAPID consisted of three latent constructs daily life skills, parent-child interaction, and overall safety. Parenting skills across all domains significantly improved for families remaining intact and those completing the program. The validated SAPID should be considered for use in assessing parenting skills for those with ID. The validated SAPID should be considered for use in assessing parenting skills for those with ID.The after-visit summary (AVS), a document generated from the electronic health record that summarizes patients' encounters with the healthcare system, is a widely used communication tool. Its use by and usefulness for populations with limited English proficiency (LEP) and limited health literacy (LHL) is poorly understood. In this cross-sectional study, we assessed use and usefulness of the AVS among English-, Spanish-, Cantonese-, or Mandarin-speaking Latinx and Chinese primary-care patients. Outcome measures were self-reported AVS use (did not use/looked-at only/shared only/looked-at and shared) and usefulness (useful/not useful). Among 993 participants, 57% were ≥65 years old, 61% had LEP, 21% had LHL, 30.2% were Latinx, 69.8% were Chinese. The majority used the AVS (86%) and found it useful (65%). https://www.selleckchem.com/products/nps-2143.html In adjusted models, participants with LEP were more likely to "look at" (OR 1.68, 95% CI 1.07-2.62) and "look at and share" (OR 1.65, 1.02-2.66) the AVS, but less likely to find it useful (OR 0.68, 0.47-0.98) compared to English speakers. Those with LHL were less likely to "look at" (OR 0.60, 0.39-0.93) and less likely to find the AVS useful (OR 0.67, 0.46-0.99) compared to those with adequate health literacy. Our results emphasize the need for easy-to-understand and fully language-concordant AVS. The long-term effects of pediatric concussion on brain morphometry remain poorly delineated. This study used magnetic resonance imaging (MRI) to investigate cortical volume and thickness in youth several years after concussion. Participants aged 8-19 years old with a history of concussion (n = 37) or orthopedic injury (n = 20) underwent MRI, rated their postconcussion symptoms, and completed cognitive testing on average 2.6 years (SD = 1.6) after injury. FreeSurfer was used to obtain cortical volume and thickness measurements as well as determine any significant correlations between brain morphometry, postconcussion symptoms (parent and self-report), and cognitive functioning. No significant group differences were found for either cortical volume or thickness. Youth with a history of concussion had higher postconcussion symptom scores (both parent and self-report Postconcussion Symptom Inventory) than the orthopedic injury group, but symptom ratings did not significantly correlate with cortical volume or thickness. Across both groups, faster reaction time on a computerized neurocognitive test battery (CNS Vital Signs) was associated with a thinner cortex in the left pars triangularis of the inferior frontal gyrus and the left caudal anterior cingulate. Better verbal memory was associated with a thinner cortex in the left rostral middle frontal gyrus. Findings do not support differences in cortical volume or thickness approximately 2.5 years postconcussion in youth, suggesting either long-term cortical recovery or no cortical differences as a result of injury. Further research using a longitudinal study design and larger samples is needed. Findings do not support differences in cortical volume or thickness approximately 2.5 years postconcussion in youth, suggesting either long-term cortical recovery or no cortical differences as a result of injury. Further research using a longitudinal study design and larger samples is needed. Older adults vary in their safe and unsafe sexual behaviors. While researchers are beginning to understand more about the sexual and intimate expression of older adults, only recently are they beginning to understand how older adults make decisions about sexual risk. Bandura's social cognitive theory offers a frame for understanding how self-efficacy, environmental factors, and goal motivation are related to sexual risk behaviors for older adults, including the interplay between these variables. Using a diverse sample of older adults ( = 720) age 50+years, social cognitive theory was modeled to determine the relationship between environment variables (age, gender, and sexual health conversations with practitioners), behavioral variables (self-efficacy), and cognitive variables (importance of sexual wellness goals) with the outcome variable of sexual risk behaviors. Self-efficacy had an indirect effect on sexual risk via sexual wellness goal motivation. Healthcare provider conversations had both direct and indirect effects on older adults' sexual risk through sexual wellness goal motivation. Models were similarly predictive for older men and women. Sexual risk behaviors among older adults are more influenced by environmental factors in their healthcare settings and their perception and prioritization of sexual wellness goals. Providers play a key role in initiating and maintaining sexual health discussions with older patients, potentially mitigating sexual risk and bolstering self-efficacy. Providers play a key role in initiating and maintaining sexual health discussions with older patients, potentially mitigating sexual risk and bolstering self-efficacy.Abstract The aim of the present study was to clarify the effect of electrical muscle stimulation (EMS) on the spatial distribution pattern of electromyographic activity in healthy young adults using multi-channel surface electromyography (SEMG). A total of 32 men (age = 21-26 years) were randomly assigned to the intervention group (n = 18) and control group (n = 14). Participants in the intervention group performed EMS to stimulate the bilateral lower limb muscle for four weeks (20 min/3 days/week). The control group received no EMS intervention. To understand the effects of EMS, the following measurements were made at baseline and four weeks knee extension torque, muscle mass, and spatial distribution of neuromuscular activation during a target torques [10%, 30%, 50%, and 70% of the maximal voluntary contraction (MVC)] using multi-channel SEMG. The knee extension torque was significantly increased in intervention group compared with control group (p  less then  0.0001). However, the muscle mass did not show a significant difference between pre and post intervention in each group.