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Nostalgia is a social, self-relevant, and bittersweet (although mostly positive) emotion that arises when reflecting on fond past memories and serves key psychological functions. The majority of evidence concerning the prevalence, triggers, and functions of nostalgia has been amassed in samples from a handful of largely Western cultures. If nostalgia is a fundamental psychological resource, it should perform similar functions across cultures, although its operational dynamics may be shaped by culture. This study (N = 2,606) examined dispositional nostalgia, self-reported triggers of nostalgia, and functions of experimentally induced nostalgia in young adults across 28 countries and a special administrative region of China (i.e., Hong Kong). Results indicated that nostalgia is frequently experienced across cultures, albeit better valued in more-developed countries (i.e., higher national wealth and life-expectancy). Nostalgia is triggered by psychological threats (especially in warmer countries), sensory stimuli (especially in more-developed countries), and social gatherings (especially in less-developed countries). The positive or negative affect prompted by experimentally induced nostalgia varied by country, but was mild overall. More importantly, recalling a nostalgic (vs. ordinary) memory increased social connectedness, self-continuity, and meaning in life across cultures. In less-developed countries, recalling an ordinary memory also conferred some of these functions, reducing the effect size of nostalgia. Finally, recalling a nostalgic (vs. ordinary) memory augmented state satisfaction with life in countries with lower quality of living (i.e., lower life-expectancy and life-satisfaction). Overall, findings confirm the relevance of nostalgia across a wide range of cultures and indicate cultural nuances in its functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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Duodenal diverticulitis is a relatively uncommon finding in patients. Treatment of complications of duodenal diverticulitis may be challenging in patients with altered intestinal anatomy such as those with altered anatomy from weight loss procedures involving intestinal bypass. We present a case report describing the management of duodenal diverticulitis following a biliopancreatic diversion, our decision-making process, and our final treatment strategy.

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Single-anastomosis duodenal switch (SADI-S) is effective for weight loss with low reported rates of complications. Bile reflux into the stomach or esophagus is an uncommonly reported complication but can lead to significant symptoms for patients suffering from this complication. Concurrent paraesophageal hernia can exacerbate the symptoms of biliary reflux gastritis. We present a case report describing the management of biliary reflux gastritis with concurrent paraesophageal hernia, our decision-making process, and technical pearls and possible pitfalls.

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Purpose: Sexual and gender minority (SGM) people experience many health care disparities. We aimed to determine if medical students viewed sexual minority patients (lesbian, gay, or bisexual [LGB] men/women) as more complex than heterosexual patients, even when presenting with the same symptoms, and whether this perceived complexity affected confidence caring for LGB patients. Methods: A fictional patient with an upper respiratory infection was presented with systematic variation of the patient's sexual orientation across six experimental conditions in an online, vignette-based experimental study. Participants rated their perception of the medical, therapeutic, and social complexity of the patient, and completed a measure of stigma toward SGM people. Finally, participants indicated their confidence caring for the presented patient. Results: Overall, 665 students participated. Participants viewed the LGB patients as more complex across all domains, relative to heterosexual patients. Perceived medical and social complexity predicted lower confidence caring for the patient. Participants reported lower confidence caring for gay male patients with indirect effects of medical and social complexity. LGB identity was broadly and indirectly associated with lower confidence through social complexity. Conclusion: Our results suggest students view LGB patients as more complex compared with heterosexual patients. Medical education programs must provide training about the effects of social biases on clinical judgments and care for LGB patients, as well as build skills to ensure confidence caring for LGB patients.

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HIV pre-exposure prophylaxis (PrEP) is critical for ending the HIV epidemic, and a necessary part of health professions education. We present data from a US survey study (N = 2085) about educational experiences (coursework and extracurricular), in which medical, physician assistant, nursing, and pharmacy students received training about HIV risk factors and PrEP. We found a discrepancy between the percentage of courses covering HIV risk factors (84.7%) compared to PrEP (54.6%) for all students (P < .001), and specifically among final-year students (92.0% vs. 59.7%; P < .001). Pharmacology courses were the most common exposure to PrEP (46.0%), and 61.3% of students were introduced to PrEP through an extracurricular experience. Health professions education must present HIV risk factors in conjunction with PrEP. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01265-3.

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BACKGROUND: Preexposure prophylaxis (PrEP) is a highly effective, pharmacologic method of HIV prevention. Despite its safety and efficacy, PrEP prescription remains low in those patients who are at highest risk for HIV infection. One possible reason for this may be the lack of inclusion of PrEP and HIV prevention discussions within the curricula of health professions education. METHODS: An online survey was administered to a cross-sectional sample of future prescribers (osteopathic/allopathic medical and physician assistant students), future nurses, and future pharmacists (n = 2085) in the United States between January and July 2019 to assess and compare awareness of PrEP, PrEP education, PrEP knowledge, and confidence in 2 areas related to PrEP. RESULTS: We show that, overall, awareness of PrEP is high among future health care providers (81.6%), with the future pharmacists reporting the greatest awareness (92.2%; P < 0.001) and more commonly reporting PrEP education (71.0%). Students had mixed knowledge of PrEP, with future pharmacists reporting the highest knowledge of PrEP. Approximately 30% of students in all disciplines reported having low confidence counseling a patient about PrEP and low confidence educating a colleague about PrEP. Knowledge of PrEP was a significant predictor of confidence counseling a patient about PrEP (P < 0.001) and educating a colleague about PrEP (P < 0.001). CONCLUSIONS: This study identifies opportunities to improve and incorporate evidence-based strategies for educating future health care providers about PrEP for HIV prevention within health professions curricula.

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Purpose: Evaluating medical students' attitudes toward sexual and gender minority (SGM) people is important to identify negative attitudes early in education and to design curriculum to mitigate biases. The purpose of this study was to investigate medical students' attitudes toward SGM people as a whole as well as specific populations within the SGM community. We sought to determine whether attitudes toward SGM people differed between students' demographics and training. Methods: We conducted an online survey-based study among 1007 medical students at 12 U.S. medical schools. Participants completed the Attitudes Toward LGBT People Scale and were randomized to complete another scale specific to one group within the SGM community. We evaluated the association between student demographics and medical training and attitudes toward SGM people overall and toward specific SGM populations. This study was conducted between January and June 2020. Results: Overall, we found that medical students had positive attitudes toward SGM people and specific SGM groups. The most important factor affecting medical students' attitudes on all scales was religiosity, as very religious students held less positive attitudes toward SGM people. In addition, cisgender female students held more positive attitudes toward SGM people overall and toward specific SGM populations. Conclusion: Medical education must ensure that future physicians receive comprehensive and culturally competent training to prepare them to care for SGM patients. Based on our findings, this training should include specific content to help medical students identify potential biases toward SGM people, as well as strategies to acknowledge and confront these biases.

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BACKGROUND: Daily, oral pre-exposure prophylaxis (PrEP) is an effective and safe prevention strategy for people at risk for HIV. However, prescription of PrEP has been limited for patients at the highest risk. Disparities in PrEP prescription are pronounced among racial and gender minority patients. A significant body of literature indicates that practicing healthcare providers have little awareness and knowledge of PrEP. Very little work has investigated the education about PrEP among health professionals in training. OBJECTIVE: The objective of this study was to compare health professions students' awareness of PrEP and education about PrEP between regions of the US, and to determine if correlations between regional HIV incidence and PrEP use were present. DESIGN: Survey study. PARTICIPANTS: A cross-sectional sample of health professions students (N = 1859) representing future prescribers (MD, DO, PA), pharmacists, and nurses in the US. KEY RESULTS: Overall, 83.4% of students were aware of PrEP, but only 62.2% of fourth-year students indicated they had been taught about PrEP at any time during their training. Education about PrEP was most comprehensive in the Northeastern US, the area with the highest PrEP to need ratio (4.7). In all regions, transgender patients and heterosexual men and women were least likely to be presented in education as PrEP candidates, and men who have sex with men were the most frequently presented. CONCLUSIONS: There are marked differences in education regarding PrEP both between academic programs and regions of the USA.

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We examined symptoms of disordered eating in the context of autobiographical memory via a phenomenon termed the Fading Affect Bias (FAB). The FAB is the tendency for the affect elicited by thinking about positive past events to fade slower than the affect elicited by thinking about negative past events. In Study 1 via an online survey procedure (Event N = 714), and via a booklet laboratory procedure in both Study 2 (Event N = 916) and Study 3 (Event N = 516) each participant described six (Studies 1 & 3) and four (Study 2) autobiographical events. They rated each event's affect at occurrence, affect at recall, and event rehearsal frequency. Participants also reported their own symptoms of eating concerns. Across studies, eating, shape, and weight concerns each moderated the FAB: above-average ratings were associated with a small FAB or no FAB. In all studies, restrictive eating ratings did not moderate the FAB. These results remained while controlling for event rehearsal frequency. The results clarify the relation between subclinical disordered eating and emotion regulation via the FAB during reminiscence about ordinary life events. We discuss the theoretical and methodological implications of our findings.

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In three studies, participants remembered real-life behaviours at Time 1 and attempted to recall them at Time 2. When the recall target was the self, a positivity bias emerged: self-positivity. In Study 3, self-positivity extended to an individual (target) who was liked by the participant, but did it not extend to a disliked target. For this latter target, a negativity bias emerged. For recall targets that were participants' acquaintances, self-positivity in recall was also eliminated in Studies 1 and 3, and a negativity bias in recall emerged in Study 2. Finally, in Study 2 (but not Study 3), the favourability of participants' self-view predicted the magnitude of the self-positivity in self-recall, but it did not predict valence effects in other-recall. Taken together, the results indicate that the link between behaviour valence and recall is moderated by the recall target and the favourability of one's self-view.

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The impact of replacing a mono-substituted benzene (phenyl) ring with thirty three aromatic and nine aliphatic heterocycles on nine ADME-related screens (solubility, lipophilicity, permeability, protein binding CYP450 inhibition and metabolic clearance) was assessed using matched molecular pair analysis. The results indicate that the influence on the ADME profile can differ significantly depending on the ring identity and importantly on the individual regioisomers that are possible for some rings. This information enables the medicinal chemist to make an informed choice about which rings and regioisomers to employ as mono-substituted benzene replacements, based upon the knowledge of how such replacements are likely to influence ADME-related parameters, for example to target higher solubility whilst avoiding CYP450 liabilities.

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The intensity of positive affect elicited by recall of positive events exceeds the intensity of negative affect elicited by recall of negative events (fading affect bias, or FAB). The research described in the present article examined the relation between the FAB and three regulatory goals of the self: esteem, continuity and meaningfulness. The extent to which an event contributed to esteem (Study 1), continuity (Study 2) or meaningfulness (Study 3) was related to positive affect at event recall provoked by positive memories and to negative affect at event recall provoked by negative memories. The relation between affect experienced at recall and the three regulatory goals was bidirectional. The results showcase how individuals use recall for self-regulatory purposes and how they implement self-regulatory goals for positive affect.

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Declaring and thinking about heroes are common human preoccupations but surprisingly aspects of heroism that reinforce these behaviors are not well-understood. In four thematically consistent studies, we attempt to identify lay perspectives about the psychological functions served by heroes. In Study 1, participants (n = 189) freely generated open-ended descriptions of hero functions, which were then sorted by independent coders into 14 categories (e.g., instill hope, guide others). In Study 2, in an attempt to identify the most important functions associated with heroes, participants (n = 249) rated how each function corresponded with their personal views about heroes. Results from a confirmatory factor analysis suggested that a three-factor model of hero functions fit the data well: participants thought that heroes enhanced the lives of others, promoted morals, and protected individuals from threats. In Study 3 (n = 242), participants rated heroes as more likely to fulfill a protecting function than either leaders or role models. In Studies 4A (n = 38) and 4B (n = 102), participants indicated that thinking about a hero (relative to a leader or an acquaintance) during psychological threat fulfilled personal enhancement, moral modeling, and protection needs. In all, these findings provide an empirical basis to spur additional research about the social and psychological functions that heroes offer.

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The Defense Style Questionnaire-40 (DSQ-40; Andrews, Singh, & Bond, 1993) uses pairs of items to measure 20 individual defense mechanisms. In a statistical sense, these item pairs represent parcels and are subject to the standards of unidimensionality demanded of parcels in general. Using a 2-facet modeling approach (N = 672), the present study examined the dimensionality of the defense-mechanism parcels in the DSQ-40 and found that the majority of the parcels did not satisfy the criteria for unidimensionality. In addition, the original 3-factor model of defense styles was not tenable with the present data. Overall, the results suggest caution when attempting to assess individual defense mechanisms using the DSQ-40.

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Heroes are ubiquitous in literature and popular discourse, yet little is known about cognitive representations of heroes. We examined lay conceptions of heroes using a prototype approach, compared heroes with other persons of influence, and studied how individuals use hero features to identify heroes. In Study 1, participants (N = 189) generated open-ended descriptions of heroes, which were sorted by independent coders into 26 meaningful categories. In Study 2, participants (N = 365) rated the centrality of these features, and subsequently classified each feature as either central (e.g., brave, moral integrity) or peripheral (e.g., humble, proactive). In a reaction time (RT) paradigm, participants in Study 3 (N = 33) identified central features of heroes faster than peripheral features. In Study 4, participants (N = 25) remembered more central hero features than peripheral features in a surprise recall task. In Study 5 (N = 89), participants most strongly identified a hero when the target was described with central features (vs. peripheral or neutral features). In Studies 6 (N = 212) and 7 (N = 307), participants' ratings evidenced that the prototypical features of heroes did not fit conceptually as well for role models and leaders. In all, these studies contribute new ideas to existing knowledge about heroes, and contribute to a shared understanding of what a hero means to people. Our research is thus an important step in refining heroism into a scientific concept. The notion of the prototypical features of heroes provides a basis for future hero research and intervention.

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The fading affect bias (FAB) refers to the negative affect associated with autobiographical events fading faster than the positive affect associated with such events, a reliable and valid valence effect established by researchers in the USA. The present study examined the idea that the FAB is a ubiquitous emotion regulating phenomenon in autobiographical memory that is present in people from a variety of cultures. We tested for evidence of the FAB by sampling more than 2400 autobiographical event descriptions from 562 participants in 10 cultures around the world. Using variations on a common method, each sample evidenced a FAB: positive affect faded slower than negative affect did. Results suggest that in tandem with local norms and customs, the FAB may foster recovery from negative life events and promote the retention of the positive emotions, within and outside of the USA. We discuss these findings in the context of Keltner and Haidt's levels of analysis theory of emotion and culture.

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Published physicochemical descriptors of molecules that convey aromaticity-related character are reviewed in the context of drug design and discovery. Studies that have employed aromatic descriptors are discussed, and several descriptors are compared and contrasted.

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Nostalgia is a frequently experienced complex emotion, understood by laypersons in the United Kingdom and United States of America to (a) refer prototypically to fond, self-relevant, social memories and (b) be more pleasant (e.g., happy, warm) than unpleasant (e.g., sad, regretful). This research examined whether people across cultures conceive of nostalgia in the same way. Students in 18 countries across 5 continents (N = 1,704) rated the prototypicality of 35 features of nostalgia. The samples showed high levels of agreement on the rank-order of features. In all countries, participants rated previously identified central (vs. peripheral) features as more prototypical of nostalgia, and showed greater interindividual agreement regarding central (vs. peripheral) features. Cluster analyses revealed subtle variation among groups of countries with respect to the strength of these pancultural patterns. All except African countries manifested the same factor structure of nostalgia features. Additional exemplars generated by participants in an open-ended format did not entail elaboration of the existing set of 35 features. Findings identified key points of cross-cultural agreement regarding conceptions of nostalgia, supporting the notion that nostalgia is a pancultural emotion.

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Treatment noncompliance in randomized experiments threatens the validity of causal inference and the interpretability of treatment effects. This article provides a nontechnical review of 7 approaches: 3 traditional and 4 newer statistical analysis strategies. Traditional approaches include (a) intention-to-treat analysis (which estimates the effects of treatment assignment irrespective of treatment received), (b) as-treated analysis (which reassigns participants to groups reflecting the treatment they actually received), and (c) per-protocol analysis (which drops participants who did not comply with their assigned treatment). Newer approaches include (d) the complier average causal effect (which estimates the effect of treatment on the subpopulation of those who would comply with their assigned treatment), (e) dose-response estimation (which uses degree of compliance to stratify participants, producing an estimate of a dose-response relationship), (f) propensity score analysis (which uses covariates to estimate the probability that individual participants will comply, enabling estimates of treatment effects at different propensities), and (g) treatment effect bounding (which calculates a range of possible treatment effects applicable to both compliers and noncompliers). The discussion considers the areas of application, the quantity estimated, the underlying assumptions, and the strengths and weaknesses of each approach.

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Using a published drug-likeness score based on the calculated physicochemical properties of marketed oral drugs (quantitative estimate of drug-likeness, QED) and published human data, high-scoring and low-scoring drugs were compared to determine how well the score correlated with their actual pharmaceutical and pharmacokinetic (PK) profiles in humans. Drugs with high QED scores exhibit higher absorption and bioavailability, are administered at lower doses and have fewer drug-drug interaction warnings, P-glycoprotein interactions and absorption issues due to a food effect. By contrast, the high-scoring drugs exhibit similar behaviour to low-scoring drugs with respect to free fraction in plasma, extent of gut-wall metabolism, first-pass hepatic extraction, elimination half-life, clearance, volume of distribution and frequency of dosing.

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