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Sleep quality is linked to disordered eating, obesity, depression, and weight-related functioning. Most research, however, has focused on clinical populations. The current study investigated relationships between sleep quality, disordered eating, and patterns of functioning in a community sample to better understand relationships among modifiable health behaviors. Participants ( N  = 648) recruited from Amazon Mechanical Turk completed assessments of eating, depression, weight-related functioning, and sleep. Self-reported height and weight were used to calculate body mass index ( M  = 27.3, SD  = 6.9). Participants were on average 37.6 years ( SD  = 12.3), primarily female (65.4%), and White, not Hispanic (72.7%). Over half of participants endorsed poor sleep quality, and average sleep scores were above the clinical cutoff for poor sleep quality. Sleep scores were significantly positively correlated with disordered eating, depression, and weight-related functioning, even after adjusting for age, body mass index, and sex. Multivariate regression models predicting weight-related functioning and depression showed that both sleep quality and disordered eating independently predicted depression. Sleep quality did not independently predict weight-related functioning; however, disordered eating did. To the best of our knowledge, this is the first study to assess sleep behaviors, disordered eating, and weight-related functioning in a community sample of weight diverse participants. Results indicate that most participants endorsed poor sleep quality, which was associated with disordered eating patterns, including binge eating and poorer weight-related functioning, even after controlling for body mass index, highlighting that this relationship exists across the weight spectrum. These results speak to the importance of health behavior assessment and intervention within nonclinical samples. Level of evidence Level III: evidence obtained from well-designed cohort or case–control analytic studies

Workplace incivility is a current challenge in organizations, including smaller firms, as is the development of programs that enhance employees' treatment of coworkers and ethical decision making. Ethics programs in particular might attenuate tendencies toward interpersonal misconduct, which can harm ethical reasoning. Consequently, this study evaluated the relationships among the presence of ethics codes and employees' locus of control, social aversion/malevolence, and ethical judgments of incivility using information secured from a sample of businesspersons employed in smaller organizations (N=189). Results indicated that ethics code presence was associated with a more internal locus of control and stronger ethical judgment of workplace incivility. Social aversion/malevolence was negatively related to ethical judgment, and internal locus of control was positively related to ethical judgment. Smaller firms should develop ethics codes to manage individuals' perceptions of control, thus encouraging enhanced ethical reasoning in situations that involve the mistreatment of coworkers; they should also monitor counterproductive tendencies that harm such reasoning and precipitate incivility.

Burnout is high among Applied Behavior Analysis (ABA) technicians providing care to individuals with autism spectrum disorder. To evaluate and expand upon the Job Demands-Resources (JD-R) model, the current study was designed to investigate whether workplace demands, particularly stressors within the work environment, play a mediating role in the relationship between personality traits and burnout. Participants included 126 ABA technicians (118 females, 93.7%) of ages 20–55 ( M  = 27.29, SD  = 5.81) who worked with children and adolescents with autism spectrum disorder in center-based ABA programs. Participants completed measures of the Big Five personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), and three dimensions of burnout, namely emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). When accounting for workplace demands as a mediator, analyses revealed direct effects between neuroticism and EE and DP. Neuroticism and extraversion shared an indirect effect with all three burnout variables. Agreeableness had a significant direct effect with DP, and both agreeableness and conscientiousness shared an indirect effect with EE and DP, but not PA. Furthermore, results suggest that neuroticism, extraversion, and workplace demands appear to be more strongly correlated with burnout than hours worked, duration of employment, income, and on-site child to staff ratios. Implications for prevention, intervention efforts, and hiring practices to reduce burnout among behavior technicians, are discussed.

This study investigates antecedents of entrepreneurial intentions of young adults, the next generation of entrepreneurs. We determine whether aspiring entrepreneurs' positive and dark traits relate to entrepreneurial intentions. Results indicated that entrepreneurial fitness, a second-order construct comprised of multiple positive and bright traits, positively relates to entrepreneurial intention, while the dark traits of Machiavellianism and narcissism differentially relate to entrepreneurial fitness and intention. Narcissism positively relates to entrepreneurial fitness and intention both directly and indirectly. Though Machiavellianism positively and directly relates to entrepreneurial intention, it also negatively and indirectly relates to intention through a negative relationship with entrepreneurial fitness. However, overall, entrepreneurial fitness positively relates with entrepreneurial intention. Findings extend the core model of entrepreneurial intention by concurrently illuminating the adaptive and maladaptive aspects of the dark side of narcissism and Machiavellianism with the bright, positive antecedents of entrepreneurial intention with entrepreneurial fitness. Theoretical and practical implications are discussed.

Some evidence suggests parents are drawn to media-based interventions over face-to-face interventions, but little is known about the factors associated with parents' use of Internet-based or Internet-enhanced programs, especially among military families. Research is needed to understand characteristics of parents who may be most likely to use online components or attend face-to-face meetings in order to ensure maximum engagement. In this study, we examined characteristics that predict various patterns of Internet use and face-to-face attendance in a parenting program designed for military families. An ecological framework guided analysis of differences in patterns of Internet-based use and face-to-face attendance by parents' demographic characteristics (gender, education, employment, and child age), incentives offered, and number of months the parent was deployed. We reported differences in the total number of online components completed over the 14 modules, total number of face-to-face sessions attended, and the use of different types of online components accessed (videos, downloadable handouts, mindfulness exercises, knowledge checks, and downloadable summaries). Then, we computed multinomial logistic regression accounting for nestedness (parents within families) to examine associations between demographic, programmatic, and military-related characteristics and patterns of engagement (use of online components and attendance at face-to-face sessions). Just over half (52.2%, 193/370) of the participants used the online components at least once, and the majority of participants (73.2%, 271/370) attended at least 1 face-to-face session. An examination of different patterns of participation revealed that compared with those who participated primarily in face-to-face sessions, parents who participated online but had little face-to-face participation were more likely to have received incentives than those who did not (95% CI 1.9-129.7). Among participants who had been deployed, those who had earned a 4-year degree (95% CI 1.0-2.2) and those who had been offered incentives to participate online (95% CI 2.1-58.6) were more likely to be highly engaged in online components and attend face-to-face compared with those who attended primarily face-to-face. However, those with a high number of months of deployment (95% CI 0.6-1.0) were less likely to be in the pattern of highly engaged in online components and face-to-face attendance. Compared with those who participated primarily face-to-face, deployed mothers were about 4 times more likely to engage in moderate online use with face-to-face attendance than deployed fathers (95% CI 1.21-11.83) and participate primarily online (95% CI 0.77-25.20). Results imply that parents may be drawn to different delivery options of a parenting program (online components vs face-to-face sessions) depending on their education level, incentives to engage in online components, and their military-related experience. Results suggest potential directions for tailoring Internet-based interventions.

Workplace bullying can potentially spiral into numerous counterproductive behaviors and negative organizational outcomes. Therefore, the purpose of this study was to determine the degree to which increased perceptions of workplace bullying were associated with stronger expressions of (subclinical) psychopathic traits and weakened ethical decision making. Data were collected from national and regional samples of selling and business professions using a self-report questionnaire that contained relevant measures and an ethics scenario, and structural equation modeling was employed to investigate the proposed relationships. Findings indicated that perceived workplace bullying operated through psychopathy to influence the recognition of an ethical issue (or full mediation). The implications of these findings are discussed, along with the study’s limitations and suggestions for future research.

This study aimed to quantify the burden of relapse following successful treatment for uncomplicated severe acute malnutrition (SAM) and to identify associated risk factors in rural Niger. We used data from 1490 children aged 6−59 months discharged as recovered from an outpatient nutritional programme for SAM and followed for up to 12 weeks after admission. Postdischarge SAM relapse was defined as weight‐for‐height Z‐score <−3, mid‐upper arm circumference (MUAC) <115 mm or bipedal oedema after having been discharged as recovered. Postdischarge hospitalisation was defined as admission to inpatient SAM treatment or hospitalisation for any cause after having been discharged as recovered. We used multivariate log‐binomial models to identify independent risk factors. After programmatic discharge, 114 (8%) children relapsed to SAM and 89 (6%) were hospitalised. Factors associated with SAM relapse were discharge during the lean season (relative risk [RR] = 1.80 [95% confidence interval [CI] = 1.22−2.67]) and larger household size (RR = 1.56 [95% CI = 1.01−2.41]), whereas older child age (RR = 0.94 [95% CI = 0.88−1.00]), higher child MUAC at discharge (RR = 0.93 [95% CI = 0.87−1.00]) and maternal literacy (RR = 0.54 [95% CI = 0.29−0.98]) were protective factors. Discharge during the lean season (RR = 2.27 [95% CI = 1.46−3.51]) was independently associated with postdischarge hospitalisation. Future nutritional programmes in the context of Niger may consider modification of anthropometric discharge criteria or the provision of additional home support or follow‐up during the lean season as potential interventions to prevent relapse. More research including postdischarge follow‐up is needed to better understand the sustainability of treatment outcomes after discharge and the type of intervention that may best sustain recovery over time. Clinical Trial Registration: ClinicalTrials.gov number, NCT01613547. This study examined risk factors for postdischarge relapse to severe acute malnutrition and hospitalisation among 1490 children 6−59 months of age discharged as recovered from an outrpatient nutritional programme in rural Niger. Discharge during the lean season was a risk factor for both postdischarge relapse and hospitalisation. Older child age, smaller household size, higher child mid‐upper arm circumference (MUAC) at discharge and maternal literacy were protective factors for relapse. MUAC at discharge performed better than weight‐for‐height Z‐score in identifying cases of relapse. Key messages Following successful discharge from a community‐based nutritional programme for severe acute malnutrition (SAM) treatment in rural Niger, the prevalence of SAM relapse was 8% and the prevalence of postdischarge hospitalisation was 6% within 12 weeks from admission. Factors associated with SAM relapse were child age at programme admission, child mid‐upper arm circumference (MUAC) at discharge, discharge from the nutritional programme during the lean season, and maternal literacy. Anthropometry at discharge was a primary risk factor for relapse. MUAC at discharge performed better than weight‐for‐height Z‐score (WHZ) in classifying SAM relapse cases. ‘Optimal’ cut‐offs, defined using the Liu method which maximises the product of the sensitivity and specificity, were MUAC of 121 mm with 66% sensitivity and 67% specificity and WHZ of −1.38 with 54% sensitivity and 57% specificity. Future programmes may consider additional support or follow‐up of children at high risk of postdischarge relapse or hospitalisation, including those discharged during the lean season. Modification of current anthropometric discharge criteria may also be explored as an actionable target to further reduce the risk of relapse.

Debate for a greater role of mid-upper arm circumference (MUAC) measures in nutritional programming continues, but a shift from therapeutic feeding programs admitting children using MUAC and/or weight-for-height Z (WHZ) to a new model admitting children using MUAC only remains complicated by limited information regarding the clinical profile and response to treatment of children selected by MUAC vs. WHZ. To broaden our understanding of how children identified for therapeutic feeding by MUAC and/or WHZ may differ, we aimed to investigate differences between children identified for therapeutic feeding by MUAC and/or WHZ in terms of demographic, anthropometric, clinical, and laboratory and treatment response characteristics. Using secondary data from a randomized trial in rural Niger among children with uncomplicated severe acute malnutrition, we compared children that would be admitted to a therapeutic feeding program that used a single anthropometric criterion of MUAC< 115 mm vs. children that are admitted under current admission criteria (WHZ< -3 and/or MUAC< 115 mm) but would be excluded from a program that used a single MUAC< 115 mm admission criterion. We assessed differences between groups using multivariate regression, employing linear regression for continuous outcomes and log-binomial regression for dichotomous outcomes. We found no difference in terms of clinical and laboratory characteristics and discharge outcomes evaluated between children that would be included in a MUAC< 115 mm therapeutic feeding program vs. children that are currently eligible for therapeutic feeding but would be excluded from a MUAC-only program. A single anthropometric admission criterion of MUAC < 115 mm did not differentiate well between children in terms of clinical or laboratory measures or program outcomes in this context. If nutritional programming is to use a single MUAC-based criterion for admission to treatment, further research and program experience can help to identify the most appropriate criterion in a broad range of contexts to target children in most urgent need of treatment.

IntroductionCurrent guidelines for the outpatient treatment of severe acute malnutrition (SAM) recommend the provision of routine medications to all children at admission and prescribed medications as clinically indicated thereafter. The objective of this study was to describe the amount and purpose of medications prescribed during outpatient SAM treatment and explore the effect of routine antibiotics at admission on subsequent medication prescription.MethodsMedications prescribed during outpatient treatment were described by medication category, time from admission, and diagnoses among children with SAM in a placebo-controlled, double-blind trial of 7-day amoxicillin use. Total medications were compared by parent trial intervention arm (amoxicillin vs placebo) and differences assessed using Χ2 and two-sample t-tests.ResultsOf the 2399 children enrolled, 74.6% of children received ≥1 prescribed medication during outpatient treatment. Antipyretics/analgesics (44.1% of children), antimalarials (56.6%) and antibiotics (30.0%) were prescribed most frequently. Children who received placebo in the parent trial received fewer total medications (mean difference: −0.80, 95% CI: −0.96 to –0.65) and oral antibiotics (mean difference: −0.96, 95% CI: −0.99 to –0.92) during treatment compared with children who received routine amoxicillin.ConclusionsWe found high rates of medication prescription during outpatient treatment for SAM, but fewer total medications and oral antibiotics prescribed to children receiving placebo in the parent trial. Our findings underscore the role of outpatient treatment programmes as an important source of medicine prescription and suggest that provision of antibiotics on a clinically indicated basis for outpatient SAM cases may be a strategy to support prudent antibiotic use in certain settings.Trial registration numberClinicalTrials.gov Registry (NCT01613547; https://clinicaltrials.gov/ct2/show/NCT01613547).