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The prevalence of coral diseases has significantly surged in the past couple of years, particularly within the Caribbean region. Notably, certain corals exhibiting resistance harbor symbiotic bacteria, suggesting a potential role of these microorganisms in bolstering resilience. In this study, I explored four strains of symbiotic bacteria, hypothesizing their capability to produce antibiotic compounds targeting coral pathogens. Through culturing these bacteria and evaluating their extracts, we found that only Glutamicibacter soli displayed inhibitory effects, although without complete pathogen eradication. Further chemical analysis of G.soli culture extracts unveiled the presence of two prominent molecules: cholic acid and a previously undescribed aromatic compound: N-[2-(4-Hydroxyphenyl)ethyl]-3-methylbutanamide. The isolation of cholic acid stands out as a unique finding, shedding light on its origin within marine bacterial extracts and expanding our understanding of symbiotic interactions in coral health.

In Kenya, if you cannot pay your hospital bill you don’t go home. You are detained within the hospital until your bill, which can be inherited and accrues interest for each day you are there, is paid. This practice is called body detention and is the central healthcare phenomenon this research investigates. This dissertation constellates how antiblackness, mothering, and the Kenyan Healthcare System in Mathare Constituency, Nairobi, Kenya is a foundational state project in modern-day Kenya. Drawing on black diasporic approaches to geography and ongoing conceptualizations of antiblackness, it argues that the historical production of antiblackness through Indian Ocean and Transatlantic Ocean chattel trades, and integrated corporate development plans from 1909 to present, built the political formation called the Republic of Kenya by operationalizing techniques of capture and an ecology of terror as death-dealing force. This mode of crafting State, and the World, as political forms of Order, must simultaneously wage war. The relations of this war maintain a predatory relationship to Black women, children, and the Earth. This dissertation ethnographically examines these conditions as Critical Participatory Action Research from 2019-2023 through two guiding questions: (1) What are the spatial, social, structural, and spiritual elements producing conditions of capture in Mathare within Black children’s healthcare journeys? (2) What strategies have Black women and children in Mathare used and needed to embody bodily integrity? Methodologically, I combine ethnographic and archival methods. The findings come from a disparate, study-created people’s archive which gathers open access maps of health facilities and Mathare, (auto)ethnographic entries, notes on walking routes though hospital wards and wards of Mathare Constituency, shared reflections on group conversations, oral histories, urban ethnographies, and Black women’s reports on body detention, gender-based violence, and

This research reorients a clinical question regarding the relationship between overly narrow femoral intercondylar notches and anterior cruciate ligament (ACL) injury within an anthropological perspective. I argue that biomedical research tends to assume that the dimensions of the notch are only related to genetics or previous ACL rupture. This view, while intended to help determine risk factors for narrow notch development, is a biologically deterministic one that ignores how differential access to resources and opportunities shape individuals’ life experiences and health outcomes. To address this shortcoming, I shift the question from a medical perspective – which groups are most likely to suffer narrow notches and therefore ACL injury? – to an anthropological one: to what degree do genetics, metabolic stress, and mechanical factors influence femoral intercondylar notch morphology, and what is the importance of the historical socioeconomic context on these factors? To answer this question, I analyzed historically documented remains from the mid-19th to mid-20th century Santa Clara Valley and use the osteological data to draw conclusions about assigned racial categories, the construction of Whiteness in this region, lived experiences, and their relationship to morphological outcomes at the knee joint.The six most important findings from this research are presented as an enumerated list in the concluding chapter, and consist of the following: (1) notch width index and notch volume are not redundant measures and do quantify the notch in noticeably different ways, (2) experiences of metabolic stress, particularly those resulting in porotic hyperostosis, are positively correlated with notch volume, (3) notch volume is not linked to femoral rousticity or shaft shape, (4) notch volume scales with body size, (5) genetics do not seem to significantly influence notch volume, and (6) osteological results support that the category of whiteness in California and the Santa Clar

Outbreaks of food-borne diseases has been increasingly linked to plant-based products, as human pathogens can utilize plants as transmission vectors. The human pathogen Salmonella enterica serovar Typhimurium 14028s (hereafter STm 14028s) can persist on and within the leaf for extended periods of time but does not cause disease on the plant. This study aims to understand how STm 14028s alters the leaf surface environment, also known as the phylloplane, during its interaction with the plant. In this work, I show how STm 14028s changes the metabolites accumulated on the leaf surface. I provide evidence that the alteration of metabolites is unique to STm 14028s through comparison to the plant pathogen Pseudomonas syringae pv. tomato DC3000 (hereafter Pst DC3000). In addition, this study is the first to describe the mechanism STm 14028s utilizes to overcome stomatal immunity. I highlight the role of auxin in the mechanism deployed by STm 14028s by demonstrating that both plant- and microbe-derived auxin contribute to STm 14028s’s stomatal reopening. I show that the the Arabidopsis auxin signaling pathway is manipulated by STm 14028s to cause stomatal reopening. Finally, I characterize the JAZ family in lettuce to create Lsjaz4 mutant lines that will hopefully be more resistant to human pathogens. Overall, this study illustrates that STm 14028s causes unique changes to the leaf surface environment to promote its survival on a non-host.

Nuclear magnetic resonance (NMR) spectroscopy is a powerful analytical technique and can be used to analyze anything from small molecules to large polymers and proteins. This non-destructive tool is useful in many fields of research from basic science to applied work. In this thesis, NMR is applied in a multitude of ways including analyzing small molecule structure, backbone fingerprinting of polymeric material, and protein ligand interactions and dynamics.In the first two chapters of this thesis, amorphous melanin polymers are analyzed by solid-state NMR cross polarization 13C experiments. Through this technique we identify types and distributions of carbon within a sample and correlate proposed starting material with fingerprints of complex, chemoenzymatically generated melanins. We also use solid-state NMR to estimate purity of extracted melanin samples from marine melanin species by identification of components of marine tissue material. The third chapter of this thesis investigates how a predicted toxic metabolite, methylene diphenyl diamine, is biodegraded over time by microbial organisms and communities by analyzing the nitrogen state changes. Using an 15N labeled small molecule and 15N INEPT experiments, nitrogen environment changes are observed for monitoring a how this molecule is metabolized after feeding studies to microbial communities and thus identifying new insights into the biodegradation process. In this work NMR and LCMS are combined toward a possible explanation of how methylene diphenyl diamine is altered after potential release from bio-based polyurethane biodegradation. In the final chapter of this thesis, NMR is used to monitoring carrier protein-ligand dynamics by employing a site specific 15N labeled probe. Synthetic organic chemistry is utilized to develop a versatile 15N tool which can be applied to various carrier protein dependent systems through a simple modification. NMR’s capability to monitor dynamic changes of a system over time is

Both Dr. Dvorak and Sir Haddow described cancer as a wound that never heals, and while this comparison has been in place since the late 1900s, the intricate molecular underpinnings shared between these two contexts remain elusive. Previous endeavors have unveiled the multifaceted nature of the cadherin, desmoglein 2 (Dsg2). Dsg2 has been implicated as a key mediator of inflammation, mitogenic signaling, pro-growth and -migratory programming, and has thus emerged as a central player in both cancer and wound repair. miRNA sequencing (miRNA-seq) revealed that Dsg2 expression led to a decrease in miR-146a and a simultaneous rise in miR-155. These miRNAs have been implicated in the regulation of inflammation, but their roles in proliferation and migration have been less well-defined. MiR-146a, often termed the master regulator of inflammation, does so by targeting IRAK1 and TRAF6 in the NFkB pathway, resulting in the reduction of proinflammatory molecules, including the chemokine, interleukin 8 (IL-8). In the course of this research, one avenue of exploration led to the intersection of the Dsg2/miR-146a/IL-8 regulatory axis and the crucial subject of response to immune checkpoint inhibitors (ICIs) in head and neck squamous cell carcinoma (HNSCC). Patient pre-treatment biopsies unveiled an elevation of Dsg2 at baseline in HPV-positive (HPVpos) patients, who would ultimately remain unresponsive to ICI. Delving further, an analysis of patient plasma small extracellular vesicles (sEV) showed that miR-146a was lower in these non-responding HPVpos patients, while IL-8 level was increased. To understand the impact of miR-146a expression in HPVpos HNSCC, in vitro studies using HPVpos HNSCC cells revealed that restoration of miR-146a expression reduced the expression of IL-8 and increased cell death. To better understand the regulation of Dsg2, miRNet.ca and ScanmiRWalk were used to identify miRNAs that could decrease Dsg2 expression. Interestingly, miR-155 was determined to be u

Despite awareness of the need for better teaching of students from nondominant backgrounds, few studies exist in Dutch research that position members of these groups as experts. Using a theoretical lens that centers culturally responsive pedagogical practices in the three domains of teaching, we conducted 14 interviews with teachers from racially minoritized groups who attended Dutch schools to understand how their experiences shape their current teaching. Findings suggest that participants' experiences with (not) belonging in school particularly shape their teaching in the domain of relationships. Participants also had deficit perspectives, highlighting the need to develop teachers’ critical consciousness.

Student engagement operates as a mediator between supportive school environments and academic achievement. The developing interest in student engagement and its relation to students’ feelings of congruences with their academic success and wellbeing has become a focal point to enhance learning and teaching. Understanding the various factors that determine students’ degrees of engagement is pivotal in order to address the best practices to increase academic achievement. Student factors related to academic engagement have been identified as key components that are related to the effectiveness of student academic engagement. In addition to these factors, there are individual student variables that also have an influence on academic engagement. Individual students' variables such as gender, ethnicity and student wellness have been found to have an impact on their academic engagement. The association between teacher support and student engagement is possibly different for boys and girls. Females indicate more engagement than boys due to the types of activities provided and content being more feminine. In addition, research has found that minority students are at times alienated from the classroom due to the differences between patterns of home and school interaction, impacting their ability to be engaged and perform well academically. Lastly, research has found that integrating mental health supports and services in the school setting is an effective delivery system for student wellbeing. The focus of this research is to examine one aspect of student wellness which is sense of belonging and how it differs based on gender and ethnicity. In addition, this research will look at how this area of sense of belonging is related to other areas of student well-being.

Wastewater-based epidemiology (WBE) has become a valuable tool for monitoring the prevalence of SARS-CoV-2 on university campuses. However, concerns about effectiveness of raw sewage as a COVID-19 early warning system still exist, and its not clear how useful normalization by simultaneous comparison of Pepper Mild Mottle Virus (PMMoV) is in addressing variations resulting from fecal discharge dilution. This study aims to contribute insights into these aspects by conducting an academic-year field trial at the student residences on the University of Tennessee, Knoxville campus, raw sewage. This was done to investigate the correlations between SARS-CoV-2 RNA load, both with and without PMMoV normalization, and various parameters, including active COVID-19 cases, self-isolations, and their combination among all student residents. Significant positive correlations between SARS-CoV-2 RNA load a week prior, during the monitoring week, and the subsequent week with active cases. Despite these correlations, normalization by PMMoV does not enhance these associations. These findings suggest the potential utility of SARS-CoV-2 RNA load as an early warning indicator and provide valuable insights into the application and limitations of WBE for COVID-19 surveillance specifically within the context of raw sewage on university campuses.

Cranial irradiation used to control brain malignancies invariably leads to progressive and debilitating declines in cognition. Clinical efforts implementing hippocampal avoidance and NMDAR antagonism, have sought to minimize dose to radiosensitive neurogenic regions while normalizing excitatory/inhibitory (E/I) tone. Results of these trials have yielded only marginal benefits to cognition, prompting current studies to evaluate the potential of systemic extracellular vesicle (EV) therapy to restore neurocognitive functionality in the irradiated brain. Here we tested the hypothesis that EVs derived from inhibitory but not excitatory neuronal cultures would prove beneficial to cognition and associated pathology. Rats subjected to a clinically relevant, fractionated cranial irradiation paradigm were given multiple injections of either GABAergic- or glutamatergic-derived EV and subjected to behavioral testing. Rats treated with GABAergic but not glutamatergic EVs showed significant improvements on hippocampal- and cortical-dependent behavioral tasks. While each treatment enhanced levels of the neurotrophic factors BDNF and GDNF, only GABAergic EVs preserved granule cell neuron dendritic spine density. Additional studies conducted with GABAergic EVs, confirmed significant benefits on amygdala-dependent behavior and modest changes in synaptic plasticity as measured by long-term potentiation. These data point to a potentially more efficacious approach for resolving radiation-induced neurological deficits, possibly through a mechanism able to restore homeostatic E/I balance.

People often interact with groups (i.e., ensembles) during social interactions. Given that group-level information is important in navigating social environments, we expect perceptual sensitivity to aspects of groups that are relevant for personal threat as well as social belonging. Most ensemble perception research has focused on visual ensembles, with little research looking at auditory or vocal ensembles. Across four studies, we present evidence that (i) perceivers accurately extract the sex composition of a group from voices alone, (ii) judgments of threat increase concomitantly with the number of men, and (iii) listeners sense of belonging depends on the number of same-sex others in the group. This work advances our understanding of social cognition, interpersonal communication, and ensemble coding to include auditory information, and reveals peoples ability to extract relevant social information from brief exposures to vocalizing groups.

Water service providers need to prepare for more extreme weather events in a changing climate. A geospatial analysis found that differences in boil-water advisory lengths issued during 2021's Winter Storm Uri were based on the population served and rural or urban location. A cross-sectional survey showed that many individuals were unaware of or confused about the advisories that were (or were not) issued., Peer Reviewed, Postprint (published version)

Holly Mansell,1 Nicola Rosaasen,2 Jenny Wichart,3 Patricia West-Thielke,4 David Blackburn,1 Juxin Liu,5 Rahul Mainra,6 Ahmed Shoker,6 Brianna Groot,7 Kevin Wen,8 Anita Wong,9 Bita Bateni,10 Cindy Luo,11 Paraag Trivedi12 1College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada; 2Saskatchewan Transplant Program, Saskatchewan Health Authority, Saskatoon, SK, Canada; 3Department of Pharmacy, Alberta Health Services, Calgary, AB, Canada; 4University of Illinois Health Sciences System, Chicago, IL, USA; 5Department of Mathematics and Statistics, College of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada; 6Saskatchewan Transplant Program; Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada; 7Canadian Hub for Applied and Social Research, University of Saskatchewan, Saskatoon, SK, Canada; 8Division of Nephrology and Transplant Immunology, Department of Medicine University of Alberta, Edmonton, AB, Canada; 9Department of Pharmacy, University of Alberta Hospital, Edmonton, AB, Canada; 10St. Paul’s Hospital, and University of British Columbia, Vancouver, BC, Canada; 11Vancouver General Hospital; Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC, Canada; 12Transplant Recipient/Patient Advisor, Regina, SK, CanadaCorrespondence: Holly Mansell, College of Pharmacy and Nutrition, Health Sciences Building (E3208), 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada, Email holly.mansell@usask.caAbstract: Sub-optimal adherence to immunosuppressant medications reduces graft survival for kidney transplant recipients and adherence-enhancing interventions are resource and time intensive. We performed a multi-center randomized controlled trial to investigate the impact of an electronically delivered intervention on adherence. Of 203 adult kidney transplant recipients who received a de novo kidney transplant n = 173 agreed to participate (intent-to-treat population) and were randomized t

Background: Rapid development and implementation of vaccines constituted a crucial step in containing the COVID-19 pandemic. A comprehensive understanding of physiological responses to these vaccines is important to build trust in medicine. Objective: This study aims to investigate temporal dynamics before and after COVID-19 vaccination in 4 physiological parameters as well as the duration of menstrual cycle phases. Methods: In a prospective trial, 17,825 adults in the Netherlands wore a medical device on their wrist for up to 9 months. The device recorded their physiological signals and synchronized with a complementary smartphone app. By means of multilevel quadratic regression, we examined changes in wearable-recorded breathing rate, wrist skin temperature, heart rate, heart rate variability, and objectively assessed the duration of menstrual cycle phases in menstruating participants to assess the effects of COVID-19 vaccination. Results: The recorded physiological signals demonstrated short-term increases in breathing rate and heart rate after COVID-19 vaccination followed by a prompt rebound to baseline levels likely reflecting biological mechanisms accompanying the immune response to vaccination. No sex differences were evident in the measured physiological responses. In menstruating participants, we found a 0.8% decrease in the duration of the menstrual phase following vaccination. Conclusions: The observed short-term changes suggest that COVID-19 vaccines are not associated with long-term biophysical issues. Taken together, our work provides valuable insights into continuous fluctuations of physiological responses to vaccination and highlights the importance of digital solutions in health care.

We address the question of whether holographic entropy inequalities obeyed in static states (by the RT formula) are always obeyed in time-dependent states (by the HRT formula), focusing on the case where the bulk spacetime is 2+1 dimensional. An affirmative answer to this question was previously claimed by Czech-Dong. We point out an error in their proof when the bulk is multiply connected. We nonetheless find strong support, of two kinds, for an affirmative answer in that case. We extend the Czech-Dong proof for simply-connected spacetimes to spacetimes with $\pi_1=\mathbb{Z}$ (i.e. 2-boundary, genus-0 wormholes). Specializing to vacuum solutions, we also numerically test thousands of distinct inequalities (including all known RT inequalities for up to 6 regions) on millions of randomly chosen configurations of regions and bulk spacetimes, including three different multiply-connected topologies; we find no counterexamples. In an appendix, we prove some (dimension-independent) facts about degenerate HRT surfaces and symmetry breaking., Comment: 30 pages. Watch a 4-minute video abstract: https://www.youtube.com/watch?v=ols92YU8rus

Kemajuan teknologi sering menyebabkan kebisingan dari aktivitas mesin di kawasan industri yang memengaruhi gangguan pendengaran. Penelitian ini bertujuan memetakan kebisingan dan menganalisis pengaruh usia, masa kerja, kebisingan, dan kepatuhan pemakaian alat pelindung telinga (APT) terhadap gangguan pendengaran pegawai ULPTG/MG Duri PT PLN (Persero) UPDK Pekanbaru akibat kebisingan. Data diperoleh dari pengukuran pada sumber kebisingan menggunakan SV 971A Class 1 Sound Level Meter dan Sound Level Meter Krisbow QPEM 39 di 26 titik seluas 14 Ha dan penyebaran kuisioner berjenis tertutup kepada 48 responden yang dilakukan menggunakan uji Analisis Korelasi Pearson Product Momment, analisis regresi berganda, dan uji F. Pengukuran kebisingan dilakukan dengan metode titik sampling berjarak 10 meter, di ruang kerja pegawai, dan dilaha kosong, kemudian diolah menggunakan software Surfer 23 untuk memetakan persebaran kebisingan. Hasil penelitian menunjukkan tingkat kebisingngan tertinggi berasal dari ruang engine sebesar 103,6 dBA dan pada jarak 30 meter dari sumber, kebisingan berada dibawah baku tingkat kebisingan (85 dBA). Nilai kebisingan terrendah berada pada kantor HSSE sebesar 50,4 dBA. Usia, masa kerja, kebisingan, dan kepatuhan pemakaian APT berpengaruh secara signifikan terhadap keluhan pendengaran, dengan p value sebesar 0,000 (≤ 0,05). Hasil regresi berganda menunjukkan kepatuhan penggunaan APT merupakan faktor paling mempengaruhi gangguan pendengaran. Hasil uji F sebesar 849,671> Ftabel sebesar 2,821menjelaskan bahwa usia, masa kerja, kebisingan, dan kepatuhan pemakaian APT secara bersamaan dapat mempengaruhi gangguan pendengaran.

Canadians are increasingly reporting feeling lonely, socially isolated, or ostracized. Yet, instances of ostracism and its deleterious effects may not be equally distributed across the population. Many segments of society, including those with low socioeconomic status (SES), may be both more likely to experience ostracism and more reactive to it. Thus, they may be especially susceptible to experiencing its detrimental psychological and physical effects. According to theory on the relationship between SES and perceived control this heightened reactivity may result because individuals with low SES (LSES) may possess a limited reserve of perceived primary control that is directly targeted ostracism. Alternative perspectives, such as the shift-and-persist model, suggest that LSES may actually be less negatively affected by ostracism as a result of relying on perceived secondary control. These competing predictions were tested in a series of six online studies (N = 4420). While direct evidence of divergent affective reactions did not emerge, ostracism indirectly predicted increases in negative affect and hurt feelings among LSES. Evidence of aggressive behavioral reactions was also minimal. However, tentative findings suggested that LSES may react aggressively if certain factors exacerbate the threat posed by ostracism. Contrary to hypotheses, this enhanced reactivity appeared to be driven by reductions in perceptions of secondary control. Notably, behavioral responses characterized by escape and perhaps centred on restoring secondary control through sense making are suggestive of adaptive coping that may ultimately fuel resilience. This complex pattern of findings underscores the importance of directly addressing factors that contribute to the exclusion and devaluation of LSES and suggests that social policy efforts aimed at combating increasing feelings of loneliness, isolation, and ostracism and maintaining the well-being of Canadians need to be attentive to the socio

Unfortunately, crises occur quite frequently throughout the world. In an increasingly digital age, where most news outlets post articles about events online, there are often tens or even hundreds of articles about the same event. Although the information found in each article is often similar, some information may be specific to a certain article or news outlet. And, as each news outlet usually writes a lengthy article for each crisis event that happens, it can be hard to quickly locate and learn the basic, important information about a given crisis event. This web app project aims to expedite this lengthy process by consolidating any number of articles about a crisis event into who, what, where, when, and how (WWWWH). This information extraction is accomplished using machine learning for named entity recognition and dependency parsing. The extracted WWWWH info is displayed to the user in an easily digestible table, which allows for users to quickly learn the essential information regarding any given crisis event. Both the user’s input and the output data will be saved to a database, so that users can see their previous usages of the program again at any time. While users must manually input web articles into the program, whether as links or .txt files, there is potential in the future to use a web crawler to automate this initial article gathering. The stack for this applications utilizes the MERN Stack. MongoDB was chosen due to its flexible document structure. For the back-end features such as natural language processing and our server we utilized Python and Express/Node.js. The front-end consists of React which is used to fetch our data and utilizes component libraries such as MUI for consistent design language. The deliverables for this project include our Final Presentation and Final Report which show our progress throughout the development stages, and finally our code for the application which are submitted to our professor and client, Mohamed Farag.

The present research project aims to determine the models and approaches of family intervention employed in the Family Guidance department at the Institute of Criminology, Criminalistics, and Psychosocial and Family Intervention, based on the issues and needs of families. The research approach adopted for its analysis is mixed, as qualitative and quantitative methods have been combined to leverage the strengths of both methodologies. The techniques outlined for the study include a baseline that discloses the study variables: models and approaches used in the Family Guidance area at the Institute during the year 2022 through documentary review, based on a quantitative scope. Similarly, regarding the qualitative aspect, the study involves the technique of in-depth interviews with a professional and three pre-professionals from the Family Guidance area. The sample obtained consisted of 94 cases attended by the Family Guidance department in the year 2022. The study results allow us to identify that the selection and subsequent application of the family intervention model and approach exhibit a knowledge bias. Inconsistencies in the applied knowledge were evident when developing family care processes. Therefore, the research clearly determined that both the models and approaches to family intervention are not adequately determined by professionals and pre-professionals in the Family Guidance department. During the analysis, confusion was found regarding their selection, considering that their execution was not suitable, as verified through the documentary review conducted for the development of this study.

The present research project aims to determine the models and approaches of family intervention employed in the Family Guidance department at the Institute of Criminology, Criminalistics, and Psychosocial and Family Intervention, based on the issues and needs of families. The research approach adopted for its analysis is mixed, as qualitative and quantitative methods have been combined to leverage the strengths of both methodologies. The techniques outlined for the study include a baseline that discloses the study variables: models and approaches used in the Family Guidance area at the Institute during the year 2022 through documentary review, based on a quantitative scope. Similarly, regarding the qualitative aspect, the study involves the technique of in-depth interviews with a professional and three pre-professionals from the Family Guidance area. The sample obtained consisted of 94 cases attended by the Family Guidance department in the year 2022. The study results allow us to identify that the selection and subsequent application of the family intervention model and approach exhibit a knowledge bias. Inconsistencies in the applied knowledge were evident when developing family care processes. Therefore, the research clearly determined that both the models and approaches to family intervention are not adequately determined by professionals and pre-professionals in the Family Guidance department. During the analysis, confusion was found regarding their selection, considering that their execution was not suitable, as verified through the documentary review conducted for the development of this study.

The present research project aims to determine the models and approaches of family intervention employed in the Family Guidance department at the Institute of Criminology, Criminalistics, and Psychosocial and Family Intervention, based on the issues and needs of families. The research approach adopted for its analysis is mixed, as qualitative and quantitative methods have been combined to leverage the strengths of both methodologies. The techniques outlined for the study include a baseline that discloses the study variables: models and approaches used in the Family Guidance area at the Institute during the year 2022 through documentary review, based on a quantitative scope. Similarly, regarding the qualitative aspect, the study involves the technique of in-depth interviews with a professional and three pre-professionals from the Family Guidance area. The sample obtained consisted of 94 cases attended by the Family Guidance department in the year 2022. The study results allow us to identify that the selection and subsequent application of the family intervention model and approach exhibit a knowledge bias. Inconsistencies in the applied knowledge were evident when developing family care processes. Therefore, the research clearly determined that both the models and approaches to family intervention are not adequately determined by professionals and pre-professionals in the Family Guidance department. During the analysis, confusion was found regarding their selection, considering that their execution was not suitable, as verified through the documentary review conducted for the development of this study.

In response to increasing demands to move away from carbon-intensive academic conferences, and a need to address social justice issues, the author-team designed, implemented, and experimented with a new conference model. Three key-design choices informed the model. First, instead of the common single-host-single-location approach, we established a partnership between three universities across three continents. Second, we adopted a hub model of three online conference days, followed by three non-hybrid, in-person only conference days. Third, we sought to accommodate global participation by organizing each of the online conference days during daylight hours in the respective time zones. We find that the model promotes less air travel and improved global south participation. Our approach adds to a growing number of experiments with new modes of academic conferencing in a world that is facing climate and inequality crises.

In 1992, the UN banned the use of large‐scale pelagic driftnets on the high seas (UNGA Resolution 46/215). Three decades later, however, drift gillnets remain one of the primary fishing gears in the Indian Ocean, accounting for approximately 30% of tuna catches in this ocean. Recent estimates indicate that several million small cetaceans have been killed in Indian Ocean gillnets over the past few decades. National agencies and the regional fisheries management organization charged with managing tuna fisheries, the Indian Ocean Tuna Commission, have yet to effectively document the bycatch of small cetaceans in these fisheries. Here, we review current information on cetacean bycatch in Indian Ocean drift gillnets and propose potential solutions to this important conservation issue.

Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC.Methods This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.Results One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.Conclusions North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs., Funding Agencies|Leonie-Wild Foundation; Leyla Erkan Family Fund for ARVD Research; Hugh Calkins, Marvin H. Weiner, and Jacqueline J. Bernstein Cardiac Arrhythmia Center; Dr Francis P. Chiaramonte Private Foundation; Dr Satish, Rupal, and Robin Shah ARVD Fund at Johns Hopkins; Bogle Foundation; Campanella Family; Patrick J. Harrison Family; Peter French Memorial Foundation; ALF foundation; Wilmerding Endowments; NIH [T32HL007227]; NIH Loan Repayment Program [L30HL165535]; Philippa and Marvin Carsley Cardiology Research Chair; Montreal Heart Institute Foundation; Norwegian Research Council [309762, 288438, 298736]; ZonMW Off Road personal research grant; Dutch Heart Association; Netherlands Cardiovascular Research Initiative - Dutch Heart Foundation [2018-30 PREDICT2]; Dutch Heart Foundation; Netherlands Heart Institute [06901]; Georg and Bertha Schwyzer-Winiker Foundation; Baugarten Foundation; Swiss National Science Foundation; Swiss Heart Foundation; USZ Foundation; Daniel Bravo Foundation; Spanish Society of Cardiology; Sociedad Espanola de Cardiologia; Swedish Heart Lung Foundation

Beyond our solar system, aurorae have been inferred from radio observations of isolated brown dwarfs (e.g. Hallinan et al. 2006; Kao et al. 2023). Within our solar system, giant planets have auroral emission with signatures across the electromagnetic spectrum including infrared emission of H3+ and methane. Isolated brown dwarfs with auroral signatures in the radio have been searched for corresponding infrared features but have only had null detections (e.g. Gibbs et al. 2022). CWISEP J193518.59-154620.3. (W1935 for short) is an isolated brown dwarf with a temperature of ~482 K. Here we report JWST observations of strong methane emission from W1935 at 3.326 microns. Atmospheric modeling leads us to conclude that a temperature inversion of ~300 K centered at 1-10 millibar replicates the feature. This represents an atmospheric temperature inversion for a Jupiter-like atmosphere without irradiation from a host star. A plausible explanation for the strong inversion is heating by auroral processes, although other internal and/or external dynamical processes cannot be ruled out. The best fit model rules out the contribution of H3+ emission which is prominent in solar system gas giants however this is consistent with rapid destruction of H3+ at the higher pressure where the W1935 emission originates (e.g. Helling et al. 2019)., Comment: Accepted in Nature 9 February 2024

We present the direct imaging discovery of a substellar companion (a massive planet or low-mass brown dwarf) to the young, $\gamma$ Doradus-type variable star, HIP 39017 (HD 65526). The companion's SCExAO/CHARIS JHK ($1.1-2.4\mu$m) spectrum and Keck/NIRC2 L$^{\prime}$ photometry indicate that it is an L/T transition object. A comparison of the JHK+L$^{\prime}$ spectrum to several atmospheric model grids finds a significantly better fit to cloudy models than cloudless models. Orbit modeling with relative astrometry and precision stellar astrometry from Hipparcos and Gaia yields a semi-major axis of $23.8^{+8.7}_{-6.1}$ au, a dynamical companion mass of $30^{+31}_{-12}$~M$_J$, and a mass ratio of $\sim$1.9\%, properties most consistent with low-mass brown dwarfs. However, its mass estimated from luminosity models is a lower $\sim$13.8 $M_{\rm J}$ due to an estimated young age ($\lesssim$ 115 Myr); using a weighted posterior distribution informed by conservative mass constraints from luminosity evolutionary models yields a lower dynamical mass of $23.6_{-7.4}^{+9.1}$~M$_J$ and a mass ratio of $\sim$1.4\%. Analysis of the host star's multi-frequency $\gamma$ Dor-type pulsations, astrometric monitoring of HIP 39017b, and Gaia DR4 astrometry of the star will clarify the system age and better constrain the mass and orbit of the companion. This discovery further reinforces the improved efficiency of targeted direct imaging campaigns informed by long-baseline, precision stellar astrometry.

First responders (FRs) navigate hazardous, unfamiliar environments in the field (e.g., mass-casualty incidents), making life-changing decisions in a split second. AR head-mounted displays (HMDs) have shown promise in supporting them due to its capability of recognizing and augmenting the challenging environments in a hands-free manner. However, the design space have not been thoroughly explored by involving various FRs who serve different roles (e.g., firefighters, law enforcement) but collaborate closely in the field. We interviewed 26 first responders in the field who experienced a state-of-the-art optical-see-through AR HMD, as well as its interaction techniques and four types of AR cues (i.e., overview cues, directional cues, highlighting cues, and labeling cues), soliciting their first-hand experiences, design ideas, and concerns. Our study revealed both generic and role-specific preferences and needs for AR hardware, interactions, and feedback, as well as identifying desired AR designs tailored to urgent, risky scenarios (e.g., affordance augmentation to facilitate fast and safe action). While acknowledging the value of AR HMDs, concerns were also raised around trust, privacy, and proper integration with other equipment. Finally, we derived comprehensive and actionable design guidelines to inform future AR systems for in-field FRs.

Blind or Low-Vision (BLV) users often rely on audio descriptions (AD) to access video content. However, conventional static ADs can leave out detailed information in videos, impose a high mental load, neglect the diverse needs and preferences of BLV users, and lack immersion. To tackle these challenges, we introduce SPICA, an AI-powered system that enables BLV users to interactively explore video content. Informed by prior empirical studies on BLV video consumption, SPICA offers novel interactive mechanisms for supporting temporal navigation of frame captions and spatial exploration of objects within key frames. Leveraging an audio-visual machine learning pipeline, SPICA augments existing ADs by adding interactivity, spatial sound effects, and individual object descriptions without requiring additional human annotation. Through a user study with 14 BLV participants, we evaluated the usability and usefulness of SPICA and explored user behaviors, preferences, and mental models when interacting with augmented ADs.

Background: Our institution has longstanding post-graduate education and training partnership programs in Emergency Medicine (EM) across India. A programmatic challenge has been the integration and uptake of evidence-based medicine and lifelong learning concepts. Formative assessment (FA) is intended to enable learners to monitor learning, identify strengths and weaknesses, and target areas of growth. As part of a program improvement initiative, we introduced an online FA tool to existing summative assessments. This study investigates how the FA tool was used and perceived by trainees. Methods: 246 trainees across 19 sites were given access to the FA tool. Usage metrics were monitored over 12 months. Semi-structured interviews were conducted in person with trainees using a purposive sampling methodology. A hybrid thematic analysis approach was used to determine themes. Interviews were coded independently by two blinded researchers using NVivo software. The study was deemed exempt by our institutional review board. Results: There was high variability in trainees’ utilization of the FA tool. Trainees who used the FA tool more performed better on summative exams (r = 0.35, p < 0.001). Qualitative analysis revealed that trainees were motivated to learn for improved clinical knowledge and to be a good physician, not only passing exams. Benefits of the tool included the relationship to clinical practice and thorough explanation of answers, while disadvantages included topics unrelated to India. Conclusion: The integration of a FA tool has provided positive outcomes for trainees in EM education programs in India. Lessons learned may apply globally to other contexts and programs.

Unmanned aerial vehicles (UAVs) have proven their value for reconnaissance missions, but integrating UAVs into manned aircraft to extend mission capabilities is an emerging field. Launch UAV’s goal is to design an aircraft that fits inside a G-sized sonobuoy canister, deploys from a manned aircraft in flight, and flies for at least 50 miles and 45 minutes while providing live video and telemetry to a remote operator. Multiple UAVs can be deployed in the air to expand the search capabilities of manned aircraft. An example scenario would be a search and reconnaissance mission over a large expanse of open land. The multiple UAVs would be deployed, loiter over an area, transmit their findings, and then fly back to base to be recovered and reused. To develop the design, aircraft characteristics such as aerodynamics, weight, and stability were modeled in MATLAB and assessed to judge overall performance. A high-wing/twin-tail aircraft configuration was selected by considering the outcomes of multiple trade studies. Wing-folding mechanisms were prototyped to evaluate candidate design concepts and technologies. The folding mechanisms used in thisUAV allow it to achieve the benefits of a longer wingspan while remaining strong and compact. Three prototype airframes have been built and prove that the UAV is stable in flight. Launch UAV validated the structure of the aircraft through load testing and the drag through wind tunnel testing. Another flight model will be ready shortly that incorporates the results from testing.

Human performance can be critically impacted by fatigue resulting from inadequate sleep. In a technological society, the consequences of fatigue related inattention or impaired response time are greater than ever. Industries such as aviation, rail, trucking, and medicine are mandated to have a Fatigue Management System (FMS) in place to ensure their personnel are ready for duty. We are testing the idea that a commercial, off the shelf (COTS) smart watch application using a new biomathematical model can provide continuous, obvious, real-time predictions about the wearer’s level of fatigue impairment. Our evidence shows that the correlation between a clinically approved measure with that of our smart watch application is strong enough to warrant applied trials with industry. We will also report on the correlation between subjective fatigue measures and the model’s fatigue predictions of subjective fatigue score throughout the waking hours. The conclusion of this study may show that continuous prediction of fatigue is possible hours before the point of endangerment, particularly for those industries requiring FMS to ensure public safety.

Human performance can be critically impacted by fatigue resulting from inadequate sleep. In a technological society, the consequences of fatigue related inattention or impaired response time are greater than ever. Industries such as aviation, rail, trucking, and medicine are mandated to have a Fatigue Management System (FMS) in place to ensure their personnel are ready for duty. We are testing the idea that a commercial, off the shelf (COTS) smart watch application using a new biomathematical model can provide continuous, obvious, real-time predictions about the wearer’s level of fatigue impairment. Our evidence shows that the correlation between a clinically approved measure with that of our smart watch application is strong enough to warrant applied trials with industry. We will also report on the correlation between subjective fatigue measures and the model’s fatigue predictions of subjective fatigue score throughout the waking hours. The conclusion of this study may show that continuous prediction of fatigue is possible hours before the point of endangerment, particularly for those industries requiring FMS to ensure public safety.

An obvious way to alleviate memory difficulties in GPU-based AI computing is via CPU offload, where data are moved between GPU and CPU RAM, so inexpensive CPU RAM is used to increase the amount of storage available. While CPU offload is an obvious idea, it can greatly slow down a computation, due to the relatively slow transfer rate between CPU RAM and GPU RAM. Thus, any system for CPU offload needs to ensure that when such a transfer needs to happen, no computation is blocked waiting for the transfer to finish. One of the key challenges when using CPU offload is that memory transfers introduce nondeterminacy into the system: it is not possible to know before runtime when the transfers will finish, and hence what is the best order of operations to run to ensure there is no blocking. In this paper, we describe TURNIP, which is a system for running AI computations using CPU offload. The key innovation in TURNIP is the compilation of the AI computation into a dependency graph that gives the TURNIP runtime freedom to run operations such as GPU kernel calls in many different orders; at runtime, TURNIP chooses the best order in response to real-time events.

For event management success, event management students must understand and develop skills relating to storyline development for festival (and event) experiences. However, as this teaching and learning note explains, students may not be fully developing their theoretical understanding and how to apply that understanding in practice due to their growing reliance on non-academic online resources. Teaching notes offer practical guidance for delivering and teaching various topics, but are not often directed towards students. This article adapts the traditional teaching note to highlight this issue and offers a dual teaching and learning note to better support student learning and skills development.

Over the last few decades, storytelling, as a subject for study, has grown exponentially across a number of interdisciplinary fields. However, it remains underdeveloped in event management research, and specifically concerning festival experiences. Following a critical review of the existing research that has contributed to current understanding of storytelling within festival contexts and highlighting the key arguments of these publications, this article provides a comprehensive overview of how storytelling is currently understood within festival contexts. Extending the literature, this article introduces the contributing papers of the Special Issue, which demonstrate the value of storytelling for audiences, hosts and researchers. This article closes with a call for more research into storytelling within festival contexts and encourages future studies to address the identified gaps to help progress understanding of storytelling, its practice and dynamics, and its value for festival experiences.

In the early stages of the COVID-19 pandemic, many events and conferences hastily converted to a virtual format, and many commercial ventures promptly developed tools promising seamless transitions to virtual spaces. In particular, efforts to expand and monetize augmented and virtual reality environments increased. While these spaces increased accessibility for some, others were left behind. In 2024, many events returned to on-site venues, yet virtual spaces remain central in academic and research communities, particularly for disabled scholars. As such, in this paper, we advocate for continued virtual access and improved virtual spaces; we also identify some potentially overlooked harms in immersive and embodied virtual spaces., Comment: This is an accepted position statement of CHI 2024 Workshop (Novel Approaches for Understanding and Mitigating Emerging New Harms in Immersive and Embodied Virtual Spaces: A Workshop at CHI 2024)

Black families have historically experienced state sanctioned family separation for decades, originally via the institution of slavery and currently through the present-day child “welfare” or carceral family system. Schools act as an agent of surveillance for this system and report more Black families for suspected child maltreatment than families of other races. While in schools, Black foster youth disproportionately experience disparate educational outcomes in comparison to both their foster youth and non-foster youth peers, such as high rates of suspension, expulsion, special education placement, chronic absenteeism, and low graduation rates. Building upon carceral studies, critical education literature and social work scholarship this study provides a more complex understanding of the ways that the schools often collude with the carceral family system using over surveillance, hyper-criminalization, and disproportionate reporting, to impact the educational journeys of Black foster youth students in K-12. This qualitative study explores the experiences of Black foster youth students in college as they reflect on their educational trajectories. Much of the research on the foster youth community lacks a racialized lens and views the community as monolithic. This study builds on emerging research by centering the voice of Black foster youth students and by illuminating how they describe their schooling experiences, and how, if at all carceral systems work collaboratively with schools to shape their lives.

The Gambia, like other Sub-Saharan African nations, has seen a slow transition from traditional, dirty fuels to cleaner ones. Although measurement of energy access for lighting and cooking purposes has been performed in other Sub-Saharan African countries, no similar analysis has been published for The Gambia. Using data from the 2010 and 2015 Gambian Integrated Household Surveys, this study derives lighting and cooking fuel access levels and factors driving energy fuel transitions. Generalized linear modeling is used to determine the driving factors of lighting and cooking fuel choice among Gambian households over time. Results indicate that household’s primary lighting fuel shows an overall decline in fuel use and rise in decentralized energy sources, instead of grid electricity. Further, grid electricity is concentrated in urban areas compared to rural. Household primary cooking fuel has shown little change over time and remains to be mostly firewood. Access to charcoal, a slightly cleaner fuel, is concentrated in urban areas.

I argue that colonialism and capitalism have utilized a specific narrative of reproduction to devalue reproducers and produce and maintain control over their bodies and lives. This builds on the work of other reproductive justice and feminist scholars and activists which seek to challenge this “dominant” discourse and destabilize the notion that there is one correct way to reproduce and birth. This podcast study uses key-word-in-context and critical discourse analyses methods to compare the ways different care providers (e.g., doctors, midwives, doulas) in the US currently situate authority and power regarding individuals (e.g., birthing people and care providers) and decision-making (e.g., knowledge, choices). I selected two podcasts, both interested in “women’s rights/health,” representative of two different approaches: holistic reproductive health (Birthful) and obstetric/gynecologic perspectives (The Ob/Gyn Podcast). Frequency count data and critical discourse analysis, drawing on 20 randomly selected episode transcripts from each podcast, revealed four main themes: worth and importance, provider roles in birthing spaces, integral actors in reproduction and birthing decision-making, and shaping legitimacy. Findings elucidate (1) key differences in the ways podcast speakers ascribe meaning and value to certain types of knowledge and individuals regarding decision-making and (2) subtle and overt ways in which care providers reify or challenge the narrative that positions the birthing person as a passive agent to whom birth happens at the hands of more capable experts. Acknowledging and challenging the presumed role of authority and power in reproduction and birthing has real-world implications for birthing people and their mental health, reproductive justice, and ethics of care.

This dissertation aims to advance the understanding of upstream mechanisms that influence population health by investigating issues centering racism, diversity, inclusion, and equity within the physician and health services and policy research workforces and workplaces. Aim 1 explored the relationship between representation of Black faculty in medical schools and report of frequent burnout among practicing physicians and examined the effect of racial concordance between practicing physicians and representation of faculty on the report of frequent burnout among practicing physicians. Aim 2 estimated the occurrence of workplace racism, sexual harassment, and sexism from both coworkers and patients experienced by US practicing physicians and compared these experiences by race-ethnicity, gender, and the intersection of racial-ethnic and gender identity. Finally, Aim 3 investigated issues of diversity, equity, and inclusion within the workplace culture of health services and policy research, as experienced by the systematically excluded individuals in the workforce and educational pathway. These three studies aimed to answer the overarching question: How does racism operates in and affect the health services delivery and research workforce and workplace? This dissertation illuminated interpersonal racism (e.g., workplace racism, discrimination, abuse, exploitation, tokenism), institutional racism (e.g., inequitable allocation of resources, lack of institutional support, institutional violence, and struggle seeking federal funding and peer-review publication), sexual harassment, and sexism experienced by systematically underrepresented individuals in the health services delivery and research workforce. The findings have implications for future research and interventions to improve workplace culture and learning environment of the health services delivery and research.

Antietam Farm is a historic vernacular farmstead located south of Sharpsburg in Washington County, Maryland. The farm, set in an agricultural area of high historical interest, reflects the development and events in this part of Washington County. David Showman acquired 220 acres in 1842 and built the farmhouse ca. 1844. The house has Federal and Greek Revival elements, contrasting with the German vernacular farmhouses in the region. Sharpsburg and the surrounding area were the location of the 1862 Battle of Antietam. Following the Battle, the house was the headquarters for Union General Ambrose Burnside and the Union Army’s 9th Corps. President Abraham Lincoln visited the Antietam battlefield and met with Burnside at this house. Some 70,000 Union troops occupied the region for an extended time, devastating the region’s agriculture and farms. Over the last three decades, the owners have carefully restored the farm to its mid-19th-century appearance. The result is a property whose historical significance, integrity, and contributing resources make it eligible for the National Register of Historic Places under Criteria A and C.

Through CalAIM (California Advancing and Innovating Medi-Cal), a multiyear initiative to transform the Medi-Cal program, managed care plans now have the option to offer any of 14 Community Supports that provide person-centered services to address a variety of social drivers of health. Several of these Community Supports could help older adults and people with disabilities remain in their own homes, participate in their communities, and live independently in the setting of their choice.To support understanding and increased uptake of these services over time, this report provides an overview of and evidence summary for six Community Supports most relevant to supporting independent living for older adults and people with disabilities, including:Respite Services. Short-term services aimed at providing relief to caregivers of those who require occasional or temporary assistance or supervision.Nursing Facility Transition / Diversion to Assisted Living Facilities. Services that help people remain in the community by facilitating transitions from a nursing facility back into a home-like, community setting or prevent nursing facility admissions for those with imminent need.Community Transition Services / Nursing Facility Transition to a Home. Nonrecurring support, including setup expenses, to avoid further institutionalization and help people remain in the community as they return home from a licensed nursing facility.Personal Care and Homemaker Services. Supports for people needing assistance with daily activities, such as bathing, dressing, cooking, eating, and personal hygiene.Environmental Accessibility Adaptations (Home Modifications). Physical adaptations to a home when necessary to ensure health, welfare, and safety, or promote greater independence at home through improved functionality and mobility.Medically Supportive Food / Meals / Medically Tailored Meals. Meal services to help people achieve their nutritional goals at critical times (such as after a hospital or

Through testimonio methodology (Pérez Huber, 2009) rooted in Chicana feminist epistemologies and situated within Latinx critical race theory (LatCrit) (Delgado Bernal, Pérez Huber, Malagón, 2019) this three-article dissertation reframes the college transition experiences of Chicana/Latina undergraduates at a Research 1 (R1) public university by taking a race, gender, class, immigration, and intersectional centered understanding of the Chicana/Latina college transition. 15 second-year Chicana/Latina undergraduate testimonios at this Emerging Hispanic Serving Institution (eHSI) were explored through Chicana/Latina /o critical race theory (LatCrit) and Chicana feminist methodologies and frameworks. This dissertation centers the Chicana/Latina undergraduate transition testimonios to uncover the systems and structures of marginality Chicana/Latina undergraduates navigate as they experience the transition to college through their embodied identities. The central data collection method in this dissertation are pláticas, a Chicana feminist method that is rooted in Chicana/Latina ways of knowing and everyday talk within Latinx communities (Fierros & Delgado Bernal, 2016). Testimonios are crafted in this dissertation through the braiding of a series of individual pláticas, a set of group pláticas, journaling, and visual representations of the transition. The testimonios will contribute to capturing the complexity and intricacies in the Chicana/Latina transition experience, through a race and gender centered exploration of the Chicana/Latina R1 college transition situated within the systems of marginality that underlie the lives of Chicanas/Latinas in the United States. Therefore, this dissertation contributes to one of the first explorations of a mujer centered theorization of the transition to college that draws from the braiding of LatCrit and Chicana feminist epistemologies and frameworks to theorize about college processes.

Through CalAIM (California Advancing and Innovating Medi-Cal), a multiyear initiative to transform the Medi-Cal program, managed care plans now have the option to offer any of 14 Community Supports that provide person-centered services to address a variety of social drivers of health. Several of these Community Supports could help older adults and people with disabilities remain in their own homes, participate in their communities, and live independently in the setting of their choice.To support understanding and increased uptake of these services over time, this report provides an overview of and evidence summary for six Community Supports most relevant to supporting independent living for older adults and people with disabilities, including:Respite Services. Short-term services aimed at providing relief to caregivers of those who require occasional or temporary assistance or supervision.Nursing Facility Transition / Diversion to Assisted Living Facilities. Services that help people remain in the community by facilitating transitions from a nursing facility back into a home-like, community setting or prevent nursing facility admissions for those with imminent need.Community Transition Services / Nursing Facility Transition to a Home. Nonrecurring support, including setup expenses, to avoid further institutionalization and help people remain in the community as they return home from a licensed nursing facility.Personal Care and Homemaker Services. Supports for people needing assistance with daily activities, such as bathing, dressing, cooking, eating, and personal hygiene.Environmental Accessibility Adaptations (Home Modifications). Physical adaptations to a home when necessary to ensure health, welfare, and safety, or promote greater independence at home through improved functionality and mobility.Medically Supportive Food / Meals / Medically Tailored Meals. Meal services to help people achieve their nutritional goals at critical times (such as after a hospital or