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While the literature is abundant on hand therapy assessment and treatment of nonsurgical thumb carpometacarpal (CMC) osteoarthritis (OA), clarity and uniformity are meager, making it a desirable diagnosis to establish expert consensus. This study aimed to ascertain if consensus exists for the assessment and treatment of nonsurgical management of thumb CMC OA in the hand therapy clinical setting. This was a consensus paper via the modified Delphi approach. A modified Delphi method was used to determine consensus among an expert panel, including hand therapists and hand surgeons, via two online surveys. A consensus paper steering committee (from the American Society of Hand Therapist's research division) designed the surveys and analyzed responses. Consensus was established as 75% agreement among the expert panel. Demographic information was collected from the expert panel. The expert panel included 34 hand therapists and seven hand surgeons. The survey response rates were 93.6% for the first survey and 90.2% for the second survey. Consensus recommendations were classified according to the World Health Organization categorization. These included evaluating the body structures for clinical signs/clinical testing and body functions for pain, range of motion for palmar abduction, radial abduction, opposition, and thumb metacarpal phalangeal flexion/extension, and grip and tripod pinch strength. Further consensus recommendations were for the assessment of function using a region-specific, upper extremity patient-reported outcome measure (activity and participation), environmental factors, outcome expectation, and illness perception within the patient's unique environmental and social contexts. Treatment recommendations included the use of an orthosis during painful activities, a dynamic stability program (stable C posture, release of tight adductors, and strengthening of stabilizers), patient education, joint protection techniques, adaptive equipment, and functional-based intervention. The findings describe the consensus of a group of experts and provide a clinical reference tool on the hand therapy assessment and treatment of nonsurgical thumb CMC joint OA. • A consensus paper using a modified Delphi process to determine consensus on non-surgical assessment and treatment of thumb CMC OA. • Assessment recommendations: evaluate clinical signs/testing, pain, thumb range of motion grip and tripod pinch, a region-specific PROM, environmental factors, outcome expectation, and illness perception. • Treatment: orthosis during painful activities as needed, a dynamic stability program, patient education, joint protection techniques, adaptive equipment, and functional based intervention. • Findings provide a clinical reference tool on hand therapy assessment and treatment of non-surgical CMC joint OA. [ABSTRACT FROM AUTHOR]

This study focused on how adopted adults who have reunited with at least one birth family member experienced identity shifts related to their original birth certificates (OBCs). Framed by the Communication Theory of Identity (CTI), 50 adopted adults discussed their experiences related to their OBCs and how their identities are connected to this symbol through three of the layers of CTI, the personal, enacted, and relational layers. Participants discussed the presence of an ambiguous and unsolvable identity that interpenetrated with their other identity layers. Findings extend CTI to include an additional layer for adoptees – phantom identity – which can explain the life adoptees would have lived had they not been adopted. This identity was salient for participants as it manifested in ways such as expressing frustration with obstacles in gaining access to their OBC and refocusing their professional life to support other adopted adults. Moreover, findings offer implications for the examination into current adoption record practices in the United States, additional state mutual consent registries, and increased access to adoption-competent counselors for adoptees. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The Healthy, Hunger-Free Kids Act of 2010 ( HHKA) required schools to make changes to meals provided to children. Rural school districts have limited resources, with increased obesity rates and local food insecurity. In this study we sought to understand the perceptions of rural food service directors and the barriers to implementing the changes. METHODS Food service directors from rural school districts were invited to complete a semistructured telephone interview and online survey. A total of 51 respondents completed both, 6 completed only the online survey, and 16 completed only the telephone interview. Qualitative interview data were analyzed through open thematic coding; descriptive statistics were calculated for the quantitative data. RESULTS Food service directors mostly perceived the changes as negative, challenging, and burdensome. They believed that the changes resulted from concern about childhood obesity, which they did not view as a problem for their students. Diverse challenges were reported related to cost, preparation, and student preference. CONCLUSIONS Food service directors in isolated, rural areas need support to enhance understanding of HHKA requirements, build professional networks to learn from one another, and communicate with students, families, and other stakeholders. Future efforts should focus on changing perceptions and supporting directors in order to make implementation a success. [ABSTRACT FROM AUTHOR]

Aims: A discussion of the personal and social contexts for Millennial family caregivers and the value of including complex identity and intersectionality in Millennial family caregiving research with practical application. Design: Discussion paper. Data sources This discussion paper is based on our own experiences and supported by literature and theory. Implications for Nursing: Millennial family caregivers have distinct generational, historical and developmental experiences that contribute to the care they provide as well as their own well‐being. Complex identity, the integration of multiple identities, and intersectionality, systems and structures that disempower and oppress individuals with multiple identities, need to be addressed in nursing research so intervention tailoring and health equity can be better supported in this population. From research conceptualization and design to data analysis, data must be used intentionally to promote equity and reduce bias. The inclusion of diverse Millennial caregivers throughout all stages of the research process and having a diverse nursing research workforce will support these efforts. Conclusion: Millennial family caregivers comprise one‐quarter of the family caregiving population in the United States, and they are more diverse than previous family caregiving generational cohorts. Their needs will be more fully supported by nursing scientists with the adoption of methods and techniques that address complex identity and intersectionality. Impact: Nursing researchers can use the following research approaches to address complex identity and intersectionality in Millennial caregivers: inclusion of qualitative demographic data collection (participants can self‐describe); data disaggregation; data visualization techniques to augment or replace frequencies and descriptive statistics for demographic reporting; use of researcher reflexivity throughout the research process; advanced statistical modelling techniques that can handle complex demographic data and test for interactions and differential effects of health outcomes; and qualitative approaches such as phenomenology that centre the stories and experiences of individuals within the population of interest. [ABSTRACT FROM AUTHOR]

A traditionally salient topic of empirical investigation in the sociology of religion, this paper seeks to offer a recent investigation into the intergenerational transmission of religion and the parental forms of religious engagement that predict adult engagement with religion. The study of this paper explores the intergenerational transmission of religion, focusing on the parental forms of religious identity and engagement that influence religious identity, beliefs, and practices in adulthood. By analyzing the 2018 GSS dataset in the United States with multiple regression analyses, I found strong parental and childhood influences on adult religiosity, religious service attendance, and belief in God. Indeed, this engagement often mirrors parental engagement for these variables. However, while paternal religious identity often predicts these religious variables, I found that the religious identity and engagement of parents generally do not predict religious identity in adulthood. Ultimately, while these results generally show strong predictive mechanisms of intergenerational transmission, they also illustrate that these relationships are variably dependent on the form of parental and adult religious engagement, and which parent participates or is associated with that engagement. [ABSTRACT FROM AUTHOR]

In this paper, we present findings from four separate studies using different data sources and methods to examine Chinese attitudes toward the United States amid the COVID-19 pandemic. The empirical results consistently indicate a marked and significant decline in Chinese attitudes toward the US between late 2019 and the end of 2022. Using a quasi-experimental design and granular survey data that exploit daily variations in public opinion, we offer additional evidence that the decline in Chinese attitudes toward the United States followed a distinct pattern not true for Chinese attitudes toward other countries. Specifically, the rise in Chinese unfavorability toward the United States closely corresponded to the heightened Chinese attention to the pandemic's progression in the United States. These results collectively suggest a causal effect of COVID-19, shedding light on how public health crises, international relations, and media jointly shape the increasing enmity between the two great powers. [ABSTRACT FROM AUTHOR]

Background: Incarcerated trans women experience significant victimization, mistreatment, barriers to gender-affirming care, and human rights violations, conferring high risk for trauma, psychological distress, self-harm, and suicide. Across the globe, most carceral settings are segregated by sex assigned at birth and governed by housing policies that restrict gender expression—elevating ‘safety and security’ above the housing preferences of incarcerated people. Aim/methods: Drawing upon the lived experiences of 24 formerly incarcerated trans women in Australia and the United States and employing Elizabeth Freeman’s notion of chrononormativity, Rae Rosenberg’s concept of heteronormative time, and Kadji Amin’s use of queer temporality, this paper explores trans women’s carceral housing preferences and contextual experiences, including how housing preferences challenge governing chrononormative and reformist carceral housing systems. Findings: Participants freely discussed their perspectives regarding housing options which through thematic analysis generated four options for housing: 1) men’s carceral settings; 2) women’s carceral settings; 3) trans- and gay-specific housing blocks; and 4) being housed in protective custody or other settings. There appeared to be a relationship between the number of times the person had been incarcerated, the duration of their incarceration, and where they preferred to be housed. Conclusions: This analysis contributes to richer understandings regarding trans women’s experiences while incarcerated. This paper also informs the complexities and nuances surrounding housing preferences from the perspectives of trans women themselves and considers possible opportunities to enhance human rights, health and wellbeing when engaging in transformative approaches to incarceration. [ABSTRACT FROM AUTHOR]

Neutrality in librarianship is a nonsensical concept that libraries of all kinds (e.g., public, academic, special, etc.) should not strive to embody in any shape or form. The following paper investigates the intricate relationships between neutrality and racism as they are demonstrated by tangible and intangible forms in library and information science (LIS) spaces. Ian Williams' book chapter, "More Than Half of Americans Can't Swim", from his book, Disorientation: Being Black in the World (2021), is utilized to critically reflect on Blackness as identity and some ways in which antiracist practices clash with neutrality within LIS spaces. I conclude with urgent reminders of how detrimental neutrality can be if it is not thoroughly rooted out and supplanted with antiracist practices that the LIS field is in dire need of. [ABSTRACT FROM AUTHOR]

This paper addresses the experiences of US child welfare professionals during the COVID pandemic. Using an online survey, we report on a convenience sample of 444 child welfare workers. The majority reported receiving adequate guidance on staying safe; 86.3% were given access to face masks. Workers reported 75.8% of clients used masks; 10.7% reported contracting COVID through work. About 80% worried that child clients were more at-risk. Workers who felt the most supported and least at-risk were those with stay-at-home orders. Results are discussed in terms of supporting child welfare professionals during periods of crisis. [ABSTRACT FROM AUTHOR]

Public libraries in the United States (U.S.) are important sources of health information. Immigrants comprise a large portion of the U.S. population, and research suggests that public libraries help immigrants adjust to life in a new country. Public libraries help immigrants access information directly related to health and provide programs that have indirect impacts on health outcomes, including learning a new language and forging social ties. The purpose of this paper was to examine perspectives from librarians related to interactions with immigrant patrons and how their library supports them in this role. Public librarians (n = 205) from two selected U.S. states completed an online survey focusing on how comfortable they were in helping immigrants with inquiries related to health and the role of the public library in supporting librarians in this endeavor. Respondents generally reported high levels of comfort interacting with immigrants, although there was limited interaction on potentially sensitive topics (i.e., immigration, health). Library staff perceived that libraries overall were not effective in meeting the needs of immigrant populations and that librarians were infrequently offered professional training related to cultural competency and diversity. The findings echo previous studies that demonstrate the need for professional development to ensure that librarians are aware of library resources available to assist immigrant patrons. Findings from this study suggest opportunities for public health professionals and public librarians to collaborate to ensure the provision of reliable resources, health information, and referrals to community-based services. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

Earlier pubertal onset has been associated with increased disordered eating symptoms in cisgender girls. Although this finding has been replicated across studies of disordered eating, most studies have focused on white samples. The lack of studies is surprising given that early pubertal timing may impact disordered eating risk in Black and Latinx girls differently due to trends of earlier pubertal onset in these groups and increased stressors related to interpersonal and structural racism and economic marginalization. Current methods of examining pubertal timing among Black and Latinx girls may also not fully capture their experience. Contextual factors (e.g., neighborhood and school racial/ethnic composition) may influence how minoritized girls both perceive and are affected by their pubertal timing. Moreover, factors such as ethnic–racial identity development and experiences of discrimination may be important mechanisms explaining the association between pubertal timing and disordered eating risk. This paper aims to provide a brief overview of studies examining pubertal timing and disordered eating risk among Black and Latinx girls in the US and to discuss recommendations for future research that integrate contextual factors in the examination of pubertal timing and its effects. Public significance: Early pubertal timing has been associated with increased risk of disordered eating symptoms among cisgender girls; however, studies have been limited due to the use of predominantly white samples. The article provides a brief overview of findings related to pubertal timing effects among Black and Latinx girls, discusses considerations for the measurement of pubertal timing, and highlights the need for inclusion of contextual factors in future research. [ABSTRACT FROM AUTHOR]

Background: As of 2017, American Indian/Alaska Natives (AI/AN) had the highest prevalence of illicit drug use of any ethnic group in the United States, with 17.6% of the population aged 12 and older reporting using illicit drugs in the last month. Studies have shown the positive correlation between a history of trauma and substance use disorder. In fact, the majority of youth in treatment for substance misuse reported a history of trauma. Intergenerational trauma, systematic discrimination, and displacement are downstream effects of colonization, and experiences of racism often define the life experiences of AI/ANs who use substances. This paper describes the process of designing a developmentally and culturally appropriate primary prevention supplement for an evidence‐based program to prevent substance use and increase cultural identity among AI/AN youth. [ABSTRACT FROM AUTHOR]

This essay introduces Analyses of Social Issues and Public Policy's collection of papers on the social psychology of the 2012 election, framing it in terms of two prior collections. The papers are described as reflecting four themes: President or Barack Obama's path from outsider to incumbent, the nation's shift toward increasingly racialized politics, contemporary perceptions of 'Americanness,' and the role of moral values in political engagement. [ABSTRACT FROM AUTHOR]

The article discusses a report titled "How Obama did away with the US constitution" by Abu Mariam, which can be located at http://oppression.org/site/index.php/world/americas/190-shredded-paper-how-obama-is-doing-away-with-the-us-constitution.

Belonging is a human need, one that is particularly difficult for children of immigrants to achieve. The Second-generation youth hangs in a balance between the culture of their parents and that of their friends and peers. Often these youth feel that they are not heard or seen by those around them, enhancing the feeling of not belonging in their communities, or even in their country. Therapeutic interventions could potentially create a "third space" in which they feel a sense of belonging. This paper explores the complexity in the experience of belonging in second-generation Latinx youth through a review of the literature, psychodynamic theories, a composite clinical case example and the reflections and implications to and from Second-generation Latina therapist. [ABSTRACT FROM AUTHOR]

On January 6th, 2021, Donald Trump's speech during a 'Save America' rally was followed by mass violence, with Trump's supporters storming the U.S. Capitol to prevent the certification of Joe Biden's victory in the presidential election. In its wake, there was a great deal of debate around whether the speech contained direct instructions for the subsequent violence. In this paper, we use a social identity perspective on leadership (and more specifically, on toxic leadership) to analyse the speech and see how its overall argument relates to violence. We show that Trump's argument rests on the populist distinction between the American people and elites. He moralises these groups as good and evil respectively and proposes that the very existence of America is under threat if the election result stands. On this basis he proposes that all true Americans are obligated to act in order prevent Biden's certification and to ensure that the good prevails over evil. While Trump does not explicitly say what such action entails, he also removes normative and moral impediments to extreme action. In this way, taken as a whole, Trump's speech enables rather than demands violence and ultimately it provides a warrant for the violence that ensued. [ABSTRACT FROM AUTHOR]

INTRODUCTION The FDA's 'The Real Cost' tobacco prevention campaign aimed to counter tobacco marketing efforts directed toward children and youths. Our objectives were to explore the associations between exposure to the FDA's campaign and cigarette risk perception among the US adolescent population, and between exposure and cigarette smoking curiosity among adolescents who never smoked cigarettes. METHODS We analyzed 3 cycles of National Youth Tobacco Survey (NYTS 2018-2020, n=53738). Multivariable logistic regression models were fitted to measure the relationship between campaign exposure and cigarettes risk perception (among all), as well as the relationship between campaign exposure and cigarette curiosity (among cigarette never smokers). RESULTS Majority of youths have reported exposure to the campaign 63% between 2018-2020. The odds of youths perceiving cigarettes as risky were 1.6 times higher among exposed compared to those not exposed (adjusted odds ratio, AOR=1.60; 95% CI: 1.43-1.79). There were some racial disparities in risk perceptions among Hispanics and Non-Hispanic Blacks across exposure groups. Exposure was associated with higher cigarettes curiosity odds among Hispanic youths who never smoked (AOR=1.26; 95% CI: 1.10-1.44) compared to their Non-Hispanic White peers. CONCLUSIONS The FDA's 'The Real Cost' campaign had exposure levels deemed essential for population-level perceptions change. Exposure was associated with youths having higher risk perceptions about the negative health outcomes related to cigarette smoking. However, students that never smoked were more curious about smoking with campaign exposure. Therefore, future health communication plans should consider both the potential benefits and possible unintended consequences prior to launching such campaigns. [ABSTRACT FROM AUTHOR]

To better serve the growing population of interracial and interethnic parents raising children and adolescents, social workers must strive to understand their unique experiences. The authors analyzed 15 qualitative interviews with parents in interracial and interethnic marriages raising at least one child 11- to 18-years-old to understand their parenting practices and what they are confronting. Five racial-ethnic socialization strategies were found – cultural socialization, preparation for bias, promoting egalitarianism, imparting anti-racist messages, and teaching the strengths of Biracialism. In addition, three themes or challenges were found that the parents were faced with and to which they needed to respond. These included being affected by the current racial climate in the United States, their children's racial presentation, and the role the children's grandparents and extended family play. This paper includes recommendations for social worker practice. [ABSTRACT FROM AUTHOR]

Consumers around the world give away billions of dollars annually in the form of voluntary payments (aka, tips) to service workers who have served them. This widespread and important economic activity varies across geographic areas within nations, but that geographic variability has been under-studied. This paper seeks to answer the question: "Are state differences in tipping attitudes and behavior attributable to state differences in motivations for tipping?" To that end, new measures of average tipping attitudes and motives in each of the states of the United States are developed, and their relationships with state tipping behaviors, as well as other theoretically relevant state-level measures, are tested. Results suggest meaningful and reliable state differences in attitudes toward and motivations for tipping, and that the latter differences underlie some, but not all, state differences in tipping behavior. [ABSTRACT FROM AUTHOR]

Objectives: In 2019 the United States experienced the largest outbreak of measles in 27 years, 19 years after the United States declared measles eliminated. The purpose of this paper was to present a population study of a measles outbreak within Orthodox Jewish communities in New York that led to the elimination of religious exemption for school mandated vaccines. Methods: Peer reviewed articles, news media, health department, and government resources were used to investigate environmental factors that led to this outbreak. State, county, and city immunization records were accessed to explore measles compliance rates before and after policy change. Results: Rockland County had low compliance rates compared to the rest of the state, and the elimination of religious exemptions raised compliance rate almost to state level. In all but one affected New York City zip codes, compliance following policy change rose to 97.95%–99.15%. Conclusions: Overall, changes in measles compliance rates reflect policy goals, but localized differences imply a need for more customized interventions for each unique community. Public health planning to promote vaccination should be sensitive to the concerns and perceptions of each community in order for health interventions to have a positive effect. [ABSTRACT FROM AUTHOR]

This article maps and compares four universities' policies and procedures for addressing faculty and staff sexual misconduct in higher education in the UK and US. While universities have engaged in significant work to grapple with student-student sexual misconduct, attention to misconduct perpetrated, and experienced, by higher education employees is relatively nascent. In this paper, we explore the maze of institutional processes and actors that victimsurvivors of FASSM might encounter. We describe what is known about prevalence of FASSM in the US and UK and offer an overview of the policy landscape in both settings. Inspired by Patricia Yancey Martin, we analyze publicly available policy documents on FASSM from two US and two UK universities and map out visually the range of investigative, reporting, and sanctioning processes. We introduce an analytic distinction between an actor and a practitioner within the FASSM context, whereby actors are those tasked with administrative duties in handling sexual misconduct reports, while practitioners are those with specialized knowledge and training that enables them to prioritize victim-survivor needs. These illustrative diagrams suggest that while university employees are tasked to act on reports and disclosures of sexual misconduct, it is difficult to identify specialist practitioners with expertise to support victim-survivors of FASSM. Ultimately, this work provides a deeper understanding of what practice looks like in relation to higher education FASSM, and we outline implications for future research directions. [ABSTRACT FROM AUTHOR]

In this paper, we provide a theoretical and empirical framework that allows us to synthesize and assess the burgeoning literature on CEO overconfidence. We also provide novel empirical evidence that overconfidence matters for corporate investment decisions in a framework that explicitly addresses the endogeneity of firms' financing constraints. [ABSTRACT FROM AUTHOR]

Muslim Americans constitute one of the United States' most vulnerable minority groups, facing frequent discrimination from both the public and the government. Despite this vulnerability, few studies evaluate interventions for reducing prejudice against Muslim Americans. Building from an insightful literature on the sources of prejudice against Muslim Americans, this paper tests whether attitudes can be improved with information countering misperceptions of the community as particularly foreign, threatening, and disloyal to the United States. The experimental treatment modestly improved attitudes, including among some subgroups predisposed to prejudice against Muslim Americans. However, the treatment struggled to change policy views, and it demonstrated some vulnerability to social desirability bias and priming on terrorism threats. The findings suggest that information campaigns addressing misperceptions can help to reduce prejudice on the margins, but primarily in less politicized contexts. [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) is highly prevalent among adults in the US and is associated with substantial personal and societal costs. Yet only a small percentage of adults with AUD initiate treatment, including those with severe AUD symptoms who are most in need of treatment. In this paper we use latent profile analysis (LPA) to describe differences in symptoms of AUD severity and alcohol-related consequences among untreated adults with severe AUD symptoms who were recruited from the community. Identification of such differences will result in better understanding of this population and will improve methods of treatment outreach. The LPAs were conducted on the baseline data of 403 (50% male, 77% White, M age = 40.74 with severe AUD recruited from the community and enrolled in a trial of an intervention designed to encourage treatment initiation. Participants reported no prior AUD treatment history. The LPAs were based on indicators of AUD severity, alcohol-related negative consequences, and self-reported intention to initiate AUD treatment. The LPAs revealed 4 profiles. Profile membership was predicted by baseline participant sex and whether they were living with a partner and was associated with baseline past 30-days alcohol consumption. The findings characterize and describe the variability among adults in the community with untreated severe AUD on variables that tend to motivate such individuals to seek treatment, which could significantly advance treatment outreach efforts. [ABSTRACT FROM AUTHOR]

The novel coronavirus (COVID-19) has spread across the United States, resulting in significant changes in almost all aspects daily life. These changes place parents at increased risk for parental burnout. Parental burnout is a chronic condition resulting from high levels of parenting-related stress due to a mismatch between the demands of parenting and the resources available for parents to meet those demands. Research on parental burnout has suggested that parents who experience burnout are more likely to engage in child abuse and neglect, placing children at risk for detrimental short- and long-term outcomes. The purpose of this paper is to review the concept of parental burnout, discuss parental burnout in the context of the current COVID-19 pandemic, and focus specifically on the effects of child maltreatment. Implications for practitioners will be discussed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe and discuss both the early implementation of a US mental health intervention for young children in the context of its introduction to a pilot site in a London borough and the progress made in establishing a randomised controlled trial (RCT). Design/methodology/approach: This paper describes an evaluation of a new intervention and the learning that followed in terms of its implementation and future evaluation. Qualitative data were collected from a range of stakeholders and practitioners through interviews and small group discussions. These interviews focussed on both of these issues, with particular reference to the proposal to conduct an RCT. Findings: The findings of this evaluation add to the evidence on how best to support new initiatives that have been introduced from other settings and countries to embed in a receiving site and the optimal timing and feasibility of conducting an RCT. At the end of the feasibility study, which took place within the year of the service being introduced and which was only open to clients for six months of this year the conclusion was that an RCT at that point was neither possible nor desirable. Over the following years, the commitment of the judiciary to examine if there was a way to make an RCT study in respect of this intervention meant that a template was established that may well have broader application. Research limitations/implications: At a time when there is an increasing demand for evidence on effective interventions this paper makes a valuable contribution to the development of RCTs in general and specifically in the family court arena. It also recommends that attention must also be paid to the time, which is needed to implement and establish interventions and then to test them. Practical implications: This paper highlights the need to establish realistic timescales not only around the implementation of initiatives but also for their evaluation. Originality/value: This study breaks new ground in considering implementation challenges in the court and children's services' context. It brings to the fore the important role of the judiciary in approving new processes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the results of an online program evaluation survey conducted in the USA in 2018 which was designed to understand how members of an enhanced multidisciplinary team (E-MDT) use the expertise of a forensic accountant (FA) in suspected cases of elder financial exploitation. Design/methodology/approach: This paper analyzes responses to an online survey from 54 E-MDT members. Narrative responses to open-ended questions were analyzed by using cross-case thematic analysis. Data from demographic questions and those with nominal response options were analyzed using descriptive statistics. Findings: Overwhelmingly, the E-MDT members described how useful the FA's expertise and subsequent detailed reports are in helping determine whether financial exploitation is taking place and providing information needed to continue an investigation and pursue criminal charges. Practical implications: The increasing longevity and sheer number of older adults present ongoing challenges in the fight to address financial exploitation. Findings suggest that FAs working with E-MDTs can help identify signs, collect evidence and help investigate cases of suspected financial abuse of older adults. The development of training programs focused on educating accountants to fill a need in a growing area of forensic accounting may be needed. Originality/value: This paper adds to the growing evidence of multidisciplinary teams as an effective model for investigating cases of financial elder exploitation by focusing specifically on the expertise of an FA. [ABSTRACT FROM AUTHOR]

As the population of students identified as English learners (ELs) with disabilities grows, schools need to be preparing educators to serve this vulnerable population. This paper presents findings from an inductive analysis of interviews with teachers and administrators in one suburban district. We examine the ways teachers and administrators perceive their roles and the needs of these students. We found that teachers grapple with identifying needs of students at the intersection of English Learning and Special Education, determining how best to support them, and coordinating across programs. These struggles seem to stem from a lack of understanding and expertise. We posit that through creative collaboration, special education teachers and ELs can help each other build capacity and dispel misconceptions. [ABSTRACT FROM AUTHOR]

Background: While research on trans People of Color's experiences has been increasing in recent years, this intersectional work has often not included a focus on the specificities of multiracial and multiethnic trans experiences. Aims: This study explores shifts in racial identity by multiracial/multiethnic trans people as they transition gender and the ways Whiteness and nationalist ideology shape their racialized gender experiences. Methods: This paper is based on six in-depth, semi-structured interviewswith self-identifiedmultiracial, multiethnic, andmulti-heritage trans people in the USA. Data collection centered participants' experiences of self-identification and interactionswith others (e.g., family, acquaintances, and strangers). Results: As participants transitioned gender and were acknowledged by others in their gender identity, shifts in their embodiment were used by others to ascribe a new racialized gender. This often resulted in participants reflecting on their sense of self and racialized gender identities in new ways. Discussion: Multiracial and multiethnic transgender people's experiences in transitioning race confirm the importance of intersectional analysis, reveal the intersectional fluidity of social categories, explicate how social understandings of one category (e.g., race) influence another category (e.g., gender), demonstrate that the meanings associated with racialized gender are based in relations of power, and show that, in transgender studies particularly, we must attend to the ways that the concept of transition implicates not only gender, but also other categories such as race and nationality. [ABSTRACT FROM AUTHOR]

This paper examines the effort devoted to securing interviews with a very wealthy part of the sample for the 2007 Survey of Consumer Finances (SCF). Only about a quarter of the group completed an interview. At the close of the field period, more than a third of this part of the sample was judged by the field staff to be still workable - that is, those cases were neither complete nor final refusals. The evolution of the field work was driven both by the behavior of respondents and the behavior of the field staff. The paper uses the formal data coded in the call records for each case to describe the work. But that information is inconclusive about the factors that drove the work. However, informal notes in the call records do provide a clear picture of the points of resistance among respondents. Although it was difficult to locate, contact, and convince respondents of the legitimacy and value of the survey, it appears that the ultimate constraint in a large proportion of cases was the length of the interview - potentially several hours for these respondents. Examination of the available auxiliary data provides little evidence of nonresponse bias. [ABSTRACT FROM AUTHOR]

Recent scholarship suggests that the urban design profession is flourishing with many newly created urban design departments, programmes and certificates. Within this context, this paper suggests that urban design education should explore how urban designers can acquire a deeper understanding of the larger socio-economic processes which have an impact on urban form and different groups in the city. More specifically, it posits that urban designers should take notice of the informal urbanism that is burgeoning in many cities of the Global North. For this to happen, urban design pedagogy should prepare future urban designers to better understand and positively intervene in informal urban landscapes, and the urban design studio is an appropriate venue where this can happen. The paper articulates a four-tier framework of responding to informal urbanism through urban design that concentrates on the scope, context, process and practice of urban design. It details a graduate urban design studio that followed this framework to offer spatial solutions and accommodation of street vending in one Los Angeles inner city neighbourhood. [ABSTRACT FROM PUBLISHER]

As of November 2020, the United States leads the world in confirmed coronavirus disease 2019 (COVID-19) cases and deaths. Over the past 10 months, the United States has experienced three peaks in new cases, with the most recent spike in November setting new records. Inaction and the lack of a scientifically informed, unified response have contributed to the sustained spread of COVID-19 in the United States. This paper describes major events and findings from the domestic response to COVID-19 from January to November 2020, including on preventing transmission, COVID-19 testing and contact tracing, ensuring sufficient physical infrastructure and healthcare workforce, paying for services, and governance. We further reflect on the public health response to-date and analyse the link between key policy decisions (e.g. closing, reopening) and COVID-19 cases in three states that are representative of the broader regions that have experienced spikes in cases. Finally, as we approach the winter months and undergo a change in national leadership, we highlight some considerations for the ongoing COVID-19 response and the broader United States healthcare system. These findings describe why the United States has failed to contain COVID-19 effectively to-date and can serve as a reference in the continued response to COVID-19 and future pandemics. [ABSTRACT FROM AUTHOR]

Background: Despite a fast-paced environment, the emergency clinician has a duty to meet the palliative patient's needs. Despite suggested models and interventions, this remains challenging in practice. Aim: To raise awareness of these challenges by exploring the experience of palliative care patients and their families and informal carers attending the emergency department, and of the clinicians caring for them. Design: Qualitative systematic literature review and thematic synthesis. Search terms related to the population (palliative care patients, family carers, clinicians), exposure (the emergency department) and outcome (experience). The search was international but restricted to English and used a qualitative filter. Title, abstracts and, where retrieved, full texts were reviewed independently by two reviewers against predefined inclusion criteria arbitrated by a third reviewer. Studies were appraised for quality but not excluded on that basis. Data sources: MEDLINE [1946-], Embase[1947-], CINAHL [1981-] and PsycINFO [1987-] with a bibliography search. Results: 19 papers of 16 studies were included from Australia (n = 5), the United Kingdom (n = 5), and United States (n = 9) representing 482 clinical staff involved in the emergency department (doctors, nurses, paramedics, social workers, technicians), 61 patients and 36 carers. Nine descriptive themes formed three analytic themes: 'Environment and Purpose', 'Systems of Care and Interdisciplinary Working' and 'Education and Training'. Conclusion: In the included studies, provision of emergency palliative care is a necessary purpose of the emergency department. Failure to recognise this, gain the necessary skills or change to systems better suited to its delivery perpetuates poor implementation of palliative care in this environment. [ABSTRACT FROM AUTHOR]

Abstract: This paper analyzes the effect of a change in the status of housing equity as a protected asset for Medicaid long‐term care payment eligibility. A difference‐in‐difference‐in‐differences strategy is employed to estimate the effect of the policy on the housing equity holdings of potentially treated individuals. Using a panel of unmarried homeowners, the policy induced treated individuals who were likely to require long‐term care to hold less housing equity by values of $82,000 to $193,000 relative to control individuals. This equates to relative reductions of 12 to 29 percent for treated individuals after the policy change. Similar effects are not observed when considering health measures less predictive of long‐term care services and for a sample of married households who were unlikely affected by the policy. These estimates confirm the importance of the housing asset as a shelter for Medicaid eligibility. [ABSTRACT FROM AUTHOR]

Syringe service programs (SSP) increasingly serve rural areas of the United States, yet little is known about access and perceived need for their services. Objectives: This paper presents the HIV and viral hepatitis prevention, testing, and treatment, and, substance use disorder treatment and overdose prevention services offered at three SSPs and which services their clients accessed. Across the three SSPs, 45 clients (people who inject drugs [PWID]), 11 staff, and five stakeholders were interviewed. Results: Most clients (n = 34) reported accessing SSP services weekly and primarily for sterile syringes and injection-related supplies. All clients reported testing for HIV at least once, though concern for acquiring or transmitting HIV was divided between some or no concern. Most clients (n = 43) reported testing for hepatitis C virus (HCV). Concern for acquiring or transmitting HCV was also mixed. Vaccination for hepatitis A and/or B teetered around half (HAV: n = 23) to a third (HBV: n = 15). Most clients (n = 43) knew where to access the overdose countering medication, Narcan. Feelings about substance use treatment options varied, yet most felt not enough were available. Of note, not all assessed services were offered by the sampled SSPs. Conclusions/Importance: The findings help us understand PWIDs' rationale regarding services accessed and preference for particular services. The need for some services was not perceived by those at risk for the illness the services addressed. Discussing risk and providing tailored education is important when providing SSP services to rural residing PWIDs. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to extend the consideration of distributed leadership in health-care settings. Leadership is typically studied from the classical notion of the place of single leaders and continues to examine distributed leadership within small teams or horizontally. The purpose is to develop a practical understanding of how distributed leadership may occur vertically, between different layers of the health-care leadership hierarchy, examining its influence on health-care outcomes across two hospitals. Design/methodology/approach: Using semi-structured interviews, data were collected from 107 hospital employees (including executive leadership, clinical management and clinicians) from two hospitals in Australia and the USA. Using thematic content analysis, an iterative process was adopted characterized by alternating between social identity and distributed leadership literature and empirical themes to answer the question of how the practice of distributed leadership influences performance outcomes in hospitals? Findings: The perceived social identities of leadership groups shaped communication and performance both positively and negatively. In one hospital a moderating structure emerged as a leadership dyad, where leadership was distributed vertically between hospital hierarchal layers, observed to overcome communication limitations. Findings suggest dyad creation is an effective mechanism to overcome hospital hierarchy-based communication issues and ameliorate health-care outcomes. Originality/value: The study demonstrates how current leadership development practices that focus on leadership relational and social competencies can benefit from a structural approach to include leadership dyads that can foster these same competencies. This approach could help develop future hospital leaders and in doing so, improve hospital outcomes. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has impacted routine health care services including immunization delivery. The most common sexually transmitted infection in the United States is the human papillomavirus (HPV), and its sequelae may be prevented by vaccination. Sequelae that can develop if one's immune system is not able to clear the infection include warts, precancerous lesions, and cancer. The American College of Obstetricians & Gynecologists (ACOG) reports almost everyone who is sexually active will encounter the virus at some time during their life. Most of the estimated 79 million infections occur among people who are in their late teens or early 20s. Since 2006, there has been a vaccine available to prevent HPV infections in both males and females; however, administration of this vaccine has only been about half the rate of other vaccines and vaccine hesitancy may play a role. Public health nurses are vital in providing accurate and nonjudgmental vaccine education to their clients, especially unaccompanied minors seeking care in public health department clinics. This paper will explore the recommendations for providing this vaccine as well as a snapshot of current practice in two health departments in the Southeast region of the United States during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

This paper examines the contribution of out-of-town second-house buyers to mispricing in the housing market. We show that demand from out-of-town second-house buyers during the mid 2000s predicted not only house-price appreciation rates but also impliedto- actual-rent-ratio appreciation rates, a proxy for mispricing. We then apply a novel identification strategy to address the issue of reverse causality. We give supporting evidence that out-of-town second-house buyers behaved like misinformed speculators, earning lower capital gains (misinformed) and consuming smaller dividends (speculators). [ABSTRACT FROM AUTHOR]

This study investigates the Rejection-Identification Model (RIM) by examining impacts of group-level and personal experiences with discrimination on different measures of ethnic identity and cultural importance among Hispanic immigrants. The RIM is used to describe associations between discrimination and increased ethnic identity and the mediating role of ethnicity on negative outcomes of discrimination. Growing empirical support for the RIM has prompted inquiry into its application among different populations, including immigrants who face numerous types of discrimination. Using the Latino Immigrant National Election Survey, the study found that the perception of group-level discrimination was associated with a higher likelihood of reporting Hispanic identity importance, however, personal experiences with discrimination were not. Further, results showed that neither type of discrimination impacted cultural or Spanish language maintenance importance. This paper discusses the implications of these findings and how the protective factors presented by the RIM may vary among populations and when considering personal and group-level discrimination. [ABSTRACT FROM AUTHOR]

Purpose: In 2018, the Centers for Disease Control and Prevention (CDC) released an evidence‐based guideline on pediatric mild traumatic brain injury (mTBI) to educate health care providers on best practices of mTBI diagnosis, prognosis, and management/treatment. As residents living in rural areas have higher rates of mTBI, and may have limited access to care, it is particularly important to disseminate the CDC guideline to rural health care providers. The purpose of this paper is to describe rural health care providers' experience with pediatric mTBI patients and their perceptions on incorporating the guideline recommendations into their practice. Method: Interviews with 9 pediatric rural health care providers from all US regions were conducted. Interview transcripts were coded and analyzed for themes for each of the main topic areas covered in the interview guide. Findings: Common causes of mTBI reported by health care providers included sports and all‐terrain vehicles. While health care providers found the guideline recommendations to be helpful and feasible, they reported barriers to implementation, such as lack of access to specialists. To help with uptake of the CDC guideline, they suggested the development of concise implementation tools that can be referenced quickly, integrated into electronic health record‐based systems, and that are customized by visit type and health care setting (eg, initial vs follow‐up visits and emergency department vs primary care visits). Conclusion: Length, accessibility, and usability are important considerations when designing clinical tools for busy rural health care providers caring for pediatric patients with mTBI. Customized information, in both print and digital formats, may help with uptake of best practices. [ABSTRACT FROM AUTHOR]

This paper explores how surrogates negotiate the meaning of familial belonging and family identity when they discuss surrogacy with their husband, children, and other relatives. We suggest that surrogacy necessitates reflexive explication of what a family is and how this family is implicated in surrogacy. Our comparative study analyzes ethnographic data on Israeli and US surrogates to illuminate key similarities in surrogates' strategies vis-a-vis their husband and children, pointing to the importance of daily family practices in how people understand family belonging. First, we map out the ways surrogates engage their husbands in order to gain their support and protect their nuclear family unit before entering the process. Next, we look at how surrogates explain surrogacy to their children in efforts to clarify siblingship and the boundaries between the two families, and to make surrogacy into an educational family project. We analyze the metaphors and rituals in surrogates' family-bounding practices. [ABSTRACT FROM AUTHOR]

Even after two decades of intense research, social scientists are still in disagreement over whether the American public is polarized. Starting from the premise that disagreement is multifaceted, this paper attempts to clarify how and which aspects of ideological disagreement have changed over the past few decades. Three major structural features of ideological disagreement that have been discussed under the umbrella term "polarization" are identified from the literature--polarization, partisan sorting, and dimensional alignment--and redefined into analytically distinct and non-overlapping concepts. Two different scaling methods are applied to the American National Election Studies from 1980 to 2012 in order to examine changes in how citizens organize their attitudes regarding concrete political and social issues (operational ideology) and their self-identifications with the ideological labels "liberal" and "conservative" (symbolic ideology). Results show at best mixed evidence of growing polarization. Partisan sorting has increased over time on both symbolic and operational ideology. However, it is mainly the symbolic side on which disagreement across partisan lines is most pronounced. Finally, contrary to the popular notion of a culture war dividing the United States, the public has become less polarized on moral issues, and the moral dimension of citizens' operational ideology has become dealigned from the economic and civil rights dimension over the past decade. [ABSTRACT FROM AUTHOR]

Purpose: People with mental disorders experience higher rates of disability and mortality disproportionately than the general population. Until recently, psychiatric palliative care (PPC) for people with serious mental illness (SMI) was not explored as a treatment option. This paper aims to explore the feasibility of PPC as a supportive care model for people with serious mental illness. Design/methodology/approach: Fifteen health-care professionals' in the USA and Europe participated in semi-structured phone interviews regarding PPC for people with SMI. The Qualitative Analysis Guide of Leuven (QUAGOL) was used to conduct thematic analysis of the data. Findings: PPC was identified as a supportive care model that could improve quality of life and enhance patient autonomy for people with SMI. While PPC was endorsed as a possible new standard of care, it is imperative that the model be piloted to determine its efficacy as a viable treatment option among adults. Originality/value: There are limited studies that investigate the perceptions of health professionals' regarding the use of PPC as a treatment option for people with SMI. [ABSTRACT FROM AUTHOR]

This paper tests whether effects of individual characteristics on redistributive preferences are constant across ideological subgroups. Using data from the U.S. General Social Surveys, we estimate ordered probit models for a full pooled sample, and liberal, moderate, and conservative subsamples. Wide cleavages in redistributive attitudes between liberals and conservatives, and between Democrats and Republicans are observed. Substantial gaps between Democrats and Republicans persist within ideological subgroups. Attitudinal differences across social classes exist for conservatives and moderates, but not liberals. Among moderates and conservatives, blacks are more likely than whites to support government redistribution. No black-white gap is observed among liberals. Though conservative women are more likely than conservative men to support major government involvement in redistribution, no gender gap emerges for liberals or moderates. Full sample results suggest that education has no discernible impact on redistributive attitudes, but subsample results strongly suggest that a college degree reinforces ideological effects. [ABSTRACT FROM AUTHOR]

Context Few qualitative findings have been published that explore and identify the challenges experienced by independent abortion providers during the COVID‐19 pandemic in the United States (US). In this paper, we explore these themes while expanding the concept of "abortion exceptionalism" beyond its original legal meaning to address the impact of abortion stigma. Methods: Twenty abortion providers from independent abortion clinics throughout the US South and Midwest participated in semi‐structured interviews in June and July 2020. Interviews explored the challenges of providing abortion care in the wake of the COVID‐19 pandemic and sought to identify how clinics strategized and amended their clinical practices to continue providing abortion care during this time. Results: All providers we spoke to noted significant challenges to providing abortion care in the early days of COVID‐19. In addition to experiencing the same concerns as other health care institutions, abortion clinics also faced additional, unique burdens that can only be attributed to the politics of abortion exceptionalism. Examples of this abortion exceptionalism include abrupt orders to close clinics, the need to rely on traveling physicians, legislature‐imposed limits on telemedicine, heightened activities of protesters, and non‐evidence‐based regulation of medication abortion. Conclusion: Despite major challenges and differential treatment, independent abortion clinics in the US persevered to continue to provide abortion care throughout the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

INTRODUCTION E-cigarette use among youth and young adults remains of public health concern. Pod-based e-cigarettes, including JUUL, significantly changed the e-cigarette landscape in the US. Using an online survey, we explored the socio-behavioral correlates, predisposing factors, and addictive behaviors, among young adult pod-mod users within a University in Maryland, USA. METHODS In total, 112 eligible college students aged 18--24 years, recruited from a University in Maryland, who reported using pod-mods were included in this study. Participants were categorized into current/non-current users based on past- 30-day use. Descriptive statistics were used to analyze participants' responses. RESULTS The mean age of the survey participants was 20.5 ± 1.2 years, 56.3% were female, 48.2% White, and 40.2% reported past-30-day (current) use of pod-mods. The mean age of first experimentation with pod-mods was 17.8 ± 1.4 years, while the mean age of regular use was 18.5 ± 1.4 years, with the majority (67.9%) citing social influence as the reason for initiation. Of the current users, 62.2% owned their own devices, and 82.2% predominantly used JUUL and menthol flavor (37.8%). A significant proportion of current users (73.3%) reported buying pods in person, 45.5% of whom were aged <21 years. Among all participants, 67% had had a past serious quit attempt. Among them, 89.3% neither used nicotine replacement therapy nor prescription medications. Finally, current use (adjusted odds ratio, AOR=4.52; 95% CI: 1.76--11.64), JUUL use (AOR=2.56; 95% CI: 1.08-6.03), and menthol flavor (AOR=6.52; 95% CI: 1.38-30.89) were associated with reduced nicotine autonomy, a measure of addiction. CONCLUSIONS Our findings provide specific data to inform the development of public health interventions targeted at college youth, including the need for more robust cessation support for pod-mod users. [ABSTRACT FROM AUTHOR]

The psychological bases of the selection and attitudinal response to news media have received ample attention in political communication research. However, the interplay between three crucial factors in today's online, high-choice news media settings remains understudied: (1) textual versus multimodal (text-plus-visual) communication; (2) attitude congruent versus attitude incongruent versus balanced content; and (3) political versus nonpolitical genres. Relying on an experimental study of refugee and gun control news in the United States (N = 1,159), this paper investigates how people select and avoid, and also the extent to which they agree with, congenial, uncongenial, and balanced political news in a realistic multimodal selective-exposure setting in which political news is presented alongside sports and entertainment news. Although the findings partially depend on the issue, we find that the presence of multimodal (compared to textual) entertainment and sport items can increase avoidance of political news. Multimodal (compared to textual) political news augments attitude congruent selective exposure instead of encouraging cross-cutting selective exposure. Once selected, multimodal political news articles evoke stronger emotions and lead to higher issue agreement than textual news, regardless of an article's attitude congruence. By linking research on text-alone to multimodal selective exposure, this study shows that visuals in high-choice media environments can contribute to the selective avoidance of political news generally and cross-cutting political news more specifically. [ABSTRACT FROM AUTHOR]

This paper evaluates American-Muslims' perceptions of the police. With regard to studies of the police and Muslim communities, much of the focus has centered on evaluating police officers' perceptions of the Muslim community. Attitudes toward the police reflect an important measure of police legitimacy for minority communities. The current study analyzes responses from a convenience sample (N = 142) collected from around the United States. Our t test analysis of first-and-second generation American Muslims found no significant differences between attitudes toward the police. However, our OLS Regression models suggest that education, fear of negative treatment due to race, ethnicity, or religion, fear of victimization, negative media portrayal, and neighborhood factors significantly affected perceptions of the police. [ABSTRACT FROM AUTHOR]

White, politically conservative males in the United States have been widely found to maintain petro‐masculine attitudes that include aspects of racism, misogyny, and climate change denial. These beliefs and their associated behaviors, including climate destructiveness, can be conceptualized as compensatory reactions to modern‐day racial, gender, and climate‐related anxieties that are experienced as threats to traditional white male privilege and power. They then manifest as and energize authoritarian desires and their associated sociopolitical movements, including the current Republican effort to Make American Great Again. This paper utilizes psychoanalytic concepts concerning individual and large‐group identity, group psychodynamics and processes, and the intergenerational transmission of idealized myth and fantasy to further elucidate and expand upon these complex phenomena. It then suggests specific strategies for disentangling the strong links between white hegemonic masculinity, fossil fuel use, and climate change denial, thus opening doors to alternative, non climate‐destructive yet still empowering notions of individual, large‐group, and national identity that are, instead, based in communal concern and climate care. [ABSTRACT FROM AUTHOR]