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Background: The United States is increasingly recognizing period product insecurity, insufficient access to menstrual products and limited private spaces for managing menstruation due to financial constraints, as an issue impacting the well-being and dignity of Americans. One strategy to address period product insecurity has been distributing free period products via period supply banks. The outcomes of period product distribution outside the school setting are absent from the literature. Objectives: This study, a formative evaluation of the free period product distribution efforts of the Alliance for Period Supplies, aims to identify (1) characteristics of individuals receiving products from period supply banks and their experiences of period product insecurity and (2) health and social outcomes experienced by recipients of free period products. Design: Survey data collection occurred at two points: baseline and one-year follow-up. All study participants provided verbal consent. Methods: Between Fall 2018 and Spring 2020, 1863 baseline and 80 follow-up surveys were administered. Participants received free period products for themselves and/or a household member from one of 20 participating Alliance for Period Supplies period supply banks directly or from one of their 64 partner agencies. Results: At baseline, 72.4% of participants had to choose between buying period products and another basic need. One year after accessing a period supply bank, 36.3% of participants reported this experience (p = 0.018). Participants reported at baseline, on average, 7.8 days in the past year of avoiding seeing others, canceling appointments, or skipping work or school because they did not have access to period products. At follow-up, this was reduced to 1.2 days, on average, t (68) = 2.214, p < 0.05. Conclusion: Period supply banks play an essential role in facilitating access to period products and the resulting benefits. Our study highlights the need for sustainable, well-funded policies and interventions to address period product insecurity effectively in society. Plain Language Summary: How people in the United States benefit when they get free period products from a period supply bank Why we did this study: In the United States, many individuals cannot afford to buy period supplies and the other stuff they need to live. Period supply banks want to help by giving them free period products. Researchers do not know if getting free period products is helpful for individuals. What we wanted to learn: The Alliance for Period Supplies is a membership program for period supply banks. We wanted to learn about the individuals who get free period products and whether getting them was helpful. What we did: For a year, starting in Fall 2018, we asked 1863 individuals to fill out paper surveys. A year later, we asked 80 of those same individuals to fill out a second survey. We asked participants to take the survey if they got free period products from a period supply bank for themselves or someone they live with. Individuals only participated in the study if they told us they wanted to. What we learned: Individuals who cannot afford period products must navigate difficult decisions between purchasing products or choosing other basic needs. Providing free products through a period supply bank has lessened the burden on these individuals, reducing the number who had to choose. Individuals unable to afford period products may sometimes opt out of going places they want to go for pleasure or miss important events, like work or school, because they do not have period products. Getting free period products has eased these challenges, letting individuals participate more fully in activities and engagements without worry about period products. Why is this important: Period supply banks are essential places where individuals receive free period products. The period supply banks need more individuals, including our government, to donate period supplies or money to buy them so they can help more individuals. [ABSTRACT FROM AUTHOR]

Background: Revision rates and outcome measures after anterior cruciate ligament reconstruction (ACLR) with suture tape as an internal brace is not well-documented because of the emerging nature of the technique. Hypothesis: ACLR with internal bracing (IB) would lead to decreased revision ACLR compared with traditional ACLR while exhibiting comparable patient outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 200 patients were included in this study. Patients aged between 13 and 39 years at the time of surgery who underwent primary autograft ACLR with IB between 2010 and 2020 and were enrolled in our institution's registry with a minimum of 2-year follow-up were identified and matched 1 to 1 with a non-internal brace (no-IB) group based on concomitant procedures and patient characteristics. Pre- and postoperatively, patients completed the Knee injury and Osteoarthritis Outcome Score, Marx activity rating scale, Veterans RAND 12-Item Health Survey, and visual analog scale for pain. Knee laxity measurements via the KT-1000 arthrometer were included in the pre- and postoperative objective clinical assessments. Results: A total of 100 IB patients were matched with 100 no-IB patients based primarily on concomitant procedures and secondarily on patient characteristics. The IB group underwent significantly fewer revision ACLRs (1% vs 8%; P =.017). Even though the no-IB group had a significantly longer mean final follow-up time (48.6 months [95% CI, 45.4-51.7] vs 33.4 months [95% CI, 30.3-36.5]; P <.001), the time elapsed from the original ACLR to the revision did not differ significantly between groups, and the mean ages for the IB and no-IB groups were comparable (19 vs 19.9 years). All postoperative patient-reported outcome scores between the 2 groups were comparable and significantly improved postoperatively except for the Marx score, which significantly decreased stepwise for both groups postoperatively. KT-1000 measurements significantly improved in both groups after surgery with the IB and no-IB cohorts yielding comparable results at the manual maximum pull (0.97 vs 0.65 mm). Conclusion: ACLR with IB resulted in a significantly decreased risk of revision ACLRs while maintaining comparable patient-reported outcomes. Therefore, incorporating an internal brace into ACLR appears to be safe and effective within these study parameters. [ABSTRACT FROM AUTHOR]

To mitigate COVID-19 exposure risks in methadone clinics, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a temporary modification of regulations in March 2020 to permit, with state concurrence, extended take-home methadone doses. The modification allowed for up to 28 days of take-home methadone for stable patients and 14 days for those less stable. Using both interrupted time series and difference-in-differences methods, this study examined the association between the policy change and fatal methadone overdoses, comparing states that permitted the expansion of take-home doses with states that did not. The findings suggest the pandemic emergency take-home policy did not increase methadone-involved mortality. [ABSTRACT FROM AUTHOR]

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end. [ABSTRACT FROM AUTHOR]

Preparing patients for posthospital care may improve readmission risk. Alternative payment models (APMs) incent hospitals to reduce readmissions by tying payment to outcomes. The impact of APMs on preparation for discharge is not well understood. We assessed whether patient-reported preparation for posthospital care was associated with reduced readmissions, and whether APM participation was associated with improved preparation for posthospital care. We used mixed-effects regression on retrospective (2013–2017) observational data for 2685 U.S. hospitals. We measured patient-reported preparation for posthospital care using the 3-Item Care Transition Measure and readmission using 30-day all-cause risk-adjusted readmissions from Hospital Compare. Participation in accountable care organizations (ACOs), Medical Homes, and Medicare's Bundled Payments for Care Improvement program was obtained from Medicare, the American Hospital Association's Annual Survey, and Leavitt Partner's ACO database. We found that APMs are not associated with improved preparation for posthospital care, even though it was associated with reduced readmissions (Marginal Effect: −0.012 percentage points). This may be because hospitals are not investing in patient engagement. This study has limited insight into causality and reduced generalizability among smaller, rural, and non-teaching hospitals. [ABSTRACT FROM AUTHOR]

Introduction: Missed visits have been estimated to cost the U.S. healthcare system $50 billion annually and have been linked to healthcare inefficiency, higher rates of emergency department visits, and worse outcomes. COVID-19 disrupted existing outpatient healthcare utilization patterns. In our study, we sought to examine the frequency of missed outpatient visits over the course of the COVID-19 pandemic and to examine patient-level characteristics associated with non-attendance. Methods: This study utilized data from a longitudinal cohort study (the Chicago COVID-19 Comorbidities (C3) study). C3 participants were enrollees in 1 of 4 active, "parent" studies; they were rapidly enrolled in C3 at the onset of the pandemic. Multiple waves of telephone-based interviews were conducted to collect experiences with the pandemic, as well as socio-demographic and health characteristics, health literacy, patient activation, and depressive and anxiety symptoms. For the current analysis, data from waves 3 to 8 (05/01/20-05/19/22) were analyzed. Participants included 845 English or Spanish-speaking adults with 1 or more chronic conditions. Results: The percentage of participants reporting missed visits due to COVID-19 across study waves ranged from 3.1 to 22.4%. Overall, there was a decline in missed visits over time. No participant sociodemographic or health characteristic was consistently associated with missed visits across the study waves. In bivariate and multivariate analysis, only patient-reported anxiety was significantly associated with missed visits across all study waves. Conclusion: Findings reveal that anxiety was consistently associated with missed visits during the COVID-19 pandemic, but not sociodemographic or health characteristics. Results can inform future public health initiatives to reduce absenteeism by considering patients' emotional state during times of uncertainty. [ABSTRACT FROM AUTHOR]

Given the rapid aging of the U.S. population and reductions in federal funding, elder care has become a major issue for many families. This paper focuses on a long-term consequence of elder care by asking how caring for elderly parents affects women's subsequent risks of living in poverty. Using longitudinal data from the Health and Retirement Study, we examine whether and how caregiving for parents in 1991 increases women's risks of living in households with incomes less than the poverty threshold, receiving public assistance, and receiving Medicaid in 1999. Our findings illustrate that caregiving in earlier life raises women's poverty risks in later life by intensifying the negative effects of stopping work and declining health on women's economic well-being. [ABSTRACT FROM AUTHOR]

This paper examines how multiple roles affect the mental health of the elderly in Japan and the United States, two countries with vastly different cultures. Hypotheses were drawn based on the cultural differences in role experiences, and these hypotheses are tested by analyzing nationally representative samples of the elderly in these countries. The results show that Americans are more likely to be involved in roles related to family, work, and community, while the Japanese are more likely to be involved in only those roles related to family and work. Multiple roles are also found to be less beneficialfor the mental health of Japanese elderly compared to American counterparts. National differences in the effects of individual roles and role configurations on mental health are also documented. Overall, the results show the importance of broad cultural contexts for understanding the relationship between roles and mental health. [ABSTRACT FROM AUTHOR]

Background: Acupuncture and yoga have both been shown to be effective in chronic pain. Underrepresented populations have poorer pain outcomes with less access to effective pain care. Objective: To assess the feasibility of bundling group acupuncture with yoga therapy for chronic neck, back or osteoarthritis pain in safety net settings. Methods: This was a feasibility pilot in Bronx and Harlem primary care community health centers. Participants with chronic neck, back or osteoarthritis pain received acupuncture and yoga therapy over a 10-week period. Participants received 10 weekly acupuncture treatments in group setting; with Yoga therapy sessions beginning immediately following the 3rd session. Primary outcome was pain interference and pain intensity on the Brief Pain Inventory (BPI); Outcomes were measured at baseline, 10-week close of intervention, and 24-week follow-up. Results: 93 patients were determined to be eligible and completed the baseline interview. The majority of participants were non-White and Medicaid recipients. 78 (84%) completed the intervention and 10-week survey, and 58 (62%) completed the 24-week post intervention survey. Participants received an average number of 6.5 acupuncture sessions (out of a possible 10), and 4 yoga sessions (out of a possible 8) over the 10-week intervention. Patients showed statistically significant improvements in pain at the close of the intervention and at a somewhat lesser rate, at 24-weeks post intervention. Challenges included telephone outreach and site coordination integrating acupuncture with yoga therapy. The trial also had to be stopped early due to the COVID-19 pandemic. Conclusions: Bundling acupuncture therapy and yoga therapy is feasible for an underrepresented population with chronic pain in urban community health centers with preliminary indications of acceptability and benefit to participants. [ABSTRACT FROM AUTHOR]

Lifestyle Medicine (LM) is an emerging field dedicated to the prevention, management, and reversal of chronic diseases by promoting healthy lifestyle choices. LM utilizes six pillars targeting the root causes of diseases to promote health, improve clinical outcomes and significantly enhance overall quality of life. They include plant-based nutrition, physical activity, sleep health, tobacco cessation/managing risky alcohol use, and spiritual/emotional well-being. LM holds great promise as an evidence-based solution for the rising rates of chronic diseases and healthcare costs in the United States. Loma Linda University Health (LLUH), a pioneer of LM, has successfully implemented a phased expansion of its novel LM inpatient consultation services to positively impact the trajectory of morbidity and mortality among patients with chronic conditions and/risk factors admitted to the hospital. This was achieved by boosting awareness, hiring LM-trained providers to meet growing demand, and making consultations accessible hospital-wide. The service has been very well received and saw a 50-fold increase in consultations between 2016 and 2022. It is also reimbursed by all major insurers. LLUH's experience shows that establishing and growing an inpatient LM consultation service is a viable clinical and cost-effective chronic care model that can be utilized in a tertiary care setting. [ABSTRACT FROM AUTHOR]

Background: Stress during pregnancy can lead to significant adverse outcomes for maternal mental health. Early evaluation of prenatal stress can help identify treatment needs and appropriate interventions. Disparities in the social determinants of health can contribute to stress, but what constitutes stress during pregnancy within the social determinants of health framework is poorly understood. Objective: To scope how prenatal stress is defined and measured among pregnant people exposed to three prominent social stressors in the United States: insecurity pertaining to food, housing, and immigration. Eligibility Criteria: We included all studies that focused on stress during pregnancy in the context of food insecurity, housing instability, and immigration, given their recent policy focus due to the COVID-19 pandemic and ongoing political discourse, in addition to their importance in American College of Obstetricians and Gynecologists (ACOG's) social determinants of health screening tool. Sources of Evidence: We searched PubMed, Scopus, and Web of Science for articles published between January 2012 and January 2022. Charting Methods: Using a piloted charting tool, we extracted relevant study information from the selected articles and analyzed the content pertaining to stress. Results: An initial search identified 1,023 articles, of which 24 met our inclusion criteria. None of the studies defined prenatal stress, and only one used the Prenatal Distress Questionnaire, a prenatal stress-specific tool to measure it. The Perceived Stress Scale was the most common instrument used in seven studies. Fifteen studies measured over 25 alternative exposures that researchers theorized were associated with stress, and 4 of the 15 studies did not explain the association between the measure and stress. Conclusions: Our findings demonstrate a fundamental inconsistency in how prenatal stress is defined and measured in the context of social determinants of health, limiting the comparison of results across studies and the potential development of effective interventions to promote better maternal mental health. [ABSTRACT FROM AUTHOR]

Introduction: Given the significant rise in methamphetamine use and related mortality in the United States, it is critical to explore differences in treatment trends with particular attention to women and ethnoracial groups in hard-hit areas like Los Angeles County. Methods: We analyzed a large sample across 4 waves: 2011 (105 programs, 10 895 clients), 2013 (104 programs, 17 865 clients), 2015 (96 programs, 16 584 clients), and 2017 (82 programs, 15 388 clients). We completed a comparative analysis to identify differences across subgroups and a trend analysis of treatment episodes by gender and ethnoracial group to differentiate users of methamphetamine and users of other drugs. Results: Treatment clients using methamphetamine increased over time for each gender and race. There were also significant differences across age groups. Women comprised a greater proportion of treatment episodes involving methamphetamine use (43.3%) compared to all other drugs combined (33.6%). Latinas represented 45.5% of methadone-related admissions. Compared with other drug users, methamphetamine users had a lower successful treatment completion rate and were served by programs with less financial and culturally responsive capacity. Conclusions: Findings highlight a sharp increase in treatment admissions for methamphetamine users of all gender and ethnocultural groups. Women, especially Latinas, saw the most significant increases, with a widening gender gap over time. All subgroups of methamphetamine users had a lower treatment completion rate compared with users of other drugs, and critical differences existed in the programs where they received services. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggest that the funding breakdown of autism research in the United States may not align with stakeholder priorities. Furthermore, the majority of stakeholder-engaged research involves parents of autistic individuals rather than autistic adults themselves, who may have differing perspectives on research and funding priorities. Women and non-binary adults have been historically underrepresented in autism research. Objectives: The goal of the current study was to examine the autism research priorities of a group of autistic adults, with a particular focus on how these priorities are influenced by one's gender identity. Design: A concurrent mixed-methods design was used for this study. Methods: Seventy-one autistic adults (n = 18 men, n = 29 women, n = 24 non-binary adults) completed an online survey regarding the current funding landscape for autism research. Participants ranked the main research topics of the Interagency Autism Coordinating Committee (IACC) and identified top-priority research areas through free-text responses. Response themes were analyzed using content analysis and compared with the existing topic rankings. Results: Overall rankings of IACC research areas had a near inverse relationship with the amount of funding per research area. Main themes of stakeholder-generated research topics included "Characterization," "Societal Change," "Well-Being & Trauma," "Diagnosis & Healthcare," and "Accessibility & Services." There was a relatively high overlap between topics identified by the IACC and by the stakeholder-generated topics. Subtle but important differences in topics arose based on gender, with women and non-binary adults identifying topics that were not identified by autistic men. Conclusion: Unique priorities generated by those typically excluded from autism research development underscore the importance of co-creating research with underrepresented stakeholders impacted by this work. The current study echoes the growing movement in the field of autism research to center autistic perspectives at every stage of research, including the establishment of funding priorities. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) is the leading cause of death for males, females, and people of most racial and ethnic groups in the United States. In addition to known epidemiological and behavioral risk factors, recent evidence suggests that circumstantial or behavioral factors may also be associated with CVD. This study evaluates the contribution of cardiovascular disease (CVD) risk factors, community vulnerabilities, and individual health behaviors to individual physical and mental wellness among Black and White, male, and female Medicare beneficiaries. Methods: This study utilized data from the Behavioral Risk Factor Surveillance System, county-level CVD risk factor prevalence, and selected items from the Social Vulnerability Index. Results: Correlations were found between unhealthy days reported by males and area social vulnerabilities and health behaviors. Prevalence of disease was correlated with mentally unhealthy days for White males. Among White females, health behaviors, disease prevalence, and social vulnerability measures were associated with unhealthy days. Among Black females, disease prevalence was highly correlated with mentally unhealthy days. Discussion: While individual-level health behaviors are highly associated with perceived physical and mental health, the self-reported health of Black respondents is also heavily correlated with local area vulnerabilities, including community poverty, group housing, and crowding. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has been associated with increased social and economic stressors among pregnant individuals. While community and social services have been available to mitigate stressors in pregnancy (e.g. food insecurity and financial hardship) and reduce the risk of adverse maternal outcomes, it is unclear how the pandemic impacted access to these resources, particularly in communities of color with lower incomes. Objective: To examine the experiences accessing community and social service resources during the COVID-19 pandemic among pregnant people of color with low incomes. Design: Participants for this COVID-related qualitative study were recruited from two sources—a prospective comparative effectiveness study of two models of enhanced prenatal care and the California Black Infant Health Program between August and November of 2020. Methods: We conducted 62 interviews with Medicaid-eligible participants in California's Central Valley. During their interviews, study participants were asked to share their pregnancy-related experiences, including how they felt the pandemic had affected those experiences. Results: We identified two broad themes: challenges with accessing community and social service resources during the pandemic and opportunities for improving access to these resources. Sub-themes related to challenges experienced included difficulty with remote access, convoluted enrollment processes for community and social services, and problems specific to accessing COVID-19 resources (e.g. testing). Sub-themes related to opportunities to improve access included leveraging instrumental support from perinatal staff and informational (e.g. practical) support from other community programs and pregnant peers. Participant recommendations included leveraging opportunities to improve client experiences through increased transparency and better patient–provider communication. Conclusion: This study highlights some important trends that emerged with the rollout of remote service delivery for social services among a vulnerable population. Many participants were able to leverage support through other programs and perinatal staff. These individuals identified additional opportunities to improve client experiences that can inform the future implementation of support services for pregnant people. [ABSTRACT FROM AUTHOR]

BACKGROUND: Research focusing on predictors for discharge destination after rehabilitation of inpatients recovering from severe stroke is scarce. The predictive value of rehabilitation admission NIHSS score among other potential predictors available on admission to rehabilitation has not been studied. AIm: The aim of this retrospective interventional study was to determine the predictive accuracy of 24 hours and rehabilitation admission NIHSS scores among other potential socio-demographic, clinical and functional predictors for discharge destination routinely collected on admission to rehabilitation. MATERIAL AND METHODS: On a university hospital specialized inpatient rehabilitation ward 156 consecutive rehabilitants with 24 hours NIHSS score >15 were recruited. On admission to rehabilitation, routinely collected variables potentially associated with discharge destination (community vs institution) were analyzed using logistic regression. RESULTS: 70 (44.9%) of rehabilitants were discharged to community, and 86 (55.1%) were discharged to institutional care. Those discharged home were younger and more often still working, had less often dysphagia/tube feeding or DNR decision in the acute phase, shorter time from stroke onset to rehabilitation admission, less severe impairment (NIHSS score, paresis, neglect) and disability (FIM score, ambulatory ability) on admission, and faster and more significant functional improvement during the in-stay than those institutionalized. CONCLUSION: The most influential independent predictors for community discharge on admission to rehabilitation were lower admission NIHSS score, ambulatory ability and younger age, NIHSS being the most powerful. The odds of being discharged to community decreased with 16.1% for every 1 point increase in NIHSS. The 3-factor model explained 65.7% of community discharge and 81.9% of institutional discharge, the overall predictive accuracy being 74.7%. The corresponding figures for admission NIHSS alone were 58.6%, 70.9% and 65.4%. [ABSTRACT FROM AUTHOR]

BACKGROUND: COVID-19 placed a significant burden on the global healthcare system. Strain in critical care capacity has been associated with increased COVID-19-related ICU mortality. This study evaluates the impact of an early warning system and response team implemented on medical floors to safely triage and care for critically ill patients on the floor and preserve ICU capacity. METHODS: We conducted a multicenter, retrospective cohort study, comparing outcomes between intervention and control hospitals within a US eight-hospital urban network. Patients hospitalized with COVID-19 pneumonia between April 13th, 2020 and June 19th, 2020 were included in the study, which was a time of a regional surge of COVID-19 admissions. An automated, electronic early warning protocol to identify patients with moderate-severe hypoxemia on the medical floors and implement early interventions was implemented at one of the eight hospitals ("the intervention hospital"). RESULTS: Among 1024 patients, 403 (39%) were admitted to the intervention hospital and 621 (61%) were admitted to one of the control hospitals. Adjusted for potential confounders, patients at the intervention hospital were less likely to be admitted to the ICU (HR = 0.73, 95% CI 0.53, 1.000, P =.0499) compared to the control hospitals. Patients admitted from the floors to the ICU at the intervention hospital had shorter ICU stay (HR for ICU discharge: 1.74; 95% CI 1.21, 2.51, P =.003). There was no significant difference between intervention and control hospitals in need for mechanical ventilation (OR = 0.93; 95% CI 0.38, 2.31; P =.88) or hospital mortality (OR = 0.79; 95% CI 0.52, 1.18; P =.25). CONCLUSION: A protocol to conserve ICU beds by implementing an early warning system with a dedicated response team to manage respiratory distress on the floors reduced ICU admission and was not associated with worse outcomes compared to hospitals that managed similar levels of respiratory distress in the ICU. [ABSTRACT FROM AUTHOR]

Introduction: Good preconception and interconception health are fundamental to optimizing women's health and reducing risk factors for adverse maternal–infant outcomes. Although rural women in the United States tend to experience health disparities, no published qualitative studies have focused on their preconception/interconception health. The purpose of this study was to determine what rural, Midwestern women perceive to be their most pressing health needs and effective ways to provide outreach and education regarding preconception/interconception health and care. Methods: Non-pregnant, reproductive-age women in Hardin County, Ohio, regardless of parity, were recruited through convenience sampling. Semi-structured interviews with four domains (beliefs and behaviors; perceived needs; knowledge and information sources; barriers to care) were conducted in May–June 2021 until saturation was reached. Qualitative methods were used to analyze data and determine themes. Binomial tests were used to compare selected demographic characteristics of participants to the county's reproductive-age residential female population. Results: Nineteen women aged 20–44 years were individually interviewed. Comparing race/ethnicity, education, and insurance status, participants appeared to be representative of the county population. Four themes were identified: (1) needs regarding healthcare and other resources; (2) lack of preconception/interconception care and perceived unimportance due to intergenerational knowledge transfer and paucity of healthcare providers; (3) difference in understanding of the term "women's health" and low health literacy; and (4) suggested interventions including education and outreach. Conclusion: Interviews with rural Midwestern women revealed needs regarding preconception/interconception health and care and potential ways to raise awareness. These findings can inform strategies to improve rural women's health and birth outcomes. [ABSTRACT FROM AUTHOR]

Background: The wide range of clinical applications and controversial scientific evidence associated with platelet-rich plasma (PRP) therapy in musculoskeletal medicine requires an examination of the most commonly cited studies within this field. Purpose: To identify the 50 most cited articles on PRP, assess their study design, and determine any correlations between the number of citations and level of evidence (LoE) or methodological quality. Study Design: Cross-sectional study. Methods: The Web of Science database was queried to identify the top 50 most cited articles on PRP in orthopaedic surgery. Bibliometric characteristics, number of citations, and LoE were recorded. Methodological quality was evaluated using the Modified Coleman Methodology Score (MCMS), Methodological Index for Non-randomized Studies (MINORS), and Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO). The Pearson correlation coefficient and Spearman correlation coefficient (r S) were used to determine the degree of correlation between the number of citations or citation density and LoE, MCMS, MINORS score, and MIBO score. Student t tests were performed for 2-group comparisons. Results: The top 50 articles were published between 2005 and 2016 in 21 journals. The mean number of citations and citation density were 241 ± 94 (range, 151-625) and 23 ± 8, respectively, and the mean LoE was 2.44 ± 1.67, with 15 studies classified as LoE 1. The mean MCMS, MINORS score, and MIBO score were 66.9 ± 12.6, 16 ± 4.7, and 12.4 ± 3.7, respectively. No correlation was observed between the number of citations or citation density and LoE, MCMS, MINORS score, and MIBO score. A significant difference (P =.02) was noted in LoE in articles from the United States (3.56 ± 1.7) versus outside the United States (2 ± 1.5). Seven of the 8 in vivo studies were published between 2005 and 2010, whereas 19 of the 25 clinical outcome investigations were published between 2011 and 2016. Studies that were published more recently were found to significantly correlate with number of citations (r S = –0.38; P =.01), citation density (r S = 0.36; P =.01), and higher LoE (r S = 0.47; P =.01). Conclusion: The top 50 most cited articles on PRP consisted of high LoE and fair methodological quality. There was a temporal shift in research from in vivo animal studies toward investigations focused on clinical outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Levels of knowledge about the sexual transmission of Zika virus are consistently low in populations at risk of a mosquito-borne outbreak, including among women of childbearing age and women who are pregnant or intend to become pregnant. We investigated the effectiveness of sources of public health messaging about sexual transmission to women who are pregnant or intend to become pregnant in Arizona. Methods: In 2017, we conducted an Arizona-statewide survey 15 months after the initial release of US guidelines on sexual transmission of Zika virus. We used Poisson regression, adjusting for demographic factors, to estimate the likelihood among women who were pregnant or intended to become pregnant of knowing that Zika virus is sexually transmitted relative to other women of childbearing age. We used multinomial logistic regression models to explore associations with most used health information sources, either in person (eg, medical providers) or online (eg, Facebook), categorized by extent of dependability. Results: Women who were pregnant or intended to become pregnant had similarly poor knowledge of the sexual transmission of Zika virus as compared with other women of childbearing age (adjusted prevalence ratio = 1.14 [95% CI, 0.83-1.55]). Only about one-third of all respondents reported knowledge of sexual transmission. Reliance on high- vs low-dependability information sources, whether in person or online, did not predict the extent of Zika virus knowledge among women who were pregnant or intended to become pregnant. Conclusion: As late as the second year of local Zika virus transmission in the United States, in 2017, women in Arizona were not receiving sufficient information about sexual transmission, even though it was available. To prepare for possible future outbreaks, research should explore which aspects of Zika information campaigns were ineffective or inefficient. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic highlighted plasma as a strategic resource with continually increasing demand. Demographic data for plasma donors are limited compared with blood donors. Increased information regarding pre-pandemic donor demographics may serve as a baseline for evaluation of post-pandemic practices. OBJECTIVES: This study asked the question, "What were the demographics of source plasma donors in the US compared to the general population and how did these change over a five-year period preceding the pandemic?" STUDY DESIGN: Donor demographic data were retrospectively analyzed for the years 2014, 2016 and 2018 from a network of US plasma centers. METHODS: Routine demographic data obtained prior to source plasma collection from all plasma donors at Grifols US centers were retrospectively analyzed. Donor screening and eligibility requirements were standardized across all donor sites and met all donor eligibility requirements (Code of Federal Regulations: 21 CFR part 600). During each calendar year, only data from the first donation in that year were included with each cohort year. RESULTS: This study included 1,303,049 unique donors. Donors were predominantly young adult males, although females increased from 37.4% to 41.6%. Caucasians constituted the highest proportion, followed by African American and Hispanic donors. Demographics were generally stable, but the 2018 cohort and the US population exhibited significantly different age, race/ethnicity, and sex profiles. Of 2014 donors, 9.0% returned in all three years studied (2014-2016-2018), with a higher return rate of 16.0% observed for donors returning in just two of the years (2014-2016). Multiyear donors were predominantly male and African American. CONCLUSION: US plasma donor demographics over a five-year period (2014-2018) showed generally consistent characteristics but differed from the general US population. Multiyear donors were demographically distinct from single-year donors. These data serve as a snapshot of the US source plasma donor base prior to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Using representative national surveys, this paper compares economic outcomes among Latin American migrants to Spain and the United States in the first cross-national comparison using quantitative data. Considering the geographic location and social proximity of each country with respect to Latin America, we detect a critical selection effect whereby the majority of Latin American migrants to Spain originate in South America from middle class backgrounds, whereas most migrants to the United States are Central Americans of lower class origins. This selection effect accounts for cross-national differences in the probability of employment, occupational attainment, and wages earned. Despite differences in the origins and characteristics of Latino immigrants to each country, demographic and human and social capital factors appear to operate similarly in both places; and when models are estimated separately by legal status, we find that effects are more accentuated for undocumented compared with documented migrants, especially in the United States. [ABSTRACT FROM AUTHOR]

An EMR system implementation would significantly reduce clinician workload and medical errors while saving the US healthcare system major expense. Yet, compared to other developed nations, the US lags behind. This article examines EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for implementation of EMR, industry comparisons to highlight the differences between successful and non-successful EMR ventures, references to costs and benefit information, and identification of root causes. ‘Poka-yokes’ (avoid (yokeru) mistakes (poka)) will be inserted to provide insight into how to systematically overcome challenges. Implementation will require upfront costs including patient privacy that must be addressed early in the development process. Government structure, incentives and mandates are required for nationwide EMR system in the US. [ABSTRACT FROM PUBLISHER]

This paper develops a framework for estimating previous illegal experience among annual cohorts of new legal immigrants to the United States – using public-use administrative microdata alone, survey data alone, and the two jointly – and provides estimates for the FY 1996 cohort of new immigrants, based on both administrative and survey data. Our procedures enable assessment of type of illegal experience, including entry without inspection, visa overstay, and unauthorized employment. We compare our estimates of previous illegal experience to estimates that would be obtained using administrative data alone; examine the extent of previous illegal experience by country of birth, immigrant class of admission, religion, and geographic residence in the United States; and estimate multivariate models of the probability of having previous illegal experience. To further assess origins and destinations, we carry out two kinds of contrasts, comparing formerly illegal new legal immigrants both to fellow immigrants who do not have previous illegal experience and also to the broader unauthorized population, the latter using estimates developed by the U.S. Department of Homeland Security (2002 ), Passel (2002 ), and Costanzo et al. (2002 ). [ABSTRACT FROM AUTHOR]

Objective: We provide a review and analysis of much of the published literature on binocular rivalry that is relevant to the design and use of head-worn displays (HWDs).Background: This review draws heavily from both the basic vision literature and applied HWD literature in order to help provide insight for minimizing the effects of binocular rivalry when HWDs are worn.Method: Included in this review are articles and books found cited in other works as well as articles and books obtained from an Internet search.Results: Issues discussed and summarized are (a) characteristics of binocular rivalry, (b) stimulus factors affecting rivalry, (c) cognitive variables affecting rivalry, and (d) tasks affected by rivalry.Conclusion: This paper offers a set of recommendations for minimizing the effects of binocular rivalry when HWDs are used as well as recommendations for future research.Application: Considerations of the basic vision literature on binocular rivalry will provide insight for future design solutions for HWDs. [ABSTRACT FROM AUTHOR]

Objective: Two experiments were conducted to examine the effects of vision and masking friction on contact perception and compliance differentiation thresholds in a simulated tissue-probing task.Background: In minimally invasive surgery, the surgeon receives limited haptic feedback because of the current design of the instrumentation and relies on visual feedback to judge the amount of force applied to the tissues. It is suggested that friction forces inherent in the instruments contribute to errors in surgeons' haptic perception. This paper investigated the psychophysics of contact detection and cross-modal sensory processing in the context of minimally invasive surgery.Method: A within-subjects repeated measures design was used, with friction, vision, tissue softness, and order of presentation as independent factors, and applied force, detection time, error, and confidence as dependent measures. Eight participants took part in each experiment, with data recorded by a custom force-sensing system.Results: In both detection and differentiation tasks, higher thresholds, longer detection times, and more errors were observed when vision was not available. The effect was more pronounced when haptic feedback was masked by friction forces in the surgical device (p < .05).Conclusion: Visual and haptic feedback were equally important for tissue compliance differentiation.Application: A frictionless endoscopic instrument can be designed to restore critical haptic information to surgeons without having to create haptic feedback artificially. [ABSTRACT FROM AUTHOR]

Objective: We provide a review and analysis of much of the published literature on visual perception issues that impact the design and use of head-mounted displays (HMDs).Background: Unlike the previous literature on HMDs, this review draws heavily from the basic vision literature in order to help provide insight for future design solutions for HMDs.Method: Included in this review are articles and books found cited in other works as well as articles and books obtained from an Internet search.Results: Issues discussed include the effect of brightness and contrast on depth of field, dark focus, dark vergence, and perceptual constancy; the effect of accommodation-vergence synergy on perceptual constancy, eyestrain, and discomfort; the relationship of field of view to the functioning of different visual pathways and the types of visual-motor tasks mediated by them; the relationship of binocular input to visual suppression; and the importance of head movements, head tracking, and display update lag.Conclusion: This paper offers a set of recommendations for the design and use of HMDs.Application: Consideration of the basic vision literature will provide insight for future design solutions for HMDs. [ABSTRACT FROM AUTHOR]

Objective: This paper explores the development of a rigorous computational model of driver behavior in a cognitive architecture--a computational framework with underlying psychological theories that incorporate basic properties and limitations of the human system.Background: Computational modeling has emerged as a powerful tool for studying the complex task of driving, allowing researchers to simulate driver behavior and explore the parameters and constraints of this behavior.Method: An integrated driver model developed in the ACT-R (Adaptive Control of Thought-Rational) cognitive architecture is described that focuses on the component processes of control, monitoring, and decision making in a multilane highway environment.Results: This model accounts for the steering profiles, lateral position profiles, and gaze distributions of human drivers during lane keeping, curve negotiation, and lane changing.Conclusion: The model demonstrates how cognitive architectures facilitate understanding of driver behavior in the context of general human abilities and constraints and how the driving domain benefits cognitive architectures by pushing model development toward more complex, realistic tasks.Application: The model can also serve as a core computational engine for practical applications that predict and recognize driver behavior and distraction. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Drug overdose is the leading cause of injury-related death in the United States. It has been linked to respiratory depression and cardiac toxicity, both of which can lead to cardiac arrest. Despite this potential association, few studies have examined this relationship, particularly in transport to the hospital. The purpose of this research was to determine if there was a relationship between opioid overdose and cardiac arrest in transport. METHODS: A sample (n = 1 000 000) was utilized from the National EMS Information System (NEMSIS) from the year 2019. A logistic regression model was used to predict cardiac arrest from dispatch reason with gender, race, and age included as controls. RESULTS: Overdose-related dispatch reason was associated with an increased likelihood of cardiac arrest in transport (Odds Ratio = 1.65, 95% Confidence Interval: [1.22, 2.22]). CONCLUSIONS: Opioid overdose is associated with an increased incidence of cardiac arrest in transport in the United States. [ABSTRACT FROM AUTHOR]

Background: Athletes display persistent muscle deficits and altered limb-loading mechanics at the time of return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR). Purpose: To compare an objective profile of adolescent athletes at RTS after ACLR to matched healthy controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included were 124 participants; 62 patients who underwent ACLR (15.4 ± 1.7 years) and 62 healthy controls (15.3 ± 1.7 years). Motion capture and force plates were used to capture joint motions during jump landing (JL) and single-limb squat (SLS) tasks. Energy absorption contribution (EAC) was calculated, and repeated-measures analysis of variance was used to assess for EAC differences between groups. Participants completed an International Knee Documentation Committee (IKDC) Subjective Knee Form, and isokinetic quadriceps and hamstring strength testing was performed on each limb. Independent t tests were run to examine age, height, weight, and IKDC scores as well as compare differences between groups for quadriceps and hamstring strength. Results: A significant group × joint interaction was found for JL (P <.001) and SLS (P <.001). For JL, patients who underwent ACLR utilized significantly greater hip (P <.001) and significantly less knee (P <.001) EAC on the surgical limb compared with controls. During SLS, patients who underwent ACLR utilized significantly greater hip (P <.001) and significantly less knee (P <.001) EAC on the surgical limb compared with controls. The ACLR cohort demonstrated lower IKDC scores (P <.001) and significantly lower quadriceps strength on the surgical limb (P <.001) than controls. There were no differences in surgical limb hamstring strength between the ACLR cohort and healthy controls (P =.701). Conclusion: Compared with matched healthy controls, the participants who underwent ACLR in this study demonstrated an inferior objective profile at RTS, consisting of deficits in surgical limb loading, self-reported outcomes, and strength. [ABSTRACT FROM AUTHOR]

The Federal Aviation Administration's effort to automate air traffic control (ATC) requires that the functionality provided today be captured in future systems. We report the first quantitative naturalistic observation of paper flight progress strip interactions during operational use. Strip use was similar in a variety of situations, but some uses varied as a function of altitude, staffing, or the cooperative style used by controller teams. Design of automation should proceed by prioritizing changes based on frequency of use and importance and should ensure that an effective method of interacting with flight information is incorporated. In addition to applied relevance to the ATC domain, the results touch on several theoretical concerns relevant to dynamic environments. Actual and potential applications of this research include the establishment of a database of strip activity and an arsenal of information valuable to system designers. [ABSTRACT FROM AUTHOR]

Methodologies for assessing human judgment in complex domains are important for the design of both displays that inform judgment and automated systems that suggest judgments. This paper uses the n-system lens model to evaluate the impact of displays on human judgment and to explicitly assess the similarity between human judgments and a set of potential judgment algorithms for use in automated systems. First, the need for and concepts underlying judgment analysis are outlined. Then the n-system lens model and its parameters are formally described. This model is then used to examine a previously conducted study of aircraft collision detection that had been analyzed using standard analysis of variance methods. Our analysis found the same main effects as did the earlier analysis. However, n-system lens model analysis was able to provide greater insight into the information relied upon for judgments and the impact of displays on judgment. Additionally, the analysis was able to identify attributes of human judgments that were--and were not--similar to judgments produced by automated systems. Potential applications of this research include automated aid design and operator training. [ABSTRACT FROM AUTHOR]

This paper presents the VDM2000, a computational model of target detection designed for use in military developmental test and evaluation settings. The model integrates research results from the fields of early vision, object recognition, and psychophysics. The VDM2000 is image based and provides a criterion-independent measure of target conspicuity, referred to as the vehicle metric (VM). A large data set of human responses to photographs of military vehicles in a field setting was used to validate the model. The VM adjusted by a single calibration parameter accounts for approximately 80% of the variance in the validation data. The primary application of this model is to predict detection of military targets in daylight with the unaided eye. The model also has application to target detection prediction using infrared night vision systems. The model has potential as a tool to evaluate the visual properties of more general task settings. [ABSTRACT FROM AUTHOR]

In low-stakes assessments, some students may not reach the end of the test and leave some items unanswered due to various reasons (e.g., lack of test-taking motivation, poor time management, and test speededness). Not-reached items are often treated as incorrect or not-administered in the scoring process. However, when the proportion of not-reached items is high, these traditional approaches may yield biased scores and thereby threatening the validity of test results. In this study, we propose a polytomous scoring approach for handling not-reached items and compare its performance with those of the traditional scoring approaches. Real data from a low-stakes math assessment administered to second and third graders were used. The assessment consisted of 40 short-answer items focusing on addition and subtraction. The students were instructed to answer as many items as possible within 5 minutes. Using the traditional scoring approaches, students' responses for not-reached items were treated as either not-administered or incorrect in the scoring process. With the proposed scoring approach, students' nonmissing responses were scored polytomously based on how accurately and rapidly they responded to the items to reduce the impact of not-reached items on ability estimation. The traditional and polytomous scoring approaches were compared based on several evaluation criteria, such as model fit indices, test information function, and bias. The results indicated that the polytomous scoring approaches outperformed the traditional approaches. The complete case simulation corroborated our empirical findings that the scoring approach in which nonmissing items were scored polytomously and not-reached items were considered not-administered performed the best. Implications of the polytomous scoring approach for low-stakes assessments were discussed. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice. Methods: This three-year exploratory mixed methods study included transformational assistance from 9 interprofessional coaches, one assigned to each of 9 interprofessional primary care teams that included family medicine, internal medicine, pediatrics, nursing, pharmacy and behavioral health. Coaches interacted with teams during 2 in-person training sessions, an in-person site visit, and then as requested by their teams. Surveys administered at 1 year and end study assessed the coaching relationship and process. Results: The majority of participants (82% at end of Year 1 and 76.6% at end study) agreed or strongly agreed that their coach developed a positive working relationship with their team. Participants indicated coaches helped them: (1) develop as teams, (2) stay on task, and (3) respond to local context issues, with between 54.3% and 69.2% agreeing or strongly agreeing that their coaches were helpful in these areas. Cronbach's alpha for the 15 coaching survey items was 0.965. Challenges included aligning the coach's expertise with the team's needs. Conclusions: While team coaching was well received by interprofessional teams of primary care professionals undertaking educational and clinical redesign, the 3 primary care disciplines have much to learn from each other regarding how to improve inter- and intra-professional collaborative practice among clinicians and staff as well as with interprofessional learners rotating through their outpatient clinics. [ABSTRACT FROM AUTHOR]

Although the commercialization of public-sector technology is a primary federal strategy for improving the international competitiveness of U.S. industry, the potential role of spin-off entrepreneurship in this strategy is poorly understood. Inventors from three large national laboratories are compared to each other and to spin-off entrepreneurs from the same laboratories. A 1992 survey gathered data on personal characteristics, attitudes, and perceptions of situational variables from 213 inventors and 24 spin-off entrepreneurs. This paper identifies differences among the laboratories as well as differences between each of the laboratories and the entrepreneurs that have started ventures from Inventions discovered at these laboratories. These differences should be used to identify areas of change that are needed to increase the number of inventions that are spun-off from the laboratories. These changes include affecting the inventors' entrepreneurial attitudes and perceptions of key situational variables. [ABSTRACT FROM AUTHOR]

Though a significant number of studies of scholarly productivity have accumulated in the past decade, the majority have focused on limited samples of specialists in one or only a few scientific disciplines, making it difficult to generalize findings across dissimilar academic disciplines. This paper tests a model incorporating both academic and nonacademic factors as determinants of productivity with samples of physical and biological scientists, social scientists, and humanists taken from the 1972-73 American Council on Education survey of faculty at U.S. institutions of higher learning. We find considerable variation in the process determining productivity both across the broad disciplinary categories as well as within categories when article and book productivity are compared. We also examine the relative influence of the disciplinary context and attributes of scholars on productivity. Our evidence suggests that the decisive edge that physical and biological scientists enjoy over social scientists and humanists in article productivity is largely the result of the nature of work or a favorable disciplinary milieu, while the lower rate of productivity among humanists is more heavily determined by their attributes. [ABSTRACT FROM AUTHOR]

Telemedicine has recently garnered more attention from healthcare professionals because it provides access to health services to patients in rural areas while making patient healthcare information more vulnerable to security breaches. The objective of this research is to identify factors that play a critical role in possible adoption of telemedicine in the United States and Brazil. A model with eight hypotheses was used to establish a research framework. A survey was conducted involving healthcare professionals in the aforementioned countries. The results show that telemedicine adoption is influenced by policies and culture in both countries and influenced by security and privacy in the United States. It can be inferred from the research that perceptions of the American and Brazilian healthcare professionals are similar in telemedicine issues covered in this research. These healthcare professionals, however, disagree on how patients' privacy should be preserved in the two countries. [ABSTRACT FROM AUTHOR]

Objectives: To estimate additional spending if NHS England paid the same prices as US Medicare Part D for the 50 single-source brand-name drugs with the highest expenditure in English primary care in 2018.Design: Retrospective analysis of 2018 drug prescribing and spending in the NHS England prescribing data and the Medicare Part D Drug Spending Dashboard and Data. We examined the 50 costliest drugs in English primary care available as brand-name-only in the US and England. We performed cost projections of NHS England spending with US Medicare Part D prices. We estimated average 2018 US rebates as 1 minus the quotient of net divided by gross Medicare Part D spending.Setting: England and US.Participants: NHS England and US Medicare systems.Main Outcome Measures: Total spending, prescriptions and claims in NHS England and Medicare Part D. All spending and cost measures were reported in 2018 British pounds.Results: NHS England spent £1.39 billion on drugs in the cohort. All drugs were more expensive under US Medicare Part D than NHS England. The US-England price ratios ranged from 1.3 to 9.9 (mean ratio 4.8). Accounting for prescribing volume, if NHS England had paid US Medicare Part D prices after adjusting for estimated US rebates, it would have spent 4.6 times as much in 2018 on drugs in the cohort (£6.42 billion).Conclusions: Spending by NHS England would be substantially higher if it paid US Medicare Part D prices. This could result in decreased access to medicines and other health services. [ABSTRACT FROM AUTHOR]

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This comparative study examines survey data from 464 call centers in the United States, 167 in the United Kingdom, and 387 in Canada to explore two questions: whether institutional differences shape employers' choices of ways to improve work force flexibility, both numerical and functional; and whether strategies for numerical flexibility and functional flexibility are related. The results suggest that institutional differences across these liberal market economies--specifically, in dismissal regulations and union strength--did affect how employers chose to achieve work force flexibility. For example, the use of part-time workers was more common in countries with more stringent rules regulating dismissals. Organizational characteristics also mattered, with outsourced firms being more likely than in-house firms to use part-time workers. Evidence also suggests that managers used numerical flexibility and functional flexibility strategies as substitutes: higher employee job discretion was associated with both lower dismissal rates and a lower likelihood of temporary use. [ABSTRACT FROM AUTHOR]

Objectives: As the life expectancy of people infected with human immunodeficiency virus (HIV) infection has increased, the spectrum of illness has evolved. We evaluated whether people living with HIV accessing primary care in US community health centers had higher morbidity compared with HIV-uninfected patients receiving care at the same sites. Methods: We compared data from electronic health records for 12 837 HIV-infected and 227 012 HIV-uninfected patients to evaluate the relative prevalence of diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, and malignancies by HIV serostatus. We used multivariable logistic regression to evaluate differences. Participants were patients aged ≥18 who were followed for ≥3 years (from January 2006 to December 2016) in 1 of 17 community health centers belonging to the Community Health Applied Research Network. Results: Nearly two-thirds of HIV-infected and HIV-uninfected patients lived in poverty. Compared with HIV-uninfected patients, HIV-infected patients were significantly more likely to be diagnosed and/or treated for diabetes (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.22-1.41), hypertension (OR = 1.38; 95% CI, 1.31-1.46), dyslipidemia (OR = 2.30; 95% CI, 2.17-2.43), chronic kidney disease (OR = 4.75; 95% CI, 4.23-5.34), lymphomas (OR = 4.02; 95% CI, 2.86-5.67), cancers related to human papillomavirus (OR = 5.05; 95% CI, 3.77-6.78), or other cancers (OR = 1.25; 95% CI, 1.10-1.42). The prevalence of stroke was higher among HIV-infected patients (OR = 1.32; 95% CI, 1.06-1.63) than among HIV-uninfected patients, but the prevalence of myocardial infarction or coronary artery disease did not differ between the 2 groups. Conclusions: As HIV-infected patients live longer, the increasing burden of noncommunicable diseases may complicate their clinical management, requiring primary care providers to be trained in chronic disease management for this population. [ABSTRACT FROM AUTHOR]

Objective. Coronary heart disease (CHD) mortality has declined in the past few decades; however, it is unclear whether the reduction in CHD deaths has been similar across urbanization levels and in specific racial groups. We describe the pattern and magnitude of urban-rural variations in CHD mortality in the U.S. Methods. Using data from the National Center for Health Statistics, we examined trends in death rates from CHD from 1999 to 2009 among people aged 35-84 years, in each geographic region (Northeast, Midwest, West, and South) and in specific racial-urbanization groups, including black and white people in large and medium metropolitan (urban) areas and in non-metropolitan (rural) areas. We also examined deaths from early-onset CHD in females aged <65 years and males aged <55 years. Results. From 1999 to 2009, there was a 40% decline in age-adjusted CHD mortality. The trend was similar in black and white people but was more pronounced in urban than in rural areas, resulting in a crossover in 2007, when rural areas began showing a higher CHD mortality than urban areas. White people in large metropolitan areas had the largest decline (43%). Throughout the study period, CHD mortality remained higher in black people than in white people, and, in the South, it remained higher in rural than in urban areas. For early-onset CHD, the mortality decline was more modest (30%), but overall trends by urbanization and region were similar. Conclusion. Favorable national trends in CHD mortality conceal persisting disparities for some regions and population subgroups (e.g., rural areas and black people). [ABSTRACT FROM AUTHOR]

In the U.S. South, a free labor market rapidly—although, in some cases, only nominally—replaced the plantation system of slave labor in the years following the American Civil War. Drawing on data comprising 75,099 transactions in the antebellum period, as well as 1,378 labor contracts in the postbellum era, I examine how the valuation of black labor was transformed between the 1830s and the years of emancipation. I trace the process of valuation through four markets for labor, moving from slave purchases and appraisals within the plantation economy, to the antebellum system of hiring out, to wage-setting for black labor under the auspices of the Freedmen’s Bureau. Comparative analysis of labor pricing across these markets reveals systematic differences: slave markets placed price premiums on children and young women, and occupational skills emerged as the most salient influence in the pricing of wage labor. I conclude by theorizing how transvaluation of labor occurs when markets for unfree and free workers are governed by distinct institutional conditions. [ABSTRACT FROM PUBLISHER]

Objectives. CDC 2006 recommendations for new HIV testing methods in U.S. health-care settings (opt-out approach, general medical consent, and optional prevention counseling) have been the subject of a public ethical debate. Ethical concerns might limit their implementation and affect expanded HIV screening efforts. We compared clinicians' and patients' perspectives on the ethical concerns raised about, justifications provided in support of, and preferences for the 2006 CDC-recommended HIV testing methods for the U.S. health-care setting, in contrast with the 2001 CDC-recommended HIV testing methods (opt-in approach, specific written consent, and mandatory prevention counseling). Methods. We conducted a non-inferiority trial and survey of 249 clinicians and random samples of 1,013 of their patients at three emergency departments and three ambulatory care clinics at university-affiliated hospitals in Rhode Island from June to December 2007. Results. Clinicians found the 2006 CDC HIV testing methods to be more ethically concerning than the 2001 testing methods (i.e., ethically inferior), while patients had few ethical concerns. In regard to ethical justifications cited for the 2006 CDC HIV testing methods, clinicians were more supportive of the ethical justifications cited for using an opt-out approach and general medical consent, while patients were more supportive of the justifications for optional HIV prevention counseling. Clinicians showed a relatively greater preference for the opt-out approach and use of general medical consent, while patients had a relatively greater preference for optional HIV prevention counseling. Conclusions. Clinicians and their patients hold divergent ethical perspectives on CDC's 2006 HIV testing methods. The results indicate an opportunity to review not only these but also future HIV testing recommendations, as well as how they are presented for implementation. [ABSTRACT FROM AUTHOR]

The article discusses a study on the cognitive advantages of East Asian American children. Panel data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) is used to compare East Asian American children's cognitive abilities with six other racial/ethnic groups at nine months and at two and four years old. The East Asian American children made greater cognitive gains than the other non-European American groups during the age period of nine months and two years. Four-year-old East Asian American children did better than their peers in all other racial/ethnic groups did on math and literacy tests. Cognitive advantages explained by differences in parental resources are noted.

Epidemiological research typically focuses on the intensity, frequency, or duration of physical activity, without consideration of the socially meaningful dimensions of exercise. The authors use data from the 1998 National Health Interview Survey (N = 17,455) and information on participation in 15 exercise behaviors to examine educational differences in exercise among non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Factor analysis identifies three types of exercise: team sports (e.g., basketball, football), fitness activities (e.g., running, weight lifting), and activities that require the use of specialized facilities (e.g., golf, tennis). Cultural capital and human capital perspectives offer insight into different dimensions of the relationship between education and exercise. Whites disproportionately undertake facility-based exercise, blacks tend toward team and fitness activities, and Mexican Americans gravitate toward team sports. Our findings offer insight into the social stratification of health and can aid the design of public health interventions. [ABSTRACT FROM PUBLISHER]

Using twin pairs from the National Survey of Midlife Development in the United States, we estimate that 35 percent of the variance in regular smoking is due to additive genetic influences. When we disaggregate the sample by birth cohort we witness strong genetic influences on smoking for those born in the 1920s, 1930s, and 1950s, but negligible influences for those born in the 1940s and 1960s. We show that the timing of the first Surgeon General’s Report coincides with an increase in the genetic influences on regular smoking, but subsequent legislation prohibiting smoking in public places has significantly reduced these influences. These results are in line with existing gene-environment interaction theory, and we argue that variation in genetic influences across cohorts makes it difficult and potentially misleading to estimate genetic effects on health behaviors from data obtained from a single point in time. [ABSTRACT FROM PUBLISHER]

Recent analyses of state-level proficiency standards under No Child Left Behind indicate that states' benchmarks for determining whether a child is proficient in reading and math are widely divergent. This article explores whether the capacity of states to employ different proficiency standards imposes different performance standards across demographic groups. Using a newly devised metric that allows for interstate comparison of state-level proficiency cut scores, along with aggregated district-level demographic data, this article provides a descriptive analysis of the distribution of proficiency standards across demographic groups to determine whether some groups systematically face higher or lower proficiency cut scores. The findings indicate that while an "expectations gap" does exist, it does not operate consistently across categories of race, ethnicity, and poverty status. The article concludes by reviewing the trade-offs required under three possible policy responses to these findings. [ABSTRACT FROM AUTHOR]

Using data from a 2005 national survey of working adults in the United States, we examine the effects of the gender composition of the superordinate-subordinate role-set on mental and physical health measures. Subordinates' and superordinates' genders are important determinants. Men who work in gender-mixed superordinate contexts (i.e., with one male and one female superior) report lower levels of distress and physical symptoms than men who work with one male superior. Women who work with one male superior report less distress and fewer physical symptoms compared to women who work with one female superior or in gender-mixed superordinate contexts. With a few exceptions, these observations generally hold net of occupation, job sector, and an array of work-related conditions. We discuss the implications of these findings in light of predictions derived from the similarity-attraction and role congruity theories. We also outline ways that theoretical development in relational demography can be refined by a more specific focus on the demographic characteristics--especially gender--of the superordinate-subordinate role-set. [ABSTRACT FROM AUTHOR]