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Work has not examined if acculturation or enculturation may predict endorsed benefits, barriers, and intentions to seek mental health services for depression, specifically among Latino students enrolled in a rural and majority Latino immigrant institution of higher education. An improved understanding of factors informing mental health help-seeking is needed to identify possible intervention points to address gaps in accessing depression treatment. Participants (N = 406) read a vignette depicting a person with depressive symptoms. Participants were asked if they would seek help for depression if in the situation described in the vignette. Participants provided text responses about their preferences for managing depression symptoms and their mental health help-seeking history. Additionally, participants completed a self-report depression symptom screener, demographic surveys, acculturation assessment, and questionnaires on perceived benefits and barriers to seeking mental health services. Path analysis was used to test the link between acculturation status and intent to seek services for depression, with benefits and barriers as mediators. The results revealed that higher perceived benefits and lower barriers were directly associated with greater intentions to seek help. Furthermore, an indirect effect of acculturation on help-seeking intentions via higher perceived benefits of seeking care was observed. These findings persisted after controlling for age, gender, depression, and history of seeking care for depression. Future work should test the replicability of this finding with diverse college students living in predominantly immigrant communities. Universities might consider tailoring outreach initiatives to provide information on the range and accessibility of mental health services, the location of mental health service centers, and the procedures for accessing such services. [ABSTRACT FROM AUTHOR]

Sexual and gender minorities (SGM) of colour in the United States experience heightened HIV vulnerability, but prevention interventions have not adequately met their needs. We analysed survey responses from sexually active men who have sex with men, transgender people and gender-nonconforming people of colour (N = 216), regarding barriers to participation in HIV prevention research and services. We applied Meyer's Minority Stress Theory (MST), which highlights that SGM are at increased risk for mental health disorders due to the psychosocial stress resulting from experiences of stigmatisation and discrimination. Themes regarding barriers to participation in HIV prevention research and accessing prevention services included: (1) concern regarding familial rejection; (2) decreased access to timely sexual health education; (3) financial challenges regarding study participation and continued access to antiretroviral medications; (4) concerns regarding intersectionality, race and stigma ; and (5) lived experiences of stigma, discrimination and internalised homophobia among Black respondents. Healthcare providers and researchers can utilise this information to better tailor HIV prevention interventions to the specific health needs of SGM of colour. [ABSTRACT FROM AUTHOR]

Anatomical sciences curricula have been under constant reform over the years, with many countries having to reduce course hours while trying to preserve laboratory time. In Mexico, schools have historically been autonomous and unregulated, and data regarding structure and methods are still lacking. A national survey was sent by the Mexican Society of Anatomy to 110 anatomical sciences educators. The questionnaire consisted of 50 items (open and multiple choice) for gross anatomy, microscopic anatomy, neuroanatomy, and embryology courses in medical schools across Mexico. A clinical approach was the most common course approach in all disciplines. Contact course hours and laboratory hours were higher in Mexican anatomy education compared to other countries, with the highest reported contact hours for embryology (133.4 ± 44.1) and histology (125 ± 33.2). There were similar contact hours to other countries for gross anatomy (228.5 ± 60.5). Neuroanatomy course hours (43.9 ± 13.1) were less than reported by the United States and similar to Saudi Arabia and higher than the United Kingdom. Dissection and microscopy with histological slides predominate as the most common laboratory activities. Traditional methods prevail in most of the courses in Mexico and only a few educators have implemented innovative and technological tools. Implementation of new methods, approaches, and curricular changes are needed to enhance anatomical sciences education in Mexico.

Cancer is the top leading cause of death among Latino people. Lack of health insurance is a significant contributor to inadequate cancer detection and treatment. Despite healthcare policy expansions such as the Affordable Care Act, Latino people persistently maintain the highest uninsured rate among any ethnic and racial group in the US, especially among Latino individuals who are immigrants or part of a mixed immigration status household. Recognizing that immigration status is a critical factor in the ability of Latino community members to seek health insurance and access healthcare services, a few US states and the District of Columbia have implemented policies that have expanded coverage to children and adults regardless of immigration status. Expansion of Medicaid eligibility regardless of immigration status may significantly benefit Latino communities, however the facilitators and barriers to enrolling in these programs need to be evaluated to ensure reach and achieve health equity across the cancer control continuum for all Latinos. [ABSTRACT FROM AUTHOR]

Background: Abdominal pain due to menses (primary dysmenorrhea) is an extremely pervasive and debilitating symptom affecting up to 90% of menstruating individuals. Objective: The objective of this randomized control trial was to investigate the effect of a commercial transcutaneous electrical nerve stimulation unit, Therabody PowerDot® (Therabody Inc., Los Angeles) on dysmenorrhea compared with non-steroidal anti-inflammatory drug use. Design: This was a randomized cross-over study. Methods: A total of 47 participants agreed to participate in the study, with 34 completing it. Participants completed treatments across three consecutive menstrual cycles in randomized order: single-unit transcutaneous electrical nerve stimulation (Uno), dual unit transcutaneous electrical nerve stimulation (Duo), and non-steroidal anti-inflammatory drug use (Control). Upon onset of dysmenorrhea, participants applied transcutaneous electrical nerve stimulation to their abdomen for a minimum of 30 min. Control participants were instructed to take non-steroidal anti-inflammatory drugs as needed. Surveys were used to record pain before and after treatment. We hypothesized that the PowerDot would decrease self-reported pain scores, and decrease non-steroidal anti-inflammatory drug consumption during menses. Results: Participants experienced a statistically and clinically significant reduction in pain during the Control (−3.52 ± 1.9), Uno (−2.10 ± 1.6), and Duo (−2.19 ± 1.7) cycles (p < 0.001). The doses of non-steroidal anti-inflammatory drugs consumed during the Control cycle (3.5 ± 2.6), was significantly different as compared with that of Uno (1.5 ± 3.0), or Duo (1.1 ± 2.6) (p = 0.004). Conclusions: Use of a commercial transcutaneous electrical nerve stimulation unit results in significant decrease in pain. Although not as robust as the relief in pain induced by non-steroidal anti-inflammatory drugs, the adverse events of transcutaneous electrical nerve stimulation are minimal in comparison. Therefore, transcutaneous electrical nerve stimulation appears to be a viable alternative to pain relief from dysmenorrhea. Clinical Trial Registration: NCT05178589 Plain Language Summary: The role of electrical signals for period pain relief Menstruation, also known as the period, is a cyclicly occurring event in people who are assigned female at birth. Often, the period is associated with abdominal pain that can be debilitating for many. This abdominal pain is typically treated using over-the-counter medications, such as ibuprofen; however, there several noted side effects that can arise from use of such medication. As such, this study aimed to understand if a device (Therabody PowerDot®; Therabody Inc., Los Angeles) that sends an electrical current to pads placed over the abdomen, much like a heating pad, could be used to decrease pain during the period to a similar level as medication. The research team studied three consecutive periods with differing setups: a single, elongated pad, placed on the lower abdomen (Uno), two circular pads placed on the lower abdomen (Duo), or no use of the device, only medication (Control). The researchers analyzed data from 34 individuals. It was found that all three cycles experienced a significant decrease in pain, with the control cycle having a greater decrease in pain than both the Uno and Duo. This study suggests that the electrical stimulation used here can greatly decrease pain during the period, though not as substantial as medication. [ABSTRACT FROM AUTHOR]

Parenting in the context of migration involves navigating competing socialization norms between one’s receiving community and those from one’s natal home. Although research shows that parenting acculturates to some degree after migration, the complexity of this process has not been adequately explored such as how some parenting domains shift more readily than others and how migrant parents deal with incongruences. This study examined shifts and stability in parenting beliefs and practices among Filipino migrants in four communities in the United States with varying levels of co-ethnic density. Drawing from indigenous Filipino psychology methods, findings reveal the adaptive nature of parenting, with some domains shifting to better match norms in receiving communities. Findings also highlight the powerful force that culturally embedded beliefs impose on socialization, with most parenting goals and practices continuing to reflect natal notions. Regardless of community, respondents reported stresses around migrant parenting and various strategies to cope with competing childrearing notions. [ABSTRACT FROM AUTHOR]

About 16 million adults present with chronic back pain, the sixth most costly condition in the United States (US). Estimates suggest that about 60% of initial back surgeries have a successful outcome; however, many don't, leaving over 80,000 failed back surgeries per year. Failed Back Surgery Syndrome (FBSS) is defined by the International Association for the Study of Pain as back pain, with or without radiating pain, located in the lower limbs, of unknown origin, which persists or begins after surgical procedures are performed to treat lumbar disc herniations. Psychiatric comorbidities and psychosocial factors have been associated with patients presenting with this syndrome. A retrospective cross-sectional study was performed to identify the prevalence of FBSS in a population of patients during the period of January 2019-December 2020 across Hospital Corporation of America (HCA) Healthcare in the US. With a sample of 28,426 patients who underwent back surgery only 8% had FBSS. Those with FBSS (N = 2434) were mainly females (54.27%) with a mood disorder (61.18%), P -value <.0001. Among those with FBSS, there was a statistically significant relationship between mood disorder and smoking (57.37%) and obesity (54.61%) compared to non-smokers and non-obese. Lifestyle interventions may ameliorate disabling symptoms and improve the well-being of this population. [ABSTRACT FROM AUTHOR]

Since laws prohibiting interracial marriages were abolished, the United States has seen an increase in interracial relationships. Individuals in interracial relationships experience the typical challenges of partnered life; however, these relationships also have the potential to face additional challenges existing in a racialized society. Individuals in interracial relationships are experiencing increased anxiety due to heated public debate concerning racial justice, immigration reform, and even direct attacks on certain minority groups. This analysis investigates the challenges of interracial relationships and provides clinicians with insight into their unique challenges. Further, this article discusses implications for clinicians encountering this population in clinical settings. [ABSTRACT FROM AUTHOR]

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that can infect healthcare personnel (HCP) and patients in healthcare settings. Specific care activities, in particular, aerosol-generating procedures, may have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 has created significant challenges in healthcare facilities, particularly with severe shortages of personal protective equipment (PPE) used to protect HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators. Objective Our objective was to develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known coronavirus disease 2019 (COVID-19). Methods The Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel that included front-line clinicians, infectious diseases specialists, experts in infection control, and guideline methodologists with representation from the disciplines of preventive care, public health, medical microbiology, pediatrics, critical care medicine, and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then, a systematic review of the peer-reviewed and gray literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence and make recommendations. Results The IDSA guideline panel agreed on 8 recommendations and provided narrative summaries of other interventions undergoing evaluations. Conclusions Using a combination of direct and indirect evidence, the panel was able to provide recommendations for 8 specific questions on the use of PPE for HCP who provide care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. Significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 remain, and PPE recommendations may need to be modified in response to new evidence. [ABSTRACT FROM AUTHOR]

Respiratory Syncytial Virus (RSV) is a leading cause of acute respiratory tract infection, with the greatest impact on infants, immunocompromised individuals, and older adults. RSV prevalence decreased substantially in the United States (US) following the implementation of COVID-19-related non-pharmaceutical interventions but later rebounded with abnormal seasonality. The biological and epidemiological factors underlying this altered behavior remain poorly defined. In this retrospective cohort study from 2009 to 2023 in Chicago, Illinois, US, we examined RSV epidemiology, clinical severity, and genetic diversity. We found that changes in RSV diagnostic platforms drove increased detections in outpatient settings post-2020 and that hospitalized adults infected with RSV-A were at higher risk of intensive care admission than those with RSV-B. While population structures of RSV-A remained unchanged, RSV-B exhibited a genetic shift into geographically distinct clusters. Mutations in the antigenic regions of the fusion protein suggest convergent evolution with potential implications for vaccine and therapeutic development. Non-pharmaceutical interventions for COVID-19 also impacted the transmission of other viruses including respiratory syncytial virus (RSV). Here the authors describe the changing epidemiology, clinical severity, and genetic diversity of RSV in Chicago, Illinois, from July 2010 to April 2023. [ABSTRACT FROM AUTHOR]

Evidence of geographic variation in child maltreatment report rates among Latine families is growing. This study investigates whether structural community characteristics, namely rurality and Latine ethnic density, associate with variation in Latine child maltreatment rates across 925 US counties. Using ten years of cross-sectional data from the National Child Abuse and Neglect Data System (NCANDS), ACS and USDA, OLS regression models examined rurality and Latine density's association with child maltreatment report and substantiation rates. Rurality associated with increased maltreatment rates; however, Latine ethnic density buffered this across most maltreatment subtypes. Results highlight a complex interaction between ethnicity, rurality, and maltreatment. [ABSTRACT FROM AUTHOR]

Medical legal partnerships address individual legal needs that can create impediments to health. Little is known about outcomes from medical legal partnerships and their relationship to access to justice. This paper reports outcomes from one medical legal partnership from the perspective of the client, with specific emphasis on impact on health and concepts related to access to justice. We suggest a conceptual model for incorporating medical legal partnerships into a broader framework about access to justice. [ABSTRACT FROM AUTHOR]

In the US, the first pediatric donation after circulatory death (DCD) thoracic transplant was done in 2004; however, ethical controversy led to minimal utilization of these donors. The present study was performed to characterize the current state of pediatric DCD heart and lung transplantation (HTx, LTx). Children (<18 year old) who underwent HTx or LTx using DCD donors from June 2004 to June 2022 were identified in the United Network for Organ Sharing registry. A total of 14 DCD recipients were identified: 7 (50%) HTx and 7 (50%) LTx. Donor and recipient demographics are described in Table 1. One and 5-year post-transplant survival were as follows: HTx recipients (64% for each) and LTx recipients (86%, 55%). Although often discussed, the national experience with DCD donors for pediatric HTx and LTx remains limited and not being practiced consistently by any pediatric program. Given the critical organ shortage, DCD use in the field of pediatric thoracic transplantation should be strongly considered. [ABSTRACT FROM AUTHOR]

Introduction: Frequent exposure to peer‐shared alcohol‐related content (ARC) on social media is associated with greater alcohol consumption and related consequences among undergraduates. Social media influencers also share ARC; yet, the effect of exposure to influencer‐shared ARC on alcohol outcomes has not been examined. The current study examined whether following influencers who share ARC and the frequency of sharing were associated with alcohol outcomes, and associations between influencer type (e.g., actors) and alcohol outcomes. Methods: Undergraduates (N = 528) from two universities in the United States completed an online survey assessing demographics, social media use, alcohol use and related consequences. They listed up to five influencers they followed and viewed the most content from. A series of linear regression models were conducted. Results: Having a larger proportion of influencers sharing ARC was associated with greater quantity, frequency and peak drinks, but not consequences. Frequency of influencers sharing ARC was associated with greater quantity and peak drinks, but not frequency or consequences. Findings remained significant, even after controlling for peer ARC. Actor ARC, everyday person ARC and 'other' type influencer ARC were associated with several alcohol outcomes. Discussion and Conclusions: This study added to the literature by examining how following influencers who share ARC, and sharing frequency, were associated with drinking outcomes over and above exposure to peer ARC. It also examined whether ARC content from specific types of influencers was associated with alcohol outcomes. Findings highlight that the source of ARC is relevant when studying the effects of ARC exposure on college drinking. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has been linked to stress, anxiety, and depression among college students, with heightened distress tied to greater drinking for some individuals. Emerging research suggests that these associations may differ across race, but few studies use adequate samples to examine this, particularly among college students, an at‐risk population for both heavy drinking and mental distress. Specifically, pandemic‐related stressors and mental distress may be higher among Black students than White students. The current study examined: (1) whether mental distress cross‐sectionally mediates the association between pandemic‐specific stressors and drinking and (2) whether race (Black or White) moderates these associations. Methods: A cross‐sectional online survey of 400 college drinkers (43% White, 28% Black) in fall 2020 assessed pandemic‐related stressors (e.g., losing a job, contracting COVID‐19, changed living situation), mental distress (stress, anxiety, depression), and drinking (past‐month drinking, perceived changes since the start of the pandemic). Results: Cross‐sectional mediation models indicated that financial stressors and social distancing were linked to greater quantity and frequency of past‐month drinking through greater mental distress. For perceived changes in drinking, only financial stressors were linked to drinking greater quantities and drinking more often (compared to pre‐pandemic levels) via mental distress. Moderated mediation models among students identifying as White or Black revealed that changed living situation was a robust stressor across race. Financial stressors and social distancing were linked with greater distress only among White students, whereas essential worker status was a protective factor against distress only among Black students. Conclusions: Select stressors were linked to increased drinking through greater mental distress, with differential risks across Black versus White students. Findings suggest campus administrators should focus on connecting students with resources (e.g., counseling centers and health promotion offices) during times of distress. [ABSTRACT FROM AUTHOR]

There is a strong connection between cities and literature; they inhabit and shape each other. Sociologists have studied the relationship between them, looking at how literary meaning is developed and how it shapes urban and social milieus. While there is a large body of poetry-based research, newspaper poetry remains largely unexplored in the United States. Drawing on discourse and content analysis of a new and never-used set of poems published in Milwaukee's two major alternative newspapers between 1967 and 1973, this article analyses poetic representations of Milwaukee's social, institutional and urban dimensions. Additionally, it examines variability and continuity in the focus of these poems, as well as the factors that might shape these patterns. The results show multiple technical and rhetoric mechanisms used by poets when representing that historical period poetically and reveal that even in periods of intense social upheaval, 'love' and 'death' appear to be the primary themes in which poets focus on. This article also devotes particular attention to the relationship between poetry and the urban space, and the implications of platforms of distribution and consumption in poetic representations of cities' historical periods and change building on literature on the connections between local environment and cultural production. [ABSTRACT FROM AUTHOR]

In this paper, we examined the collaborative mentoring processes of a transnational network. A narrative approach was employed to explore the mentoring practices and experiences of 19 women involved in the CURVE-Y-FRiENDs (C-Y-F) network. Their mentoring practices go beyond transnational, ethnic, discipline, and university borders. The processes employed in the network can be conceptualized as pathways to professional relationships. The narratives of C-Y-F members illustrated collaborative mentoring as an expression of the personal and professional dimensions of support, which must be part of academic life. Collaborative mentoring relationships and discourse provided a response to the current inconsistencies in faculty mentoring practices and have implications for the ways in which administrations and faculty in general initiate more empathetic structures and procedures that better meet the mentoring needs of women and minority faculty in academia.

This narrative describes how my educational journey led me to become a Latina feminist community psychologist. My experiences as a Central American woman living in the United States has made me deeply committed to feminist community values and the importance of social justice. Throughout the journey, I connect how immigration status, culture, and gender are intertwined in my career path. My journey includes discussion of my education from elementary school to a doctoral program. I acknowledge the positive role that mentors have had in my educational success. I also discuss how the voices of people of color and women are not always adequately heard or represented in feminist community psychology (FCP). My intensely personal stories are shared in the spirit of connecting with other women and acknowledging that lived experiences are a way of learning and valid forms of inquiry in the field of FCP. (Contains 2 footnotes.)

This study examines the role of immediate social companions in the prosocial behaviors of children from two cultural communities from the USA and the Philippines. Materials for this study comprised behavioral observations drawn from the Six Cultures Study--with 612 five-minute observations of 23 children (12 girls, 11 boys) from Orchard Town, MA and 570 observations of 24 children (12 girls, 12 boys) from Tarong, Philippines, ranging in age from 3 to 11 years. Data were coded for instances of prosocial behaviors, as well as characteristics of social companions (age and relationship to actor). Results revealed several interesting findings. First, frequency of children's behaviors varied as a function of the age of their social companions. Children generally directed the highest number of prosocial behaviors towards infants and toddlers, except for younger children's prosocial behaviors towards relatives which were directed mostly towards adults. Second, frequency of prosocial behaviors varied as a function of kinship, but differently for the community groups. Tarong children were generally more prosocial towards relatives, while Orchard Town children showed more prosocial behaviors towards non-relatives. Results highlight the role of immediate contexts in prosocial behaviors of children, and the value of using cross-cultural methodology to examine contextual factors in developmental processes. (Contains 1 table and 4 figures.)

In this paper, we undertake a cross-national comparison of early partial immersion programmes, known as dual language or Modelo B programmes, in the USA and the Basque Country in Spain, respectively. We attempt to make sense of their growth, the expanded social uses of the minority languages, and address seemingly contradictory pedagogical principles. In both settings, the growth and the expansion of the use of the minority language in new social spaces is associated with inclusion of the majority populations much as the assertion of minority language rights. The evidence found in the comparison further suggests that the degree of exposure to the minority language cannot be disassociated from the broader sociolinguistic context and is significant for both minority and majority populations.

Although dental caries in the pediatric and adolescent population has consistently declined in the United States, it is still the most common childhood disease. Dental problems are the number one reason for missing school next to the common cold. Dental caries are an infectious, communicable disease resulting in destruction of tooth structure by acid-forming bacteria found in dental plaque, an intraoral biofilm, in the presence of sugar. The etiology of rampant disease is very complex. It is multifactorial and has a close relationship to a number of risk factors. It is important that school nurses identify patients at risk for dental caries early to determine their risk and refer them for disease prevention and control. (Contains 7 figures.)

Objectives: Ambulatory antibiotic stewardship generally aims to address the appropriateness of antibiotics prescribed at in-person visits. The prevalence and appropriateness of antibiotics prescribed outside of in-person visits is poorly studied. Design and setting: Retrospective cohort study of all ambulatory antibiotic prescribing in an integrated health delivery system in the United States. Participants: Antibiotic prescribers and patients receiving oral antibiotic prescriptions between January 2016 and December 2019. Main outcome measures: Proportion of antibiotics prescribed with in-person visits or not-in-person encounters (e.g., telephone, refills). Proportion of prescriptions in in 5 mutually exclusive appropriateness groups: 1) chronic antibiotic use; 2) antibiotic-appropriate; 3) potentially antibiotic-appropriate; 4) non-antibiotic-appropriate; and 5) not associated with a diagnosis. Results: Over the 4-year study period, there were 714,057 antibiotic prescriptions ordered for 348,739 unique patients by 2,391 clinicians in 467 clinics. Patients had a mean age of 41 years old, were 61% female, and 78% White. Clinicians were 58% women; 78% physicians; and were 42% primary care, 39% medical specialists, and 12% surgical specialists. Overall, 81% of antibiotics were prescribed with in-person visits and 19% without in-person visits. The most common not-in-person encounter types were telephone (10%), orders only (5%), and refill encounters (3%). Of all antibiotic prescriptions, 16% were for chronic use, 15% were antibiotic-appropriate, 39% were potentially antibiotic-appropriate, 22% were non-antibiotic-appropriate, and 8% were not associated with a diagnosis. Antibiotics prescribed in not-in-person encounters were more likely to be chronic (20% versus 15%); less likely to be associated with appropriate or potentially appropriate diagnoses (30% versus 59%) or non-antibiotic-appropriate diagnoses (8% versus 25%); and more likely to be associated with no diagnosis (42% versus <1%). Conclusions: Ambulatory stewardship interventions that focus only on in-person visits may miss a large proportion of antibiotic prescribing, inappropriate prescribing, and antibiotics prescribed in the absence of any diagnosis. [ABSTRACT FROM AUTHOR]

Background: The effects of climate change are seen with a rise of extreme weather and climate events (EWCEs) which lead to the closures of many healthcare facilities, such as community pharmacies. Pharmacists in community pharmacies are seen as the most accessible healthcare professional to the public and are responsible for the continued delivery of care to patients. However, amid closures due to EWCEs and the emergence of pharmacy deserts, there is decreased access to pharmacies and a disruption of care. Objective: It is important to address the preparedness and accessibility of pharmacies post-EWCEs to guide future research and policy. Additionally, to tackle health disparities that arise due to pharmacy deserts, the populations most affected by a decreased access to pharmacies should be identified. We conducted a scoping review to assess the preparedness and accessibility of pharmacies post-EWCEs and to identify populations most affected by pharmacy deserts. Methods: We searched PubMed, Embase, and Web of Science from January 1, 2012 to September 30, 2022 and included all English-language, peer-reviewed primary literature that examined the preparedness and accessibility of community pharmacies in the United States post-EWCEs and addressed disparities within pharmacy deserts. Studies meeting these criteria were screened of their titles and abstracts by the first author and discrepancies were resolved with co-authors. We used Covidence for data extraction. Results: A total of 472 studies were identified (196 duplicates removed) and after screening, 53 studies were assessed for eligibility. The results of included publications (N = 26) showed that pharmacists and pharmacies are not equipped with the necessary emergency protocols which could lead to decreased access of pharmacies in the wake of EWCEs. Pharmacy deserts disproportionately affect residents living in rural, lower income, and Black/African American and Hispanic/Latino neighborhoods. The lack of preparedness of pharmacies post-EWCEs could worsen medication access. Conclusion: This scoping review addresses challenges impacting pharmacies and patients post-EWCEs and within pharmacy deserts. In times of increased need, these challenges implicate the well-being of communities affected by EWCEs by breaking the continuum of care and access to medications. Here we offer suggestions for future research and directions for policy change. [ABSTRACT FROM AUTHOR]

We investigate underlying sources of the US entrepreneurial ecosystem's advantage compared to other innovative economies by assessing the benefits that Israeli startups derive from migrating to the United States. Addressing positive sorting into migration, we show that migrants raise larger funding amounts and are more likely to have a U.S. trademark and be acquired than nonmigrants. Migrants also achieve a higher acquisition value. However, their patent output is not larger. We conclude that the United States entrepreneurial ecosystem's advantage vis-à-vis other innovative economies arises from several sources producing sizeable gains for startups. These sources are investor availability as well as large consumer and acquisitions markets. [ABSTRACT FROM AUTHOR]

Objective Antibiotic stewardship should be an essential component of neonatology training as neonatal intensive care units (NICU) have unique stewardship needs. Our aim was to assess neonatology fellowship trainees' knowledge, attitudes, and perceptions about antibiotic stewardship to inform sustainable curriculum development. Study Design We distributed an electronic survey to neonatology fellows in the United States over 4 months (January–April 2018) via Accreditation Council for Graduate Medical Education program directors. Results Of 99 programs in the United States with an estimated 700 fellows, 159 (23%) fellows from 52 training programs (53%) responded to the survey and 139 (87%) provided analyzed responses. Majority of respondents were training in southern (59; 42%) and northeastern (43; 31%) regions and were equally spread across all 3 years of training. One hundred (72%) respondents reported an antibiotic stewardship program (ASP) in their institution. While 86% (120/139) were able to identify the components of an ASP, 59% (82/139) either did not or were unsure if they had received antibiotic stewardship training during fellowship. Furthermore, while answering case studies, 124 (89%) respondents identified the optimal antibiotic for methicillin susceptible Staphylococcus aureus (MSSA) infection and 69 (50%) respondents chose appropriate empiric antibiotics for neonatal meningitis. Notably, fellowship training year was not significantly related to the proportion of incorrect knowledge responses (p = 0.40). Most survey respondents (81; 59%) identified small group sessions as the most useful teaching format, while others chose audit and feedback of individual prescribing behavior (52; 38%) and didactic lectures (52; 38%). Finally, ninety-five (69%) respondents preferred trainee-led ASP interventions targeting focal areas such as antifungal and surgical prophylaxis. Conclusion Antibiotic stewardship is a critical part of neonatology training. Neonatology fellows report variation in access to ASP during their training. Fellows prefer dedicated trainee-led interventions and stewardship curriculum taught within small group settings to promote targeted NICU ASP. Key Points Most neonatology programs expose trainees to internal or external antibiotic stewardship programs. Over half of fellow trainees are unsure about receiving targeted antibiotic stewardship training. Most neonatology fellows prefer a trainee-led antibiotic stewardship intervention. [ABSTRACT FROM AUTHOR]

Native bee species in the United States provide invaluable pollination services. Concerns about native bee declines are growing, and there are calls for a national monitoring program. Documenting species ranges at ecologically meaningful scales through coverage completeness analysis is a fundamental step to track bees from species to communities. It may take decades before all existing bee specimens are digitized, so projections are needed now to focus future research and management efforts. From 1.923 million records, we created range maps for nearly 88% (3158 species) of bee species in the contiguous United States, provided the first analysis of inventory completeness for digitized specimens of a major insect clade, and perhaps most important, estimated spatial completeness accounting for all known bee specimens in USA collections, including undigitized bee specimens. Completeness analyses were very low (3–37%) across four examined spatial resolutions when using the currently available bee specimen records. Adding a subset of observations from community science data sources did not significantly increase completeness, and adding a projected 4.7 million undigitized specimens increased completeness by only an additional 12–13%. Assessments of data, including projected specimen records, indicate persistent taxonomic and geographic deficiencies. In conjunction with expedited digitization, new inventories that integrate community science data with specimen‐based documentation will be required to close these gaps. A combined effort involving both strategic inventories and accelerated digitization campaigns is needed for a more complete understanding of USA bee distributions. [ABSTRACT FROM AUTHOR]

Objective To identify differences between baseline Canadian JIA practices and the 2019 ACR guidelines for JIA. Methods Canadian paediatric rheumatologists were surveyed for their opinions on reasonable a priori target adherence rates for JIA guideline recommendations. Prospectively collected data for 266 newly diagnosed children from 2017 to 2019 were analysed to calculate observed adherence rates. Kaplan–Meier survival curves were used to estimate the cumulative incidence of starting synthetic or biologic DMARDs (sDMARD or bDMARD, respectively) for different patient groups. Results A total of 25/61 (41%) eligible physicians answered the survey. Most survey respondents (64%) felt that adherence targets should vary depending on the strength of the recommendation and quality of evidence, from a mean of 84% for strong recommendations with high-quality evidence to 29% for conditional recommendations with very low-quality evidence. Data showed 13/19 (68%) recommendations would have met proposed targets and 10/19 (53%) had ≥80% observed adherence. Exceptions were the use of subcutaneous vs oral MTX (53%) and infrequent treatment escalation from NSAIDs to bDMARDs in patients with sacroiliitis (31%) or enthesitis (0%). By 12 weeks, 95% of patients with polyarthritis received sDMARDs, 38% of patients with systemic JIA received bDMARDs and 22% of patients with sacroiliitis received bDMARDs. Conclusion Canadian paediatric rheumatology practices were in line with many 2019 JIA guideline recommendations before their publication, except for frequent use of oral MTX and infrequent direct escalation from NSAIDs to bDMARDs in sacroiliitis and enthesitis. [ABSTRACT FROM AUTHOR]

Background: Latin American patients in the United States experience significant health disparities. Community health workers (promotoras de salud) reduce disparities by providing culturally appropriate education. While educational interventions have been studied in atopic dermatitis (AD), a chronic dermatologic condition affecting children, none have evaluated the use of promotoras in Spanish‐speaking pediatric patients in the United States. Objective: To create and evaluate a promotora‐led education program for Spanish‐speaking caregivers of Latin American, pediatric patients with AD through a randomized, controlled, evaluator‐blinded study. Methods: Children with moderate/severe AD (n = 48) were recruited from the pediatric dermatology clinic at Children's Health℠ in Dallas, TX and randomized to receive clinic education (n = 26) or clinic education plus promotora home visits (n = 22). The primary outcome was overall adherence to topical emollients over the 12‐week study, quantified by MEMSCap™ devices; several secondary endpoints were evaluated. Results: Intention‐to‐treat analysis revealed a trend toward increased overall adherence to emollients over the 12‐week study period in promotora (median [interquartile range, IQR]: 43% [26%–61%]) versus non‐promotora (median [IQR]: 20% [11%–49%]) (p =.09) groups. SCORAD, AD knowledge, and Spanish‐language Parental Quality of Life Questionnaire for AD (Sp‐PIQoL‐AD) improved in both groups, although there was no statistically significant difference between groups. There was a trend toward increased AD knowledge at Week 4 (p =.06) in the promotora group. Conclusions: A promotora‐led educational intervention is a promising approach in increasing caregiver medication adherence in pediatric, Latin American patients with AD in the United States. Further research using creative and culturally appropriate strategies to increase medication adherence is necessary to reduce health disparities in other racial and ethnic minority populations in the United States. [ABSTRACT FROM AUTHOR]

Despite being relatively uncommon in the general population, thumb amputations cause severe disability. More than 3,300 thumb amputations occurred in the United States. The thumb makes up around 40% of the function of the hand. Therefore, losing it would result in significant medical, hospital, and societal costs. Thumb reconstruction surgery's primary goal is to restore grip strength, including the range of motion, fine and tripod pinch, power grasp, strength, and sensibility, while secondary goals include restoring hand aesthetics. In cases of thumb replantation, like-for-like replacement is possible; however, when thumb replantation is not possible, great toe-to-hand transplantation is the best available reconstruction. When compared with other reconstructive options such as osteoplastic thumb reconstruction, pollicization, second toe transplantation, and the use of a thumb prosthesis, great toe transplantation provides superior function and aesthetics. For restoring pinch, sensitivity, strength, and aesthetics of the hand with well-tolerated donor site morbidity, toe to thumb transplantation is regarded as the gold standard. [ABSTRACT FROM AUTHOR]

At the time of this special issue, coronavirus disease 2019 (COVID‐19) is the leading cause of death in the United States and has contributed to millions of deaths worldwide. The world had no idea how the pandemic was going to impact our lives. COVID‐19 exposed the inequities in our world and the individuals that were most impacted by it: vulnerable populations. Vulnerable populations may be defined as those living in poverty, living with disability, and racial, ethnic, sexual, and gender minorities. Additionally, as community psychologists we understand that the impact of inequities do not appear singlehandedly since as human beings we do not exist in a vacuum and there are multiple factors that create our level of health and well‐being. Therefore, the idea of examining COVID‐19 in a syndemic framework allows us to explore how a synergistic epidemic (i.e., the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions) exacerbates the prognosis and burden of disease, which can impact vulnerable populations simultaneously. The main goal of this special issue concentrates on how COVID‐19 had a synergistic impact on vulnerable populations and how these populations reacted and coped with these events. [ABSTRACT FROM AUTHOR]

The availability of three COVID-19 vaccines in the United States provides an unprecedented opportunity to examine how vaccine platforms and timing of vaccination in pregnancy impact maternal and neonatal immunity. Here, we characterize the antibody profile after Ad26.COV2.S, mRNA-1273 or BNT162b2 vaccination in 158 pregnant individuals and evaluate transplacental antibody transfer by profiling maternal and umbilical cord blood in 175 maternal-neonatal dyads. These analyses reveal lower vaccine-induced functions and Fc receptor-binding after Ad26.COV2.S compared to mRNA vaccination and subtle advantages in titer and function with mRNA-1273 versus BN162b2. mRNA vaccines have higher titers and functions against SARS-CoV-2 variants of concern. First and third trimester vaccination results in enhanced maternal antibody-dependent NK-cell activation, cellular and neutrophil phagocytosis, and complement deposition relative to second trimester. Higher transplacental transfer ratios following first and second trimester vaccination may reflect placental compensation for waning maternal titers. These results provide novel insight into the impact of platform and trimester of vaccination on maternal humoral immune response and transplacental antibody transfer. Pregnant individuals infected with SARS-CoV-2 are at high risk of morbidity and mortality, in addition to adverse pregnancy outcomes, yet little is known regarding trimester-specific immunity and maternal protection from COVID-19 vaccine platforms. Authors utilise a systems serology approach to characterise the material antibody response and the transplacental antibody transfer, dependent on vaccine platform and trimester of vaccination. [ABSTRACT FROM AUTHOR]

Introduction: Millions of people present to the emergency department (ED) with chest pain annually. Accurate and timely risk stratification is important to identify potentially life-threatening conditions such as acute coronary syndrome (ACS). An ED-based observation unit can be used to rapidly evaluate patients and reduce ED crowding, but the practice is not universal. We estimated the number of current hospital admissions in the United States (US) eligible for ED-based observation services for patients with symptoms of ACS. Methods: In this cross-sectional analysis we used data from the 2011-2015 National Hospital Ambulatory Medical Care Survey (NHAMCS). Visits were included if patients presented with symptoms of ACS (eg, chest pain, dyspnea), had an electrocardiogram (ECG) and cardiac markers, and were admitted to the hospital. We excluded patients with any of the following: discharge diagnosis of myocardial infarction; cardiac arrest; congestive heart failure, or unstable angina; admission to an intensive care unit; hospital length of stay > 2 days; alteplase administration, central venous catheter insertion, cardiopulmonary resuscitation or endotracheal intubation; or admission after an initial ED observation stay. We extracted data on sociodemographics, hospital characteristics, triage level, disposition from the eD, and year of ED extracted from the NHAMCS. Descriptive statistics were performed using sampling weights to produce national estimates of ED visits. We provide medians with interquartile ranges for continuous variables and percentages with 95% confidence intervals for categorical variables. Results: During 2011-2015 there were an estimated 675,883,000 ED visits in the US. Of these, 14,353,000 patients with symptoms of ACS and an ED order for an ECG or cardiac markers were admitted to the hospital. We identified 1,883,000 visits that were amenable to ED observation services, where 987,000 (52.4%) were male patients, and 1,318,000 (70%) were White. Further-more, 739,000 (39.2%) and 234,000 (12.4%) were paid for by Medicare and Medicaid, respectively. The majority (45.1%) of observation-amenable hospitalizations were in the Southern US. Conclusion: Emergency department-based observation unit services for suspected ACS appear to be underused. Over half of potentially observation-amenable admissions were paid for by Medicare and Medicaid. Implementation of ED-based observation units would especially benefit hospitals and patients in the American South. [ABSTRACT FROM AUTHOR]

Introduction: National reports suggest that Hispanic patients may underutilize influenza and pneumococcal vaccination, although studies sometimes conflict on this point. A clearer picture of adult immunization utilization in older Hispanic patients is necessary to ensure equity in adult vaccinations. Methods: Using electronic health records from 648 community health centers (CHCs) across 21 states, we compared English‐preferring Hispanic patients, Spanish‐preferring Hispanic patients, and Non‐Hispanic White (NHW) adults aged ≥50 years across five outcomes between 2012–2017: (1) Odds of ever receiving pneumococcal vaccination after age 65, (2) Odds of ever receiving ≥2 pneumococcal vaccinations for those ≥65, (3) odds of vaccination between the ages of 50 and 64 for those with diabetes or heart disease, (4) odds of influenza vaccine, and (5) annual rate of influenza vaccination. Results: Of our total study sample (N = 143,869), 85,562 were age 50–64 during the entire study period, and 65,977 were ≥65 at some point during the study period. In patients aged 50–64, Spanish‐preferring Hispanic patients were more likely to have ever had an influenza vaccination (covariate‐adjusted odds ratio [aOR] = 1.33, 95% CI = 1.29–1.37), had higher rates of annual influenza vaccination (covariate‐adjusted rate ratio [aRR] = 1.41, 95% CI = 1.38–1.44), and higher odds of pneumococcal vaccination (aOR = 1.87, 95% CI = 1.76–1.98) than NHW patients. These findings were similar in Spanish‐preferring Hispanic patients ≥65. English‐preferring Hispanics ≥65 were less likely than NHW patients to ever have an influenza vaccination (aOR = 0.91, 95% CI = 0.85–0.98) and to have ever received at least one (aOR = 0.92, 95% CI = 0.86–0.99) or two (aOR = 0.86, 95% CI = 0.77–0.95) pneumococcal vaccine doses. Conclusions: In a multistate CHC network, Spanish‐preferring Hispanic patients were more likely to receive influenza and pneumococcal vaccinations than NHW patients; older English‐preferring Hispanic patients were often less likely than NHW patients to receive these vaccinations. In vaccine initiatives, English‐preferring Hispanic patients may be at higher risk of vaccination inequity. [ABSTRACT FROM AUTHOR]

The landscape for STEM instruction is rapidly shifting in the United States. Attention toward STEM instruction and assessment opportunities is increasing. All students must have opportunities to gain access to the STEM content and show what they know and are able to do. We caution that attention to fairness and accessibility is critical for students from special populations, particularly English learners and students with disabilities. Opportunities for equitable access to STEM instruction and assessment are diminished without accessibility. In this report, we use an assets‐based perspective to discuss and reframe common misconceptions and challenges as opportunities. We argue that attention to accessibility at the onset of STEM instruction and assessment is the pivotal foundation for fair opportunities in STEM. We highlight key opportunities and conclude with recommendations for improved fairness and access in STEM. Report Number: RR‐21‐11 [ABSTRACT FROM AUTHOR]

Substantial progress has been made toward applying technology enhanced conversation‐based assessments (CBAs) to measure the English‐language proficiency of English learners (ELs). CBAs are conversation‐based systems that use conversations among computer‐animated agents and a test taker. We expanded the design and capability of prior conversation‐based instructional and assessment systems and developed a CBA designed to measure the English language skills and the mathematics knowledge of middle school ELs. The prototype CBA simulates an authentic and engaging mathematics classroom where the test taker interacts with two virtual agents to solve math problems. We embedded feedback and supports that are triggered by how the CBA interprets students' written responses. In this study, we administered the CBA to middle school ELs (N = 82) residing in the United States. We examined the extent to which the CBA system was able to consistently interpret the students' responses (722 responses for the 82 students). The study findings helped us to understand the factors that affect the accuracy of the CBA system's interpretations and shed light on how to improve CBA systems that incorporate scaffolding. Report Number: RR‐21‐03 [ABSTRACT FROM AUTHOR]

Consultation-liaison services are an integral part of many pediatric hospital settings, yet characteristics of this patient population have not been extensively documented. The current study is a retrospective one-year chart review of the consultation-liaison service at a large pediatric hospital in the Southwestern United States. The purpose of this study is twofold: (1) to characterize this hospital's CL population and (2) to use these characteristics to identify preliminary evidence-based practices that should be considered for CL provider training. Identifying evidence-based practice elements that align with the characteristics of consultation–liaison patient populations may inform trainings for consultation-liaison staff. This would help to ensure that youth seen in hospital consultation-liaison services are getting the best available services, which is critical given the shortened time frame available to work with this patient population. [ABSTRACT FROM AUTHOR]

Flooding risk results from complex interactions between hydrological hazards (e.g., riverine inundation during periods of heavy rainfall), exposure, vulnerability (e.g., the potential for structural damage or loss of life), and resilience (how well we recover, learn from, and adapt to past floods). Building on recent coupled conceptualizations of these complex interactions, we characterize human-flood interactions (collective memory and risk-enduring attitude) at a more comprehensive scale than has been attempted to date across 50 US metropolitan statistical areas with a sociohydrologic (SH) model calibrated with accessible local data (historical records of annual peak streamflow, flood insurance loss claims, active insurance policy records, and population density). A cluster analysis on calibrated SH model parameter sets for metropolitan areas identified two dominant behaviors: 1) "riskenduring" cities with lower flooding defenses and longer memory of past flood loss events and 2) "risk-averse" cities with higher flooding defenses and reduced memory of past flooding. These divergent behaviors correlated with differences in local stream flashiness indices (i.e., the frequency and rapidity of daily changes in streamflow), maximum dam heights, and the proportion of White to non-White residents in US metropolitan areas. Riskaverse cities tended to exist within regions characterized by flashier streamflow conditions, larger dams, and larger proportions of White residents. Our research supports the development of SH models in urban metropolitan areas and the design of risk management strategies that consider both demographically heterogeneous populations, changing flood defenses, and temporal changes in community risk perceptions and tolerance. [ABSTRACT FROM AUTHOR]

In light of declining rural economies and dissipating rural populations, scholars, policy makers and program developers have increasingly looked to local business development and entrepreneurship as a means of revitalizing small communities across the United States. This study explores the perceptions of youth and business owners regarding the unique challenges and benefits or rural contexts for entrepreneurship, as well as perceptions regarding the potential role of youth in contributing to rural economies. Drawing from in-depth interviews and focus groups among local business owners and young rural residents, findings support earlier research regarding structural challenges that hamper rural business development (e.g., weak infrastructure) but also shed light on social challenges brought about by small and tightly bonded communities (e.g., openness to unfamiliar businesses). Notwithstanding these challenges, findings also suggest several perceived benefits of small communities such as local support for residents' enterprises and ease of communication with one's customer base. Finally, business owners expressed placing a high value on rural youth and their potential to make unique contributions to business development, nonetheless, found challenges around providing meaningful hands-on experiences for youth to learn about business operations. • Rural business owners' and rural youths' perceptions regarding business development were explored in four small U.S. communities. • Responses highlight unique challenges of rural structural contexts, as well as challenges around the social contexts of rural communities. • Respondents noted benefits of rural contexts that are often overlooked in scholarship. • Business owners value youth as contributors to the business environment but struggle with finding meaningful ways to include them. [ABSTRACT FROM AUTHOR]

Immigration is at the forefront of national, state, and local policy struggles in the United States, and Latinx/@ immigrants have experienced increased deportations, detention, and individual threats. A mobilities perspective allows analysis to extend our view of migration beyond frameworks confined to pre- and postmigration, examining trajectories of social inclusion and exclusion that are influenced by multiple factors in the receiving country. The Immigrant Well-being Project, a community-based participatory research project involving university faculty, students, staff, and representatives from 4 community-based organizations (CBOs), was initiated in New Mexico in 2017 to better understand and promote Latinx/@ immigrant mental health and integration by creating change at multiple levels. We began these efforts by conducting an in-depth study of the mental health needs, stressors, current socioeconomic, legal, and political context, and local solutions as experienced by 24 Latinx/@ immigrants and their mixed status families. Five trajectories of immigrant integration emerged: continuous exclusion, simultaneous exclusion and inclusion, continuous inclusion, movement from exclusion to inclusion, and movement from inclusion to exclusion. These diverse mobilities were shaped by participants' social locations, agency, and experiences with CBOs, which played critical roles in creating, maintaining, and/or transforming immigrants' trajectories. However, CBOs could not completely buffer immigrants from the current hostile climate and related stressors that resulted in experiences of exclusion or movement from inclusion to exclusion. These findings add to understandings of immigrant mental health, complex ongoing mobility, and mechanisms of resilience and resistance within the United States and have important implications for policy and practice. (PsycInfo Database Record (c) 2020 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Wheat growing regions and seasons are diverse, mandating different varietal adaptation and management practices. Grain yield is the primary target for soft-red winter (SRW) wheat, due to lower protein content requirements. The growing season for SRW wheat in the eastern United States takes up to 9 months under variable environments, highlighting the importance of variety and management. In this study, we present the results of a 2-year field-based investigation of yield response of 30 wheat lines to different nitrogen treatments by dissecting yield to its components. For 5 out of the 30 lines, we performed in-tissue nitrogen analysis. Spring nitrogen (N) treatments were two levels of 0 kg N ha–1 (low N) and 112 kg N ha–1 (high N). On average, application of 112 kg N in the spring, in addition to fall N fertilizer, increased phytomass by 22% at maturity, enhanced fertile tiller numbers by 16%, and increased grain yield by 18% that coincided with a 26% increase in grain number per unit area. N in the grains, or the nitrogen harvest index, was lower (36% of total) in high N than in low N (40% of total) treatment, which indicated plants did not increase the in-grain utilization of N. The 18% higher grain yield with 112 kg N treatment occurred without considerable change in grain N content. However, lines with greater biomass produced greater yields in low N. Therefore, increasing tiller numbers and grain numbers for SRW wheat are the targeted traits for improving grain yield under N management, with less emphasis on the utilization of N in grains because N content is not critically influential for the marketability of soft wheat grains. [ABSTRACT FROM AUTHOR]

Background: Achilles injuries are devastating injuries, especially for competitive athletes. No studies have examined the outcomes of Achilles injuries in NCAA athletes. Therefore, a better characterization and understanding of the epidemiology is crucial.Methods: Achilles injuries across 16 sports among NCAA men and women during the 2004-2005 to 2013-2014 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Achilles tendon injury rate (IR) per 100,000 athlete-exposures (AEs), operative rate, annual injury rate trends, reinjury rates, mechanism of injury, in-season status (pre/regular/post season), and time loss distributions were compiled and calculated. A sub-analysis of comparing gender and injury mechanism was also performed for both all injuries and severe injuries.Results: Overall, N = 255 Achilles injuries were identified with an injury rate (IR) of 2.17 (per 100,000 AEs). These injuries occurred most often in women's gymnastics (IR = 16.73), men's basketball (IR = 4.26), and women's basketball (IR = 3.32), respectively. N = 52 injuries were classified as severe injuries which have higher median time loss (48 days) and higher operative rate (65.4%). For severe Achilles injuries, female athletes had higher operative (77.8% vs. 58.8%) and higher time loss compared to male athletes (96 days vs. 48 days). Contact mechanisms were associated with a higher season-ending injury rate.Conclusion: Overall, 20.4% of Achilles injuries were considered severe with 65.6% operative rate. About 73.1% were season-ending injuries, and the remaining athletes have a median time loss of 48 days. Severe Achilles injuries create significant impact on playing time and career for NCAA athletes. [ABSTRACT FROM AUTHOR]

Background: Acute flaccid myelitis (AFM) is a severe illness similar to paralytic poliomyelitis. It is unclear how frequently AFM occurred in U.S. children after poliovirus elimination. In 2014, an AFM cluster was identified in Colorado, prompting passive US surveillance that yielded 120 AFM cases of unconfirmed etiology. Subsequently, increased reports were received in 2016 and 2018. To help inform investigations on causality of the recent AFM outbreaks, our objective was to determine how frequently AFM had occurred before 2014, and if 2014 cases had different characteristics. Methods: We conducted a retrospective study covering 2005–2014 at 5 pediatric centers in 3 U.S. regions. Possible AFM cases aged ≤18 years were identified by searching discharge ICD-9 codes and spinal cord MRI reports (>37,000). Neuroradiologists assessed MR images, and medical charts were reviewed; possible cases were classified as AFM, not AFM, or indeterminate. Results: At 5 sites combined, 26 AFM cases were identified from 2005–2013 (average annual number, 3 [2.4 cases/100,000 pediatric hospitalizations]) and 18 from 2014 (12.6 cases/100,000 hospitalizations; Poisson exact p<0.0001). A cluster of 13 cases was identified in September–October 2014 (temporal scan p = 0.0001). No other temporal or seasonal trend was observed. Compared with cases from January 2005–July 2014 (n = 29), cases from August–December 2014 (n = 15) were younger (p = 0.002), more frequently had a preceding respiratory/febrile illness (p = 0.03), had only upper extremities involved (p = 0.008), and had upper extremity monoplegia (p = 0.03). The cases had higher WBC counts in cerebrospinal fluid (p = 0.013). Conclusion: Our data support emergence of AFM in 2014 in the United States, and those cases demonstrated distinctive features compared with preceding sporadic cases. [ABSTRACT FROM AUTHOR]

Despite limited program evaluations of Medicaid accountable care organizations (ACOs), no studies have examined if cost-saving goals negatively affect quality of life and health care experiences of low-income enrollees. The Hennepin Health ACO uses an integrated care model to address the physical, behavioral, and social needs of Medicaid expansion enrollees. As part of a larger evaluation, we conducted semistructured interviews with 35 primary care using Hennepin Health members enrolled for 2 or more years. Using fuzzy set qualitative comparative analysis, we assessed enrollee complexity and use of the care model and improvements in quality of life. We found improved quality of life was consistently associated with strong bonds to primary care, consistent mental health care, and support from extended care team members. Comprehensive, integrated care models within ACOs may improve quality of life for low-income Medicaid enrollees through coordinated primary and mental health care. [ABSTRACT FROM AUTHOR]

High annual turnover rates that plague child welfare agencies are costly and disrupt services. Numerous studies have focused on aspects of the workplace and the characteristics of child welfare workers that may be associated with leaving. Fewer studies have explored the types of worker supports that agencies can offer to encourage retention. This two-study paper utilized data from public child welfare caseworkers to examine predictors of self-reported intent to stay and its association with actually staying at the agency. Results of Study 1 indicated that that self-reported intent to stay was a key predictor of staying (as was number of years on the job). Results of Study 2 indicated that self-efficacy, peer support, supervision, and organizational supports were key predictors of intent to stay. Newer workers differed somewhat from more experienced workers, providing an opportunity for reflection on how agencies can best support staff during different phases of their career. [ABSTRACT FROM AUTHOR]

Aims: Public service announcements often create media messages intended to stigmatize negative behaviors to reduce and prevent these behaviors. Drawing on social and cognitive psychology, we hypothesize that stigmatizing messages can create stereotype threat would be associated with shorter latency to first cigarette in the laboratory compared to the control condition. Design A double‐blind, randomized, controlled trial in which participants completed two smoking lapse tasks, one at baseline and one post‐intervention/control. Setting: An experimental psychopharmacology laboratory in the western United States. Participants: A community sample of non‐treatment‐seeking daily smokers (n = 77) received either a stereotype threat (n = 39) or neutral/control (n = 38) message. Intervention: Participants received either a stereotype threat message that stigmatized smoking or a control message. Measurements The primary outcome measure was participants' ability to delay smoking during the smoking lapse task in the experimental session Findings The difference in delay time during the experimental session at the point where 50% of each group had smoked was 3 minutes. Cox proportional hazard models revealed that participants in the stereotype threat group were significantly less able to delay initiating smoking compared to the control group (hazard ratio = 0.504, P = 0.010, 95% confidence interval = 0.30, 0.85), after controlling for baseline latency to smoke. Conclusions: Messages that elicit negative stereotypes of smokers operated as 'smoking‐promoting messages' in the context of our controlled laboratory investigation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to create and prototype a dual language assessment task that allows young English learners to use their entire cadre of linguistic resources (language and non-verbal resources) to obtain information about their emergent language abilities. We developed a dual language assessment task in which students described a picture, predicted a story, and retold a story. This task allows students to translanguage, that is, to use all their linguistic resources in ways that fit their communicative needs, and the students' responses are scored regardless of the language(s) or communicative strategies that are used. In this paper, we report our findings concerning how 17 kindergarten Spanish-speaking English learners in the United States interacted with the dual language assessment task, whether and how they used their language (e.g., English and Spanish) and non-verbal (e.g., body movements, gestures, gazes, visual cues, posture, drawings, signs) resources, and what we learned about their cross-linguistic emergent language abilities. [ABSTRACT FROM AUTHOR]

There is a growing interest in converting marginal lands to bioenergy crop production instead of using high quality croplands which could jeopardize food security and soil quality. Miscanthus (Miscanthus x giganteus Greef & Deuter ex Hodkinson & Renvoize) is a promising feedstock due to its high biomass production under temperate climate and a wide range of soil properties. Appalachian region contains about 1.1 million hectares (Mha) of reclaimed minesoils (RMS) that can be used to produce bioenergy crops and spare arable lands for food production. This study was conducted on 27 years old RMS which was converted to corn and miscanthus land uses in 2013. We assessed the growth performance (plant populations, height, tillers), and aboveground dry biomass (AB) yields of miscanthus and corn (Zea mays L.) compared to antecedent meadow under reclaimed mined land (RML) as affected by different fertilization practices during the first three years of establishment of corn and miscanthus. Results show that the growth and AB yields did not significantly vary between source (synthetic and organic) and rate of nitrogen applications (0, 75, 150, 225 kg N h−1) within each land-use. For the first three years meadow and corn on average had a 30% higher cumulative potential AB harvest compared to miscanthus (12.2 Mg ha−1). Miscanthus generally takes about three years to establish good stand. However, miscanthus had the highest AB yields in the third year (19.6 Mg ha−1) and is expected to maintain higher yields than the meadow (8.0 Mg ha−1) and corn (8.3 Mg ha−1) land-uses, resulting in a greater harvestable AB yield potential in the long-term. Continued monitoring of AB yields is critical to determining whether sustained yields can be maintained with little or no inputs in RML. • Miscanthus biomass yield increased linearly during the first three years of the establishment. • Miscanthus biomass production potential in RMS is significantly higher than meadow and corn. • Corn and meadow biomass yields were comparable during the second and third year. • Miscanthus showed potential to be a bioenergy crop of choice for degraded lands. [ABSTRACT FROM AUTHOR]

Background The US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity. Methods We conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. We assessed food security and receipt of food assistance. We used multivariable logistic regression to examine factors associated with very low food security. Results The majority of the cohort was male and African American. Over half (55.4%) met criteria for food insecurity, 24.3% reported very low food security. Half (51.7%) reported receiving monetary food assistance. In the multivariable model, those who were primarily sheltered in the prior 6 months, (multi-institution users [AOR = 0.44, 95% CI: 0.22–0.86]) had less than half the odds of very low food security compared with those who were unsheltered. Depressive symptoms (AOR = 3.01, 1.69–5.38), oral pain (AOR = 2.15, 1.24–3.74) and cognitive impairment (AOR = 2.21, 1.12–4.35) were associated with increased odds of very low food security. Conclusions Older homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups. [ABSTRACT FROM AUTHOR]