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The study aims to analyze marriage expectations among sexual minority youth in the United States. The possibility of marriage for same-sex couples is recent in the United States. As same-sex couples used to be excluded from getting married, LGB adults have expressed concerns about the institution of marriage and have been less likely than their heterosexual peers to consider it for themselves. However, research is lacking when considering marriage expectations and attitudes regarding marriage among LGBTQ youth. We use wave 2 of the SOGI-Q Health Study, a community sample of 542 LGBTQ youth aged 15–21 collected in 2013, a time prior to federal marriage equality. We assessed measured marriage expectations, both to a same-sex partner and to a different-sex partner, as well as attitudes regarding marriage. Results indicated that gay and lesbian youth were more likely than queer and bisexual youth to expect to get married to a same-sex partner. Individual factors (e.g., higher levels of disclosure to family members) and structural factors (e.g., knowing a married same-sex couple), were associated with higher marriage expectations to a same-sex partner. Religiosity was associated with higher expectations of marriage to a different-sex partner. Sexual identity, religiosity, disclosure, and knowing married same-sex couples were significantly associated with LGBTQ youths' expectations to marry a same-sex and/or different-sex partner, as well as their attitudes about marriage more broadly. Attitudes and expectations regarding marriage among sexual minority youth have implications for their future couple and family formation, which are broadly associated with well-being across the adult lifespan. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education (CSE) has been shown to have a wide range of positive impacts for K-12 students. Despite its demonstrated benefits, many K-12 students in the USA do not receive CSE. Because of this, college may be an opportune time to teach this information. However, little is known about the impact of CSE in institutions of higher education. To synthesise knowledge about the impacts of college-level sexual health courses in the USA, a review of the topic was conducted. A review searching Ebscohost, ProQuest, PubMed, and Google Scholar was undertaken. Following the search, a second coder reviewed the articles to confirm eligibility. 13 articles, published between 2001 and 2020, met the inclusion criteria and were included in the review. A wide range of outcomes were reported. These included increased health promoting behaviours, less homophobic and judgemental attitudes around sexuality, improved communication and relationships, and increased understanding of sexual violence. College sexual health courses have high potential efficacy to provide CSE and fill gaps in US students' sexual health knowledge. Future research should corroborate the existing outcomes using randomisation and more diverse samples, and examine whether these courses are effective in preventing sexual assault. [ABSTRACT FROM AUTHOR]

Background Out-of-pocket (OOP) costs can be substantial financial burdens for patients and may even cause patients to delay or forgo necessary medical procedures. Although overall healthcare costs are rising in the United States, recent trends in patient OOP costs for foot and ankle orthopaedic surgical procedures have not been reported. Fully understanding patient OOP costs for common orthopaedic surgical procedures, such as those performed on the foot and ankle, might help patients and professionals make informed decisions regarding treatment options and demonstrate to policymakers the growing unaffordability of these procedures. Questions/purposes (1) How do OOP costs for common outpatient foot and ankle surgical procedures for commercially insured patients compare between elective and trauma surgical procedures? (2) How do these OOP costs compare between patients enrolled in various insurance plan types? (3) How do these OOP costs compare between surgical procedures performed in hospital-based outpatient departments and ambulatory surgical centers (ASCs)? (4) How have these OOP costs changed over time? Methods This was a retrospective, comparative study drawn from a large, longitudinally maintained database. Data on adult patients who underwent elective or trauma outpatient foot or ankle surgical procedures between 2010 and 2020 were extracted using the MarketScan Database, which contains well-delineated cost variables for all patient claims, which are particularly advantageous for assessing OOP costs. Of the 1,031,279 patient encounters initially identified, 41% (427,879) met the inclusion criteria. Demographic, procedural, and financial data were recorded. The median patient age was 50 years (IQR 39 to 57); 65% were women, and more than half of patients were enrolled in preferred provider organization insurance plans. Approximately 75% of surgical procedures were classified as elective (rather than trauma), and 69% of procedures were performed in hospital-based outpatient departments (rather than ASCs). The primary outcome was OOP costs incurred by the patient, which were defined as the sum of the deductible, coinsurance, and copayment paid for each episode of care. Monetary data were adjusted to 2020 USD. A general linear regression, the Kruskal-Wallis test, and the Wilcoxon-Mann-Whitney test were used for analysis, as appropriate. Alpha was set at 0.05. Results For foot and ankle indications, trauma surgical procedures generated higher median OOP costs than elective procedures (USD 942 [IQR USD 150 to 2052] versus USD 568 [IQR USD 51 to 1426], difference of medians USD 374; p < 0.001). Of the insurance plans studied, high-deductible health plans had the highest median OOP costs. OOP costs were lower for procedures performed in ASCs than in hospital-based outpatient departments (USD 645 [IQR USD 114 to 1447] versus USD 681 [IQR USD 64 to 1683], difference of medians USD 36; p < 0.001). This trend was driven by higher coinsurance for hospital-based outpatient departments than for ASCs (USD 391 [IQR USD 0 to 1136] versus USD 337 [IQR USD 0 to 797], difference of medians USD 54; p < 0.001). The median OOP costs for common outpatient foot and ankle surgical procedures increased by 102%, from USD 450 in 2010 to USD 907 in 2020. Conclusion Rapidly increasing OOP costs of common foot and ankle orthopaedic surgical procedures warrant a thorough investigation of potential cost-saving strategies and initiatives to enhance healthcare affordability for patients. In particular, measures should be taken to reduce underuse of necessary care for patients enrolled in highdeductible health plans, such as shorter-term deductible timespans and placing additional regulations on the implementation of these plans. Moreover, policymakers and physicians could consider finding ways to increase the proportion of procedures performed at ASCs for procedure types that have been shown to be equally safe and effective as in hospital-based outpatient departments. Future studies should extend this analysis to publicly insured patients and further investigate the health and financial effects of highdeductible health plans and ASCs, respectively. Level of Evidence Level III, economic and decision analysis. [ABSTRACT FROM AUTHOR]

Background: It has yet to be fully elucidated how differing populations of obstetric patients adapted to the disruptions in perinatal care and postpartum support from the COVID‐19 pandemic. We surveyed an enriched sample of socioeconomically advantaged patients to understand the influence of COVID‐19 on their perinatal care experience, well‐being, and coping. Methods: We surveyed pregnant and postpartum patients (n = 6140) at a large academic medical center in the Midwest of the United States using the Coronavirus and Perinatal Experiences instrument in Spring 2021. Results: The survey was sent to 6141 pregnant and postpartum patients; 1180 (17.8%) respondents completed the survey, including 256 who were pregnant and 834 postpartum. Most pregnant patients experienced no changes in their prenatal care with 16.5% indicating somewhat worsened care. In the postpartum cohort, 37.5% stated their care had somewhat worsened. In describing influences on stress and mental health, 58.1% of postpartum respondents stated it was moderately, and 17.4% significantly, worse. The pandemic had a somewhat or moderately negative influence for 72.7% of respondents, with 11.0% stating these effects were extremely negative. Both cohorts characterized a range of coping strategies, most commonly, talking with friends and family (76.3%). Conclusion(s): Even among this sample of socioeconomically advantaged patients, respondents indicated that the pandemic disrupted many facets of their medical care and daily life, especially social activities and postpartum support. Our findings suggest that counseling on coping and adaptation strategies for stressors and increased health systems support be part of perinatal care during public health emergencies for all demographic groups. [ABSTRACT FROM AUTHOR]

Summary: Paediatric weight management (PWM) programs in the United States (US) face challenges in providing sustainable multidisciplinary care for patients. The aim of this study was to report PWM program approaches to sustaining program delivery. A survey of 39 PWM programs was administered to identify challenges and solutions to program sustainability. Common and useful strategies for optimizing reimbursement for services included the use of applicable reimbursable diagnostic codes and management, billing for assessments and non‐medical personnel services, and the use of hospital outpatient department clinic billing. Increasing clinical breadth and capacity was achieved by offering telemedicine and other services, such as psychotherapy, pharmacotherapy, and metabolic and bariatric surgery, as well as active management of schedules. Securing institutional and extramural funding was also reported. One of the positive changes during the pandemic was the fast adoption of telemedicine services. Although delivering sustainable evidence‐based multidisciplinary PWM under the current US payment models has its challenges, PWM programs implement practical operational strategies to support this work. [ABSTRACT FROM AUTHOR]

Background/Objective: There is limited information about the potential relationship of socioeconomic status (SES) with acne in preadolescents. Our objective was to assess the possible relationship between SES and preadolescent acne. Methods: A population-based retrospective cohort study was conducted to identify Olmsted County, Minnesota, residents with an initial acne diagnosis between 7 and ≤12 years old during 2010 to 2018 using the Rochester Epidemiology Project. For each acne case, we randomly selected 2 sex- and age-matched controls without an acne diagnosis from the county. Individual HOUsing-based SocioEconomic Status index (HOUSES) derived from real property data was used to evaluate SES, represented as four quartiles with higher quartile representing higher SES. Results: A total of 604 patients met the criteria. HOUSES distribution significantly differed between cases and controls (p = .001); a higher proportion of acne cases were in quartile 4 (42.2% vs. 32.7%), indicating higher SES. Race and ethnicity did not significantly differ between cases and controls. Among cases and controls, 74.5% and 72.3% were White, respectively. Study limitations include its retrospective design, only patients who visited a physician were included, and Olmsted County residents are largely non-Hispanic White. Conclusion: Preadolescents diagnosed with acne have a higher SES than those without diagnosed acne, highlighting a potential disparity in access to care and appropriate diagnosis. [ABSTRACT FROM AUTHOR]

Background/Objectives: Little is known about acne incidence in preadolescents and its potential association with body mass index (BMI). Our study aims to determine acne incidence in preadolescents and its association with BMI. Methods: A population-based retrospective cohort study identified 7- to ≤12 yearolds with an initial acne diagnosis during 2010–2018, and incidence was calculated. Two age- and sex-matched controls without acne were randomly selected per case, and BMI was recorded. Results: A total of 643 acne patients were identified. Annual age- and sex-adjusted incidence rate was 58.0 per 10,000 person-years, higher in females vs. males (89.2 vs. 28.2 per 10,000 person-years, p < .001), and increased with age (4.3, 24.4, and 144.3 per 10,000 person-years among 7–8, 9–10, and 11–12 year-olds, respectively, p < .001). Systemic medication use was associated with increasing BMI (odds ratio = 1.43 per 5 kg/m² increase in BMI, 95% CI 1.07–1.92, p = .015). Median BMI percentile was higher among acne cases vs. controls (75.0 vs. 65.0, p < .001), as was the proportion with BMI ≥95th percentile (16.7% vs. 12.2%, p = .01). Conclusion: Acne incidence is higher in preadolescent girls than boys and increases with age. Preadolescents with acne are more likely to be obese than those without acne. Those with higher BMIs are more likely to be given systemic treatment. [ABSTRACT FROM AUTHOR]

Elder tribal members are important cultural and spiritual leaders and experts among many American Indian and Alaska Native (AI/AN) cultures. AI/AN Elders play a key role in the maintenance and transmission of traditional cultural knowledge and practices and are highly valued members of AI/AN communities. AI/AN populations face disparities in healthcare outcomes, and the healthcare needs of AI/AN Elders remain an understudied area of research, particularly among tribes in the South and for tribes who do not have federal recognition. Qualitative data was collected through semi-structured interviews among 31 women, all of whom are members of a state-recognized Tribe in the Southern United States. While the interview questions were specific to their own reproductive healthcare experiences, repeated concerns were voiced by the women regarding the health of the Elders in their community. Key findings captured several concerns/barriers regarding Elders' healthcare experiences including: (a) Language and communication barriers between Elders and healthcare workers; (b) Prior negative experiences with Western medicine; (c) Lasting impacts of educational discrimination; (d) Concerns over self-invalidation; (e) Transportation barriers; and (f) Need for community programs. Issues related to these barriers have resulted in a concern that Elders are not receiving the full benefit of and access to Western healthcare systems. The purpose of this analysis was to highlight the concerns voiced by women tribal members on the health and wellbeing of Elders in their community. Opportunities related to the importance of prioritizing and improving AI/AN Elders' healthcare experiences and access are also described. [ABSTRACT FROM AUTHOR]

The United States has a higher rate of teen pregnancy than any other developed country with 30% of American girls becoming pregnant before the age of 20. Laws regarding the inclusion and content of sexuality education vary across the country, which are associated with differences in pregnancy and sexually transmitted infection (STI) rates between states. This systematic review aims to determine whether comprehensive sexuality education (CSE) is more effective than abstinence-only or no sexuality education at reducing teenage pregnancy. Secondary objectives include analyzing the effect of CSE on STI incidence, sexual activity, safe-sex behaviors, and social discomfort. We searched multiple databases for studies published from 1990 to 2021. Twenty-nine studies met our inclusion criteria. Seven included pregnancy as an outcome, with three fitting our meta-analysis criteria. There was a decrease in pregnancy rates for participants in the CSE intervention compared to the control (n = 3, risk ratio = 0.89, 95%CI 0.79–1.00, I2 = 0%). We found that CSE is likely to reduce pregnancy rates; however, there was limited data available on this outcome. CSE increased safe-sex behaviors but did not have a notable impact on sexual activity or STIs. This review can serve as evidence for the implementation of CSE in the US. [ABSTRACT FROM AUTHOR]

Adults born preterm (birth <37 weeks' gestation) have a two-fold increased risk of early cardiovascular mortality. With 10% of the U.S. population born prematurely and perinatal advancements dramatically improving survival rates, millions of survivors are now reaching adulthood. This phenomenon has introduced a whole new population of individuals with a history of preterm birth. Although the prevailing notion has been that preterm birth is a condition confined only to infancy and early childhood, we now know preterm birth is a risk for lifelong chronic health conditions. Despite almost a decade of epidemiological evidence showing increased cardiovascular risk for those born preterm, this has not yet been translated into clinical practice. As a result, clinicians are caring for adults born prematurely without screening and treatment guidelines for this at-risk population and few inquire about birth history during clinical encounters. This brief report presents growing evidence about disrupted cardiogenesis and consequential structural and functional modifications. By asking the question "Were you born preterm?," nurse practitioners can take the first step of increasing their awareness of this at-risk population and mitigate adverse cardiovascular outcomes by using preterm birth as a risk factor when determining health promotion and treatment decisions. [ABSTRACT FROM AUTHOR]

Fire location and burning area are essential parameters for estimating fire emissions. However, ground-based fire data (such as fire perimeters from incident reports) are often not available with the timeliness required for real-time forecasting. Fire detection products derived from satellite instruments such as the GOES-16 Advanced Baseline Imager or MODIS, on the other hand, are available in near real-time. Using a ground fire dataset of 2699 fires during 2017–2019, we fit a series of linear models that use multiple satellite fire detection products (HMS aggregate fire product, GOES-16, MODIS, and VIIRS) to assess the ability of satellite data to detect and estimate total burned area. It was found that on average models fit with fire detections from GOES-16 products performed better than those developed from other satellites in the study (modelled R2 = 0.84 and predictive R2 = 0.88). However, no single satellite product was found to best estimate incident burned area, highlighting the need for an ensemble approach. With our proposed modelling ensemble, we demonstrate its ability to estimate burned area and suggest its further use in daily fire tracking and emissions-modeling frameworks. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To quantify geographic variation in home health expenditures per Medicare home health beneficiary and investigate factors associated with this variation. STUDY DESIGN: Retrospective study design analyzing US counties in which at least 1 home health agency served 11 or more beneficiaries in 2016. Several sources of 2016 national public data were used. METHODS: The key variable is county-level Medicare home health expenditures per home health beneficiary. Counties were grouped into quintiles based on per-beneficiary expenditures. Analyses included calculation of coefficients of variation, computation of the ratio of 90th percentile to 10th percentile in expenditures, and linear regression predicting expenditure. The control variables included characteristics of patients, agencies, and communities. RESULTS: Significant variation in home health expenditures was identified across county quintiles, with a 90th-to- 10th-percentile expenditure ratio of 2.5. The percentage of for-profit agencies in the lowest quintile was 15.7 compared with 81.7 in the highest quintile of spending. Unadjusted spending differed by $3864 (95% CI, $3793-$3936), compared with $3611 (95% CI, $3514-$3708) in the adjusted model, between counties in spending quintiles 1 and 5. Although state fixed effects explained nearly 20% of the variation in home health expenditures, 42% of the variation remained unexplained. CONCLUSIONS: Home health care exhibits considerable unwarranted variation in per-patient expenditures across counties, signifying inefficiency and waste. Given the expected growth in home health demand, strategies to reduce unwarranted geographic variation are needed. [ABSTRACT FROM AUTHOR]

The complex relationship between professional success and civic engagement among educated immigrant professionals is little understood. This qualitative study examines the social processes linking professional attainment and civic involvement among immigrant professionals, with the purpose to deepen understanding of the mechanisms through which civic participation is tied to occupational pathways and advancement. We report on findings from interviews with 62 U.S. immigrants, all professionals and employed in various occupations to understand the dynamic processes through which civic involvement and professional achievement are mutually constitutive. Immigrant professionals are engaged civically; community engagement among this population is overwhelmingly tied to professional and vocational interests and skills. They participate in both formal and informal community-based organizations and groups, and many are transnational in scope. [ABSTRACT FROM AUTHOR]

The authors comment on the target article which reported that ethics consultation (EC) practices have not improved significantly since 2000 and question whether the status quo affords patients and hospitals an appropriate mechanism for addressing ethical concerns. Topics include the role of ethics consultations in healthcare settings, an ethics gap in public health practice, and implications of the ethics gap.

The prevalence of substance use disorders (SUDs) is growing among older adults, and older adults in rural areas face disparities in access to SUD care. Rural older adults with SUDs commonly have comorbid chronic conditions that puts them at risk for frequent acute healthcare utilization. In rural areas, primary care for patients with SUDs are increasingly provided by nurse practitioners (NPs), and quality primary care services may decrease ED visits in this population. Yet, NP-delivered primary care for rural older adults with SUDs may be limited by work environment barriers, which include lack of support, autonomy, and visibility. This study assessed the relationship between the NP work environment and ED utilization among rural older adults with SUDs. This was a secondary analysis of cross-sectional data from a large survey of NPs in six U.S. states merged with Medicare claims. The study measured the NP work environment by the four subscales of the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), which measure 1) independent practice and support, 2) NP-physician relations, 3) NP-administration, and 4) professional visibility. Multilevel logistic regression models, adjusted for practice and patient covariates, assess the relationship between the NP work environment and all-cause ED use. The sample included 1152 older adults with SUDs who received care at 126 rural NP primary care practices. NP independent practice and support at the practice was associated with 49 % lower odds of all-cause ED visits among older adults with SUDs. There were no relationships between the other NP-PCOCQ subscales and all-cause ED visits. Organizational support for NP independent practice is associated with lower odds of all-cause ED utilization among rural older adults with SUDs. Practice administrators should ensure that NPs have access to support and resources to enhance their ability to care for rural older adults with SUDs. Ultimately, these practice changes could reduce ED utilization and health disparities in this population. • Rural older adults with substance use disorders frequently use the emergency room. • Relations, teamwork, autonomy, and support may impact nurse practitioner (NP) care. • Support for NP independent practice associated with less emergency room use. • Organizational administrators should ensure NP autonomy and access to support. [ABSTRACT FROM AUTHOR]

Many older adults do not engage in age-based prevention despite evidence to support reduced health risks and enhanced successful aging. The purpose of this study was to determine whether self-perceived aging (SPA) differed among older adults by age (young-old vs. old-old), participation in healthy lifestyle behaviors, screening, vaccinations, and self-rated health. Community-dwelling older adults (n=204) completed questionnaires reporting their SPA, self-rated health, and participation in recommended preventive healthy lifestyle behaviors, screening, and vaccinations. Our findings indicated that adults who were older and engaged in more preventive health behaviors, yet had lower self-rated health, tended to have better SPA. Prevention was greater in older adults who scored higher on aging well and aging successfully. Old-old (75 years or older) participants scored higher on aging successfully than those who were younger. Self-rated health was inversely related to SPA scores. Reporting poor or fair health did not diminish positive SPA in this sample. [ABSTRACT FROM AUTHOR]

Background and Objectives: Fentanyl and other highly potent synthetic opioids are the leading cause of opioid overdose deaths in the United States. Methods: This study was an open‐label, uncontrolled 12‐week outpatient clinical trial to test the feasibility of a single‐day induction onto extended‐release buprenorphine (BXR) injection treatment for five adults (N = 5) with opioid use disorder using heroin‐containing fentanyl. Participants were planned to receive three monthly BXR injections (300, 300, and 100 mg). Results: After receiving 24 mg sublingual buprenorphine (SL‐BUP), all five participants received the BXR 300 mg injection on the first day of induction. All five participants were retained for the full 3‐month study period postinduction and received all three scheduled BXR injections. Discussion and Conclusion: This study provides preliminary evidence supporting the feasibility of inducting users of heroin‐containing fentanyl onto BXR 300 mg in a single day. Scientific Significance: The ability to administer a long‐acting injection of BXR that assures therapeutic serum levels for a month on the first day of treatment contact is a promising development for the treatment of OUD. [ABSTRACT FROM AUTHOR]

Objective: Obesity is a prominent public health concern significantly impacting various minority groups, especially Latina Americans. However, little study has explored acculturation-related factors associated with obesity among Latinas in the United States. This study examines the link between acculturation-related factors and obesity among Latinas. Design: Using the National Latino and Asian American Study (NLAAS), we detected the incremental associations of acculturation-related factors, especially perceived discrimination with obesity, after controlling for socio-demographics, among all 1427 Latinas. Two-step logistic regression analyses were conducted to investigate the association. Results: Results indicated perceived discrimination and older age were positively associated with Latinas' obesity. Conversely, income and acculturation stress were negatively associated with obesity. Further, results revealed a significant moderating effect of education on the association between perceived discrimination and obesity. Conclusion: The findings suggest the need for clinical attention towards socio-cultural influences and ethnic backgrounds in obesity assessment and intervention. [ABSTRACT FROM AUTHOR]

Identifying childhood cognitive processes that predict adolescent problem behaviors can help guide understanding and prevention of these behaviors. In a community sample of 313 youth recruited in a small Midwestern city between 2006 and 2012 (49% male, 64% European American), executive control and foundational cognitive abilities were assessed at age 5 in a lab setting with performance-based measures. In adolescence, youth provided self-report of problem behaviors in surveys administered annually between ages 14 and 16. Executive control was negatively associated with externalizing behavior problems and adolescents getting in trouble at school, accounting for foundational cognitive abilities and family background covariates. Executive control had negative, but nonsignificant, associations with internalizing problems and substance use initiation. The findings point to deficits in executive control as a childhood risk factor for later problems and a potential target for preventive interventions. [ABSTRACT FROM AUTHOR]

• 42% of customers surveyed store leftover drugs in their homes. • Customer reported dropbox usage was higher at pharmacies with dropboxes. • Pharmacists at dropbox locations gave safe and consistent disposal recommendations. • Increased pharmacy dropbox locations are necessary to improve proper drug disposal. Production and use of pharmaceuticals in the United States is high and continues to grow. This, combined with poor wastewater removal rates for drugs in excreted waste, and improper pharmaceutical disposal leads to the presence of pharmaceuticals in fresh- and marine waters and wildlife. In the United States, safe drug take-back boxes, or dropboxes, were established in pharmacies after federal legislation passed in 2014, allowing for year-round safe collection of leftover pharmaceuticals. The overarching objective of this work was to identify opportunities for improving access to proper pharmaceutical disposal. We assessed consumer behavior regarding drug disposal choices and knowledge of dropboxes at pharmacies, investigated pharmacist attitudes toward and recommendations about leftover drug disposal, and compared responses at locations with and without dropboxes. We also explored obstacles to dropbox adoption and usage. We found that customer awareness of dropboxes as well as knowledge about risks of improper disposal are low, however awareness was greater at pharmacies with dropboxes. Additionally, pharmacists at dropbox locations were more consistent in their messaging to customers, more likely to recommend proper disposal methods, and more supportive of drug take-back programs. Through a focus group, we learned that further consumer education would overwhelm the capacity of the existing dropboxes. Based on our findings, we recommend solutions to improper disposal focus on legislation mandating dropboxes at pharmacies and pressure on the pharmaceutical industry to fund proper disposal of unused pharmaceuticals. [ABSTRACT FROM AUTHOR]

Emergency powers are essential to the proper functioning of the government. Emergencies demand swift and decisive action; yet, our system of government also values deliberation and procedures. To enable such agility in a system fraught with bureaucracy, Congress frequently delegates unilateral statutory emergency powers directly to its most nimble actor: the President. The powers Congress delegates to the President are vast and varied, and often sacrifice procedural requirements in favor of expediency. Most scholars and policymakers have come to terms with this tradeoff, assuming that the need to respond quickly is outweighed by any loss of accountability. This Article challenges this long-standing assumption and is skeptical of the zero-sum framework that suggests accountability and expediency cannot coexist in statutory emergency delegations. Specifically, it develops an Executive Delegations Matrix to better evaluate the different delegation options, demonstrating that accountability and expediency need not be mutually exclusive. This Article then uses emergency energy powers to test the viability of the factors favoring unilateral delegations, ultimately finding these factors unpersuasive in the energy-emergency context. Instead of the common knee-jerk reaction to unilateral presidential control over emergencies, this Article finds that Congress can often cultivate a more balanced decision-making framework by providing a greater role for expert agencies. By challenging the assumptions underlying unilateral presidential delegations for energy emergencies, this Article provides a new framework for assessing the world of unilateral presidential delegations more broadly. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVES: To examine the prevalence of potentially inappropriate medication (PIM) prescribing and its association with healthcare utilization and related expenditures utilizing nationally representative data from the United States. DESIGN: Retrospective cohort study. SETTING: The 2011–2015 Medical Expenditure Panel Survey (MEPS). PARTICIPANTS: Community‐dwelling sample of U.S. adults aged 65 and older during the first round of each MEPS cycle. MEASUREMENTS: A qualified definition operationalized from the 2019 American Geriatrics Society Beers Criteria® was used to estimate the prevalence of PIM prescribing over the study period. Negative binomial models were assembled to examine associations between PIM exposure and healthcare utilization including hospitalizations, emergency department (ED) visits, and outpatient provider visits. Generalized linear models with the log link function and gamma distribution were used to analyze associations between PIM exposure and healthcare expenditures. Sensitivity analyses were conducted utilizing inverse probability treatment weighting using propensity scores for being prescribed a PIM. RESULTS: The period prevalence of PIM prescribing over the 5‐year sample was 34.4%. PIM prescribing was positively associated with hospitalizations (adjusted incidence rate ratio [aIRR] = 1.17; 95 confidence interval [CI] = 1.08–1.26; P <.001), ED visits (aIRR = 1.26; 95% CI = 1.17–1.35; P <.001), and outpatient provider visits (aIRR = 1.18; 95% CI = 1.14–1.21; P <.001). PIM exposure was associated with higher marginal costs within outpatient visits ($116; 95% CI = $105–$243; P <.001), prescription medications ($128; 95% CI = $72–$199; P <.001), and total healthcare expenditures ($458; 95% CI = $295–$664; P <.001). Similar results were found in our propensity score analyses. CONCLUSION: PIMs continue to be prescribed at a high rate among older adults in the United States. Our results suggest that receipt of PIMs is associated with higher rates of healthcare utilization and increased costs across the healthcare continuum. Further work is needed to implement evidence‐based deprescribing interventions that may in turn reduce unnecessary healthcare utilization. [ABSTRACT FROM AUTHOR]

A biography of former U.S. Extension Service Poultry Specialist Harriette Eliza Cushman is presented. She was born in 1890 in Alabama and studied at Mount Holyoke College and Cornell University. After completing school she worked in a lab and began overseeing chicken farms during World War I. Other topics include the employment of women in scientific fields, Cushman's work with Native Americans in Montana, and how Cushman handled gender roles in her personal and professional lives.

Background: Studies have shown adverse effects of a disadvantaged childhood on adult health-promoting behaviors and related outcomes. Optimism and social support have been linked to greater likelihood of engaging in healthy behavior, but it is unclear whether these positive psychosocial factors may buffer harmful effects of early adversity. This study aims to determine if optimism and social support in adulthood can modify effects of childhood disadvantage on health behavior-related outcomes. Methods: Longitudinal data were analyzed from a subset of participants in a US birth cohort established in 1959–1966 (ns of 681–840, per outcome). An index of childhood social disadvantage was derived from adverse socioeconomic and family stability factors reported by mothers at child's birth and age 7 years. Health behavior-related outcomes were self-reported when participants were of mean age 47 years. Multivariable adjusted robust Poisson regressions were performed. Results: Regardless of level of childhood social disadvantage, we found higher levels of optimism and social support were both associated with higher probabilities of being a non-smoker (relative risk [RR]optimism = 1.17, 95% confidence interval [CI] = 1.09–1.26; RRsocial support = 1.24, 95%CI = 1.11–1.39), having a healthy diet (RRoptimism = 1.25, 95%CI = 1.10–1.43; RRsocial support = 1.27, 95%CI = 1.04–1.56), and a healthy body mass index (RRoptimism = 1.18, 95%CI = 1.00–1.40; RRsocial support = 1.29, 95%CI = 1.00–1.66). Interactions link higher optimism or social support with lower risk of smoking among those with moderate childhood disadvantage. Conclusions: Overall, these findings are consistent with the possibility that positive psychosocial resources contribute to maintaining a healthy lifestyle in mid-adulthood and may buffer effects of childhood social disadvantage. [ABSTRACT FROM AUTHOR]

Young peoples' acceptance and use of nontraditional, descriptive identity labels (e.g., pansexual, genderqueer) require nurses to consider moving beyond use of traditional terms (e.g., gay, transgender). This mixed methods study explores (a) labels used by sexual orientation and gender identity (SOGI) minority youth, (b) their expressed importance and meaning of these labels, and (c) differences in label usage. Sixty-six SOGI minority adolescents in British Columbia, Minnesota, and Massachusetts (mean age = 16.6) participated in "go-along" interviews; during interviews, 42 (63.6%) commented on labels. Chi-square and t tests were used to compare traditional versus nontraditional labels across participant demographic categories. Inductive thematic analysis was used to identify representative themes. Approximately, 1/3 of participants used nontraditional sexual orientation identity labels; this finding was associated with a trans identity and nontraditional gender labels. Using terminology that is meaningful and representative to the youth themselves has potential to facilitate representative research and welcoming environments in practice. [ABSTRACT FROM AUTHOR]

Background and Aims: Alcohol use and marijuana use tend to be social activities among adolescents. Some youth use alcohol or marijuana while alone. This article provides a framework for examining the risk factors for and consequences of solitary alcohol and marijuana use, grounded in a motivational model that emphasizes coping with negative emotions, and provides the first systematic review of research on solitary alcohol and marijuana use among middle school‐ and high school‐aged adolescents in the United States. Methods PubMed, PsycINFO and Web of Science were searched. Articles were included if they mention solitary alcohol or marijuana (or illicit drug) use among adolescents aged 12–18 years. Studies on non‐human animals, college students, non‐English language publications and articles exclusively about solitary tobacco or inhalant use were excluded. Overall, 22 articles were selected. Results Prevalence of adolescent solitary alcohol and marijuana use was relatively high (e.g. 14% life‐time solitary drinking in the general adolescent population), particularly in high‐risk subgroups (e.g. 38.8% life‐time solitary drinking in a sample of youth recruited from clinical and community settings). Risk factors for solitary alcohol and marijuana use include earlier onset and heavier use, coping motives, negative emotions and positive expectancies about use. Solitary alcohol and marijuana use are prospectively associated with later substance use disorder (SUD) symptoms, diminished academic performance and perceived health. Conclusions: Approximately 1 in 7 adolescents in the US appear to have engaged in solitary alcohol and marijuana use at some point. It is positively associated with extent of drinking and marijuana use, cop;ing motives, negative emotions, and positive expectancies, as well as subsequent SUD symptoms and poor academic and health‐related outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Publicity on incidents of electronic nicotine delivery systems (ENDS) exploding or catching fire may influence smokers' risk perceptions and decisions about using ENDS for quitting smoking. We examined combustible cigarette smokers' perceptions of the possibility of injury from exploding ENDS and the relationship of those perceptions to ENDS use, perceived risk relative to smoking, and perceived costs and benefits of ENDS use. Methods: We used data from the 2017 Tobacco Products and Risk Perceptions Survey of a national probability sample of US adults, conducted online in August and September 2017. The analytic sample consisted of 1181 current combustible cigarette smokers aware of ENDS. Results: Among combustible cigarette smokers aware of ENDS, a medium/high perceived risk of injury from exploding ENDS was associated with lower odds of current ENDS use (adjusted odds ratio [aOR] = 0.50; 95% confidence interval [CI], 0.30-0.86; P =.01), perceiving ENDS to be at least as harmful as cigarettes (aOR = 3.22; 95% CI, 2.11-4.93; P <.001), and feeling that the negatives of ENDS use outweighed the positives (aOR = 3.50; 95% CI, 2.00-6.14; P <.001). Conclusions: Product standards, improved product labeling, and education about how to properly use, charge, and store ENDS can help protect consumers from injury. Communication efforts should seek to fully inform combustible cigarette smokers about both the absolute health risks of ENDS, including risk of explosions, and their relative risks compared with those of cigarette smoking. [ABSTRACT FROM AUTHOR]

This study examines the intersection of sexual and gender identities among adolescents, including the prevalence of these groups and rates of emotional distress and bullying victimization. Data come from a large population-based sample; two measures of sexual orientation and gender identity create eight identity groups. Youth who report identifying both as lesbian, gay, bisexual or queer/questioning (LGBQ) and as transgender/gender diverse (TGD) had significantly higher levels of two measures of emotional distress and four measures of bullying victimization than those who report only identifying as LGBQ non-TGD or straight TGD. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Aim: Geographical ranges largely reflect the projection of species' environmental niches onto the landscape, but dispersal limitation can cause ranges to fall short of niche limits. Understanding the prevalence of niche and dispersal limitation is a fundamental problem in ecology and biogeography, and it is relevant in predicting climate‐driven range shifts. Dispersal limitation could also cause widely used ecological niche models (ENM), which relate records of occurrence to environmental predictors, to underestimate properties of the ecological niche. Using a combination of experimental transplants and ENM, we tested for (a) dispersal and niche limitation across a species' range boundary and (b) associations between ENM predictions and population performance. Location: Oregon, USA. Taxon: Scarlet monkeyflower (Erythranthe cardinalis). Methods: We created experimental populations within and beyond the northern range edge and used integral projection models (IPM) to infer potential population growth trajectories. We also built two classes of ecological niche models (ENM), one using climatic predictors and the other using fine‐scale stream habitat variables, to estimate habitat suitability across the northern range edge. Finally, we tested whether higher ENM suitability scores predict greater demographic performance. Results: Consistent with dispersal limitation, experimental populations beyond the range were projected to persist or spread in three of four sites (compared to two of four sites within the range) and stream habitat ENM projected abundant suitable stream microhabitat within the species' thermal envelope beyond the range edge. In contrast, climatic ENM suggested decreasing habitat suitability and availability at the northern range edge. Unexpectedly, higher climatic ENM scores were associated with negative population growth rates, while higher stream habitat ENM scores were unrelated to population growth. Main conclusions: The northern range edge falls short of the species niche limit and is instead limited by dispersal into suitable habitat. Dispersal limitation caused correlative niche models to underestimate the climatic niche and to poorly predict demographic performance in a short‐term field study. These results highlight key challenges to applying predictions from correlative ENM to understanding range and niche limits. [ABSTRACT FROM AUTHOR]

Objective: Hispanic immigrants represent the largest and fastest growing ethnic minority within the US, justifying increased attention to identify factors that influence declining immigrant health across generations. This study investigates the range of psychosocial stress exposures and coping mechanisms of Mexican immigrant mothers, and implications for the health of their US-born children. Design: We conducted 10 focus groups with 1st generation Mexican-born immigrant mothers (n = 32 women) in Nashville, TN, in the summer of 2014. Focus groups elicited challenges and benefits of life as an immigrant mother. Data were analyzed using a modified grounded theory approach. Results: We identified four themes that indicate how maternal stressors could impact children's health: (1) work-family tradeoff, (2) limited freedom/mobility, (3) reduction of social networks, and (4) transmission of anxiety and fears to children. Women in our study also engage in a range of coping mechanisms, including the creation of new social networks, seeking support in religion, and seeking help from community resources. Conclusion: These results highlight the importance of developing new questionnaires to elicit stress exposures for Mexican immigrant mothers. Findings also suggest the value of intervention strategies and social policies that would ultimately improve maternal and child health in this marginalized population. [ABSTRACT FROM AUTHOR]

This article summarizes the four articles in the Social Development quartet focused on positive affect regulation in youth. Each article in the quartet shows that parents' socialization of youth positive affect (e.g., encouraging, enhancing, savoring, or dampening responses) is associated with youth positive affect regulation and depressive symptoms. Further, three of the studies provide novel evidence for an indirect relationship whereby parental socialization predicts youth depressive symptoms through youth positive affect regulation. The studies include samples of youth across mid‐childhood and adolescence (7–18‐year‐olds) from three countries (the United States, Belgium, and India), and utilize several methods of assessing youth positive affect regulation or parental socialization (parent‐reported surveys, youth‐reported surveys, coded parent–child discussions). This integrative article also identifies several ways in which the study of youth positive affect regulation can be advanced. We address the conceptualization of positive affect regulation and the socialization of children's positive affect, constraints on the adaptiveness of upregulating positive emotions, methodological directions, potential moderated effects based on child characteristics such as sex or temperament, and the importance of studying outcomes beyond depression. [ABSTRACT FROM AUTHOR]

In this paper, we explore the perspectives of expert stakeholders about who owns data in a medical information commons (MIC) and what rights and interests ought to be recognized when developing a governance structure for an MIC. We then examine the legitimacy of these claims based on legal and ethical analysis and explore an alternative framework for thinking about participants' rights and interests in an MIC. [ABSTRACT FROM AUTHOR]

This research contributes to social movement framing theory about frame variation, along with the social problems literature on child protectionism. I extend the theorizing on frames by arguing that frame variation can be a response to new agendas and goals of countermovements and opponents. Specifically, for opponents to rights activism, frame variation can be reaction to the assertion of rights for new protagonists, specifically their entry into new spaces. This study analyzes frame variation of the most deleterious child protectionist claims about stranger danger, assertions that the presence of racial, gender, and sexual others in public spaces will harm children. This paper is a content analysis of political flyers and messages developed by Religious Right campaigns at the state and municipal level between 1974 and 2013; these campaigns framed gay men and transgender woman as threats to children in classrooms and bathrooms. For both gay men and transgender women, these claims were most common at the start of rights advocacy. I argue that challengers make the most overt, deleterious arguments about harm to children when new groups initially advocate for legal rights and access to new spaces; as marginalized groups become more familiar and less "strange," challengers make more covert claims about these groups, as stranger danger claims have waning cultural and political resonance. [ABSTRACT FROM AUTHOR]

• Student experiences with COVID-19 are characterized by severity and type of impact. • Gender identity, generation, and year in school distinguished impact profiles. • Impact profiles were not distinguished by student race/ethnicity. • Impact profile was associated with college adjustment and self-esteem. The COVID-19 pandemic has been highly disruptive for college students and has altered their living, learning, and working environments. COVID-19-related financial impact, access to needed resources, and psychological impacts are reported amongst college students, though research has yet to examine how severity and type of impact varies by student. This study investigated how undergraduate college students were impacted during the COVID-19 pandemic regarding finances, access to needed resources, and psychological well-being, and explored outcomes associated with patterns of perceived impact. Participants were 894 college students at a southeastern university who completed an online survey during the Spring 2021 semester. Students reported on how the COVID-19 pandemic affected their finances, resources, and psychological health; students also reported their current self-esteem, and adjustment to college (academic and relational). Latent profile analysis was utilized to develop profiles of COVID-19-related impact. Results indicated that most participants experienced moderate levels of financial and psychological impact but low resource impact (34.6%) or experienced low impact across the range of financial, resource, and psychological domains (32.5%). Seventeen percent were highly impacted across all domains and 15.8% experienced moderate financial and resource impact but low psychological impact. Student gender identity, generational status, and first-year status were significant predictors of profile membership – student race was not associated with profile membership. Highly impacted students had significantly lower self-esteem and college adjustment compared to students in relatively less-impacted profiles. [ABSTRACT FROM AUTHOR]

In the United States, medical crowdfunding is an increasingly common response to overwhelming healthcare costs. Semi-structured interviews were conducted with 30 individuals crowdfunding for health (e.g. cancer, paralysis, brain injury) on behalf of themselves or others, to better understand this new phenomenon as it informs theory on social support, identity, and privacy. First, findings suggest that crowdfunding is often a resource for both instrumental and emotional social support. Second, many crowdfunders weighed the need for support against perceived privacy risks, which is consistent with and extends privacy calculus theory. Finally, highly vulnerable self-disclosures were often reinterpreted to be empowering, which also supports and extends work on identity shift. Using crowdfunding as a context for inquiry, findings point to new theoretical frameworks to describe how users navigate needs for both privacy and support online and the often positive consequences of that negotiation for identity. [ABSTRACT FROM AUTHOR]

In this article, we further the understanding of both changes in public opinion on capital punishment in the United States and changes in the factors associated with public opinion on the death penalty. Support for the death penalty may be motivated by events happening during specific time periods, and it can vary across birth cohorts as a result of cohort-specific socialization processes, demographic changes, and formative events that are specific to each generation. An explication of the sources of and variation in death penalty attitudes over time would benefit from the accounting for the age of the respondent, the year of the survey response, and the birth cohort of the respondent. We improve on previous research by using multiple approaches including hierarchical age-period-cohort models and data from the General Social Survey (N = 41,474) to examine changes in death penalty attitudes over time and across birth cohorts. The results showed curvilinear age effects, strong period effects, and weak cohort effects on death penalty support. The violent crime rate explained much of the variation in support for the death penalty across periods. The examination of subgroup differences suggests that support for the death penalty is becoming concentrated among Whites, Protestants, and Republicans. [ABSTRACT FROM AUTHOR]

Background. Randomized controlled trials have demonstrated that the newest latent tuberculosis (LTBI) regimen, 12 weekly doses of directly observed isoniazid and rifapentine (3HP), is as efficacious as 9 months of isoniazid, with a greater completion rate (82% vs 69%); however, 3HP has not been assessed in routine healthcare settings. Methods. Observational cohort of LTBI patients receiving 3HP through 16 US programs was used to assess treatment completion, adverse drug reactions, and factors associated with treatment discontinuation. Results. Of 3288 patients eligible to complete 3HP, 2867 (87.2%) completed treatment. Children aged 2-17 years had the highest completion rate (94.5% [155/164]). Patients reporting homelessness had a completion rate of 81.2% (147/181). In univariable analyses, discontinuation was lowest among children (relative risk [RR], 0.44 [95% confidence interval {CI}, .23-.85]; P = .014), and highest in persons aged =65 years (RR, 1.72 [95% CI, 1.25-2.35]; P < .001). In multivariable analyses, discontinuation was lowest among contacts of patients with tuberculosis (TB) disease (adjusted RR [ARR], 0.68 [95% CI, .52-.89]; P = .005) and students (ARR, 0.45 [95% CI, .21-.98]; P = .044), and highest with incarceration (ARR, 1.43 [95% CI, 1.08-1.89]; P = .013) and homelessness (ARR, 1.72 [95% CI, 1.25-2.39]; P = .001). Adverse drug reactions were reported by 1174 (35.7%) patients, of whom 891 (76.0%) completed treatment. Conclusions. Completion of 3HP in routine healthcare settings was greater overall than rates reported from clinical trials, and greater than historically observed using other regimens among reportedly nonadherent populations. Widespread use of 3HP for LTBI treatment could accelerate elimination of TB disease in the United States. [ABSTRACT FROM AUTHOR]

The article compares and contrasts two approaches to addressing inequalities in kindergarten through grade 12 (K-12) education in America as of 2017, and it mentions an effort to reduce the number of high poverty schools in the U.S., as well as economic integration initiatives and a push to alter the character of the schools that disadvantaged students attend. Academic achievement and socioeconomic status are addressed, along with U.S. educational law cases such as Brown v. Board of Education.

A ’turn’ to quality is frequently associated with the proliferation of alternative agrifood networks and food system localization has been a prominent expression of such efforts. Yet quality is subjective and is influenced by historical, social, and cultural contexts. While there is a strong tradition of studying European consumers’ quality perceptions, less is known about U.S. consumers. Due to increasing consumer interest in local beef, this paper examines U.S. consumer definitions of local beef and how these notions inform consumers’ perceptions of beef quality. This study investigated beef consumers (N = 174) at grocery stores across Alabama using face-to-face intercept surveys designed to elicit meanings associated with the term ’local beef’. Content analysis identified five major definition types: geographic, production, knowledge, relational, and sociopolitical. Consumers’ top-of-the mind definitions also provided insight into how and what type of quality inferences consumers made about local beef. Analysis revealed that local beef was perceived as quality cue that was generally tied to a specific geographic area (80.3%). Overall, quality inferences were made about local beef and shipping distances, freshness, type of animal feed, animal treatment, additives, and contributions to the local economy and community. [ABSTRACT FROM AUTHOR]

Attention toward who can use which gender binary, multi-stall bathroom has brought to the forefront, once again, the ways in which youth are supported or marginalized. No study has documented sexual and gender minority youths' experiences with and perspectives about bathrooms. We collected qualitative data in 2014-2015. Participants were 25 lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth, aged 14-19, in the United States and Canada. Their comments describe first- and second-hand bathroom experiences, identify advocacy efforts, and highlight the roles of peers and adults in making bathrooms safe (or not). Youth emphasized the importance of gender-neutral bathrooms in fostering a sense of safety and inclusivity. Adult support and gay-straight alliances (GSAs) were important contributors to a welcoming environment and fostered advocacy efforts for gender-neutral bathrooms. We encourage purposeful inclusivity of youths' voices when enacting bathroom-specific policies and legislation that directly influence their health and well-being. [ABSTRACT FROM AUTHOR]

Background: Guidelines recommend that patients with low ejection fraction (EF) after myocardial infarction (MI) have their EF reassessed 40 days after MI for implantable cardioverter-defibrillator (ICD) candidacy. This study examines rates of EF reassessment and their association with 1-year ICD implantation in post-MI patients with low EF.Methods: We examined rates of postdischarge EF reassessment and ICD implantation among 10 289 Medicare-insured patients ≥65 years of age with an EF≤35% during the index MI admission from January 2007 through September 2010 in ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines). Multivariable Cox models tested the association between time-dependent EF reassessment and 1-year ICD implantation, stratified by revascularization status during the index MI admission.Results: Among patients with EF ≤35% during the index MI admission, 66.8% (95% confidence interval [CI], 65.9-67.8) had EF reassessment within the next year. Revascularized patients were more likely to have EF reassessment (76.9% [95% CI, 75.8-78.0)] versus 53.7% [95% CI, 52.2-55.2]; P<0.001) and had shorter times to EF reassessment (median, 67 versus 84 days; P<0.001) than nonrevascularized patients. Among patients with EF reassessment, only 11% received an ICD within 1 year. Reassessment of EF was associated with a higher likelihood of ICD implantation for both revascularized (unadjusted, 12.1% versus 2.4%, P<0.001; adjusted hazard ratio, 10.6, 95% CI, 7.7-14.8) and nonrevascularized (unadjusted, 10.0% versus 1.7%, P<0.001; adjusted hazard ratio, 6.1, 95% CI, 4.1-9.2) patients.Conclusions: In US practice, EF reassessments are commonly performed among patients with MI with an initially reduced EF. Although 1-year EF reassessment is associated with increased likelihood of ICD implantation, 1-year ICD implantation rates remain very low even among patients with EF reassessment, regardless of revascularization status. [ABSTRACT FROM AUTHOR]

Mixing alcohol with diet beverages, as compared to mixing the same amount of alcohol with a regular beverage, is associated with greater intoxication. This may occur because diet mixers increase alcohol absorption rates. Thus, it is plausible that the use of diet mixers may increase the risk of alcohol-related harms. The current study sought to (1) determine the rate/frequency of use in among college students, (2) examine the relationship between mixing alcohol with diet beverages and alcohol-related problems, above typical alcohol use and sensation seeking, and (3) explore key traits (gender, restricting food while drinking, and body mass index [BMI]) that may characterize users. Participants were 686 (73% female) undergraduate students who completed self-reports of alcohol use (including diet mixer use), alcohol-related problems, eating behaviors while drinking, sensation seeking, and demographic information. Results revealed that about 36% of the sample reported consuming alcohol with diet mixers, and users typically consumed this beverage at least once a month. Students who reported mixing alcohol with diet beverages experienced more alcohol-related problems. And, the more frequently one consumed this beverage, the more problems were reported. These associations were found after controlling for typical level of alcohol use and sensation seeking. No differences were observed between user-status on gender, eating behaviors while drinking, and BMI. Our findings suggest that mixing alcohol with diet beverages could be a risk factor for experiencing more alcohol-related harms. Further research is needed to understand this relationship, as it may help guide intervening efforts aimed to reduce alcohol-related risks. [ABSTRACT FROM AUTHOR]

The authors discuss the findings of the U.S. Department of Health and Human Services (HHS) Office of Adolescent Health (OAH) Teen Pregnancy Prevention (TPP) Program from 2010 to 2015, and it mentions how the OAH TPP is designed to reduce the risky behavior that is associated with adolescent pregnancy. American government funding for organizations to replicate evidence-based TPP programs and additional teenage pregnancy prevention plans is examined, along with organizational goals.

Background: Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet a majority of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls. Purpose: The purpose of this retrospective study was to determine which patient factors are associated with injurious falls in hospitalized adults. Methods: The study site's adverse event reporting database was used to identify 1,369 patients who fell between January 1, 2006, and October 31, 2013. Of these, 381 (27.8%) subjects suffered injurious falls. Variables of interest included age, sex, fall history, use of diuretics, use of central nervous system medications, cognitive impairment, primary discharge diagnoses, abnormal laboratory values, impaired mobility, and body mass index. Findings: Bivariate analysis revealed a statistically significant association between injurious falls and having a primary discharge diagnosis of "symptoms, signs, and ill-defined conditions." Having this discharge diagnosis was a significant predictor of injurious falls. Conclusions: Findings from this study may help hospital clinicians to better identify which patients are most at risk for injurious falls and to create better fall-related injury prevention interventions. [ABSTRACT FROM AUTHOR]

The ability to link each nurse to each patient provides a new capability to investigate not only nursing care in general, but the contribution of each nurse providing care to each patient. Linking nurses to patients using identifying keys could open new lines of research. [ABSTRACT FROM AUTHOR]

The article discusses the mock debutante pageant called Corny-ation which was held in San Antonio, Texas during the city's annual urban festival at the time of the cold war in an attempt to give public access to queer culture. Topics include the signifiers of homosexuality at the time of the Cold War like drag, camp and cross-dressing, and the social conditions of gay people during the Cold War period.

Road salt (NaCl) applications to highways have increased stream sodium and chloride concentrations due to retention within watersheds. The mechanisms for retention and export of Na + and Cl − from different environments are not fully understood. This field study examines the hydrologic and cation exchange processes that store and release Na + and Cl − from a calcareous fen adjacent to a highway. Despite high concentrations of Ca 2 + and Mg 2 + , elevated salt concentrations enable Na + to occupy up to 15% of the cation exchange capacity of shallow peat. Calculations of selectivity coefficients show that Na + preferentially exchanges with Mg 2 + , and Na + can be desorbed under more dilute conditions caused by precipitation and snowmelt. Detailed sampling of surface and ground waters during three snowmelt events illustrate early releases of Na + and Cl − at the onset of melting, with maximum fluxes coinciding with peak discharge. From 7 March through 4 April 2005, the flux of dissolved salt exiting the wetland amounts to 13% (Na) and 17% (Cl) of annual rock salt applied to the highway. For all of 2005, the total salt mass leaving the wetland via Kampoosa Brook is similar to the amount of road salt applied; 50% of the annual salt efflux occurred during the snowmelt season of March through May. In general, exported Na + and Cl − correlate with the number of lane miles of highway crossing the watershed. Large rain events outside of winter months are more effective than snowmelt with reducing dissolved salts because snowmelt also introduces contamination. For this and other wetlands having alkaline geochemistry and high flushing rates, management strategies that reduce rock salt amounts to roadways will assist with reducing salt contamination to levels less toxic to vegetation and aquatic organisms. [ABSTRACT FROM AUTHOR]