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International collaborative research has great value in helping each of the participant's view their respective situations from novel and various perspectives. When people involved in the same work tackle problems from different perspectives, new awareness arises, and innovative solutions are created. Kagawa University and Colorado State University have conducted excellent research exchanges in the field of early childhood education based on their international exchange agreements. As the trend in Japan towards nuclear families continues in tandem with Japan's aging society and low childbirth rate, a number of parents and guardians are becoming increasingly isolated and unsure of how to raise their children. The process of introducing a new childcare support system based on Japan's national policies and the problems Japanese regional prefectural governments face in early childhood education were clarified through exchanges between Kagawa University and Colorado State University. By sharing information and giving an overview concerning efforts and successful cases in Japan and the U.S., mutual clues were found for problem analysis and problem solving. This research analyzed the factors for constructive interaction and provided clues for the problems highlighted by the results. It enabled several researchers in Kagawa who have experience in this field, overseas as well as locally, and those at the prefectural level involved as leaders in professional guidance in this field of childcare, to understand the current situation and trends for childcare in the U.S. This has the potential to lead to improvements in the quality of childcare and the training of teachers in Japan. It also put forward a direction and recommendations for development in international collaborative research.

Background: HIV affects 1.2 million Americans, with 20% of new diagnoses being 13 to 24-year-olds. Young adult college students are more likely than the general population of 18 to 24-year-olds in the U.S. to engage in sexual practices that increase their risk of STIs. Objectives: This scoping review explores factors that promote or hinder STD/STI/HIV self-testing among U.S. college students. Search Methods: A scoping review of original, experimental (randomized or nonrandomized), observational (longitudinal and cross-sectional), and qualitative or mixed-methods U.S. research was conducted using OVID Medline, OVID Embase, PubMed, CINAHL, Web of Science Core Collection, and Cochrane CENTRAL. English-language studies measured STD/STI/HIV self-test kits and college student testing. Selection Criteria: Inclusion and exclusion criteria were used to narrow down articles that addressed barriers and facilitators to STD/STI/HIV testing, and self-testing among college students in the U.S. Results: Database searches yielded 8,373 articles. After removing duplicates, 6173 items remained. After independent dual-title/abstract screening, 100 papers were full-text reviewed. Seven retrieved articles were unavailable, and 93 were selected for full-text screening. After reviewing the whole text, 89 papers did not fulfill the inclusion requirements and were deleted, leaving 4 articles in the final analysis. Conclusion: Additional research on self-testing among college students in the U.S. is urgently required. The results should guide university health policies on the need to cater to the unique requirements of college students by increasing the availability of healthcare and embracing STD/STI/HIV self-testing. This can enhance testing rates, diminish stigmas, and ultimately contribute to wider endeavors to reduce the transmission of infections in the U.S. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of current psychiatric disorders among children and adolescents (collectively called children) of mothers entering treatment for depression; to examine maternal predictors of child psychopathology among children of depressed mothers; and to determine consistency of findings with a similar child study ancillary to Sequenced Treatment Alternatives to Reduce Depression (STAR*D) from seven United States sites (STAR*D-Child). Method: Mothers (N = 82) with major depressive disorder (MDD) enrolled in a treatment study in Ottawa (Ontario, Canada) or New York City, and their eligible children (N = 145) (aged 7 through 17 years) were assessed independently when the mother enrolled. Results: Among the children of depressed mothers, 42% had at least one current psychiatric diagnosis, including affective (15%), anxiety (19%), behavioral (23%), and/or substance use (2%) disorders. In all, 40% of the children were rated as impaired by clinical assessors. Mothers' comorbid anxiety disorders predicted the highest rates of current disorders in the child in both studies. The severity of the mother's depression predicted behavioral problems in the child. The current and lifetime rates of psychiatric disorders in the children of depressed mothers were compared to rates found in STAR*D Child and findings were consistent. Both studies used similar diagnostic assessments. Conclusion: Given the high prevalence of offspring psychiatric disorders, inquiring about the mental health of the children when a depressed mother comes for treatment, and referring children for treatment when appropriate, are important. (Contains 6 tables.)

Simple Summary: Cancer remains one of the leading causes of death in Poland as well as in the United States. Modifiable risk factors, such as tobacco use, obesity, and low utilization of preventive cancer screenings, all contribute to greater cancer incidence and mortality in both countries. However, these risk factors have triggered some mitigating solutions in the U.S not seen in Poland, namely the implementation of standard annual wellness visits fully covered by health insurance. The aim of this study was to determine the level of impact that standardized, preventive wellness visits have had on uptake of cancer prevention measures, namely cancer screenings, among women in a largely rural region of the U.S. where cancer risk is often high. Based on the observation that wellness visits are associated with greater use of cancer screenings and other preventive health behaviors, findings from this study were used to support the inclusion of no-cost wellness visits into proposed strategies for systemic solutions to reduce cancer burden in Poland. Background: Cancer is one of the leading causes of death among Polish women in general, and first in women aged 25–64. Contributing to this cancer burden are modifiable behavioral risk factors, including low utilization of cancer screenings. Poland has an urgent need for new systemic solutions that will decrease cancer burden in the female Polish population. This study examined the United States' implementation of preventive wellness visits as a viable solution for implementation in Poland. Methods: Health insurance claims data for nearly three million women in five states of the U.S. were examined to identify use of mammograms, colorectal cancer screening, and lung cancer screening. Three subgroups of the cohort were assessed for the probability of receipt of screening associated with type of healthcare visit history (women with wellness visits—W; with wellness visits and related preventive services and screenings—W+P; and control group—C). All multiple comparisons were significant (alpha = 0.05) at p < 0.0001, except comparison between subgroups (W vs. P+W) for lung cancer screening. Results: Breast and colorectal cancer screenings had substantially higher participation after W and W+P in comparison with C; moreover, a slight increase after W or P+W was seen for lung cancer as well. Conclusions: Results indicate that wellness visits are an effective tool for increasing cancer screening among women in the U.S. Introduction of a similar solution in Poland could potentially help produce higher screening rates, address cancer prevention needs (not only for secondary cancer prevention), and lower cancer burden. [ABSTRACT FROM AUTHOR]

Background US hospitals typically provide a set of code status options that includes Full Code and Do Not Resuscitate (DNR) but often includes additional options. Although US hospitals differ in the design of code status options, this variation and its impacts have not been empirically studied. Design and methods Multi-institutional qualitative study at 7 US hospitals selected for variability in geographical location, type of institution and design of code status options. We triangulated across three data sources (policy documents, code status ordering menus and in-depth physician interviews) to characterise the code status options available at each hospital. Using inductive qualitative methods, we investigated design differences in hospital code status options and the perceived impacts of these differences. Results The code status options at each hospital varied widely with regard to the number of code status options, the names and definitions of code status options, and the formatting and capabilities of code status ordering menus. DNR orders were named and defined differently at each hospital studied. We identified five key design characteristics that impact the function of a code status order. Each hospital's code status options were unique with respect to these characteristics, indicating that code status plays differing roles in each hospital. Physician participants perceived that the design of code status options shapes communication and decisionmaking practices about resuscitation and life-sustaining treatments, especially at the end of life. We identified four potential mechanisms through which this may occur: framing conversations, prompting decisions, shaping inferences and creating categories. Conclusions There are substantive differences in the design of hospital code status options that may contribute to known variability in end-of-life care and treatment intensity among US hospitals. Our framework can be used to design hospital code status options or evaluate their function. [ABSTRACT FROM AUTHOR]

Objective: To develop a model for identifying clinic performance at fulfilling next-day and walk-in requests after adjusting for patient demographics and risk.Data Source: Using Department of Veterans Affairs (VA) administrative data from 160 VA primary care clinics from 2014 to 2017.Study Design: Using a retrospective cohort design, we applied Bayesian hierarchical regression models to predict provision of timely care, with clinic-level random intercept and slope while adjusting for patient demographics and risk status. Timely care was defined as the provision of an appointment within 48 hours of any patient requesting the clinic's next available appointment or walking in to receive care.Data Collection/extraction Methods: We extracted 1 841 210 timely care requests from 613 263 patients.Principal Findings: Across 160 primary care clinics, requests for timely care were fulfilled 86 percent of the time (range 83 percent-88 percent). Our model of timely care fit the data well, with a Bayesian R2 of .8. Over the four years of observation, we identified 25 clinics (16 percent) that were either struggling or excelling at providing timely care.Conclusion: Statistical models of timely care allow for identification of clinics in need of improvement after adjusting for patient demographics and risk status. VA primary care clinics fulfilled 86 percent of timely care requests. [ABSTRACT FROM AUTHOR]

The article presents empirical research on the interrelationship of domestic money supplies during the floating rate period. Particular attention is given to the hypothesis that monetary growth in the U.S. influences the rate of foreign countries' domestic money growth. The effects of U.S. intervention activity on that influence is evaluated. Provided is a model of exchange rate effects on monetary growth as a result of interventions in central banking, as well as a discussion on why three incentives for exchange rate management are possible reasons for a specific central bank policy.

The authors comment on the article "Does Controlled Donation After Circulatory Death Violate the Dead Donor Rule (DDR)?," by Nielsen Busch et al., focusing on the challenges related to concerns about the DDR contradicts controlled donation after circulatory death (cDCD) protocols and the loss of recoverable organs. They focus on acknowledging clinicians' concern about death and cDCD protocols and administrative, psychosocial or ethical issues that pose challenges for organ procurement experts.

Objective: To estimate the effect of Medicare use on the receipt of outpatient services from 2001 through 2015 for a cohort of Veterans Administration (VA) users who became age-eligible for Medicare in 1998-2000.Data Sources/study Setting: VA administrative data linked with Medicare claims for veterans who participated in the 1999 Large Health Survey of Enrolled Veterans.Study Design: We coded each veteran as VA-reliant or Medicare-reliant based on the number of visits in each system and compared the health and social risk factors between VA-reliant and Medicare-reliant veterans. We used bivariate probit and instrumental variables models to estimate the association between a veteran's reliance on Medicare and the receipt of outpatient procedures in Medicare and the VA.Principal Findings: Veterans who chose to rely on the VA (n = 4,317) had substantially worse social and health risk factors than Medicare-reliant veterans (n = 2,567). Medicare reliance was associated with greater use of outpatient services for 24 of the 28 types of services considered. Instrumental variable estimates found significant effects of Medicare reliance on receipt of advanced imaging and cardiovascular testing.Conclusions: Expanded access to fee-for-service care in the community may be expensive, while the VA will likely continue to care for the most vulnerable veterans. [ABSTRACT FROM AUTHOR]

Objective: To examine the long-term reliance on outpatient care at the population (i.e., system) level among fee-for-service Medicare-enrolled elderly veterans in the Department of Veterans Affairs (VA) health care system and Medicare from 2003 to 2014.Data Sources/study Setting: We analyzed a 5 percent random sample, stratified by facility, age, gender, and race, of Medicare-enrolled veterans enrolled in a VA primary care panel using VA administrative data and Medicare claims.Study Design: We performed a repeated cross-sectional analysis over 48 quarters. VA reliance was defined at the system level as the proportion of total visits (VA + Medicare) that occurred in VA. We examined four visit types and seven high-volume medical subspecialties. We applied direct standardization adjusting for age, gender, and race using the 2010 population distribution of Medicare-enrolled veterans.Principal Findings: Over the 12-year period, VA provided the vast majority of mental health care. Conversely, veterans received slightly more than half of their primary care and most of their specialty care, surgical care, and seven high-volume medical subspecialties through Medicare. However, reliance on VA outpatient care steadily increased over time for all categories of care.Conclusions: Despite the controversies about VA access to care, Medicare-enrolled veterans, who have a choice of using VA or Medicare providers, appear to increase their use of VA care prior to the Choice Act. [ABSTRACT FROM AUTHOR]

New ways of thinking about sustainability provide cities with leverage for making improvements, and several cities have already created more sustainable futures. [ABSTRACT FROM AUTHOR]

Massachusetts Health Reform (MHR), implemented in 2006, introduced new health insurance options that may have prompted some veterans already enrolled in the Veterans Affairs Healthcare System (VA) to reduce their reliance on VA health services. This study examined whether MHR was associated with changes in VA primary care (PC) use. Using VA administrative data, we identified 147,836 veterans residing in Massachusetts and neighboring New England (NE) states from October 2004 to September 2008. We applied difference-in-difference methods to compare pre-post changes in PC use among Massachusetts and other NE veterans. Among veterans not enrolled in Medicare, VA PC use was not significantly different following MHR for Massachusetts veterans relative to other NE veterans. Among VA-Medicare dual enrollees, MHR was associated with an increase of 24.5 PC visits per 1,000 veterans per quarter ( p = .048). Despite new non-VA health options through MHR, VA enrollees continued to rely on VA PC. [ABSTRACT FROM AUTHOR]

To examine whether U.S. public opinion may become as sharply polarized on adaptation responses as it has been on mitigation policies, we surveyed a sample of urban coastal residents in Maryland ( n = 378). We then tested the impact of a community deliberative event ( n = 40) with small-group sea level rise discussions as a depolarization strategy. Cultural worldviews which contribute to politically polarized beliefs about climate were predictive of perceptions of sea level rise risk. Living close to flooding hazards also significantly predicted respondents’ perceptions of household or neighborhood risks, but not of risks to the entire county. The event significantly increased topic knowledge among all participants and, among those with a worldview predisposing them to lower risk perceptions, significantly increased problem identification and concern about impacts. These results suggest small-group deliberation focused on local problem-solving may be an effective tool for reducing the polarizing effects of cultural worldviews on decision-making. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Centers for Disease Control and Prevention frequently receives inquiries from health care providers, public health officials, and the general public seeking data or guidance on vaccine- safety issues. Past inquiries to public health authorities identified potential problems including viscerotropic illness rarely associated with yellow fever vaccination. OBJECTIVE: To systematically describe vaccine-safety inquiries received at the Centers for Disease Control and Prevention. METHODS: External and internal inquiries were recorded in a database from May 1,2002 to May 31,2009. Key variables analyzed included the source of the question, the type of information being sought, and the vaccine type(s) associated with the inquiry. RESULTS: A total of 983 vaccine-safety inquiries were answered and analyzed. Health care workers were the source of 43% of the questions, and the general public accounted for 19% of the questions. Nearly half of the requests (49%) concerned information about the Vaccine Adverse Event Reporting System, and nearly one-fourth (21%) were requests from providers for clinical guidance. The most frequent specific topics of inquiry and vaccines involved were neurologic adverse events (AEs) temporally associated with vaccination (17%) and safety of all vaccines or childhood vaccines (20%), respectively. CONCLUSIONS: Questions about rare but potentially serious AEs and general concerns about vaccine safety were encountered relatively frequently. The substantial number of clinically focused inquires may indicate a need for more provider support tools and resources. Tracking of inquiries can supplement information received through vaccine AE reporting and contribute to an enhanced scientific and communications response to vaccine-safety concerns. [ABSTRACT FROM AUTHOR]

Chapter 7 of the book "Research in Finance," Volume 26, edited by John W. Kensinger is presented. It presents a study on the relationship between risk-free bonds and interest rate swaps which uses and analyzes data from five-year U.S. Treasury bond yield and interest rate swaps. It discusses data used and explains the six probable scenarios of swap and bond price movements. It offers details on the modeling techniques used in the study such as the bivariate threshold autoagressive (BTAR).

This article discusses the findings of the 2001 report entitled "Crossing the Quality Chasm" released by the Institute of Medicine (IOM) in the U.S. in which it was recommended that nurses should make use of evidence-based resources on the Internet as part of meeting the performance expectations for the healthcare system in the 21st century. It explains that the foremost challenge for nurses is getting a satisfactory level of confidence in using evidence-based resources from the Web. It is common for nurses to feel lacking in skills to make get relevant information from the Web. It presents information on Web sites that can offer quality information for nurses such as htt://www.ahrq.gov/ and http://www.ahrq.gov/qual/.

There are many new methods and ideas for conveying landscape information, particularly over the Internet. While there are very sophisticated tools available, Internet-based mapping packages should nevertheless be both uncomplicated and meaningful. Example map packages inform the argument that principles such as accessibility, format, and interpretation are important to landscape mapping, particularly when it is distributed over the Internet, which is an open and visually efficient medium. [ABSTRACT FROM PUBLISHER]

Describes a late Permian Chinese gastropod species, possibly larval, in the Middle Pennsylvanian of New Mexico. Characteristics of diverse gastropod assemblages from southern China, mostly from Late Permian strata; Similarity between the Naticasinus sinus and Lunulazona? sp.; Analysis of whether Naticasinus Pan and Erwin, 2002, represent the protoconch of Naticopsis M'Coy, 1846.

A total of 150 women who qualified for a protection order against an intimate partner were interviewed on the day of application and 3 months later to study factors associated with the receipt or dropping of a protection order. At 3 months, 54% of the women received protection orders, 28% dropped the process, and 18% did not receive protection orders. Differences (p < .05) in relationship status existed at intake between the women that received or dropped the protection order. Women who dropped were more likely in current relationships with the perpetrator, whereas protection order recipients considered the perpetrator a former partner. At intake and 3 months later, women in current relationships, irrespective of protection receipt or drop, reported significantly (p < .005) more physical assaults. Relationship status is a significant correlate of abused women's receipt or dropping of a protection order as well as the level of assault experienced. [ABSTRACT FROM AUTHOR]

Abstract Quasi-synoptic sampling along a transect from Alaska to California carried out in spring and summer 2000 using Continuous Plankton Recorders reveals that the abundant calanoid copepod Neocalanus plumchrus (Marukawa) reaches the surface at approximately the same time across the region. However, monthly sampling also reveals that the timing of peak biomass (when 50% of the population consists of copepodites at stage CV) occurs about 5 weeks earlier at the southernmost part of its range than at the northernmost part, with intermediate areas having intermediate timings. Surface water temperature differed by about 4°C between the warmer south and the cooler north, and we suggest that such a difference would reduce development duration by about 3 weeks. If food supply in the north is more conducive to lipid accumulation, as seems possible from phytoplankton biomass data, then the use of the differences in timing of peak N. plumchrus biomass in each area as a measure of the differences in development time may not be accurate. We find that the estimate of the time of peak biomass varying by about 5 weeks between north and south may be an exaggeration of the actual difference in the development duration. Temperature is probably the most important factor governing the shorter development duration of N. plumchrus in southern latitudes. [ABSTRACT FROM AUTHOR]

Examines the ruling of the North Carolina Supreme Court on the case McAllister versus Ha which deals on the recovery of medical costs for wrongful conception. Facts on the case; Discussion on the ruling lower courts on the case; Exploration on the arguments of the parties to the case.

Talks about the relationship among monetary policy, exchange rate and agricultural exports in the United States. Discussion on the real exchange rate and farm exports; Money growth since 1980; Model of the real exchange rate; Role of the value of the dollar in the volume of farm exports.

Replies to the comment of Daniel Himarios on the economic impact of foreign exchange rates in the U.S. Discussion on the role of currency substitution in domestic inflation; Details on the calculation of the rest-of-the-world money stock; Approximation of the lag between money and inflation.

In this paper we test the currency substitution hypothesis in the context of explaining observed inflation in the United States during the flexible exchange rate period, 1972-1982. To investigate the possible impact of currency substitution we estimate a reduced-form model of inflation using quarterly observations. In contrast, much of the previous work testing this hypothesis over the same time period has been based largely on annual data, yielding only a few degrees of freedom. Our investigation also brings together several approaches to test for currency substitution. More specifically, we use three procedures to capture international influences on U.S. inflation: McKinnon's [10] calculations of rest-of-world money growth, Spinelli's [19] approach to measuring rest-of-world money growth, and the change in the effective change rate, recently promoted by McKinnon [11] as the most appropriate variable to capture foreign influences. We also investigate the relative impacts of currency substitution on two measures of inflation; the GNP deflator and the producer price index (PPI). By examining these different approaches in one paper with one data set, our test of the currency substitution hypothesis is more complete and exhaustive than any of the previous studies. It has been asserted that the domestic demand for U.S. money is unstable due to the impact of foreign influences that generate a reallocation of assets within portfolios. Consequently, it is hypothesized that U.S. inflation during the floating exchange rate period cannot be explained adequately by U.S. money growth alone, but more appropriately by U.S. money growth plus a measure of rest-of-world money growth or changes in the effective exchange rate. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a worldwide public health problem. In the United States, the prevalence and incidence of kidney failure are rising. Costs are high and outcomes are poor. According to the National Kidney Foundation, 1 in every 9 adults or approximately 20 million Americans has CKD and most do not know it. [ABSTRACT FROM AUTHOR]

The article discusses cases of severe leptospirosis in Florida and Missouri with signs similar to those of pandemic H1N1. The first patient had a fever, myalgia, calf pain, headache, and malaise. The second patient has a history of obesity and was hospitalized due to fever, myalgia, and calf pain among others while the third patient has a history of obesity and diabetes mellitus. According to the authors, leptospirosis should be included in the differential diagnosis of acute febrile illness in industrialized countries.

The article discusses the water operator partnership program which aims to improve and expand basic water and sanitation services to all consumers in the U.S. It highlights the critical role of water agencies in improving the operation of urban water agencies in developing countries by providing hands-on training opportunity. Wally Bishop, a member of American Water Works Association's (AWWA) International Council, highlights the benefits of the program to water utilities throughout the world.

OBJECTIVES: Hedge language is a category of language that refers to words or phrases that make statements "fuzzier." We sought to understand how physicians use hedge language during goals-of-care conferences in the ICU. DESIGN: Secondary analysis of transcripts of audio-recorded goals-of-care conferences in the ICU. SETTING: Thirteen ICUs at six academic and community medical centers in the United States. PATIENTS: Conferences were between clinicians and surrogates of incapacitated, critically ill adults. INTERVENTIONS: Four investigators performed a qualitative content analysis of transcripts using deductive followed by inductive methods to identify types of hedge language used by physicians, then coded all instances of hedge language across 40 transcripts to characterize general patterns in usage. MEASUREMENTS AND MAIN RESULTS: We identified 10 types of hedge language: numeric probabilistic statement ("there's an 80% chance"), qualitative probabilistic statement ("there's a good chance"), nonprobabilistic uncertainty statement ("hard to say for her"), plausibility shield ("we expect"), emotion-based statement ("we're concerned"), attribution shield ("according to Dr. X"), adaptor ("sort of"), metaphor ("the chips are stacking up against her"), time reference ("too soon to tell"), and contingency statement ("if we are lucky"). For most types of hedge language, we identified distinct subtypes. Physicians used hedge language frequently in every transcript (median: 74 hedges per transcript) to address diagnosis, prognosis, and treatment. We observed large variation in how frequently each type and subtype of hedge language was used. CONCLUSIONS: Hedge language is ubiquitous in physician-surrogate communication during goals-of-care conferences in the ICU and can be used to introduce vagueness to statements in ways beyond expressing uncertainty. It is not known how hedge language impacts decision-making or clinician-surrogate interactions. This study prioritizes specific types of hedge language for future research based on their frequency and novelty. [ABSTRACT FROM AUTHOR]

Stresses the need for total quality management (TQM) to function within a Total Quality Culture. Total Quality Culture as the concentration of people and resources in search for greater quality and service in every dimension of the organization; Values and principles to be observed in building a Total Quality Culture; Significance of a committed leader in the successful implementation of Total Quality Culture.

Offers explanations from businessmen involved in the United States Industrial Payroll Savings Committee, regarding potential savings from the purchase of U.S. Energy Savings Bond, Series EE. Reasons for supporting the Savings Bond program; Unique features of the Series EE bonds; Financial advantages over traditional bonds. INSET: THE BIG PROBLEM.