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In this commentary, the authors reflect on their 2012 article, "The Centrality of Engagement in Higher Education" (EJ1001357) reprinted in this 20th anniversary issue of "Journal of Higher Education Outreach and Engagement." In their original article, they argued that for higher education to contribute meaningfully to transformational change in society, it would have to act to make engagement scholarship a central aspect of its work, spanning the spectrum of its disciplinary units, centers, and institutes (Fitzgerald, Bruns, Sonka, Furco, & Swanson, 2012). Solving societal problems requires recognition that the problems are in society; as an embedded part of complex society systems, these societal problems affect universities and the students, alumni, faculty, and staff who are a part of both the university and community systems. Thus, they argued, efforts to solve problems-in-society require new approaches to knowledge generation, generally described within the context of partnerships, collaboration, exchange of knowledges, and cocreation of solutions. Herein, the authors suggest ways to engage community, and perhaps to generate intergenerational input such as making more effective use of social media to build networks and organizations that are inclusive of community partners. Additionally, they raise questions relating to data sources, or "big data," and how analytics may provide new dimensions for community engagement scholarship in experiential learning settings as well as student performance and success analytics, particularly in just-in-time feedback for instructors. The article concludes with a review of several seminal events, such as the emergence of the Academy of Community Engagement Scholarship (ACES) and the induction of its first two sets of members, that have occurred since publication of their original 2012 article. [For "The Centrality of Engagement in Higher Education" (2016), see EJ1097192.]

The centrality of engagement is critical to the success of higher education in the future. Engagement is essential to most effectively achieving the overall purpose of the university, which is focused on the knowledge enterprise. Today's engagement is scholarly, is an aspect of learning and discovery, and enhances society and higher education. Undergirding today's approach to community engagement is the understanding that not all knowledge and expertise resides in the academy, and that both expertise and great learning opportunities in teaching and scholarship also reside in non-academic settings. By recommitting to their societal contract, public and land-grant universities can fulfill their promise as institutions that produce knowledge that benefits society and prepares students for productive citizenship in a democratic society. This new engagement also posits a new framework for scholarship that moves away from emphasizing products to emphasizing impact. (Contains 2 tables and 1 figure.)

All around the world, partnerships among schools and other youth-serving systems are promoting more comprehensive school-based mental health services. This article describes the development of international networks for school mental health (SMH) including the International Alliance for Child and Adolescent Mental Health and Schools (INTERCAMHS) and the more recent School Mental Health International Leadership Exchange (SMHILE). In conjunction with World Conferences on Mental Health Promotion, SMHILE has held pre-conference and planning meetings and has identified five critical themes for the advancement of global SMH: 1) Cross-sector collaboration in building systems of care; 2) meaningful youth and family engagement; 3) workforce development and mental health literacy; 4) implementation of evidence-based practices; and 5) ongoing monitoring and quality assurance. In this article we provide general background on SMH in four nations, two showing strong progress (the United States and Canada), one showing moderate progress (Norway), and one beginning the work (Liberia). Following general background for each country, actions in relation to the SMHILE themes are reviewed. The article concludes with plans and ideas for future global collaboration towards advancement of the SMH field.

Innovation is often promoted as the path to overcoming the burdens of bureaucratic organizations and fostering improved service to the public. In a moment where governments face dynamic administrative and policy challenges, there is great need for leveraging innovative ideas from public sector employees. What is less clear are which factors of employee human capital correlate with feeling encouraged to innovate. We test how three types of human capital influence innovation: organization level, industry specific, and individual specific human capital. We also explore whether there are differences in feeling encouraged to innovate linked to education, training, and demographics such as gender, race, and age. Using survey responses from 2,191 public procurement officers from various levels of government in the United States, we find human capital components including experience, and age correlate with feeling encouraged to innovate, though not always in expected ways. [ABSTRACT FROM AUTHOR]

Background: Living near an incident of firearm violence can negatively impact youth, regardless of whether the violence is experienced firsthand. Inequities in household and neighborhood resources may affect the prevalence and consequences of exposure across racial/ethnic groups. Findings: Using data from the Future of Families and Child Wellbeing Study and the Gun Violence Archive, we estimate that approximately 1 in 4 adolescents in large US cities lived within 800 m (0.5 miles) of a past-year firearm homicide during 2014–17. Exposure risk decreased as household income and neighborhood collective efficacy increased, though stark racial/ethnic inequities remained. Across racial/ethnic groups, adolescents in poor households in moderate or high collective efficacy neighborhoods had a similar risk of past-year firearm homicide exposure as middle-to-high income adolescents in low collective efficacy neighborhoods. Conclusions: Empowering communities to build and leverage social ties may be as impactful for reducing firearm violence exposure as income supports. Comprehensive violence prevention efforts should include systems-level strategies that jointly strengthen family and community resources. [ABSTRACT FROM AUTHOR]

Existing studies of reentry programs in the United States focus on the successes and failures of reentering offenders when compared to matched reentering offenders who did not receive structured reentry services. Little attention has been focused solely on the reentry participants themselves, and on how the level of program exposure may be related to recidivism outcomes. This study reports the recidivism outcomes of 357 reentry participants released to the community during a multiyear study period. All of the 357 participants studied were released for at least one full year, making it possible to examine recidivism behaviors by levels of reentry program exposure, at similar points in time. Thus, a range of descriptive and program attributes and an analysis of these attributes vis-a-vis defined recidivism measures is presented to answer the question: "Who goes back to prison?" (Contains 3 tables.)

The wraparound process has been promoted in the children's services field as a mechanism to achieve collaborative service planning and delivery for families of young people with complex emotional and behavioral needs that span multiple agencies. We compared results of two surveys of state children's mental health directors, completed in 1998 and 2008, to derive estimates of the extent of wraparound implementation in the United States and to better understand trends in how wraparound has been implemented and supported over time. Results from 2008 found that 88% of states reported having some type of wraparound program that conformed to the definition and provided an estimate of 100,000 children and families served via wraparound in that year. Between 1998 and 2008, states reported increased application of wraparound standards, a greater number of agencies involved in wraparound initiatives, and more formal evaluations of wraparound initiatives. Results provide substantiation of the widespread implementation of wraparound implementation in the United States, and evidence that the model is becoming more consistently supported by formal implementation structures over time. (Contains 2 tables.)

Professional musicians and college students commonly study orchestral excerpts, but a similar practice has yet to be implemented in the band field. Due to their widespread use in orchestral auditions, excerpts have been incorporated as a tool for musical development. Many college professors regularly assign excerpt study as part of their curricula. In addition, professional musicians teach master classes based solely around the playing and interpretation of these passages. Because of the limited number of professional bands in the United States today, musicians may not think of wind excerpts as a vehicle for technical and musical growth. A well-considered approach to wind literature, however, will open up new material for technical development in an authentic musical context. Additionally, band students at the high school and college levels can reap important musical benefits by adopting the methodology of orchestral colleagues. In this article, the author discusses how to implement a wind excerpt program. (Contains 3 figures, 2 tables and 6 notes.)

Objective: The overarching goal of this review is to provide a clinical overview of epidemiology, diagnosis, and treatment, and to discuss the public health impact, social determinants including access to care, and implications for health care delivery and research. It is estimated that approximately 1 in 4 individuals suffering from a serious mental illness (SMI) may have a co‐occurring opioid use disorder (OUD). In these individuals, the overall disease burden is higher and clinical outcomes are worse compared to those without a co‐occurring illness, making an integrated approach to diagnosis and treatment an urgent priority. Methods: We conducted a selective review of the literature to investigate prevalence, etiology for co‐occurring OUD and SMI, and diagnostic and clinical guidelines in the United States, and consideration special populations. Findings: Our findings suggest that, despite the high prevalence of co‐occurring OUD and SMI, contemporary diagnostics and treatment approaches are underutilized in this patient population. The literature also suggests that both pharmacological and psychosocial treatment approaches need to be tailored to optimize clinical management, and that integrated treatment is pivotal for improving overall outcomes, yet comprehensive clinical guidelines for co‐occurring OUD and SMI are lacking at this time. [ABSTRACT FROM AUTHOR]

For the United States Navy, too, the terrorist attacks of 9/11 marked a turning point. On a grim level of tragic loss of life, one third of the victims in the Pentagon that day were Navy personnel. Institutionally, the sea-going military service needed to cope with the emerging American policy focus on what came to be known as small wars. Under the umbrella of the "Global War on Terrorism", its focus areas stretched from the Afghan mountains to the Iraqi desert - and much further. These developments were very land-centric, relying on Army, Air Force, and transformed Marine Corps units on the most part. In the public and political eye, the Navy risked being relegated to only a supporting function in these campaigns, despite evidence to the contrary. Thus, strategically the Navy set out to use 9/11 and its aftermath to re-fashion its sense of self. Together with the Coast Guard and the Marine Corps, it produced a maritime strategy in 2007 that underlined the broad diplomatic, economic, and security/defense missions of seapower. Maritime terrorism and the role of naval forces against terrorists were incorporated, fully aware that navies could counter terrorism but are not procured for just that. The Navy had experienced its own prelude to 9/11 in the Yemini port of Aden in 2000. That day's attack on the destroyer USS COLE by terrorists preempted September 11 by less than a year. With the "Global War on Terrorism" and its costly land wars in Asia closing down and being replaced by other challenges in the past decade, the US Navy is once again shifting its focus to provide tools to American policy-makers. For the US Navy, the post-9/11 developments will have to be shed in favor of China, the emerging peer competitor. [ABSTRACT FROM AUTHOR]

Background: COVID-19, the disease caused by SARS-CoV-2, has caused a pandemic, sparing few regions. However, limited reports suggest differing infection and death rates across geographic areas including populations that reside at higher elevations (HE). We aimed to determine if COVID-19 infection, death, and case mortality rates differed in higher versus low elevation (LE) U.S. counties. Methods: Using publicly available geographic and COVID-19 data, we calculated per capita infection and death rates and case mortality in population density matched HE and LE U.S. counties. We also performed population-scale regression analysis to investigate the association between county elevation and COVID-19 infection rates. Findings: Population density matching of LA (< 914m, n = 58) and HE (>2133m, n = 58) counties yielded significantly lower COVID-19 cases at HE versus LE (615 versus 905, p = 0.034). HE per capita deaths were significantly lower than LE (9.4 versus 19.5, p = 0.017). However, case mortality did not differ between HE and LE (1.78% versus 1.46%, p = 0.27). Regression analysis, adjusted for relevant covariates, demonstrated decreased COVID-19 infection rates by 12.82%, 12.01%, and 11.72% per 495m of county centroid elevation, for cases recorded over the previous 30, 90, and 120 days, respectively. Conclusions: This population-adjusted, controlled analysis suggests that higher elevation attenuates infection and death. Ongoing work from our group aims to identify the environmental, biological, and social factors of residence at HE that impact infection, transmission, and pathogenesis of COVID-19 in an effort to harness these mechanisms for future public health and/or treatment interventions. [ABSTRACT FROM AUTHOR]

This study develops theory on how coordination occurs in collaboration across multiple expert domains. Ethnographic fieldwork at two top U.S. universities explored the emerging field of systems biology cancer research, an extreme case of cross-functional work. Scientists make diverse contributions compatible by engaging in the coordination practices of joint assessment and consultation and in the collaborative practices of counterprojection and alignment. The study advances a process model of coordination as an ensemble of different types of practices that drive collaboration across domains. Insights into how experts coordinate work within domains and how this affects temporal dynamics of collective work have implications for the literature on cross- functional coordination, innovation, and practice. [ABSTRACT FROM AUTHOR]

Background: Surgical telementoring, consisting of an expert surgeon guiding a less experienced surgeon through advanced or novel cases from a remote location, is an evolving technology which has potential to become an integral part of surgical practice. This study sought to apprise the attitudes of rural general surgeons toward the possible benefits and applications of surgical telementoring in their practices.Methods: A survey assessing demographics and attitudes toward telementoring was e-mailed to members of the American College of Surgeons (ACS) Advisory Council for Rural Surgery and posted to the ACS website in areas targeting rural surgeons. A link to a webpage with a description of surgical telementoring and brief demonstrative video were included with the survey.Results: There were 159 respondents, with 82.3 % of them practicing in communities smaller than 50,000 people. Overall, 78.6 % felt that telementoring would be useful to their practice, and 69.8 % thought it would benefit their hospitals. There was no correlation between years of practice and perceived usefulness of surgical telementoring. When asked the single most useful, or primary, application of surgical telementoring there was a split between learning new techniques (46.5 %) and intraoperative assistance with unexpected findings (39.0 %). When asked to select all applications in which they would be interested in using telementoring from a list of possible uses, surgeons most frequently selected: intraoperative consultation for unexpected findings (67.7 %), trauma consultation (32.9 %), and laparoscopic colectomy (32.9 %).Conclusions: Surgical telementoring is on the verge of widespread use but industry and surgical societies remain ambivalent about supporting its implementation due to concerns over lack of interest. This study demonstrates interest among rural surgeons. While there are differing opinions regarding compensation of the telementoring, the most common, single interest in the use of surgical telementoring was for learning new techniques or skill sets. [ABSTRACT FROM AUTHOR]

Background: Surgical treatment of inguinal hernias in adolescents is controversial as these patients do not fit into the traditional pediatric and adult populations. We aimed to compare the preferences of adult general surgeons and pediatric surgeons in managing adolescents by conducting a survey through social media.Methods: A poll was posted on the International Hernia Collaboration Group Facebook page as well as the Facebook page for the authoring pediatric surgeon. The poll gave scenarios of a 16-year-old male with an inguinal hernia and asked surgeons to select one of five listed procedures to repair the hernia: high ligation (open or laparoscopic), mesh repair (open or laparoscopic) or open muscle repair. The four scenarios differed in the diameter of the internal ring (1 vs. 4 cm) and the BMI of the patient (20 vs. 35). Fisher's exact test was implemented for statistical analysis.Results: In total, 43 (67 %) adult surgeons and 21 (33 %) pediatric surgeons responded. In the routine adolescent (normal BMI, small defect), 65 % of adult surgeons chose adult-type repairs (mesh or muscle repairs) whereas 86 % of pediatric surgeons chose pediatric-type repairs (high ligation). When the size of the defect increased, 100 % of adult surgeons and 81 % of pediatric surgeons selected an adult-type repair, suggesting agreement. When the patient was obese, there was a tendency to prefer laparoscopy. In all patient scenarios, the answers were significantly different between pediatric and adult surgeons (p < 0.05).Conclusion: For the same routine adolescent inguinal hernia, pediatric surgeons and adult general surgeons choose a different procedure. This finding suggests that further study is needed to determine the optimal treatment for inguinal hernias in adolescents, as the type of practitioner to whom the patient is referred, rather than the disease process itself, currently dictates treatment. [ABSTRACT FROM AUTHOR]

In the rural United States the infant mortality rate (IMR) is 6.5 per 1,000, and in rural states like Alabama this rate jumps to 9.1. Rural obstetric services are disappearing such that over half of U.S. rural counties do not have enough obstetric services. In contrast, Cuba's IMR is 4.3 while spending half as much as a percent of their gross domestic product than the United States. This raises the question: how has Cuba achieved this health outcome and what lessons can be learned and applied in the United States given decreased availability of obstetric services? This paper presents a field case study of one of Cuba's national public health policies. Specifically, we explore Cuba's Hogares Maternos, or maternity homes. We argue that the Cuban model, which focuses on social determinants of health, ought to be explored. We discuss how Hogares Maternos may be adopted and adapted within the rural United States by leveraging existing infrastructure. [ABSTRACT FROM AUTHOR]

A nurse-led QI initiative used interventions such as clinician education, visual reminders, flag reminders, and a monetary incentive to increase the number of secondhand smoke screenings providers performed and the number of patients screened and counseled. Exposure to secondhand smoke (SHS), also known as environmental tobacco smoke, adversely affects human health across the life cycle and has important economic consequences. The fact that many health care providers don't routinely screen all patients for SHS exposure and educate them on the risks associated with it is exacerbated by the lack of any requirement to do so, as well as the absence of adequate SHS screening questions in many electronic health record (EHR) systems. Further research on improving screening and education interventions is therefore warranted. In this quality improvement initiative, we introduced flag reminders, visual reminders, education, and a monetary incentive for providers, which improved their screening for and education on SHS exposure in the patients in a primary care clinic. The clinicians' behavior change in response to these interventions supports our proposal that an effective screening question with a flag reminder be added to the EHR, and confirms the need for continued research on screenings, EHR efficacy, and clinical behavior change. [ABSTRACT FROM AUTHOR]

This article discusses roles and missions of the United States Navy with a particular focus on the Baltic Sea. That particular sea has gained renewed political and military attention following Russia's resurgent and increasingly hybrid-offensive foreign policy. Baltic nations, uncertain of what the future holds, ought to look at sea power and maritime missions in the Baltic, as well as US naval presence in Europe, to draw lessons for future posture. [ABSTRACT FROM AUTHOR]

Studies have found considerable heterogeneity in the links between employment and mental health, finding that certain work conditions, such as nonstandard schedules and low job quality, are linked with poorer mental health. One largely overlooked facet of work is multiple job holding. In this article, we examine the link between multiple job holding and mental health among low-income mothers. We used data from the Fragile Families and Child Wellbeing Study (n = 7,844 person-wave observations), a longitudinal cohort study (1999–2016) of mostly low-income mothers in 20 large U.S. cities, to examine the link between multiple job holding and maternal depression and life dissatisfaction. Across a number of different model specifications, we find that multiple job holding is associated with higher probabilities of depression (3–4 percentage points higher). We also find some weaker evidence that multiple job holding is associated with life dissatisfaction (2–4 percentage points higher). When we include measures of job quality and intensity, we continue to see an independent association between multiple job holding and mental health. We also find that the associations between multiple job holding and depression/life dissatisfaction are strongest for mothers who also work 45 hours or more per week, work nonstandard schedules, and have lower earnings. Our study suggests that multiple job holding is associated with a greater likelihood of experiencing depression and somewhat associated with greater life dissatisfaction and should be considered by mental health practitioners and researchers seeking to understand drivers of depression. [ABSTRACT FROM AUTHOR]

The article highlights the symposium on work and success of women surgeons in the field of surgery from all over the world. Topics discussed include Improved conditions of women in medical schools; efforts of American College of Surgeons in bringing awareness about the difficulties of women surgeons and helps to develop their carrier through training and organizing courses for women surgeons; challenges and benefits to women in the field of medical science in U.S.

Many formal policies have suggested that officers need a college degree; however, policies forced little change in practices of American police organizations. Six hundred-fifty patrol officers employed in 12 medium-sized police departments in three Midwestern states were surveyed as to their current educational attainment and job performance. The purpose of this study was to determine the relationship between educational level and police performance. [ABSTRACT FROM AUTHOR]

In 2015, the Division for Early Childhood of the Council for Exceptional Children released a position statement on leadership in early intervention and early childhood special education (EI/ECSE). Division for Early Childhood emphasized the importance of developing and supporting high-quality leadership within and across all levels of EI/ECSE service systems.Moreover, therewas a call for related research because of the paucity of related research in the field. This cross-sectional survey was designed to address this call. The study expands on an earlier investigation designed to gain an understanding of the competencies needed to be an effective leader at any level of the EI service system under the Individuals with Disabilities Education Act (IDEA), Part C. Using a network-sampling approach, participants in the study described here were recruited from the population of individuals who were engaged, at any level in the EI/ECSE service delivery systems under the IDEA (Part B-619 and Part C). A sample of 820 individuals completed an Internet-based questionnaire. A factor analysis yielded 6 knowledge areas and 5 competency areas considered necessary for effective EI/ECSE leadership. The 6 knowledge areas comprised child development, evidence-based practices, state laws and regulations, family-centered approaches, federal laws and regulations, and group processes. The 5 competency areas comprised Professional Learning, Effective Relationships, Shared Responsibility, Data Use, and Effective Communication. The study results suggest avenues for further examinations of leadership within the EI/ECSE service systems. [ABSTRACT FROM AUTHOR]

Background/Objectives The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score ( GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii ( GTOS II) estimating probability of unfavorable discharge. Design Retrospective cohort. Setting Four geographically diverse Level 1 trauma centers. Participants Trauma admissions aged 65 to 102 years surviving to discharge from 2000 to 2013. Intervention None. Measurements Age, injury severity score ( ISS), transfusion at 24 hours post-admission, discharge dichotomized as favorable (home/rehabilitation) or unfavorable (skilled nursing/long term acute care/hospice). Training and testing samples were created using the holdout method. A multiple logistic mixed model ( GTOS II) was created to estimate the odds of unfavorable disposition then re-specified using the GTOS II as the sole predictor in a logistic mixed model using the testing sample. Results The final dataset was 16,114 subjects (unfavorable discharge status = 15.4%). Training (n = 8,057) and testing (n = 8,057) samples had similar demographics. The formula based on the training sample was ( GTOS II = Age + [0.71 × ISS] + 8.79 [if transfused by 24 hours]). Misclassification rate and AUC were 15.63% and 0.67 for the training sample, respectively, and 15.85% and 0.67 for the testing sample. Conclusion GTOS II estimates the probability of unfavorable discharge in injured elders with moderate accuracy. With the GTOS mortality calculator, it can help in goal setting conversations after geriatric injury. [ABSTRACT FROM AUTHOR]

This qualitative study examined caregivers' perceptions of Parent Peer Support (PPS) services, embedded in the Wraparound service delivery model for youth with severe emotional and behavioral disturbances (SEBD), to identify potential engagement facilitators and barriers. Wraparound is a holistic process involving multiple formal and informal providers to collectively implement an individualized, family-centered plan of care focused on maintaining youth with SEBD within the community. PPS are frequently referred to caregivers involved in Wraparound to provide additional support. Caregivers ( n = 35) previously involved in an evaluation of one state's Wraparound model participated in a single 30-60-min interview. Interview questions examined caregivers' expectations about PPS, reasons for accepting or refusing PPS, and caregivers' perceived impact of PPS. Transcribed interviews were analyzed using strategies from grounded theory methodology. Perceived need, as well as desire for shared experiences, knowledge, and assistance in accessing resources, facilitated accepting the PPS service. Barriers included inaccurate expectations of PPS, time limitations on Wraparound services, escalating youth behavior requiring more restrictive placements, scheduling difficulties, perceived unresponsiveness, and caregivers feeling overwhelmed by the number of providers. Caregivers indicated that PPS provided several benefits for themselves, youth in the care, and their families. However, potential barriers to ongoing engagement included perceived intrusiveness, as well as misalignment between services offered and caregivers' needs. [ABSTRACT FROM AUTHOR]

Wraparound is a team-based care coordination strategy for children and youth with complex behavioral health needs and their families. Despite widespread adoption, a review of the literature pertaining to Wraparound has not previously been conducted. To address this gap, we conducted a comprehensive review, ultimately identifying 206 unique Wraparound-related publications in peer-reviewed outlets. We then coded and analyzed the publications' methods, main foci, measures, and findings. Eighty-three publications (40%) were non-empirical, most of which focused on defining Wraparound and advocating for its use, largely based on its alignment with the System of Care philosophy. Among empirical studies ( n = 123; 60%), 22 controlled studies were found, most finding positive or mixed evidence for Wraparound's effectiveness. Other empirical studies examined implementation issues such as necessary system conditions and measurement and influence of fidelity. Major gaps include rigorous tests of Wraparound's change mechanisms, workforce development models, peer support, and the use of specific treatments. We conclude that literature produced to date has provided useful information about Wraparound's core components, program-level and system-level implementation supports, and applicability across systems and populations, as well as preliminary information about effectiveness and cost-effectiveness. The Wraparound research base would, however, benefit from additional studies of the model's intervention and implementation components, as well as more rigorous effectiveness studies. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges surrounding U.S. Defend Trade Secrets Act (DTSA). Topics discussed include amendment of DTSA for preempting state and common law to protect trade secrets; encouraging fair competition and employment mobility; and Whyte v. Schlage Lock Co. court case addressing the same.

The wraparound process aims to provide an effective practice-level approach to coordinating care for youths with complex behavioral health needs, and reformed system structures to support such integration of care. The current study provides an update to two prior surveys of state children's mental health directors, completed in 1998 and 2007, on the extent of wraparound implementation in the United States and implementation supports that have been employed. Results from 2013 found that 100 % of states reported having some type of wraparound program that conformed to the definition and yielded an estimate of 75,000 children and families served via wraparound in that year. States reported a continued increase in use of wraparound standards; however, fewer states reported collection of fidelity data, and availability of internal resources for training and coaching. Over three-quarters of states reported availability of parent to parent peer support, and 46 % of states are supporting wraparound implementation by blending or braiding funding across child-serving systems. Results also revealed that 61 % of states had a centralized oversight entity for wraparound, an important finding given that such 'statewideness' was also associated with more youth served, greater accountability, use of standards, and other implementation supports. [ABSTRACT FROM AUTHOR]

Objective: Empirical study of public behavioral health systems' use of data and their investment in evidence-based treatments (EBTs) is limited. This study describes trends in state-level EBT investment and research supports from 2001 to 2012.Methods: Data were from National Association for State Mental Health Program Directors Research Institute (NRI) surveys, which were completed by representatives of state mental health authorities (SMHAs). Multilevel models examined change over time related to state adoption of EBTs, numbers of clients served, and penetration rates for six behavioral health EBTs for adults and children: supported housing, supported employment, assertive community treatment, therapeutic foster care, multisystemic therapy, and functional family therapy. State supports related to research, evaluation, and information management were also examined.Results: Increasing percentages of states reported funding an external research center, promoting the adoption of EBTs through provider contracts, and providing financial incentives for EBTs. Decreasing percentages of states reported promoting EBT adoption through stakeholder mobilization, monitoring fidelity, and specific budget requests. There was greater reported use of adult-focused EBTs (65%-80%) compared with youth-focused EBTs (25%-50%). Overall penetration rates of EBTs were low (1%-3%) and EBT adoption by states showed flat or declining trends. SMHAs' investment in data systems and use of research showed little change.Conclusions: SMHA investment in EBTs, implementation infrastructure, and use of research has declined. More systematic measurement and examination of these metrics may provide a useful approach for setting priorities, evaluating success of health reform efforts, and making future investments. [ABSTRACT FROM AUTHOR]

The article discusses the U.S. Court of Appeals for the Ninth Circuit's (Ninth Circuit's) ruling in the 2015 securities law case United States v. Salman, and it mentions how the Ninth Circuit declined to follow the insider trading (IT) legal standard that was adopted America's Court of Appeals for the Second Circuit in the 2014 conspiracy and IT litigation matter United States v. Newman. Legal interpretations and sufficient evidence for establishing a breach of fiduciary duty claim are examined.

Background: Epidemiologic evidence indicates that food allergies are increasing in the population. Information on a change in self-reported food allergy (srFA) in adults over time is lacking. Objective: To report the prevalence of srFA and compare differences at three time points over a decade. Methods: We analyzed srFA and reported physician-diagnosed food allergy in >4000 U.S. adults who participated in the 2010 U.S. Food and Drug Administration Food Safety Survey. Information on causative food(s), reaction severity characteristics, and various diagnostic factors was also analyzed. We compared 2010 Food Safety Survey data with 2006 and 2001 data, and highlighted relevant differences. Results: SrFA prevalence increased significantly, to 13% in 2010 and 14.9% in 2006 compared with 9.1% in 2001 (p < 0.001). Physician diagnosed food allergy was 6.5% in 2010, which was not significantly different compared with 7.6% in 2006 and 5.3% in 2001. SrFA increased in both men and women, non-Hispanic white and black adults, 50-59 year olds, and in adults with a high school or lower education. In 2010, milk, shellfish, and fruits were the most commonly reported food allergens, similar to 2001. Also, in 2010, 15% of reactions reportedly required a hospital visit and 8.4% were treated with epinephrine. Minor differences in reaction severity characteristics were noted among the surveys. Conclusions: Analysis of survey results indicates that the prevalence of srFA increased among U.S. adults from 2001 to 2010 and that adults are increasingly self-reporting FAs without obtaining medical diagnosis. Improved education about food allergies is needed for this risk group. [ABSTRACT FROM AUTHOR]

Purpose: Though primary repair of colon injuries is preferred, certain injury patterns require colostomy creation. Colostomy reversal is associated with significant morbidity and healthcare cost. Complication rates may be influenced by technique of diversion (loop vs. end colostomy), though this remains ill-defined. We hypothesized that reversal of loop colostomies is associated with fewer complications than end colostomies. Methods: This is a retrospective, multi-institutional study (four, level-1 trauma centers) of patients undergoing colostomy takedown for trauma during the time period 1/2006-12/2012. Data were collected from index trauma admission and subsequent admission for reversal and included demographics and complications of reversal. Student's t test was used to compare continuous variables against loop versus end colostomy. Discrete variables were compared against both groups using Chi-squared tests. Results: Over the 6-year study period, 218 patients underwent colostomy takedown after trauma with a mean age of 30; 190 (87 %) were male, 162 (74 %) had penetrating injury as their indication for colostomy, and 98 (45 %) experienced at least one complication. Patients in the end colostomy group ( n = 160) were more likely to require midline laparotomy (145 vs. 18, p < 0.001), had greater intra-operative blood loss (260.7 vs. 99.4 mL, p < 0.001), had greater hospital length of stay (8.4 vs. 5.5 days, p < 0.001), and had more overall complications (81 vs. 17, p = 0.005) than patients managed with loop colostomy ( n = 58). Conclusions: Local takedown of a loop colostomy is safe and leads to shorter hospital stays, less intra-operative blood loss, and fewer complications when compared to end colostomy. [ABSTRACT FROM AUTHOR]

In the face of global environmental change, the importance of protected areas in biological management and conservation is expected to grow. Birds have played an important role as biological indicators of the effectiveness of protected areas, but with little consideration given to where species occur outside the breeding season. We estimated weekly probability of occurrence for 308 bird species throughout the year within protected areas in the western contiguous USA using eBird occurrence data for the combined period 2004 to 2011. We classified species based on their annual patterns of occurrence on lands having intermediate conservation mandates (GAP status 2 and 3) administered by the Bureau of Land Management (BLM) and the United States Forest Service (USFS). We identified species having consistent annual association with one agency, and species whose associations across the annual cycle switched between agencies. BLM and USFS GAP status 2 and 3 lands contained low to moderate proportions of species occurrences, with proportions highest for species that occurred year-round or only during the summer. We identified two groups of species whose annual movements resulted in changes in stewardship responsibilities: (1) year round species that occurred on USFS lands during the breeding season and BLM lands during the nonbreeding season; and (2) summer species that occurred on USFS lands during the breeding season and BLM lands during spring and autumn migration. Species that switched agencies had broad distributions, bred on high-elevation USFS lands, were not more likely to be identified as species of special management concern, and migrated short (year-round species) to long distances (summer species). our findings suggest cooperative efforts that address the requirements of short-distance migratory species on GAP status 2 lands (n = 20 species) and GAP status 3 lands (n = 24) and long-distance migratory species on GAP status 2 lands (n = 9) would likely benefit their populations. Such efforts may prove especially relevant for species whose seasonal movements result in associations with different environments containing contrasting global change processes and management mandates. [ABSTRACT FROM AUTHOR]

Objectives Somatic/psychiatric symptoms are frequently found in chronic pain patients ( CPPs). The objectives of this study were to determine 1) which somatic/psychiatric symptoms are more commonly found in acute pain patients ( APPs) and CPPs vs community nonpatients without pain ( CNPWPs) and 2) if somatic/psychiatric symptom prevalence differs between APPs and CPPs. Design The above groups were compared statistically for endorsement of 15 symptoms: fatigue, numbness/tingling, dizziness, difficulty opening/closing mouth, muscle weakness, difficulty staying asleep, depression, muscle tightness, nervousness, irritability, memory, falling, nausea, concentration, and headaches. Results After controlling for age, gender, and level of pain, APPs and CPPs had a statistically significantly greater prevalence (at a P < 0.01 level) for 11 and 13 symptoms, respectively, vs CNPWPs. After controlling for age, gender, and level of pain, CPPs had a statistically significantly greater prevalence (at a P < 0.01 level) for eight symptoms vs APPs. Symptoms were highly correlated in both APPs and CPPs. Conclusions CPPs are characterized to a significantly greater extent than comparison groups by somatic/psychiatric symptoms that are highly intercorrelated. This has implications for clinical practice and future research. [ABSTRACT FROM AUTHOR]

American sea power and forward-deployed U.S. naval forces play a crucial role for the defense and security policy of the United States. However, indiscriminate budget cuts, a degree of rebalancing towards the Pacific, some ground-breaking changes in strategic dependencies, and a shift in political priorities could curtail the U.S. Navy's abilities to influence events at and from the sea in some areas of the world. As a consequence, other powers need to fill the geopolitical vacuum, with very broad ramifications for European navies. This essay, although skeptical towards Europe's ability to muster such efforts decisively, provides some broad policy recommendations for how to optimize German and European sea power accordingly. [ABSTRACT FROM AUTHOR]

The wraparound process is a type of individualized, team-based care coordination that has become central to many state and system efforts to reform children's mental health service delivery for youths with the most complex needs and their families. Although the emerging wraparound research base is generally positive regarding placements and costs, effect sizes are smaller for clinical and functional outcomes. This article presents a review of literature on care coordination and wraparound models, with a focus on theory and research that indicates the need to better connect wraparound-enrolled children and adolescents to evidence-based treatment (EBT). The article goes on to describe how recently developed applications of EBT that are based on quality improvement and flexible application of “common elements” of research-based care may provide a more individualized approach that better aligns with the philosophy and procedures of the wraparound process. Finally, this article presents preliminary studies that show the feasibility and potential effectiveness of coordinating wraparound with the Managing and Adapting Practice system, and discusses intervention development and research options that are currently under way. [ABSTRACT FROM AUTHOR]

Objectives. The objectives of this study were to (1) compare the prevalence of smoking within chronic pain patients ( CPPs) to community non-patients without pain ( CNPWP), community patients with pain ( CPWP), and acute pain patients ( APPs); and (2) compare smokers to nonsmokers within CPPs, APPs, and CPWP for highest pain level. Design. CNPWP, CPWP, APPs, and CPPs were compared to each other for smoking status (nonsmoker, less than one pack per day, one pack/day or more, any amount per day). Within CPWP, APPs, and CPPs, smokers were also compared to nonsmokers by t-test for highest reported pain level. For both analyses, sub-analyses were performed controlling for age or gender, or race or education. Results. Utilizing all available patients, the prevalence of smokers within CPPs was significantly greater vs each of the comparison groups ( CNPWP, CPWP, APPs). In the sub-analyses, only CPPs who were 38 or younger or male or White, or had some college or above were at greater risk than CPWP for smoking one pack or greater per day. CPP smokers were not significantly more likely than nonsmokers to have higher pain, and this was confirmed in the sub-analyses. Conclusions. The prevalence of smokers could be significantly greater within CPPs vs CPWP. CPPs who smoke do not have higher levels of pain than nonsmoking CPPs. [ABSTRACT FROM AUTHOR]

Hypothesis. Passive, active, and historical suicidality are associated with preference for death over disability. Design. Community nonpatients without pain, community patients with pain, and patients with acute and chronic pain were compared for endorsement of disability perception and preference for death over disability. Phi correlations and chi-square analyses were calculated between preference for death over disability and six suicidality items representing passive, active, and historical suicidality. Logistic regression was used to predict preference for death over disability in patients with acute and chronic pain. Results. For patients with acute and chronic pain, endorsement of preference for death over disability correlated significantly with all six suicidality items. The logistic regression models identified the following variables as predictors for preference for death over disability in patients with acute pain: the Behavior Health Inventory (BHI 2) family dysfunction scale, history of wanting to die, and disability perception. For patients with chronic pain, predictors were the BHI 2 Borderline scale, history of wanting to die, treated fairly by family item, frequent suicide ideation, people I trust turn on me item, and disability perception. Preference for death over disability was a statistically significant predictor in patients with chronic pain for disability perception, recent suicide ideation, having a suicidal plan, and a history of wanting to die but was not a significant predictor for any suicide items in patients with acute pain. Conclusion. Preference for death over disability is associated with passive and active suicide ideation and historical suicidality in patients with chronic pain. [ABSTRACT FROM AUTHOR]

The article offers information on the importance of efficient peer reporting system to companies in the U.S. The authors believed that the creation of peer reporting system is beneficial to companies because they can prevent fraudulent activities, dishonest customer interactions and unethical utilization of corporate assets. They also mention that the system can also lead to collusion, wherein some workers agree to do fraudulent activities and cover each other. Moreover, ways on how to create an ethical working environment are also mentioned.

Politicians seeking reelection need voters to know what they have done for them. Thus, incentives may arise to spend more money where media coverage is higher. We present a simple model to explain the allocation of public spending across jurisdictions contingent on media activity. A politician seeking to maximize the probability of reelection will shift more money to jurisdictions where an extra dollar raises more votes because a larger share of the electorate is informed about his policy. The main prediction of the model is that media activity is higher in the core areas of media markets. This implies higher spending levels there and lower spending levels in remote jurisdictions. Empirical support for this prediction is found using United States data on county-level federal grant allocation, Designated Market Areas and the location of licensed television stations. [ABSTRACT FROM AUTHOR]

A growing body of research is examining the strengths and weaknesses of specific after school programs and their effect on youth outcomes. Few reviews, however, have sought to examine the components of citywide system-building—to understand intentional efforts to develop, support and sustain high quality after school programming across a community. Beginning in the mid-1990s and continuing through the present, private funders, public officials and program practitioners in cities across America have joined together to build systems to support the expansion and improvement of after school programs at the city-level. This paper presents the community context and underlying principles that drove the development of Baltimore’s After- School Strategy; articulates a set of system components derived from this experience and the available literature; and lays out future work to expand high quality after-school opportunities for youth in Baltimore and in other distressed urban environments. [ABSTRACT FROM AUTHOR]

Wraparound is a team-based service planning and coordination process intended to improve outcomes for children and youth with serious emotional and behavioral disorders and support them in their homes, schools, and communities. Given the substantial resources devoted to implementing wraparound, a meta-analysis of outcome studies was conducted to better understand current empirical support for this process. A literature search identified seven studies between 1986 and 2008 that documented the effects of youth receiving wraparound compared to control groups. Mean treatment effects across outcome domains ranged from medium for youth living situation (0.44) to small for mental health outcomes (0.31), overall youth functioning (0.25), school functioning (0.27), and juvenile justice-related outcomes (0.21). The overall mean effect size across studies was 0.33. Interpretation of results was complicated by the lack of consistent documentation of implementation fidelity across studies and conditions, variations in target population and intended outcomes, and methodological concerns. The authors conclude that, though the published wraparound research base is expanding and findings are largely positive, it continues to be in a preliminary state of development. However, there are insufficient data to support calls for wraparound’s acceptance or dismissal based on the strength of existing studies. [ABSTRACT FROM AUTHOR]

Mild traumatic brain injury accounts for 1% to 2% of emergency department visits in the United States. Up to 15% of these patients will have an acute intracranial lesion identified on head computed tomography; less than 1% of mild traumatic brain injuries will require neurosurgical intervention. Clinical research over the past decade has focused on identifying the subgroup of patients with mild traumatic brain injury with acute traumatic lesions on computed tomography and specifically those at risk for harboring a potentially catastrophic lesion. This research has been used to generate evidence-based guidelines to assist in clinical decision making. There is no evidence to support the use of plain film radiographs in the evaluation of patients with mild traumatic brain injury. The utility of brain-specific biomarkers is rapidly evolving, and a growing body of evidence supports their potential role in determining the need for neuroimaging. Clinical predictors for identifying patients with abnormal computed tomography have been established and, if used, may have a significant positive impact on traumatic brain injury-related morbidity and healthcare utilization in the United States. Patients with negative computed tomography are at almost no risk of deteriorating; however, they should be counseled regarding postconcussive symptoms and should be given appropriate written instructions and referrals at discharge. [ABSTRACT FROM AUTHOR]

The article describes a unique association of states in the U.S. that are investigating how administrators and stakeholders should create public policy through their statewide evidence-based practice implementation efforts for children and adolescents. The section presents background on such issue, significant theory and research, and descriptions of approaches followed by six of these U.S. states. It also provides a synthesis of these state approaches, including recommendations for state policy, federal policy, and future research.

Objective. Physicians are at risk of patient-perpetrated violence. The objective of this study was to test a clinical model of patient violence, which had been developed previously by Fishbain and colleagues. The developers of this model believed that it would be associated with increased risk of violence in pain patients. Design. Hypotheses generated by the model were tested usingmanova and chi-square procedures. Setting. A total of 527 subjects for this study were patients obtained from 90 medical facilities in 30 U.S. states. Patients. All subjects were patients being treated for injury and nonmalignant pain. All of the subjects were adults, ranging in age from 18 to 65 years, and were able to read at the sixth-grade level. The demographics of the sample approximated U.S. Census data for race, education, age, and gender. Results. The results included findings that violent ideation was associated with higher levels of physical difficulties, including pain ( P = 0.01), problems with functioning ( P = 0.0003), and somatic complaints ( P = 0.0001). Significant psychosocial variables included hostility ( P < 0.0001), dependency ( P < 0.0001), substance abuse ( P < 0.0001), litigation ( P < 0.001), and a lack of trust in the physician ( P < 0.001). Conclusions. Using the Battery for Health Improvement 2 as a measure, the findings of this study consistently supported the Fishbain Model of violence risk, and also reinforced the need for psychological assessment and management when working with chronic pain patients. Suggestions for intervention were also offered, but further research will be necessary to see whether these interventions are effective in decreasing patient violence. [ABSTRACT FROM AUTHOR]

The article examines the relations between a set of program- and system-level variables and fidelity to the wraparound process for children and families or the Wraparound Fidelity Index (WFI). A measure of WFI was administered to families and children receiving services in eight U.S. mental health agencies. Results showed variation across programs in the number and type of program and system supports for wraparound implementation.

This article explores the nature of expanded school mental health (ESMH) services in Baltimore City, which at the time of the study were incorporated into 40% of the city's public schools. A provider survey was distributed to ESMH clinicians to gather information on the characteristics of service providers and recipients, types of services being provided, and their proposed outcomes. Provider reports indicated an impressive service capacity, augmentation of traditional school-based services, and the continual need for increased mental health service hours in their buildings. In addition, the most frequently voiced benefits of the ESMH programs were increased mental health awareness and improved school climate. Implications of the findings for future programming development and research are discussed. [ABSTRACT FROM AUTHOR]

Journal of Ecology (2003) 91, 1071–1080 [ABSTRACT FROM AUTHOR]

In this study we examine the distribution of Rhizopogon species in spore banks from five California pine forests. Four of the forest sites were discontinuous populations of Pinus muricata and a fifth was a Pinus ponderosa stand in Sierra National Forest. Rhizopogon species were retrieved by bioassaying the soils with pine seedlings followed by isolation of axenic cultures from individual root tips with typical Rhizopogon ectomycorrhizal morphology. The cultures were screened by ITS-RFLP and all unique patterns were sequenced. These sequences then were compared with those derived from identified sporocarp material. Bioassaying proved to be an efficient way to bring Rhizopogon species into culture. Approximately 50% of the pots contained ectomycorrhizal tips with Rhizopogon-like morphology, and axenic Rhizopogon cultures were obtained from half these pots. Our results showed that Rhizopogon spores usually are well distributed within local forest areas, while there is significant structuring of species at the regional scale. Spore longevity and homogenization by soil and water movement might explain their distribution within local forest areas, while the regional pattern might be explained by limited long distance dispersal or climatic and edaphic differences. [ABSTRACT FROM AUTHOR]