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Background: The novel coronavirus (SARS-CoV-2) has produced a considerable public health burden but the impact that contracting the disease has on mental health is unclear. In this observational population-based cohort study, we examined longitudinal changes in psychological distress associated with testing positive for coronavirus disease 2019 (COVID-19). Methods: Participants (N = 8002; observations = 139 035) were drawn from 23 waves of the Understanding America Study, a nationally representative probability-based online panel of American adults followed-up every 2 weeks from 1 April 2020 to 15 February 2021. Psychological distress was assessed using the standardized total score on the Patient Health Questionnaire-4. Results: Over the course of the study, 576 participants reported testing positive for COVID-19. Using regression analysis including individual and time-fixed effects we found that psychological distress increased by 0.29 standard deviations (p < 0.001) during the 2-week period when participants first tested positive for COVID-19. Distress levels remained significantly elevated (d = 0.16, p < 0.01) for a further 2 weeks, before returning to baseline levels. Coronavirus symptom severity explained changes in distress attributable to COVID-19, whereby distress was more pronounced among those whose symptoms were more severe and were slower to subside. Conclusions: This study indicates that testing positive for COVID-19 is associated with an initial increase in psychological distress that diminishes quickly as symptoms subside. Although COVID-19 may not produce lasting psychological distress among the majority of the general population it remains possible that a minority may suffer longer-term mental health consequences. [ABSTRACT FROM AUTHOR]

Objectives. To test whether the prevalence of reported psychological distress increased among working-age adults in the United States between 1999 and 2018. Methods. I examined psychological distress in the past 30 days using the Kessler-6 Distress Scale, completed by 403 223 participants aged 25 to 64 years across 20 annual waves of the National Health Interview Study conducted from 1999 to 2018. I examined overall and demographic-specific trends. Results. The prevalence of psychological distress in the past 30 days increased from 16.1% in 1999–2000 to 22.6% in 2017–2018, an increase of 6.5 percentage points (95% confidence interval [CI] = 5.6, 7.3) or 40% from 1999–2000 levels. Statistically significant increases in the prevalence of distress were observed across all age, gender, race/ethnicity, and educational attainment subgroups examined. Rates of serious psychological distress increased from 2.7% in 1999–2000 to 4% in 2017–2018, an increase of 1.3 percentage points (95% CI = 0.9, 1.6). Conclusions. Since 1999, there has been an upward trend in reported psychological distress among working-aged adults in the United States. (Am J Public Health. 2022;112(7):1045–1049. https://doi.org/10.2105/AJPH.2022.306828) [ABSTRACT FROM AUTHOR]

Objectives: It has been shown that psychological distress rose rapidly as the COVID‐19 pandemic emerged and then recovered to pre‐crisis levels as social lockdown restrictions were eased in the United States. The aim of the current study was to investigate psychosocial and behavioural factors that may explain the rise and fall of distress during the initial months of the COVID‐19 crisis. Design: This study examined six waves of longitudinal nationally representative data from the Understanding America Study (UAS) collected between March and June 2020 (N = 7,138, observations = 34,125). Methods: Mediation analysis was used to identify whether changes in distress (PHQ‐4) during the COVID‐19 pandemic were explained by the following factors: perceived infection risk and risk of death, perceived financial risks, lifestyle changes resulting from the virus, perceived discrimination related to the virus, and changes in substance use and employment status. Results: All mediating factors played a role in explaining changes in distress and together accounted for 70% of the increase in distress between 10‐18 March and 1‐14 April and 46.4% of the decline in distress between 1‐14 April and early June 2020. Changes in perceived health risks were most important in explaining changes in distress followed by changes in lifestyle and the perceived financial risks associated with COVID‐19. Conclusions: This study provides longitudinal population‐based evidence detailing the mediating factors explaining changes in distress during the COVID‐19 crisis. Perceived health risks associated with the virus may play a key role in explaining rising and falling levels of psychological distress during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

There is growing concern that the COVID-19 crisis may have long-standing mental health effects across society particularly amongst those with pre-existing mental health conditions. In this observational population-based study, we examined how psychological distress changed following the emergence of the COVID-19 crisis in the United States and tested whether certain population subgroups were vulnerable to persistent distress during the crisis. We analyzed longitudinal nationally representative data from eight waves of the Understanding America Study (UAS) collected between March 10th and July 20th, 2020 (N = 7319 Observations = 46,145). Differences in distress trends were examined by age, sex, race/ethnicity, and household income and by the presence of a pre-existing mental health diagnosis. Psychological distress was assessed using the standardized total score on the Patient Health Questionnaire-4 (PHQ-4). On average psychological distress increased significantly by 0.27 standard deviations (95% CI [0.23,0.31], p <.001) from March 10–18 to April 1–14, 2020 as the COVID-19 crisis emerged and lockdown restrictions began in the US. Distress levels subsequently declined to mid-March levels by June 2020 (d = –0.31, 95% CI [–0.34, –0.27], p <.001). Across the sociodemographic groups examined and those with pre-existing mental health conditions we observed a sharp rise in distress followed by a recovery to baseline distress levels. This study identified substantial increases in distress in the US during the emergence of the COVID-19 crisis that largely diminished in the weeks that followed and suggests that population level resilience in mental health may be occurring in response to the pandemic. • The global spread of COVID-19 may have had an enduring impact on mental health. • Longitudinal nationally representative studies addressing this topic are scarce. • This study examines mental health beyond the initial stage of the COVID-19 crisis. • Identifies a substantial rise in distress in the U.S. from March to April 2020. • Psychological distress levels returned to baseline by June 2020. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) and the associated social distancing and lockdown restrictions are expected to have substantial and enduring mental health effects. In this study, we aimed to assess depression levels before and during the COVID-19 pandemic in the United States.Methods: We used the Patient Health Questionnaire-2 (PHQ-2) brief screening instrument to detect probable depression in two nationally representative surveys of US adults. Pre-pandemic levels of depression were assessed in a sample of 5,075 adults from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). Depression was assessed in March (N = 6,819) and April 2020 (N = 5,428) in the Understanding America Study, a representative sample of the US population.Results: The percentage of US adults with depression increased significantly from 8.7% (95% CI[7.6%-9.8%]) in 2017-2018 to 10.6% (95% CI[9.6%-11.6%) in March 2020 and 14.4% (95% CI[13.1%-15.7%]) in April 2020. Statistically significant increases in depression levels were observed for all population subgroups examined with the exception of those aged 65+ years and Black participants. Young adults (aged 18-34) experienced a marked increase in depression of 13.4 percentage points (95% CI [9.5%-17.2%]) that was larger than any other age group. Additional analyses of depression trends in NHANES from 2007/2008-2017/2018 showed that the substantial increase in depression in April 2020 was unlikely to be due to typical year-to-year variation.Conclusions: Our findings suggest that depression levels have risen substantially during the COVID-19 pandemic and reinforce recent findings indicating that young adults may be particularly vulnerable to the mental health effects of the pandemic. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine whether BMI and weight discrimination are associated with psychological, behavioral, and interpersonal responses to the coronavirus pandemic.Methods: Using a prospective design, participants (N = 2,094) were first assessed in early February 2020 before the coronavirus crisis in the United States and again in mid-March 2020 during the President's "15 Days to Slow the Spread" guidelines. Weight, height, and weight discrimination were assessed in the February survey. Psychological, behavioral, and interpersonal responses to the coronavirus were assessed in the March survey.Results: Prepandemic experiences with weight discrimination were associated with greater concerns about the virus, engaging in more preventive behaviors, less trust in people and institutions to manage the outbreak, and greater perceived declines in connection to one's community. BMI tended to be unrelated to these responses.Conclusions: Despite the risks of complications of coronavirus disease associated with obesity, individuals with higher BMI were neither more concerned about the virus nor taking more behavioral precautions than individuals in other weight categories. Weight discrimination, in contrast, may heighten vigilance to threat, which may have contributed to both positive (greater concern, more precautionary behavior) and negative (less trust, declines community connection) responses to the pandemic. [ABSTRACT FROM AUTHOR]

This online survey study of US adults characterizes trends in coronavirus vaccine hesitancy and public trust in vaccination before and after COVID-19 vaccine availability in the US. [ABSTRACT FROM AUTHOR]

The article discusses the effectiveness of the comparability tables of the Census of Retail Distribution by the U.S. Bureau of the Census. The comparability tables were necessary because between the years of 1929 and 1939, retail outlets had shifted functions considerably, and a person using the Census information would have had to use their best judgment for specialty retailers. The author illustrates that the tables by the Census Bureau failed to illustrate proper comparisons between retailers of 1929 with those of 1939, and offers suggestions on how to improve the tables. The author's table is included in the article.

Highly concentrated radionuclide waste produced during the Cold War era is stored at US Department of Energy (DOE) production sites. This radioactive waste was often highly acidic and mixed with heavy metals, and has been leaking into the environment since the 1950s. Because of the danger and expense of cleanup of such radioactive sites by physicochemical processes, in situ bioremediation methods are being developed for cleanup of contaminated ground and groundwater. To date, the most developed microbial treatment proposed for high-level radioactive sites employs the radiation-resistant bacterium Deinococcus radiodurans. However, the use of Deinococcus spp. and other bacteria is limited by their sensitivity to low pH. We report the characterization of 27 diverse environmental yeasts for their resistance to ionizing radiation (chronic and acute), heavy metals, pH minima, temperature maxima and optima, and their ability to form biofilms. Remarkably, many yeasts are extremely resistant to ionizing radiation and heavy metals. They also excrete carboxylic acids and are exceptionally tolerant to low pH. A special focus is placed on Rhodotorula taiwanensis MD1149, which was the most resistant to acid and gamma radiation. MD1149 is capable of growing under 66 Gy/h at pH 2.3 and in the presence of high concentrations of mercury and chromium compounds, and forming biofilms under high-level chronic radiation and low pH. We present the whole genome sequence and annotation of R. taiwanensis strain MD1149, with a comparison to other Rhodotorula species. This survey elevates yeasts to the frontier of biology's most radiation-resistant representatives, presenting a strong rationale for a role of fungi in bioremediation of acidic radioactive waste sites. [ABSTRACT FROM AUTHOR]

To incentivize hospitals to provide better quality care at a lower cost, the Affordable Care Act of 2010 included the Hospital Readmissions Reduction Program (HRRP), which reduces payments to hospitals with excess 30-day readmissions for Medicare patients treated for certain conditions. We use triple difference estimation to identify the HRRP's effects in Virginia hospitals; this method estimates the difference in changes in readmission over time between patients targeted by the policy and a comparison group of patients and then compares those difference-in-differences estimates in patients treated at hospitals with readmission rates above the national average (i.e., those at risk for penalties) and patients treated at hospitals with readmission rates below or equal to the national average (those not at risk). We find that the HRRP significantly reduced readmission for Medicare patients treated for acute myocardial infarction (AMI). We find no evidence that hospitals delay readmissions, treat patients with greater intensity, or alter discharge status in response to the HRRP, nor do we find changes in the age, race/ethnicity, health status, and socioeconomic status of patients admitted for AMI. Future research on the specific mechanisms behind reduced AMI readmissions should focus on actions by healthcare providers once the patient has left the hospital. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To examine whether perceived weight discrimination is associated with change in health markers over time and whether it is associated with daily stressors, physical symptoms, and affect.Methods: Participants were selected from the Midlife in the United States (MIDUS) study if they had data on perceived weight discrimination and health markers at MIDUS II (2004-2006), health markers at MIDUS III (2013-2014), and a body mass index ≥25 kg/m(2) (N = 1,841). A subset of these participants (N = 1,153) reported on their experiences daily for 8 days as part of the second National Study of Daily Experiences.Results: Perceived weight discrimination was associated with declines in mental and physical health over time (median β = 0.06). Participants who reported weight discrimination experienced more daily stressors (β = 0.13), physical symptoms (β = 0.13), and negative affect (β = 0.13) and less positive affect (β = -0.12) over the 8 days of the second National Study of Daily Experiences. Weight discrimination was most strongly associated with interpersonal stressors (median β = 0.14), feelings of anger (β = 0.16) and frustration (β = 0.14), lower attention (β = -0.14) and activity (β = -0.16), and more nonspecific physical symptoms (e.g., fatigue; β = 0.10).Conclusions: This research replicates the association between perceived weight discrimination and worse health over time and extends this literature to show that people who experience weight discrimination have more daily stressors, physical symptoms, and negative emotions. [ABSTRACT FROM AUTHOR]

Objective: Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. Method: The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification) were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns. Results: After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58) was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46), which likely represents self-interest in retaining property (guns). Conclusions: Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites’ paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions. [ABSTRACT FROM AUTHOR]

The article focuses on the U.S. Supreme Court case Anderson v. Wachovia Mortgage Corp., which dealt with mortgage discrimination under U.S. commercial laws. Topics include burden of proof requirements, lending discrimination, and requests for summary judgment. Information is provided on predatory lending and discriminatory mortgage conditions.

The article presents information on the decisions by the courts regarding the maritime issues under the admiralty and maritime law of the U.S. The cases regarding the claims by seamen were decided by the Supreme Court of the U.S. under the Federal Employer's Liability Act (FELA) and the claims against the seamen were brought under the Jones Act claim by the seamen. The death of an individual due to neglect or wrongful act comes under the Death on the High Seas Act and the law of the sea. Information on the cases regarding other issues like maritime insurance, piracy, maritime damages and the jurisdiction of the maritime law is also presented.

The article discusses the prospective waiver doctrine in the context of the U.S. Eleventh Circuit's decision in the case Thomas v. Carnival Corp. It discusses the development of the doctrine in the decision of the Supreme Court in Mitsubishi Motors Corp. v. Soler Chrysler-Plymouth, Inc. and its appellate court progeny. According to the authors, the prospective waiver doctrine may impinge upon the U.S. policy which favors allowing parties to resolve their disputes in arbitration or in selected courts.

The article discusses various developments in the admiralty and maritime law from October 2008 to November 2009 in the U.S. It mentions several court cases concerning admiralty jurisdiction, attachments pursuant to Rule B of the Supplemental Rules for Admiralty or Maritime Claims and Asset Forfeiture Actions and claims by seamen. It highlights the changes in cargo law which were proposed at the Convention on Contracts for the International Carriage of Goods Wholly or Party by Sea in September 2009.

This article provides information about nonsignatory arbitration and class arbitration. It also examines the role and influence of the U.S. in international arbitration. It explains growth of multiparty arbitrations in the U.S. and Europe. In conclusion, the article states that nature of international arbitration is changing and must fit the gaps left by imperfect national-court systems and one way to do this is to continue to expand international arbitration.

Strains of Klebsiella pneumoniae that produce one of three possible carbapenemases--KPC--have recently been identified with increasing frequency among isolates recovered from patients residing along the East Coast of the United States, particularly within the New York City metropolitan region. These strains have exhibited resistance to multiple antibiotic classes, including carbapenem agents. We report a case of nosocomial pneumonia and empyema caused by a KPC-producing isolate of K. pneumoniae at a large midwestern U.S. tertiary care facility in which the patient was treated with tigecycline. Although the pneumonia was treated successfully, the empyema recurred in association with a treatment-emergent tigecycline minimum inhibitory concentration (MIC) increase from 0.75 to 2 µg/ml. Clinicians should be aware of the potential occurrence of this treatment-emergent MIC increase, especially in the setting of sustained tigecycline therapy. In addition, the emergence of carbapenem-resistant Enterobacteriaceae reinforces the importance of antibiotic stewardship and strict infection control practices. [ABSTRACT FROM AUTHOR]

Focuses on trade barrier trends in the United States. Evaluation of the economic growth from 1990 to 1999; Implications of zero tariff application for the national tariff line; Involvement of import prohibitors, import licensing and quantitative restrictions in nontariff barriers; Decline in the use of countervailing duties to counteract unfair trade practices.

Individuals with obesity often experience unfair treatment because of their body weight. Such experiences are associated with binge eating, but less is known about its association with other eating-related behaviors and whether these relations are specific to discrimination based on weight or extend to other attributions for discrimination. The present research uses a large national sample (N = 5129) to examine whether weight discrimination is associated with diet and meal rhythmicity, in addition to overeating, and whether these associations generalize to nine other attributions for discrimination. We found that in addition to overeating, weight discrimination was associated with more frequent consumption of convenience foods and less regular meal timing. These associations were generally similar across sex, age, and race. Discrimination based on ancestry, gender, age, religion, and physical disability were also associated with overeating, which suggests that overeating may be a general coping response to discrimination. Unfair treatment because of body weight is associated with unhealthy eating-related behaviors, which may be one pathway through which weight discrimination increases risk for weight gain and obesity. [ABSTRACT FROM AUTHOR]

The article studies the impact of meeting donor management goals (DMG) at several time points during the organ donation process on the number of organs transplanted per donor (OTPD) in the U.S.' United Network for Organ Sharing Region 5. The study involved nine DMGs representing normal cardiovascular, pulmonary, renal and endocrine end points. It finds that the donor hospital management of patients with catastrophic brain injuries, before the intent to donate is known, affects outcomes.

Sediments from a high-level nuclear waste plume were collected as part of investigations to evaluate the potential fate and migration of contaminants in the subsurface. The plume originated from a leak that occurred in 1962 from a waste tank consisting of high concentrations of alkali, nitrate, aluminate, Cr(VI), 137Cs, and 99Tc. Investigations were initiated to determine the distribution of viable microorganisms in the vadose sediment samples, probe the phylogeny of cultivated and uncultivated members, and evaluate the ability of the cultivated organisms to survive acute doses of ionizing radiation. The populations of viable aerobic heterotrophic bacteria were generally low, from below detection to ∼104 CFU g-1, but viable microorganisms were recovered from 11 of 16 samples, including several of the most radioactive ones (e.g., > 10 µCi of 137Cs/g). The isolates from the contaminated sediments and clone libraries from sediment DNA extracts were dominated by members related to known gram-positive bacteria. Gram-positive bacteria most closely related to Arthrobacter species were the most common isolates among all samples, but other phyla high in G+C content were also represented, including Rhodococcus and Nocardia. Two isolates from the second-most radioactive sample (>20 µCi of 137Cs g-1) were closely related to Deinococcus radiodurans and were able to survive acute doses of ionizing radiation approaching 20 kGy. Many of the gram-positive isolates were resistant to lower levels of gamma radiation. These results demonstrate that gram-positive bacteria, predominantly from phyla high in G+C content, are indigenous to Hanford vadose sediments and that some are effective at surviving the extreme physical and chemical stress associated with radioactive waste. [ABSTRACT FROM AUTHOR]

This work details the laboratory analysis of a suite of 10 samples collected from an inverted fluvial channel near Hanksville, Utah, USA as a part of the CanMars Mars Sample Return Analogue Deployment (MSRAD). The samples were acquired along the rover traverse for detailed off-site analysis to evaluate the TOC and astrobiological significance of the samples selected based on site observations, and to address one of the science goals of the CanMars mission: to evaluate the ability of different analytical techniques being employed by the Mars2020 mission to detect and characterize any present biosignatures. Analytical techniques analogous to those on the ExoMars, MSL and the MER rovers were also applied to the samples. The total organic carbon content of the samples was <0.02% for all but 4 samples, and organic biosignatures were detected in multiple samples by UV–Vis–NIR reflectance spectroscopy and Raman spectroscopy (532 nm, time-resolved, and UV), which was the most effective of the techniques. The total carbon content of the samples is < 0.3 wt% for all but one calcite rich sample, and organic C was not detectable by FTIR. Carotene and chlorophyll were detected in two samples which also contained gypsum and mineral phases of astrobiological importance for paleoenvironment/habitability and biomarker preservation (clays, gypsum, calcite) were detected and characterized by multiple techniques, of which passive reflectance was most effective. The sample selected in the field (S2) as having the highest potential for TOC did not have the highest TOC values, however, when considering the sample mineralogy in conjunction with the detection of organic carbon, it is the most astrobiologically relevant. These results highlight importance of applying multiple techniques for sample characterization and provide insights into their strengths and limitations. • Detection and characterization of organic carbon and biomolecules by multiple rover-equivalent instruments. • Detection and characterization of astrobiologically relevant mineral phases. • Application of lab-based techniques analogues to instrumentation from multiple rover missions. [ABSTRACT FROM AUTHOR]

Background: We examined the role of psychological well-being related measures in explaining the associations between obesity and increased risk of non-communicable diseases (NCDs: hypertension, heart disease, stroke, diabetes, arthritis, cancer, and memory-related disease) in older adults., Methods: Data were from the English Longitudinal Study of Ageing (ELSA), UK (baseline: Wave 4-2008/2009; n = 8127) and the Health and Retirement Study (HRS), US (baseline: Waves 9 and 10-2008/2010; n = 12,477). Objective body mass index was used to define obesity. A range of psychological well-being related measures (e.g., depressive symptoms, life satisfaction) was available in ELSA (n = 7) and HRS (n = 15), and an index of overall psychological well-being was developed separately in each study. NCDs were from a self-reported doctor diagnosis and/or other assessments (e.g., biomarker data) in both studies; and in ELSA, NCDs from linked hospital admissions data were examined. Longitudinal associations between obesity status, psychological well-being measures, and NCDs were examined using Cox proportional hazard models (individual NCDs) and Poisson regression (a cumulative number of NCDs). Mediation by psychological well-being related measures was assessed using causal mediation analysis., Results: Obesity was consistently associated with an increased prospective risk of hypertension, heart disease, diabetes, arthritis, and a cumulative number of NCDs in both ELSA and HRS. Worse overall psychological well-being (index measure) and some individual psychological well-being related measures were associated with an increased prospective risk of heart disease, stroke, arthritis, memory-related disease, and a cumulative number of NCDs across studies. Findings from mediation analyses showed that neither the index of overall psychological well-being nor any individual psychological well-being related measures explained (mediated) why obesity increased the risk of developing NCDs in both studies., Conclusion: Obesity and psychological well-being may independently and additively increase the risk of developing NCDs., (© 2024. The Author(s).)

Introduction: Vaccines against COVID-19 have been developed in unprecedented time. However, the effectiveness of any vaccine is dictated by the proportion of the population willing to be vaccinated. This observational population-based study examines intentions to be vaccinated against COVID-19 throughout the pandemic., Methods: In November 2020, longitudinal data from a nationally representative sample of 7,547 U.S. adults enrolled in the Understanding America Study were analyzed using multinomial logistic regression. Participants reported being willing, undecided, and unwilling to get vaccinated against COVID-19 across 13 assessments conducted from April to October 2020. Public attitudes to vaccination against COVID-19 were also assessed on a 4-point Likert-type scale., Results: Willingness to vaccinate declined from 71% in April to 53.6% in October. This was explained by an increase in the percentage of participants undecided about vaccinating (from 10.5% to 14.4%) and the proportion of the sample unwilling to vaccinate (from 18.5% to 32%). The population subgroups most likely to be undecided/unwilling to vaccinate were those without a degree (undecided: RR=2.47, 95% CI=2.04, 3.00; unwilling: RR=1.92, 95% CI=1.67, 2.20), Black participants (undecided: RR=2.18, 95% CI=1.73, 2.74; unwilling: RR=1.98, 95% CI=1.63, 2.42), and female participants (undecided: RR=1.41, 95% CI=1.20, 1.65; unwilling: RR=1.29, 95% CI=1.14, 1.46). Participants who were older or were on higher incomes were least likely to be undecided or unwilling to vaccinate. Concerns about potential side effects of a vaccine were common., Conclusions: Intentions to be vaccinated against COVID-19 have declined rapidly during the pandemic, and close to half of Americans are undecided or unwilling to be vaccinated., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Identifying oneself as overweight is a risk factor for poor mental health and suicidality independent from objective weight status. The stigma associated with heavier body weight has risen in recent decades and this may have exacerbated the detrimental mental health effects of perceived overweight. In this study, we examined the association between perceived overweight and suicidality in a nationally representative sample (N = 115,180) of US adolescents assessed from 1999 to 2017. We drew on data from the Youth Risk Behavior survey, a biennial population-based survey of students in grades 9-12. Suicidality was gauged by participant reports of past-year suicidal ideation, suicide plans, or suicide attempts. Across all waves, perceived overweight (vs. perceived "normal" weight) predicted a 7.7 percentage point (p < 0.001) increased risk of suicidality after adjustment for age, sex, ethnicity, and BMI. The risk of suicidality associated with perceived overweight increased from 5.7 percentage points in 1999-2001 to 10.1 points in 2015-2017, a difference of 4.4 points (p = 0.001). This growth was most evident after 2009 and was apparent across suicidality measures. Among US adolescents, perceiving one's body as overweight increases risk of suicidality and this risk appears to have grown substantially from 2009 to 2017.

Physician acceptance is an important dimension of access to care, especially for Medicaid patients. We constructed two new measures to quantify primary care physician (PCP) acceptance of Medicaid patients using geocoded Virginia physician addresses and population data and geospatial methods. For each Census block group, we measured the shares of "accessible PCPs" accepting any Medicaid patients or new Medicaid patients. Accessible PCPs were defined as those located within 30-minute travel from patient locations and patient locations were proxied by Census block group geographic centroids. We found that the shares of accessible PCPs accepting Medicaid varied within Virginia, and were significantly lower in urban communities where larger fractions of the population were Hispanic, even controlling for unobserved market-level traits associated with Medicaid acceptance. Policy makers and Medicaid program officials should continue to improve nonfinancial access to primary care, especially by addressing access barriers in communities with high shares of minority residents.

Objective: Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites., Method: The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification) were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns., Results: After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58) was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46), which likely represents self-interest in retaining property (guns)., Conclusions: Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites' paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions.

Background: There is a national shortage of organs available for transplantation. Implementation of preset donor management goals (DMGs) to improve outcomes is recommended, but uniform practices and data are lacking. We hypothesized that meeting DMGs before organ procurement would result in more organs transplanted per donor (OTPD)., Methods: The eight organ procurement organization in United Network for Organ Sharing Region 5 selected 10 critical care end points as DMGs. Each organ procurement organization submitted retrospective data from 40 standard criteria donors. "DMGs met" was defined as achieving any eight DMGs before procurement. The primary outcome was ≥4 OTPD. Binary logistic regression was used to determine independent predictors of ≥4 OTPD with a p<0.05., Results: Three hundred twenty standard criteria donors had 3.6±1.6 OTPD. Donors with DMGs met had more OTPD (4.4 vs. 3.3, p<0.001) and were more likely to have ≥4 OTPD (70% vs. 39%, p<0.001). Independent predictors of ≥4 OTPD were age (odds ratio [OR]=0.94), serum creatinine (OR=0.65), thyroid hormone use (OR=2.0), "DMGs met" (OR=4.4), and achieving the following individual DMGs: central venous pressure 4 mm Hg to 10 mm Hg (OR=1.9), ejection fraction>50% (OR=4.0), Pao2:FIO2>300 (OR=4.6), and serum sodium 135 to 160 mEq/L (OR=3.4)., Conclusions: Meeting DMGs before procurement resulted in more OTPD. Donor factors and critical care end points are independent predictors of organ yield. Prospective studies are needed to determine the true impact of each DMG on the number and function of transplanted organs.