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This chapter uses Kolb's (1984) theory of experiential learning to examine the learning process in two related contexts: A university-facilitated study tour for in-service English teachers from Norway and a short-term study-abroad program to Norway for US preservice teachers.

The United States' current rivalry with China should be seen as a technology race in which the ability to imagine, discover and apply innovations will decide who wins. While the United States spends more than China on research and development (R&D), China's state-centred system enables it to transform funding and talent into deployed capabilities faster than the United States' private-enterprise-centred system can. Accordingly, the US must avoid complacency about the inherent advantage of the democratic-capitalist system in scientific discovery and devise more effective mechanisms for stimulating free enterprise to develop new military technology. This requires the US Department of Defense to devote more resources to R&D by asking allies to contribute more for military operations, and to better incentivise military innovation by investing funds in private enterprise to defray start-up costs before production can yield steady revenue. [ABSTRACT FROM AUTHOR]

Narrative identity – how individuals narrate their lived and remembered past – is usually assessed via independent rater coding, but new methods relying on self-report have been introduced. To test the assumption that different methods assess aspects of the same underlying construct, studies measuring similar components of narrative identity with different methods are needed. However, such studies are surprisingly rare. To begin to fill this gap, the present study compared the narrative variables, temporal coherence, causal coherence, and thematic coherence, measured via rater coding of participants' self-generated narratives of the remembered past and via subscales of the self-report measure Awareness of Narrative Identity Questionnaire (ANIQ). The results showed that the ANIQ subscales did not correlate significantly with their corresponding rater-coded dimension, and that the ANIQ subscales were generally unrelated to the other rater-coded dimensions. Furthermore, an exploratory factor analysis demonstrated that the ANIQ subscales loaded together on a factor that did not include any rater-coded variables. The findings suggest that the narrative variables share little empirical overlap when assessed via the ANIQ and rater coding of self-generated narratives. [ABSTRACT FROM AUTHOR]

Professionals with lived experience (LE) of mental distress might better understand service users, educate colleagues, and serve as role models. This exploratory quantitative study asked U.S. social work education leaders if they perceive positives and negatives of professionals having LE; what advice they would offer students with LE; and analyzed whether certain experiences influenced responses. Having LE and/or close relationships with people with LE was associated with perceiving positives, which was associated with advising students about using LE to help others. Perceiving negatives was associated with advising about difficulties. Implications are offered for preparing professionals to use LE in practice. [ABSTRACT FROM AUTHOR]

Background: Millions of people struggle with alcohol use disorder (AUD). Abrupt abstinence after a period of chronic alcohol use can precipitate the alcohol withdrawal syndrome (AWS), which includes hyperexcitability and, potentially, seizures. We have shown that T‐type Ca2+ channels are novel, sensitive targets of alcohol, an effect that is dependent upon protein kinase C (PKC). The purpose of this study was to (1) understand midline thalamic neuronal hyperexcitability during alcohol withdrawal and its dependence on PKC; (2) characterize T channel functional changes using both current clamp and voltage clamp methods; and (3) determine which PKC isoform may be responsible for alcohol withdrawal (WD) effects. Methods: Whole‐cell patch clamp recordings were performed in midline thalamic neurons in brain slices prepared from C57bl/6 mice that underwent chronic intermittent alcohol exposure in a standard vapor chamber model. The recordings were compared to those from air‐exposed controls. T‐channel inactivation curves and burst responses were acquired through voltage‐clamp and current‐clamp recordings, respectively. Results: Whole‐cell voltage clamp recordings of native T‐type current exhibited a depolarizing shift in the voltage‐dependency of inactivation during alcohol withdrawal compared to air‐exposed controls. A PKCε translocation inhibitor peptide mitigated this change. Current clamp recordings demonstrated more spikes per burst during alcohol withdrawal. Consistent with voltage clamp findings, the PKCɛ translocation inhibitor peptide reduced the number of spikes per burst after WD. Conclusion: We found that alcohol WD produces T channel‐mediated hyperexcitability in the midline thalamus, produced in part by a shift in the inactivation curve consistent with greater availability of T current. WD effects on T current inactivation were reduced to control levels by blocking PKCε translocation. Our results demonstrate that PKCε translocation plays an important role in the regulation of alcohol withdrawal‐induced hyperexcitability in midline thalamic circuitry. [ABSTRACT FROM AUTHOR]

We used triannual reading curriculum-based measurement of oral reading fluency data from 11,834 U.S. students in Grades 2 and 3 enrolled in an evidence-based Tier 2 reading intervention program (Reading Corps) to investigate the extent to which family involvement in the intervention might buffer against a negative effect of lower intervention dosage. The relation between family involvement in Reading Corps and growth in oral reading fluency was stronger when students spent fewer hours in tutoring, suggesting that family involvement in tiered reading intervention can compensate for receiving less intervention dosage. There was noticeable variation in this effect across tutors, suggestive of tutor-level heterogeneity of this relation. The relation between sending family engagement materials to families and the materials that are returned to tutors also substantially varied across tutors. We discuss findings in terms practical significance for school-based academic intervention systems. We highlight limitations and opportunities for future directions as well. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) elimination is an important global public health goal. However, the United States is not on track to meet the World Health Organization's 2030 targets for HCV elimination. Recently, the White House proposed an HCV elimination plan that includes point-of-care (POC) HCV RNA testing, which is currently in use in many countries but is not approved in the United States. POC HCV RNA testing is crucial for implementing community-based testing and for enabling test-and-treat programs, assessing cure, and monitoring for reinfection. Here, we review the status of POC HCV RNA testing in the United States, discuss factors that are needed for successful implementation, and issue specific public health and policy recommendations that would allow for the use of POC HCV RNA testing to support HCV elimination. [ABSTRACT FROM AUTHOR]

Lung cancer is the second most diagnosed cancer and the first cause of cancer related death for men and women in the United States. Early detection is essential as patient survival is not optimal and recurrence rate is high. Copy number (CN) changes in cancer populations have been broadly investigated to identify CN gains and deletions associated with the cancer. In this research, the similarities between cancer and paired peripheral blood samples are identified using maximal information coefficient (MIC) and the spatial locations with substantially high MIC scores in each chromosome are used for clustering analysis. The results showed that a sizable reduction of feature set can be obtained using only a subset of locations with high MIC values. The clustering performance was evaluated using both true rate and normalized mutual information (NMI). Clustering results using the reduced feature set outperformed the performance of clustering using entire feature set in several chromosomes that are highly associated with lung cancer with several identified oncogenes. [ABSTRACT FROM AUTHOR]

The evolution of symbiotic interactions may be affected by unpredictable conditions. However, a link between prevalence of these conditions and symbiosis has not been widely demonstrated. We test for these associations using Dictyostelium discoideum social amoebae and their bacterial endosymbionts. D. discoideum commonly hosts endosymbiotic bacteria from three taxa: Paraburkholderia, Amoebophilus and Chlamydiae. Three species of facultative Paraburkholderia endosymbionts are the best studied and give hosts the ability to carry prey bacteria through the dispersal stage to new environments. Amoebophilus and Chlamydiae are obligate endosymbiont lineages with no measurable impact on host fitness. We tested whether the frequency of both single infections and coinfections of these symbionts were associated with the unpredictability of their soil environments by using symbiont presence-absence data from D. discoideum isolates from 21 locations across the eastern United States. We found that symbiosis across all infection types, symbiosis with Amoebophilus and Chlamydiae obligate endosymbionts, and symbiosis involving coinfections were not associated with any of our measures. However, unpredictable precipitation was associated with symbiosis in two species of Paraburkholderia, suggesting a link between unpredictable conditions and symbiosis. [ABSTRACT FROM AUTHOR]

Tourniquets are a mainstay of life-saving hemorrhage control. The US military has documented the safety and effectiveness of tourniquet use in combat settings. In civilian settings, events such as the Boston Marathon bombing and mass shootings show that tourniquets are necessary and life-saving entities that must be used correctly and whenever indicated. Much less research has been done on tourniquet use in civilian settings compared to military settings. The purpose of this study is to describe the prehospital use of tourniquets in a regional EMS system served by a single trauma center. All documented cases of prehospital tourniquet use from 2015 to 2020 were identified via a search of EMS, emergency department, and inpatient records, and reviewed by the lead investigator. The primary outcomes were duration of tourniquet placement, success of hemorrhage control, and complications; secondary outcomes included time of day (by EMS arrival time), transport interval, extremity involved, who placed/removed the tourniquet, and mechanism of injury. Of 182 patients with 185 tourniquets applied, duration of application was available for 52, with a median (IQR) of 43 (56) minutes. Hemorrhage control was achieved in all but two cases (96%). Three cases (5.8%) required more than one tourniquet. Complications included five cases of temporary paresthesia, one case of ecchymosis, two cases of fasciotomy, and two cases of compression nerve injury. The serious complication rate was 7.7% (4/52). Time of day was daytime (08:01-16:00) = 15 (31.9%), evening (16:01-00:00) = 27 (57.4%), and night (00:01- 08:00) = 5 (10.6%). The median transport interval was 22 (IQR 5] minutes. The limbs most often injured were the left and right upper extremities (15 each). EMS clinicians and police officers were most often the tourniquet placers. Common mechanisms of injury included gunshot wounds, motorcycle accidents, and glass injuries. Tourniquets used in the prehospital setting have a high rate of hemorrhage control and a low rate of complications. [ABSTRACT FROM AUTHOR]

Working pine (Pinus spp.) forests in the southern United States rely on herbicides to remove competing vegetation and improve productivity. We conducted a review of the effects of herbicides on understory plants in southern working forests. We also discuss the impacts of herbicides on insect taxa associated with understory vegetation and its litter layer, including Coleoptera (carabid beetles), Hemiptera (true bugs), Hymenoptera (bees/ants), Lepidoptera (moths/butterflies), and Orthoptera (grasshoppers). Herbicides have few reported long-term impacts on understory herbaceous cover and species richness/diversity when applied according to labeled uses and application rates. However, the method of chemical treatment (e.g. broadcast spray or banded application) may influence understory plant structure and composition. Responses of insects to herbicides were species- and taxa-specific and highly variable given their forage/habitat requirements and life histories. Long-term research is needed to evaluate the effects of herbicides on vegetation-associated insects to provide a comprehensive profile of herbicide nontarget impacts. Study Implications: Land managers rely on herbicides to remove competing vegetation and increase working forest productivity. Given the objective of sustainable forest management to conserve biodiversity, it is important to understand how biological communities respond to chemical applications in intensively managed forest ecosystems. Our review indicated that herbicides have few reported long-term impacts on understory plant communities when applied appropriately. Despite their taxonomic diversity, invertebrates were rarely included in assessments of forest herbicides. Further research is needed to assess the potential nontarget impacts of herbicide applications on forest insect communities. [ABSTRACT FROM AUTHOR]

This study employed organizational justice theory to examine the influence of employee perceptions of distributive, procedural, and interactional justice on whether employees trust their supervisors and management. Analysis of survey results from 322 employees of a state prison located in the Southern United States indicate that procedural and interactional justice—but not distributive justice—predict employee trust in both supervisors and management. These findings present important policy implications that suggest that the employing organization would benefit from having mechanisms in place to ensure that decisions follow consistent rules and strategies. Considering the relevance of employee trust to the organization, transparency in the use of pre-determined standards to allocate resources and rewards fairly needs to become a priority in institutions of corrections. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to examine how involvement in the Whole Health System of care, clinically and personally (through employee-focused activities), would affect employee satisfaction, engagement, burnout, and turnover intent in the Veterans Health Administration. Methods: Multivariate logistic regression analysis of cross-sectional survey from Veterans Health Administration employees was used to determine the influence of Whole Health System involvement and EmployeeWhole Health participation on job attitudes. Results: Whole Health System involvement was associated higher job satisfaction, higher levels of engagement, lower burnout, and lower turnover intent.A similar pattern of results was identified when looking specifically at Employee Whole Health participation and associated job attitudes. Conclusions: Employees who are either directly involved in delivering Whole Health services to veterans or who have participated in Whole Health programming for their own benefit may experience a meaningful positive impact on their well-being and how they experience the workplace. [ABSTRACT FROM AUTHOR]

Academic integrity issues, e.g. plagiarism, continue to plague higher education across the globe. Research has noted that the identification and tolerance of cheating behaviors varies dependent upon local culture. This quantitative, comparative study investigated the potential differences among actual rates of incidence of plagiarism among predominant countries and regions in which the literature identified as having academic integrity problems. This study gathered doctoral dissertations and master's theses from institutions in the selected locations and analyzed them with Turnitin® originality assessment software. Regions and countries evaluated were based on guidance from exigent literature. A Kruskal-Wallis test was conducted to evaluate any differences in the prevalence of plagiarism among these locations. The results indicated that there was a statistically significant difference among groups, ?[superscript 2] (6, N = 266) = 19.545, p = 0.003, ?[superscript 2] = 0.074. Further analysis determined a mix of findings that both support and deny conceptions in other literature.

South Carolina made a significant step forward in middle level education reform by enacting middle level teacher certification in 2001. This qualitative case study documents the process through which the state legislation developed, with a particular focus on how middle level teacher certification arrived and remained on the public policy agenda in South Carolina. The study is framed by three key research questions, which are derived from Kingdon's (1995) theoretical model of the policy process: (1) How did middle level teacher certification become defined as a public policy problem or issue in South Carolina? (2) What policy solutions addressing the problem of middle level teacher certification in South Carolina were or became available to decision makers? and (3) What political processes and conditions were involved in advancing and sustaining middle level teacher certification as a legislative agenda item? Data sources for the study include records of semi-structured interviews and conversations with key actors (i.e., policy makers and other public officials, faculty and administrators in higher education, and school district personnel), as well as policy documents and reports. In a political climate in which any educational change is tenuous, it is critical for middle level reform advocates to understand the many facets of the policy process. This study illuminates the essential role of bottom-up pressure for middle level reform at the state level; it maps the relationships that formed among state officials, higher education, and school personnel; and it highlights the importance of key individuals in moving the policy process forward.

Background: Approximately 100,000 anterior cruciate ligament (ACL) reconstructions (ACLRs) occur annually in the United States, and postoperative surgical-site infection is a relatively rare but devastating complication, often leading to graft failure or septic arthritis of the knee, necessitating repeat surgery. Wrapping allografts in vancomycin-soaked gauze has been adopted as a common sterilization technique in the operating room to reduce surgical-site infection; however, identifying effective alternatives to vancomycin has not been extensively pursued. Hypothesis: Tobramycin would be as effective as vancomycin in reducing the concentrations of Staphylococcus epidermidis bacteria on tendon allografts. Study Design: Controlled laboratory study. Methods: S. epidermidis strain ATCC 12228 was inoculated onto the human cadaveric gracilis tendon. The tendons were wrapped in sterile gauze saturated with tobramycin or vancomycin at various experimental concentrations. Bacteria remaining on the tendon were dislodged, serially diluted, and plated for colony counting. Statistical analysis was performed utilizing 2-way analysis of variance testing. Results were considered statistically significant when P <.05. Results: Vancomycin (P =.0001) and tobramycin (P <.0001) reduced bacterial concentration. Tobramycin was found to produce a statistically significant reduction in bacterial concentration at concentrations as low as 0.1 mg/mL (P <.0001 and P =.01 at 10 and 20 minutes), while vancomycin produced a statistically significant reduction at a concentration as low as 2.5 mg/mL (P <.0001 at both 10 and 20 minutes). Conclusion: This study demonstrates that tobramycin is as effective as vancomycin in bacterial concentration reduction but can achieve this reduction level at lower doses. Further studies clarifying the biomechanical and cytotoxic effects of tobramycin on tendon tissue are indicated to solidify its use as a clinical alternative to vancomycin in ACLR. Clinical Relevance: These results will begin establishing tobramycin as an alternative to vancomycin in ACL graft decontamination. Because of relatively frequent shortages of vancomycin, establishing tobramycin as an alternative agent is a useful option for the orthopaedic surgeon. [ABSTRACT FROM AUTHOR]

Objectives. To examine whether a previously reported association between airborne lead exposure and children's cognitive function replicates across a geographically diverse sample of the United States. Methods. Residential addresses of children (< 5 years) were spatially joined to the Risk-Screening Environmental Indicators model of relative airborne lead toxicity. Cognitive outcomes for children younger than 8 years were available for 1629 children with IQ data and 1476 with measures of executive function (EF; inhibitory control, cognitive flexibility). We used generalized linear models using generalized estimating equations to examine the associations of lead, scaled by interquartile range (IQR), accounting for individual- and area-level confounders. Results. An IQR increase in airborne lead was associated with a 0.74-point lower mean IQ score (b = −0.74; 95% confidence interval = −1.00, −0.48). The association between lead and EF was nonlinear and was modeled with a knot at the 97.5th percentile of lead in our sample. Lead was significantly associated with lower mean inhibitory control but not with cognitive flexibility. This effect was stronger among males for both IQ and inhibitory control. Conclusions. Early-life exposure to airborne lead is associated with lower cognitive functioning. (Am J Public Health. 2024;114(3):309–318. https://doi.org/10.2105/AJPH.2023.307519) [ABSTRACT FROM AUTHOR]

Background: Improving quality of care provided to short‐stay patients with dementia in nursing homes is a policy priority. However, it is unknown whether dementia‐focused care strategies are associated with improved clinical outcomes or lower utilization and costs for short‐stay dementia patients. Methods: We performed a national survey of nursing home administrators in 2020–2021, asking about the presence of three dementia‐focused care services used for their short‐stay patients: (1) a dementia care unit, (2) cognitive deficiency training for staff, and (3) dementia‐specific occupational therapy. Using Medicare claims, we identified short‐stay episodes for beneficiaries residing in surveyed skilled nursing facilities (SNFs) with and without dementia. We compared clinical, cost, and utilization outcomes for dementia patients in SNFs, which did and did not offer dementia‐focused care services. As a counterfactual control, we compared these differences to those for non‐dementia patients in the same facilities. Our primary quantity of interest was an interaction term between a patients' dementia status and the presence of a dementia‐focused care tool. Results: The study population included 102,860 Medicare episodes of care from 377 SNF survey respondents in 2018–2019. In adjusted comparisons of the interaction between dementia status and the presence of each dementia‐focused care tool, dementia care units were associated with a 1.5‐day increase in healthy days at home in the 90 days following discharge (p = 0.01) and a 3.1% decrease in the likelihood of a subsequent SNF admission (p = 0.001). Cognitive deficiency training was also associated with a 2.0% increase in antipsychotics (p = 0.03), whereas dementia‐specific occupational therapy was associated with a 1.2% increase in falls (p = 0.01) per patient episode. Conclusions: Self‐reported use of dementia care units for short‐stay patients was associated with modestly better performance in some, but not all, outcome measures. This provides hypothesis‐generating evidence that dementia care units could be a promising mechanism to improve care delivery in nursing homes. [ABSTRACT FROM AUTHOR]

The accurate accounting of where and for whom deprivations occur is fundamental to addressing poverty. In the United States, the official poverty measure considers only a person's income, although poverty is increasingly understood internationally as a set of multiple, interlinked deprivations. This article introduces a decomposable multidimensional poverty (MDP) measure that addresses these shortcomings by using thirteen American Community Survey microdata indicators to identify education, health, housing, and economic security deprivations for individuals. In 2017, the national poverty rate was 13.7 percent when measured using MDP and 13.1 percent using official poverty. Although similar at the national scale, Hispanic, Asian, and older persons had higher poverty rates using the multidimensional measure, whereas Black and young persons had higher rates when using official poverty. MDP tended to be higher than official poverty in dense urban areas, whereas official poverty tended to be higher in rural areas. Further, MDP was a stronger correlate with COVID-19 death rates than official poverty through the first three waves of the pandemic. The design of MDP recognizes that individuals can experience poverty in different ways and provides a more holistic view of people and places. [ABSTRACT FROM AUTHOR]

Mitigating nonpoint source pollution from stormwater runoff demands effective strategies for treating the first flush depth. Whether through off-stream storage or pass-through treatment devices, designing diversion structures and filtering materials is critical. This study proposes a streamlined procedure for determining first flush design flow rates, employing the modified rational method and rainfall intensity–duration equations applicable to any U.S. location. The dimensionless solution, which is presented as an equation requiring an iterative calculation for the desired flow rates, is complemented by precision graphs. Examples from the semi-arid Southwestern United States illustrate the methodology's utility. [ABSTRACT FROM AUTHOR]

Building on a movement within the sociology of religion to better situate studies of spirituality in relation to contexts, practices, and power relations, the current study examines shifts in spiritual practice associated with "deconstruction" among graduate students within theological education. We rely on new interview data with a cohort of 30 students at time 1 (2020) and follow-ups with 22 of those students at time 2 (2022), comparing students at four different types of schools (Mainline Protestant, Evangelical Protestant, Catholic, and Black Protestant), and oversampling for students of historically minoritized identities. After identifying patterns in the spirituality of deconstruction, including trends toward embodiment, attunement to the natural world, social activism, and syncretism, we examine how these students perceive the responses of their theological schools to students' deconstructing spirituality. We especially note a pattern of ambivalence, where certain aspects of the institution (especially some individual faculty and administrators, and student affinity groups) support and model deconstruction for their students. We argue that the spirituality of deconstruction may, therefore, function to both challenge and regenerate institutionalized contexts of religion in an overall setting of institutional decline. [ABSTRACT FROM AUTHOR]

Introduction: Psychological evaluation is required by insurance companies in the United States prior to proceeding with a spinal cord stimulation or a dorsal root ganglion stimulation trial. Since January 2017, we implemented a Multidisciplinary Team Conference for Neuromodulation in our center to facilitate the collaboration between pain physicians and psychologists and to optimize screening of neuromodulation candidates. This study aims to report the impact of this team conference on improvement of neuromodulation outcome in our center. Methods: Appropriateness of neuromodulation were discussed in the team conference after initial visit with the pain specialist and psychological evaluation. For this study, we prospectively and retrospectively collected data on neuromodulation candidates who went through the team conference and those who did not as controls. Results: We discussed 461 patients in the team conference sessions from January 2017 to July 2023. Out of these, a spinal cord stimulator or a dorsal root ganglion stimulator trial was performed in 164 patients with 80.5% (132 cases) trial success rate leading to 140 implants. Out of these implants, 26 (18.6%) explanted and 21 (15%) required revision in 41 (29.3%) patients. We performed neuraxial neuromodulation trial for 70 patients without going through the team conference from January 2016 to July 2023 with a trial success rate of 45.7% (32 cases). In this group, 7 (21.9%) and 6 (18.8%) patients underwent explant and revision. The differences between the groups were statistically significant for trial success rate (odds ratio of 4.9 with p-value of <0.01) but not for explant (odds ratio of 0.8 with p-value of 0.627) or revision (odds ratio of 0.8 with p-value of 0.595). Conclusion: Implementing Multidisciplinary Team Conference increased trial success rate in our center. Team conference provides therapeutic benefit for patients, and also provides the opportunity for an educational discussion for trainees. [ABSTRACT FROM AUTHOR]

Purpose: Early reports of 30-day mortality in COVID-positive patients with hip fracture were often over 30% and were higher than historical rates of 10% in pre-COVID studies. We conducted a multi-institutional retrospective cohort study to determine whether the incidence of 30-day mortality and complications in COVID-positive patients undergoing hip fracture surgery is as high as initially reported. Methods: A retrospective chart review was performed at 11 level I trauma centers from January 1, 2020 to May 1, 2022. Patients 50 years or older undergoing hip fracture surgery with a positive COVID test at the time of surgery were included. The primary outcome measurements were the incidence of 30-day mortality and complications. Post-operative outcomes were reported using proportions with 95% confidence interval (C.I.). Results: Forty patients with a median age of 71.5 years (interquartile range, 50–87 years) met the criteria. Within 30-days, four patients (10%; 95% C.I. 3–24%) died, four developed pneumonia, three developed thromboembolism, and three remained intubated post-operatively. Increased age was a statistically significant predictor of 30-day mortality (p = 0.01), with all deaths occurring in patients over 80 years. Conclusion: In this multi-institutional analysis of COVID-positive patients undergoing hip fracture surgery, 30-day mortality was 10%. The 95% C.I. did not include 30%, suggesting that survival may be better than initially reported. While COVID-positive patients with hip fractures have high short-term mortality, the clinical situation may not be as dire as initially described, which may reflect initial publication bias, selection bias introduced by testing, or other issues. Levels of Evidence: Therapeutic Level III. [ABSTRACT FROM AUTHOR]

Objective: To examine purpose in life (PIL) and ethnic identity (EI) as buffers to suicide ideation for Asian American, Hispanic, and Black emerging adults who perceive racial discrimination. Method: Two-hundred eighty-nine undergraduate students enrolled at a large university in the southwestern region of the United States (40.8% Asian American, 32.5% Hispanic, 26.6% Black; 61.2% women; mean age = 20.47, SD = 1.83) reported on experiences of racial discrimination, PIL, EI, and suicidal thoughts. Covariates were intrinsic religiosity, gender, and age. Results: Regression analysis showed that EI was not a significant moderator for the association between perceived racial discrimination (PRD) and suicidal ideation (β = −.08, p =.13; 95% confidence interval (CI) [−.19,.03]). However, PIL was a significant moderator (β = −.11, p =.025; CI [−.20, −.01]). A hierarchical regression showed that PIL as a moderator explained additional variance (ΔR2 = 0.11, p <.001) in suicide ideation above and beyond EI. Conclusions: These findings provide some insight into how life purpose might ameliorate the impact of social stressors above and beyond a positive cultural identity for young racial/ethnic minority adults. [ABSTRACT FROM AUTHOR]

This study provides a comparison of the operational HRRR version 4 and its eventual successor, the experimental Rapid Refresh Forecast System (RRFS) model (summer 2022 version), at predicting the evolution of convective storm characteristics during widespread convective events that occurred primarily over the eastern United States during summer 2022. In total 32 widespread convective events were selected using observations from the MRMS composite reflectivity, which includes an equal number of MCSs, quasi-linear convective systems (QLCSs), clusters, and cellular convection. Each storm system was assessed on four primary characteristics: total storm area, total storm count, storm area ratio (an indicator of mean storm size), and storm size distributions. It was found that the HRRR predictions of total storm area were comparable to MRMS, while the RRFS overpredicted total storm area by 40%–60% depending on forecast lead time. Both models tended to underpredict storm counts particularly during the storm initiation and growth period. This bias in storm counts originates early in the model runs (forecast hour 1) and propagates through the simulation in both models indicating that both miss storm initiation events and/or merge individual storm objects too quickly. Thus, both models end up with mean storm sizes that are much larger than observed (RRFS more so than HRRR). Additional analyses revealed that the storm area and individual storm biases were largest for the clusters and cellular convective modes. These results can serve as a benchmark for assessing future versions of RRFS and will aid model users in interpreting forecast guidance. [ABSTRACT FROM AUTHOR]

Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice with people with mental illnesses, and attitudes about students with mental illnesses. On average, educators' general and practice attitudes were not negative. However, respondents did view a student with a mental illness differently from a "typical social work student." Findings suggest that we, as social work educators, must raise our awareness and address our own attitudes to support students and uphold our social work values.

Fairness is a core concept in U.S. society, including in the workplace. Organizational justice theory holds that workers expect to be treated in a fair and just manner and that higher levels of organizational justice usually result in lower levels of withdrawal work behaviors, such as absenteeism and turnover intent, while lower levels of organizational justice perceptions are associated with higher engagement in withdrawal behaviors. The current study examined the relationship between organizational justice views, specifically distributive and procedural justice, and turnover intent, while controlling for the personal characteristics of age, gender, position, tenure, educational level, and marital status and the work variables of job stress and job involvement. Using the responses from 322 employees from a state prison located in the Southern region of the United States, procedural justice was observed to have a significant negative association with turnover intent, but distributive justice had a nonsignificant relationship. Job stress was associated with a significantly higher level of turnover intent, while job involvement was significantly associated with lower turnover intent. Among the personal characteristics, only age had a significant association, with older workers expressing lower turnover intent. [ABSTRACT FROM AUTHOR]

Importance: More than 109,000 Americans died of drug overdose in 2022, with 81,231 overdose deaths involving opioids. Methadone, buprenorphine and naltrexone are the most widely used medications for opioid use disorders (MOUD) and the most effective intervention for preventing overdose deaths. However, there is a concern that methadone results in long QT syndrome, which increases the risk for fatal cardiac arrythmias. Currently few studies have systematically evaluated both the short‐term and long‐term differences in cardiac and mortality outcomes between MOUD. Objectives: To compare the risks of cardiac arrythmias, long QT syndrome and overall mortality between patients with opioid use disorders (OUD) who were prescribed methadone, buprenorphine or naltrexone. Design, Setting, and Participants: Retrospective cohort study based on a multicenter and nationwide database of electronic health records (EHRs) in the United States. The study population was comprised of 144,141 patients who had medical encounters for OUD in 2016‐2022, were prescribed MOUD within 1 month following a medical encounter for OUD diagnosis and had no diagnosis of cardiac arrythmias or long QT syndrome before any MOUD prescription. The study population was divided into three cohorts: (1) Methadone cohort (n = 40,938)—who were only prescribed methadone. (2) Buprenorphine cohort (n = 80,055)—who were only prescribed buprenorphine. (3) Naltrexone cohort (n = 5,738)—who were only prescribed naltrexone. Exposures: methadone, buprenorphine, or naltrexone. Main Outcomes and Measures: Cardiac arrythmias, long QT syndrome, and death. Hazard ratio (HR) and 95% confidence interval (CI) of outcomes at six different follow‐up time frames (1‐month, 3‐month, 6‐month, 1‐year, 3‐year, and 5‐year) by comparing propensity‐score matched cohorts using Kaplan‐Meier survival analysis. Results: Patients with OUD who were prescribed methadone had significantly higher risks of cardiac arrhythmias, long QT syndrome and death compared with propensity‐score matched patients with OUD who were prescribed buprenorphine or naltrexone. For the 1‐month follow‐up, the overall risk for cardiac arrythmias was 1.03% in the Methadone cohort, higher than the 0.87% in the matched Buprenorphine cohort (HR: 1.20, 95% CI: 1.04−1.39); The overall risk for long QT syndrome was 0.35% in the Methadone cohort, higher than the 0.15% in the matched Buprenorphine cohort (HR: 2.40, 95% CI: 1.75−3.28); The overall mortality was 0.59% in the Methadone cohort, higher than the 0.41% in the matched Buprenorphine cohort (HR: 1.48, 95% CI: 1.21−1.81). The increased risk persisted for 5 years: cardiac arrhythmias (HR: 1.31, 95% CI: 1.23−1.38), long QT syndrome (HR: 3.14, 95% CI: 2.76−3.58), death (HR: 1.50, 95% CI: 1.41−1.59). Conclusions and Relevance: Methadone was associated with a significantly higher risk for cardiac and mortality outcomes than buprenorphine and naltrexone. These findings are relevant to the development of guidelines for medication selection when initiating MOUD treatment and inform future medication development for OUD that minimizes risks while maximizing benefits. [ABSTRACT FROM AUTHOR]

Objectives Higgs and Gilleard (2015) have uniquely theorized the fourth age as a "social imaginary" of deep old age that blends notions of frailty, abjection, and the moral relations of care. This report evaluates the coherence and reach of the fourth-age imaginary among older adults in relative good health. Methods In a qualitative design and within samples at 5 sites (in Czechia, Germany, Hong Kong, Taiwan, and the United States), 138 adults aged 70+ and still living independently discussed what it would mean to be "not independent" in later life. Replies referenced other people in general, specific people, and one's own actual or potential experience. Results Pooled across sites, the views of our participants confirm the theorized features of the social imaginary. Participants spoke readily of gateway infirmities heralding frailty and of frailty's abjection; expressed dread and abhorrence of dependence, some saying that death would be preferable; and were anxious about nursing homes and about burdening others with an obligation to care for them. Discussion The bleak but formidable reputation of the fourth age impinges on those living in the third. The consonant expression of fourth-age features among older adults on 3 continents supports Gilleard and Higgs's claim that the fourth-age imaginary "contains a universal ontological quality" owing to human corporeality and the senescence to which it is subject. Fourth-age studies that document the lived experience of frailty and dependence have the potential to undermine the imaginary and furnish new narratives for facing the future. [ABSTRACT FROM AUTHOR]

In this study, data were used from 322 employees at a large medium- and maximum-security prison in the Southern United States to examine the influence of job demands (dangerousness of the job, role overload, role ambiguity) and job resources (employee input into decision-making, instrumental communication, job variety) on employee job involvement. We also controlled for demographic characteristics (gender, age, position, tenure, and educational attainment). Drawing on the job demands–job resources model, four separate equations were estimated to assess the influence of job demands and job resources both separately and jointly. Overall, job resources (specifically, employee input into decision-making and job variety) have a stronger influence on job involvement than do job demands. The findings indicate that to boost employee job involvement in correctional settings, employers must implement policies and practices that facilitate the sharing of job resources in the work environment. Implications for policy and future research are also discussed. [ABSTRACT FROM AUTHOR]

Food insecurity is standardly measured at the household level or for groups of household members. However, food hardships may differ for individuals within households. Summary measures of people's individual experiences of food insecurity are needed. This study aims to develop and analyze psychometrically sound multi-item scales of people's individual experiences of food insecurity. It further aims to examine whether and how the distributions of personal food insecurity differ across age groups, from household food insecurity, and with people's observed characteristics. The study analyzes questionnaire data on personal food security outcomes, household food security outcomes, and other characteristics. The 29,040 participants in the study responded to the 2005-2006 through 2009-2010 cycles of the National Health and Nutrition Examination Survey in the United States. The main outcomes are five-item scales of personal food insecurity for children younger than age 12 years, young adolescents aged 12 to 15 years, and people aged 16 years and older. The study develops the personal food insecurity scales through factor analyses and polytomous Item Response Theory models and analyzes characteristics that are related to the scale outcomes through multivariate regressions. The article develops personal food insecurity scales that are related to but distinct from the standard household scales, with different scales being needed to capture the experiences of its three age groups. Children younger than age 12 years have much lower risks of personal food insecurity than other age groups, whereas young adolescents have higher risks than other groups. Three percent of children had an indication of personal food insecurity, whereas 10% of adolescents and 7% of adults had indications. Among adults, women and people between ages 31 and 65 years have higher risks of personal food insecurity than men and people of other ages, but they have similar risks for household food insecurity. Personal food insecurity is a distinct component of well-being that can be summarized through scale measures. Evidence that characteristics, such as sex and age, are related to personal food insecurity but not household food insecurity indicates that food experiences can differ within households and that some people may be systematically disadvantaged. [ABSTRACT FROM AUTHOR]

Objective: Given overlapping pathophysiology, this study sought to assess the association between osteoarthritis (OA), functional impairment, and cognitive impairment in the aging population. Methods: The National Health and Nutrition Examination Survey was used to identify participants >60 years of age. We analyzed multivariable associations of grouped participants that underwent cognitive function testing using linear and logistic regression, adjusting for sex, age, race, and ethnicity. Results: Of 2776 identified participants representing a population of 50,242,917, 40% did not report OA or functional limitations; 21% had OA but not functional limitations; 15% did not have OA but had functional limitations; 17% had OA and related functional limitations; and 7% had OA and non-arthritic functional limitations. OA was not independently associated with cognitive impairment. Contrarily, functional limitations were associated with cognitive impairment regardless of OA diagnosis. Discussion: Cognitive impairment is not associated with OA, but rather functional limitations, potentially guiding future intervention. [ABSTRACT FROM AUTHOR]

Many climate models exhibit a dry and warm bias over the central United States during the summer months, including the Energy Exascale Earth System Model (E3SM) and its Multiscale Modeling Framework (MMF) configuration. Understanding the causes of this bias is important to shine a light on this common model error and reduce the uncertainty in future projections. In this study, we use E3SMv2 and E3SM-MMF to assess how parameterized and resolved convection affect temperature and precipitation biases over the Southern Great Plains site of the Atmospheric Radiation Measurement program. Both configurations overestimate near-surface temperature and underestimate precipitation at the ARM SGP site. The bias is associated with a lack of low-level clouds during days without precipitation and too much incoming solar radiation causing the surface to warm. Low-level cloud fraction in E3SM-MMF during the nonprecipitating days is lower in comparison to E3SMv2 and observation, consistent with the larger warm bias. We also find that the underestimated precipitation can be characterized as "too frequent, too weak" in E3SMv2 and "too rare, too intense" in E3SM-MMF. These deficiencies conspire to sustain the warm and dry bias over the central United States. [ABSTRACT FROM AUTHOR]

Background: Communities in the United States (US) exist on a continuum of urbanicity, which may inform how individuals interact with their food environment, and thus modify the relationship between food access and dietary behaviors. Objective: This cross-sectional study aims to examine the modifying effect of community type in the association between the relative availability of food outlets and dietary inflammation across the US. Methods: Using baseline data from the REasons for Geographic and Racial Differences in Stroke study (2003–2007), we calculated participants' dietary inflammation score (DIS). Higher DIS indicates greater pro-inflammatory exposure. We defined our exposures as the relative availability of supermarkets and fast-food restaurants (percentage of food outlet type out of all food stores or restaurants, respectively) using street-network buffers around the population-weighted centroid of each participant's census tract. We used 1-, 2-, 6-, and 10-mile (~ 2-, 3-, 10-, and 16 km) buffer sizes for higher density urban, lower density urban, suburban/small town, and rural community types, respectively. Using generalized estimating equations, we estimated the association between relative food outlet availability and DIS, controlling for individual and neighborhood socio-demographics and total food outlets. The percentage of supermarkets and fast-food restaurants were modeled together. Results: Participants (n = 20,322) were distributed across all community types: higher density urban (16.7%), lower density urban (39.8%), suburban/small town (19.3%), and rural (24.2%). Across all community types, mean DIS was − 0.004 (SD = 2.5; min = − 14.2, max = 9.9). DIS was associated with relative availability of fast-food restaurants, but not supermarkets. Association between fast-food restaurants and DIS varied by community type (P for interaction = 0.02). Increases in the relative availability of fast-food restaurants were associated with higher DIS in suburban/small towns and lower density urban areas (p-values < 0.01); no significant associations were present in higher density urban or rural areas. Conclusions: The relative availability of fast-food restaurants was associated with higher DIS among participants residing in suburban/small town and lower density urban community types, suggesting that these communities might benefit most from interventions and policies that either promote restaurant diversity or expand healthier food options. [ABSTRACT FROM AUTHOR]

Background and Aims: Treatment of depression‐related psychological factors related to smoking behavior may improve rates of cessation among adults with major depressive disorder (MDD). This study measured the efficacy and safety of 12 weeks of behavioral activation for smoking cessation (BASC), varenicline and their combination. Design, Setting, Participants: This study used a randomized, placebo‐controlled, 2 × 2 factorial design comparing BASC versus standard behavioral treatment (ST) and varenicline versus placebo, taking place in research clinics at two urban universities in the United States. Participants comprised 300 hundred adult smokers with current or past MDD. Interventions: BASC integrated behavioral activation therapy and ST to increase engagement in rewarding activities by reducing avoidance, withdrawal and inactivity associated with depression. ST was based on the 2008 PHS Clinical Practice Guideline. Both treatments consisted of eight 45‐min sessions delivered between weeks 1 and 12. Varenicline and placebo were administered for 12 weeks between weeks 2 and 14. Measurements: Primary outcomes were bioverified intent‐to‐treat (ITT) 7‐day point‐prevalence abstinence at 27 weeks and adverse events (AEs). Findings No significant interaction was detected between behavioral treatment and pharmacotherapy at 27 weeks (χ2(1) = 0.19, P = 0.67). BASC and ST did not differ (χ2(1) = 0.43, P = 0.51). Significant differences in ITT abstinence rates (χ2(1) = 4.84, P = 0.03) emerged among pharmacotherapy arms (16.2% for varenicline, 7.5% for placebo), with results favoring varenicline over placebo (rate ratio = 2.16, 95% confidence interval = 1.08, 4.30). All significant differences in AE rates after start of medication were higher for placebo than varenicline. Conclusion: A randomized trial in smokers with major depressive disorder found that varenicline improved smoking abstinence versus placebo at 27 weeks without elevating rates of adverse events. Behavioral activation for smoking cessation did not outperform standard behavioral treatment, with or without adjunctive varenicline therapy. [ABSTRACT FROM AUTHOR]

In the United States, approximately 2% to 3% of adults and 8% of children have a food allergy. Allergic reactions range from minor pruritus to life-threatening anaphylaxis. These allergies often lead to significant anxiety and costs for patients and caregivers. Common food allergies include peanuts, cow's milk, shellfish, tree nuts, egg, fish, soy, and wheat. Peanut allergy, the most common, is the leading cause of life-threatening anaphylaxis. Children with asthma, allergic rhinitis, atopic dermatitis, or an allergy to insect venom, medications, or latex are at an increased risk of developing food allergies. Diagnosis of food allergy starts with a detailed, allergy-focused history. Serum immunoglobulin E and skin prick testing provide reliable information regarding food allergy diagnoses. Primary treatment involves elimination of the offending food from the diet. Prevention strategies proven to decrease the risk of developing a food allergy include restricting exposure to cow's milk in the first three days of life and early sequential exposure to allergenic foods starting between four and six months of age. Exclusive breastfeeding for three to four months reduces the likelihood of developing eczema and asthma but does not reduce development of food allergies. Most children eventually outgrow allergies to cow's milk, egg, soy, and wheat. However, allergies to tree nuts, peanuts, and shellfish are more likely to be lifelong. (Am Fam Physician. 2023; 108(2): 159–165. Copyright © 2023 American Academy of Family Physicians.) In the United States, approximately 2% to 3% of adults and 8% of children have a food allergy. Allergic reactions range from minor pruritus to life-threatening anaphylaxis. These allergies often lead to significant anxiety and costs for patients and caregivers. Common food allergies include peanuts, cow's milk, shellfish, tree nuts, egg, fish, soy, and wheat. Peanut allergy, the most common, is the leading cause of life-threatening anaphylaxis. Children with asthma, allergic rhinitis, atopic dermatitis, or an allergy to insect venom, medications, or latex are at an increased risk of developing food allergies. Diagnosis of food allergy starts with a detailed, allergy-focused history. Serum immunoglobulin E and skin prick testing provide reliable information regarding food allergy diagnoses. Primary treatment involves elimination of the offending food from the diet. Prevention strategies proven to decrease the risk of developing a food allergy include restricting exposure to cow's milk in the first three days of life and early sequential exposure to allergenic foods starting between four and six months of age. Exclusive breastfeeding for three to four months reduces the likelihood of developing eczema and asthma but does not reduce development of food allergies. Most children eventually outgrow allergies to cow's milk, egg, soy, and wheat. However, allergies to tree nuts, peanuts, and shellfish are more likely to be lifelong. [ABSTRACT FROM AUTHOR]

Background: The American Rescue Plan Act of 2021 awarded $500 million toward scaling "strike teams" to mitigate the impact of Coronavirus Disease 2019 (COVID‐19) within nursing homes. The Massachusetts Nursing Facility Accountability and Support Package (NFASP) piloted one such model during the first weeks of the pandemic, providing nursing homes financial, administrative, and educational support. For a subset of nursing homes deemed high‐risk, the state offered supplemental, in‐person technical infection control support. Methods: Using state death certificate data and federal nursing home occupancy data, we examined longitudinal all‐cause mortality per 100,000 residents and changes in occupancy across NFASP participants and subgroups that varied in their receipt of the supplemental intervention. Results: Nursing home mortality peaked in the weeks preceding the NFASP, with a steeper increase among those receiving the supplemental intervention. There were contemporaneous declines in weekly occupancy. The potential for temporal confounding and differential selection across NFASP subgroups precluded estimation of causal effects of the intervention on mortality. Conclusions: We offer policy and design suggestions for future strike team iterations that could inform the allocation of state and federal funding. We recommend expanded data collection infrastructure and, ideally, randomized assignment to intervention subgroups to support causal inference as strike team models are scaled under the direction of state and federal agencies. See related Commentary by Berry et al. in this issue. [ABSTRACT FROM AUTHOR]

This article discusses the impact of pediatric psychology on child injury prevention. It highlights the significant number of child injuries and deaths that occur each year in the United States and globally. The article traces the history of research on child injury prevention and the role of pediatric psychology in understanding risk factors and developing intervention programs. It emphasizes the interdisciplinary collaborations, focus on underserved populations, and theory-driven research that have contributed to advancements in the field. The article concludes by highlighting several articles in a special section that demonstrate the current thinking and innovations in pediatric psychology's approach to preventing and treating child injuries. [Extracted from the article]

To date, no empirical research has focused solely upon understanding the personal and sociocultural stressors of Chinese international students in the United States. This qualitative inquiry examined what the most stressful aspects of their personal and social lives in the United States are, how they characterize their stress, and what conditions they believe tend to account for their stress. This study reveals that the life of Chinese students in the United States is not easy and that these students have to endure multifaceted life stresses. These results can be used to help Chinese international students adapt to the American educational environment and to improve the services and programs American universities deliver to their foreign students.

Objective: To characterize the experiences of nursing home administrators as they manage facilities across the United States during the COVID‐19 pandemic. Data Sources and Study Setting: We conducted 156 interviews, consisting of four repeated interviews with administrators from 40 nursing homes in eight health care markets across the country from July 2020 through December 2021. Study Design: We subjected the interview transcripts to a rigorous qualitative analysis to identify overarching themes using a modified grounded theory approach to applied thematic analysis. Data Collection Methods: In‐depth, semi‐structured qualitative interviews were conducted virtually or by phone, and audio‐recorded, with participants' consent. Audio recordings were transcribed. Principal Findings: Interviews with nursing home administrators revealed a number of important cross‐cutting themes. In interviewing each facility's administrator four times over the course of the pandemic, we heard perspectives regarding the stages of the pandemic, and how they varied by the facility and changed over time. We also heard how policies implemented by federal, state, and local governments to respond to COVID‐19 were frequently changing, confusing, and conflicting. Administrators described the effect of COVID‐19 and efforts to mitigate it on residents, including how restrictions on activities, communal dining, and visitation resulted in cognitive decline, depression, and weight loss. Administrators also discussed the impact of COVID‐19 on staff and staffing levels, reporting widespread challenges in keeping facilities staffed as well as strategies used to hire and retain staff. Administrators described concerns for the sustainability of the nursing home industry resulting from the substantial costs and pressures associated with responding to COVID‐19, the reductions in revenue, and the negative impact of how nursing homes appeared in the media. Conclusions: Findings from our research reflect nursing home administrator perspectives regarding challenges operating during COVID‐19 and have substantial implications for policy and practice. [ABSTRACT FROM AUTHOR]

Brook trout populations have been declining throughout their native range in the east coast of the United States. Many populations are now distributed in small, isolated habitat patches where low genetic diversity and high rates of inbreeding reduce contemporary viability and long‐term adaptive potential. Although human‐assisted gene flow could theoretically improve conservation outcomes through genetic rescue, there is widespread hesitancy to use this tool to support brook trout conservation. Here, we review the major uncertainties that have limited genetic rescue from being considered as a viable conservation tool for isolated brook trout populations and compare the risks of genetic rescue with other management alternatives. Drawing on theoretical and empirical studies, we discuss methods for implementing genetic rescue in brook trout that could yield long‐term evolutionary benefits while avoiding negative fitness effects associated with outbreeding depression and the spread of maladapted alleles. We also highlight the potential for future collaborative efforts to accelerate our understanding of genetic rescue as a viable tool for conservation. Ultimately, while we acknowledge that genetic rescue is not without risk, we emphasize the merits that this tool offers for protecting and propagating adaptive potential and improving species' resilience to rapid environmental change. [ABSTRACT FROM AUTHOR]