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There are an estimated 1.6 to 3.8 million sports and recreation-related concussions annually in the United States, with an average annual increase in incidence of 15.5% from 1998 to 2007. From 2009 to 2014, all 50 states enacted youth concussion legislation. This study clarifies core elements common to state concussion legislation and State Interscholastic Athletic Association (SIAA) implementation. A concussion literature, legislative, and SIAA concussion bylaw review was performed for all 50 U.S. states. Mandated concussion education varies in the frequency of certification and method of education. Student athletes and their parents/guardians in a majority of states are required to sign annual educational information sheets. Forty-nine states specifically mandate removal from play. Return-to-play protocols vary with regard to the timeline, content, and health care professional that can provide written clearance. In conclusion, it is important for sports medicine clinicians to stay abreast of current and revised concussion legislation in the jurisdictions in which they provide care. [ABSTRACT FROM AUTHOR]

Despite decades of investment and improvements in infant health in the United States, efforts to ensure the health and well-being of birthing people, especially those from racialized and minoritized communities, have been underfunded and neglected. As a result, many birthing people do not have access to the quality care they deserve and suffer disproportionately from adverse health outcomes such as severe maternal morbidity and maternal mortality. Through a Reproductive Justice lens, this paper will discuss structural causes for maternal health disparities as well as some of the structural solutions necessary to support the correction of centuries of discrimination on the basis of race, sex, gender, and other minoritized identities., Competing Interests: Disclosures We certify that, to the best of our knowledge, no aspect of our current personal or professional circumstance places us in the position of having a conflict of interest with this chapter., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Like many governmental actors in recent decades, the U.S. National Park Service (NPS) has operated increasingly through partnerships with other state and federal agencies, non-governmental organizations (NGOs), community groups, and private sector corporations. Perhaps the most salient example of this trend toward partnerships is the rapid growth and development of national heritage areas (NHAs). Since the first NHA received congressional designation in 1984, NHAs have become an increasingly popular strategy for protecting and managing landscapes. To date, congressional designation has been granted to 49 NHAs, making them one of the fastest growing initiatives involving the NPS. Despite this growth, no prior research has examined the efficacy or effectiveness of the NHA model. This article introduces the NHA concept, while reviewing the literature on evaluation research and its application to protected area management. We then offer an NHA program theory model for evaluating NHAs. The model was developed using a theory-based, process evaluation approach, along with 90 qualitative interviews conducted at three study sites: Blackstone River Valley National Heritage Corridor, MA-RI (BLAC); Delaware and Lehigh National Heritage Corridor, PA (DELE); and Cane River National Heritage Area, LA (CANE). We conclude by discussing the key challenges and implications associated with developing a long-term research agenda for evaluating NHAs.

People aging into Medicare need to choose a health plan. Several challenges exist for consumers in choosing a Medicare health plan, including limited knowledge of Medicare, limited experience in using comparative health plan quality information, and limited experience and ability to pull together and use plan information from different sources like employers and the Medicare program. The Choose with Care System was developed to help consumers aging into Medicare make informed Medicare health plan choices. Choose with Care is an innovative decision support tool for employers to use to assist people approaching age 65 to learn about their Medicare health plan options and how to incorporate information on the quality of care and services offered by health plans into their choices. Employers are the targeted channel for distributing the Choose with Care materials because they are one of the most recognized and accessible formal intermediaries for information about health insurance. We used multiple methods to test the Choose with Care products. Product testing showed that the Choose with Care materials increase older consumers' knowledge of Medicare and how it relates to retiree health insurance and improves their comprehension and use of comparative quality information when choosing a health plan.

We report on a federal initiative to develop a CAHPS (The Consumer Assessment of Healthcare Providers and Systems) survey to measure residents' experiences with quality-of-care and quality-of-life in nursing homes (known as NHCAHPS). We focus on how we created and tested questions for inclusion in the instrument and tested a possible cognitive screener to determine which residents could participate in a NHCAHPS interview. The major lessons learned were: (1) In contrast to other CAHPS surveys, ratings were more useful than reports because of the difficulty that residents had with summarizing over time and people; (2) consistent with other CAHPS surveys, the 0 to 10 response scale appeared to work well with nursing home residents for many of the quality-of-care questions; however, a different response scale was needed for many of the quality-of-life items; and (3) in contrast with typical survey methodology and other CAHPS surveys where explicit time reference periods are used, a non-specific present reference period in questions seemed to work best.