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Despite consensus on the importance of early detection and intervention for autistic children, health disparities exist, limiting access to timely services. One specific service type in the United States is Individuals with Disabilities Education Act, Part C Early Intervention programs, which are federally funded interventions for children birth-to-three with developmental delays. This study aimed to assess access to Part C, Early Intervention services for children who were evaluated for autism spectrum disorder and to examine factors that predicted parent-reported access to these services. This study extracted sociodemographic and service access data from the medical records of 709 children aged 12–40 months who were evaluated for autism spectrum disorder. Results showed that only 50% of the sample had reportedly accessed Part C, Early Intervention services. Those who identified as Black had decreased odds of having accessed Part C, Early Intervention, relative to those who identified as White, while those with a lower age of first parent concern had increased odds of having accessed Part C, Early Intervention. When inputting the independently significant variables into the model, both variables, identifying as Black and a lower age of first concern, remained significantly associated with accessing Part C, Early Intervention. Future work should investigate how these disparities come to be. Health disparities are defined as preventable differences in the opportunities to achieve optimal health outcomes experienced by marginalized and underrepresented communities. For families with autistic children, health disparities limit accessing early intervention services—which have been found to improve quality of life and other outcomes. One specific early intervention service in the United States is Individuals with Disabilities Education Act, Part C Early Intervention programs, which are federally funded interventions for children birth-to-three with developmental delays. This study adds to this topic by examining which factors impact accessing Part C, Early Intervention services for children who were evaluated for autism. Results showed that only half of the sample received these services despite there being concerns about development for all children. In addition, results showed that those who identified as Black had decreased odds of having accessed Part C, Early Intervention compared to those who identified as White. These results suggest that there are disparities when it comes to accessing important early intervention services that may be negatively impacting the Black autistic community. [ABSTRACT FROM AUTHOR]

Rationale: The shift toward virtual academic detailing (AD) was accelerated by the COVID‐19 pandemic. Aims and Objectives: We aimed to examine the role of external, contextual, and intrinsic programme‐specific factors in virtual engagement of healthcare providers (HCPs) and delivery of AD. Methods: AD groups throughout North America were contacted to participate in semistructured interviews. An interview guide was constructed by adapting the Consolidated Framework for Implementation Research (CFIR). A point of emphasis included strategies AD groups employed for provider engagement while implementing virtual AD programmes. Independent coders conducted qualitative analysis using the framework method. Results: Fifteen AD groups from Canada (n = 3) and the United States (n = 12) participated. Technological issues and training detailers and HCPs were challenges during the transition to virtual AD visits. Restrictions on in‐person activities during the pandemic created difficulties engaging HCPs and fewer AD visits. Continuing education was one strategy to incentivize participation, but credits were often not claimed by HCPs. Groups with established networks and prior experience with virtual AD leveraged connections to mitigate disruptions and continue AD visits. Other facilitators included emphasizing contemporary topics, including opioid education beyond fundamental guidelines. Virtual AD had the additional benefit of expanding geographic reach and flexible scheduling with providers. Conclusions: AD groups across North America have shifted to virtual outreach and delivery strategies. This trend toward virtual AD may aid outreach to vulnerable rural communities, improving health equity. More research is needed on the effectiveness of virtual AD and its future implications. [ABSTRACT FROM AUTHOR]

Objectives: To develop a value set reflecting the United States (US) general population's preferences for health states described by the Functional Assessment of Cancer Therapy (FACT) eight-dimensions preference-based multi-attribute utility instrument (FACT-8D), derived from the FACT-General cancer-specific health-related quality-of-life (HRQL) questionnaire. Methods: A US online panel was quota-sampled to achieve a general population sample representative by sex, age (≥ 18 years), race and ethnicity. A discrete choice experiment (DCE) was used to value health states. The valuation task involved choosing between pairs of health states (choice-sets) described by varying levels of the FACT-8D HRQL dimensions and survival (life-years). The DCE included 100 choice-sets; each respondent was randomly allocated 16 choice-sets. Data were analysed using conditional logit regression parameterized to fit the quality-adjusted life-year framework, weighted for sociodemographic variables that were non-representative of the US general population. Preference weights were calculated as the ratio of HRQL-level coefficients to the survival coefficient. Results: 2562 panel members opted in, 2462 (96%) completed at least one choice-set and 2357 (92%) completed 16 choice-sets. Pain and nausea were associated with the largest utility weights, work and sleep had more moderate utility weights, and sadness, worry and support had the smallest utility weights. Within dimensions, more severe HRQL levels were generally associated with larger weights. A preference-weighting algorithm to estimate US utilities from responses to the FACT-General questionnaire was generated. The worst health state's value was −0.33. Conclusions: This value set provides US population utilities for health states defined by the FACT-8D for use in evaluating oncology treatments. [ABSTRACT FROM AUTHOR]

By the end of 2019, there were 70,630 drug overdose deaths in the United States and 9.5 million adults had co-occurring disorders of mental health and substance use disorder. There is a great need to enhance community-based experiential training for students preparing to become behavioral professionals who will work with individuals experiencing mental health and substance use disorders (SUDs). The aim of this pilot study was to evaluate an opioid use disorder (OUD) and other SUDs training program designed to prepare MSW students for delivering prevention, treatment, and recovery services in high need and high demand areas. Two 3-hr trainings on OUD and other SUDs were implemented with 20 MSW students. Students demonstrated a statistically significant increase in their knowledge of opioid use and other substance use disorders from pre- to posttest for and a statistically significant increase in their confidence levels in knowledge about OUD and other SUDs. [ABSTRACT FROM AUTHOR]

This study aimed to develop a scoring function to calculate health utilities for health states described by the Health Utility for Glaucoma (HUG-5) based on the preferences of the general population in the United States. Preferences for HUG-5 health states were elicited using the standard gamble and visual analog scale through an online survey. Quota-based sampling was used to recruit a representative sample of the US general population in terms of age, sex, and race. A multiple attribute disutility function (MADUF) approach was adopted to derive scoring for the HUG-5. Model fit was assessed using mean absolute error associated with 5 HUG-5 marker health states that describe mild/moderate and severe glaucoma. Of 634 respondents completing the tasks, 416 were included in the estimation of the MADUF; 260 respondents (63%) considered worst possible HUG-5 health state better than death. The preferred scoring function generates the utilities ranging from 0.05 (worst HUG-5 health state) to 1 (best HUG-5 health state). The correlation between mean elicited and estimated values for marker states was strong (R 2 = 0.97) with mean absolute error = 0.11. The MADUF for HUG-5 is used to measure health utilities on the scale of perfect health and death, which can be used to estimate quality-adjusted life-years for economic evaluations of glaucoma interventions. [ABSTRACT FROM AUTHOR]

Decision makers need to know the drivers of surface water phosphorus (P) concentrations, the environmental factors that mediate P loading in freshwater systems, and where pollution sources and mediating factors are co‐located to inform water quality restoration efforts. To provide this information, publicly available spatial data sets of P pollution sources and relevant environmental variables, like temperature, precipitation, and agricultural soil erodibility, were matched with >7,000 stream and lake total P observations throughout the conterminous United States. Using three statistical approaches, consisting of (a) correlation, (b) regression, and (c) machine learning techniques, we identified likely drivers of P concentrations. Surface water concentrations in streams were more strongly correlated and effectively predicted by annual fertilizer and manure input rates and agricultural legacy sources compared to that of lakes. This observation suggests that streams may be more immediately responsive to improvements in agricultural nutrient management. In contrast, lake concentrations, though still positively associated with agricultural input and surplus variables, may be more influenced by historic erosional inputs, internal lake recycling, and other environmental factors. Thus, lake TP concentrations may not be as immediately responsive as streams to improvements in phosphorus management. Both stream and lake P concentrations will potentially increase because of warming temperatures and forest recovering from past acidification, putting even further pressure on existing water quality restoration efforts to meet nutrient loading reduction targets. The identified spatial data sets and relationships elucidated in this effort can inform the placement and development of watershed restoration strategies to reduce excess P in aquatic systems. Plain Language Summary: Over the past century, increasing agricultural production and urbanization increased the amount of phosphorus entering lakes and streams across the United States. Increased nutrient inputs have degraded water quality, and substantial effort has been put into decreasing phosphorus loads to surface water. Decision makers need to know the drivers of lake and stream phosphorus concentrations and the environmental factors (e.g., soil characteristics, precipitation, temperature, etc.) that moderate phosphorus loss to surface water to optimize restoration plans and consider future challenges. This work highlights that stream concentrations may be more immediately responsive to improvements in farm nutrient management, but like lakes, the loss of legacy phosphorus from erodible soils may delay or even offset anticipated improvements. Future climate change, particularly increases in air temperature, will likely result in increased phosphorus concentration in lakes and streams thus putting further pressure on rural and urban stakeholders to decrease phosphorus loss. The statistical evidence summarized in this work, combined with the publicly available maps of pollution sources and environmental factors, can help guide watershed managers on where and how to implement watershed restoration plans, communicate expected watershed responses to management actions, and anticipate future challenges in the Anthropocene. Key Points: Three statistical techniques identified major environmental and anthropogenic drivers of lake and stream phosphorus concentrationsStreams may be more responsive to shifts in nutrient inputs, whereas lakes will likely show a lagged response due to internal recyclingWarming temperatures and more intense summertime precipitation will likely increase aquatic phosphorus concentrations in the future [ABSTRACT FROM AUTHOR]

There is a large body of research indicating that substance use disorder treatment completion leads to higher rates of sustained recovery. However, not much is known about how age and opioid treatment programs (OTPs) OTPinteract to affect treatment completion. The purpose of this article is to better understand the pathway between age, OTP, and treatment completion. Data from the US 2017 Treatment Episodes Data Set was analyzed. Seemingly unrelated bivariate probit regression was used to determine whether OTP access mediates the relationship between age and treatment completion. We used propensity score matching to simulate the effects of a randomized control trial and to attenuate the likelihood of a Type 1 error. Older adults have a higher likelihood than their younger counterparts of completing treatment regardless of OTP status in inpatient and outpatient settings. Those who received OTP in inpatient treatment had a 45% increased probability of completing treatment in detox settings and a 41% increased probability of completing treatment in inpatient settings. Older adults (age 50+) were more likely to receive OTP than their younger counterparts. There is a small but significant indirect effect of age on treatment completion in inpatient settings. Older adults are more likely to receive OTP in both inpatient and outpatient settings. However, age does not appear to affect the probability of treatment completion when individuals receive OTP, except in inpatient settings. Implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Medication-assisted treatment has been shown to be effective in treating opioid use disorder among both older adults and veterans of U.S. Armed Forces. However, limited evidence exists on MAT's differential effect on treatment completion across age groups. This study aims to ascertain the role of MAT and age in treatment completion among veterans seeking treatment in non-Department of Veterans Affairs healthcare facilities for opioid use disorder.Methods: We used the Treatment Episode Data Set-Discharges (TEDS-D; 2006-2017) to examine trends in treatment and MAT usage over time and TEDS-2017 to determine the role of age and MAT in treatment completion. We examined a subset of those who self-identified as veterans and who sought treatment for an opioid use disorder.Results: Veterans presented in treatment more often as heroin users than prescription opioid users, and older veterans were more likely to get MAT than younger veterans. We found that before propensity score matching, MAT initially appeared to be associated with a lower likelihood of treatment completion in inpatient ($\beta $ = -1.47, 95% CI -1.56 to -1.39) and outpatient ($\beta $ = -1.40, 95% CI -2.21 to -0.58) settings, and age (50+ years) appeared to mediate the effect of MAT on treatment completion ($\beta $ = -0.54, 95% CI -0.87 to -0.21). After matching, older veterans were more likely to complete substance use disorder treatment ($\beta $ = 0.21, 95% CI 0.01-0.42), while age no longer mediated the effect of MAT, and MAT had a significant positive impact on treatment completion in detox settings ($\beta $ = 1.36, 95% CI 1.15-1.50) and inpatient settings ($\beta $ = 1.54, 95% CI 1.37 -1.71).Conclusion: The results show that age plays an important role in outpatient treatment completion, while MAT plays an important role in inpatient treatment completion. Implications for veterans are discussed. [ABSTRACT FROM AUTHOR]

The dramatic slowdown in population growth in Appalachia since 1980 is the result of a sharp change in migration patterns. Both the metropolitan and nonmetropolitan populations increased much more slowly than in the United States as a whole, with metropolitan growth rates lagging farther behind the national rates. (BRR)

Projections of 1980 population figures for the Appalachian Region are discussed in terms of growth rates, population trends, income levels, and changes in urban and rural counties. Tabular data are presented for population of the Appalachian Region, state parts, local development districts and subregions, and poverty status of household populations. (DS)

Purpose: To compare self-rated health among the United States general population in 2002 and 2017.Methods: Secondary data were analyzed from two EQ-5D valuation studies conducted in 2002 and 2017. Both studies included the EQ-5D-3L self-classifier and visual analog scale (VAS), where health is rated from 0 (worst imaginable health) to 100 (best imaginable health). VAS scores were compared between time points using regression models, adjusting for sociodemographic factors (Model 1), plus illness (Model 2), and health problems according to the EQ-5D classifier (Model 3).Results: Mean VAS scores in 2002 [84.4 (SD = 16.1)] were not different from 2017 [84.6 (SD = 14.5)] (p = 0.63), nor different after adjusting for demographics (Model 1) or illness (Model 2). However, 2017 VAS mean scores were significantly higher than 2002 [2.2 (95% CI 1.36-3.10)] upon adjusting for the presence of dimension-specific health problems.Conclusions: Self-rated health of the general US adult population in 2017 was similar to 2002, but after adjusting for health problems, scores were slightly higher in 2017. Sociodemographic shifts in age and education explain some of the differences in scores, and by removing health and sociodemographic factors, we found the VAS reveals self-rated health is slightly better in 2017 than 2002. [ABSTRACT FROM AUTHOR]

Objective: To derive a US-based value set for the EQ-5D-5L questionnaire using an international, standardized protocol developed by the EuroQol Group.Methods: Respondents from the US adult population were quota-sampled on the basis of age, sex, ethnicity, and race. Trained interviewers guided participants in completing composite time trade-off (cTTO) and discrete choice experiment (DCE) tasks using the EuroQol Valuation Technology software and routine quality control measures. Data were modeled using a Tobit model for cTTO data, a mixed logit model for DCE data, and a hybrid model that combined cTTO and DCE data. Model performance was compared on the basis of logical ordering of coefficients, statistical significance, parsimony, and theoretical considerations.Results: Of 1134 respondents, 1062, 1099, and 1102 respondents provided useable cTTO, DCE, and cTTO or DCE responses, respectively, on the basis of quality control criteria and interviewer judgment. Respondent demographic characteristics and health status were similar to the 2015 US Census. The Tobit model was selected as the preferred model to generate the value set. Values ranged from -0.573 (55 555) to 1 (11 111), with 20% of all predicted health states scores less than 0 (ie, worse than dead).Conclusions: A societal value set for the EQ-5D-5L was developed that can be used for economic evaluations and decision making in US health systems. The internationally established, standardized protocol used to develop this US-based value set was recommended by the EuroQol Group and can facilitate cross-country comparisons. [ABSTRACT FROM AUTHOR]

Results of randomized controlled trials have demonstrated significant reductions in anxiety symptoms following cognitive behavior therapy participation. Although promising, the extent to which previous research has included families from low socioeconomic status or racially/ethnically diverse backgrounds is unknown. Aims of this study are as follows: (1) What is the race, ethnicity, and educational attainment of youth with autism spectrum disorder and their families who have participated in research examining the efficacy of cognitive behavior therapy for anxiety? and (2) How do the demographics of these participants compare to that of the United States census? A total of 14 studies were reviewed that included 473 participants. Chi-square analyses indicated that there are significant differences between the race/ethnicity of youth with autism spectrum disorder participating in cognitive behavior therapy research for anxiety and that of youth in the United States. Standard residuals indicated significant overrepresentation of White youth and significant underrepresentation of Black and Latino youth in cognitive behavior therapy research (all p -values <0.001). Similarly, there were significant differences in the educational attainment of caregivers participating in cognitive behavior therapy research, with a significant underrepresentation of caregivers from low socioeconomic status backgrounds (p < 0.001). These findings have implications for the development of cognitive behavior therapy interventions for youth with autism spectrum disorder and anxiety that are both rigorous and inclusive. [ABSTRACT FROM AUTHOR]

Purpose: Advanced practice providers (APPs, which include NPs and physician assistants [PAs]) are integral members of oncology teams. This study aims first to identify all APPs in oncology and, second, to understand personal and practice characteristics (including compensation) of those APPs. Methods: We identified APPs who practice oncology from membership and claims data. We surveyed 3,055 APPs about their roles in clinical care. Results: We identified at least 5,350 APPs in oncology and an additional 5,400 who might practice oncology. Survey respondents totaled 577 out of 3,055, which provided a 19% response rate. Results focused on 540 NPs and PAs. Greater than 90% reported satisfaction with career choice. Respondents identified predominately as white (89%) and female (94%). NPs and PAs spent the majority (80%) of time in direct patient care. The top four patient care activities were patient counseling (NPs, 94%; PAs, 98%), prescribing (NPs, 93%; PAs, 97%), treatment management (NPs, 89%; PAs, 93%), and follow-up visits (NPs, 81%; PAs, 86%). A majority of all APPs reported both independent and shared visits (65% hematology/oncology/survivorship/prevention/pediatric hematology/oncology; 85% surgical/gynecologic oncology; 78% radiation oncology). A minority of APPs reported that they conducted only shared visits. Average annual compensation was between $113,000 and $115,000, which is about $10,000 higher than average pay for APPs not in oncology. Conclusion: We identified 5,350 APPs in oncology and conclude that number may be as high as 7,000. Survey results suggest that practices that incorporate APPs routinely rely on them for patient care. Given the increasing number of patients with and survivors of cancer, APPs are important to ensure access to quality cancer care now and in the future. [ABSTRACT FROM AUTHOR]

The Fairness Doctrine, one of the most famous and controversial media policies ever enacted, suffered a final deathblow in August 2011 when the Federal Communications Commission permanently struck it from the books. However, the Doctrine continues to be invoked by proponents and detractors alike. Using mixed methods, this study historically contextualizes the Fairness Doctrine while drawing attention to how it figures within contemporary regulatory debates. By tracing over time the shifting ideologies and discourses surrounding the Fairness Doctrine, we can see how political conflict shapes the normative foundations of core media policies, especially those involving positive freedoms. [ABSTRACT FROM AUTHOR]

Objective: Heroin use in the United States has reached epidemic proportions. The objective of this paper is to estimate the annual societal cost of heroin use disorder in the United States in 2015 US dollars. Methods: An analytic model was created that included incarceration and crime; treatment for heroin use disorder; chronic infectious diseases (HIV, Hepatitis B, Hepatitis C, and Tuberculosis) and their treatments; treatment of neonatal abstinence syndrome; lost productivity; and death by heroin overdose. Results: Using literature-based estimates to populate the model, the cost of heroin use disorder was estimated to be $51.2 billion in 2015 US dollars ($50,799 per heroin user). One-way sensitivity analyses showed that overall cost estimates were sensitive to the number of heroin users, cost of HCV treatment, and cost of incarcerating heroin users. Conclusion: The annual cost of heroin use disorder to society in the United States emphasizes the need for sustained investment in healthcare and non-healthcare related strategies that reduce the likelihood of abuse and provide care and support for users to overcome the disorder. [ABSTRACT FROM AUTHOR]

Costs of repairing and expanding aging infrastructure and competing demands for water from other sectors such as industry and agriculture are stretching water managers’ abilities to meet essential domestic drinking water needs for future generations. Using Bayesian statistical modeling on past and present water use, we project domestic water demand in the context of four climate scenarios developed by the Intergovernmental Panel on Climate Change as part of the their Special Report on Emission Scenarios (SRES). We compare 2010 demand to projections of domestic water demand for the years 2030, 2060 and 2090 for the four SRES scenarios. Results indicate that the number of counties exceeding fifty percent or greater demand over 2010 levels increases through 2090 for two of the scenarios and plateaus around 2050 for the other two. Counties experiencing the largest increases in water demand are concentrated in the states of California, Texas, and isolated portions of the Mid-West, Southeast, and Mid-Atlantic. Closer examination of the spatial distribution of high demand counties reveals that they are typically found near or adjacent to metropolitan centers, potentially placing greater stress on already taxed systems. Identifying these counties allows for targeted adaptive management and policies, economic incentives, and legislation to be focused towards locations that are potentially the most vulnerable. [ABSTRACT FROM AUTHOR]

Copyright of Northeast Historical Archaeology is the property of Council for Northeast Historical Archaeology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To estimate changes in oral human papillomavirus (HPV) prevalence attributable to vaccination vs herd immunity, this national survey study uses National Health and Nutrition Examination Survey data to compare oral HPV prevalence for 4 types targeted by HPV vaccine and 33 nonvaccine types in unvaccinated US adults aged 18 to 59 years from 2009 to 2016. [ABSTRACT FROM AUTHOR]

Objectives. To consider whether Youth All Engaged! (a text message intervention) intensified the effects of the adolescent pregnancy prevention Teen Outreach Program (control) for youths. Methods. In this trial performed inDenver, Colorado, from 2011 to 2014,we randomized 8 Boys& Girls Clubs each of 4 years into 32 clubs per year combinations to ensure each club would serve as a treatment site for 2 years and a control site for 2 years. Control intervention consisted of the Teen Outreach Program only. We enrolled 852 youths (aged 14-18 years), and 632were retained at follow-up, with analytic samples ranging from50 to 624 across outcomes. We examined program costs, and whether the intervention increased condom and contraceptive use, access to care, and pregnancy prevention. Results. Control program costs were $1184 per participant, and intervention costs were an additional $126 per participant (+10.6%). There were no statistically significant differences in primary outcomes for the full sample. Hispanic participants in the intervention condition had fewer pregnancies at follow-up (1.79%) than did those in the control group (6.72%; P = .02). Conclusions. Youth All Engaged is feasible, low cost, and could have potential benefits for Hispanic youths. [ABSTRACT FROM AUTHOR]

What do you do when faced with wrongdoing--do you blame or do you forgive? Especially when confronted with offences that lie on the more severe end of the spectrum and cause terrible psychological or physical trauma or death, nothing can feel more natural than blame. Indeed, in the UK and the USA, increasingly vehement and righteous public expressions of blame and calls for vengeance have become commonplace; correspondingly, contemporary penal philosophy has witnessed a resurgence of the retributive tradition, in the modern form usually known as the 'justice' model. On the other hand, people can and routinely do forgive others, even in cases of severe crime. Evolutionary psychologists argue that both vengeance and forgiveness are universal human adaptations that have evolved as alternative responses to exploitation, and, crucially, strategies for reducing risk of re-offending. We are naturally endowed with both capacities: to blame and retaliate, or to forgive and seek to repair relations. Which should we choose? Drawing on evolutionary psychology, we offer an account of forgiveness and argue that the choice to blame, and not to forgive, is inconsistent with the political values of a broadly liberal society and can be instrumentally counter-productive to reducing the risk of future re-offending. We then sketch the shape of penal philosophy and criminal justice policy and practice with forgiveness in place as a guiding ideal. [ABSTRACT FROM AUTHOR]

This research synthesis analyzed qualitative depictions of adult literacy learners and identified five ways in which they are typically characterized: the Heroic Victim, the Needy (Problem) Child, the Broken (but Repairable) Cog, the Pawn of Destiny, and the Capable Comrade. These types do not capture the diversity or complexity of all adult literacy learners, and we do not argue that they are comprehensive. Rather they are representative of the ways in which adult literacy learners are portrayed in the research literature. We argue that each type, like characters in a narrative, drive the "action" in research, policy, and practice arena. The ways in which they populate research may have very real consequences for how adult literacy learning opportunities are provided and the outcomes that can be expected. [ABSTRACT FROM AUTHOR]

This Comment analyzes a recent decision by the U.S. Court of Appeals for the Eleventh Circuit focusing on the role of an implied good faith inquiry in the "for cause" provision in Chapter 7 of the Bankruptcy Code. The decision in Piazza v. Nueterra Healthcare (In re Piazza) contributes to a purported circuit split on whether the "for cause" provision should be the locus for an implied good faith inquiry or whether such an inquiry should be left to other parts of the Code. Circuit courts that embrace an implied good faith inquiry in the "for cause" provision are further fractured on the question of the nature of the test that should be applied. This Comment argues that the circuit split on the implied good faith inquiry is an illusion. All circuit courts that have examined the issue would likely consider the same behaviors to be grounds for dismissal for bad faith in a future case. The more critical issue for debtors and creditors in bankruptcy is discord among the courts of appeals with regard to the implied good faith test. This Comment argues that multifactor tests like the one endorsed in Piazza are counteractive to the goal of the implied good faith inquiry, namely deterring abuse of the bankruptcy system. Further, by applying a rule-like factor test, the Piazza court creates harsh results for debtors through the inherent over- and under-inclusivity of such tests. Invoking jurisprudential concerns, this Comment concludes that the best application of the implied good faith inquiry is an amorphous good faith standard that allows bankruptcy judges maximum discretion. [ABSTRACT FROM AUTHOR]

By providing historical context for the recurring regulatory retreat in the face of structural problems in the news media, this study examines the policy discourse that continues to define the US journalism crisis and government’s inability to confront it. To contextualize this pattern, I compare two historical junctures, the first occurring in the 1940s, exemplified by the Hutchins Commission, and the second occurring in the more recent policy debates during the years 2009–2011, exemplified by the Waldman Report. Both of these historical moments represented a societal response to a journalism crisis, and both entailed deeply normative discussions about the role of media in a democratic society and government’s role in managing that relationship. A comparison of these historical case studies brings into focus recurring weaknesses in liberal reform efforts. Specifically, it highlights what I refer to as the “discursive capture” reflected in common assumptions about the proper relationship between media and government, and how this American paradigm is constrained by an implicit market fundamentalism. [ABSTRACT FROM PUBLISHER]

The concept of proportionality has been central to the retributive revival in penal theory, and underlies desert theory's normative and practical commitment to limiting punishment. Theories of punishment combining desert-based and consequentialist considerations also appeal to proportionality as a limiting condition. In this paper we argue that these claims are founded on an exaggerated idea of what proportionality can offer, and in particular fail properly to consider the institutional conditions needed to foster robust limits on the state's power to punish. The idea that appeals to proportionality as an abstract ideal can help to limit punishment is, we argue, a chimera: what has been thought of as proportionality is not a naturally existing relationship, but a product of political and social construction, cultural meaning-making, and institution-building. Drawing on evolutionary psychology and comparative political economy, we argue that philosophers and social scientists need to work together to understand how the appeal of the idea of proportionality can best be realised through substantive institutional frameworks under particular conditions. [ABSTRACT FROM AUTHOR]

As American newspapers came under various forms of financial strain in the 1940s, arguably the most significant threat facing the industry during this period was an onslaught of media criticism in conjunction with a series of attempted state interventions. This paper fleshes out recurring themes of 1940s media criticism and shows how they coincided with moves toward regulating the press, which had begun in the late 1930s. Using historical methods, including close readings of newspaper, trade press, and activist literature and other materials that shed light on debates around press reform, this critical revisionist history brings into focus a formative period in the American press system's development. The history that emerges from this archival evidence does not simply bring previously under-researched areas into focus; it also questions the presumed natural laissez-faire arrangement between the American government and the press—an assumption that largely remains intact to this day. [ABSTRACT FROM PUBLISHER]

We investigated the association of demographic and behavioral factors with oral human papillomavirus (HPV) load for 18 high-risk types among 211 individuals with prevalent high-risk HPV within the National Health and Nutrition Examination Survey 2009–2010. Factors independently associated with HPV load above the median included older age (odds ratio, 1.04 per year increase [95% confidence interval, 1.01–1.07]; P = .004) and intensity of current smoking (P for trend <.001). A marginally greater percentage of men than women had an HPV load above the median (55.7% vs 32.8%; P = .069), and HPV load increased marginally with increasing alcohol use (P for trend = .062). In conclusion, older age and current smoking are associated with a high oral load of high-risk HPV types among individuals with a prevalent infection. [ABSTRACT FROM PUBLISHER]

The article determines the prevalence of oral human papillomavirus (HPV) infection in the U.S. from 2009-2010. Results revealed a 6.9 percent prevalence of oral HPV infection among men and women aged 14 to 69 years, and 1.0 percent prevalence of HPV type 16. The researchers observed a bimodal pattern of oral HPV infection with respect to age, with peak prevalence among individuals aged 30-34 and 60-64 years. Women were found to have lower prevalence for any oral HPV infection than men. It appeared that individuals without a history of any type of sexual contact, increased number of sexual partners and cigarettes smoked per day are less likely to have HPV infection.

A major priority for funding agencies and researchers involved in comparative-effectiveness research (CER) is to ensure that research questions will produce findings that are relevant and feasible to implement. In this article, we describe a process for involving experts and stakeholders in identifying and prioritizing CER studies, as illustrated by our experience in chronic obstructive pulmonary disease (COPD). [ABSTRACT FROM AUTHOR]

The World Wide Web is commonly seen as a platform that can harness the collective abilities of large numbers of people to accomplish tasks with unprecedented speed, accuracy, and scale. To explore the Web's ability for social mobilization, the Defense Advanced Research Projects Agency (DARPA) held the DARPA Network Challenge, in which competing teams were asked to locate 10 red weather balloons placed at locations around the continental United States. Using a recursive incentive mechanism that both spread information about the task and incentivized individuals to act, our team was able to find all 10 balloons in less than 9 hours, thus winning the Challenge. We analyzed the theoretical and practical properties of this mechanism and compared it with other approaches. [ABSTRACT FROM AUTHOR]

The article discusses the different Internet policy battles that would help shape the future of the fundamental structures of the Internet in the U.S. It explores the problems confronting the country's Internet industry including the decline in broadband penetration and the lack of choice and competition. Moreover, it analyzes some threats to communications in a democratic society and the policy provisions needed to keep the Internet from feudalization.

Although consensus has been reached that journalism is in crisis, few agree on the nature of its decline or the means of resolving it. After providing an overview of this ongoing debate, the author contextualizes the journalism crisis within several historical, political, intellectual, and structural processes that help highlight what is at stake and what can be done to support the journalism required for a democratic society in the United States. He concludes with an emphasis on normative considerations regarding the future of journalism and provides several policy proposals that aim to provide the resources necessary for a robust and independent press. These policies, he suggests, will help facilitate the transition from a failing commercial media system to a public-service model of the press. [ABSTRACT FROM AUTHOR]

The article discusses the future of Rule 11 sanctions for unethical conduct before the U.S. Court of International Trade (CIT). It provides an overview of CIT which has a jurisdiction over international trade issues such as antidumping (AD) and countervailing duty (CVD) investigations and trade remedy laws in the country. It points out that increase in misrepresentations to agencies to carry over to the CIT is reasonable since it has not been compelled to grant Rule 11 sanctions motions.

During the 1940s a media reform movement of grassroots activists and a progressive Federal Communication Commission (FCC) emerged to challenge the commercial interests consolidating control of US media. A key initiative born out of this movement was the so-called Blue Book, a high-water mark for FCC progressive activism that mandated social responsibility obligations for broadcasters in return for their use of the public airwaves. Ultimately, red-baiting tactics defeated the policy initiatives outlined in the Blue Book and the media reform movement was largely contained. The following analysis draws from archival materials to illuminate the resulting arrangement for US broadcasters. [ABSTRACT FROM PUBLISHER]

This paper examines the landmark Hutchins Commission's unpublished minutes and correspondence to uncover a potential radicalism that advocated for and then shied away from significant structural reform of the US media system. With an eye towards contemporary media problems, this project aims to recuperate lost alternatives and yield fresh insights regarding the institutional role of the press in a modern democratic society. By situating the Hutchins Commission in a historical trajectory of media criticism and media reform movements, this paper illuminates perennial tensions and confrontations between the liberal ideals and commercial imperatives driving the US press system. Drawing from Gramscian theory to contextualize the US media system's current crisis, the paper concludes by outlining an emergent consensus that calls for structural reform and for re-evaluating core normative democratic principles underpinning the social contract between US media institutions and the public. [ABSTRACT FROM AUTHOR]

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The purpose of the present study was to examine the feasibility of conducting a parent-based intervention in a pediatric health clinic to prevent HIV, sexually transmitted infections (STIs), and unintended pregnancies among urban African American and Latino youth. Eight focus groups were conducted with health care providers, adolescent patients and the mothers of adolescent patients ( n = 41) from December 2007 to February 2008. All participants were recruited from a community-based pediatric health clinic in the Bronx, New York. Content analysis of focus group transcripts identified results in three primary areas: (1) the role of parents and providers in preventing HIV, STDs and unintended pregnancies among adolescents, (2) feasibility of the intervention in the clinic setting; and (3) optimal recruitment, retention and intervention delivery strategies. Study results suggest that a parent-based intervention delivered in a community-based pediatric health clinic setting is feasible. Focused recommendations for intervention recruitment, delivery, and retention are provided. [ABSTRACT FROM AUTHOR]

Objective: The D1 model that was developed to predict US societal preferences for EQ-5D health states addressed several important conceptual and statistical issues. However, it has been criticized for being too complex, failing to account for the nonnormal distribution of health state values, and the transformation of preferences for worse-than-death health states before estimation. This research was conducted to develop an improved model for predicting median preferences for EQ-5D health states for the US population. Methods: Probability-weighted least absolute deviations regression was used to fit models to the time trade-off data collected in the US Valuation of the EQ-5D Health States study. No transformation was applied to the values for states considered worse than death. Several model specifications that differed with respect to explanatory variables were evaluated using two-sample cross-validation. Results: The best-fitting model included only fixed effects for moderate or severe problems in each of the 5 EQ-5D dimensions and excluded a constant. This specification yielded rank correlations between observed and predicted values and median observed and predicted values of 0.635 and 0.991, respectively, as well as a median absolute error of 0.026. The predicted median preferences ranged from 1.00 for full health, to –0.81 for the worst possible health state. Conclusions: Due to its simplicity and robustness, a median model is superior to other models for predicting US population preferences for EQ-5D health states. The predictions of this model are suggested for use in applications that require US societal health state values. [ABSTRACT FROM AUTHOR]

While many policy analysts have focused on the fate of the 700 MHz auctions, the digital TV transition, and the promise of white space devices, a more vast and underutilized resource has gone largely unnoticed: government spectrum. The best available data suggests that the majority of federal spectrum capacity is left unused. Strategic reuse of this spectrum could help obviate the need for significant additional reallocation while enabling a wide range of creative new uses and social benefits. Based on what little information is publicly available, it is reasonable to assume that the repurposing of government spectrum would go far in addressing a number of access-related communication problems. Repurposing currently unused U.S. government-controlled spectrum for opportunistic unlicensed use would benefit society by dramatically expanding access to high-speed broadband and increasing the pace of wireless technology innovation. This approach to spectrum policy presents a "third option" for reform, drawing from both the commons and property rights models of spectrum management. [ABSTRACT FROM AUTHOR]

The article presents a cohort study which evaluates the effectiveness of regimens containing tiotropium bromide in patients with chronic obstructive pulmonary disease (COPD). The study observed two separate groups of patients with a diagnosis of COPD in the U.S. Veterans Affairs health care system. Results of the study indicate that the use of tiotropium, with inhaled corticosteroids (ICS) and long-acting β-agonists (LABA), was associated with reduced risk of mortality in COPD patients.

Purpose. An overview of the emerging field of comparative effectiveness research (CER) and its relevance to pharmacists and pharmacy-based decision-makers is provided. Summary. The U.S. government is investing over $1 billion on CER over the next two years. This investment is in part driven by the recognition that, despite having the highest per capita health care expenditures in the world, the United States does not always perform well on measures of health compared with other countries. There also is increased awareness of the limited information provided by results of traditional randomized clinical trials to inform decisions about therapeutic alternatives as applied in actual practice. Comparative effectiveness studies have two important principal components: (1) the comparison of two or more agents or interventions that are considered true therapeutic alternatives and (2) the examination of effects (outcomes) in actual practice. Comparative effectiveness studies differ from traditional efficacy studies in several ways, including the research question addressed, comparison groups, patient population, setting, outcomes measured, and validity. Studies that are within the scope of CER can be categorized as primary comparative effectiveness studies or secondary comparative effectiveness studies. CER also can be used to compare medical devices, procedures, health services, or any competing intervention. Conclusion. Comparative effectiveness is an emerging area of research relevant to many areas of health care, especially pharmacotherapy. The knowledge gained from CER is important to pharmacists when applying drug information and making decisions related to drug therapy. [ABSTRACT FROM AUTHOR]

The article discusses various developments related to the issue of national security. In 1996, the U.S. Congress amended the Foreign Sovereign Immunities Act (FSIA) to allow civil suits by U.S. victims of terrorist attacks. In May 2008, 111 countries adopted the Convention on Cluster-Munitions (CCM) to prevent future loss of human lives due to military weapons. In September 2008, the U.S. approved legislation against Iran to discourage it from proliferating nuclear weapons.

OBJECTIVES: To determine whether inpatient palliative consultation services improve outcomes of care. DESIGN: Retrospective telephone surveys conducted with family members of veterans who received inpatient or outpatient care from a Department of Veterans Affairs (VA) medical facility in the last month of life. SETTING: Five VA Medical Centers or their affiliated nursing homes and outpatient clinics. PARTICIPANTS: Veterans had received inpatient or outpatient care from a participating VA in the last month of life. One family member completed each survey. MEASUREMENTS: The telephone survey assessed nine aspects of the care the patient received in his or her last month of life: the patient's well-being and dignity (4 items), adequacy of communication (5 items), respect for treatment preferences (2 items), emotional and spiritual support (3 items), management of symptoms (4 items), access to the inpatient facility of choice (1 item), care around the time of death (6 items), access to home care services (4 items), and access to benefits and services after the patient's death (3 items). RESULTS: Interviews were completed with 524 respondents. In a multivariable linear regression model, after adjusting for the likelihood of receiving a palliative consultation (propensity score), palliative care patients had higher overall scores: 65 (95% confidence interval (CI)=62–66) versus 54 (95% CI=51–56; P<.001) and higher scores for almost all domains. Earlier consultations were independently associated with better overall scores (β=0.003; P=.006), a difference that was attributable primarily to improvements in communication and emotional support. CONCLUSION: Palliative consultations improve outcomes of care, and earlier consultations may confer additional benefit. [ABSTRACT FROM AUTHOR]