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The Health Resources and Services Administration's (HRSA) Health Center Program provides health care to vulnerable persons across theUS, regardless of their ability to pay for health care.We examined characteristics of populations living within and outside a 30-minute drive-time to HRSA-supported health centers to establish a baseline to better understand the differences in these populations. Using a descriptive, cross-sectional study design and geographic information systems, we found that 94% of persons in the US live within a 30-minute drive-time of a health center. Of those outside a 30-minute drive-time to a health center, 11.7 million (60.11%) are rural and over 1.5 million households (20.32%) lack broadband internet access. [ABSTRACT FROM AUTHOR]

As China advances, attitudes about ethical reasoning will continue to evolve from norms rooted in Confucianism, guanxi, and collectivism toward attitudes consistent with developed countries. With the lack of understanding of reasoning in China, business executives, professors, and students from developed countries rely on their society's cultural norms to inform ethical reasoning. The purpose of this study was to examine cross-cultural ethical reasoning skills of the next generation of executives in the United States and China represented by students from mid-sized universities. Using the Accounting Ethical Dilemma Instrument [Thorne, 2000. The development of two measures to assess accountants' prescriptive and deliberative moral reasoning. "Behavioral Research in Accounting," 12, 139-169. https://aaajournals.org/loi/bria] and Hofstede's [1991. "Cultures and organizations." McGraw-Hill] taxonomy of cultural identities, the researchers determined that students from a public university in the United States exhibited higher reasoning skills than their Chinese peers. With the potential evolution of ethical reasoning in China, findings from this study may prove beneficial in the future of the convergence of Chinese and Western cultures.

Women remain underrepresented in medical physics in the United States, and determinants of persisting disparities remain unclear. Here, we performed a detailed investigation of American Association of Physicists in Medicine (AAPM) membership trajectories to evaluate trends in Full membership with respect to gender, age, and highest degree. Membership data, including gender, date of birth, highest degree, membership type, and years of active membership for 1993 to 2023 were obtained from AAPM. Group 1 included Full members who joined AAPM in 1993 or later. A subset of group 1 including only members who joined and left AAPM since 1993 (former members, group 1 F) was used to calculate age at membership cessation and duration. Results were compared by gender and highest degree. A Kaplan-Meier analysis was also used to evaluate membership "survival" by age and highest degree. Complete data were available for 6647 current and former Full members (group 1), including 2211 former members (group 1 F). On average, women became Full members at a significantly younger age than men (34.6 vs 37.5 years of age, P <.001) and ended their memberships (if applicable) at a significantly younger age than men (46.1 vs 50.1 years of age, P <.001). The Kaplan-Meier "survival" analysis showed that for a given age, women were at a significantly greater risk of membership cessation than men, and women with master's degrees had the lowest membership survival of any gender/degree subgroup. When analyzing by membership duration, there was no difference in survival by gender alone. Still, women with PhDs were found to have the greatest membership survival among gender/degree subgroups. Both gender and degree type influenced AAPM membership trajectories. Although we have offered a discussion of possible explanations, qualitative data collected from both continuing and departing AAPM members will be critical in the ongoing journey toward gender parity in the profession of medical physics. [ABSTRACT FROM AUTHOR]

Background Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug-resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak. Methods Cases were defined as a US patient's first isolation of P. aeruginosa sequence type 1203 with carbapenemase gene bla VIM-80 and cephalosporinase gene bla GES-9 from any specimen source collected and reported to the Centers for Disease Control and Prevention during 1 January 2022–15 May 2023. We conducted a 1:1 matched case-control study at the post–acute care facility with the most cases, assessed exposures associated with case status for all case-patients, and tested products for bacterial contamination. Results We identified 81 case-patients from 18 states, 27 of whom were identified through surveillance cultures. Four (7%) of 54 case-patients with clinical cultures died within 30 days of culture collection, and 4 (22%) of 18 with eye infections underwent enucleation. In the case-control study, case-patients had increased odds of receiving artificial tears versus controls (crude matched OR, 5.0; 95% CI, 1.1–22.8). Overall, artificial tears use was reported by 61 (87%) of 70 case-patients with information; 43 (77%) of 56 case-patients with brand information reported use of Brand A, an imported, preservative-free, over-the-counter (OTC) product. Bacteria isolated from opened and unopened bottles of Brand A were genetically related to patient isolates. Food and Drug Administration inspection of the manufacturing plant identified likely sources of contamination. Conclusions A manufactured medical product serving as the vehicle for carbapenemase-producing organisms is unprecedented in the United States. The clinical impacts from this outbreak underscore the need for improved requirements for US OTC product importers. [ABSTRACT FROM AUTHOR]

A multiple family discussion group program was implemented and evaluated by school counselors working with families of young children referred by their teachers for aggression and attention problems. The logic guiding construction of the program and the program's unique aspects are described. Outcome data revealed that the program was effective in reducing the children's hyperactive, defiant, and aggressive behavior and improving the parents' management skills. The advantages of school counselors conducting this program are discussed. (Contains 1 table.)

Objectives: To determine whether Latina women's upward economic mobility from early-life residence in impoverished urban neighborhoods is associated with preterm birth (< 37 weeks, PTB). Methods: Multivariate logistic regression analyses were performed on the Illinois transgenerational birth-file with appended US census income information for Hispanic infants (born 1989–1991) and their mothers (born 1956–1976). Results: In Chicago, modestly impoverished-born Latina women (n = 1,674) who experienced upward economic mobility had a PTB rate of 8.5% versus 13.1% for those (n = 3,760) with a lifelong residence in modestly impoverished neighborhoods; the unadjusted and adjusted (controlling for age, marital status, adequacy of prenatal care, and cigarette smoking) RR equaled 0.65 (0.47, 0.90) and 0.66 (0.47, 0.93), respectively. Extremely impoverished-born Latina women (n = 2,507) who experienced upward economic mobility across their life-course had a PTB rate of 12.7% versus 15.9% for those (n = 3,849) who had a lifelong residence in extremely impoverished neighborhoods, the unadjusted and adjusted RR equaled 0.8 (0.63. 1.01) and 0.95 (0.75, 1.22), respectively. Conclusions for Practice: Latina women's upward economic mobility from early-life residence in modestly impoverished urban neighborhoods is associated with a decreased risk of PTB. A similar trend is absent among their peers with an early-life residence in extremely impoverished areas. Significance: What is Already Known on this Subject?: Robust literature supports a life-course conceptual model of birth outcome. Prior studies have demonstrated associations between upward economic mobility from poverty and decreased rates of preterm birth in non-Latina Black and White women. What this Study Adds?: Upward economic mobility is associated with decreased rates of preterm birth in US-born Latina women. This finding adds context to the life-course conceptual model of birth outcomes and may be salient to understanding the increased risk of adverse birth outcome among US-born (versus foreign-born) Latina women. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is the most common cancer among men in the United States. Treatment guidelines recommend active surveillance for low-risk prostate cancer, which involves monitoring for progression, to avoid or delay definitive treatments and their side effects. Despite increased uptake, adherence to surveillance remains a challenge. Methods: We conducted semi-structured, qualitative, virtual interviews based on the Theoretical Domains Framework (TDF), with men (15) who were or had been on active surveillance for their low-risk prostate cancer in 2020. Interviews were transcribed and coded under TDF's behavioral theory-based domains. We analyzed domains related to adherence to surveillance using constructivist grounded theory to identify themes influencing decision processes in adherence. Results: The TDF domains of emotion, beliefs about consequences, environmental context and resources, and social influences were most relevant to surveillance adherence-. From these four TDF domains, three themes emerged as underlying decision processes: trust in surveillance as treatment, quality of life, and experiences of self and others. Positive perceptions of these three themes supported adherence while negative perceptions contributed to non-adherence (i.e., not receiving follow-up or stopping surveillance). The relationship between the TDF domains and themes provided a theoretical process describing factors impacting active surveillance adherence for men with low-risk prostate cancer. Conclusions: Men identified key factors impacting active surveillance adherence that provide opportunities for clinical implementation and practice improvement. Future efforts should focus on multi-level interventions that foster trust in surveillance as treatment, emphasize quality of life benefits and enhance patients' interpersonal experiences while on surveillance to optimize adherence. [ABSTRACT FROM AUTHOR]

A series of linked relationships is advanced which together suggest changes should be made to training programs for airside drivers at major airports in the United States, Australia and the United Kingdom. Overall, the links suggest a relationship between the number of airside incidents such as collisions at airports, the ethnic diversity evident among airside drivers, and the training programs for those drivers. The article advances literature from religious, sporting and ethnic communications research which strongly suggests that addressing an individual or group's ethnic characteristics, especially kinship relationships, increases the effectiveness of business-oriented communications such as education and marketing. But data from interviews among developers and managers of airside driver training programs suggests that no attempt has been made previously to address airside drivers' ethnic background. Reasons presented for this include a widespread lack of recognition of ethnic diversity as an issue in airside driver training, and a consequent lack of government regulation to incorporate such recognition in training programs. Other reasons include cost factors in training development, and the fragmentation of the airside business space between hundreds, if not thousands, of independent contractors. This article suggests that the inclusion of ethnically-oriented strategies in airside driver training programs will act to improve training outcomes and result in fewer airside incidents over time. Benefits available to the transport industry include reductions in liability costs, improvements in passenger and asset safety, and reduction in network blockages.

Loris Malaguzzi, founder and guide for 50 years to the schools of young children in Reggio Emilia, Italy, passed away in January 1994. In this interview, conducted in 1990, Malaguzzi speaks directly to early childhood educators in the United States. He blends theory and practice as he clarifies the theoretical base of the Reggio schools and discusses pedagogical implications for early childhood practitioners who want to work from a deep understanding of children's thinking and questions.

Faculty modeling of desired behaviors has historically been a part of the apprenticeship model of clinical teaching, yet little is known about best practices for modeling. This study compared the educational impact of implicitly versus explicitly modeled communication skills among U.S. medical students. Fourth-year medical students from six U.S. academic medical centers were randomly assigned one simulated clinical encounter in which faculty provided either implicit or explicit modeling of important communication skills. Outcomes were assessed by electronic surveys immediately before and after the simulations. Students were blinded to the purpose of the study. Students in the explicit arm were more likely to correctly cite two of the three key specific communication elements modeled by faculty: deliberate body position (53.3% vs. 18.6%, p < 0.001) and summarizing patient understanding (62.2% vs. 11.6%, p < 0.001). More students in the explicit study arm reported faculty 'demonstrated a key behavior that they wanted me to be able to perform in the future' (93.2% versus 62.8%, p = 0.002). Participating faculty stated they would modify their teaching approach in response to their experiences in the study. In a multi-center randomized trial, explicit faculty role-modeling led to greater uptake of communication knowledge, greater recognition of skills, and a greater sense that faculty expected these skills to be adopted by students. These results must be considered in the context, however, of a simulated environment and a short timeframe for assessing learning with students who volunteered for a simulated experience. [ABSTRACT FROM AUTHOR]

Older immigrants of Latin American descent are disproportionately impacted by dementia, yet little is known about their dementia- and brain health-related knowledge. We explored perspectives on brain health and aging in this population to inform the development of culturally-relevant interventions. Individual, semi-structured interviews were conducted with 30 Spanish-speaking immigrants over 60. Questions addressed knowledge about the brain, perceptions of healthy and unhealthy aging, ideas of how to take care of one's brain, and where knowledge was acquired. Responses were analyzed using thematic analysis. The following themes emerged: (1) Descriptions of the brain varied, from anatomy, cognition, and psychology to disease. (2) Perceptions of healthy aging included independence, memory, emotions, and orientation. (3) Ideas of how to care for the brain included physical, social, and cognitive engagement. (4) Knowledge was acquired in childhood, communities, healthcare settings, careers, and media. Results showed significant variability in knowledge. Findings may be leveraged to improve interventions that address brain health literacy disparities among older Latin American immigrants. Takeaways involve increasing education about the structure and functions of the brain, promoting realistic understandings of what nonnormative brain aging entails, and increasing knowledge of empirically-supported maintenance approaches. Dissemination may be increased via healthcare providers, community centers, churches, and media. [ABSTRACT FROM AUTHOR]

Background: There is a need for alternative topical therapies as a consequence of the increased prevalence of meticillin‐resistant Staphylococcus pseudintermedius (MRSP) skin infections in dogs. Sodium oxychlorosene has been used as a topical antibacterial agent in human medicine since 1955. Objectives: To determine whether 0.2% and 0.4% sodium oxychlorosene solutions have a bactericidal effect (>3‐log reduction) on MRSP strains isolated from canine skin infections. Methods and materials: A genetically heterogeneous collection of MRSP isolates from dogs was assembled from laboratories across the United States. Time–kill assays were performed with 0.2% and 0.4% sodium oxychlorosene on a 0.5 McFarland standard [approximately 108 colony‐forming units (cfu/ml)] suspension of each strain. The average bacterial counts (cfu/ml) of each MRSP strain then were determined at 5, 10, 20 and 60 s after exposure to sodium oxychlorosene; cfu/ml data were converted to log10 scale to calculate microbial reduction. Results: The average bacterial counts following exposure to the 0.2% solution at 5, 10, 20 and 60 s were 6.94 × 104, 5.63 × 103, 2.96 × 102 and 1.48 × 102 cfu/ml, respectively. For the 0.4% solution, the average bacterial count at 5 s was 2.12 × 103 cfu/ml. No bacterial growth was observed for any MRSP strain by 10 s. The greatest reduction in cfu/ml occurred within 5 s following exposure to each solution 3.4‐log and 4.9‐log reduction for 0.2% and 0.4%, respectively. Conclusions and Clinical Relevance: 0.2% and 0.4% sodium oxychlorosene solutions have a bactericidal effect (>99.9% reduction) against MRSP in vitro. Further in vivo studies are necessary to determine whether it is an appropriate alternative therapy for canine pyoderma [ABSTRACT FROM AUTHOR]

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The Korean War is paradoxically remembered in the United States as "The Forgotten War." While there are many reasons for this amnesia, the war's representation in American popular culture, and cinema in particular, remains a key factor. Looking beyond the narrow canon of Korean War film "classics," this article surveys a broad spectrum of American-produced Korean War films made since 1951 in terms of their capacity (or rather incapacity) to serve as adequate means of Korean War remembrance. Building on memory studies scholar Astrid Erll's theory of media and cultural memory, the article proposes a typology of the kinds of (non-)memory work done by American Korean War films, with a specific focus on common narrative strategies that not only hinder remembrance but facilitate forgetting. These include the frequent subordination of the war to background or other ancillary roles, overly generic and nonspecific treatments of the war, and the tendency to conflate Korea with WWII. The article frames the mnemonic implications of these narrative strategies in terms of the compromised memory potentials they generate, including "peripheral memory," "vague memory," and "parasitic memory." [ABSTRACT FROM AUTHOR]

Objective: To ascertain the component of the excess preterm birth (< 37 weeks, PTB) rate among US-born (compared to foreign-born) Black women attributable to differences in acknowledged father's education attainment. Methods: Stratified analyses and Oaxaca-Blinder decomposition methods were performed on the 2013 National Center for Health Statistics birth certificate files of singleton infants with acknowledged fathers. Results: US-born Black women (N = 196,472) had a PTB rate of 13.3%, compared to 10.8% for foreign-born Black women (N = 51,334; Risk Difference (95% confidence interval) = 2.5 (2.3, 2.8). Infants of US-born black women had a greater a percentage of fathers with a high school diploma or less and a lower percentage of fathers with bachelor's degrees or higher than their counterparts of foreign-born women. In both subgroups, PTB rates tended to decline as the level of paternal education attainment rose. In an Oaxaca model (controlling for maternal age, education, marital status, parity, adequacy of prenatal care utilization, and chronic medical conditions), differences in paternal education attainment explained 15% of the maternal nativity disparity in PTB rates. In contrast, maternal education attainment accounted for approximately 4% of the disparity in PTB rates. Conclusions for Practice: Acknowledged father's low level of education attainment, or something closely related to it, explains a notable proportion of the disparity in PTB rates between US-born and foreign-born Black women. [ABSTRACT FROM AUTHOR]

Immigrant Mexican American (MA) youth are at greater risk for violence exposure due to risk factors associated with migration–postmigration processes and as they settle into urban U.S. communities marked by crime and poverty. Less is known about the contexts of this exposure. Specifically, what are the ecological contexts in which youth witness intimate partner violence (IPV), how do these experiences differ by immigration generational status, and what is the impact on youth's externalizing and internalizing behaviors? MA adolescents (N = 279; 15–17 years, M = 16.17, SD = 0.81) from the Southwest United States participated in an online survey. Over half of adolescents had witnessed at least one incidence of IPV in the prior 2 weeks, usually involving their peers. Adolescents who had spent more time in the United States were more likely to witness violence and rated it as more severe than more recently immigrated youth. A cross-sectional path model revealed that witnessing IPV was associated with internalizing and externalizing problems. However, the associations between witnessing IPV and dating violence perpetration and victimization were mediated through acceptance of dating violence norms. Each successive generation may be more likely to witness violence across a range of ecological contexts. Witnessing violence may be central to a host of negative outcomes, including deviancy, poor mental health, and dating violence. However, preventive interventions can help youth to challenge violence norms within intimate partnerships as well as to cope with violence in their homes, peer groups, and communities. [ABSTRACT FROM AUTHOR]

The criminalization of homelessness refers to the enactment and enforcement of laws and policies that punish unsheltered people for surviving in public space, even when those individuals have no reasonable alternative.2 The constitutional and civil rights issues stemming from criminally charging unsheltered people for public survival are clear, albeit not uncontested. But cities often skirt legal challenges to criminalization by pursuing means other than criminal charges to punish homelessness. Many cities "civilly criminalize" homelessness through civil enforcement, which extends from infractions or fines to "invisible persecution," such as the persistent policing and surveilling of unsheltered people. While courts, legislatures, and advocates largely focus on criminal charges, those punishments are just the tip of the criminalization iceberg: civil enforcement is arguably more extensive and damaging. However, courts and legislatures largely do not protect people experiencing homelessness from civil criminalization. This Article argues for greater attention to the devastating impact of civil punishments, drawing from other critiques that expose how civil tools punish poor and vulnerable people. It also examines how punishment operates outside of both criminal charges and civil sanctions, severely penalizing unsheltered people and requiring reform. [ABSTRACT FROM AUTHOR]

Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent antibiotic resistant threat. Only sporadic reports of CRE in companion animals have been described. Our objective was to identify risk factors associated with the acquisition of a blaNDM-5 CR-Escherichia coli strain as part of an outbreak investigation at a tertiary veterinary hospital in the United States. A matched case–control study was conducted among companion animals admitted during July 1, 2018, through June 30, 2019. The 15 identified blaNDM-5 CR-E coli cases were matched 1:2 with controls (culture negative for blaNDM-5 CR-E coli) based on species and number of days of hospitalization before bacterial culture sample collection. The association between exposure to various procedures and hospital services and the acquisition of blaNDM-5 CR-E. coli was assessed through conditional logistic regression. Case patients had significantly higher odds of exposure to the anesthesia service (odds ratio [OR] = 12.8, P =.017), the surgical service (OR = 4.0, P =.046), and to endotracheal intubation (OR = 10.0, P =.03). Veterinary hospitals should be aware of the potential for transmission of CRE via anesthetic and surgical procedures, especially those that require the placement of endotracheal tubes. [ABSTRACT FROM AUTHOR]

Ovarian cancer is the second most common gynecologic cancer with an estimated 13,940 mortalities across the United States in 2020. Natural polyphenols have been shown to double the survival time of some cancer patients due to their anticancer properties. Therefore, the effect of polyphenols extracted from Chinese hickory seed skin Carya cathayensis (CHSP) on ovarian cancer was investigated in the present study. Cell viability results showed that CHSP is more effective in inhibiting ovarian cancer cells than normal ovarian cells, with the IC50 value for inhibition of cell proliferation of Ovarian cancer cells (OVCAR-3) being 10.33 ± 0.166 µg/mL for a 24 h treatment. Flow cytometry results showed that the apoptosis rate was significantly increased to 44.21% after 24 h treatment with 20 µg/mL of CHSP. Western blot analysis showed that CHSP induced apoptosis of ovarian cancer cells through a p53-dependent intrinsic pathway. Compared with control values, levels of VEGF excreted by OVCAR-3 cancer cells were reduced to 7.87% with a 40 µg/mL CHSP treatment. Consistent with our previous reports, CHSP inhibits vascular endothelial growth factor (VEGF) secretion by regulating the HIF-1α-VEGF pathway. In addition, we also found that the inhibitory effect of CHSP on ovarian cancer is related to the up-regulation of Phosphatase and tension homolog (PTEN) and down-regulation of nuclear factor kappa-B (NF-kappa B). These findings provide some evidence of the anti-ovarian cancer properties of CHSP and support the polyphenols as potential candidates for ovarian cancer adjuvant therapy. [ABSTRACT FROM AUTHOR]

Healthcare organisations and governments have invested heavily in electronic health records in anticipation that they will deliver improved health outcomes for consumers and efficiencies across emergency departments. Despite such investment, electronic health records designed to support emergency care have been poorly evaluated. Given the accelerated development and adoption of information technology across healthcare, it is timely that a systematic review of this evidence base is updated in order to drive improvements to design, interoperability and overall clinical utility of electronic health record systems implemented in emergency departments. To assess the impact of electronic health records on healthcare outcomes and efficiencies in the emergency department we carried out a systematic review of published studies on this topic. This is the first review to summarise the cost efficiencies associated with electronic health record use outside of just the United States of America. A systematic search was performed in three scientific databases (MEDLINE, EMcare and EMBASE), of literature published between January 2000 and September 2019. Studies were included in this review if they evaluated electronic health records or health information exchanges (and synonyms for these terms), reported patient outcome and/or healthcare efficiency benefits, were peer-reviewed and published in English. Out of 6635 articles, 23 studies met our inclusion criteria. Wide variation regarding electronic health record access in the emergency department was reported (1.46–56.6%), yet was most frequently reported as less than 20%. Seven different types of health outcomes and three different types of efficiency improvements associated with electronic health record use in the emergency department were identified. The most frequently reported findings were efficiencies, including reductions in diagnostic tests, imaging and costs. This review is the first to report moderate to significant increases in admission rates are associated with electronic health record use in the emergency department, contrasting the findings of previous reviews. Diversity in the methodology employed across the included studies emphasises the need for further research to examine the impact of electronic health record implementation and system design on the findings reported, in order to ensure return on investment for stakeholders and optimised consumer care. [ABSTRACT FROM AUTHOR]

The4 article comments on the avoidable-consequences doctrine in tort law when intermingled with religion in the U.S. It mentions that under the common-law doctrine of avoidable consequences, plaintiffs must take reasonable steps to mitigate their damages from a contract breach or tort if they desire full reimbursement for their injuries. It also mentions that First Amendment to U.S. Constitution's religion clauses.

Sexual- and gender-minority (e.g., lesbian, gay, bisexual, and transgender) undergraduate students are at greater risk for sexual assault victimization than their cisgender (i.e., nontransgender) heterosexual peers. However, few studies have examined how social environments affect sexual assault victimization among sexual- and gender-minority undergraduate students. Nevertheless, this research area was identified as a priority by the Institute of Medicine as well as President Barack Obama's White House Task Force to Protect Students From Sexual Assault. Therefore, we tested the association between college campuses' inclusion of sexual- and gender-minority people and experiences of sexual assault victimization. Cross-sectional surveys were completed by sexual- and gender-minority undergraduate students (N = 1,925) from higher education institutions in all 50 U.S. states in 2010. Our dependent variable was experiencing sexual assault victimization at college. Our primary independent variable was campus climate, measured with items assessing perceived inclusion of sexual- and gender-minority people and witnessing sexual- or gender-minority harassment. We used multivariable logistic regression with generalized estimating equations (accounting for the clustering of students within schools) to estimate the association between campus climate and experiencing sexual assault victimization. Overall, 5.2% of the sample reported ever being victims of sexual assault at college. Controlling for sexual orientation, gender identity, race/ethnicity, and year in school, greater perceived inclusion of sexual- and gender-minority people on campus was associated with significantly lower odds of experiencing sexual assault victimization. Our study suggests that improving campus climate for sexual- and gender-minority individuals may reduce their prevalence of college sexual assault, which has potential implications for college practitioners and administrators as well as sexual assault prevention programs and policies. [ABSTRACT FROM AUTHOR]

In this brief retrospective of LGBT issues on US College Campuses: 1990–2020, the authors first review the extensive changes in the language used to 'define' people within these communities. Given the fluid and evolving language used in sexual and gender minority communities, it is crucial to examine how community members are named and who is centered as a result of this naming. The authors use the terms queer-spectrum and trans-spectrum to honor how individuals choose to identify themselves as opposed to placing them into socially constructed, fixed categories of sexuality and gender. Next, they explore how the climate has changed in higher education to support queer-spectrum and trans-spectrum students. Finally, the authors examine the research on how queer-spectrum and trans-spectrum students experience their campuses and the climate's influence on specific outcomes. This retrospective contends that higher education scholars must continue to examine outcomes that will facilitate success for queer- and trans-spectrum student populations. [ABSTRACT FROM AUTHOR]

The article informs on circuit split regarding noncompetitive reassignment under the U.S. Americans with Disabilities Act (ADA) of 1990. Topics discussed include brief background of the ADA and reasonable accommodation; U.S. Court of Appeals for the Eleventh Circuit court case EEOC v. St. Joseph's Hospital, Inc. addressing reasonable accommodation; and the U.S. Supreme Court case U.S. Airways, Inc. v. Barnett on reasonable accommodation of a disabled employee.

Objectives To explore associations between race, nativity, and low birth weight (LBW) among Latina and non-Latina women, with special attention to the Black Latina subgroup. Methods Using US natality data from 2011 to 2013, we designed a population-based study to compare LBW (< 2500 g) rates across six groups of women with self-identified race (N = 7,865,264)—White and Black Latina, foreign-born and US-born; non-Latina Black; and non-Latina White—creating 4 models for analysis: unadjusted (Model 1) and adjusted for sociodemographic factors (Model 2), sociodemographic plus medical risk factors (Model 3), and Model 3 factors plus smoking (Model 4). Results Infant LBW rate for Black Latinas (7.9%) was higher than White Latinas (5.6%) and varied by nativity: US-born (8.9%) versus foreign-born (6.1%). Among all study groups, US-born Black Latinas' LBW rate (8.9%) was second only to non-Latina Blacks (11.0%). In unadjusted Model 1, US-born Black Latinas had 81% (odds ratio [OR]: 1.81; 95% confidence interval [CI]: 1.74–1.88) and foreign-born Black Latinas had 22% (OR: 1.22; 95% CI 1.15–1.29) higher odds of LBW than non-Latina White women (reference group). However, in Model 2, ORs for foreign-born Black Latinas were nearly identical to non-Latina Whites (OR: 1.03; 95% CI 0.97–1.1), while US-born Black Latinas' odds were still 47% higher (OR: 1.47; 95% CI 1.42–1.53). Model 3 ORs for each group were similar to Model 2. Conclusions for Practice A significant subgroup of Latina women self-identify as Black, and their LBW rates are higher than White Latinas. Black Latinas born in the United States fare worse than their foreign-born counterparts, implicating negative effects of Black race specific to the US context. [ABSTRACT FROM AUTHOR]

Aim: The aim was to understand how health policy education is currently being delivered in the United States' graduate nursing programs. Methods: This exploratory cross‐sectional design used an anonymous online survey to target graduate nursing students attending American Association of College of Nursing (AACN) member institutions. Results: Over 75% of the sample (n = 140) reported taking a dedicated health policy course and 71.5% (n = 131) of the sample responded that a health policy course was required and an equal distribution among master's and doctoral students. There was no significant difference between type of graduate degree sought and the requirement to take a health policy course (P = 0.37). For students involved in health policy, there was a greater proportion of master's students involved at the state level, than doctorate of nursing practice (DNP) or PhD students (P = 0.04). Conclusions: Health policy and advocacy education are important aspects of graduate nursing curriculum and have been integrated into curricula. Graduate nursing students at all levels reported that health policy AACN Essential competencies are being included in their program, either as stand‐alone health policy courses or integrated health policy learning activities during matriculation. [ABSTRACT FROM AUTHOR]

We report isolation of a New Delhi metallo-β-lactamase-5-producing carbapenem-resistant Escherichia coli sequence type 167 from companion animals in the United States. Reports of carbapenem-resistant Enterobacteriaceae in companion animals are rare. We describe a unique cluster of blaNDM-5-producing E. coli in a veterinary hospital. [ABSTRACT FROM AUTHOR]

Few studies have examined contributions of paternal factors to birth outcomes. Weathering is a pattern of increasing rates of adverse birth outcome with increasing maternal age. This study evaluates for an association between paternal involvement and weathering in the context of preterm birth (PTB, <37 weeks) among non-Hispanic African-American and non-Hispanic White women with and without lifelong exposure to neighborhood poverty. Using the Illinois transgenerational dataset with appended US census income information of infants (1989–1991) and their mothers (1956–1976), we compared infants of women by degree of paternal involvement: married, unmarried with father named on birth certificate, and unnamed father. Data were stratified by maternal residence in higher or lower income neighborhoods at both the time of mothers' birth and infants’ birth, estimating maternal lifelong economic context. We computed race-specific PTB rates according to maternal age, lifelong neighborhood income, and paternal involvement. We calculated Mantel-Haenszel chi-square tests of linear trend from contingency tables to evaluate weathering. Among African-Americans (n = 39,991) with unnamed fathers and lifelong residence in lower income neighborhoods, PTB rate was lowest among teens at 18.8%, compared to 21.5% for 30-35 year-old mothers (p for linear trend <0.05). Among African-Americans with unnamed fathers and lifelong residence in higher income neighborhoods, PTB rate among teens was 16%, compared to 25% for 30-35 year-old mothers (p = 0.21). Among married African-Americans with lifelong residence in lower income neighborhoods, PTB rate among teens was 16.4%, compared to 12.5% for 30-35 year-old mothers (p = 0.79). Among married African-Americans with lifelong residence in higher income neighborhoods, PTB rate among teens was 20%, compared to 11.4% for 30-35 year-old mothers (p = 0.40). White mothers (n = 31,981) did not demonstrate weathering, regardless of paternal involvement and neighborhood poverty. We conclude that weathering was not seen among married African-Americans, independent of neighborhood income, suggesting a potentially protective mechanism associated with paternal involvement. [ABSTRACT FROM AUTHOR]

We used a hermeneutic phenomenological approach to address the question, ‘What does it mean to experience food insecurity?’ Youth focus group interviews incorporating art/writing prompts and interviews with programme director interviews contributed to our understanding of youth feeling out of place around other people. Young people living in food‐insecure homes in rural areas may experience complicated sets of interactions that simultaneously connect them to others living in similar circumstances, yet isolate them from the community at large. A multitude of complex factors, including place, affects food insecurity. We also discuss implications for practitioners who work with youth who live with food insecurity. [ABSTRACT FROM AUTHOR]

This study investigates the impact of Securities and Exchange Commission (SEC) enforcement actions on individuals holding Certified Public Accountant (CPA) accreditation. While prior research has investigated both the characteristics of companies that have been investigated by the SEC and litigation against audit firms, it has not addressed the ways in which SEC investigations impact CPAs. Using a sample of 262 CPAs, we find that the most common CPA breach was associated with overstating revenues/income or earnings. The study finds serious consequences for CPAs in terms of employment restrictions and SEC actions, incorporating suspension, which is often permanent. We find that the primary factors relating to the severity of actions by the SEC is whether the CPA intentionally breached the professional code of conduct, the age of the CPA, whether the CPA is still a member of the AICPA with CPA status and whether the CPA was operating as an external auditor or in a corporate accounting role. Our findings have implications for accounting practitioners, the AICPA and boards of directors. [ABSTRACT FROM AUTHOR]

Background: The United States is faced with an unprecedented epidemic of drug abuse. Every year thousands of Americans visit the emergency departments all over the country with illicit drug related complaints. These drugs have been known to be associated with a range of renal pathologies, from reversible acute kidney injuries to debilitating irreversible conditions like renal infarction. So far, no comprehensive study or systematic review has been published that includes the commonly used street drugs and designer drugs with potential nephrotoxic outcomes.Methods: We conducted a systematic review of published case reports, case series, and cross sectional studies of nephrotoxicities related to drugs of abuse. Literature review was conducted using PubMed/Medline from January 1, 2005 -December 31, 2016 to search for publications related to drug abuse with a defined renal outcome. Publications which reported renal injury in relation to the use of illicit drugs were selected, specifically those cases with raised creatinine levels, clinically symptomatic patients, for instance those with oliguria and proven renal biopsies.Results: A total of 4798 publications were reviewed during the search process and PRISMA flow chart and Moose protocol regarding systematic reviews were followed. 110 articles were shortlisted for the review. A total of 169 cases from case reports and case series, and 14 case studies were analyzed. Renal manifestations of specific illicit drug abuse were included in this review.Conclusion: Based on the evidence presented, a wide range of renal manifestations were found to be associated with drug abuse. If the trend of increasing use of illicit drug use continues, it will put a significant percentage of the population at an elevated risk for poor renal outcomes. This study is limited by the nature of the literature reviewed being primarily case reports and case series. [ABSTRACT FROM AUTHOR]

This chapter describes how institutions can best use data from the Campus Pride Index, focusing on student recruitment and resource/policy advocacy for LGBTQ constituencies. [ABSTRACT FROM AUTHOR]

Objectives The authors investigated the association between maternal birth weight and adverse birth outcome as measured by rates of low birth weight (<2500 g, LBW), preterm birth (<37 weeks, PTB), and small for gestational age (weight <10th percentile for gestational age, SGA) among African American and White twin pregnancies. Methods Stratified and multivariable regression analyses were performed on the Illinois transgenerational dataset of non-Latina African American and non-Latina White twin pairs (born 1989-1991) and their mothers (born 1956-1976). Results Former LBW (n = 104) and non-LBW (n = 742) African American mothers had LBW rates in both twins of 76 and 56 %, respectively; RR (95 % CI) = 1.4 (1.2-1.6). Former LBW (n = 105) and non-LBW (n = 2136) White mothers had LBW rates in both twins of 41 and 34 %, respectively; RR = 1.2 (0.9-1.5). In multivariable regression models, the adjusted (controlling for maternal age, education, marital status, parity, prenatal care usage, and cigarette smoking) RR of LBW in both twins among former LBW (compared to non-LBW) African American and White mothers equaled 1.4 (1.2-1.6) and 1.2 (0.9-1.5), respectively. Maternal LBW was associated with a modestly increased risk of PTB but not SGA among African American twin pregnancies: adjusted RR = 1.3 (1.1-1.4) and 1.1 (0.8-1.5), respectively. Conclusions In African American twin pregnancies, maternal LBW is a risk factor for LBW in both twins. Further research is needed to determine whether a similar generational association occurs among non-Latina White twin pregnancies. [ABSTRACT FROM AUTHOR]

Focuses on the impact of computer technology on the administration of sports medicine in the U.S. Organization of medical managerial functions; Use of athletic injury database software; Accuracy in making financial decisions; Storage of personal data.

Context The recent National Academy of Science, Engineering, and Medicine (NASEM) report entitled Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care called for action to build a strong primary care system to achieve national and individual health outcome goals. The NASEM report included a list of implementation recommendations aimed at improving the national investment in primary care. One of the recommendations was an annual national scorecard on primary care to include a parsimonious collection of primary care measures that are readily available at the national and state. Objective: We report on the development of a national scorecard on primary care based on the NASEM report. Study Design/Setting/Data/Population/Measures: Descriptive, secondary data analysis. Based on an in-depth review of available measures and data, and the NASEM Report recommendations 5 objectives and 17 measures were chosen. Results: 5 main objectives proposed by the NASEM Report. 17 individual measures. 1) Pay for primary care teams to care for people, not doctors to deliver services. 2) Ensure that high-quality primary care is available to every family in every community. 3)Train primary care teams where people live and work. 4)Design information technology that serves patients, their families, and the interprofessional primary care team. 5)Ensure that high-quality primary care is implemented in the United States. Full description of each measure, data source and analytic plan will be described. Conclusion: We can change what we can measure. The national scorecard on primary care will provide an opportunity to identify state and national policy levers to improve primary care payment, access, training, health IT, and research. [ABSTRACT FROM AUTHOR]

Purpose Providing long-acting reversible contraception (LARC) in the immediate postpartum period is an evidence-based strategy for expanding women's access to highly effective contraception and for reducing unintended and rapid repeat pregnancy. The purpose of this article is to demonstrate the application of implementation science methodology to study the complexities of rolling-out policies that promote immediate postpartum LARC use across states. Description The Immediate Postpartum LARC Learning Community, sponsored by the Association of State and Territorial Health Officials (ASTHO), is made up of multi-disciplinary, multi-agency teams from 13 early-adopting states with Medicaid reimbursement policies promoting immediate postpartum LARC. Partners include federal agencies and maternal and child health organizations. The Learning Community discussed barriers, opportunities, strategies, and promising practices at an in-person meeting. Implementation science theory and methods, including the Consolidated Framework for Implementation Research (CFIR), and a recent compilation of implementation strategies, provide useful tools for studying the complexities of implementing immediate postpartum LARC policies in birthing facilities across early adopting states. Assessment To demonstrate the utility of this framework for guiding the expansion of immediate postpartum LARC policies, illustrative examples of barriers and strategies discussed during the in-person ASTHO Learning Community meeting are organized by the five CFIR domains-intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and process. Conclusion States considering adopting policies can learn from ASTHO's Immediate Postpartum LARC Learning Community. Applying implementation science principles may lead to more effective statewide scale-up of immediate postpartum LARC and other evidence-based strategies to improve women and children's health. [ABSTRACT FROM AUTHOR]

Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists' contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVES: Low back pain (LBP), a prevalent costly condition, has evidence-based pharmacological and nonpharmacological treatments. Because the prevalence of LBP and the use of opioids differ between the U.S. Census Regions, we compared the treatments used for LBP and their related costs between regions. METHODS: Deidentified patient health claims data from persons with LBP along with treatments received were extracted from a large commercially insured data set (2007-2009; N = 1,630,438). Descriptive statistics and analyses of variance were used during data analysis. RESULTS: An opioid was used by 49.8% (n = 812,479) of this sample, whereas nonpharmacological therapies were used less frequently (8%, psychological therapies; 19%, exercise therapies; 12%, physical therapy). The median costs for pharmacological and nonpharmacological treatments are variable. We found significant differences in the medications and therapies used in the U.S. Census Regions (p < .0001). CONCLUSION: Overuse of pharmacological treatment and underuse of nonpharmacological treatment are common among persons with LBP. Differences exist in the receipt of various LBP treatments geographically. [ABSTRACT FROM AUTHOR]

Background: US-born Mexican American women have greater rates of preterm birth and consequent overall infant mortality than their Mexico-born peers. However, the relation of Mexican American women's nativity to rates of congenital anomalies is poorly understood. Hispanic ethnicity and young maternal age are well-known risk factors for gastroschisis.Objective: To determine the extent to which nativity of Mexican American women is associated with abdominal wall defects.Methods: Stratified and multivariable logistic regression analyses were performed on the 2003-2004 National Center for Health Statistics linked live birth-infant death cohort. Only Mexican American infants were studied. Maternal variables examined included nativity, age, education, marital status, parity, and prenatal care usage.Results: Infants with US-born Mexican American mothers (n=451,272) had an abdominal wall defect rate of 3.9/10,000 compared with 2.0/10,000 for those with Mexico-born mothers (n=786,878), RR=1.9 (1.5-2.4). Though a greater percentage of US-born (compared wtih Mexico-born) Mexican American mothers were teens, the nativity disparity was actually widest among women in their 20s. The adjusted (controlling for maternal age, education, marital status, parity, and prenatal care) odds ratio of abdominal wall defects among infants of US-born (compared with Mexico-born) Mexican American mothers was 1.6 (1.2-2.0).Conclusions: US-born Mexican American women have nearly a two-fold greater rate of delivering an infant with an abdominal wall defect than their Mexico-born counterparts. This phenomenon is only partially explained by traditional risk factors and highlights a detrimental impact of lifelong residence in the United States, or something closely related to it, on the pregnancy outcome of Mexican American women. [ABSTRACT FROM AUTHOR]

A paucity of published data exists on the factors underlying the relatively poor birth outcome of non-Hispanic White women in the United States. To determine whether downward economic mobility is a risk factor for preterm birth (<37 weeks, PTB) among upper class-born White women. Stratified and multilevel logistic regression analyses were performed on an Illinois transgenerational dataset of non-Hispanic White infants (1989-1991) and their women (1956-1976) with appended US census income information. The study sample was restricted to singleton births of Chicago-born upper-class (defined by early-life residence in affluent neighborhoods) non-Hispanic White women. Upper class-born White women (n = 4,891) who did not experience downward economic mobility by the time of delivery had a PTB rate of 5.4 %. Those women who experienced slight (n = 5,112), moderate (n = 2,158), or extreme (n = 339) downward economic mobility had PTB rates of 6.5, 8.5, and 10.1 %, respectively; RR (95 % CI) = 1.2 (1.0-4.0), 1.6 (1.3-1.9), and 1.9 (1.3-2.6), respectively. Maternal downward economic mobility was also associated with an increased prevalence of biologic, medical, and behavioral risk factors. Interestingly, the relationship between moderate to extreme downward mobility and preterm birth was stronger among former low birth weight (<2500 g, LBW) than non-LBW women: 2.8 (1.4-5.8) versus 1.6 (1.3-1.9), respectivel y. In multilevel logistic regression models, the adjusted odds ratio of preterm birth for former LBW and non-LBW women who experienced any downward mobility (compared to those women with lifelong upper class status) equaled 2.4 (1.1-5.3) and 1.1 (1.0-1.1), respectively. Downward economic mobility is associated with an increased risk of preterm birth among upper class-born White urban women; this phenomenon is strongest among former low birth weight women. [ABSTRACT FROM AUTHOR]

We examined experiences with technology and dating conflict among Mexican American (MA) adolescents (ages 15-17 years) using mixed qualitative methodologies. Focus groups, divided by three levels of acculturation and gender (N = 20), and videotaped observations of couples (N = 34), found that technology (i.e., cell phones, social media) afforded adolescents increased visibility of their partners’ day-to-day peer interactions. Feelings of romantic jealousy resulted in text message harassment and the expectation of immediate technology-facilitated contact. Females were more flirtatious as well as emotionally affected by jealousy resulting from social media sites, and males set rules regarding other-sex texting. Social media was particularly salient among more highly acculturated youth. Online spaces offered an opportunity for outside parties to observe unhealthy relationships and to offer support. [ABSTRACT FROM AUTHOR]

The article presents a study on the impact of the proposed worker protection standard of the U.S. Environmental Protection Agency (EPA) on farmworker protection. The study compares EPA's proposal with the Worker Protection Standard and key measures analyzed include farm labor hazards, historic occupational health, labor and immigration policy. Results suggest that revisions to the proposal should be strengthened by those suggested by farm workers and other labor laws must also be amended.

This Article examines an emerging movement so far unexplored by legal scholarship: the proposal and, in some states, the enactment of a Homeless Bill of Rights. This Article presents these new laws as a lens to re-examine storied debates over positive and social welfare rights. Homeless bills of rights also present a compelling opportunity to re-examine rights-based theories in the context of social movement scholarship. Specifically, could these laws be understood as part of a new "rights revolution"? What conditions might influence the impact of these new laws on the individual rights of the homeless or the housed? On American rights culture and consciousness? The Article surveys current efforts to advance homeless bills of rights across nine states and the U.S. territory of Puerto Rico and evaluates these case studies from a social movement perspective. Ultimately, the Article predicts that these new laws are more likely to have an incremental social and normative impact than an immediate legal impact. Even so, homeless bills of rights are a critical, if slight, step to advance the rights of one of the most vulnerable segments of contemporary society. Perhaps as significantly, these new laws present an opportunity for housed Americans to confront our collective, deeply-rooted biases against the homeless. [ABSTRACT FROM AUTHOR]