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The article discusses the inadequacies of using cost-benefit research as a means for decision-making regarding extensive public undertakings, such as the U.S. Lower Snake dams. It mentions that social and political decisions in Cost-Benefit Analysis (CBA) incorporate the value of non-market goods and activities, with non-market costs and benefits playing a vital role in determining outcomes.

Introduction: The United States Medical Licensing Examination (USMLE) Step 1 test evolved into a key metric utilized by program directors (PDs) in assessing candidates for residency. The transition to a USMLE Step 1 binary pass/fail scoring system has resulted in a loss of an important objective assessment. With national movements toward pass/fail systems for clerkship grading and trends toward abandonment of class ranking, assessing residency applications has become increasingly challenging., Methods: The Society of Academic Urologists convened a task force to, in part, assess the perspectives of urology PDs regarding the importance of various aspects of a residency application for predicting clinical performance. An anonymous survey was disseminated to all urology PDs in the US. Perspectives on 11 potential application predictors of clinical performance and demographics were recorded. Descriptive statistics characterized PD responses. Friedman test and pairwise Wilcoxon tests were used to evaluate the relative ranks assigned to application elements by PDs., Results: There was a 60.5% response rate (89/147). Letters of recommendation (LORs) were ranked as the most important predictor, with a mean rank of 2.39, median of 2 (IQR 1-3). Clerkship grades and USMLE Step 1 were comparable and ranked second. Medical school reputation ranked the lowest. There was significant subjective heterogeneity among categories; however, this was less so for LORs, which predominated as the most important factor among application elements ( P < .001)., Conclusions: To our knowledge, this is the largest sample size assessing PD perspectives on application factors that predict clinical performance. The second (clerkship grades) and third (USLME Step 1) most important factors moving toward binary pass/fail systems create an opportunity for actionable change to improve assessment objectivity. Our data demonstrate LORs to be the most important factor of residency applications, making a compelling argument for moving toward a standardized LOR to maximize this tool, mitigate bias, and improve interreviewer reliability.

Background: Parenteral nutrition (PN) shortages and lack of qualified professional staff to manage PN impact safe, efficacious care and costs of PN. This American Society for Parenteral and Enteral Nutrition (ASPEN)-sponsored survey assessed the frequency and extent to which PN access affects PN delivery to patients., Methods: Healthcare professionals involved with PN were surveyed. Questions were developed to characterize the respondent population and determine the extent and severity of PN access issues to components, devices, and healthcare professionals, as well as their effects on discharge and transfer issues. Reimbursement issues included cost, adequacy of therapy, and healthcare professional reimbursement. Burdens were types and frequency of errors, adverse events, and nutrition problems resulting from PN access issues. Impact on professionals and organizations was determined., Results: Respondents (N = 350) worked in hospitals (75%) and home infusion (25%). Per day, clinicians cared for <15 patients receiving PN. All age populations were represented. Respondents reported shortages of macronutrients (72%, 233 of 324) and micronutrients (91%, 297 of 324). Issues with access to healthcare workers were observed. PN access issues contribute to increased costs of PN, and knowledge regarding the current rate of PN reimbursement is limited. Respondents (75%, 197 of 261) observed an error due to PN access issues. Adverse events (57%, 149 of 259) were observed leading to temporary or permanent harm (24%, 61 of 259) as well as near death (4%, 9 of 259) and death (1%, 2 of 259). Providers reported time away from other job responsibilities and workplace stress., Conclusion: PN access issues result in "PN insecurity" that negatively impacts patients and healthcare providers and leads to adverse events including death in patients receiving PN., (© 2023 American Society for Parenteral and Enteral Nutrition.)

Whenever athletes willfully or accidentally ingest performance-enhancing drugs or other banned substances (such as drugs of abuse), markers of those drugs can be detected in biological samples (e.g., biofluids: urine, saliva, blood); in the case of some drugs, that evidence can be apparent for many weeks following the last exposure to the drug. In addition to the willful use of prohibited drugs, athletes can accidentally ingest banned substances in contaminated dietary supplements or foods and inadvertently fail a drug test that could mean the end of an athletic career and the loss of a good reputation. The proliferation of performance-enhancing drugs and methods has required a corresponding increase in the analytical tools and methods required to identify the presence of banned substances in biofluids. Even though extraordinary steps have been taken by organizations such as the World Anti-Doping Agency to limit the use of prohibited substances and methods by athletes willing to cheat, it is apparent that some athletes continue to avoid detection by using alternative doping regimens or taking advantage of the limitations in testing methodologies. This article reviews the testing standards and analytical techniques underlying the procedures used to identify banned substances in biological samples, setting the stage for future summaries of the testing required to establish the use of steroids, stimulants, diuretics, and other prohibited substances. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. The Association of Academic Physiatrists convened a Women's Task Force in 2016, under the leadership of then Association of Academic Physiatrists President Gerard Francisco, MD, to evaluate data and metrics pertaining to the representation and inclusion of female physiatrists in the society. An initial published report focused on a retrospective analysis of data in categories such as leadership, conference presentations, and recognition awards. The findings, which highlighted areas in which the Association of Academic Physiatrists had been successful in supporting gender equity as well as areas in which female physiatrists were underrepresented, provided a base from which to strategically focus on closing gaps in representation. The task force developed an action plan that was approved by the Board of Trustees and included strategies aimed at closing gaps and collecting data to determine corresponding effectiveness. Because most of the categories fell under the supervision of various Association of Academic Physiatrists committees, an appointee from each committee ("diversity steward") liaised with the Women's Task Force. The diversity stewards reviewed the plan with their respective committees and collected data within their committee's purview. This task force follow-up report documents recent progress, consistent with the Association of Academic Physiatrists Board of Trustees commitment to transparency and gender equity. [ABSTRACT FROM AUTHOR]

The article explores how the American society and law can evolve in response to disruptive events such as the COVID-19 pandemic and the death of African American George Floyd. Topics discussed include philosophers John Rawls and Robert Nozick's different views of justice and fairness, self-interest and caring in tort law, and ways that the law of torts could be reformed to embody ethics of care and mutual respect.

The article presents a message from the author as president of Library Information Technology Association (LITA). Topics discussed include how being LITA president also means being president of a division of the American Library Association, the role of speaking to a diverse community, and the other Division Vice Presidents as part of the team of the president.

Background: Unfortunately, racism and discrimination against Ethnic minority (EM) has been globalized, universally infecting industries worldwide, and the field of nursing has not been spared. In the United States (US), overt and institutionalized racism (IR) still permeates the fields of nursing, nursing leadership, and nursing education. Programs to address these disparities, and efforts by nursing professional societies and nursing education policymaking bodies to address racism in the nursing field, specifically with nursing leadership and education, have met with little success. Objective: The purpose of this paper is to illustrate the existence and magnitude of racism and its impact on the fields of nursing, nursing leadership, and nursing education, and to make evidence-based recommendations for an agenda for reforming nursing education in the US. Methods: A narrative literature review was conducted with a focus on pulling together the strongest evidence on which to base policy recommendations. Results: Based on the available literature, we put forth five recommendations aimed at modifying nursing education in the US as a strategy to counter IR in the US in the nursing field. Conclusions: Recommendations to address IR in nursing focus on nursing education, and involve implementing programs to address the lack of opportunity for both EM students and faculty in nursing, developing an anti-discriminatory pedagogy, and incorporating diversity initiatives as key performance indicators (KPIs) in the process of approval and accreditation of nursing programs. [ABSTRACT FROM AUTHOR]

Competing Interests: None.

The practice of forensic psychiatry requires balance; the forensic psychiatrist encounters the need for balance routinely and in a variety of areas. Balance is necessary for sound judgment and objectivity when striving for excellence in the field. It is also necessary to effectively balance a career in forensic psychiatry with one's personal life. The American Academy of Psychiatry and the Law (AAPL) has stressed the virtue of balance in the preamble of its ethics guidelines, noting the importance of balancing competing obligations to the individual and society. Keeping in mind the importance of balance will assist forensic psychiatry with the many challenges of a postinternet era, such as rapidly changing technology, culture, and society. A substantial challenge for forensic psychiatry, now and in the future, involves data overflow and the so-called big data explosion. Information now flows too fast and in such vast amounts that a single individual can no longer keep pace. Balance may be pursued by adapting and leveraging certain skills to confront these challenges more effectively. The current inflection point of rapid technological, social, and cultural change, stresses the importance of balance through teamwork, technology, and prioritizing civil discourse., (© 2024 American Academy of Psychiatry and the Law.)

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Background: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Although adenotonsillectomy is first-line management for pediatric OSA, up to 40% of children may have persistent OSA. This document provides an evidence-based clinical practice guideline on the management of children with persistent OSA. The target audience is clinicians, including physicians, dentists, and allied health professionals, caring for children with OSA. Methods: A multidisciplinary international panel of experts was convened to determine key unanswered questions regarding the management of persistent pediatric OSA. We conducted a systematic review of the relevant literature. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to rate the quality of evidence and the strength of the clinical recommendations. The panel members considered the strength of each recommendation and evaluated the benefits and risks of applying the intervention. In formulating the recommendations, the panel considered patient and caregiver values, the cost of care, and feasibility. Results: Recommendations were developed for six management options for persistent OSA. Conclusions: The panel developed recommendations for the management of persistent pediatric OSA based on limited evidence and expert opinion. Important areas for future research were identified for each recommendation.

Background: Identifying groups at increased risk for political violence can support prevention efforts. We determine whether "Make America Great Again" (MAGA) Republicans, as defined, are potentially such a group., Methods: Nationwide survey conducted May 13-June 2, 2022 of adult members of the Ipsos KnowledgePanel. MAGA Republicans are defined as Republicans who voted for Donald Trump in the 2020 presidential election and deny the results of that election. Principal outcomes are weighted proportions of respondents who endorse political violence, are willing to engage in it, and consider it likely to occur., Findings: The analytic sample (n = 7,255) included 1,128 (15.0%) MAGA Republicans, 640 (8.3%) strong Republicans, 1,571 (21.3%) other Republicans, and 3,916 (55.3%) non-Republicans. MAGA Republicans were substantially more likely than others to agree strongly/very strongly that "in the next few years, there will be civil war in the United States" (MAGA Republicans, 30.3%, 95% CI 27.2%, 33.4%; strong Republicans, 7.5%, 95% CI 5.1%, 9.9%; other Republicans, 10.8%, 95% CI 9.0%, 12.6%; non-Republicans, 11.2%, 95% CI 10.0%, 12.3%; p < 0.001) and to consider violence usually/always justified to advance at least 1 of 17 specific political objectives (MAGA Republicans, 58.2%, 95% CI 55.0%, 61.4%; strong Republicans, 38.3%, 95% CI 34.2%, 42.4%; other Republicans, 31.5%, 95% CI 28.9%, 34.0%; non-Republicans, 25.1%, 95% CI 23.6%, 26.7%; p < 0.001). They were not more willing to engage personally in political violence., Interpretation: MAGA Republicans, as defined, are more likely than others to endorse political violence. They are not more willing to engage in such violence themselves; their endorsement may increase the risk that it will occur., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wintemute et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Life in Hollywood in the 1950s seemed completely at odds with the moral foundations of authoritarian Portugal. By looking at the coverage of the lives of Hollywood stars in Portuguese magazines, however, it is possible to imagine how a conservative society could be exposed to changing values. Readers became acquainted with the period's most famous cases of divorce. Divorce was at first seen as unacceptable, but the continuous news on the lives of famous people produced a strange impact on the Portuguese public sphere: the end of marriage became familiar and even acceptable in some circumstances. The article disentangles this paradox, by treating magazines as a mediated social actor. The foreign origin of the news may have led readers to assume that divorce was a distant phenomenon. Simultaneously, the social circulation of magazines permeated the everyday with subversive ideas. Magazines thus constitute a decisive source for exploring how North American cultural forms work through the fabric of foreign societies. Imagining the impact of Hollywood in Portugal through the mediation of magazines allows us to identify forms of social change evolving in an apparently uneventful decade, and to grasp the contribution of feelings and attitudes in historical transformation. [ABSTRACT FROM AUTHOR]

The article draw attention to a further way in which contract is wreaking its revenge. Topics include examines that prevalence of waivers has produced something that neither Gilmore nor Prosser saw coming: a waiver society in which contract has once again, as it last did more than a century ago, succeeded in displacing large swaths of tort; and announce a new website dedicated to collecting, displaying, and marveling at the sheer chutzpah and lush variety of waivers in American life.

Objective: Assess the effects of American Council for Graduate Medical Education (ACGME) resident work hour restrictions on the preparedness of incoming facial plastic surgery fellows as assessed by American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) fellowship directors. Methods: Observational survey study evaluating the perception of ACGME resident duty hour change on resident surgical and clinical skills from fellowship directors of AAFPRS fellowship programs in the US. A cross-sectional survey was sent to 47 fellowship directors of AAFPRS fellowship programs. Perceived change in resident clinical and surgical skills were measured using a 5-point Likert scale (1 = significantly improved, 2 = improved, 3 = neither improved nor worsened, 4 = worsened, 5 = significantly worsened) to evaluate 15 benchmarks. Results: Responses received from 36 fellowship directors. The results indicate no statistically significant perceived trend of ACGME duty hour reform on fellows for AAFPRS fellowships among fellowship directors. However, cohort analysis demonstrated that fellowship directors with more than 10 years of service perceived a more negative impact in 2 clinical benchmarks (assessment/planning and basic exposure) over time. Conclusions: The study results appear to show no significant perceived trend over time on the effect of duty hour reform on fellows for AAFPRS fellowships among fellowship directors. However, there are some apparent opinion differences between fellowship directors separated by years of service, with more negative perceptions noted in 2 clinical areas by those with more than 10 years of service. This study is in line with the more recent literature that suggests a trend toward a less negative perception of the duty hour change. This may suggest resident education is adapting to the ACGME duty hour regulations. [ABSTRACT FROM AUTHOR]

This study investigated characteristics and trends associated with sports- and recreation-related dental injuries among children <18 years old treated in US emergency departments using data from the National Electronic Injury Surveillance System for 2000 to 2017. There were an estimated 198 787 (95% confidence interval = 162 216-235 358) injuries during the study period, averaging 11 044 injuries annually. The rate of dental injuries per 100 000 US population <18 years old fluctuated during the study, starting at 16.9 in 2000 and ending at 13.9 in 2017. Injuries most commonly occurred among males (69.8%) and children 7 to 12 years old (44.6%). Pediatric sports- and recreation-related dental injuries were most commonly associated with bicycles (28.6%), playground equipment (15.3%), and baseball/softball (12.4%). Although emergency department visits for pediatric sports- and recreation-related dental injuries decreased during the study period overall, sports and recreation remain an important source of preventable dental injury, particularly among children 7 to 12 years old. [ABSTRACT FROM AUTHOR]

The article discusses the political and environmental activism of gardening clubs in the U.S. in the early 20th century. It examines the alleged propensity of garden clubs to preserve and plant native species of plants. The author states that garden clubs illustrated the regionalism the American landscape tradition. The article discusses organizations such as the Washington Roadside Council (WRC), the California Native Plant Society (CNPS), and the Native Plant Conservation Campaign (NPCC).

The article discusses the results of a survey of readers regarding the Library and Information Technology Association (LITA). Survey results are discussed for topics including the demographics of LITA members, the level of satisfaction that readers have with LITA and the journal, and readers' views on the direction that LITA should take in the future.

The article offers "Civil War History" news briefs. The U.S. organization Scholars Research Program is offering grants to qualified scholars. Josepth T. Glatthaar has been awarded the 2008 Jefferson Davis Award for outstanding narrative work. The Society of Civil War Historians is holding its first annual Tom Watson Brown Book Award.

The article presents a collection of news briefs related to finance in the United States. In 2004 the American Financial Association board authorized a History of Finance project with Stephen Buser named as historian. The 2007 annual meeting of the American Financial Association was held January 5-7 in Chicago, Illinois. Professor Kenneth French was the Program Chair. The American Financial Association and the Department of Finance have entered into a joint venture to maintain and enhance the finance faculty directory on the University's website.

Deals with the origin of nuclear secrecy throughout World War II and the Cold War in the United States. Security measures at several nuclear laboratories; Decline in security restrictions after World War II; Stance of the Federation of American Scientists on nuclear energy; Contradictory effects of the limits to communication imposed by classification of government documents.

The article presents the report of the Executive Secretary and Treasurer of the American Finance Association. Blackwell Publishers continues to do a good job with the Association's printing and publishing needs. All back issues of the "Journal of Finance" up through Volume 52 of 1997 are now available online. The Association's finances are in good shape, even though membership has experienced a small decline from 1997 to 1999. The Annual Meeting for 2000 will be held in Boston, Massachusetts on January 7-9, 2000.

Background The utility of traditional academic factors to predict residency candidates' performance is unclear. Many programs utilize holistic review processes assessing applicants on an expanded range of application and interview characteristics. Determining which characteristics might predict performance-related difficulty in residency is needed. Objective We aim to elucidate factors associated with residency performance-related difficulty in a large academic internal medicine residency program. Methods In 2022, we conducted a retrospective cohort study of Electronic Residency Application Service and interview data for residents matriculating between 2018 and 2020. The primary outcome was a composite of performance-related difficulty during residency (referral to the Clinical Competency Committee; any rotation evaluation score of 2 out of 5 or lower; and/or a confidential "comment of concern" to the program director). Logistic regression models were fit to assess associations between resident characteristics and the composite outcome. Results Thirty-eight of 117 residents met the composite outcome. Gold Humanism Honor Society (odds ratio [OR] 0.24, 95% confidence interval [CI] 0.16-0.87) or Alpha Omega Alpha (OR 0.36, 95% CI 0.14-0.99) members were less likely to have performance-related difficulty, as were residents with higher United States Medical Licensing Examination Step 2 Clinical Knowledge scores (OR 0.97, 95% CI 0.47-1.00). One-point increases in general faculty overall interview score, leadership competency score, and leadership overall score were associated with 41% to 63% lower odds of meeting the composite outcome. Interview or file review "flags" had an OR of 2.82 (95% CI 1.37-5.80) for the composite outcome. Conclusions Seven metrics were associated with the composite outcome of resident performance-related difficulty.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. While must is the term to be used in the guidelines, if an entity that adopts the guideline has shall as the preferred term, the AAPM considers that must and shall have the same meaning. Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances., (© 2023 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.)

Objectives. To determine the level of preparedness among New York City community-based organizations by using a needs assessment. Methods. We distributed online surveys to 582 human services and 6017 faith-based organizations in New York City from March 17, 2016 through May 11, 2016. We calculated minimal indicators of preparedness to determine the proportion of organizations with preparedness indicators. We used bivariate analyses to examine associations between agency characteristics and minimal preparedness indicators. Results. Among the 210 human service sector respondents, 61.9% reported emergency management plans and 51.9% emergency communications systems in place. Among the 223 faith-based respondents, 23.9% reported emergency management plans and 92.4% emergency communications systems in place. Only 10.0% of human services and 18.8% of faith-based organizations reported having funds allocated for emergency response. Only 2.9% of human services sector and 39.5% of faith-based sector respondents reported practicing emergency communication alerts. Conclusions. New York City human service and faith-based sector organizations are striving to address emergency preparedness concerns, although notable gaps are evident. Public Health Implications. Our results can inform the development of metrics for community-based organizational readiness. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the properties of a frailty index (FI), constructed using data from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort, as a novel health measure in systemic lupus erythematosus (SLE). Methods: For this secondary analysis, the baseline visit was defined as the first study visit at which both organ damage (SLICC/American College of Rheumatology Damage Index [SDI]) and health‐related quality of life (Short‐Form 36 [SF‐36] scores) were assessed. The SLICC‐FI was constructed using baseline data. The SLICC‐FI comprises 48 health deficits, including items related to organ damage, disease activity, comorbidities, and functional status. Content, construct, and criterion validity of the SLICC‐FI were assessed. Multivariable Cox regression was used to estimate the association between baseline SLICC‐FI values and mortality risk, adjusting for demographic and clinical factors. Results: In the baseline data set of 1,683 patients with SLE, 89% were female, the mean ± SD age was 35.7 ± 13.4 years, and the mean ± SD disease duration was 18.8 ± 15.7 months. At baseline, the mean ± SD SLICC‐FI score was 0.17 ± 0.08 (range 0–0.51). Baseline SLICC‐FI values exhibited the expected measurement properties and were weakly correlated with baseline SDI scores (r = 0.26, P < 0.0001). Higher baseline SLICC‐FI values (per 0.05 increment) were associated with increased mortality risk (hazard ratio 1.59, 95% confidence interval 1.35–1.87), after adjusting for age, sex, steroid use, ethnicity/region, and baseline SDI scores. Conclusion: The SLICC‐FI demonstrates internal validity as a health measure in SLE and might be used to predict future mortality risk. The SLICC‐FI is potentially valuable for quantifying vulnerability among patients with SLE, and adds to existing prognostic scores. [ABSTRACT FROM AUTHOR]

Female genital mutilation/cutting (FGM/C) is common across the globe and seen in high income countries that host migrants from high prevalence countries. Management of FGM/C in the host countries can be complicated due its often conflicting social, cultural, ethical, legal, and medical dynamics. Health profession organizations often create policy and position statements that set the tone and direction for the organization and describe desired methods, behaviors and actions applicable to the entire organization and its members. It is unclear whether or what organizational statements exist on FGM/C. We reviewed publicly available statements made by health profession organizations whose members care for women and girls affected by or at risk for, FGM/C, and assessed their content related to medicalization, reinfibulation and vacation cutting. Of a total of 47 organizations, 24 (51%) had any statements. Of 15 physician organizations, only 4 (26%) US-based physician organizations had any statements. 17 had specific statements on clinician involvement, but the tone and instructional nature varied. Re-infibulation was mentioned by 41% organizations with statements. 29% mentioned vacation cutting. Many, but not all, health profession organizations have statements for their members on FGM/C, and those vary in what is covered, and in what recommendations are given. Health profession organizations serve and are the face and voice of their members. As such, they have a responsibility to educate their members, set the tone for the conversation, and make their stand clear to their members and other stakeholders, including patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine whether there was difference in the OASIS (Outcome and Assessment Information Set) activities of daily living (ADL) items scores between the Safe Strides program and Safe Strides plus Zōntago program. Eight home care offices were selected for this prospective randomized quality improvement study where Safe Strides versus Safe Strides plus Zōntago were compared. Rehabilitation outcome OASIS ADL change scores were analyzed for 112 total patient care episodes. The Safe Strides + Zōntago mean total ADL score change and ADL change per visit were higher than the Safe Strides group. Differences in ADL outcomes in older adults undergoing home care provided by physical therapists and physical therapist assistants in the Safe Strides exercise program versus the Safe Strides plus Zōntago program were noted. The Safe Strides + Zōntago compared with Safe Strides alone improved patient functional outcomes as measured by the OASIS. [ABSTRACT FROM AUTHOR]

It is widely believed that there is a crisis of confidence in law enforcement in the United States. What remains to be seen, however, is whether adolescents actually differentiate between legal authorities and other types of authorities. Leveraging cross-sectional, nationally representative data of 12th graders from every year from 2006 to 2017 from Monitoring the Future (N = 10,941), the results indicate that adolescents distinguish between legal authorities (e.g., law enforcement, justice system) and social authorities (e.g., schools, religious institutions). Youth report more confidence in social authorities than in legal authorities. Furthermore, whereas confidence in social authorities remained largely stable between the cohorts over the last decade, confidence in legal authorities, and in law enforcement in particular, has declined markedly. Although there may be an era of mistrust in legal authorities, it cannot be attributed to a ubiquitous anti-authority attitude among modern adolescents in the United States. [ABSTRACT FROM AUTHOR]

Given the increasing number and diversity of older adults and the transformation of health care services in the United States, it is the position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior that all older adults should have access to evidence-based food and nutrition programs that ensure the availability of safe and adequate food to promote optimal nutrition, health, functionality, and quality of life. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, in partnership with other practitioners and nutrition educators, should be actively involved in programs that provide coordinated services between the community and health care systems that include regular monitoring and evaluation of programming outcomes. The rapidly growing older population, increased demand for integrated continuous support systems, and rising cost of health care underscore the need for these programs. Programs must include food assistance and meal programs, nutritional screening and assessment, nutrition education, medical nutrition therapy, monitoring, evaluation, and documentation of evidence-based outcomes. Coordination with long-term care services and support systems is necessary to allow older adults to remain in their homes; improve or maintain their health and manage chronic disease; better navigate transitions of care; and reduce avoidable hospital, acute, or long-term care facility admissions. Funding of these programs requires evidence of their effectiveness, especially regarding health, functionality, and health care–related outcomes of interest to individuals, caregivers, payers, and policy makers. Targeting of food and nutrition programs involves addressing unmet needs for services, particularly among those at high risk for poor nutrition. Registered dietitian nutritionists and nutrition and dietetics technicians, registered must increase programmatic efforts to measure outcomes to evaluate community-based food and nutrition services. It is the position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior that older adults should have access to evidence-based food and nutrition programs that ensure the availability of safe and adequate food to promote optimal nutrition, health, functionality, and quality of life. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, in partnership with other practitioners and nutrition educators, should be actively involved in programs that provide coordinated services between the community and health care systems that include regular monitoring and evaluation of programming outcomes. The rapidly growing older population, increased demand for integrated continuous support systems, and rising cost of health care underscore the need for these programs. [ABSTRACT FROM AUTHOR]

Graduate nutrition training in the United States prepares graduates for careers in academia, industry, and government and nongovernment sectors by enhancing critical thinking skills and providing specific technical skills necessary for doctoral-level employment. However, it is often not designed to develop skills in leadership that are key to fully successful careers. The Dannon Institute's Nutrition Leadership Institute was initiated in 1998 to provide leadership training to fill this gap and to enable early-career nutrition scientists to achieve their career goals. After 20 years of experience with the Nutrition Leadership Institute, this article describes the program's genesis and evolution, captures its key features and principal outcomes as expressed by alumni, and highlights its value to its participants and the larger nutrition community. [ABSTRACT FROM AUTHOR]

The official vision of the U.S. Alzheimer's Association is "A world without Alzheimer's disease." The "dual mission" of the organization is "to eliminate Alzheimer's disease through the advancement of research and to enhance care and support for individuals, their families and caregivers." Using numerous reports from leading researchers and practitioners, a case is made by which the "dual mission" is grossly unbalanced with predominant focus on biomedical research aimed at curing the disease compared to research and practices focused on the psycho-social impacts of and adaptations to living with it. These experts discuss the likelihood of curing the disease, the complexity of realizing this goal, and the urgent need to "bring back the social and psychological aspects" of living with dementia to center stage. The moral responsibility to balancing the "dual mission" in accordance with the original motivation of the grassroots organizations who formed the association in 1980 is discussed. [ABSTRACT FROM AUTHOR]

Introduction: A recent study of pediatric organ donation after the neurologic determination of death (DNDD) demonstrated an association between the use of donor management goals (DMGs) by organ procurement organizations (OPOs) and organ yield. Objective: To describe the pediatric DMGs used by OPOs and any association between specific DMGs and organ yield. Design: Query of US OPOs who utilized DMGs in the care of pediatric DNDD organ donors from 2010 to 2013. Results: All 23 OPOs using DMGs for pediatric DNDD organ donors during the study period participated (100%). The OPOs pursued an average 9.6 goals (standard deviation: 3.9; range: 5-22) with 113 unique definitions that targeted 33 aspects of donor hemodynamics, gas exchange/mechanical ventilation, electrolytes/renal function, blood products, thermoregulation, and infection control. The DMGs used by >50% of OPOs included blood pressure, oxygenation (partial pressure of arterial oxygen (PaO2), oxygen saturation of hemoglobin by pulse oximetry, or PaO2/fractional concentration of inspired oxygen [FiO2] ratio), pH, central venous pressure, serum sodium, urine output, limitations on inotropic support, and serum glucose. There was no significant correlation between the number of DMGs pursued by OPOs and organ yield. There was a difference in the observed/expected organs transplanted in the 0- to 10-year age-group for OPOs that included serum creatinine among their DMGs (P =.046). Conclusions: The pediatric DMGs used by OPOs were generally measurable but diverse in definition and the number of goals pursued. There was no benefit in organ yield from larger DMG bundles. There may be a benefit in organ yield through the use of serum creatinine as a DMG in pediatric donors aged 0 to 10 years. [ABSTRACT FROM AUTHOR]

The article discusses the consequences of repeated concussions from high impact sports such as football, soccer, hockey, wrestling,rugby, and lacrosse, particularly concussion among high school girls. Topics discussed include the association between downhill skiing, martial arts, horse riding, and parachuting and traumatic brain injury (TBI), a study by National Football League (NFL) on brain damage among football players, and development of chronic traumatic encephalopathy.

Child welfare supervisors have a unique vantage point, leading local service delivery efforts while representing a larger organizational bureaucracy. They also play a key role in workforce stability, as high caseworker turnover remains a real problem that affects clients, communities, and agency budgets. Using a qualitative thematic content analysis to analyze data collected from a sample of public child welfare supervisors in a southern state (n = 117), findings from this study provide suggestions for systematically addressing workforce turnover through the unique perspective of the child welfare supervisor. Supervisors made recommendations to improve agency infrastructure, organizational climate, and organizational culture as areas for immediate consideration to address this significant problem. [ABSTRACT FROM AUTHOR]

Attention to the need for a trauma-informed systems approach to child well-being has grown in the past decade. Technology has the potential to improve how child welfare agencies implement trauma-informed systems reform. As new technological innovations emerge to support and sustain the implementation of trauma informed practices, broad dissemination is imperative (Breyette, 2014). This paper describes the rationale for and details of technological solutions supporting and sustaining the implementation of trauma-informed interventions in three states. [ABSTRACT FROM AUTHOR]

"How are you going to feed your baby?" Such a seemingly simple question. Yet, invariably, mothers will be besieged by advice as to their infant-feeding choice from well-meaning others. Such advice can be reassuring or discouraging, supportive or conflicting. Each pregnant woman deserves accurate information to form an infant-feeding decision that is right for her. That decision (whether to exclusively breastfeed, partially breastfeed, or not to breastfeed at all) will inherently conflict with the opinions of others. Only each mother is able to decide what is right for her and her infant, and that decision may need to change over time. This commentary distills the wisdom of decades of professional practice devoted to advising mothers on infant-feeding decisions. [ABSTRACT FROM AUTHOR]