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This survey research compares the structure and practices of 7 community studio art programs for artists with disabilities in Europe to 8 studio art therapy programs in the United States. Art therapy and disability arts literature was reviewed to establish a theoretical context for this project. A survey research method was used, with statistical and narrative analysis to interpret the data. In general, more similarities than differences were found between the two samples. The theoretical and philosophical implications of these comparisons are discussed with respect to expanding models of art therapy practice. (Contains 2 tables.)

While the role of affective factors in learning is well understood in geoscience, math attitudes have been overlooked. This study sought to explore the relationships between math attitudes and geoscience attitudes, namely math anxiety, self-efficacy, and geoscience interest. Baseline data were collected from 245 undergraduate students enrolled in introductory geoscience courses at three colleges and universities in the United States, with self-report measures of math anxiety, math self-efficacy, geoscience self-efficacy, geoscience interest, and demographic information. Results show strong relationships and predictive values of math attitudes for students' geoscience attitudes, particularly for female-identifying students. This research provides important empirical support for the study of math attitudes in geoscience; additionally, educators can use this knowledge to inform their understanding of their students' math attitudes and possible interest in geoscience. [ABSTRACT FROM AUTHOR]

This article features the American Counseling Association Practice Research Network (ACA-PRN). Without additional current and ongoing research data, ACA and the counseling profession are seriously hampered when they discuss counseling outcomes. Without a sound, dynamic research base that better articulates the characteristics of practicing counselors, their respective practices, and counseling outcomes, professional counseling is unlikely to be competitive in the contemporary environment of increased accountability, managed care, and research-based practices (Sexton, Whiston, Bleuer, & Walz, 1997). Given the need for information about professional counseling, the American Counseling Association Practice Research Network (ACA-PRN) was established. The authors of this article describe the makeup of the ACA-PRN and how the ACA-PRN offers a new research model designed to provide a better link between practice and research among counseling professionals.

Candida auris is an emerging fungal threat that has been spreading in the United States since it was first reported in 2016. This article uses case counts and data on colonization screening and antifungal susceptibility testing to describe changes in the U.S. epidemiology of C auris between 2019 and 2021. Visual Abstract. Worsening Spread of Candida auris in the United States, 2019 to 2021.: Candida auris is an emerging fungal threat that has been spreading in the United States since it was first reported in 2016. This article uses case counts and data on colonization screening and antifungal susceptibility testing to describe changes in the U.S. epidemiology of C auris that occurred from 2019 to 2021. Background: Candida auris is an emerging fungal threat that has been spreading in the United States since it was first reported in 2016. Objective: To describe recent changes in the U.S. epidemiology of C auris occurring from 2019 to 2021. Design: Description of national surveillance data. Setting: United States. Patients: Persons with any specimen that was positive for C auris. Measurements: Case counts reported to the Centers for Disease Control and Prevention by health departments, volume of colonization screening, and antifungal susceptibility results were aggregated and compared over time and by geographic region. Results: A total of 3270 clinical cases and 7413 screening cases of C auris were reported in the United States through 31 December 2021. The percentage increase in clinical cases grew each year, from a 44% increase in 2019 to a 95% increase in 2021. Colonization screening volume and screening cases increased in 2021 by more than 80% and more than 200%, respectively. From 2019 to 2021, 17 states identified their first C auris case. The number of C auris cases that were resistant to echinocandins in 2021 was about 3 times that in each of the previous 2 years. Limitation: Identification of screening cases depends on screening that is done on the basis of need and available resources. Screening is not conducted uniformly across the United States, so the true burden of C auris cases may be underestimated. Conclusion: C auris cases and transmission have risen in recent years, with a dramatic increase in 2021. The rise in echinocandin-resistant cases and evidence of transmission is particularly concerning because echinocandins are first-line therapy for invasive Candida infections, including C auris. These findings highlight the need for improved detection and infection control practices to prevent spread of C auris. Primary Funding Source: None. [ABSTRACT FROM AUTHOR]

Healthcare workers are experiencing high stress and burnout, at rates up to 70%, hindering patient care. Studies often focus on stressors in a particular setting or within the context of the pandemic which limits understanding of a more comprehensive view of stressors experienced by healthcare workers. The purpose of this study was to assess healthcare workers' self-reported major stressors. Between June 2018 and April 2019, U.S. healthcare workers (N = 2,310) wrote answers to an open-ended question: "What are your biggest stressors as you look back over the last few weeks?" A summative content analysis was used to analyze the data. Healthcare workers described three types of stressors: work stressors (49% of total stressors), personal life stressors (32% of total stressors), and stressors that intersect work and personal life (19% of total stressors). Future research and clinical practice should consider the multi-faceted sources of stress. [ABSTRACT FROM AUTHOR]

Objective: To qualitatively explore and describe fertility information-seeking experiences of sexual minority women (SMW) couples using assisted reproduction.Design: Qualitative thematic analysis of 30 semistructured, in-depth individual and dyadic interviews with SMW couples.Setting: Video conferencing.Patient(s): Twenty self-identified lesbian, bisexual, and queer women comprising 10 same-sex cisfemale couples (10 gestational and 10 nongestational partners) using assisted reproduction technology in the United States.Intervention(s): Not applicable.Main Outcome Measure(s): We describe how SMW came to learn about ways to achieve pregnancy through information seeking, acquisition, appraisal, and use.Result(s): Analysis revealed three primary themes. First, uncertainty and information scarcity: SMW have basic knowledge about how to conceive but uncertainty persists due to information scarcity regarding how same-sex couples navigate assisted reproduction. Second, women attempt to collect fragmented information from disparate sources. The participants discussed a mixture of formal and informal, online, textual (books), and in-person seeking, finding, and synthesizing information that ranged from reliable to unreliable and from accurate to inaccurate. Finally, persistent heteronormative communication focused on the needs and conditions of male-female couples who experienced subfertility or infertility, rather than barriers related to social constraints and the absence of gametes that SMW sought to overcome.Conclusion(s): These findings support and extend existing evidence that has focused primarily on online fertility information seeking. Our findings suggest that shifts in fundamental assumptions about who seeks assisted reproductive support and why, together with improvements in fertility-related health communication, may result in more inclusive care for this population. [ABSTRACT FROM AUTHOR]

Background: The United States (US) Expanded Access Program (EAP) to coronavirus disease 2019 (COVID-19) convalescent plasma was initiated in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. While randomized clinical trials were in various stages of development and enrollment, there was an urgent need for widespread access to potential therapeutic agents. The objective of this study is to report on the demographic, geographical, and chronological characteristics of patients in the EAP, and key safety metrics following transfusion of COVID-19 convalescent plasma.Methods and Findings: Mayo Clinic served as the central institutional review board for all participating facilities, and any US physician could participate as a local physician-principal investigator. Eligible patients were hospitalized, were aged 18 years or older, and had-or were at risk of progression to-severe or life-threatening COVID-19; eligible patients were enrolled through the EAP central website. Blood collection facilities rapidly implemented programs to collect convalescent plasma for hospitalized patients with COVID-19. Demographic and clinical characteristics of all enrolled patients in the EAP were summarized. Temporal patterns in access to COVID-19 convalescent plasma were investigated by comparing daily and weekly changes in EAP enrollment in response to changes in infection rate at the state level. Geographical analyses on access to convalescent plasma included assessing EAP enrollment in all national hospital referral regions, as well as assessing enrollment in metropolitan areas and less populated areas that did not have access to COVID-19 clinical trials. From April 3 to August 23, 2020, 105,717 hospitalized patients with severe or life-threatening COVID-19 were enrolled in the EAP. The majority of patients were 60 years of age or older (57.8%), were male (58.4%), and had overweight or obesity (83.8%). There was substantial inclusion of minorities and underserved populations: 46.4% of patients were of a race other than white, and 37.2% of patients were of Hispanic ethnicity. Chronologically and geographically, increases in the number of both enrollments and transfusions in the EAP closely followed confirmed infections across all 50 states. Nearly all national hospital referral regions enrolled and transfused patients in the EAP, including both in metropolitan and in less populated areas. The incidence of serious adverse events was objectively low (<1%), and the overall crude 30-day mortality rate was 25.2% (95% CI, 25.0% to 25.5%). This registry study was limited by the observational and pragmatic study design that did not include a control or comparator group; thus, the data should not be used to infer definitive treatment effects.Conclusions: These results suggest that the EAP provided widespread access to COVID-19 convalescent plasma in all 50 states, including for underserved racial and ethnic minority populations. The study design of the EAP may serve as a model for future efforts when broad access to a treatment is needed in response to an emerging infectious disease.Trial Registration: ClinicalTrials.gov NCT#: NCT04338360. [ABSTRACT FROM AUTHOR]

Background We investigated patients with potential severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection in the United States during May–July 2020. Methods We conducted case finding for patients with potential SARS-CoV-2 reinfection through the Emerging Infections Network. Cases reported were screened for laboratory and clinical findings of potential reinfection followed by requests for medical records and laboratory specimens. Available medical records were abstracted to characterize patient demographics, comorbidities, clinical course, and laboratory test results. Submitted specimens underwent further testing, including reverse transcription polymerase chain reaction (RT-PCR), viral culture, whole genome sequencing, subgenomic RNA PCR, and testing for anti-SARS-CoV-2 total antibody. Results Among 73 potential reinfection patients with available records, 30 patients had recurrent coronavirus disease 2019 (COVID-19) symptoms explained by alternative diagnoses with concurrent SARS-CoV-2 positive RT-PCR, 24 patients remained asymptomatic after recovery but had recurrent or persistent RT-PCR, and 19 patients had recurrent COVID-19 symptoms with concurrent SARS-CoV-2 positive RT-PCR but no alternative diagnoses. These 19 patients had symptom recurrence a median of 57 days after initial symptom onset (interquartile range: 47–76). Six of these patients had paired specimens available for further testing, but none had laboratory findings confirming reinfections. Testing of an additional 3 patients with recurrent symptoms and alternative diagnoses also did not confirm reinfection. Conclusions We did not confirm SARS-CoV-2 reinfection within 90 days of the initial infection based on the clinical and laboratory characteristics of cases in this investigation. Our findings support current Centers for Disease Control and Prevention (CDC) guidance around quarantine and testing for patients who have recovered from COVID-19. [ABSTRACT FROM AUTHOR]

The author analyzes the implications of a non-unified field of Black studies in relation to a 2015 symposium on Black studies at the University of California and the 2017 event "Scenes @ 20" at Rutgers University. Topics discussed include his efforts to make the students aware of racial health inequality in the symposium, and scandal in the historicization offered by the book "Scenes of Subjection: Terror, Slavery, and Self-Making in 19th-Century America" examined in the Rutgers event.

The article discusses the Emergency department (ED) boarding by pediatric patients with mental health (MH) conditions prior to the COVID-19 pandemic. Topics include the increases in pediatric presentations for acute MH conditions during the COVID-19 pandemic; significant difference in ED LOS by age, ethnicity, gender, and multicenter retrospective study of children less than 18 years old who were boarding in the ED for MH conditions.

Increasingly popular in qualitative and mixed-methods research design, visual timelines help organize participants' life histories with an emphasis on temporality and the context in which important life events and experiences take place. Often, research using timelines focuses on individual participants. Yet, we know that life events, experiences, and decisions that individuals highlight in life history and narrative forms of research are relational in nature. Dyadic interviews allow for participant interaction, exploration of relationality, and the potential for increased breadth and depth in data collection. Recently, LGBTQ+ researchers have begun to evaluate dyadic approaches to timeline research. This paper describes a dyadic approach to timeline development designed to be combined with dyadic narrative interviews. We explain the data elicitation process, utility and value derived from the approach, and detail the development of post hoc linear, graphic timelines. This complementary approach leverages the strengths of dyadic narrative interviews and visual qualitative data synthesis and analysis to explore shared lives in context, highlighting their value as applied in research focused on a sample of sexual minority female couples (a community in which particular types of health disparities have been documented) from across the United States engaged in a series of clinically intensive shared decisions. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been significant research on the mental health effects of classic psychedelic use, but there is very little evidence on how classic psychedelics might influence physical health.Aims: The purpose of the present study was to investigate the associations between lifetime classic psychedelic use and markers of physical health.Methods: Using data from the National Survey on Drug Use and Health (2015-2018) with 171,766 (unweighted) adults aged 18 or above in the United States, the current study examined the associations between lifetime classic psychedelic use and three markers of physical health (self-reported overall health, body mass index, and heart condition and/or cancer in the past 12 months) while controlling for a range of covariates.Results: Respondents who reported having tried a classic psychedelic at least once in their lifetime had significantly higher odds of greater self-reported overall health and significantly lower odds of being overweight or obese versus having a normal weight. The association between lifetime classic psychedelic use and having a heart condition and/or cancer in the past 12 months approached conventional levels of significance, with lower odds of having a heart condition and/or cancer in the past 12 months for respondents who had tried a classic psychedelic at least once.Conclusion: The results of the present study suggest that classic psychedelics may be beneficial to physical health. Future research should investigate the causal effects of classic psychedelics on physical health and evaluate possible mechanisms. [ABSTRACT FROM AUTHOR]

Town and village justice courts have been the center of municipal law, both civil and criminal, since the mid-nineteenth century. However, in the modern world, they have become corrupt, poorly managed institutions, creating issues involving procedural integrity and civil rights. In order to remedy these failures and modernize the New York State Unified Court System, state legislators must look to the district court model as it currently exists in Nassau and Eastern Suffolk Counties. The district court model offers several benefits, including the imposition of educational and experiential requirements for judges, the creation of internal and external oversight institutions, the expansion of jurisdiction for local judges, and increased transparency in records and court dealings. By creating such a centralized, professionalized system of municipal courts, oversight can be expanded, procedural uniformity can be promoted, and basic civil rights now left unguarded or outright denied by justice courts can be protected. Moreover, to preserve the spirit of democratically elected local judicial offices, the Vermont justice of the peace model may be adopted in New York, creating popularly elected positions responsible for handling key local functions, such as giving oaths of office, solemnizing marriages, and hearing tax appeals. By moving away from the unwieldy, outdated town and village justice court regime, New York can catch up with a growing number of similarly minded states, move forward with its efforts to reform the justice system, and ensure that fair local justice is guaranteed to all New Yorkers--not just those living downstate. [ABSTRACT FROM AUTHOR]

Our objectives were to review the Grange as a rural community organization with the potential to increase the reach of public health efforts. We examined seven years of Grange member newsletters and publications for content pieces that reflected a public health focus and organized our findings according to the Healthy People 2020 five determinant areas within the Social Determinants of Health. Results: We found ample evidence of overlap between the goal and objectives of public health and those of the Grange. The Grange currently operates programs of education or participation in all five of the determinant areas: (1) Health and Health Care Access; (2) Social and Community Context; (3) Education; (4) Economic Stability; and (5) the Neighborhood and the Built Environment. The Grange is a grass roots rural organization that is uniquely positioned to offer a rich and nuanced partnership with public health agencies. The Grange has been contributing towards rural health for over 150 years, but despite this predisposition to the mission of public health, the Grange remains an underused community resource capable of improving rural health and addressing a variety of rural public health issues. [ABSTRACT FROM AUTHOR]

We examined the presence of sexist experiences encountered by female undergraduate students across six geology departments in the United States. Two departments graduated a high percentage of female students compared to the national average (high sites), two departments had a moderate percentage (medium sites), and two had a low percentage (low sites). Over 50% of all participants reported encountering sexism. Hostile sexism was the most frequently reported type of sexism, subtle stereotype sexism the second most frequently reported, and subtle benevolent sexism the least frequently reported. Low and medium sites had a higher percentage of participants reporting sexism than at high sites. Most of the hostile experiences were reported at low and medium sites, and nearly 50% of participants at those site types reported sexist experiences, suggesting that there may be a more pervasive hostile social climate in low and medium sites. These findings suggest that sexism may be common within the six geology departments and particularly at low and medium sites. We speculate that hostile sexism may serve as a barrier for recruitment and retention of women in low and medium sites. [ABSTRACT FROM AUTHOR]

Objective: Obesity and its complications place an enormous burden on society. Yet antiobesity medications (AOM) are prescribed to only 2% of the eligible population, even though few individuals can sustain weight loss using other strategies alone. This study estimated the societal value of greater access to AOM.Methods: By using a well-established simulation model (The Health Economics Medical Innovation Simulation), the societal value of AOM for the cohort of Americans aged ≥ 25 years in 2019 was quantified. Four scenarios with differential uptake among the eligible population (15% and 30%) were modeled, with efficacy from current and next-generation AOM. Societal value was measured as monetized quality of life, productivity gains, and savings in medical spending, subtracting the costs of AOM.Results: For the 217 million Americans aged ≥ 25 years, AOM generated $1.2 trillion in lifetime societal value under a conservative scenario (15% annual uptake using currently available AOM). The introduction of next-generation AOM increased societal value to $1.9 to $2.5 trillion, depending on uptake. Finally, societal value was higher for younger individuals and Black and Hispanic individuals compared with White individuals.Conclusions: This study suggests that AOM provide substantial gains to patients and society. Policies promoting broader clinical access to and use of AOM warrant consideration to reach national goals to reduce obesity. [ABSTRACT FROM AUTHOR]

Background: Novel psychedelics approximate classic psychedelics, but unlike classic psychedelics, novel psychedelics have been used by humans for a shorter period of time, with fewer data available on these substances.Aims: The purpose of this study was to determine the prevalence of novel psychedelic use and the associations of novel psychedelic use with mental health outcomes.Methods: We estimated the prevalence of self-reported, write-in lifetime novel psychedelic use and evaluated the associations of novel psychedelic use with psychosocial characteristics, past month psychological distress, and past year suicidality among adult respondents pooled from years 2008-2016 of the National Survey on Drug Use and Health (weighted n=234,914,788).Results: A fraction (weighted n=273,720; 0.12%) reported lifetime novel psychedelic use. This cohort tended to be younger, male, and White, have greater educational attainment but less income, be more likely to have never been married, engage in self-reported risky behavior, and report lifetime illicit use of other drugs, particularly classic psychedelics (96.9%). (2-(4-Bromo-2,5-dimethoxyphenyl)ethanamine) (2C-B) (30.01%), (2,5-dimethoxy-4-iodophenethylamine) (2C-I) (23.9%), and (1-(2,5-dimethoxy-4-ethylphenyl)-2-aminoethane) (2C-E) (14.8%) accounted for the majority of lifetime novel psychedelic use. Although lifetime novel psychedelic use was not associated with psychological distress or suicidality compared to no lifetime novel psychedelic use or classic psychedelic use, relative to lifetime use of classic psychedelics but not novel psychedelics, lifetime novel psychedelic use was associated with a greater likelihood of past year suicidal thinking (adjusted Odds Ratio (aOR)=1.4 (1.1-1.9)) and past year suicidal planning (aOR=1.6 (1.1-2.4)).Conclusion: Novel psychedelics may differ from classic psychedelics in meaningful ways, though additional, directed research is needed. [ABSTRACT FROM AUTHOR]

Background The Kidney Donor Risk Index (KDRI)/Kidney Donor Profile Index (KDPI) is relied upon for donor organ allocation in the USA, based on its association with graft failure in time-to-event models. However, the KDRI/KDPI has not been extensively evaluated in terms of predictive metrics for graft failure and allograft estimated glomerular filtration rate (eGFR) outside of the USA. Methods We performed a retrospective analysis of outcomes in the Irish National Kidney Transplant Service Registry for the years 2006–13. Associations of the KDRI/KDPI score with eGFR at various time points over the follow-up and ultimate graft failure were modelled. Results A total of 772 patients had complete data regarding KDRI/KDPI calculation and 148 of these allografts failed over the follow-up. The median and 25–75th centile for KDRI/KDPI was 51 (26–75). On repeated-measures analysis with linear mixed effects models, the KDRI/KDPI (fixed effect covariate) associated with eGFR over 5 years: eGFR = −0.25 (standard error 0.02; P < 0.001). The variability in eGFR mathematically accounted for by the KDRI/KDPI score was only 21%. The KDRI/KDPI score did not add significantly to graft failure prediction above donor age alone (categorized as > and <50 years of age) when assessed by the categorical net reclassification index. Conclusions In this cohort, while the KDRI/KDPI was predictive of eGFR over the follow-up, it did not provide additive discrimination above donor age alone in terms of graft failure prediction. Therefore it is unlikely to help inform decisions regarding kidney organ allocation in Ireland. [ABSTRACT FROM AUTHOR]

Each fall, thousands of Rocky Mountain Sandhill Cranes and other migratory birds congregate at the Bosque del Apache National Wildlife Refuge in New Mexico's Rio Grande Valley in search of wintering habitat. As such, this refuge is known as one of the premier destinations for bird viewing and photography in the United States. Using contingent valuation data, this case study quantifies the value associated with migratory bird recreation at this refuge to be $7.5 million in 2010. It is estimated that this annual value increased by more than $6.4 million in 2017 due to growth in annual refuge visitation. [ABSTRACT FROM AUTHOR]

The difference in food prices to blacks and to whites is one source of urban unrest. The author surveys the answers to the question, "Do blacks pay more?" An effort is made to show what is known and where further research is needed. This article is an example of the potential role of marketing research in public policy. [ABSTRACT FROM AUTHOR]

The article presents a list of articles and other information resources related to accounting that can help U.S. labor unions in their operations. They include "State Laws Requiring Union Registration and Financial Reports," published in Vol. 64, pp. 1052-1056 of "Monthly Labor Review," "How Rich Are the Unions: Organized Labor Is Neither Weak Nor Poor, the Unions Have Been Growing Through the Years," by J. J. Daly published in the "Nations Business." There are booklets such as Guide for UPWA Local Unions' Financial Secretary-Treasurers," by Lewis J. Clark.

Background: Organizations that encourage the respectful expression of diverse spiritual views have higher productivity and performance, and support employees with greater organizational commitment and job satisfaction. Within healthcare, there is a paucity of studies which define or intervene on the spiritual needs of healthcare workers, or examine the effects of a pro-spirituality environment on teamwork and patient safety. Our objective was to describe a novel survey scale for evaluating spiritual climate in healthcare workers, evaluate its psychometric properties, provide benchmarking data from a large faith-based healthcare system, and investigate relationships between spiritual climate and other predictors of patient safety and job satisfaction.Methods: Cross-sectional survey study of US healthcare workers within a large, faith-based health system.Results: Seven thousand nine hundred twenty three of 9199 eligible healthcare workers across 325 clinical areas within 16 hospitals completed our survey in 2009 (86% response rate). The spiritual climate scale exhibited good psychometric properties (internal consistency: Cronbach α = .863). On average 68% (SD 17.7) of respondents of a given clinical area expressed good spiritual climate, although assessments varied widely (14 to 100%). Spiritual climate correlated positively with teamwork climate (r = .434, p < .001) and safety climate (r = .489, p < .001). Healthcare workers reporting good spiritual climate were less likely to have intentions to leave, to be burned out, or to experience disruptive behaviors in their unit and more likely to have participated in executive rounding (p < .001 for each variable).Conclusions: The spiritual climate scale exhibits good psychometric properties, elicits results that vary widely by clinical area, and aligns well with other culture constructs that have been found to correlate with clinical and organizational outcomes. [ABSTRACT FROM AUTHOR]

Background Healthcare is approaching a tipping point as burnout and dissatisfaction with work-life integration (WLI) in healthcare workers continue to increase. A scale evaluating common behaviours as actionable examples of WLI was introduced to measure work-life balance. Objectives (1) Explore differences in WLI behaviours by role, specialty and other respondent demographics in a large healthcare system. (2) Evaluate the psychometric properties of the work-life climate scale, and the extent to which it acts like a climate, or group-level norm when used at the work setting level. (3) Explore associations between work-life climate and other healthcare climates including teamwork, safety and burnout. Methods Cross-sectional survey study completed in 2016 of US healthcare workers within a large academic healthcare system. Results 10 627 of 13 040 eligible healthcare workers across 440 work settings within seven entities of a large healthcare system (81% response rate) completed the routine safety culture survey. The overall work-life climate scale internal consistency was α=0.830. WLI varied significantly among healthcare worker role, length of time in specialty and work setting. Random effects analyses of variance for the work-life climate scale revealed significant between-work setting and within-work setting variance and intraclass correlations reflected clustering at the work setting level. T-tests of top versus bottom WLI quartile work settings revealed that positive work-life climate was associated with better teamwork and safety climates, as well as lower personal burnout and burnout climate (p<0.001). Conclusion Problems with WLI are common in healthcare workers and differ significantly based on position and time in specialty. Although typically thought of as an individual difference variable, WLI appears to operate as a climate, and is consistently associated with better safety culture norms. [ABSTRACT FROM AUTHOR]

Hereditary angioedema (HAE) with C1 esterase inhibitor (C1-INH) deficiency (C1-INH-HAE) is a rare disease characterized by diminished levels or dysfunctional activity of C1-INH, leading to dysregulated plasma kallikrein activity within the kallikrein-kinin pathway. Symptoms manifest as painful, potentially life-threatening swelling of subcutaneous tissues throughout the body and/or submucosal edema in the upper airway or gastrointestinal tract. Attacks recur with unpredictable frequency, intensity, and duration, placing a heavy burden on patients' daily lives. Despite improved availability of medications for on-demand treatment during attacks and prophylaxis of future attacks, unmet needs remain. Lanadelumab, a fully human monoclonal antibody, may help address some of the limitations of existing prophylactic options (e.g., the need for intravenous administration or frequent dosing). Preclinical studies demonstrate that it is highly potent and specifically inhibits plasma kallikrein, and findings from phase Ia and Ib studies suggest this agent is well tolerated and provides sustained inhibition of plasma kallikrein, allowing for less frequent dosing. The phase III HELP Study (NCT02586805) evaluating the efficacy and safety of lanadelumab in preventing HAE attacks has been completed, and its open-label extension (NCT02741596) is ongoing. Lanadelumab is now approved in the USA and Canada for prophylaxis to prevent attacks of HAE in patients aged ≥ 12 years. This review provides an overview of the discovery and clinical development of lanadelumab, from preclinical through phase Ib studies, characterizing its safety/tolerability, efficacy, and pharmacokinetic and pharmacodynamic profiles. It also highlights how this agent may positively impact clinical care of patients with C1-INH-HAE. [ABSTRACT FROM AUTHOR]

The article discusses how decision-making authority on matters ranging from resource utilization to curriculum development should be allocated between a law school and its university, as discussed in a book related to Fordham University School of Law by Robert J. Kaczorowski.

An editorial is presented which discusses the role of family physicians in the prevention of gun violence in the U.S. Topics include the paper developed by the American Academy of Family Physicians (AAFP), encouraging public health approach to prevent the violence, the increase in the number of gun homicides in the country, and the importance of motivational interviewing and counseling in reducing firearm access and improving the rates of safe gun storage.

The spatial distribution of storm-based severe weather warnings, local storm reports, and radar-detected storm cells around six large cities in the central United States is examined from October 2007 to May 2017. The cities are Columbus, Ohio; Cincinnati, Ohio; Indianapolis, Indiana; Louisville, Kentucky; Nashville, Tennessee; and St. Louis, Missouri. In all six cities, warning counts within 20 km of the city center are found to vary by 20%–40%. In every city except St. Louis, a maximum in warnings is located 5–15 km to the east (downwind) of the city center. Additional analysis reveals that the location of the warning maxima often varies with wind direction. Areas of enhanced convective activity are also evident in and around each city. Many of these areas are found to the east of the city center and are coincident with areas of increased warnings. This alignment could suggest that urban influences are creating areas of enhanced severe weather potential on the eastern side of large cities. However, there are also instances where the locations of maxima in warnings, local storm reports, and convective activity are spatially offset. In these locations, it is possible that other factors are impacting the distribution of one or more of these fields. [ABSTRACT FROM AUTHOR]

Substance misuse is prevalent among veterans entering the criminal justice system, and is related to recidivism. Research demonstrates that trauma exposure and posttraumatic stress (PTS) symptoms, which commonly co-occur with substance misuse, also increase the risk of legal involvement and recidivism. However, it is unclear whether the associations between trauma, PTS symptoms and violent and nonviolent crime may be conflated by substance use. The aim of the present study was to understand the association between PTS symptoms and criminal justice involvement (both violent and nonviolent crime) among substance-using veterans seeking Veterans Affairs (VA) specialty mental health care after accounting for substance use frequency and demographics including age, gender, and ethnicity. Further, this study examined whether specific clusters of PTS were associated with violent and nonviolent veteran offending. Participants included 697 veterans (52 women) aged 21 to 75 (M -- 47.49, SD = 13.51) with a history of trauma exposure. Veterans self-reported past-month PTS symptoms, substance use, and lifetime legal charges. Logistic regression results indicated total PTS symptoms were associated with violent, but not nonviolent charges, above and beyond age, sex, race, cocaine use, and heavy alcohol use. Intrusion symptoms, in particular, were associated with violent charges. Results highlight the utility of examining PTS as a multifaceted construct and have implications for the assessment and treatment needs of justice-involved veterans. For example, the findings suggest that treatment needs appear to differ for those reporting violent or nonviolent offending, with a greater need for assessing and treating PTS for those involved with violent crime. [ABSTRACT FROM AUTHOR]

Beginning in the fall of 2020, in response to reader comments and the historic heightened awareness of racism as a public health crisis,1American Family Physician (AFP) editors have taken steps to improve our approach to and the advancement of health equity. Like many other journals across the United States and the world, AFP has historically fallen short in presenting diverse perspectives, and by not recognizing or challenging implicit biases in editorial content we have been silently complicit in allowing racial health disparities to persist. This editorial discusses enhancements to our editorial processes, improvements in representation in articles on skin conditions, and the addition of author guidance on the critical appraisal of medical literature. [ABSTRACT FROM AUTHOR]

As the percentage of older adults aged 65 and over continues to rise dramatically in the United States and globally, psychology must develop ways to meet the behavioral health needs of this age group. The psychology workforce devoted to working with older adults is insufficient, and one consequence of this deficit is the underidentification of behavioral health symptoms in this age group, often closing the door for further intervention. Older adults with mild-moderate symptoms and who reside in rural and/or underresourced areas are least likely to seek help for behavioral health concerns, and, when they do, it is most often requested from their primary care provider who may not recognize symptoms as indicative of a behavioral health concern. Psychologists in training participated in a clinical experience to improve their competence in providing services to older adults. This training and community engagement experience focused on the identification of mild-moderate behavioral health symptoms within a rural, community-dwelling older adult population over a 6-year span. Students provided behavioral health screenings, psychoeducation, feedback, and referral to assessment/treatment services for older adults during regional health and wellness events. Screening results revealed high rates of anxiety, mild neurocognitive disorder, and depressive symptomology in our sample (n = 658) of older adults, providing evidence for routine and systematic screening and early detection of behavioral health symptoms in the older adult age group. Impacts on readiness to work with older adults by those who completed this clinical training experience are discussed. [ABSTRACT FROM AUTHOR]

Pain is an increasing clinical challenge affecting about half the population, with a substantial number of people suffering daily intense pain. Such suffering can be linked to the dramatic rise in opioid use and associated deaths in the United States. There is a pressing need for new analgesics with limited side effects. Here, we summarize what we know about the genetics of pain and implications for drug development. We make the case that chronic pain is not one but a set of disease states, with peripheral drive a key element in most. We argue that understanding redundancy and plasticity, hallmarks of the nervous system, is critical in developing analgesic drug strategies. We describe the exploitation of monogenic pain syndromes and genetic association studies to define analgesic targets, as well as issues associated with animal models of pain. We appraise present-day screening technologies and describe recent approaches to pain treatment that hold promise. [ABSTRACT FROM AUTHOR]

The mid-nineteenth century witnessed a revolution in steam transportation. This essay considers how innovations in transport transformed North America's politics and economics, with special focus given to the imperial formations and structures that accompanied the introduction of new systems of steam infrastructure. The essay also considers opposition to steam transport, arguing that conflicts over infrastructure left their mark on the era's national and transnational politics. [ABSTRACT FROM AUTHOR]

Rationale: Existing real-time surveillance of influenza morbidity, based primarily on time-trended U.S. hospitalization and death data, is inadequate. These surveillance methods do not accurately predict hospital resource requirements or sufficiently capture the public health impact of the current influenza season.Objectives: To determine the feasibility and potential usefulness of tracking surrogate markers of influenza morbidity among patients hospitalized with influenza.Methods: We performed a pilot study at three tertiary care referral hospitals and retrospectively collected and analyzed data on patients admitted with influenza during the 2013-2014 influenza season. We analyzed traditional influenza surveillance metrics, including weekly statistics on admissions and deaths, as well as weekly rates and trends of intensive care unit (ICU), mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) utilization.Results: In our three-hospital cohort, 431 patients were hospitalized with influenza and spent a total of 1,520 days in ICUs. Eighty-six (20%) of these patients required 1,080 days of mechanical ventilation, and 17 patients (4%) received 229 days of ECMO. Trends of ICU and mechanical ventilation use were similar but differed notably from trends of ECMO use, hospitalization, and death. In particular, at two hospitals, increases in utilization of ICU and mechanical ventilation among patients with influenza occurred several weeks after increases in hospitalization rates. Furthermore, ICU, mechanical ventilation, and ECMO utilization rates at the three-hospital network remained elevated for several weeks after the influenza-associated hospitalization rate declined.Conclusions: Surrogate markers of influenza severity were feasible to collect and revealed trends of ICU resource utilization that differed notably from trends of hospitalization and death given by traditional influenza surveillance metrics. A national network of sentinel hospitals that prospectively collects, time-trends, and reports additional influenza morbidity data would be useful to hospital administrators, hospital epidemiologists, infection preventionists, and public health officials. [ABSTRACT FROM AUTHOR]

The article evaluates the structure of the U.S. food and agricultural supply chain as of October 2017 by focusing on concentrations at the manufacturing and retailing levels and coordination across vertical stages. Topics discussed include performance of the food marketing sector in meeting the challenges facing it. Also mentioned are the implications of policies implemented to guide the evolution of the food production industry.

Background Improving the resiliency of healthcare workers is a national imperative, driven in part by healthcare workers having minimal exposure to the skills and culture to achieve work--life balance (WLB). Regardless of current policies, healthcare workers feel compelled to work more and take less time to recover from work. Satisfaction with WLB has been measured, as has work--life conflict, but how frequently healthcare workers engage in specific WLB behaviours is rarely assessed. Measurement of behaviours may have advantages over measurement of perceptions; behaviours more accurately reflect WLB and can be targeted by leaders for improvement. Objectives 1. To describe a novel survey scale for evaluating work--life climate based on specific behavioural frequencies in healthcare workers. 2. To evaluate the scale's psychometric properties and provide benchmarking data from a large healthcare system. 3. To investigate associations between work-life climate, teamwork climate and safety climate. Methods Cross-sectional survey study of US healthcare workers within a large healthcare system. Results 7923 of 9199 eligible healthcare workers across 325 work settings within 16 hospitals completed the survey in 2009 (86% response rate). The overall work-life climate scale internal consistency was Cronbach &#945=0.790. t-Tests of top versus bottom quartile work settings revealed that positive work-life climate was associated with better teamwork climate, safety climate and increased participation in safety leadership WalkRounds with feedback (p<0.001). Univariate analysis of variance demonstrated differences that varied significantly in WLB between healthcare worker role, hospitals and work setting. Conclusions The work-life climate scale exhibits strong psychometric properties, elicits results that vary widely by work setting, discriminates between positive and negative workplace norms, and aligns well with other culture constructs that have been found to correlate with clinical outcomes. [ABSTRACT FROM AUTHOR]

Objectives: This study examines the main and moderating effects of childhood abuse or neglect severity, income, and family social support on the presence of postpartum depressive symptoms (PDS). Methods: Participants included 183 postpartum mothers who endorsed a history of childhood maltreatment (CM) and enrolled in a longitudinal study of mother and child outcomes. Participants completed questionnaires to assess CM severity, associated societal and maternal characteristics, and depressive symptom severity. Results: The results confirm previously identified links between CM severity and PDS. Further, hierarchical linear regression analyses indicate the interaction of household income and interpersonal support from the family attenuates the relationship between CM severity and PDS. The final model accounted for 29% of the variance of PDS scores, a large effect size. Conclusions: This study is the first to demonstrate interrelationships between income and social support on resilience to postpartum psychopathology in childhood trauma-surviving women. Social support appeared to protect against PDS for all mothers in this study while income only conferred a protective effect when accompanied by family support. For clinicians, this implies the need to focus on improving family and other relationships, especially for at-risk mothers. [ABSTRACT FROM AUTHOR]

This paper introduces expressive writing as a new tool to build psychological resilience in nurses by helping them to reduce the negative impact of the primary sources of stress in their jobs. Delivering care to patients exposes nurses to intense stressors including staffing and workload problems, communication breakdowns, death, bereavement, and medical error. Not surprisingly, these conditions contribute to job dissatisfaction and burnout which are primary causes of nurse turnover. There is an acute need for low cost and simple interventions that enhance nurses' coping with problems leading up to burnout and turnover. We found almost 2 out of 3 RNs reported trouble sleeping, almost half reported feeling burned out, and 1 out of 4 were depressed. Expressive writing has been widely used and is well validated in many non-nursing populations in helping people cope more effectively with job-related stress and traumatic events. Writing improves health in several ways. One way is through exposure, the process by which difficult emotions become less potent and more manageable. Second is cognitive restructuring, which brings about new ways of thinking about stress that makes painful events less upsetting. Third is improved self-regulation, which is the ability to cope with and regulate one's emotions. The well-being of nurses directly affects the quality of patient care. Expressive writing is a time-efficient and easy-to-use intervention to help nurses cope with job upheavals in an effort to reduce job distress, turnover and, ultimately, improve the work environment and patient outcomes. [ABSTRACT FROM AUTHOR]

Objective. Posttraumatic stress disorder (PTSD) and pain are frequently comorbid conditions that can result in bidirectional exacerbations. Initial research suggests physical activity may prevent PTSD symptoms or assist with recovery. Unfortunately, Veterans with PTSD are less likely to engage in physical activity, often citing pain as a primary reason. The current study examines the potential role of physical activity as a moderator of the pain and PTSD relationship. Design. Data were collected from 239 Veterans who were seeking PTSD treatment at a Veterans Affairs (VA) hospital between 2006 and 2013. Veterans completed the Clinician-Administered PTSD Scale (CAPS) to measure PTSD severity and self-report inventories to measure pain and physical activity. Multiple moderated linear regressions were used to examine the influence of physical activity on the relationship between pain and PTSD symptoms. Results. Pain severity and interference were associated with more severe PTSD. Physical activity did not have main effects on PTSD severity. However, it did moderate the relationship between PTSD and pain, such that those who were active, despite high levels of pain severity or pain interference, had fewer PTSD symptoms. Conclusions. For Veterans seeking treatment for PTSD, physical activity was particularly salient for those reporting high levels of pain severity and intensity. While assessment of pain is recommended with all Veterans, it may also be beneficial to evaluate physical activity in those with prominent pain complaints. Further examination of the role of exercise in integrated care for pain and PTSD is warranted. [ABSTRACT FROM AUTHOR]

This article addresses the relationship between anti-racism and decolonization in the North American context. It argues that the logic of decolonization movements for indigenous sovereignty and against the settler states of Canada and the USA overlap the discursive field of contemporary post-racialism in ways that circumvent the challenges and possibilities offered by black radicalism in the historic instance. After engaging recent theoretical literature on settler colonialism, it is suggested that the freedom drive that abolishes slavery unsettles both colonial and decolonial forms of sovereign determination. [ABSTRACT FROM AUTHOR]

Objective: To replicate and expand upon the relationship of somatic symptoms and posttraumatic stress disorder (PTSD) by comparing symptoms among service eras in US Veterans.Method: Data were collected from 226 Vietnam and 132 Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans who were referred to a Veterans Affairs (VA) hospital PTSD outpatient clinic between 2005 and 2013. Veterans were administered self-report inventories and a clinical interview to measure somatic symptoms and PTSD severity. A subset of Veterans (n=185) screening positive for PTSD were administered the Clinician Administered PTSD Scale (CAPS) to measure PTSD severity. Multiple moderated linear regressions were used to examine the influence of service era on the relationship between somatic and PTSD symptoms.Results: There were no significant differences between service eras in pain severity, pain interference, and total somatic symptoms reported. Vietnam Veterans were more likely to report limb/join pain (p<.05), fainting (p<.01), and shortness of breath (p<.001), whereas OIF/OEF Veterans were more likely to complain of headaches (p<.001). A significant interaction effect occurred between service era and dizziness (p<.05) and chest pain (p<.01), with OIF/OEF Veterans reporting higher levels of these symptoms significantly more likely than Vietnam Veterans to also experience more severe PTSD.Conclusion: Findings are consistent with previous research demonstrating the relationship of somatic symptoms and PTSD across service eras but provide additional data concerning similarities and differences of somatic symptoms between eras. Potential explanations for observed service era differences in somatic symptoms are discussed. [ABSTRACT FROM AUTHOR]

Background:Poor sleep among college students is a major, growing problem associated with lower academic performance, higher rates of health and emotional problems, and development of chronic sleep disorders.Purpose:Though previous studies have focused on individual colleges, our study purpose was to reveal the association of behaviors and function to sleep quality in a large sample of students from across the United States.Methods:We analyzed data from the Fall 2009 American College Health Association's National College Health Assessment–II survey using descriptive statistics, independent samplettests, chi-square tests, and logistic regression to find a representative, matched sample of 14 870 college students, both with and without a sleep problem, measured by daytime sleepiness.Results:Our correlational analysis revealed that sleep quality decreased with increasing levels of stress or alcohol/cigarette use and with decreasing levels of general health (allPs < .001).Discussion:College interventions should include efforts to address sleep quality to improve students' academic performance and long-term quality of life, especially for students experiencing substantial stress or poor general health.Translation to Health Education Practice:Educators, advisors, and leaders should incorporate sleep quality improvements into their services and programs for all students, especially students in at-risk groups. [ABSTRACT FROM PUBLISHER]

The research reported in this article is part of a larger study designed to identify teacher- and student- level factors and conditions associated with American Indian and Alaska Native (AI/AN) student achievement on the National Assessment of Education Progress (NAEP) annual mathematics assessment and as reflected in the associated survey data gathered through the National Indian Education Study (NIES) on American Indians and Alaska Natives, their teachers, and their schools. We conducted statistical analyses of 2007 NAEP data in Phase I, and in Phase II we analyzed extensive qualitative data collected in 10 schools in Alaska, New Mexico, and Arizona. We focus on data from administrator interviews and teacher focus groups to identify the formative assessment strategies these educators believe to be eff ective with AI/AN students. Our findings identify formative assessment strategies that may help improve teacher instructional practices and impact school policy related to AI/AN student math learning; the data suggest that not all strategies will be effective across communities, due to complex contextual factors. [ABSTRACT FROM AUTHOR]

The dimensions that define a food product have expanded rapidly to include characteristics of the production process, marketing arrangements, and implications that production and consumption of the product have for the environment. Some market intermediaries have responded by requiring that their suppliers abide by restrictive production practices. We examine the economic effects of such restrictions and apply this analysis to limitations on the use of antibiotics in U.S. pork production. Results from conceptual and simulation analyses show that, in the absence of demand growth, less pork is sold due to higher costs in the restricted segment, and both pork consumers (on average) and producers are harmed. Demand growth of between 6-11% from adding new consumers who will consume the restricted (antibiotic-free) product but not the conventional product is needed to return consumer surplus to the level in the base case, and between 2-4% demand growth was required to return producer surplus to base. When restricted and conventional products are modeled using a vertical differentiation framework, results depend importantly on the ease with which consumers can switch to a seller who offers their desired product type. Significant distributional impacts among consumers are present when switching costs are prohibitive. [ABSTRACT FROM AUTHOR]

Seven investigations of suspected foci of amebiasis between October 1971 and June 1974 lead to three conclusions. (1) A number of laboratories have vastly overdiagnosed amebiasis and have reported leukocytes in stools as Entamoeba histolytica. Two laboratories found to be in error were in community hospitals, and one was at a teaching hospital associated with a medical school and a school of public health. These three laboratories had been diagnosing more than 1200 cases of amebiasis a year for 20 years. (2) When amebiasis does occur, it is likely to be misdiagnosed. In one outbreak with four cases and three deaths, amebiasis was not diagnosed until two patients had died and another was critically ill. Sporadic cases may be mistakenly diagnosed as ulcerative colitis and inappropriately treated with steroids. (3) Foci of endemic amebiasis continue to exist in the United States, both in institutions and in noninstitutional settings. [ABSTRACT FROM AUTHOR]

A recurring concern in TOD pricing studies has been that short term experimental TOD rates may not stimulate as much conservation as would occur if TOD rates were implemented on a permanent basis. That is, how accurately do experimental TOD pricing results extend to nonexperimental settings? The present paper provides information relevant to this adjustment question. We examine a little analyzed component of the TOD pricing experiment conducted by the Southern California Edison (SCE) Company, wherein a subset of the TOD treatment households had a continuous-display, electricity use monitoring device installed mid- way through the experiment. The SCE experiment was one of 14 TOD pricing studies initiated by the U.S. Department of Energy (DOE). Most analyses of TOD pricing have been based on DOE-initiated studies, but this experiment was the only such study to include the monitoring component. [ABSTRACT FROM AUTHOR]