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Quarantine guidelines that arose with the COVID-19 pandemic limited opportunities for social interaction, raising concerns about increases in intimate partner violence and cyberabuse while simultaneously restricting access to help. The current study assessed increases in cyberabuse, sexual aggression, and intimate partner violence victimization and perpetration during the first year of the COVID-19 pandemic in a U.S. nationally representative sample of young adults ages 18 to 35, recruited from a probability-based household panel. Data were collected between November 2020 and May 2021. Descriptive analyses were conducted to assess the prevalence of any self-reported increase in cyberabuse, sexual aggression, or intimate partner victimization or perpetration during the COVID-19 pandemic. Logistic regression models were run for each outcome measuring any increase compared to no increase. Approximately one in ten U.S. young adults ages 18 to 35 reported experiencing an increase in cyberabuse victimization (12.6%) and cyberabuse perpetration (8.9%) during the pandemic. Similar proportions were observed for increased sexual aggression victimization (11.8%) and perpetration (9.0%). More than one in five respondents (21.4%) reported that their intimate partner was more physically, sexually, or emotionally aggressive toward them during the pandemic. Conversely, 16.2% of respondents reported that they were more physically, sexually, or emotionally aggressive themselves toward an intimate partner, compared to their behavior before the onset of the pandemic. Having an intimate partner and staying at home more than usual during the pandemic were protective factors for both cyberabuse and sexual aggression victimization. Respondent age, education, and race and ethnicity were not associated with increased victimization or perpetration of cyberabuse or sexual aggression. However, women reported lower odds of increased sexual aggression perpetration than men. These findings improve understanding of changes to interpersonal abuse and associated risk factors during a period of social disruption. [ABSTRACT FROM AUTHOR]

Zoltán Kodály, a Hungarian composer, ethnomusicologist, and music educator, is widely known for his philosophical and pedagogical contributions to music education. The purpose of this article was to trace the development of the Kodály movement in the United States from its implementation in the 1960s to present day. Questions that guided the research were (1) Who was Zoltán Kodály and what was his philosophy of music education? (2) Who were some of the American music educators who initially implemented the Kodály concept in the United States and what role did they play in the spread of the concept? and (3) How has the Kodály concept evolved in the United States? Following an overview of Kodály and his philosophy, the contributions of Mary Helen Richards, Denise Bacon, Lois Choksy, and Sr. Lorna Zemke during the early years of the Kodály movement are discussed. The evolution of the Kodály concept is discussed in relation to the work of Lois Choksy, Ann Eisen and Lamar Robertson, John Feierabend, Susan Brumfield, and Mícheál Houlahan and Philip Tacka. A conclusion includes suggestions for the advancement of the Kodály concept, including the need for research on the methods of the approach.

Climate classification is a commonly used tool to simplify, visualize and make sense of an otherwise unwieldy amount of climate data in applied climate science research. Typically, these classifications have stemmed from one of two perspectives, either a circulation‐to‐environment (C2E) approach, or an environment‐to‐circulation approach (E2C), each with advantages and drawbacks. This research discusses a novel environment‐to‐circulation‐to‐environment (ECE) perspective to applied climate classification, and develops a specific ECE methodology that utilizes canonical correlation and discriminant analysis—the CANDECE method. The benefits of the ECE approach generally, and the CANDECE methodology specifically, are demonstrated in applying climate classification to aid in modelling anomalous water levels (AWLs) along portions of the East and West coasts of the United States. Results show that the CANDECE method performs better than two traditional classification methods (k‐means and self‐organizing maps [SOMs]) at relating AWLs to their broad‐scale atmospheric setups, especially with regard to both high and low extreme AWLs. It is further demonstrated that, compared with the West coast, the CANDECE method is particularly advantageous along the southeastern US coast, where the primary modes of atmospheric variability (which drive the classifications produced by SOMs and k‐means) do not align with the relevant circulation‐based factors driving AWL variability. While AWLs were utilized for demonstrating the ECE proof‐of‐concept herein, ECE and CANDECE are designed to be useful for any climate application. [ABSTRACT FROM AUTHOR]

Rozanolixizumab (rozanolixizumab-noli; RYSTIGGO®), a humanized IgG4 monoclonal antibody with a high affinity and specificity for human neonatal Fc receptor (FcRn; which plays a vital role in the transport, distribution and persistence of IgG), is an effective and generally well tolerated treatment option in adults with acetylcholine receptor (AChR) or muscle-specific kinase (MuSK) autoantibody-positive generalized myasthenia gravis (gMG). Administered subcutaneously once weekly for 6 weeks, with subsequent treatment cycles based on clinical evaluation, it is approved for the treatment of adults with gMG in the EU, Japan and the USA. In the pivotal, multinational, phase 3 MycarinG study, one 6-week cycle of rozanolixizumab ≈ 7 mg/kg or ≈ 10 mg/kg improved multiple disease-related outcomes versus placebo, with the benefits sustained following repeated treatment cycles according to a pooled analysis of data from the phase 3 study and two phase 3 extension studies. While increased infection susceptibility could be a consequence of the transient reduction in IgG levels with rozanolixizumab therapy, no severe or serious infections were reported in either rozanolixizumab group in the pivotal study. Plain Language Summary: Myasthenia gravis (MG) is a disease in which an individual's own IgG antibodies damage the communication between nerves and voluntary muscles, thereby weakening the muscles. Eye movements, speech, swallowing, breathing and use of the limbs are affected. A cure is not yet available, with treatment (based on changing or suppressing the immune system) aimed at easing symptoms and improving well-being. Rozanolixizumab (rozanolixizumab-noli; RYSTIGGO®) is an IgG4 antibody that targets a receptor that plays a vital role in the transport, distribution and persistence of IgG. It is administered under the skin once weekly for 6 weeks, with further treatment based on the initial response to rozanolixizumab. In adults with generalized MG, the administration of rozanolixizumab once weekly for 6 weeks improved various disease-related outcomes versus placebo, with the benefits sustained following repeated treatment. Rozanolixizumab was generally well tolerated by these patients, with repeated treatment associated with an acceptable safety profile. Headache was the most frequently reported treatment-emergent adverse event. Thus, rozanolixizumab is an effective and generally well tolerated treatment option in adults with generalized MG. [ABSTRACT FROM AUTHOR]

Parental participation and cooperation in children's educational experiences is positively related to important student outcomes. It is becoming increasingly evident that context is a significant factor in understanding academic achievement, and the setting in which a child, family, and school is situated is among the salient contexts influencing performance. Although the family-school partnership research literature has increased over recent decades, it has been conducted primarily in urban and suburban settings. The goals of this paper are to (a) review the empirical literature on family involvement and family-school partnerships in rural schools, (b) provide a synthesis of the state of the science, and (c) point to a research agenda in this area. Eighteen studies were identified that met the criteria for this review. A critique of the research methods and analytical approaches is provided, along with a call for more research on the topic of family-school partnerships in rural settings, including rigorous and systematic studies pertaining to the effects of family-school involvement and partnerships in rural schools. (Contains 2 tables and 1 endnote.)

Followership, being an understudied concept, raises fundamental questions: How did followership develop? Why do people submit into becoming followers? The developmental trajectory for the development of individual attributes is as yet, uncharted. Current study provides an overview of assessed attributes of followers, as proposed by Antelo (2010). Statistical survey design and correlation procedures are applied to assess selected variables and their relationship when examining the results of a multicultural survey conducted among leaders and followers in Russia, Belarus, United States, Bolivia, Mexico and Italy, totaling in over 400 members. Findings indicate that individual worker motivation influences performance and productivity. Results of the study also illustrate that leaders typically rate themselves higher than followers do. The study discusses the need to understand how individual traits are developed, discovered, and how individuals can be formed, nurtured and prepared to become effective leaders as well as effective followers. The criticality of certain attributes characteristic to both leaders and followers is examined along with the need to analyze how some attributes can be changed. Evolutionary approach in personal development and formation of individual attributes is taken into a great consideration.

Context: The pediatric population is more susceptible to sustaining concussion and experiencing more severe and prolonged symptoms as compared with adults. Current evidence indicates conflicting beliefs within the interdisciplinary team in terms of best practices for managing pediatric concussion. Objectives: (1) To describe current practices on interdisciplinary coordination among physical therapists (PTs) and athletic trainers (ATs) during management and return to play (RTP) of children and adolescents with concussion and (2) to describe their confidence in implementing RTP protocols, their comprehension of concussion legislation, and scope of practice of their profession regarding returning pediatric athletes to sport postconcussion. Design and Methods: A 34-item anonymous survey containing questions regarding demographics, confidence with concussion management, knowledge of sports-related concussion state legislation, beliefs of interdisciplinary concussion management team, and referral/communication patterns was electronically distributed through alumni networks. Participants: 141 respondents (80 ATs and 61 PTs). Results: Only 12.5% of ATs believed that PTs had any role in the initial concussion management, whereas 65% of PTs regarded the role of ATs in initial management as important. In terms of legislation, 44% of PTs and 12.5% of ATs were unsure of state laws pertaining to concussion management or health care professions responsible for RTP. There was consensus among PTs and ATs (61 %) in the lack of interdisciplinary coordination of care and lack of awareness among physician groups regarding RTP protocols. Within their respective disciplines, a greater proportion of PTs (63%) agreed that the process of care lacked standardization as compared with ATs (21%). Conclusion: Lack of interdisciplinary communication and collaboration during management of pediatric concussion may cause premature RTP that may lead to catastrophic effects on the developing pediatric brain. Barriers regarding education, time management, knowledge of state laws, and understanding other professions' scope of practice need to be further addressed to ensure safe RTP. [ABSTRACT FROM AUTHOR]

There has been limited examination of the phenomenon of the victim-offender overlap in the field of technology-facilitated abuse (TFA). To design effective strategies to prevent TFA, it is important to understand which individuals are most at risk of victimization, perpetration, and to what extent a subset of people both experience victimization and engage in perpetration. This study drew on Cyber-Abuse Research Initiative (CARI) data, a nationally representative U.S. sample of adults ages 18–35. TFA measurement consisted of parallel scales for victimization and perpetration, each with 27 items assessing forms of technology-facilitated surveillance, monitoring/tracking, interference/communications, reputational harm, controlling/limiting access, and fraud. A bivariate probit of TFA perpetration and TFA victimization, as separate outcomes, was fit to allow for joint estimation of regression coefficients and robust standard errors. Analyses confirmed that TFA, similar to other forms of interpersonal aggression, is characterized by a substantial victim-offender overlap, with 30 percent of the sample reporting involvement both as a victim and as a perpetrator. Internet/social media use and social isolation did not distinguish victimization and perpetration. However, positive and negative affect as well as Lesbian, Gay, Bisexual, Queer, Asexual, or other sexual orientation (LGBQA+) were positively correlated with victimization, whereas female gender and having postsecondary education were positively associated with perpetration. These results may be used to design interventions and anticipate service needs. TFA, as a new topic of research, should capitalize on the theoretical and empirical article related to other forms of the victim-offender overlap. [ABSTRACT FROM AUTHOR]

Recovery housing is an important resource for those in recovery from substance use disorders. Unfortunately, we know little about its relationship to key community health risk and protective factors, potentially limiting the role it could play as a broader health resource. Leveraging county-level data on recovery residences from the National Study of Treatment and Addiction Recovery Residences (NSTARR), this study used multilevel modeling to examine Community COVID Vulnerability Index (CCVI) scores as well as availability of COVID testing and vaccination sites in relation to recovery housing. CCVI composite scores were positively associated with recovery housing availability. Analyses using CCVI thematic sub-scores found that population density and number of churches were positively associated with recovery housing availability, while epidemiological factors and healthcare system factors were negatively associated with recovery housing availability. In counties with recovery housing, there also was a positive association between CCVI and both COVID testing and vaccination availability. Recovery residences tend to be located in areas of high COVID vulnerability, reflecting effective targeting in areas with higher population density, more housing risk factors, and other high-risk environments and signaling a key point of contact to address broader health issues among those in recovery from substance use disorders. [ABSTRACT FROM AUTHOR]

Pozelimab (pozelimab-bbfg; VEOPOZ™) is a fully human immunoglobulin (Ig) G4P (i.e. IgG4 with a proline substitution to promote stabilization of the disulfide bonds between the two heavy chains) monoclonal antibody developed by Regeneron Pharmaceuticals Inc., to block the activity of complement factor 5 (C5) and prevent diseases mediated by the complement pathway. In August 2023, pozelimab received its first approval for the treatment of adults, and paediatric patients aged ≥ 1 year with CD55-deficient protein-losing enteropathy (PLE), also known as CHAPLE disease, in the USA. It is the first US FDA-approved treatment for this disease. In the USA, pozelimab has been granted orphan drug designations for the treatment of paroxysmal nocturnal haemoglobinuria (PNH) [both as a monotherapy and in combination with cemdisiran] and for the treatment of myasthenia gravis (in combination with cemdisiran). Pozelimab is also undergoing clinical development in several other countries worldwide for the treatment of CD55-deficient PLE, PNH and myasthenia gravis. This article summarizes the milestones in the development of pozelimab leading to this first approval for the treatment of adults, and paediatric patients aged ≥ 1 year with CD55-deficient PLE, also known as CHAPLE disease, in the USA. [ABSTRACT FROM AUTHOR]

Aims: To outline key factors that contribute to oral health issues of refugees and asylum seekers and provide management strategies for dental providers to teach desensitization and fear reduction for this special population. Methods and Results: We researched published literature in the PubMed database and incorporated lessons gained from treating refugee and asylee patients at a Vulnerable Populations Clinic (VPC) at an urban academic dental school. Refugees and asylees are at high risk for oral conditions due to a tendency to not seek routine dental treatment, psychological stressors, and various systemic factors. Oral health providers can teach patients desensitization and fear reduction by working to gain patients' trust by having effective communication and prioritizing comfort in the dental operatory. Providers should also utilize translation, psychological, and/or multicultural support services during their management of care. Conclusion: By having a stronger understanding of the key causes of oral health issues among refugees and asylees in the United States, dental providers can better approach managing care for this vulnerable patient population. The concepts of teaching desensitization and fear reduction utilized for this special population can be applied to managing care for the wider special needs patient community. [ABSTRACT FROM AUTHOR]

Following the end of the 1956 Revolution, a significant number of university students fled Hungary and the human capital flooding into Austria drew the attention of universities worldwide. The cold war and its influence on international student organisations and on the domestic conceptualisation of refugees in the USA contextualise this case study of 18 Hungarian student refugees. Communist reform of the education system fuelled Hungarian student discontent; following the collapse of the revolution many students fled to Austria where student and non-government organisations in Austria and the USA worked to screen them. Student organisations sourced scholarships for the refugee students in the USA in tandem with philanthropic organisations. A parallel effort was developed involving covert CIA activities for information-gathering purposes. However, not all students were able to realise their ambitions and CIA activities raise questions around researcher integrity and the breaching of research ethics.

Introduction and Methods: In this study, we evaluated self‐reported respiratory symptoms during agricultural work, respiratory protection use and experience, and perceived value of receiving respirators using Gear Up for Ag Health and Safety Program™ pre‐ and post‐surveys from 703 to 212 young adult hog producers in the United States. To our knowledge, this is one of the most extensive survey data sets on self‐reported respiratory symptoms and respiratory protection behaviors of collegiate‐aged young adults working in US livestock production. Results: About one‐third (37%) of young adult hog producers stated that they have experienced cough, shortness of breath, fever, and chills after working in dusty areas on the farm. Most (76.2%) stated that they were already "always" or "sometimes" wearing filtering facepiece (N95‐style) respirators, even before participating in an outreach program. About one‐third (30%) reported experience wearing a cartridge‐style respirator but only 5% reported having been fit‐tested for a respirator. Young adult male producers were significantly more likely to report use of both respirator types when compared to females, both before and after the program. Male producers were also more likely than females to engage in high‐risk farm tasks where respirators are recommended, such as cleaning out grain bins and mixing or grinding feed. Following an educational program, males and females reported using the respirators that they received at similar rates, and 20% of overall participants purchased additional respiratory protection. Discussion: The study found that young adult hog producers in postsecondary education are already wearing respirators with some frequency and at rates higher than previously reported by agricultural workers. More research is needed to make effective task‐based respirator‐use recommendations and investigate some significant gender differences among young adult hog producers observed in this study. [ABSTRACT FROM AUTHOR]

Widespread access to an increasing number of technology-enhanced communications channels multiplies the potential for abusive interactions (i.e., technology-facilitated abuse [TFA]). Practitioners will be better prepared to respond to the problem of TFA if more is known about how commonly victims seek help, and from whom. Through a cross-sectional, U.S. nationally representative survey of n = 1,215 young adults aged 18 to 35, respondents completed the TFA scale of the Cyber-Abuse Research Initiative. We calculated the percentage of TFA survivors who sought help for their most damaging experience of TFA, and used logistic regression to model help-seeking for health services, victim services, technological assistance, and/or criminal justice/legal assistance. For each help source, we examined risk markers including sociodemographic characteristics, online activity, the number of different forms of TFA experience, and the perpetrator's relationship to the victim. Use of a broader range of social media sites/platforms, and several indicators of more severe TFA experiences, predicted help-seeking from health services, victim services, and justice/legal assistance. Young adults who identified the TFA perpetrator as a current or ex-intimate partner were less likely than other survivors to seek two forms of help: technological assistance and/or criminal justice/legal assistance. Survivors who self-identified as Black were more likely than White survivors to seek victim services. Professionals who support survivors of interpersonal aggression may use these results to enhance their screening protocols and form cross-disciplinary partnerships to address the harms associated with TFA. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of ocular disease in draft horses in the United States. Animals: Draft horses of various breeds and ages. Procedure: Nondilated ophthalmic examination was performed using slit lamp biomicroscopy and indirect ophthalmoscopy. Intraocular pressures were measured when possible. Results: One hundred sixty‐five draft horses were examined. Age range: 10 days to 33 years (mean 10.8 years, median 10 years); 87 geldings (52.7%), 71 mares (43.0%), 7 stallions (4.2%); 64 Percherons (38.8%), 51 Belgians (30.9%), 29 Clydesdales (17.6%), 15 Shires (9%), and 6 other draft breed (3.6%). Intraocular pressure: mean 24.7 mmHg OD, range 13‐37 mmHg; mean 25.0 mmHg OS, range 11‐37 mmHg. Vision‐threatening disease was present in 9 horses (5.5%): complete cataracts 1, post‐traumatic optic nerve atrophy 1, uveitis and secondary glaucoma 1, retinal detachment 1, large chorioretinal scar 3, phthisis bulbi 2. Non‐vision‐threatening ocular disease was present in 56 horses (33.9%) involving one or more ocular structures: eyelid trauma/notch defect 14 (8.5%), SCC‐type adnexal lesions 12 (7.3%), corneal scars 16 (9.7%), keratitis 6 (3.6%), corpora nigra cyst 15 (9.1%), incipient/punctate cataract 50 (30.3%), vitreous degeneration 10 (6.1%), asteroid hyalosis 1, "bullethole" chorioretinal scars 3, RPE coloboma 1. Linear keratopathy was present in 28 horses (17%) with 2/28 having concurrent vision threatening ocular disease. Conclusions: Ocular abnormalities, in particular minor cataracts, were relatively common in this population, but not typically vision‐threatening. Additionally, this survey demonstrated a greater prevalence of linear keratopathy in draft horses compared with reports in other breeds; however, it does not appear to be associated with concurrent ocular disease. [ABSTRACT FROM AUTHOR]

The number of agricultural fatalities and injuries related to agricultural quad bike use has risen substantially in the last two decades. Safe engineering design features such as crush protection and roll bars have proven potential to lessen the burden of injury but have traditionally not been included in many quad bike safety training programs. The aim of this study was to survey more than 700 young adults working in U.S. and Canadian agriculture to examine self-reported quad bike safety behaviors and awareness of quad bike safety design engineering features. We found that U.S. males continue to be at higher risk for quad bike-rollover incidents when compared to other groups. Even when accounting for other factors such as age and country, we found that participants who reported youth occupational quad bike use (≤14 years old) were up to 200% more likely to allow extra riders and up to 489% more likely to not wear a helmet when compared to participants who reported beginning occupational quad bike use in adulthood. These findings support the Agricultural Youth Work Guideline (AYWG) for occupational quad bike use at age 16. Less than 20% of young adults working in agriculture were aware of safe design features such as wide frames, stability ratings, crush protection devices, and accessories made by the original equipment manufacturer. There is tremendous need to educate the future agricultural workforce about the importance of choosing quad bikes with safer design features. [ABSTRACT FROM AUTHOR]

Technology-facilitated abuse (TFA) is of growing concern and is a form of elder abuse. There is limited TFA research in general population samples in the U.S. among older adults. Researchers conducted a survey of behavior-based forms of TFA experiences in a nationally representative sample of n = 1,011 U.S. adults ages 50 and older. Within this sample, 63.8% of respondents reported some experience of TFA during their lifetime. Latent class analyses were applied to understand the pattern of older adults' exposure to ten different forms of TFA resulting in three classes distinguished by the number of different TFA types experienced: low TFA (55%), low-mid TFA (40%) and high TFA (5%). Socio-economic characteristics associated with these TFA profiles, as well as perpetrator relationship, post-TFA behaviors, and resulting harms associated with the TFA experiences, were examined to inform research, prevention, and intervention activities. Attention across different sectors to TFA among older adults is needed. [ABSTRACT FROM AUTHOR]

Childhood and adolescent misuse and abuse exposures remain a serious public health challenge in the United States. This study aimed to describe recent trends and patterns of intentional substance misuse and abuse exposures among school-aged children and adolescents in the United States. This study was a retrospective cohort study of intentional misuse and abuse exposures in children 6 through 18 years reported to the National Poison Data System (NPDS) from January 1, 2000, through December 31, 2020. Demographic trends, reported clinical effects, treatments, management sites, and health outcomes were assessed overall and within four age categories: 6–9, 10–12, 13–15, and 16–18. Between 2000 and 2020, there were 338,727 cases regarding intentional misuse and abuse exposures for children ages 6 through 18 years old. Overall, misuse/abuse ingestions fluctuated over time, with a peak in 2011. The majority of intentional misuse/abuse ingestions occurred in males (58.3%), and more than 80% of all reported exposure cases occurred in youth aged 13 to 18. 32.6% of ingestions resulted in worse than minor clinical outcomes. Older age groups had a greater number of severe medical outcomes compared to younger age groups. Major or life-threatening exposures (including those resulting in death) were more common in males. Overall, deaths were rare (n = 450), 0.1%). Male sex, older age, abuse ingestions, exposure site of a public area or other residence, and multiple ingested substances were other factors associated with increased mortality. Marijuana exposure rates had the highest average monthly increase overall, with the most dramatic rise occurring from 2017 to 2020. Edible marijuana preparations accounted for the highest increase in call rates compared with all other forms of marijuana. With over 330,000 poison center cases reported during the 20-year study period, intentional substance misuse and abuse exposures substantially impact the pediatric population. The substances most commonly misused/abused are more widely available substances such as over-the-counter medications, household products and pharmaceuticals commonly prescribed to youth. Differences in age and sex were evident, with males and adolescents more likely to abuse and misuse substances. Our study describes an upward trend in marijuana misuse/abuse exposures among youth, especially those involving edible products. These findings highlight an ongoing concern about the impact of rapidly evolving cannabis legalization on this vulnerable population. [ABSTRACT FROM AUTHOR]

Intimate partner sexual violence (IPSV) is a prevalent phenomenon, yet an under-researched topic. Due to the complex nature of balancing love and fear, individuals who experience IPSV have unique needs and face unique barriers to seeking care. The purpose of this systematic review was to examine the literature on help-seeking and barriers to care in IPSV. Articles were identified through PubMed, CINAHL, PsycINFO, and Web of Science. Search terms included terms related to IPSV, intimate partner violence (IPV), domestic violence, sexual assault, and rape. The review was limited to the United States, and articles that were included needed to specifically measure or identify sexual violence in an intimate relationship and analyze or discuss IPSV in relation to help-seeking behaviors or barriers to care. Of the 17 articles included in this review, 13 were quantitative studies and four were qualitative studies. Various definitions and measurements of IPSV across studies included in this review make drawing broad conclusions challenging. Findings suggest that experiencing IPSV compared to experiencing nonsexual IPV (i.e., physical or psychological IPV) may increase help-seeking for medical, legal, and social services while decreasing help-seeking for informal support. Help-seeking can also reduce risk of future IPSV and decrease poor mental health outcomes. Barriers to seeking care in IPSV included social stigma, fear, and difficulty for individuals in identifying IPSV behaviors in their relationships as abuse. More inclusive research is needed among different populations including men, non-White individuals, nonheterosexual, and transgender individuals. Suggestions for research, practice, and policies are discussed. [ABSTRACT FROM AUTHOR]

Background: Traditional epidemiologic approaches such as time-series or case-crossover designs are often used to estimate the effects of extreme weather events but can be limited by unmeasured confounding. Quasi-experimental methods are a family of methods that leverage natural experiments to adjust for unmeasured confounding indirectly. The recently developed generalized synthetic control method that exploits the timing of an exposure is well suited to estimate the impact of acute environmental events on health outcomes. To demonstrate how this method can be used to study extreme weather events, we examined the impact of the 20-26 October 2007 Southern California wildfire storm on respiratory hospitalizations.Methods: We used generalized synthetic control to compare the average number of ZIP code-level respiratory hospitalizations during the wildfire storm between ZIP codes that were classified as exposed versus unexposed to wildfire smoke. We considered wildfire exposure eligibility for each ZIP code using fire perimeters and satellite-based smoke plume data. We retrieved respiratory hospitalization discharge data from the Office of Statewide Health Planning and Development. R code to implement the generalized synthetic control method is included for reproducibility.Results: The analysis included 172 exposed and 578 unexposed ZIP codes. We estimated that the average effect of the wildfire storm among the exposed ZIP codes was an 18% (95% confidence interval: 10% to 29%) increase in respiratory hospitalizations.Conclusions: We illustrate the use of generalized synthetic control to leverage natural experiments to quantify the health impacts of extreme weather events when traditional approaches are unavailable or limited by assumptions. [ABSTRACT FROM AUTHOR]

While prior studies have addressed bullying experienced during school, limited research exists on the associations between participation in school-sponsored extracurricular activities and bullying victimization risk. The current study utilized data from the 2013, 2015, and 2017 National Crime and Victimization Survey's School Crime Supplement (n = 13,376) to examine the associations between participation in different types of extracurricular activities and three types of bullying victimization (physical, verbal, and relational) among middle and high school students. Results indicated that participation in performing arts, service clubs, and "other" activities was associated with all three types of victimization. Additionally, participation in athletics was associated with decreased risk for verbal victimization. Prevention strategies and implications for schools regarding how to reduce bullying among middle and high school students, especially in the context of extracurricular activities, are discussed. [ABSTRACT FROM AUTHOR]

Due to financial and temporal limitations, the small wind community relies upon simplified wind speed models and energy production simulation tools to assess site suitability and produce energy generation expectations. While efficient and user-friendly, these models and tools are subject to errors that have been insufficiently quantified at small wind turbine heights. This study leverages observations from meteorological towers and sodars across the United States to validate wind speed estimates from theWind Integration National Dataset (WIND) Toolkit, the European Centre for Medium-Range Weather Forecasts (ECMWF) Reanalysis v5 (ERA5), and the Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2), revealing average biases within -0:5ms-1 at small wind hub heights. Observations from small wind turbines across the United States provide references for validating energy production estimates from the System Advisor Model (SAM), Wind Report, MyWindTurbine.com, and Global Wind Atlas 3 (GWA3), which are seen to overestimate actual annual capacity factors by 2.5, 4.2, 11.5, and 7.3 percentage points, respectively. In addition to quantifying the error metrics, this paper identifies sources of model and tool discrepancies, noting that interannual fluctuation in the wind resource, wind speed class, and loss assumptions produces more variability in estimates than different horizontal and vertical interpolation techniques. The results of this study provide small wind installers and owners with information about these challenges to consider when making performance estimates and thus possible adjustments accordingly. Looking to the future, recognizing these error metrics and sources of discrepancies provides model and tool researchers and developers with opportunities for product improvement that could positively impact small wind customer confidence and the ability to finance small wind projects. [ABSTRACT FROM AUTHOR]

The growing ranks of nurse practitioners (NPs) in rural areas of the United States have the potential to help alleviate existing primary care shortages. This study uses a nationwide source of claims- and EHR-data from 2017 to construct measures of NP clinical autonomy and complexity of care. Comparisons between rural and urban primary care practices reveal greater clinical autonomy for rural NPs, who were more likely to have an independent patient panel, to practice with less physician supervision, and to prescribe Schedule II controlled substances. In contrast, rural and urban NPs provided care of similar complexity. These findings provide the first claims- and EHR-based evidence for the commonly held perception that NPs practice more autonomously in rural areas than in urban areas. [ABSTRACT FROM AUTHOR]

Sexual assault is an irrefutable trauma; an insult to the autonomy of the person forced into sexual acts. Sexual assault sequelae range from physical injury and acute traumatic stress, to pregnancy and sexually transmitted infections, including human immunodeficiency virus (HIV). HIV post-exposure prophylaxis (HIV PEP) following sexual assault may decrease the likelihood of HIV transmission. Many patients seeking healthcare post-sexual assault either do not initiate HIV PEP or do not complete the 28-day medication regimen. In this qualitative interpretive description, we interviewed sexual assault patients (N =11) about HIV PEP discussions/reactions, attitudes and understanding related to HIV and PEP, and barriers and facilitators of HIV PEP acceptance and adherence. Participants described a process of losing and reclaiming control throughout post-assault care and follow-up; and how this affected HIV PEP-related decision-making. Most HIV PEP decisions were described as a process of reclaiming control over one outcome while simultaneously losing control of another. [ABSTRACT FROM AUTHOR]

Background: Health disparities are pervasive and are linked to economic losses in the United States of up to $135 billion per year. The Flint Center for Health Equity Solutions (FCHES) is a Transdisciplinary Collaborative Center for health disparities research funded by the National Institute of Minority Health and Health Disparities (NIMHD). The purpose of this study was to estimate the economic impact of the 5-year investment in FCHES in Genesee County, Michigan.Methods: The estimated impacts of FCHES were calculated using a U.S.-specific input/output (I/O) model, IMPLAN, from IMPLAN Group, LLC., which provides a software system to access geographic specific data regarding economic sector interactions from a variety of sources. This allowed us to model the cross-sector economic activity that occurred throughout Genesee County, Michigan, as a result of the FCHES investment. The overall economic impacts were estimated as the sum of three impact types: 1. Direct (the specific expenditures impact of FCHES and the Scientific Research and Development Services sector); 2. Indirect (the impact on suppliers to FCHES and the Scientific Research and Development Services sector); and 3. Induced (the additional economic impact of the spending of these suppliers and employees in the county economy).Results: The total FCHES investment amounted to approximately $11 million between 2016 and 2020. Overall, combined direct, indirect, and induced impacts of the total FCHES federal investment in Genesee County included over 161 job-years, over $7.6 million in personal income, and more than $19.2 million in economic output. In addition, this combined economic activity generated close to $2.3 million in state/local and federal tax revenue. The impact multipliers show the ripple effect of the FCHES investment. For example, the overall output of over $19.2 million led to an impact multiplier of 1.75 - every $1 of federal FCHES investment led to an additional $.75 of economic output in Genesee County.Conclusions: The FCHES research funding yields significant direct economic impacts above and beyond the direct NIH investment of $11 million. The economic impact estimation method may be relevant and generalizable to other large research centers such as FCHES. [ABSTRACT FROM AUTHOR]

Sleep loss has been linked to heart disease, diabetes, cancer, and an increase in accidents, all of which are among the leading causes of death in the United States. Population-scale sleep studies have the potential to advance public health by helping to identify at-risk populations, changes in collective sleep patterns, and to inform policy change. Prior research suggests other kinds of health indicators such as depression and obesity can be estimated using social media activity. However, the inability to effectively measure collective sleep with publicly available data has limited large-scale academic studies. Here, we investigate the passive estimation of sleep loss through a proxy analysis of Twitter activity profiles. We use "Spring Forward" events, which occur at the beginning of Daylight Savings Time in the United States, as a natural experimental condition to estimate spatial differences in sleep loss across the United States. On average, peak Twitter activity occurs 15 to 30 min later on the Sunday following Spring Forward. By Monday morning however, activity curves are realigned with the week before, suggesting that the window of sleep opportunity is compressed in Twitter data, revealing Spring Forward behavioral change. [ABSTRACT FROM AUTHOR]

Background: Disruptions in neural circuits underlying emotion regulation (ER) may be a mechanism linking child maltreatment with psychopathology. We examined the associations of maltreatment with neural responses during passive viewing of negative emotional stimuli and attempts to modulate emotional responses. We investigated whether the influence of maltreatment on neural activation during ER differed across development and whether alterations in brain function mediated the association between maltreatment and a latent general psychopathology ('p') factor. Methods: Youth aged 8–16 years with (n = 79) and without (n = 72) exposure to maltreatment completed an ER task assessing neural responses during passive viewing of negative and neutral images and effortful attempts to regulate emotional responses to negative stimuli. P-factor scores were defined by a bi-factor model encompassing internalizing and externalizing psychopathology. Results: Maltreated youth had greater activation in left amygdala and salience processing regions and reduced activation in multiple regions involved in cognitive control (bilateral superior frontal gyrus, middle frontal gyrus, and dorsal anterior cingulate cortex) when viewing negative v. neutral images than youth without maltreatment exposure. Reduced neural recruitment in cognitive control regions mediated the association of maltreatment with p-factor in whole-brain analysis. Maltreated youth exhibited increasing recruitment with age in ventrolateral prefrontal cortex during reappraisal while control participants exhibited decreasing recruitment with age. Findings were similar after adjusting for co-occurring neglect. Conclusions: Child maltreatment influences the development of regions associated with salience processing and cognitive control during ER in ways that contribute to psychopathology. [ABSTRACT FROM AUTHOR]

Pelvic floor disorders are a significant medical issue, reportedly affecting nearly one in four women in the United States. Nonetheless, until the last decade, there has been relatively limited imaging research into this highly prevalent disorder. The three major imaging modalities utilized to assess pelvic floor function are ultrasound, MRI and fluoroscopy. Pelvic floor ultrasound is a rapidly emerging technique which takes advantage of the widespread availability of ultrasound, the non-invasive and relatively inexpensive approach and the incorporation of real-time imaging and software advances which permit 3-D volume imaging. Pelvic floor ultrasound provides the opportunity to optimize patient counseling and enhance pre-operative planning by providing an anatomic and functional roadmap for the referring clinician. We recommend the consideration of pelvic floor ultrasound, as described here, as an addition to the imaging armamentarium available to physicians and surgeons serving this patient population. [ABSTRACT FROM AUTHOR]

This retrospective descriptive analysis of 837 patients seeking postassault care at an academic hospital in the United States describes characteristics of sexual assault survivors from a sociocultural context, with a specific focus on describing survivors presenting for sexual assault nurse examiner (SANE) exams and confirming existing literature on assault characteristics, such as disabilities and alcohol and/or drug use. Assaults resulting in SANE exams increased over time. Drug and/or alcohol use at the time of the assault was reported in 44.8% of cases and 20.8% of survivors reported having a disability. Understanding the demographic and sexual assault characteristics of survivors is fundamental to providing sensitive and responsive care. [ABSTRACT FROM AUTHOR]

An editorial is presented on producing substantial improvements in patient safety. Topics include suggesting the original estimates underrepresenting the amount of harm to patients caused by medical care; and dedication to the reduction of medical error now diluted by Covid-19, workforce safety, and racial injustice.

Purpose: Sexual assault care provided by sexual assault nurse examiners (SANEs) is associated with improved health and prosecutorial outcomes. Upon completion of SANE training, nurses can demonstrate their experience and expertise by obtaining SANE certification. Availability of nurses with SANE training or certification is often limited in rural areas, and no studies of rural certified SANEs exist. The purpose of this study is to describe rural SANE availability. Methods: We analyze both county‐level and hospital‐level data to comprehensively examine SANE availability. We first describe the geographic distribution of certified SANEs across rural and nonrural (ie, urban or suburban) Pennsylvania counties. We then analyze hospital‐level data from semistructured interviews with rural hospital emergency department administrators using qualitative content analysis. Findings: We identified 49 certified SANEs across Pennsylvania, with 24.5% (n = 12) located in 8 (16.7%) of Pennsylvania's 48 rural counties. The remaining 37 certified SANEs (75.5%) were located in 13 (68.4%) of Pennsylvania's 19 nonrural counties. Interview data were collected from 63.9% of all eligible rural Pennsylvania hospitals (n = 63) and show that 72.5% (n = 29) have SANEs. Of these, 20.7% (n = 6) have any certified SANE availability. A minority of hospitals (42.5%; n = 17) have continuous SANE coverage. Conclusions: Very few SANEs in rural Pennsylvania have certification, suggesting barriers to certification may exist for rural SANEs. Though a majority of hospitals have SANEs, availability of SANEs was limited by inconsistent coverage. A lack of certified SANEs and inconsistent SANE coverage may place rural sexual assault victims at risk of receiving lower quality sexual assault care. [ABSTRACT FROM AUTHOR]

Obesity represents a major health burden to both developed and developing countries. Furthermore, the incidence of obesity is increasing in children. Obesity contributes substantially to mortality in the United States by increasing the risk for type 2 diabetes, cardiovascular-related diseases, and other comorbidities. Despite environmental changes over past decades, including increases in high-calorie foods and sedentary lifestyles, there is very clear evidence of a genetic predisposition to obesity risk. Childhood obesity cases can be categorized in one of two ways: syndromic or non-syndromic. Syndromic obesity includes disorders such as Prader-Willi syndrome, Bardet-Biedl syndrome, and Alström syndrome. Non-syndromic cases of obesity can be further separated into rarer instances of monogenic obesity and much more common forms of polygenic obesity. The advent of genome-wide association studies (GWAS) and next-generation sequencing has driven significant advances in our understanding of the genetic contribution to childhood obesity. Many rare and common genetic variants have been shown to contribute to the heritability in obesity, although the molecular mechanisms underlying most of these variants remain unclear. An important caveat of GWAS efforts is that they do not strictly represent gene target discoveries, rather simply the uncovering of robust genetic signals. One clear example of this is with progress in understanding the key obesity signal harbored within an intronic region of the FTO gene. It has been shown that the non-coding region in which the variant actually resides in fact influences the expression of genes distal to FTO instead, specifically IRX3 and IRX5. Such discoveries suggest that associated non-coding variants can be embedded within or next to one gene, but commonly influence the expression of other, more distal effector genes. Advances in genetics and genomics are therefore contributing to a deeper understanding of childhood obesity, allowing for development of clinical tools and therapeutic agents. [ABSTRACT FROM AUTHOR]

Background: COPD is the third leading cause of death in the United States, with 16 million Americans currently experiencing difficulty with breathing. Power outages could be life-threatening for those relying on electricity. However, significant gaps remain in understanding the potential impact of power outages on COPD exacerbations.Research Question: The goal of this study was to determine how power outages affect COPD exacerbations.Study Design and Methods: Using distributed lag nonlinear models controlling for time-varying confounders, the hospitalization rate during a power outage was compared vs non-outage periods to determine the rate ratio (RR) for COPD and its subtypes at each of 0 to 6 lag days in New York State from 2001 to 2013. Stratified analyses were conducted according to sociodemographic characteristics, season, and clinical severity; changes were investigated in numerous critical medical indicators, including length of stay, hospital cost, the number of comorbidities, and therapeutic procedures between the two periods.Results: The RR of COPD hospitalization following power outages ranged from 1.03 to 1.39 across lag days. The risk was strongest at lag0 and lag1 days and lasted significantly for 7 days. Associations were stronger for the subgroup with acute bronchitis (RR, 1.08-1.69) than for cases of acute exacerbation (RR, 1.03-1.40). Compared with non-outage periods, the outage period was observed to be $4.67 thousand greater in hospital cost and 1.38 greater in the number of comorbidities per case. The average cost (or number of comorbidities) was elevated in all groups stratified according to cost (or number of comorbidities). In contrast, changes in the average length of stay (-0.43 day) and the average number of therapeutic procedures (-0.09) were subtle.Interpretation: Power outages were associated with a significantly elevated rate of COPD hospitalization, as well as greater costs and number of comorbidities. The average cost and number of comorbidities were elevated in all clinical severity groups. [ABSTRACT FROM AUTHOR]

In this study, we examined self-determination theory (SDT; Deci & Ryan, 1985) as a framework for under- standing potential antecedents of burnout in 598 American college athletes. Using a cross-sectional design, the aims of the study were to investigate relationships among the dimensions of athlete burnout and the degree of self-determination among college athletes. As hypothesized, results indicated a strong relationship between the degree of self-determination and the dimensions of burnout, thus providing support for the utility of an SDT explanation regarding the occurrence of burnout. Findings also showed motivational variables to be the most powerful predictor of burnout (Devaluation, 44.5%; Reduced Sense of Accomplishment, 28%; Physical/Emotional Exhaustion, 15.4%). Implications of these results for researchers and practitioners are discussed. [ABSTRACT FROM AUTHOR]

Background: The gender gap in physician pay is often attributed in part to women working fewer hours than men, but evidence to date is limited by self-report and a lack of detail regarding clinical revenue and gender differences in practice style.Methods: Using national all-payer claims and data from electronic health records, we conducted a cross-sectional analysis of 24.4 million primary care office visits in 2017 and performed comparisons between female and male physicians in the same practices. Our primary independent variable was physician gender; outcomes included visit revenue, visit counts, days worked, and observed visit time (interval between the initiation and the termination of a visit). We created multivariable regression models at the year, day, and visit level after adjustment for characteristics of the primary care physicians (PCPs), patients, and types of visit and for practice fixed effects.Results: In 2017, female PCPs generated 10.9% less revenue from office visits than their male counterparts (-$39,143.2; 95% confidence interval [CI], -53,523.0 to -24,763.4) and conducted 10.8% fewer visits (-330.5 visits; 95% CI, -406.6 to -254.3) over 2.6% fewer clinical days (-5.3 days; 95% CI, -7.7 to -3.0), after adjustment for age, academic degree, specialty, and number of sessions worked per week, yet spent 2.6% more observed time in visits that year than their male counterparts (1201.3 minutes; 95% CI, 184.7 to 2218.0). Per visit, after adjustment for PCP, patient, and visit characteristics, female PCPs generated equal revenue but spent 15.7% more time with a patient (2.4 minutes; 95% CI, 2.1 to 2.6). These results were consistent in subgroup analyses according to the gender and health status of the patients and the type and complexity of the visits.Conclusions: Female PCPs generated less visit revenue than male colleagues in the same practices owing to a lower volume of visits, yet spent more time in direct patient care per visit, per day, and per year. (Funded in part by the Robert Wood Johnson Foundation.). [ABSTRACT FROM AUTHOR]

• A national portrait of child care arrangements by gender was provided. • In higher SES families, boys were more likely to attend centers. • In lower SES families, girls were more likely to attend centers. • Parental views of types of care mirrored these attendance differentials. • Studies incorporating multiple aspects of gender into the accommodation model are encouraged. Gender disparities in academic achievement are of longstanding scholarly and societal concern. In the extensive literature on this topic, however, relatively few studies have considered the non-parental child care contexts where children spend their earliest years. This state of the evidence differs from disparities by race-ethnicity and socioeconomic status, where differences in types of child care attended have been considered. The current study provides a national portrait of gender differences in the type of child care attended among preschool-aged children in the United States. Framed by the accommodation model, we found boys were more likely than girls to attend centers in higher socio-economic status families, but the reverse was true among less affluent families. Parents' general perspectives that center-based or home-based child care was better for preschool-aged children's development and safety also differed when the study child was a boy versus girl in these higher and lower socio-economic status families. Because preschool-aged children's center-based child care attendance has been associated with academic school readiness, we encourage future studies to probe these findings as part of continued efforts to understand and address gender disparities in average levels of school progress and achievement. [ABSTRACT FROM AUTHOR]

Cenobamate (XCOPRI®), a novel tetrazole alkyl carbamate derivative, is approved in the USA for use as monotherapy and adjunctive therapy in adults with focal seizures (also known as partial-onset seizures). Its use (within the recommended dosage of ≤ 400 mg/day) significantly reduced focal seizure frequency relative to the use of placebo in short-term (≤ 18 weeks) multinational, phase 2 studies in adults with focal seizures, with antiepileptic benefits appearing to be sustained over the longer-term (30 months). Cenobamate appears to have low abuse potential and to be generally well tolerated over the short- and longer-term (up to 79 months), with most treatment-emergent adverse events (TEAEs) being mild or moderate in severity. The most frequently reported TEAEs (somnolence, dizziness and fatigue) were CNS related, dose dependent and similar to those seen with other anti-seizure medications. [ABSTRACT FROM AUTHOR]

The current study reports the evidence for the reliability (via coefficient α, coefficient ω) and validity (via confirmatory factor analysis, correlations) of the Teacher Efficacy for Promoting Partnership measure. Participants were 255 in-service Head Start educators from all Head Start regions across the United States. Educators were sent a survey to complete with a cover letter, written consent form, survey, and compensation for their contribution. To maximize survey response rates, a follow-up post card and survey were sent. Results from the study indicated strong evidence for the reliability of the measure with both coefficient alpha and coefficient omega. Furthermore, evidence was found for convergent-related validity of the measure. The results of the confirmatory factor analyses suggest that further refinement and analysis of the measure is necessary. [ABSTRACT FROM AUTHOR]

Background: Although opioids play a critical role in the management of cancer pain, the ongoing opioid epidemic has raised concerns regarding their persistent use and abuse. We lack data-driven tools in oncology to understand the risk of adverse opioid-related outcomes. This project seeks to identify clinical risk factors and create a risk score to help identify patients at risk of persistent opioid use and abuse.Methods: Within a cohort of 106 732 military veteran cancer survivors diagnosed between 2000 and 2015, we determined rates of persistent posttreatment opioid use, diagnoses of opioid abuse or dependence, and admissions for opioid toxicity. A multivariable logistic regression model was used to identify patient, cancer, and treatment risk factors associated with adverse opioid-related outcomes. Predictive risk models were developed and validated using a least absolute shrinkage and selection operator regression technique.Results: The rate of persistent opioid use in cancer survivors was 8.3% (95% CI = 8.1% to 8.4%); the rate of opioid abuse or dependence was 2.9% (95% CI = 2.8% to 3.0%); and the rate of opioid-related admissions was 2.1% (95% CI = 2.0% to 2.2%). On multivariable analysis, several patient, demographic, and cancer and treatment factors were associated with risk of persistent opioid use. Predictive models showed a high level of discrimination when identifying individuals at risk of adverse opioid-related outcomes including persistent opioid use (area under the curve [AUC] = 0.85), future diagnoses of opioid abuse or dependence (AUC = 0.87), and admission for opioid abuse or toxicity (AUC = 0.78).Conclusion: This study demonstrates the potential to predict adverse opioid-related outcomes among cancer survivors. With further validation, personalized risk-stratification approaches could guide management when prescribing opioids in cancer patients. [ABSTRACT FROM AUTHOR]

Early math success in the PreK classroom is recognized as a strong predictor of later academic success. However, many early childhood teachers report they lack the content knowledge, confidence and beliefs to deliver high quality math experiences in their classrooms. Professional development opportunities to gain and expand these skills are often difficult for early childhood educators to access. The purpose of this article is to examine the professional development opportunities available to early childhood educators in the United States and to present a model of professional development that is accessible and effective. This article provides a description of the importance of math in the early years and reveals the need for early math professional development opportunities for early childhood teachers. A portrait of the current state of professional development opportunities for early childhood teachers in the United States is presented along with a presentation of a successful online early math professional development program that was developed to meet the need of early childhood educators. The article ends with implications for current professional development opportunities and ideas for future directions. [ABSTRACT FROM AUTHOR]

Examines various explanations for the lack of reading problems in Japan, including the nature of the Japanese written language, the interest of Japanese parents in teaching young children to read, the different perceptual processes involved in reading Japanese, and the quantity of Japanese publications suitable for preschool children. (FL)

Thermal burns are a leading cause of preventable injury in children and adolescents. Fire pits have become increasingly popular outdoor fixtures in U.S. homes. We aimed to identify trends in pediatric burn injuries related to fire pits that presented to a representative sample of United States Emergency Departments (EDs). A retrospective analysis of annual ED visits from the National Electronic Injury Surveillance System (NEISS) from January 1, 2006 through December 31, 2017 using product codes specific to fire pits. U.S. Census population estimates were used to compute rates per 100,000 population. SAS and Joinpoint weighted regression analyses were used to analyze annual estimates and rate trends across the study period. There were 10,951 (95% CI = 8535-13,367) ED visits for burn injuries secondary to outdoor fire pits in patients 19 years of age and younger across the study period. The majority of injuries occurred in children under the age of 5, and were related to falls into or on a hot fire pit. The annual modeled rate change showed an overall significant increase in burn injuries of 7.16 per 100,000 annually from 2006 to 2017 (P = .02). Outdoor fire pits represent an increasing hazard to young children who are particularly susceptible to burn injuries from falls in or around lit recreational fires. Product modifications and public awareness campaigns are necessary to prevent future life-altering injuries in pediatric patients. [ABSTRACT FROM AUTHOR]

This paper investigates the dynamic relation between net individual investor trading and short-horizon returns for a large cross-section of NYSE stocks. The evidence indicates that individuals tend to buy stocks following declines in the previous month and sell following price increases. We document positive excess returns in the month following intense buying by individuals and negative excess returns after individuals sell, which we show is distinct from the previously shown past return or volume effects. The patterns we document are consistent with the notion that risk-averse individuals provide liquidity to meet institutional demand for immediacy. [ABSTRACT FROM AUTHOR]

Focuses on the conflicts and contracts between native Americans and white settlers in Emporia and Lyon County in Kansas. Increase on the acquisition of horses and guns; Details on the attempted act to honor aboriginal possessors and the land; Emphasis on preserving ancient customs for both religion and superstition.

This paper finds that, on average, targets that terminate takeover offers significantly increase their leverage ratios. Targets that increase their leverage ratios the most reduce capital expenditures, sell assets, reduce employment, increase focus, and realize cash flows and share prices that outperform their benchmarks in the five years following the failed takeover. Our evidence suggests that leverage-increasing targets act in the interests of shareholders when they terminate takeover offers and that higher leverage helps firms remain independent not because it entrenches managers, but because it commits managers to making the improvements that would be made by potential raiders. [ABSTRACT FROM AUTHOR]

An enteral suspension (ES)/intestinal gel formulation of levodopa/carbidopa (hereafter referred to as levodopa/carbidopa ES) [Duodopa® (EU); Duopa™ (USA)] has been developed to overcome the fluctuating plasma levodopa concentrations associated with oral levodopa/carbidopa formulations. In various countries, including those of the EU (under the Mutual Recognition Procedure), it is approved for the treatment of advanced levodopa-responsive Parkinson's disease (PD) with severe motor fluctuations and hyperkinesia or dyskinesia when available combinations of Parkinson medicinal products have not given satisfactory results. In several other countries, including the USA, it is approved for the treatment of motor fluctuations in patients with advanced PD. In adults with advanced PD, levodopa/carbidopa ES improved motor fluctuations, activities of daily living and health-related quality of life (HR-QOL) during short-term (12-week) treatment, with the beneficial effects on motor fluctuations largely sustained over the longer term (up to 7 years). Levodopa/carbidopa ES was generally well tolerated in this patient population, with adverse events (AEs) associated with aging, advanced PD-related comorbidities, the procedure/device or dopaminergic therapy. Its safety profile was comparable to that of oral levodopa/carbidopa with respect to non-procedure/device-associated AEs; most procedure/device-associated AEs were consistent in nature and incidence with medically recognised complications of the procedure in non-PD patients. Current evidence indicates that levodopa/carbidopa ES is an effective and generally well tolerated option for the treatment of motor fluctuations in patients with levodopa-responsive advanced PD who are not being effectively managed with non-invasive therapies. [ABSTRACT FROM AUTHOR]