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Theoretical roots of higher education institutions (HEIs) and Stakeholder Analysis date back to mid-1990s and research was focussed on the role of HEIs in society and sustainable development. While various studies have been published about 'triple-helix model' - bringing government, academia, and industry closer, the concept of HEIs and Stakeholder Analysis needs a comprehensive review of the work carried out till date. Bibliometric and content analyses were performed, incorporating citations from Scopus' database during last 25 years. Thematic mapping was carried out and evolving trends were identified. Findings and analysis of this research disclosed that during the last 25 years there has been a growing interest among scholars towards Stakeholder Analysis and HEIs. It was also noted that majority of research pursuits concentrated in western countries such as USA and UK, while Africa, Asia and South America were under-represented. This work will not only lay a foundation for academics to carry out further research, but it will also give new insights to the policymakers which would enable them to device strategies aiming at enhanced participation of universities/HEIs in the local, regional, and national development.

Ice machines can harbor water-related organisms, and the use of ice or tap water for clinical care activities has been associated with infections in health care settings. During 2021–2022, a total of 23 cases of infection by Burkholderia multivorans (sequence type ST659) were reported at two southern California hospitals and linked to contaminated ice and water from ice machines. In addition to these 23 cases, this report also includes 23 previously unreported cases of B. multivorans ST659 infections that occurred during 2020–2024: 13 at a northern California hospital, eight at a hospital in Colorado, and two additional cases at one of the southern California hospitals. The same brand of ice machine and brands of filters, descaling, and sanitizing products were used by all four hospitals; B. multivorans was isolated from samples collected from ice machines in two of the hospitals. Whole genome sequencing indicated that all clinical and ice machine isolates were highly genetically similar (0–14 single nucleotide variant differences across 81% of the selected reference genome). Recommendations from public health officials to halt the outbreak included avoiding ice and tap water during clinical care activities. An investigation is ongoing to determine possible sources of ice machine contamination. During outbreaks of water-related organisms in health care facilities, health care personnel should consider avoiding the use of tap water, including ice and water from ice machines, for patient care. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disproportionately affected workers in certain industries and occupations, and the workplace can be a high-risk setting for SARS-CoV-2 transmission. In this study, we measured SARS-CoV-2 antibody prevalence and identified work-related risk factors in a population primarily working at industrial livestock operations. We used a multiplex salivary SARS-CoV-2 IgG assay to determine infection-induced antibody prevalence among 236 adult (≥18 yr) North Carolina residents between February 2021 and August 2022. We used the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System (NIOCCS) to classify employed participants' industry. Most participants (55%, 95% confidence interval [CI] 49% to 62%) were infection-induced IgG positive, including 71% (95% CI 60% to 83%) of animal slaughtering and processing industry workers, 1.5 to 4.3 times North Carolina general population infection-induced seroprevalence estimates during overlapping time periods. Considering self-reported diagnostic test positivity and vaccination history in addition to antibodies, the proportion of participants with evidence of prior infection increased slightly to 61% (95% CI 55% to 67%), including 75% (95% CI 64% to 87%) of animal slaughtering and processing workers. Participants with more than 1000 compared to 10 or fewer coworkers at their jobsite had higher odds of prior infection (adjusted odds ratio 4.5, 95% CI 1.0 to 21.0). This study contributes evidence of the severe and disproportionate impacts of COVID-19 on animal slaughtering and processing workers and workers in large congregate settings. [ABSTRACT FROM AUTHOR]

This study explores how often students are engaged in their science classes and their affective states during these times, using an innovative methodology that records these experiences "in situ". Sampling a subset of high schools in the U.S. and Finland, we collected over 7,000 momentary responses from 344 students over the course of a week. We examine engagement within and between students in different environments identifying common social and emotional factors they may be experiencing in their science classes, suggesting the challenges that the U.S. and Finland may encounter when implementing their new science standards (i.e., "Next Generation of Science Standards" and "Finnish National Core Curriculum"). We operationalize engagement as situational when students experience high levels of challenge, skill, and interest, which we term as optimal learning moments. Specifically we analyze: (i) the components of optimal learning; (ii) the relationship of optimal learning with other subjective measures; (iii) how optimal learning moments in science classes compare to other academic classes; and (iv) the extent that optimal learning moments predict an individual's perception of importance to self and future in science classes. Using several multivariate models, results show that when students are challenged in their classes and are appropriately skilled they are more likely to feel confident, successful, and happy during specific science classes as well as in other academic classes. When students experience more times of optimal learning in their science classes they are more likely to report that they perceive science as important to them and their futures. Females, however, report being more stressed in their science classes than males.

Background Antimicrobial stewardship (AS) is an important topic in infectious diseases (ID) training, yet many ID fellowships lack formal training, and little is known about fellows' learning preferences. Methods We conducted 24 in-depth interviews with ID fellows across the United States during 2018 and 2019 to explore their experiences with and preferences for AS education during fellowship. Interviews were transcribed, deidentified, and analyzed to identify themes. Results Fellows had variable exposure to AS before and during fellowship, which impacted their knowledge about and attitude toward stewardship as a career; however, all fellows expressed the importance of learning general stewardship principles during fellowship. Some fellows' training included mandatory stewardship lectures and/or rotations, but most fellows felt their primary stewardship learning occurred through informal experiences in the clinical setting, such as holding the antimicrobial approval pager. Fellows expressed a preference for a standardized, structured curriculum that included in-person practical, interactive discussions with multidisciplinary faculty along with the opportunity to practice and apply their skills; however, they emphasized that time needed to be set aside for those educational activities. Although they wanted to learn the evidence and rationale for stewardship recommendations, they especially wanted training in and feedback on how to communicate stewardship recommendations to other health professionals, particularly in the setting of conflict. Conclusions ID fellows believe that standardized AS curricula should be included in their fellowship training, and they prefer structured, practical, and interactive learning experiences. [ABSTRACT FROM AUTHOR]

Background: Long‐term care planning (LTCP) is critical for individuals with intellectual/developmental disabilities. Objectives of this study were to investigate progression through LTCP, and associations between social support and: (1) LTCP and (2) burden among family caregivers. Methods: A cross‐sectional survey was distributed to caregivers of individuals with intellectual/developmental disabilities in NY, OH, PA, and TX, exploring demographics, supports, burden, and LTCP behaviours. Bivariate and linear multiple regression analyses were used to investigate study objectives. Results: Caregivers (n = 405) were predominantly parents, female, non‐Hispanic, and in the 'learning to plan' stage of LTCP. Caregiver‐identified social support was associated with further progression in LTCP (p =.020) and lower caregiver burden (p <.001). Conclusion: Social support was associated with further progression in LTCP, and associated with less burden, however fewer than 40% of caregivers reported having social support. Ongoing exploration of emotional/social needs of caregivers is necessary to better support these families. [ABSTRACT FROM AUTHOR]

This article interrogates the "soft power" of teacher teamwork by probing the ways in which authority conditions the appropriation of institutional motives through collective meaning making. The study analyzes the interaction of a teacher-leader and a science teacher team across two settings of professional development organized to promote curricular reform in their U.S. secondary school. The premise of the analysis draws on frameworks from cultural-historical theories, sociological perspectives, and social semiotics to view authority as the outcome of relations of power and control. The analysis reveals how the negotiation of legitimacy in interaction functions to open up or close down possibilities for acquiring motives appropriate to subject matter, teaching, and student learning in teachers' professional practice. The article makes a novel contribution to post-Vygotskian theoretical development in its presentation of authority as an attribute of the dialectical relationship of person and society in the production of institutionalized objects. (Contains 2 tables, 4 excerpts, and 5 footnotes.)

BACKGROUND AND OBJECTIVES: Annual preparticipation physical evaluation (PPE) is used in the United States to screen adolescents for potential causes of sudden cardiac death. The American Heart Association recommends 14 screening elements of history and physical examination. This study sought to define the utilization of these screening elements by each of the 50 states before high school athletics. METHODS: PPE forms were obtained from the public website of the high school athletics governing body in every state. Form content was analyzed to identify which of the 14 screening elements were explicitly fulfilled. Additional PPE forms provided by private/parochial schools, other professional societies, or independent groups were excluded from this study. RESULTS: A total of 48 states (96%) had PPE forms posted online. The remaining 2 states (4%) deferred the specific method of PPE documentation to individual school districts and provided no standardized form. Of the 48 states providing PPE forms, 13 (27%) included all 14 American Heart Association screening elements. The median criteria included by each state was 11 (range 3--14). The 3 criteria most commonly absent were (1) the examination of femoral pulses to exclude coarctation (58%), (2) a family history of specific inherited cardiac disease (31%), and (3) personal history of hypertension (27%). CONCLUSIONS: Annual preparticipation forms are important screening tools. Only a minority of states include all 14 cardiac screening elements recommended by the American Heart Association. [ABSTRACT FROM AUTHOR]

Background Antimicrobial stewardship (AS) programs are required by Centers for Medicare and Medicaid Services and should ideally have infectious diseases (ID) physician involvement; however, only 50% of ID fellowship programs have formal AS curricula. The Infectious Diseases Society of America (IDSA) formed a workgroup to develop a core AS curriculum for ID fellows. Here we study its impact. Methods ID program directors and fellows in 56 fellowship programs were surveyed regarding the content and effectiveness of their AS training before and after implementation of the IDSA curriculum. Fellows' knowledge was assessed using multiple-choice questions. Fellows completing their first year of fellowship were surveyed before curriculum implementation ("pre-curriculum") and compared to first-year fellows who complete the curriculum the following year ("post-curriculum"). Results Forty-nine (88%) program directors and 105 (67%) fellows completed the pre-curriculum surveys; 35 (64%) program directors and 79 (50%) fellows completed the post-curriculum surveys. Prior to IDSA curriculum implementation, only 51% of programs had a "formal" curriculum. After implementation, satisfaction with AS training increased among program directors (16% to 68%) and fellows (51% to 68%). Fellows' confidence increased in 7/10 AS content areas. Knowledge scores improved from a mean of 4.6 to 5.1 correct answers of 9 questions (P  = .028). The major hurdle to curriculum implementation was time, both for formal teaching and for e-learning. Conclusions Effective AS training is a critical component of ID fellowship training. The IDSA Core AS Curriculum can enhance AS training, increase fellow confidence, and improve overall satisfaction of fellows and program directors. [ABSTRACT FROM AUTHOR]

Enterococcus faecalis and faecium with resistance to daptomycin and/or linezolid are emerging globally. We present the genomic characterization of daptomycin- and linezolid-resistant E. faecalis and E. faecium surveillance isolates from the United States, 2013–2016. Daptomycin resistance was low among E. faecalis (2/364, 0.5%) and E. faecium (17/344, 5%). The majority (71%, 12/17) of daptomycin-resistant E. faecium isolates belonged to the emerging ST736 clone and contained mutations in liaFSR and cls previously associated with resistance. However, 1/2 E. faecalis and 3/17 E. faecium did not contain these mutations previously associated with daptomycin resistance. Linezolid resistance was rare among E. faecalis (1/364, 0.3%) and E. faecium (2/344, 0.6%). These two E. faecium isolates, one of which was also resistant to daptomycin and vancomycin, contained the 23S rRNA nucleotide mutation (G2576T) associated with linezolid resistance. Long-read sequencing revealed the linezolid-resistant E. faecalis isolate contained chromosomal- and plasmid-encoded copies of optrA. The chromosomal optrA was located on the recently described Tn 6674 multiresistance transposon. The second copy of optrA was encoded on an ∼65 kb mosaic plasmid, with component regions sharing high sequence identity to optrA -encoding multiresistance plasmids of animal origin. The optrA -encoding plasmid contained open reading frames predicted to encode proteins associated with a pheromone-responsive plasmid transfer system, and filter mating experiments confirmed the plasmid was conjugative. Continued surveillance of enterococci is necessary to assess the prevalence and trends of daptomycin and linezolid resistance in the United States, characterize resistance mechanisms and how they transfer, and monitor for emerging sequence types associated with resistance. [ABSTRACT FROM AUTHOR]

Professional societies serve many functions that benefit constituents; however, few professional societies have undertaken the development and dissemination of formal, national curricula to train the future workforce while simultaneously addressing significant healthcare needs. The Infectious Diseases Society of America (IDSA) has developed 2 curricula for the specific purpose of training the next generation of clinicians to ensure the future infectious diseases (ID) workforce is optimally trained to lead antimicrobial stewardship programs and equipped to meet the challenges of multidrug resistance, patient safety, and healthcare quality improvement. A core curriculum was developed to provide a foundation in antimicrobial stewardship for all ID fellows, regardless of career path. An advanced curriculum was developed for ID fellows specifically pursuing a career in antimicrobial stewardship. Both curricula will be broadly available in the summer of 2021 through the IDSA website. [ABSTRACT FROM AUTHOR]

This paper describes the design, implementation, and process outcomes from three public deliberations held in three tribal communities. Although increasingly used around the globe to address collective challenges, our study is among the first to adapt public deliberation for use with exclusively Indigenous populations. In question was how to design deliberations for tribal communities and whether this adapted model would achieve key deliberative goals and be well received. We adapted democratic deliberation, an approach to stakeholder engagement, for use with three tribal communities to respect tribal values and customs. Public deliberation convenes people from diverse backgrounds in reasoned reflection and dialogue in search of collective solutions. The deliberation planning process and design were informed by frameworks of enclave deliberation and community-based participatory research, which share key egalitarian values. The deliberations were collaboratively designed with tribal leadership and extensive partner input and involvement in the deliberations. Each deliberation posed different, locally relevant questions about genomic research, but used the same deliberation structure and measures to gauge the quality and experience of deliberation. A total of 52 individuals participated in the deliberations across all three sites. Deliberants were balanced in gender, spanned decades in age, and were diverse in educational attainment and exposure to health research. Overall, the deliberations were positively evaluated. Participant perceptions and external observer datasets depict three deliberations that offered intensive conversation experiences in which participants learned from one another, reported feeling respected and connected to one another, and endorsed this intensive form of engagement. The adapted deliberations achieved key deliberative goals and were generally well received. Limitations of the study are described. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections (HAIs) are a growing social and economic problem in the United States. A HAI is an infection that develops as a result of medical care and is typically contracted in a hospital, outpatient surgery center, nursing home, rehabilitation facility, or while receiving wound care services. One new tool to fight the increasing threat of HAIs is photonic disinfection (optical light-based disinfection). Photonic disinfection of air, surfaces, and liquids has witnessed rapid adoption within many industries (e.g., drinking water purification, wastewater treatment, indoor air purification) over the past 20 years. More recently, light-based disinfection technologies have started to make their way into hospitals, clinics, and medical centers to aid in the disinfection of air and surfaces. Two photonic disinfection methods of interest are the use of ultraviolet-C wavelengths (200 nm to 280 nm) and blue wavelengths (400 nm to 420 nm). These wavelengths of interest have been proven to be effective disinfection tools and should be put into use to augment traditional infection-prevention techniques. [ABSTRACT FROM AUTHOR]

Background Inappropriate antibiotic use is common. Understanding how patients view antibiotic risks and/or benefits could inform development of patient education materials and clinician communication strategies. We explored current knowledge, attitudes, and behaviors related to antibiotics among populations with high antibiotic use. Methods We conducted 12 focus groups with adult patients and parents across the United States by telephone in March 2017. Purposive sampling was used to identify participants with high antibiotic use. We transcribed the discussions verbatim and performed thematic analysis. Results We identified 4 major themes. First, participants expressed uncertainty regarding which clinical syndromes required antibiotics, and emotion often influenced their desire for antibiotics. Second, they had a limited understanding of antibiotic risks. Antibiotic resistance was viewed as the primary risk but was seen as a "distant, future" issue, whereas immediate adverse events, such as side effects, were minimized; however, patients expressed concern when told about the risk of serious adverse events. Third, they prioritized antibiotic benefits over risks in their decision-making, both due to an inaccurate estimation of antibiotic risks and/or benefits and a tendency to prioritize instant gratification. Fourth, most participants were willing to defer to their clinicians' decisions about antibiotics, especially if their clinician provided symptomatic treatment and anticipatory guidance. Conclusions Patients have a limited understanding of antibiotic risks, potentially explaining why they are willing to try antibiotics even if it is unclear antibiotics will help. Educating patients on the potential antibiotic risks versus benefits, rather than just antibiotic resistance, may have a bigger impact on their decision-making. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Cardiovascular disease (CVD) is the leading cause of death worldwide, and in the United States alone, CVD causes nearly 840,000 deaths annually. Using functional magnetic resonance imaging (fMRI), a tool to assess brain activity, researchers have identified some brain-behavior connections and predicted several self-management behaviors. The purpose of this study was to examine the sample characteristics of individuals with CVD who participated in fMRI studies. Methods: A literature search was conducted in PubMed, CINAHL, and Scopus. No date or language restrictions were applied and research methodology filters were used. In October 2017, 1659 titles and abstracts were identified. Inclusion criteria were: (1) utilized an empirical study design, (2) used fMRI to assess brain activity, and (3) focused on patients with CVD-related chronic illness. Articles were excluded if they: were theory or opinion articles, focused on mental or neuropathic illness, included non-human samples, or were not written in English. After duplicates were removed (230), 1,429 titles and abstracts were reviewed based on inclusion criteria; 1,243 abstracts were then excluded. A total of 186 studies were reviewed in their entirety; after additional review, 142 were further excluded for not meeting the inclusion criteria. Forty-four articles met criteria and were included in the final review. An evidence table was created to capture the demographics of each study sample. Results: Ninety eight percent of the studies did not report the racial or ethnic composition of their sample. Most studies (66%) contained more men than women. Mean age ranged from 38 to 78 years; 77% reported mean age ≥50 years. The most frequently studied CVD was stroke (86%), while hypertension was studied the least (2%). Conclusion: Understanding brain-behavior relationships can help researchers and practitioners tailor interventions to meet specific patient needs. These findings suggest that additional studies are needed that focus on populations historically underrepresented in fMRI research. Researchers should thoughtfully consider diversity and purposefully sample groups by including individuals that are: women, from diverse backgrounds, younger, and diagnosed with a variety of CVD-related illnesses. Identifying and addressing these gaps by studying more representative samples will help healthcare providers reduce disparities and tailor interventions for all CVD populations. [ABSTRACT FROM AUTHOR]

Purpose: Breast density is an important risk factor for breast cancer and varies substantially across racial-ethnic groups. However, determinants of breast density in Vietnamese immigrants in the United States (US) have not been studied. We investigated whether reproductive factors, immigration history, and other demographic and lifestyle factors were associated with breast density in Vietnamese Americans.Methods: We collected information on demographics, immigration history, and other lifestyle factors and mammogram reports from a convenience sample of 380 Vietnamese American women in California aged 40 to 70 years. Breast Imaging Reporting and Data System (BI-RADS) breast density was abstracted from mammogram reports. Multivariable logistic regression was used to investigate the association between lifestyle factors and having dense breasts (BI-RADS 3 or 4).Results: All participants were born in Viet Nam and 82% had lived in the US for 10 years or longer. Younger age, lower body mass index, nulliparity/lower number of deliveries, and longer US residence (or younger age at migration) were associated with having dense breasts. Compared to women who migrated at age 40 or later, the odds ratios and 95% confidence intervals for having dense breasts among women who migrated between the ages of 30 and 39 and before age 30 were 1.72 (0.96-3.07) and 2.48 (1.43-4.32), respectively.Conclusions: Longer US residence and younger age at migration were associated with greater breast density in Vietnamese American women. Identifying modifiable mediating factors to reduce lifestyle changes that adversely impact breast density in this traditionally low-risk population for breast cancer is warranted. [ABSTRACT FROM AUTHOR]

Objectives: American Indian/Alaska Native (AI/AN) adults use smokeless tobacco products (eg, chewing and dip tobacco) more often than other racial/ethnic groups do. Although US adults increasingly use potentially reduced exposure tobacco products (PREPs), such as electronic cigarettes and snus, no studies have examined the use of PREPs among AI/AN smokeless tobacco users. We examined associations between current PREPs use and smokeless tobacco–related measures, including cessation attempts and cotinine levels, in a sample of American Indian adults who currently use smokeless tobacco. Methods: We collected survey and tobacco biomarker data from 299 adult American Indian smokeless tobacco users at Cherokee Nation health care facilities and events in 2016 and 2017. We used multivariable analyses to determine associations between current PREPs use and smokeless tobacco–related characteristics. Results: Current PREPs users were younger, less likely to be married or living with a partner, less likely to report a chronic medical condition, and more likely to report other tobacco use than PREPs nonusers. Among participants with annual household incomes ≤$30 000, current PREPs users were less likely than PREPs nonusers to report a definite desire to quit smokeless tobacco (P =.02). PREPs use was not associated with planning to quit smokeless tobacco, past 12-month smokeless tobacco quit attempts, amount of smokeless tobacco used per week, cotinine levels, or scores on the Fagerström Test for Nicotine Dependence–Smokeless Tobacco. Conclusions: Our study suggests that American Indian smokeless tobacco users may not be using PREPs as a smokeless tobacco cessation aid. Future studies should take this finding into consideration when evaluating the role of PREPs use in smokeless tobacco cessation and in total tobacco cessation in this population. [ABSTRACT FROM AUTHOR]

This article argues that democracy is an essentially contested concept in that its meaning and applications appear to be subject to endless contestation, but that the origins of such contestation are to be found in our political practices rather than in the concept per se. It is also argued that the idea of contestation itself is an important part of our own historically situated understanding of democracy. The implications of these arguments for how public administration scholars should think about democracy and constitutionalism are examined. [ABSTRACT FROM AUTHOR]

Our understanding of mammalian predation on salamanders is primarily restricted to small carnivorous species (i.e., shrews). We conducted a series of investigations to determine whether the Virginia opossum (Didelphis virginiana) is a predator of various salamander species [Desmognathus fuscus, Plethodon dorsalis, and Notophthalmus viridescens (adult and eft)] from the eastern United States. All species, including toxic newt efts, were palatable to opossums. These results suggest opossums could be an active predator of salamanders. In a second study, each terrestrial salamander species exhibited avoidance responses to kairomones from opossums indicating that despite a significant risk of mortality each salamander has evolved mechanisms to minimize predation risk. Combined with overlapping habitat preferences, foraging behavior that places them in contact, and a dietary preference for animal matter, these data suggest opossums may be an important predator on terrestrial salamanders. [ABSTRACT FROM AUTHOR]

Objective: Advanced driver assistance systems (ADAS) are a class of vehicle technologies designed to increase safety by providing drivers with timely warnings and autonomously intervening to avoid hazardous situations. Though laboratory testing suggests that ADAS technologies will greatly impact crash involvement rates, real-world evidence that characterizes their effectiveness is still limited. This study evaluates and quantifies the association of ADAS technologies with the likelihood of a moderate or severe crash for new-model BMWs in the United States.Methods: Vehicle ADAS option information for the cohort of model year 2014 and later BMW passenger vehicles sold after January 1, 2014 (n = 1,063,503), was coded using VIN-identified options data. ADAS technologies of interest include frontal collision warning with autonomous emergency braking, lane departure warning, and blind spot detection. BMW Automated Crash Notification system data (from January 2014 to November 2017) were merged with vehicle data by VIN to identify crashed vehicles (n = 15,507), including date, crash severity (delta V), and area of impact. Using Cox proportional hazards regression modeling, the study calculates the adjusted hazard ratio for crashing among BMW passenger vehicles with versus without ADAS technologies. The adjusted percentage reduction in moderate and severe crashes associated with ADAS is interpreted as one minus the hazard ratio.Results: Vehicles equipped with both autonomous emergency braking and lane departure warning were 23% less likely to crash than those not equipped (hazard ratio [HR] = 0.77; 95% confidence interval [CI], 0.73-0.81), controlling for model year, vehicle size and body type. Autonomous emergency braking and lane departure warning generally occur together, making it difficult to tease apart their individual effects. Blind spot detection was associated with a 14% reduction in crashes after controlling for the presence of autonomous emergency braking and lane departure warning (HR =0.86; 95% CI, 0.744-0.99). Differences were observed by vehicle type and crash type. The combined effect of autonomous emergency braking and lane departure warning was greater in newer model vehicles: Equipped vehicles were 13% less likely to crash (HR =0.87; 95% CI, 0.79-0.95) among 2014 model year vehicles versus 34% less likely to crash (HR =0.66; 95% CI, 0.57-0.77) among 2017 model year vehicles.Conclusion: This robust cohort study contributes to the growing evidence on the effectiveness of ADAS technologies. [ABSTRACT FROM AUTHOR]

Objectives To examine the relationships between prepregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), and prepregnancy body mass index, with several adverse birth outcomes: preterm delivery (PTB), low birthweight (LBW), and macrosomia, comparing American Indians and Alaska Natives (AI/AN) with other race/ethnic groups. Methods The sample includes 5,193,386 singleton US first births from 2009-2013. Logistic regression is used to calculate adjusted odds ratios controlling for calendar year, maternal age, education, marital status, Kotelchuck prenatal care index, and child's sex. Results AI/AN have higher rates of diabetes than all other groups, and higher rates of overweight and obesity than whites or Hispanics. Neither overweight nor obesity predict PTB for AI/AN, in contrast to other groups, while diabetes predicts increased odds of PTB for all groups. Being overweight predicts reduced odds of LBW for all groups, but obesity is not predictive of LBW for AI/AN. Diabetes status also does not predict LBW for AI/AN; for other groups, LBW is more likely for women with DM or GDM. Overweight, obesity, DM, and GDM all predict higher odds of macrosomia for all race/ethnic groups. Conclusions for Practice Controlling diabetes in pregnancy, as well as prepregnancy weight gain, may help decrease preterm birth and macrosomia among AI/AN. [ABSTRACT FROM AUTHOR]

Background. This randomized, multicenter, open-label clinical trial was intended to generate pilot data on the efficacy and safety of the gonadotropin-releasing hormone agonist (GnRHa) deslorelin (D) with low-dose estradiol ± testosterone (E2  ± T) add-back for endometriosis-related pelvic pain. Methods. Women with pelvic pain and laparoscopically confirmed endometriosis were treated with a six-month course of daily intranasal D with concurrent administration of either transdermal E2, intranasal E2, or intranasal E2  + T. Efficacy data included evaluation of dyspareunia, dysmenorrhea, pelvic pain, tenderness, and induration. Cognition and quality of life were also assessed. Safety parameters included assessment of endometrial hyperplasia, bone mineral density (BMD), and hot flashes. Results. Endometriosis symptoms and signs scores decreased in all treatment arms from a baseline average of 7.4 to 2.5 after 3 months of treatment and 3.4 after 6 months. BMD changes and incidence of hot flashes were minimal, and no endometrial hyperplasia was observed. Patient-reported outcomes showed significant improvement across multiple domains. Conclusions. Daily intranasal D with low dose E2  ± T add-back resulted in significant reduction in severity of endometriosis symptoms and signs with few safety signals and minimal hypoestrogenic symptoms that would be expected with the use of a GnRHa alone. [ABSTRACT FROM AUTHOR]

Gambling opportunities on and near Native American lands have increased in recent decades; yet there is a lack of research examining the patterns of problem gambling and alcohol abuse among Native Americans in the US. Traditional Native American cultural identity may be a protective factor for problem gambling and alcohol abuse among Native Americans. Telephone interviews were conducted with 415 Native American adults aged 18 years and older across the US. The past-year prevalence of gambling among Native Americans is similar to the rate for non-Native Americans in the US (80 vs. 77%). However, Native Americans have over twice the rate of problem gambling as the US sample (18 vs. 8%). Although Native Americans have a lower rate of past-year alcohol use than the US population (47 vs. 68%), they have a somewhat higher rate of alcohol abuse than their US counterparts (5.5 vs. 4.3%). Logistic regression analysis, with problem gambling as the dependent variable, revealed that lower socioeconomic status is significantly associated with an increased odds of problem gambling for Native Americans. Counter to the hypothesis, the higher the score on the Native American orientation, the higher the odds of being a problem gambler. Further, living by the "White way of life" was associated with a decreased odds of being a problem gambler; and perceived gambling convenience was associated with an increased odds of being a problem gambler. None of the Native American factors was significant in predicting alcohol abuse. These findings highlight the need for further investigation into the influence of cultural factors on Native American gambling. [ABSTRACT FROM AUTHOR]

Focuses on the work 'The Nations of a State,' by Edward H. Spicer on the history and existence of nation-states in Europe and the U.S. Definition of the phenomena of a nation-state or hidden nations; Types of states that emerged during the 20th century; Beginning of the era of the nation-state.

This article draws on the ideas of Stuart Hampshire to examine the political practices of our culture as a basis for deriving a shared understanding of justice. It is argued here that such practices intimate a notion of procedural justice or "hearing the other side:" the idea that there is virtue in settling the various disputes that arise among us concerning our different interests and conceptions of the good, including our different conceptions of substantive justice, by processes of adversarial argument rather than force. The article also argues that, if public administration scholars and practitioners wish to foster procedural justice, then, they need to have an understanding of and appreciation for our constitutional practices of adversarial argument, as well as seeking other ways of promoting such adversarial argument within their own particular agencies and organizations. [ABSTRACT FROM AUTHOR]

Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice. [ABSTRACT FROM AUTHOR]

Background Successful treatment of latent tuberculosis infection (LTBI) is an important objective in the United States' strategy for tuberculosis (TB) control. We review the impact of demographic variables and community treatment upon completion of medical therapy of LTBI in a large pediatric cohort. Methods We performed a retrospective analysis of prospectively collected data from children referred for evaluation and treatment of LTBI. Children were followed in the main hospital TB clinic or in 1 of 2 hospital-run neighborhood clinics. Those completing and not completing medical treatment were compared based on demographic and history variables, clinic location, and distance to clinic. Propensity score techniques were used to match children treated at the main hospital and neighborhood clinics on collected demographic and history variables. Results Of 1516 children evaluated, 1184 (78.1%) initiated medical therapy and returned for at least 1 visit. Of these, treatment was completed by 89.2% (166 of 186) of children in the neighborhood clinics versus 83.2% (830 of 998) of children in the main hospital TB clinic (P < .037). Neighborhood and main hospital clinic children did not differ in rates of completion when propensity score-matched groups were compared. Country of origin was the most important factor in determining both initiation and completion of therapy. Conclusions Obstacles remain for successful initiation and treatment of children from identified geographic regions. Most of the dropout occurs early in treatment, and use of neighborhood clinics does not provide an obvious advantage when similar patient groups are compared. Emphasis upon initial education and early non-clinic follow-up may be useful in enhancing therapy completion. [ABSTRACT FROM PUBLISHER]

In an effort to better understand the ancestral state of the human distal gut microbiome, we examine feces retrieved from archaeological contexts (coprolites). To accomplish this, we pyrosequenced the 16S rDNA V3 region from duplicate coprolite samples recovered from three archaeological sites, each representing a different depositional environment: Hinds Cave (∼8000 years B.P.) in the southern United States, Caserones (1600 years B.P.) in northern Chile, and Rio Zape in northern Mexico (1400 years B.P.). Clustering algorithms grouped samples from the same site. Phyletic representation was more similar within sites than between them. A Bayesian approach to source-tracking was used to compare the coprolite data to published data from known sources that include, soil, compost, human gut from rural African children, human gut, oral and skin from US cosmopolitan adults and non-human primate gut. The data from the Hinds Cave samples largely represented unknown sources. The Caserones samples, retrieved directly from natural mummies, matched compost in high proportion. A substantial and robust proportion of Rio Zape data was predicted to match the gut microbiome found in traditional rural communities, with more minor matches to other sources. One of the Rio Zape samples had taxonomic representation consistent with a child. To provide an idealized scenario for sample preservation, we also applied source tracking to previously published data for Ötzi the Iceman and a soldier frozen for 93 years on a glacier. Overall these studies reveal that human microbiome data has been preserved in some coprolites, and these preserved human microbiomes match more closely to those from the rural communities than to those from cosmopolitan communities. These results suggest that the modern cosmopolitan lifestyle resulted in a dramatic change to the human gut microbiome. [ABSTRACT FROM AUTHOR]

While research indicates that Black and Hispanic adults sentenced in the criminal court tend to be rendered more severe punishments than their White counterparts, only one prior study has examined whether this finding holds for juveniles tried in the adult system. The findings from this sole study need replication, however, since the effects posed by trial type were not taken into account and it is likely that the results are confounded by measurement error resulting from overlap in criminal sentencing. The current study addressed these issues by assessing whether race has a direct impact on waived juveniles being criminally sentenced to restitution, probation, or jail. Data were derived from a secondary, cross-sectional national dataset on felony juvenile offenders convicted in the adult system. Three hypotheses were tested. After controlling for a number of important legal and extra-legal predictors of sentencing, race differences in sentencing outcomes were observed and the findings yielded partial support for the hypotheses. The implications of the research are noted. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article discusses the ideas of John Trenchard and Thomas Gordon, as set forth in Cato’s Letters, and explores their implications for American constitutionalism and public administration. The article examines their views on the role of human passions in politics and how conflicts among such passions might be constructively harnessed to protect freedom. It is argued here that Cato’s Letters advanced an agonistic view of democratic governance, one echoed by the founders of the Constitution, in which conflicts among contesting groups, each motivated by their particular passions, serve to promote responsible governance. Therefore, if we truly wish to legitimate public administration in our constitutional practices, we must accept and, to a significant extent, embrace the conflict and contestation that these practices engender. [ABSTRACT FROM PUBLISHER]

Background: Primary data collection has established that alcohol causes injuries treated in the emergency department. No comparable data exist for injuries admitted to hospital. Data on the injury risks of heavy drinkers relative to other drinkers also are sparse. Methods: We estimated (i) whether regular heavy drinkers have higher hospitalized injury risks than other people when alcohol-negative and (ii) how much hospitalized injury risk of regular heavy drinkers and other drinkers rises when alcohol-positive. We combined national alcohol consumption data with alcohol metabolism rates to estimate hours spent alcohol-positive versus alcohol-negative during a year for heavy drinkers versus other people. A literature review provided hospitalized nonfatal injury rates for these groups by alcohol involvement. Results: Relative to other alcohol-negative people aged 18 and older, heavy drinkers have an estimated relative risk of hospitalized injury of 1.4 when alcohol-negative and 4.3 when alcohol-positive. Others have an estimated relative risk of 1.0 when alcohol-negative and 6.8 when alcohol-positive. Thus, alcohol greatly raises injury risk. The excess risk patterns persist for a wide range of sensitivity analysis values. Of hospitalized injuries, an estimated 21% are alcohol-attributable including 36% of assaults. Conclusions: Drinking alcohol is a major cause of hospitalized injury. Heavy drinkers lead risky lifestyles. They tolerate alcohol better than most drinkers, but their injury risks still triple when they drink. Our approach to attribution is a valuable complement to more costly, more precise approaches that rely heavily on primary data collection. It works for any severity of injury. Applying it only requires an existing alcohol consumption survey plus data on alcohol involvement in targeted injuries. [ABSTRACT FROM AUTHOR]

While emphasis on writing instruction has been a main concern in teaching Spanish to bilingual students in the U.S., it is an area in which very few theoretical advances have been made; in Mexico's case the situation is even more challenging. Therefore, based on classroom observations, and individual interviews with both teachers and students, and on the collection of class syllabi, this paper seeks to describe the current state of affairs regarding Spanish and English writing instruction for bilingual students in both countries. The main objectives are: 1) the analysis and comparison of the diverse teaching methodologies that high school teachers use to teach Spanish and English writing; 2) the analysis of the effects that the specific observed writing instruction has on students' perceptions about their own writing in both languages; and 3) the analysis of the perceptions that teachers have about their students' writing. [ABSTRACT FROM AUTHOR]

Objective: To study the relationships between early and combined use of alcohol and marijuana with diagnoses of alcohol and marijuana use disorders in two American Indian (AI) populations. Method: Data were drawn from a psychiatric epidemiologic study of 3084 AIs living on or near two reservations. We analysed data for adults aged 18--54 years at the time of interview ( n == 2739). Logistic regression models were estimated to examine associations between early and combined use of alcohol and marijuana with lifetime diagnoses of abuse and dependence. Results: Overall, younger AIs (18--29 years old) were more likely than older AIs (40--54 years old) to initiate substance use early and initiate use with marijuana, with or without alcohol. Persons who initiated alcohol use before age 14 were more than twice as likely as those who initiated use at older ages to meet criteria for alcohol or marijuana use disorders ( p < 0.01). The odds of abuse or dependence were two to five times higher among persons who reported combined use of alcohol and marijuana ( p< 0.01) than among those who reported use of either substance. Conclusions: These findings document the need to address both early and combined use of alcohol and marijuana in prevention and treatment programmes. [ABSTRACT FROM AUTHOR]

National Institutes of Health (NIH)-sponsored screening centers provide academic researchers with a special opportunity to pursue small-molecule probes for protein targets that are outside the current interest of. or beyond the standard technologies employed by. the pharmaceutical industry. Here, we describe the outcome of an inhibitor screen for one such target, the enzyme protein phosphatase methylesterase-1 (PME-1), which regulates the methylesterification state of protein phosphatase 2A (PP2A) and is implicated in cancer and neurodegeneration. Inhibitors of PME-1 have not yet been described, which we attribute, at least in part, to a dearth of substrate assays compatible with high-throughput screening. We show that PME-1 is assayable by fluorescence polarization-activity-based protein profiling (fluopol-ABPP) and use this platform to screen the 300,000+ member NIH small-molecule library. This screen identified an unusual class of compounds. the aza-β-lactams (ABLs), as potent (IC50 values of approximately 10 nM), covalent PME-1 inhibitors. Interestingly, ABLs did not derive from a commercial vendor but rather an academic contribution to the public library. We show using competitive-ABPP that ABLs are exquisitely selective for PME-1 in living cells and mice, where enzyme inactivation leads to substantial reductions in demethylated PP2A. In summary, we have combined advanced synthetic and chemoproteomic methods to discover a class of ABL inhibitors that can be used to selectively perturb PME-1 activity in diverse biological systems. More generally, these results illustrate how public screening centers can serve as hubs to create spontaneous collaborative opportunities between synthetic chemistry and chemical biology labs interested in creating first-in-class pharmacological probes for challenging protein targets. [ABSTRACT FROM AUTHOR]

Drawing on the ideas of Stuart Hampshire, this paper argues that American constitutionalism, thought of as a set of practices for resolving conflict, may be especially helpful in the postmodern condition because it encourages the resolution of conflict among different cultural conceptions of the good by practices of adversarial argument and procedural justice, rather than simply by force and violence. Consequently, a constitutional approach to American public administration has merit in directing our attention towards our particular practices for resolving value conflict. However, a constitutional approach cannot provide universal standards for the fair resolution of conflict. Also, any attempt to legitimate public administration in our constitutional practices is always potentially problematic because such practices, themselves, are always contestable. [ABSTRACT FROM AUTHOR]

Social scientific investigation into the religiospiritual characteristics of American Indians rarely includes analysis of quantitative data. After reviewing information from ethnographic and autobiographical sources, we present analyses of data from a large, population-based sample of two tribes (n = 3,084). We examine salience of belief in three traditions: aboriginal, Christian, and Native American Church. We then investigate patterns in sociodemographic subgroups, determining the significant correlates of salience with other variables controlled. Finally, we examine frequency with which respondents assign high salience to only one tradition (exclusivity) or multiple traditions (nonexclusivity), again investigating subgroup variations. This first detailed, statistical portrait of American Indian religious and spiritual lives links work on tribal ethnic identity to theoretical work on America's “religious marketplace.” Results may also inform social/behavioral interventions that incorporate religiospiritual elements. [ABSTRACT FROM AUTHOR]

Veterans with disabilities constitute a vast, capable, deserving, and under-utilized workforce, and many successful hiring campaigns have targeted the employment of veterans. Colleges offering comprehensive, individualized transitional services have proven successful in supporting veterans with disabilities reentering the civilian workforce. With the incorporation of learning models and reasonable academic adjustments to educational pedagogies and policies, veterans can be poised to successfully transition from college to the workforce. Disability Service (DS) offices can serve as an important bridge between the disability and career transition needs of these students. Specific suggestions are offered to increase collaboration with career offices to enhance the transition to employment. [ABSTRACT FROM AUTHOR]

The article presents the author's reflections on working with creative scholar and writer Larry Terry. The author notes that Terry's work in the field of public administration was founded on his deep respect for the U.S. Constitution and its founders. Also noted is the argument in an article written by the author and Terry, that John Rohr and other public administration scholars promoted a romanticized view of the founders of the U.S. Constitution. The author believes that public administrators should focus on constitutional practices such as limiting the abuse of power and checking the power of elected leaders.

The article studies the mental health and substance abuse service access of American Indian parents with children in child welfare. The status of American Indian parents' access to services and treatment is then compared with other ethnic groups. The factors that influence minority parents' access to substance abuse and mental health services are also discussed in the article.

Abstract: The regulations being applied to liquefied natural gas (LNG) import terminal siting in the United States are reviewed. There are no requirements for exclusion zones to protect the public from LNG spills onto water. Serious problems with current practices used to determine exclusion zones on the land-based part of the facility are identified. Many of the questions that are considered relate to the use of computational fluid dynamic (CFD) models, which appear to offer the best potential for realistic modeling to determine vapor cloud exclusion zones that result from LNG spills into impounded areas with or without dispersion in the presence of other obstacles to the wind flow. Failure to use CFD models, which are already approved by the regulation, and continued use of practices which have been demonstrated to be in error, raises important questions of credibility as well as denies the applicant full use of scientific tools that are available to optimize the design of such facilities so as to best provide for safety of the public. [Copyright &y& Elsevier]

The article presents a study on the types of help seeking for substance use problems in two American Indian reservation populations in the U.S. Furthermore, this study aims to understand the correlates of such help seeking, including measure of need, demographic characteristics, spirituality and ethnic identity. The study found that help seeking for alcohol and drug problems was common in these communities, with traditional healing and resources as essential component of the local service ecologies.

Objective: The American indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (Al- SUPERPFP) provided estimates of the prevalence of DSM-Ill-R disorders and utilization of services for help with those disorders in American Indian populations. completed between 1997 and 1999, the Al-SUPERPFP was designed to allow comparison of findings with the results of the baseline National comorbidity Survey (NCS), conducted in 1990-1992, which reflected the general United States population. Method: A total of 3,084 tribal members (1,446 in a Southwest tribe and 1,638 in a Northern Plains tribe) age 15-54 years living on or near their home reservations were interviewed with an adaptation of the University of Michigan composite International Diagnostic Interview. The life-time and 12-month prevalences of nine DSM-lII-R disorders were estimated, and patterns of help-seeking for symptoms of mental disorders were examined. Results: The most common lifetime diagnoses in the American Indian populations were alcohol dependence, posttraumatic stress disorder (PTSD), and major depressive episode. compared with NCS results, lifetime PTSO rates were higher in all American Indian samples, lifetime alcohol dependence rates were higher for all but southwest women, and lifetime major depressive episode rates were lower for Northern Plains men and women. Fewer disparities for 12-month rates emerged. After differences in demographic variables were accounted for, both American Indian samples were at heightened risk for PTSD and alcohol dependence but at lower risk for major depressive episode, compared with the NCS sample. American Indian men were more likely than those in NCS to seek help for substance use problems from specialty providers; American Indian women were less likely to talk to nonspecialty providers about emotional problems. Help-seeking from traditional healers was common in both American Indian populations and was especially common in the Southwest. conclusions: The results suggest that these American Indian populations had comparable, and in some cases greater, mental health service needs, compared with the general population of the United states. [ABSTRACT FROM AUTHOR]

Objective: American Indian populations have often been considered to be at greater risk for major depressive episode than are other groups in the United States. The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP), completed between 1997 and 1999, was designed to allow comparisons with the baseline National Comorbidity Survey (NCS), conducted in 1990-1992. The prevalence of lifetime and 12-month DSM-III-R major depressive episode was compared between the Al-SUPERPFP and NCS samples. Method: A total of 3,084 tribal members (1,446 in a Southwest tribe [73.7% of eligible participants] and 1,638 in a Northern Plains tribe [76.8% of eligible participants]) age 15-54 years living on or near their home reservations were interviewed. An adaptation of the University of Michigan Composite International Diagnostic Interview and the NCS algorithm for diagnosis were used to estimate the prevalence of lifetime and 12-month major depressive episode in these groups. Results: The prevalence estimates for life-time and 12-month major depressive episode were substantially lower in the American Indian samples, compared to the NCS sample. Detailed analyses indicated differential endorsement of lifetime symptoms between the American Indian groups and the NCS participants. Furthermore, American Indians were substantially less likely than NCS participants to indicate that depressive symptoms had co-occurred during an episode lasting at least 2 weeks. The lifetime prevalence estimates based on the NCS algorithm ranged from 3.8% to 7.9% for men and women in the two tribes. The analogous rates based on an adapted Al-SUPERPEP algorithm ranged from 7.2% and 14.3%. Few tribe, age, and gender differences were found. Conclusions: The findings underscore the need for careful examination of diagnostic instruments cross-culturally. Adaptation of the NCS algorithm for diagnosis appears necessary for estimation of the prevalence of major depressive episode in the American Indian populations included in this study. In striving to better reflect the clinical diagnostic process in epidemiological and services research, careful consideration of the resulting complexity becomes increasingly critical. [ABSTRACT FROM AUTHOR]