Search

This paper examines populous perspectives of the government's responsibility to intervene in situations of possible parental neglect of children in England, Finland, Norway, and California (USA), and ask if institutional context, defined as child protection system and children´s wellbeing situation, are formative for people's perspectives on government responsibility for children in vulnerable situations and how they view children´s future. With representative samples of populations responses to a survey vignette using ordered logistic regression, findings indicate that the institutional context shed some light on differences on state responsibility. However, similarly to welfare state research, there are differences and contradictions in important dimensions that require further investigation, especially on citizens perceptions of neglect and on intrusive interventions. Citizens with a comparatively higher education are evidently much more supportive of state responsibility for children and child protection interventions than other citizens. This finding is similar to those of other studies of state responsibility. Overall, there is a high level of support in populations for the provision of public services to children and families in vulnerable situations. [ABSTRACT FROM AUTHOR]

Introduction Collabo RATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate Collabo RATE scores and response rates across multiple clinical settings with varied patient populations. Method All adult patients at three United States primary care practices were eligible to complete Collabo RATE post-visit. To inform key learnings, we aggregated all mentions of unanticipated decisions, problems and administration errors from field notes and email communications. Mixed-effects logistic regression evaluated the impact of site, clinician, patient age and patient gender on the Collabo RATE score. Results While Collabo RATE score increased only slightly with increasing patient age ( OR 1.018, 95% CI 1.014-1.021), female patient gender was associated with significantly higher Collabo RATE scores ( OR 1.224, 95% CI 1.073-1.397). Clinician also predicts Collabo RATE score (random effect variance 0.146). Site-specific factors such as clinical workflow and checkout procedures play a key role in successful in-clinic implementation and are significantly related to Collabo RATE scores, with Site 3 scoring significantly higher than Site 1 ( OR 1.759, 95% CI 1.216 to 2.545) or Site 2 (z=−2.71, 95% CI −1.114 to −0.178). Discussion This study demonstrates that Collabo RATE can be used in diverse primary care settings. A clinic's workflow plays a crucial role in implementation. Patient experience measurement risks becoming a burden to both patients and administrators. Episodic use of short measurement tools could reduce this burden. [ABSTRACT FROM AUTHOR]

Purpose: The Relational Neurobehavioral Approach (RNA) is a set of non-aversive intervention methods to manage individuals with brain injury-related aggression. New data on interventions used in the RNA and on how the RNA interventions can be used with patients with acquired brain injury (ABI) who have differing levels of functional impairment are provided in this paper. Method: The study was conducted over a 6-week period in a secure 65-bed program for individuals with ABI that is housed in two units of a skilled nursing facility (SNF). Implementation of the RNA was compared between two units that housed patients with differing levels of functional impairment (n¼65 adults). Since this was a hierarchical clustered dataset, Generalized Estimating Equations regression was used in the analyses. Results: RNA interventions used to manage the 495 aggressive incidents included the following: Aggression ignored, Closer observation, Talking to patient, Reassurance, Physical distraction, Isolation without seclusion, Immediate medication by mouth, Holding patient. Different interventions were implemented differentially by staff based on level of functional impairment and without use of seclusion or mechanical restraint. Conclusions: The RNA can be used to non-aversively manage aggression in patients with brain injury and with differing levels of functional impairment. Programs adopting the RNA can potentially manage brain injury-related aggression without seclusion or mechanical restraint. [ABSTRACT FROM AUTHOR]

This paper introduces a new, two-part scheme for postprocessing single-valued precipitation forecast to create probabilistic quantitative precipitation forecast (PQPF). This scheme, herein referred to as the mixed-type nonhomogeneous regression (MNHR), combines the use of logistic regression for estimating rainfall intermittency and nonhomogeneous regression for estimation of additional parameters of the conditional distribution. The performance of MNHR is evaluated relative to operational mixed-type meta-Gaussian distribution (MMGD) and the censored, shifted gamma distribution (CSGD) in postprocessing Global Ensemble Forecast System (GEFS) reforecasts averaged over 25 watersheds in the American River basin in California. The results point to superior performance of MNHR relative to MMGD and CSGD in terms of the skill of postprocessed PQPFs at 24- and 96-h accumulation windows. In addition, it is observed that the performance of CSGD tends to trail behindMNHRandMMGDat least for the 24-h window, though the performance differences tend to narrow at higher forecast amounts and longer lead times. Our analyses suggest that CSGD's underperformance arises partly from its tendency to inflate the shift parameter estimates, which is pronounced over the study site possibly because of infrequent rainfall occurrence. By contrast,MNHR's use of logistic regression helps avoid such bias, and its formulation of conditional distribution addresses the lack of skewness of MMGD for higher forecast amounts. Moreover, MHNR-based PQPF exhibits both superior calibration and relatively high sharpness at short lead times and on an unconditional sense, whereas it features lower sharpness relative to the other two suites when conditioned on higher forecast amount. This trade-off between calibration and conditional sharpness warrants further research. [ABSTRACT FROM AUTHOR]

Background. American Indian/Alaska Native (AIAN) adolescents have a higher prevalence of commercial tobacco, alcohol, and marijuana use than other racial/ethnic groups in the United States. It is unclear whether cultural factors such as ethnic identity, spirituality, and ceremonial use of traditional tobacco are associated with substance use, especially use of emerging tobacco products such as electronic cigarettes, among AIAN adolescents. Methods. This study investigated the association between hypothesized cultural protective factors (ethnic identity, spirituality, and ceremonial use of traditional tobacco) and past-month use of commercial cigarettes, e-cigarettes, marijuana, blunts, and alcohol among 156 AIAN adolescents in California (mean age = 15.3 years, 55% female). Adolescents from six AIAN schools and afterschool programs completed paper-and-pencil surveys. We used Logistic regression analyses to identify the significant cultural correlates of past-month substance use, controlling for demographic covariates. Results. As hypothesized, strong ethnic identity was protective against cigarette, marijuana, and alcohol use. However, it was not protective against e-cigarette or blunt use. Spirituality was associated with an increased risk of cigarette and marijuana use. Previous ceremonial use of traditional tobacco was not associated with past-month recreational substance use. Conclusions. Results indicate that the associations between cultural factors and substance use vary across substances. Future research should identify cultural factors that protect AIAN adolescents against use of newer products such as e-cigarettes and blunts. [ABSTRACT FROM AUTHOR]

Many nations and jurisdictions have legalized non-medical adult use of cannabis, or are considering doing so. This paper contributes to knowledge of adult use legalization's associations with cannabis use disorder (CUD) treatment utilization. This study collected data from a dataset of all publicly funded substance use disorder treatment delivered in California from 2010 to 2021 (1,460,066 episodes). A logistic regression model estimates adult use legalization's impacts on CUD treatment utilization using an individual-level pre-post time series model, including individual and county-level characteristics and county and year-fixed effects. Adult use legalization was associated with a significant decrease in the probability of admission to CUD treatment (average marginal effect (AME): −0.005, 95 % CI: −0.009, 0.000). Adult use legalization was also associated with a decrease in the probability of admission to CUD treatment for males (AME: −0.025, 95 % CI: −0.027, −0.023) Medi-Cal beneficiaries (AME: −0.025, 95 % CI: −0.027, −0.023) adults ages 21+ (AME: −0.011, 95 % CI: −0.014, −0.009) and Whites (AME: −0.012, 95 % CI: −0.015, −0.010), and an increase in the probability of admission to CUD treatment for patients referred from the criminal justice system (AME: 0.017, 95 % CI: 0.015, 0.020) and Blacks (AME: 0.004, 95 % CI: 0.000, 0.007) and Hispanics (AME: 0.009, 95 % CI: 0.006, 0.011). Adult use legalization is associated with declining CUD treatment admissions, even though cannabis-related problems are becoming more prevalent. Policies and practices that protect public health, and engage people with CUD in treatment are needed. • Pre-legalization, 19 % of SUD admissions were CUD, compared to 9 % post-legalization. • Adult use legalization was associated with a decrease in CUD treatment admissions. • Differences existed in legalization's associations on different demographic groups. [ABSTRACT FROM AUTHOR]

• Factors affecting injury severity in rollover crashes were explored. • Random parameters logit model with unobserved heterogeneity in means and variances. • Findings reveal temporal instability of model specifications across individual years. • Aggregate-to-component shift quantified using out-of-sample prediction. • Implications for mitigating the associated driver injury severity. Single-vehicle rollover crashes have been acknowledged as a predominant highway crash type resulting in serious casualties. To investigate the heterogeneous impact of factors determining different injury severity levels in single-vehicle rollover crashes, the random parameters logit model with unobserved heterogeneity in means and variances was employed in this paper. A five-year dataset on single-vehicle rollover crashes, gathered in California from January 1, 2013, to December 31, 2017, was utilized. Driver injury severities that were determined to be outcome variables include no injury, minor injury, and severe injury. Characteristics pertaining to the crash, driver, temporal, vehicle, roadway, and environment were acknowledged as potential determinants. The results showed that the gender indicator specified to minor injury was consistently identified as a significant random parameter in four years' models and the joint five-year model, excluding the 2016 crash model where the night indicator associated with no injury was observed to produce the random effect. Additionally, two series of likelihood ratio tests were conducted to assess the year-to-year and aggregate-to-component temporal stability of model estimation results. Marginal effects of explanatory variables were also calculated and compared to analyze the temporal stability and interpret the results. The findings revealed an overall temporal instability of model specifications across individual years, while there is no significant aggregate-to-component variation. Injury severities were observed to be stably affected by several variables, including improper turn indicator, under the influence of alcohol indicator, old driver indicator, seatbelt indicator, insurance indicator, and airbag indicator. Furthermore, the year-to-year and aggregate-to-component shift was quantified and characterized by calculating the differences in probabilities between within-sample observations and out-of-sample predictions. The overall results imply that continuing to expand and refine the model to incorporate more comprehensive datasets can result in more robust and stable injury severity prediction, thus benefiting in mitigating the associated driver injury severity. [ABSTRACT FROM AUTHOR]

An alarming, consistent increase in U.S. pedestrian fatalities since 2009 culminated in a 28-year high of 6,283 pedestrians killed in 2018. Yet these numbers obscure a second alarming trend: 75% of pedestrian fatalities occur in darkness, and nearly 90% of the increase in pedestrian fatalities from 2009 to 2018 occurred in darkness. This paper examines data on pedestrian fatalities at the national level and pedestrian fatalities and serious injuries in California from 2012 to 2017 to better understand correlates of severe pedestrian injuries in darkness. Binary and multinomial logit models reveal that variables related to roadway design and operations (e.g., speed limits, number of lanes, roadway type, and presence of traffic control) – but not speeding – are significantly associated with the likelihood of a pedestrian fatality or serious injury occurring in darkness as compared to daylight. Critically, these factors – which were consistent for fatalities regardless of lighting presence and roadway type, with few exceptions – are all worse in darkness because they are negatively affected by a lack of visibility. Alcohol usage by drivers or pedestrians and sociodemographic characteristics were also positively associated with severe injuries in darkness. Our findings urge an explicit consideration of pedestrian safety in darkness in all future design and retrofit decisions, and particularly on higher-speed, multi-lane roadways. Immediate solutions include roadway designs and policies that slow drivers, particularly at night, and that increase illumination and driver attention, such as through additional roadway lighting, high-visibility countermeasures and protected crossings, and adaptive lighting and detection technology for vehicles. • Pedestrian fatalities on multilane roads significantly more likely in darkness. • Fatalities at speeds over 30 mph are significantly more likely in darkness. • Black and Native American pedestrian deaths significantly more likely in darkness. • Efforts to slow drivers and provide safe crossings in darkness are needed. • Roadway design efforts should explicitly consider pedestrian safety in darkness. [ABSTRACT FROM AUTHOR]

Background: Black tar heroin is typically prepared for injection with heat which decreases the risk of HIV transmission by inactivating the virus. We received reports that persons who inject drugs (PWID) in Tijuana, Baja California, Mexico, a black tar heroin market, were using only water to dissolve heroin.Objectives: Because Tijuana abuts San Diego County, CA, United States, we undertook the present analyses to determine the prevalence of this practice among PWID in San Diego, California.Methods: PWID completed quarterly behavioral assessments and serological testing for blood-borne viruses. Bivariate and multivariable logistic regression models were constructed to assess for individual, social, and structural correlates of preparing heroin without heat within the preceding 6 months.Results: Nearly half of black tar heroin users (149/305) reported they had prepared heroin without heat within 6 months. In multivariable analysis, cold preparation was independently associated with younger age (10 year decrease; AOR = 1.25; 95% CI 1.03, 1.53), more drug injecting acquaintances (per 5 acquaintance increase; AOR = 1.05; 95% CI 1.01, 1.09) and prefilled syringe use (injecting drugs from syringes that are already filled with drugs before purchase; AOR = 1.86; 95% CI 1.14, 3.02).Conclusions/Importance: To our knowledge, this is the first paper to report that PWID living in a black tar heroin market are preparing heroin without heat. Additional research is needed to determine whether this is an endemic practice or PWID are engaging in new forms of drug preparation in response to changes in the environment. [ABSTRACT FROM PUBLISHER]

Objective: Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities. Design: A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions. Setting: Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA. Subjects: Store patrons were interviewed before (n 550) and after (n 407) the intervention. Results: Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V. Conclusions: Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued. [ABSTRACT FROM AUTHOR]

The cyclical pattern of violence in the lives of homeless female ex-offenders may precipitate ongoing substance use and recidivism; all of which have shown to be mounting public health issues affecting successful reentry. This paper, which analyzed baseline data from a longitudinal study of 126 female ex-offenders in Los Angeles and Pomona, California, highlighted the factors found to be associated with violent crime among homeless female ex-offenders. A multiple logistic regression model for whether or not the last conviction was for a violent offense indicated that poor housing (p= .011) and self-reported anger or hostility (p< .001) were significant correlates. An ordinal regression model for the number of violent offenses also indicated that affectionate support was associated with committing fewer number of violent crimes (p= .001), while positive social interactions (p= .007), and anger/hostility (p= .015) were associated with greater number of violent crimes. Implications for developing a comprehensive array of strategies that can mitigate the pattern of violence often seen in the lives of homeless female who have recently exited jails and prisons is discussed. [ABSTRACT FROM AUTHOR]

High levels of HIV stigma are one of the main difficulties in engaging African-American and Latino men who have sex with men (MSM) in HIV testing. The availability of home HIV test and the possibility of self-testing in private may improve uptake and counteract stigma. This paper sought to determine the correlates of requesting home HIV test kits among a sample of MSM social media users. The odds of participants requesting a test kit were significantly associated with using social networks to seek sexual partners (aOR: 2.47, 95% CI: 1.07–6.06) and thinking it is easier to use social networks for seeking sexual partners (1.87, 1.2–3.12), uncertain HIV status (4.29, 1.37–14.4), and having sex under the influence of alcohol (2.46, 1.06–5.77). Participants who had not been tested for more than 6 months were more likely to request a test kit than those who were tested in the past 6 months (2.53, 1.02–6.37). Participants who frequently talked to others about having sex with men online were less likely to request a test kit (0.73, 0.56–0.92). By reaching people over social media and offering them access to test kits, we were able to reach at-risk individuals who were uncertain about their HIV status and had not been regularly tested. The findings of the study will help to inform future HIV testing interventions. [ABSTRACT FROM PUBLISHER]

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on "Big Data and Analytics in Healthcare".Background: Hospital readmissions raise healthcare costs and cause significant distress to providers and patients. It is, therefore, of great interest to healthcare organizations to predict what patients are at risk to be readmitted to their hospitals. However, current logistic regression based risk prediction models have limited prediction power when applied to hospital administrative data. Meanwhile, although decision trees and random forests have been applied, they tend to be too complex to understand among the hospital practitioners.Objectives: Explore the use of conditional logistic regression to increase the prediction accuracy.Methods: We analyzed an HCUP statewide inpatient discharge record dataset, which includes patient demographics, clinical and care utilization data from California. We extracted records of heart failure Medicare beneficiaries who had inpatient experience during an 11-month period. We corrected the data imbalance issue with under-sampling. In our study, we first applied standard logistic regression and decision tree to obtain influential variables and derive practically meaning decision rules. We then stratified the original data set accordingly and applied logistic regression on each data stratum. We further explored the effect of interacting variables in the logistic regression modeling. We conducted cross validation to assess the overall prediction performance of conditional logistic regression (CLR) and compared it with standard classification models.Results: The developed CLR models outperformed several standard classification models (e.g., straightforward logistic regression, stepwise logistic regression, random forest, support vector machine). For example, the best CLR model improved the classification accuracy by nearly 20% over the straightforward logistic regression model. Furthermore, the developed CLR models tend to achieve better sensitivity of more than 10% over the standard classification models, which can be translated to correct labeling of additional 400 - 500 readmissions for heart failure patients in the state of California over a year. Lastly, several key predictor identified from the HCUP data include the disposition location from discharge, the number of chronic conditions, and the number of acute procedures.Conclusions: It would be beneficial to apply simple decision rules obtained from the decision tree in an ad-hoc manner to guide the cohort stratification. It could be potentially beneficial to explore the effect of pairwise interactions between influential predictors when building the logistic regression models for different data strata. Judicious use of the ad-hoc CLR models developed offers insights into future development of prediction models for hospital readmissions, which can lead to better intuition in identifying high-risk patients and developing effective post-discharge care strategies. Lastly, this paper is expected to raise the awareness of collecting data on additional markers and developing necessary database infrastructure for larger-scale exploratory studies on readmission risk prediction. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is an important cause of cancer death in adults in the U.S.; screening is effective but underutilized, particularly among minorities. The purpose of this paper was to explore whether health belief model (HBM) constructs pertaining to CRC screening differ by race/ethnicity and primary language. Data were from the baseline surveys of 933 participants (93.5%) in a randomized trial promoting CRC screening in San Francisco. Composite scores for each construct were created from multiple items, dichotomized for analysis, and analyzed using multivariate logistic regression. Most participants were Asian (29.7%) or Hispanic (34.3%), and many were non-English speakers. Non-English speaking Hispanics (p<.001) and English-speaking Asians (p=.002) reported lower perceived susceptibility than non-Hispanic Whites (NHW). Non-English speaking Hispanics reported more and non-English speaking Asians fewer perceived barriers (psychological and structural) than NHW. Understanding how different populations think about CRC screening may be critical in promoting screening in diverse populations. [ABSTRACT FROM AUTHOR]

This paper examines inter-method reliability and validity of daily self-reports by smartphone application compared to 14-day recall web-surveys repeated over 6 weeks with people living with HIV (PLH). A participatory sensing framework guided participant-centered design prioritizing external validity of methods for potential applications in both research and self-management interventions. Inter-method reliability correlations were consistent with prior research for physical and mental health quality-of-life (r = 0.26-0.61), antiretroviral adherence (r = 0.70-0.73), and substance use (r = 0.65-0.92) but not for detailed sexual encounter surveys (r = 0.15-0.61). Concordant and discordant pairwise comparisons show potential trends in reporting biases, for example, lower recall reports of unprotected sex or alcohol use, and rounding up errors for frequent events. Event-based reporting likely compensated for modest response rates to daily time-based prompts, particularly for sexual and drug use behaviors that may not occur daily. Recommendations are discussed for future continuous assessment designs and analyses. [ABSTRACT FROM AUTHOR]

Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use. Self-report survey data were collected using electronic handheld devices for a school-based randomised trial. The survey sample includes 911 young people (mean age = 12.4 years) representative of their schools. Logistic regressions explored associations between selected sexual behaviours and relationship characteristics. For all participants, having more boy/girlfriends, dating alone, ever touching and ever having had oral sex were associated with an increased likelihood of having vaginal sex. Among young people with current partners, having a partner three or more years older, length of relationship and ever having oral sex were associated with an increased likelihood of having vaginal sex. The study data confirm the importance of accounting for relationships in sexual risk reduction programmes, and provide avenues for enhancing the relevancy of typical school-based prevention programmes. [ABSTRACT FROM PUBLISHER]

The important goals of Magnet® hospitals are to create supportive professional nursing care environments. A recently published paper found little difference in work environments between Magnet and non-Magnet hospitals. The aim of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. A secondary analysis of data from a 4-state survey of 26,276 nurses in 567 acute care hospitals to evaluate differences in work environments and nurse outcomes in Magnet and non- Magnet hospitals was conducted. Magnet hospitals had significantly better work environments (t = -5.29, P < .001) and more highly educated nurses (t = -2.27, P < .001). Magnet hospital nurses were 18% less likely to be dissatisfied with their job (P <.05) and 13% less likely to report high burnout (P < .05). Magnet hospitals have significantly better work environments than non-Magnet hospitals. The better work environments of Magnet hospitals are associated with lower levels of nurse job dissatisfaction and burnout. [ABSTRACT FROM AUTHOR]

Although exclusionary immigration policies are associated with fear of deportation and avoidance of public benefits, relationships between immigration enforcement policy and public charge policies are largely unknown. Using a California population-based survey of 1103 Asian and Latinx immigrants in 2018, we tested the relationship between immigrants' experiences with law enforcement and their concern about public charge. Direct encounters with various forms of law enforcement, including being asked to show proof of citizenship by law enforcement, staying inside to avoid police or immigration officials, and having known someone who had been deported, were associated with immigrants' avoidance of public benefits due to public charge concerns. Latinx immigrants were more likely to be concerns about public charge than Asians. Intersections among immigration policies deserve further consideration. There is a need to provide accurate and reliable information to immigrant communities about public benefits and advocate for inclusive immigration policies. [ABSTRACT FROM AUTHOR]

A small but growing body of research suggests that adolescents and young adults involved with the child welfare system and those transitioning out of foster care are at heightened risk of experiencing intimate partner violence (IPV). Understanding the factors that place youth at risk of IPV is central to prevention and treatment of this public health problem. However, questions remain about the prevalence and correlates of IPV among youth in foster care. Additionally, emotional abuse, a particular form of IPV in intimate partnerships, remains an understudied area in this population. This study aimed to address these gaps in research by exploring factors associated with IPV using longitudinal data from a representative sample of older youth in California Foster Care who participated in the California Youth Transitions to Adulthood Study (CalYOUTH). Our IPV outcome measures included victimization, perpetration, bidirectional IPV, and emotional abuse. Findings suggest that approximately one-fifth (20.4%) of CalYOUTH respondents had experienced some form of IPV at age 23, with emotional abuse and bidirectional violence being the most commonly reported types of IPV. Females reported emotional abuse, as well as bidirectional violence, at nearly double the rates of their male counterparts. Self-identified sexual minority youth (SMY; lesbian, gay, bisexual, transgender, queer, or questioning) were more likely to report IPV victimization, IPV perpetration, and bidirectional violence than their non-SMY peers. Youth with histories of emotional abuse, caregiver IPV victimization, sexual abuse in foster care, placement instability, substance use, anxiety, and incarceration were also at heightened risk of IPV involvement. Emotional abuse was most prevalent with SMY. The findings contribute to the growing research on IPV among transition-age foster youth with important implications for future research, practice, and policy. [ABSTRACT FROM AUTHOR]

Executive functions (EF) and sensorimotor skills play a critical role in children's goal-directed behavior and school readiness. The aim of the current study is to provide new insights into the relationship between executive functions and sensorimotor development by considering the risks associated with learning difficulties. Therefore, we investigate the predictive role of EF and sensorimotor skills in the development of learning difficulties during preschool years. Ninety-five preschool children (5–7 years old) were tested, comparing the performance of children that are at risk of learning difficulties (n = 55) to the performance of typically developing children (n = 40). Participants completed a battery for the assessment of sensorimotor skills (i.e., Southern California Sensory Integration Test: postural imitation, body midline crossing, bilateral motor coordination, and standing balance with eyes open) and executive functions (i.e., inhibition, cognitive flexibility, and verbal working memory). Our results show that children at risk for learning difficulties exhibited more impairments on sensorimotor and EF measures (inhibition and verbal working memory) when compared with TD children. We ran three separate binary logistic regression analyses to assess the relative influence of EF and sensorimotor functions on predicting risk for learning difficulties. Our findings demonstrated that verbal working memory as EF function (odd ratio OR = 0.91 , 95% CI 0.78-0.91, P = 0.05) and standing balance skills as a sensorimotor skill (odd ratio OR = 0.86 , 95% CI 0.81-0.98, P = 0.01) were the strongest predictors of risk for learning difficulties. The findings point to the importance of supporting children's executive function development and promoting sensorimotor development, as both fundamentally influence school readiness. [ABSTRACT FROM AUTHOR]

Background: Orthopaedic registries have shown value in tracking and surveillance of patients, implants, and outcomes associatedwith procedures. No current anterior cruciate ligament reconstruction registry (ACLRR) exists in the United States.Purpose: To describe the current cohort captured by an institutional ACLRR and describe the outcomes observed in the registeredpatients and how findings from the ACLRR are disseminated.Study Design: Cohort study; Level of evidence, 2.Methods: The anterior cruciate ligament reconstructions (ACLRs) registered between February 2005 and September 2011 by 244surgeons in 48 medical centers were evaluated. The ACLRR collected data intra- and postoperatively using paper forms and electronicmedical records. The ACLRR cohort was longitudinally followed and outcomes were prospectively ascertained. Outcomes(ie, revisions, subsequent operations, venous thromboembolism, and surgical site infections) were adjudicated via chart review.Descriptive statistics are used to describe the cohort and Kaplan-Meier curves to evaluate survival.Results: During the study period, 16,192 ACLRs (15,101 primary and 1091 revisions) with a median follow-up of 1.6 years (interquartilerange, 0.7-2.8 years) were registered. Male patients received 64% of both primary and revision ACLRs. The mean age atsurgery was 29.5 years (SD, 11.4 years) for primary and revision reconstructions. Cartilage injuries were noted in 25.2% of primaryand 37.5% of revision ACLRs, and meniscal injuries were identified in 60.8% and 53.2%, respectively. Autografts were used in57.6% of primary ACLRs and 20.9% of revisions. Allografts were used in 42.4% of primaries and 78.8% of revisions. In primaryACLR, the most common femoral and tibial fixation types were interference screws (42.2% and 79.7%, respectively). Fixationtype distribution was nearly identical in primaries and revisions. Of the primary ACLRs, 3.7% had subsequent operations onthe same knee and 1.7% on the contralateral knee. Deep surgical site infection developed in 0.3% of primaries and 0.8% ofrevisions. Symptomatic deep vein thromboses were seen in 0.2% of both primaries and revisions. The overall revision ratewas 1.7%. Lower rates of graft survival were identified in younger patients and those with allografts.Conclusion: Large, community-based ACLRRs are useful in informing participating surgeons of current treatment practices,prevalence of concurrent injuries, and outcomes associated with the procedures. Information from the ACLRR can be used todevelop interactive patient and surgeon tools that can be used to optimize patient care. [ABSTRACT FROM AUTHOR]

Optimal adherence to antiretroviral therapy (ART) is essential for reducing mortality and morbidity in persons living with HIV/AIDS (PLWHA), as well as for reducing the risk of further HIV transmission. While studies have identified psychosocial factors such as lack of social support and poor mental health status as important barriers to optimal ART adherence, few studies have explored the potential of a mediation effect of psychosocial factors on the relationship between social support and optimal ART adherence. This paper assessed whether mental health status mediated the relationship between social support and optimal ART adherence among a cross-sectional sample of 202 persons living with HIV who were recruited from HIV clinical care sites and community-based organizations in Los Angeles County (LAC). Participants completed a survey that included social support items from the Medical Outcome Study: Social Support Survey (MOS-SSS) Instrument, mental health measures from the Medical Outcomes Study Short Form (SF-12), and ART adherence based on self-report. Among those currently taking ART, 61.7% reported having optimal adherence. Social support was significantly associated with a high score on the mental health status scale (AOR =2.90; 95% CI=1.14–5.78) and optimal ART adherence (AOR=1.81; 95% CI=1.81; 95% CI=1.18–2.79). When mental health status was introduced into the model, the association between social support and optimal ART adherence was no longer significant. Our findings suggest the HIV interventions targeting social support to improve ART adherence will likely be most successful if the support bolsters the mental health of the participants. Clearly, better understanding the relationships among social support, mental health, and ART adherence will be critical for development and implementation of future ART adherence interventions. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to examine the longitudinal effects of psychological sense of control and control-related coping strategies on breast cancer outcomes. Utilizing the California Cancer Registry, follow-up data on cancer recurrence and all-cause mortality were obtained for 54 of 58 women originally diagnosed with breast cancer in 1992 to 1994. Relationships between cancer outcomes and psychological control and mood at 4 and 8 months post-diagnosis were examined. Results of the study showed that a greater sense of control at 8 months was associated with less cancer recurrence, while higher desire for control at both 4 and 8 months was associated with greater likelihood of recurrence. Utilization of an accepting mode of control appeared to mitigate the negative effects of desire for control on recurrence. No significant relationships were observed between mood and mortality or recurrence. These findings suggest the potential value of examining psychological control and control-related coping on cancer outcomes in future epidemiological and clinical studies. [ABSTRACT FROM AUTHOR]

The quality of propensity scores is traditionally measured by assessing how well they make the distributions of covariates in the treatment and control groups match, which we refer to as 'good balance'. Good balance guarantees less biased estimates of the treatment effect. However, the cost of achieving good balance is that the variance of the estimates increases due to a reduction in effective sample size, either through the introduction of propensity score weights or dropping cases when propensity score matching. In this paper, we investigate whether it is best to optimize the balance or to settle for a less than optimal balance and use double robust estimation to adjust for remaining differences. We compare treatment effect estimates from regression, propensity score weighting, and double robust estimation with varying levels of effort expended to achieve balance using data from a study about the differences in outcomes by HIV status in heterosexually active homeless men residing in Los Angeles. Because of how costly data collection efforts are for this population, it is important to find an alternative estimation method that does not reduce effective sample size as much as methods that aggressively aim to optimize balance. Results from a simulation study suggest that there are instances in which we can obtain more precise treatment effect estimates without increasing bias too much by using a combination of regression and propensity score weights that achieve a less than optimal balance. There is a bias-variance tradeoff at work in propensity score estimation; every step toward better balance usually means an increase in variance and at some point a marginal decrease in bias may not be worth the associated increase in variance. [ABSTRACT FROM AUTHOR]

This paper examines racial and ethnic disparities in continuation of mental health services for children and youth in California and how English language proficiency moderates the effect of race/ethnicity on the continuation of service. While previous research indicated racial/ethnic or geographic disparities in accessing mental health services among children and youth, few studies specifically focused on the continuation of mental health care. The authors used administrative data from California county mental health services users under age 25. Applying logistic regression, English language proficiency was found to be the major determinant of continuation of mental health services in this age group. With the exception of children of Asian descent, non-English speaking children and youth of diverse racial/ethnic background were significantly less likely to continue receiving mental health services compared with White English-speaking peers, even after controlling for sociodemographic, clinical and county characteristics. [ABSTRACT FROM AUTHOR]

common concern within HIV prevention is that HIV positive MSMW do not disclose their HIV status to female partners who are thus at increased risk for HIV infection. The present study uses unique data to examine whether MSMW disclose more often to male rather than female partners. Data were collected on most recent male and/or female primary partner and four most recent casual partners from 150 MSMW (50 African American, 50 Latino, 50 White). MSMW reported on 590 partners (31% female; 69% male). Disclosure was coded as disclosure before sex, disclosure after sex, or nondisclosure. A series of multinomial logistic regressions with partners clustered within respondents were conducted to evaluate effects of respondent characteristics and partner characteristics on timing of disclosure. In bivariate and multivariate analyses there were no significant differences in odds of disclosure to male and female partners before or after sex. Although MSMW were substantially less likely to disclose to HIV negative partners before sex compared to HIV positive partners regardless of sex, when we fully interacted the multivariate model by partner sex, the odds of disclosure to HIV negative male partners compared to HIV positive male partners before sex were significantly higher than the odds of disclosure to HIV negative female partners compared to HIV positive female partners. Patterns of mutual nondisclosure and nonreciprocal disclosure were observed with both primary and casual partners. The paper makes additional methodological contributions to the measurement and analysis of disclosure. [ABSTRACT FROM AUTHOR]

frican American men who have sex with men and women (MSMW), but who do not form a sexual identity around same-sex behavior, may experience risk for HIV infection and transmission. This paper reports cross-sectional survey findings on sexual behaviors and substance use of urban non-gay- or non-bisexual-identified African American MSMW ( n = 68), who completed behavior assessment surveys using audio-computer assisted self-interviewing technology. Overall, 17.6% reported being HIV-positive. In the past 3 months, 70.6% had unprotected insertive sex with a female, 51.5% had unprotected insertive anal sex (UIAS) with a male, 33.8% had unprotected receptive anal sex (URAS) with a male, 25% had UIAS with a transgender female, and 10.3% had URAS with a transgender female. Findings indicated a bridging potential for HIV and sexually transmitted infections across groups, such that 38.2% reported concurrent unprotected sex with female and male partners and 17.6% reported concurrent unprotected sex with female and transgender female partners. In the past 3 months, 70.6% used alcohol before sex and 85% used drugs before sex. Men who used drugs before sex had a tenfold increased likelihood for unprotected sex with male partners, and men who injected drugs had a nearly fivefold increased likelihood for unprotected sex with a transgender female. Interventions to address sexual risk behaviors, especially partner concurrency, and substance use behavior for these men are warranted. [ABSTRACT FROM AUTHOR]

In this paper, we attempt to forecast which prison inmates are likely to engage in very serious misconduct while incarcerated. Such misconduct would usually be a major felony if committed outside of prison: drug trafficking, assault, rape, attempted murder and other crimes. The binary response variable is problematic because it is highly unbalanced. Using data from nearly 10,000 inmates held in facilities operated by the California Department of Corrections, we show that several popular classification procedures do no better than the marginal distribution unless the data are weighted in a fashion that compensates for the lack of balance. Then, random forests performs reasonably well, and better than CART or logistic regression. Although less than 3% of the inmates studied over 24 months were reported for very serious misconduct, we are able to correctly forecast such behavior about half the time. [ABSTRACT FROM AUTHOR]

Background: Illicit substance use and abuse may be an important contributor to behavioral health problems of lesbian and bisexual women. This paper describes the nature and extent of self-reported illicit and licit drug use, associated severity, and substance use-related helpseeking behaviors in an urban/metropolitan community sample of sexual minority women in California. Methods: Self-administered questionnaire data from 2011 lesbian and bisexual women recruited through multiple strategies were used. Multiple logistic regression was employed to describe patterns of reported drug use and to compare lifetime severity of drug use with demographic characteristics, recent drug use, indicators of current social and emotional problems, and help-seeking behaviors. Results: Drug use, especially marijuana (33% used in the past year), was fairly common. Overall, 16.2% of the women in the study reported lifetime drug use that was associated with self-reported severity of substance use, and another 10.8% indicated moderate-risk use. Extent of lifetime drug use was positively correlated with self-reported recent drug use as well as current life problems. Of the respondents who evidenced more problematic drug use, 41.5% indicated that they had received professional help for a substance use problem, and 16.3% wanted but had not received such help. Conclusions: The women in this study reported elevated rates of illicit drug use that was frequently associated with impairment and specific life problems. A significant proportion wanted and had not received professional treatment for their drug use problems. Future studies that examine pathways by which lesbians and bisexual women can obtain referrals and treatment for substance use problems are needed. [ABSTRACT FROM AUTHOR]

Background and Aims: The increasing trend in alcohol consumption among women, exacerbated by the COVID‐19 pandemic, is of growing concern. Screening, brief intervention, and referral to treatment in primary care is an efficacious and cost‐effective treatment approach for unhealthy alcohol use. However, disparities exist in delivery of brief interventions by sex, age and race/ethnicity. This study measures brief intervention rates among eligible patients by sex, age and race/ethnicity and their intersectionality, in the context of a program of systematic alcohol screening and brief intervention program in adult primary care in a large, integrated health‐care delivery system. Design, Setting and Participants: This was a population‐based observational study among primary care clinics in an integrated health‐care delivery system in Northern California, USA. The participants comprised adult (18+) patients (n = 287 551) screening positive for unhealthy alcohol use between January 2014 and December 2017. Measurements: Receipt of brief intervention, patient and provider characteristics from electronic health records. Findings Multi‐level logistic regression showed that women had lower odds of receiving brief intervention than men among all age, racial/ethnic groups and drinking levels. Sex differences were greater among those aged 35–49 years [odds ratio (OR) = 0.67, 95% confidence interval (CI) = 0.64, 0.69]) and 50–65 years (OR = 0.69, 95% CI =0.66, 0.72) than among other age groups. Sex differences in odds of receiving brief intervention were greater for the Latino/Hispanic group for women versus men (OR = 0.69, 95% CI = 0.66, 0.72) and smaller for the Asian/Pacific Islander group (OR = 0.76, 95% CI = 0.72, 0.81). Conclusion: In the United States, compared with men, women appear to have lower odds of receiving brief intervention for unhealthy alcohol use across all age groups, particularly during middle age. Black women and Latina/Hispanic women appear to be less likely to receive brief intervention than women in other race/ethnicity groups. Receipt of brief intervention does not appear to differ by drinking levels between men and women. [ABSTRACT FROM AUTHOR]

This paper examines differences between men and women in the relationship of alcohol and drug use to criminal offenses, including violent behavior. A probability sample of men (N = 959) and women (N = 188) arrestees were interviewed in a northern California county. No significant differences were found between men and women in patterns of drug use, but more men than women reported heavy drinking. A higher proportion of men than women reported violence in the events related to their arrest (p < .02). Logistic regression examined the relationship of heavy thinking and violent offenses, controlling for drug use and demographic variables. Frequent heavy drinking (OR = 1.47), white ethnicity (OR = .5 1), and being married (OR = 1.93) were significant; gender was not significant. The results have implications for future research on gender and violence. [ABSTRACT FROM AUTHOR]

Discrete choice models of demand are growing in popularity for understanding markets for seafood, but have thus far been limited to applications using individual-level choice data. The random coefficients logit model is a discrete choice demand model designed for aggregate sales data and imparts a number of theoretical and empirical advantages. Instrumental variables account for price endogeneity, which can arise when there are unobserved product characteristics. Furthermore, correlated preferences can be accommodated in the random coefficients as well as through demographic interactions, which is especially important for seafood where product characteristics are primarily qualitative. We estimate this model for salmon fillets using four years of county-level seafood sales in California, and demonstrate the insights that can be drawn regarding consumer preferences and substitution patterns. Although the model is computationally burdensome, it offers considerable potential for further seafood demand analysis. [ABSTRACT FROM AUTHOR]

Satisfaction with life is a self-reported measure of the quality of life that has become a critical societal indicator extensively used for the evaluation and comparison of a wide range of trends and policies. This study fuses five cross-sectional travel surveys conducted from 1992 to 2018 across various geographical locations in California. Using the fused sample, we develop generalized ordered logit models to examine the effects of demographic characteristics, travel-related attributes, general and transport-related attitudinal variables, and context-control variables on individuals' self-reported measures of life satisfaction. We find that longer commute times, mobility limitations, and a tendency to see travel as a waste of time are negatively associated with life satisfaction. To enable the use of disparate cross-sectional survey data, we incorporate context-control variables into the models. We find that life satisfaction appears to be increasing as GDP per capita increases. Among employed people, the macro-scale unemployment rate positively influences their life satisfaction. Interestingly, all else equal, we find that online opinion panel respondents have lower life satisfaction relative to respondents from other sampling methods (mainly address-based sampling), a finding that should be considered in future research using these sampling methods. Overall, this study provides a unique look at life satisfaction within a transport context, while providing an example of fusing small-scale survey datasets to study longitudinal, domain-specific, influences on variables like subjective well-being. [ABSTRACT FROM AUTHOR]

The Consent-to-Contact (C2C) registry at the University of California, Irvine collects data from community participants to aid in the recruitment to clinical research studies. Self-selection into the C2C likely leads to bias due in part to enrollees having more years of education relative to the US general population. Salazar et al. (Alzheimer's Dementia Transl Res Clin Interv 6(1):e120023, 2020, https://doi.org/10.1002/trc2.12023) recently used the C2C to examine associations of race/ethnicity with participant willingness to be contacted about research studies. To obtain representative estimates from C2C we use weighted estimation of associations of interest where the weights are related to the probability of self-selection into the convenience sample. The selection probabilities are estimated using data from the National Health and Nutrition Examination Survey (NHANES). We create a combined dataset of C2C and NHANES subjects and evaluate the trade-offs of different approaches (logistic regression, covariate balancing propensity score, entropy balancing, and random forest) for estimating the probability of membership in C2C relative to NHANES. We further propose methods to estimate the variance of parameter estimates that account for uncertainty that arises from estimating propensity weights. Simulation studies explore the impact of propensity weight estimation on uncertainty. We demonstrate the approach by repeating the analysis by Salazar et al. (Alzheimer's Dementia Transl Res Clin Interv 6(1):e120023, 2020, https://doi.org/10.1002/trc2.12023) with the deduced propensity weights for the C2C subjects and contrast the results of the two analyses. This method can be implemented using our estweight package in R available on GitHub. [ABSTRACT FROM AUTHOR]

Background: The relationship between the risk of exposure to environmental hazards and the emergency preparedness of nursing homes is not wellunderstood. This study evaluates the association between wildfire exposure risk and nursing home emergency preparedness. Methods: From a sample of Centers for Medicare & Medicaid Services (CMS) certified nursing homes in California, we determined the prevalence of “exposed” facilities that were located within 5 km of a wildfire risk area, as informed by a field-tested model. Among the 1182 nursing homes, we identified emergency preparedness deficiencies from January 2017 to December 2019. We estimated associations between exposure and emergency preparedness deficiencies using unadjusted and adjusted generalized estimating equations with logistic and negative binomial distributions. Results: A greater percentage of the 495 exposed facilities had at least one emergency preparedness deficiency than the 687 unexposed facilities (83.9% vs 76.9%). The mean (3.6 vs 3.2) and median (3 vs 2) numbers of emergency preparedness deficiencies were also greater for exposed facilities. In both the unadjusted and adjusted analyses, exposure to wildfire risk was significantly associated with the likelihood of at least one emergency preparedness deficiency (adjusted odds ratio 1.52, p-value 0.007). There was a positive but not statistically significant association between exposure and the number of emergency preparedness deficiencies assigned to a nursing home (adjusted rate ratio 1.12, p-value 0.062). These results were consistent in analyses that used more stringent distance- and severity-thresholds to define exposure status. Conclusion: California nursing homes at heightened risk of exposure to wildfires have poorer emergency preparedness than unexposed facilities. These findings suggest that nursing home management and staff may be unaware of important environmental risks to which their facilities are exposed. Improved integration of nursing homes into community disaster planning may better align facility preparedness with surrounding wildfire risk. [ABSTRACT FROM AUTHOR]

To compare the effectiveness of 12 weeks of community-based, in-person, group Tai Chi (TC) and Health Education (HAP-E) in improving health and wellbeing in older adults with hypertension and in promoting psychological resilience during COVID-19. A 12-week randomized controlled trial (RCT) in San Diego County, USA. Self-reported depressive symptoms, anxiety, sleep disturbances, gratitude, resilience, mental and physical health were assessed in-person pre- and post-intervention, and by long-term follow-up surveys during COVID-19. Linear mixed-effects models were used to assess study arm differences over time and logistic regression to identify predictors of positive intervention response. Of 182 randomized participants (72.6 ± 7.9 yrs; 72% female), 131 completed the intervention. Modest improvements in health and wellbeing occurred post-intervention in both arms (Cohen's d: TC = 0.38, 95% CI: 0.25–0.51; HAP-E = 0.24, 0.11–0.37), though positive intervention responses were more than twice as likely in TC (OR = 2.29, 1.07–4.57). Younger age, higher anxiety, and poorer mental health at baseline predicted greater odds of response. Small declines in health and wellbeing were reported at the first COVID-19 follow-up, with smaller declines in the TC arm (Cohen's d: TC = −0.15, −0.31–0.00; HAP-E = −0.34, −0.49 to −0.19). Health and wellbeing stabilized at the second COVID-19 follow-up. Most participants (>70%) reported that the interventions benefitted their health and wellbeing during COVID-19. TC and HAP-E improved health and wellbeing, though TC conferred greater odds of an improved mental health response. Declines in health and wellbeing were observed at pandemic follow-up, with smaller declines in the TC arm, suggesting increased resilience. [ABSTRACT FROM AUTHOR]

Undocumented immigrants may be vulnerable to poor COVID-19 outcomes, but also may be less likely to seek medical care. To our knowledge, there have not been any investigations of potential COVID-19 disparities by immigration status. We analyzed emergency department (ED) visit data from March 20, 2020 to September 30, 2020 among patients in a safety-net hospital in Los Angeles County (n=30,023). We compared the probability of COVID-19-related ED visits between undocumented immigrants and Medi-Cal patients. We also examined differences in these comparisons over time. Undocumented patients had higher odds of COVID-19-related ED visits than Medi-Cal patients (OR: 1.41, 95% CI: 1.24–1.60) for all months in the study period except September. Even in the earliest days of the pandemic, undocumented patients were more likely than Medi-Cal patients to have a COVID-19-related ED visit. Additional analyses suggest this was likely because of higher COVID-19 exposure rather than differences in ED utilization. [ABSTRACT FROM AUTHOR]

We develop a new nonparametric approach for discrete choice and use it to analyze the demand for health insurance in the California Affordable Care Act marketplace. The model allows for endogenous prices and instrumental variables, while avoiding parametric functional form assumptions about the unobserved components of utility. We use the approach to estimate bounds on the effects of changing premiums or subsidies on coverage choices, consumer surplus, and government spending on subsidies. We find that a $10 decrease in monthly premium subsidies would cause a decline of between 1.8% and 6.7% in the proportion of subsidized adults with coverage. The reduction in total annual consumer surplus would be between $62 and $74 million, while the savings in yearly subsidy outlays would be between $207 and $602 million. We estimate the demand impacts of linking subsidies to age, finding that shifting subsidies from older to younger buyers would increase average consumer surplus, with potentially large impacts on enrollment. We also estimate the consumer surplus impact of removing the highly‐subsidized plans in the Silver metal tier, where we find that a nonparametric model is consistent with a wide range of possibilities. We find that comparable mixed logit models tend to yield price sensitivity estimates toward the lower end of the nonparametric bounds, while producing consumer surplus impacts that can be both higher and lower than the nonparametric bounds depending on the specification of random coefficients. [ABSTRACT FROM AUTHOR]

More than 500 single-room occupancy hotels (SROs), a type of low-cost congregate housing with shared bathrooms and kitchens, are available in San Francisco. SRO residents include essential workers, people with disabilities, and multigenerational immigrant families. In March 2020, with increasing concerns about the potential for rapid transmission of COVID-19 among a population with disproportionate rates of comorbidity, poor access to care, and inability to self-isolate, the San Francisco Department of Public Health formed an SRO outbreak response team to identify and contain COVID-19 clusters in this congregate residential setting. Using address-matching geocoding, the team conducted active surveillance to identify new cases and outbreaks of COVID-19 at SROs. An outbreak was defined as 3 separate households in the SRO with a positive test result for COVID-19. From March 2020 through February 2021, the SRO outbreak response team conducted on-site mass testing of all residents at 52 SROs with outbreaks identified through geocoding. The rate of positive COVID-19 tests was significantly higher at SROs with outbreaks than at SROs without outbreaks (12.7% vs 6.4%; P <.001). From March through May 2020, the rate of COVID-19 cases among SRO residents was higher than among residents of other settings (ie, non–SRO residents), before decreasing and remaining at an equal level to non–SRO residents during later periods of 2020. The annual case fatality rate for SRO residents and non–SRO residents was similar (1.8% vs 1.5%). This approach identified outbreaks in a setting at high risk of COVID-19 and facilitated rapid deployment of resources. The geocoding surveillance approach could be used for other diseases and in any setting for which a list of addresses is available. [ABSTRACT FROM AUTHOR]

Police are considered "gatekeepers" of the criminal-legal system because their decisions significantly impact case outcomes. Using rape culture as our theoretical framework, we examine rape culture-specific factors that influence police arrest decisions in sexual assault cases reported to Los Angeles police. Importantly, extant research using this approach has overwhelmingly focused on indicators of "genuine victims," and few studies have assessed rape culture-specific indicators of suspect culpability in sexual assault case processing. The present study addresses this gap. Findings indicate that arrest decisions are motivated by rape culture-specific indicators of suspect culpability and "real rape." Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Latinx adults have become increasingly vulnerable to bias motivated victimization. The impact of such incidents on Latinx communities is severely understudied, particularly concerning whether or not victims will seek help as a result of such events. Evidence within other victimization contexts demonstrate Latinx populations may be less likely to seek formal help from police, medical providers, and other formal authorities, relying instead on informal support networks such as family and friends. The current study sought to understand formal and informal help-seeking behavior among Latinx adults who experienced bias motivated victimization. The Understanding and Measuring Bias Victimization against Latinos study obtained rates of bias victimization and subsequent help-seeking behavior among Latinx adults who reported experiencing bias victimization (n = 315, 34.6% of full sample of 910). Those who experience bias victimization seek formal help at much lower rates than informal forms of support. Logistic regression analyses controlling the type of victimization demonstrated that participants who experienced a victimization constituting a hate crime were more likely to seek formal help compared to experiencing non-criminal bias events. Implications include addressing barriers to Latinx bias victims seeking forms of help, in addition to understanding the potential polyvictimization histories that predict why Latinx adults may decide to seek help. [ABSTRACT FROM AUTHOR]

Post-acute sequelae of SARS-CoV-2 (PASC) is defined as persistent symptoms after apparent recovery from acute COVID-19 infection, also known as COVID-19 long-haul. We performed a retrospective review of electronic health records (EHR) from the University of California COvid Research Data Set (UC CORDS), a de-identified EHR of PCR-confirmed SARS-CoV-2-positive patients in California. The purposes were to (1) describe the prevalence of PASC, (2) describe COVID-19 symptoms and symptom clusters, and (3) identify risk factors for PASC. Data were subjected to non-negative matrix factorization to identify symptom clusters, and a predictive model of PASC was developed. PASC prevalence was 11% (277/2,153), and of these patients, 66% (183/277) were considered asymptomatic at days 0–30. Five PASC symptom clusters emerged and specific symptoms at days 0–30 were associated with PASC. Women were more likely than men to develop PASC, with all age groups and ethnicities represented. PASC is a public health priority. [ABSTRACT FROM AUTHOR]

Context: The authors examined the association between state-level policy protections and selfrated health disparities between transgender and cisgender adults. Methods: They used data on transgender (n =4,982) and cisgender (n=1.168,859) adults from the 2014-2019 Behavioral Risk Factor Surveillance System. The authors estimated state-specific health disparities between transgender and cisgender adults, and they used multivariable logistic regression models to compare adjusted odds ratios between transgender and cisgender adults by state-level policy environments. Findings: Transgender adults were significantly more likely to report poor/fair health, frequent mental distress, and frequent poor physical health days compared to cisgender adults. Disparities between transgender and cisgender adults were found in states with strengthened protections and in states with limited protections. Compared to transgender adults in states with limited protections. transgender adults in states with strengthened protections were marginally less likely to report frequent mental distress. Conclusions: Transgender adults in most states reported worse self-rated health than their cisgender peers. Much more research and robust data collection on gender identity are needed to study the associations between state policies and transgender health and to identify best practices for achieving health equity for transgender Americans. [ABSTRACT FROM AUTHOR]

Objective: Racial/ethnic minority pediatric otolaryngology patients experience health disparities, including barriers to accessing health care. Our hypothesis for this study is that Hispanic or economically disadvantaged patients would represent a larger percentage of missed appointments and report more barriers to receiving care during the COVID-19 pandemic. Methods: A cross-sectional survey utilizing a modified version of the Barriers to Care Questionnaire was administered via telephone to no-show patients, and median income by zip code was collected. Chi-squared, logistic regression, and Student's t-tests were used to investigate any differences in those who did and did not keep their appointments as well as any differences in mean questionnaire scores. Results: No-show patients were more likely to be Hispanic than not (OR 2.3, 95% CI: 1.3, 3.9, P = .002) and to live in a zip code that had a median income less than 200% of the federal poverty level (OR 1.7, 95% CI: 1.2, 2.4, P = .004). Respondents with a high school degree tended to report more barriers to care compared to those with less education. Conclusion: In our study, we identified ethnic, financial, and logistic concerns that may contribute to patients failing to keep their appointments with the otolaryngology clinic. Future studies are needed to assess the efficacy of measures aimed to reduce these barriers to care such as preventive plans to assist new patients and expanding telehealth services. [ABSTRACT FROM AUTHOR]

Introduction: The African Americans' health paradox can be defined as better subjective health held of African American individuals compared to White individuals, despite their higher objective and medical adversities such as chronic medical conditions (CMCs). This phenomenon depicts African Americans' relative resilience (advantage). However, most of the existing literature on this topic is limited to studies comparing African Americans and Whites. There is little research, if any, on this phenomenon among other ethnic groups. To fill this gap in the literature, this study tests the African Americans' health paradox with consideration of Latinos as the control group. Methods: This cross-sectional study collected demographic data, socioeconomic status, CMCs, and subjective health of 734 African American and Latino older adults residing in south Los Angeles. Logistic regression was used for data analysis. Results: 118 Latino and 616 African Americans entered our study. Overall, a higher number of CMCs was associated with lower subjective health, however, a statistically significant interaction between ethnicity and the number of CMCs suggested that this association is weaker for African Americans than Latinos, which is the African American health paradox. Conclusion: African Americans with a higher number of CMCs report better subjective health compared to Latinos with the same number of CMCs. This finding is indicative of a relative advantage of African Americans compared to other ethnic groups. [ABSTRACT FROM AUTHOR]

Background and aims Smoke-free psychiatric hospitalisation provides opportunity for initiating tobacco cessation treatment. The current study reports on psychiatric patients' interest in continuing nicotine replacement therapy (NRT) posthospitalisation and examines patient predictors of NRT requests, quit attempts and abstinence at 1-week follow-up. Methods Daily smokers were recruited and interviewed on locked psychiatric units at three smoke-free San Francisco Bay Area hospitals. Intent to quit smoking was not required to participate and 73% of eligible smokers enrolled. Analyses focused on 816 participants (49% female) randomised to interventions providing counselling tailored to readiness to quit with availability of NRT posthospitalisation. Logistic regressions tested demographic, smoking and psychiatric factors predictive of NRT requests, quit attempts and abstinence 1-week postdischarge. Results Participants averaged 17 (SD=10) cigarettes/ day for an average of 19 (SD=14) years. Most (88%) requested study-provided NRT (74% right at discharge). Participants preparing to quit and those with more severe psychiatric symptoms were more likely to request NRT at discharge (p<0.01). Those with more severe psychiatric symptoms also were more likely to request NRT refill, as were older participants (p<0.05). Participants who requested NRT at discharge were more likely to make a 24 h quit attempt and self-report abstinence at the 1-week follow-up (54% quit attempt, 14% abstinent) than participants who did not (25% quit attempt, 4% abstinent) (p<0.05). Conclusions The great demand for NRT and the association between NRT use with quit attempts and abstinence at 1-week posthospitalisation supports adoption of tobacco treatment in acute psychiatric settings. Trial registration number # NCT00968513. [ABSTRACT FROM AUTHOR]