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Current safety data on chemotherapy during pregnancy are based on studies which focus on the mother and do not explore reproductive health and fecundity potential within the exposed offspring. We designed this randomized ex vivo animal study to evaluate the effect of chemotherapy on the developing ovarian reserve in the exposed offspring. Specimens (100 postnatal day zero C57BL/6 mouse ovaries) were randomized to control or chemotherapy drug exposure and maintained in a hanging well organ culture. Murine ovarian reserve establishment mirrors activity seen in the human fetus but with a significant time shift of the transition to meiotic arrest to the postnatal period. Exposures included: doxorubicin, cyclophosphamide, paclitaxel, docetaxel, and cisplatin. Doxorubicin resulted in a significant loss of 95.2% (p < 0.0001) of oocyte density compared to controls. Cyclophosphamide also caused depletion of 50.5% (p < 0.0001) of oocyte density. Cisplatin, docetaxel, and paclitaxel all demonstrated unique phenotypical changes on the ovaries and their oocytes, without a significant decrease in oocyte density over a five-day exposure. Exposure to chemotherapy may result in profound loss of oogonia during the transition to mature oocytes. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine if physical activity is related to greater executive functions among youth in poverty. Executive functions (cognitive flexibility, inhibition, and working memory) and physical activity were measured in participants (N = 149) in the fifth to eighth grade from three schools located in high-poverty districts. Pearson correlations revealed a statistically significant correlation between physical activity and cognitive flexibility (r = .18, p < .05). Hierarchical multiple regressions revealed that physical activity significantly improved prediction for cognitive flexibility, R2 = .09, F(6, 142) = 2.26, p = .041, adjusted R2 = .05, above sex, maturity, and school district. A two-way multivariate analysis of covariance revealed statistically significant differences in working memory in more active youth compared with less active but no statistically significant differences in cognitive flexibility or inhibition (p < .05). Greater physical activity is associated with greater working memory among youth in poverty. [ABSTRACT FROM AUTHOR]

Black peppercorn is a common ingredient imported and used in uncooked or ready‐to‐eat foods in the United States. They might be exposed to fecal coliforms and other microbial contamination due to a lack of good agricultural and manufacturing practices in some developing countries under which they were grown and harvested, thus causing economic losses to the peppercorn industry in the United States. We investigated the effect of gaseous chlorine dioxide (ClO2) on reducing the microbial population levels of coliforms, aerobic bacteria, yeasts, and molds on unprocessed black peppercorns. Treatments on peppercorns were conducted in a 30‐L airtight chamber, and equal amounts of dry media precursors were used to generate gaseous ClO2. Whole peppercorns (200 g) were exposed to 20, 30, and 40 g of precursor dose for up to 60 min at 21 ± 0.4°C and in combination with mild heat at 40 ± 2°C. Aerobic bacteria, coliforms, yeasts, and molds on peppercorns were enumerated before (7.4, 7.2, and 7.1 log CFU/g, respectively) and after treatments. Results after treatment demonstrated 0.8–1 log10 (90%) reduction for all the microbes post‐treatment at 21 ± 0.4°C. The treatments conducted with a 30 g precursor dose for 60 min at 21 ± 0.4°C reduced statistically higher (p <.05) microorganisms than those at 40 ± 2°C. Our work demonstrated that gaseous ClO2 could be used as a part of an overall hurdle technology to reduce the coliforms, aerobes, yeasts, and molds on black peppercorns without affecting the visual quality. [ABSTRACT FROM AUTHOR]

Objective: To describe child adherence to four preventative-health guidelines during the COVID-19 pandemic and investigate caregiver-level correlates of adherence. Method: Two hundred thirty-six caregivers (75% female) of children ages 6–12 years (Mage = 8 years; 53% male) living in the United States rated child adherence to four preventative-health guidelines between 10/16/2020 and 11/14/2020. Caregivers also rated perceived importance of each guideline in limiting virus spread and perceived difficulty in obtaining child compliance. Results: Child adherence was highest for mask-wearing (median [Mdn] = 96%) and hand hygiene (Mdn = 95%). Adherence to social distancing guidelines was lower. Mdn adherence for social distancing with family outside the household was 80%, and Mdn adherence for social distancing with friends was 72%. Furthermore, for each of the four guidelines, fewer than half the sample reported 100% adherence (range = 20%–43%). Adherence was positively associated with caregiver perceptions of importance of a given behavior in limiting virus spread (rs =.38–.62) and negatively associated with perceived difficulty in gaining child compliance (rs = –.37––.25). Discussion: Current results indicated parents perceive child adherence to social distancing more challenging than child adherence to mask wearing or hand hygiene. Lower caregiver perceptions of importance of the behavior and greater perceived difficulty in gaining child compliance were associated with lower adherence to all tasks. Brief targeted interventions (e.g., motivational interviewing, parent behavior management training) may be well suited to enhance caregivers' perceptions of value of the behavior, while also addressing behavioral challenges that interfere with child adherence. Public Significance Statement: Caregivers play a critical role in facilitating child adherence to COVID-19 preventative health guidelines. Public health interventions that help caregivers to see the value of preventative health guidelines and support parents around managing difficulties that arise in implementation may facilitate child adherence behaviors. [ABSTRACT FROM AUTHOR]

Background: We investigated whether associations between prevalent diabetes and cancer risk are pertinent to older adults and whether associations differ across subgroups of age, body weight status or levels of physical activity.Methods: We harmonised data from seven prospective cohort studies of older individuals in Europe and the United States participating in the CHANCES consortium. Cox proportional hazard regression was used to estimate the associations of prevalent diabetes with cancer risk (all cancers combined, and for colorectum, prostate and breast). We calculated summary risk estimates across cohorts using pooled analysis and random-effects meta-analysis.Results: A total of 667,916 individuals were included with an overall median (P25-P75) age at recruitment of 62.3 (57-67) years. During a median follow-up time of 10.5 years, 114,404 total cancer cases were ascertained. Diabetes was not associated with the risk of all cancers combined (hazard ratio (HR) = 0.94; 95% confidence interval (CI): 0.86-1.04; I2 = 63.3%). Diabetes was positively associated with colorectal cancer risk in men (HR = 1.17; 95% CI: 1.08-1.26; I2 = 0%) and a similar HR in women (1.13; 95% CI: 0.82-1.56; I2 = 46%), but with a confidence interval including the null. Diabetes was inversely associated with prostate cancer risk (HR = 0.81; 95% CI: 0.77-0.85; I2 = 0%), but not with postmenopausal breast cancer (HR = 0.96; 95% CI: 0.89-1.03; I2 = 0%). In exploratory subgroup analyses, diabetes was inversely associated with prostate cancer risk only in men with overweight or obesity.Conclusions: Prevalent diabetes was positively associated with colorectal cancer risk and inversely associated with prostate cancer risk in older Europeans and Americans. [ABSTRACT FROM AUTHOR]

Background: Granulocyte colony-stimulating factors (G-CSFs), which are used for the prevention of complications from chemotherapy-related neutropenia, are linked to the risk of developing second primary myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). The objective of this study was to examine the correlation between using a specific G-CSF agent and the risk of MDS/AML among older patients with non-Hodgkin lymphoma (NHL).Methods: This was a retrospective cohort study of adults aged >65 years who were diagnosed with first primary NHL between 2001 and 2011. With data from the Surveillance, Epidemiology, and End Results-Medicare-linked database, adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for the risk of MDS/AML associated with the receipt of G-CSF(filgrastim and pegfilgrastim) in Cox proportional-hazards models, which were stratified according to treatment accounting for confounding by indication.Results: Among 18,245 patients with NHL patients who had a median follow-up of 3.5 years, 56% received chemotherapy and/or immunotherapy, and G-CSF was most commonly used in those who received rituximab plus multiple chemotherapy regimens (77%). Subsequent MDS/AML diagnoses were identified in 666 patients (3.7%). A modest increased risk of MDS/AML was observed with the receipt of G-CSF (HR, 1.28; 95% CI, 1.01-1.62) and a trend was observed with increasing doses (Ptrend < .01). When specific agents were analyzed, an increased risk of MDS/AML was consistently observed with filgrastim (≥10 doses: HR, 1.67; 95% CI, 1.25-2.23), but not with pegfilgrastim (≥10 + doses: HR, 1.11; 95% CI, 0.84-1.45).Conclusions: A higher of MDS/AML was observed in patients with NHL risk among those who received G-CSF that was specific to the use of filgrastim (≥10 doses), but not pegfilgrastim. Neutropenia prophylaxis is an essential component of highly effective NHL treatment regimens. The differential risk related to the types of G-CSF agents used warrants further study given their increasing use and newly available, US Food and Drug Administration-approved, biosimilar products. [ABSTRACT FROM AUTHOR]

COVID-19 is a pandemic which has spread to more than 200 countries. Its high transmission rate makes it difficult to control. To date, no specific treatment has been found as a cure for the disease. Therefore, prediction of COVID-19 cases provides a useful insight to mitigate the disease. This study aims to model and predict COVID-19 cases. Eight countries: Italy, New Zealand, the USA, Brazil, India, Pakistan, Spain, and South Africa which are in different phases of COVID-19 distribution as well as in different socioeconomic and geographical characteristics were selected as test cases. The Alpha-Sutte Indicator approach was utilized as the modelling strategy. The capability of the approach in modelling COVID-19 cases over the ARIMA method was tested in the study. Data consist of accumulated COVID-19 cases present in the selected countries from the first day of the presence of cases to September 26, 2020. Ten percent of the data were used to validate the modelling approach. The analysis disclosed that the Alpha-Sutte modelling approach is appropriate in modelling cumulative COVID-19 cases over ARIMA by reporting 0.11%, 0.33%, 0.08%, 0.72%, 0.12%, 0.03%, 1.28%, and 0.08% of the mean absolute percentage error (MAPE) for the USA, Brazil, Italy, India, New Zealand, Pakistan, Spain, and South Africa, respectively. Differences between forecasted and real cases of COVID-19 in the validation set were tested using the paired t -test. The differences were not statistically significant, revealing the effectiveness of the modelling approach. Thus, predictions were generated using the Alpha-Sutte approach for each country. Therefore, the Alpha-Sutte method can be recommended for short-term forecasting of cumulative COVID-19 incidences. The authorities in the health care sector and other administrators may use the predictions to control and manage the COVID-19 cases. [ABSTRACT FROM AUTHOR]

The Supplemental Nutrition Assistance Program (SNAP) in the United States is a key element of the nation's safety net. Yet, 12.5 million US children live in households that experience food insecurity, despite national spending of $65 billion on SNAP alone. In analyses integrating data from the 36 Organisation for Economic Co-operation and Development (OECD) countries, we found that child poverty and food insecurity are much higher in the United States than in most of the other OECD countries. The United States has higher total social spending than other OECD countries, but a lower rate of spending on children and families. This international comparison suggests that potentially effective solutions implemented in other countries might help further alleviate US childhood poverty and food insecurity. Broadly, we recommend increasing investments in families with children, particularly low-income families. Our specific recommendations include increasing SNAP benefits, establishing additional benefits to support low-income families with young children, and implementing a universal child allowance. Achieving substantial reductions in child poverty and food insecurity will require overcoming many challenges, including the current US political climate, a national history of underinvestment in social programs, a lack of political will, and a culture of structural racism. [ABSTRACT FROM AUTHOR]

Land use/land cover (LULC) change has significant impacts on nutrient loading to aquatic systems and has been linked to deteriorating water quality globally. While many relationships between LULC and nutrient loading have been identified, characterization of the interaction between LULC, climate (specifically variable hydrologic forcing) and solute export across seasonal and interannual time scales is needed to understand the processes that determine nutrient loading and responses to change. Recent advances in high-frequency water quality sensors provide opportunities to assess these interannual relationships with sufficiently high temporal resolution to capture the unpredictable, short-term storm events that likely drive important export mechanisms for dissolved organic carbon (DOC) and nitrate (NO3−–N). We deployed a network of in situ sensors in forested, agricultural, and urban watersheds across the northeastern United States. Using 2 years of high-frequency sensor data, we provide a regional assessment of how LULC and hydrologic variability affected the timing and magnitude of dissolved organic carbon and nitrate export, and the status of watershed fluxes as either supply or transport controlled. Analysis of annual export dynamics revealed systematic differences in the timing and magnitude of DOC and NO3−–N delivery among different LULC classes, with distinct regional similarities in the timing of DOC and NO3−–N fluxes from forested and urban watersheds. Conversely, export dynamics at agricultural sites appeared to be highly site-specific, likely driven by local agricultural practices and regulations. Furthermore, the magnitude of solute fluxes across watersheds responded strongly to interannual variability in rainfall, suggesting a high degree of hydrologic control over nutrient loading across the region. Thus, there is strong potential for climate-driven changes in regional hydrologic cycles to drive variation in the magnitude of downstream nutrient fluxes, particularly in watersheds where solute supply and/or transport has been modified. [ABSTRACT FROM AUTHOR]

Changing climate conditions impact ecosystem dynamics and have local to global impacts on water and carbon cycles. Many processes in dynamic vegetation models (DVMs) are parameterized, and the unknown/unknowable parameter values introduce uncertainty that has rarely been quantified in projections of forced changes. In this study, we identify processes and parameters that introduce the largest uncertainties in the vegetation state simulated by the DVM Top‐down Representation of Interactive Foliage and Flora Including Dynamics (TRIFFID) coupled to a regional climate model. We adjust parameters simultaneously in an ensemble of equilibrium vegetation simulations and use statistical emulation to explore sensitivities to, and interactions among, parameters. We find that vegetation distribution is most sensitive to parameters related to carbon allocation and competition. Using a suite of statistical emulators, we identify regions of parameter space that reduce the error in modeled forest cover by 31±9%. We then generate large initial atmospheric condition ensembles with 10 improved DVM parameterizations under preindustrial, contemporary, and future climate conditions to assess uncertainty in the forced response due to parameterization. We find that while most parameterizations agree on the direction of future vegetation transitions in the western United States, the magnitude varies considerably: for example, in the northwest coast the expansion of broadleaf trees and corresponding decline of needleleaf trees ranges from 4 to 28% across 10 DVM parameterizations under projected future climate conditions. We demonstrate that model parameterization contributes to uncertainty in vegetation transition and carbon cycle feedback under nonstationary climate conditions, which has important implications for carbon stocks, ecosystem services, and climate feedback. Plain Language Summary: Changing climate conditions can impact the composition of an ecosystem. As plant types better suited for the new climate conditions begin to thrive, they can out‐compete the historical vegetation. This transformation can have impacts on the local water cycle and, if changes are large enough, on the global carbon cycle. Dynamic vegetation models (DVMs) are used to analyze the impacts of climate on vegetation and project future changes. DVMs are used across scales ranging from watersheds, informing management decisions, to the globe as an important component of the global carbon cycle. The mathematical representations of processes in DVMs are imperfect and introduce uncertainty in model projections. In this study we identify processes that introduce the largest uncertainties in the vegetation distribution modeled by a DVM. We then identify settings of model parameters that improve the modeled historical vegetation when compared to observations. While unique model parameterizations simulated the historical vegetation well, each parameterization simulated different future vegetation transitions under future climate conditions. Our study shows that model parameterization introduces uncertainty in the projected future changes in vegetation. Quantifying and appreciating this uncertainty are important when considering management decisions based on projected vegetation changes at the local to global scale. Key Points: Multiple unique parameterizations of a dynamic vegetation model met evaluation criteriaParameterizations simulated varying amounts of vegetation transitions under nonstationary climate contributing to uncertainty in the simulated carbon cycleSimulated vegetation distributions were most sensitive to parameters related to carbon allocation and competition [ABSTRACT FROM AUTHOR]

Understanding the unfolding challenges of climate change relies on climate models, many of which have large summer warm and dry biases over Northern Hemisphere continental midlatitudes. This work, with the example of the model used in the updated version of the weather@home distributed climate model framework, shows the potential for improving climate model simulations through a multiphased parameter refinement approach, particularly over the northwestern United States (NWUS). Each phase consists of (1) creating a perturbed parameter ensemble with the coupled global–regional atmospheric model, (2) building statistical emulators that estimate climate metrics as functions of parameter values, (3) and using the emulators to further refine the parameter space. The refinement process includes sensitivity analyses to identify the most influential parameters for various model output metrics; results are then used to cull parameters with little influence. Three phases of this iterative process are carried out before the results are considered to be satisfactory; that is, a handful of parameter sets are identified that meet acceptable bias reduction criteria. Results not only indicate that 74 % of the NWUS regional warm biases can be reduced by refining global atmospheric parameters that control convection and hydrometeor transport, as well as land surface parameters that affect plant photosynthesis, transpiration, and evaporation, but also suggest that this iterative approach to perturbed parameters has an important role to play in the evolution of physical parameterizations. [ABSTRACT FROM AUTHOR]

This study provides policy makers and financial planners with key information to identify demographic traits that are associated with the financial risk tolerance (FRT) of financial planning clients in order to be able to target them appropriately. It explores international nationality differences and similarities in financial risk tolerance based on previously collected survey data, using logistic regression analysis. Data were obtained from 6 828 financial planning clients in Australia, the United Kingdom, the United States and South Africa. Each country's log-regression model contained seven independent variables (age, gender, education, income, marital status, number of dependants and net worth). The results revealed national differences in the financial risk tolerance, with a younger and predominantly male South African sample showing the highest financial risk tolerance. In all the countries, being young and male was associated with higher financial risk tolerance levels. In Australia and the United Kingdom, higher income levels were associated with higher levels of financial risk tolerance, while in the United States and South Africa, those with higher levels of net worth demonstrated higher levels of financial risk tolerance. In addition, in the South African sample those with higher levels of education had higher financial risk tolerance scores. The full multivariate model (n = 3 981), which included all demographic variables, revealed that higher financial risk tolerance levels are associated with younger, more educated South African males with both higher levels of income and accumulated net worth. [ABSTRACT FROM AUTHOR]

The article presents an American Association for Dental Research (AADR) Policy Statement on community water fluoridation (CWF). Topics include the missions of the AADR, issues related to dental, oral, and craniofacial health and research, information about fluoride and fluoridation chemistry, as well as the dental and health effects of CWF.

Abstract: This paper investigates how the University of Michigan's Index of Consumer Sentiment responds to oil price shocks. While oil supply shocks play only a limited role, the effect of aggregate demand shocks is positive for the first few months and negative thereafter. A typical other oil demand shock has a significant negative impact for up to 2 years. By studying the responses of individual survey questions, we find that expectations of future inflation and a change in real household income as well as perceived vehicle and house buying conditions are the main transmission channels of oil supply and demand shocks. [ABSTRACT FROM AUTHOR]

Policy Points: Historically, reforms that have increased the duration of job‐protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well‐being. Context: Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co‐operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes. Methods: We conducted a systematic review of the peer‐reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta‐analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs. Findings: We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave‐taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied. Conclusions: There is substantial quasi‐experimental evidence to support expansions in the duration of job‐protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job‐protected paid leave or lack a national paid leave entitlement altogether. [ABSTRACT FROM AUTHOR]

Policy Points: Worldwide, more than 70% of all deaths are attributable to noncommunicable diseases (NCDs), nearly half of which are premature and apply to individuals of working age. Although such deaths are largely preventable, effective solutions continue to elude the public health community. One reason is the considerable influence of the “commercial determinants of health”: NCDs are the product of a system that includes powerful corporate actors, who are often involved in public health policymaking. This article shows how a complex systems perspective may be used to analyze the commercial determinants of NCDs, and it explains how this can help with (1) conceptualizing the problem of NCDs and (2) developing effective policy interventions. Context: The high burden of noncommunicable diseases (NCDs) is politically salient and eminently preventable. However, effective solutions largely continue to elude the public health community. Two pressing issues heighten this challenge: the first is the public health community's narrow approach to addressing NCDs, and the second is the involvement of corporate actors in policymaking. While NCDs are often conceptualized in terms of individual‐level risk factors, we argue that they should be reframed as products of a complex system. This article explores the value of a systems approach to understanding NCDs as an emergent property of a complex system, with a focus on commercial actors. Methods: Drawing on Donella Meadows's systems thinking framework, this article examines how a systems perspective may be used to analyze the commercial determinants of NCDs and, specifically, how unhealthy commodity industries influence public health policy. Findings: Unhealthy commodity industries actively design and shape the NCD policy system, intervene at different levels of the system to gain agency over policy and politics, and legitimize their presence in public health policy decisions. Conclusions: It should be possible to apply the principles of systems thinking to other complex public health issues, not just NCDs. Such an approach should be tested and refined for other complex public health challenges. [ABSTRACT FROM AUTHOR]

Is there a way to save U.S. television from the present quasi-monopoly position that stems from the scarcity of VHF channels? This brief article calls attention to some serious inequities that have developed from the manner in which this vital public property has been exploited, and suggests methods for reducing such inequities. [ABSTRACT FROM AUTHOR]

The article presents news briefs concerning industrial relations research as of October 1957. The Institute of Labor and Industrial Relations was jointly established by the governing boards of the University of Michigan and Wayne State University. There has been a shift in the focus of the research activities of the Institute of Labor Relations and Social Security of New York University. A series of studies is being conducted by the Foundation on Employee Health, Medical Care and Welfare, a joint labor-management venture between the International Association of Machinists and U.S. Industries Inc. The Division of Industrial Relations of Stanford University is conducting a study of wage, price and productivity movements from 1947 to 1955. The research program of the Institute of Industrial Relations of the University of California at Berkeley is concerned with six areas of investigation, including industrial psychology.

This article presents news on various projects and studies related to industrial labor in the U.S., as of January 1955. The long-term projects of the Textile Workers Union of America Research Department are designed to provide basic analysis of the economic and social trends affecting the textile industry in order to facilitate the interpretation of current industrial developments within it. Concerned with a number of significant problems of day-to-day human relations in the plant and looking ahead to the long-term cultivation of better employee relations at both the company and national levels, the Employee Relations Division of the National Association of Manufacturers has in its work portfolio a score of projects designed to stimulate constructive management thinking and action. The Occupational Research Center at Purdue University has completed, or in progress, a large number of projects in the areas of testing and selection, job analysis and evaluation, and attitude measurement. A joint study of unemployment insurance benefit financing in Louisiana is soon to be undertaken by Louisiana State University in cooperation with the Louisiana Division of Employment Security and the U.S. Bureau of Employment Security.

Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023-$28,800 US dollars (USD) in Japan to $14,513-$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. [ABSTRACT FROM AUTHOR]

Reducing systemic liquidity risk related to seasonal loan demand was one reason for founding the Federal Reserve System. Nevertheless, less than 8% of state‐chartered banks joined the Fed in its first decade. Banks facing high liquidity risk from seasonal loan demand were more likely to join the Fed in its first decade. We also find evidence consistent with the notion that banks could obtain some indirect access to the discount window through interbank transfers. Some banks apparently joined the Fed to pass through discount window liquidity to other banks via the interbank network. Joining the Fed increased member banks’ lending. [ABSTRACT FROM AUTHOR]

Background Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. Objective The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? Methods This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. Results The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). Conclusions Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine. [ABSTRACT FROM AUTHOR]

Background: The quality of life in neurological disorders (Neuro-QoL) is a U.S. National Institutes of Health initiative that produced a set of self-report measures of physical, mental, and social health experienced by adults or children who have a neurological condition or disorder.Objective: To describe the content of the Neuro-QoL at the item level using the World Health Organization's international classification of functioning, disability and health (ICF).Methods: We assessed the Neuro-QoL for its content coverage of functioning and disability relative to each of the four ICF domains (i.e., body functions, body structures, activities and participation, and environment). We used second-level ICF three-digit codes to classify items into categories within each ICF domain and computed the percentage of categories within each ICF domain that were represented in the Neuro-QoL items.Results: All items of Neuro-QoL could be mapped to the ICF categories at the second-level classification codes. The activities and participation domain and the mental functions category of the body functions domain were the areas most often represented by Neuro-QoL. Neuro-QoL provides limited coverage of the environmental factors and body structure domains.Conclusions: Neuro-QoL measures map well to the ICF. The Neuro-QoL-ICF-mapped items provide a blueprint for users to select appropriate measures in ICF-based measurement applications. [ABSTRACT FROM AUTHOR]

We work from a minority stress perspective to theorize health disparities across union status at the intersection of sexual minority status, race-ethnicity, and gender. We use pooled data from the Integrated National Health Interview Surveys (1997–2014) to assess a wide range of health outcomes, including self-rated physical health, psychological distress, and health behaviors. Results suggest that same-sex cohabitors face substantial health disadvantages relative to different-sex married individuals, with little variation by race-ethnicity and gender. Fewer health differences are found for same-sex cohabitors in comparison with both different-sex cohabitors and unpartnered singles, although greater variation by gender and race-ethnicity is found across these comparisons. This study highlights the importance of integrating intersectionality and minority stress theories to guide future research examining sexual minority health disparities. Results suggest that the sexual minority health disadvantage, as well as the potential health boost of same-sex marriage, may depend on the intersection of race-ethnicity and gender. [ABSTRACT FROM AUTHOR]

Soil organic carbon (SOC) is the largest terrestrial carbon (C) sink on Earth; this pool plays a critical role in ecosystem processes and climate change. Given the cost and time required to measure SOC, and particularly changes in SOC, many signatory nations to the United Nations Framework Convention on Climate Change report estimates of SOC stocks and stock changes using default values from the Intergovernmental Panel on Climate Change or country-specific models. In the United States, SOC in forests is monitored by the national forest inventory (NFI) conducted by the Forest Inventory and Analysis (FIA) program within the U.S. Department of Agriculture, Forest Service. The FIA program has been consistently measuring soil attributes as part of the NFI since 2001 and has amassed an extensive inventory of SOC in forest land in the conterminous United States and southeast and southcentral coastal Alaska. That said, the FIA program has been using country-specific predictions of SOC based, in part, upon a model using SOC estimates from the State Soil Geographic (STATSGO) database compiled by the Natural Resources Conservation Service. Estimates obtained from the STATSGO database are averages over large map units and are not expected to provide accurate estimates for specific locations, e.g., NFI plots. To improve the accuracy of SOC estimates in U.S. forests, NFI SOC observations were used for the first time to predict SOC density to a depth of 100 cm for all forested NFI plots. Incorporating soil-forming factors along with observations of SOC into a new estimation framework resulted in a 75% (48 ± 0.78 Mg/ha) increase in SOC densities nationally. This substantially increases the contribution of the SOC pool, from approximately 44% (17 Pg) of the total forest ecosystem C stocks to 56% (28 Pg), in the forest C budget of the United States. [ABSTRACT FROM AUTHOR]

Current guidelines in the setting of exposures to potentially rabid bats established by the Advisory Committee on Immunization Practices (ACIP) address post-exposure prophylaxis ( PEP) administration in situations where a person may not be aware that a bite or direct contact has occurred and the bat is not available for diagnostic testing. These include instances when a bat is discovered in a room where a person awakens from sleep, is a child without an adult witness, has a mental disability or is intoxicated. The current ACIP guidelines, however, do not address PEP in the setting of multiple persons exposed to a bat or a bat colony, otherwise known as mass bat exposure ( MBE) events. Due to a dearth of recommendations for response to these events, the reported reactions by public health agencies have varied widely. To address this perceived limitation, a survey of 45 state public health agencies was conducted to characterize prior experiences with MBE and practices to mitigate the public health risks. In general, most states (69% of the respondents) felt current ACIP guidelines were unclear in MBE scenarios. Thirty-three of the 45 states reported prior experience with MBE, receiving an average of 16.9 MBE calls per year and an investment of 106.7 person-hours annually on MBE investigations. PEP criteria, investigation methods and the experts recruited in MBE investigations varied between states. These dissimilarities could reflect differences in experience, scenario and resources. The lack of consistency in state responses to potential mass exposures to a highly fatal disease along with the large contingent of states dissatisfied with current ACIP guidance warrants the development of national guidelines in MBE settings. [ABSTRACT FROM AUTHOR]

This study examines funding from the National Institutes of Health (NIH) to US dental institutions between 2005 and 2014 based on publicly available data from the NIH Research Portfolio Online Reporting Tools. Over the 10-y span, 56 US dental institutions received approximately $2.2 billion from 20 Institutes, Centers, and Offices at the NIH. The National Institute of Dental and Craniofacial Research (NIDCR) is the largest NIH supporter of dental institutions, having invested 70% of the NIH total, about $1.5 billion. The NIDCR is also the primary supporter of research training and career development, as it has invested $177 million, which represents 92% of the total NIH investment of $192 million. Over the past 10 y, about half of the NIDCR's extramural award dollars have gone to dental schools, while the NIH has invested about 1%. There has been an approximately 10% net decrease in extramural dollars awarded to dental institutions over the past decade; however, given the year-to-year variability in support to dental institutions, it is unclear if this net decline reflects a long-term trend. In addition, there was an overall reduction in the extramural dollars awarded by the NIDCR and by the NIH. For example, from 2005 to 2014, the total NIDCR budget for extramural research decreased by roughly 4%, which represents a decrease of $20 million to dental institutions. After adjusting for inflation, the decline in funding to dental institutions from the NIDCR and NIH was approximately 30%. Although the NIDCR and NIH continue to invest in dental institutions, if the current decline were to continue, it could negatively affect the research conducted at dental institutions. Therefore, we discuss opportunities for dental institutions to increase NIDCR and NIH support and improve their capacity for research, research training, and career development. [ABSTRACT FROM AUTHOR]

We explored palliation practices and experiences among providers at university campus health centers to assess the availability and viability of non-opioid options for student patients. We interviewed 10 healthcare providers at the campus health center for a large research university in the southeastern United States. Data were collected via semistructured interviews. Analyses of interview transcripts were performed via content analysis with open coding. We identified multiple barriers to non-opioid pain management. Non-opioid modalities were more likely to receive no insurance subsidy, and thus, to go unused even if clinically indicated. Providers also reported high levels of concern with potential opioid dependency, as well as interest in safer options for long-term palliation. Contextualizing results from our case study with prior literature from other care settings suggests that lack of access to non-opioid options presents challenges for university students who live with chronic pain. [ABSTRACT FROM AUTHOR]

Focusing on U.S. red meat inspection regulations, in the context of alternative food networks (AFNs), we explore the implications of different levels of governmental governance for the number of red meat slaughter establishments in the United States. We argue that disaggregating 'the state' makes possible a more nuanced consideration of the effects of different tiers of governance. We use regression analysis with data for 40 U.S. states over 40 years to examine the effects of state (subnational) inspection programs and implementation of the federal Hazard Analysis and Critical Control Point (HACCP) regulations on the number of slaughter establishments by type. In this analysis we test two common beliefs among AFN actors: that state inspection helps, and HACCP hurts, small slaughter establishments. It also allows us to make a case for disaggregating governance tiers as we find that state inspection programs and HACCP have significant and opposite effects on the number of federally and non-federally inspected slaughter establishments. Our analysis supports the belief that state inspection is important to small slaughter establishments, but does not support the belief that HACCP has had a negative effect on them. Our conclusion is that agrifood scholars need to pay attention to different forms of governmental governance even with the increased focus on private and third-party certifications. [ABSTRACT FROM AUTHOR]

Some prior research has found that religiosity and spirituality can be related to health. However, the relationships are inconsistent, measures of religiosity and spirituality are often problematic and conflated with the health outcomes they are supposed to predict, and very little research on this topic specifies which aspects of health supposedly benefit from religiosity and spirituality. Using two sets of survey data (Sample 1N = 347; Sample 2N = 404), we examined whether religiosity and spirituality had direct or indirect effects on physical, mental, and/or social health. We found that spirituality, when conceptualized as belief and experience of the supernatural, had no direct or indirect effect on physical, mental, or social health. Religiosity had a small but significant direct effect on social health in one sample but not the other. We consider our findings in relation to religious privileging in the United States and how proreligious biases can lead to health inequalities. [ABSTRACT FROM PUBLISHER]

Medical schools in Taiwan have recently adopted the U.S. medical school admissions model by incorporating interviews into the selection process. The objective of this study was to investigate factors that contribute to successful medical school applications through the national entrance examination and interview admission routes. The sample consisted of survey data from five entry cohorts of medical students admitted to the National Yang-Ming University Faculty of Medicine from 2003 to 2007. Of the 513 students, 62% were admitted through the traditional national entrance examination route and 38% were admitted early after achieving a threshold score on the composite national exam followed by a structured interview. Students admitted through the interview route were more likely to be female, with an odds ratio (OR) of 2.17 (1.20-3.93). Maternal education level was an independent predictor of both early admission through a successful interview and higher medical school grade point average (GPA). Students admitted through the interview route had a 3.20 point higher first-year medical school GPA (p < .001) as determined by regression analyses. Those students who were admitted via interview did not have significantly different personality traits than those admitted through the traditional route. This study calls into question the ability of an admissions interview to select for noncognitive character traits. [ABSTRACT FROM AUTHOR]

Background: This article summarizes exploratory analyses of relationships between chronic inflammation, its physical consequences, and quality of life (QoL). It summarizes key findings from preliminary analyses, and contextualizes these results with extant sociomedical literature to recommend directions for future research.Methods: Cross-sectional data from the National Social Life, Health, and Aging Project (NSHAP) were used to explore these relationships. Inflammation was assessed via the biomarker C-reactive protein (CRP). We examined associations between CRP levels and two different domains of QoL: happiness with life in general and happiness with intimate relationships. We used ordinal logistic regression with companion OLS models and Sobel-Goodman tests to assess potential mediation, and also conducted a variety of sensitivity analyses.Results: Findings suggest that mediation pathways for the overall association between chronic inflammation and QoL may differ markedly across particular outcome constructs. Specifically, it shows mediation potential for the clinical sequelae of chronic inflammation in frameworks using happiness as an outcome measure, but not in those using relationship satisfaction. Disability appears to mediate the effect of inflammation by 27 %; chronic pain appears to exert a similar mediation effect of 21 %.Conclusions: Pain and disability linked to chronic inflammation appear to play a small but significant mediating role in the overall reduction in QoL observed among older adults with biomarker evidence of chronic inflammation. We note that these patterns are best framed as dynamic elements of a complex causal fabric, rather than powerful determinants that override other factors contributing to QoL. Hypotheses for further exploration using longitudinal data from the NSHAP are thus offered, pending availability of Wave III data in future years. [ABSTRACT FROM AUTHOR]

The declining number of physician scientists is an alarming issue. A systematic review of all existing programs described in the literature was performed, so as to highlight which programs may serve as the best models for the training of successful physician scientists. Multiple databases were searched, and 1,294 articles related to physician scientist training were identified. Preference was given to studies that looked at number of confirmed publications and/or research grants as primary outcomes. Thirteen programs were identified in nine studies. Eighty-three percent of Medical Scientist Training Program (MSTP) graduates, 77% of Clinician Investigator Training Program (CI) graduates, and only 16% of Medical Fellows Program graduates entered a career in academics. Seventy-eight percent of MSTP graduates succeeded in obtaining National Institute of Health (NIH) grants, while only 15% of Mayo Clinic National Research Service Award-T32 graduates obtained NIH grants. MSTP physician scientists who graduated in 1990 had 13.5 ± 12.5 publications, while MSTP physician scientists who graduated in 1975 had 51.2 ± 38.3 publications. Additionally, graduates from the Mayo Clinic's MD-PhD Program, the CI Program, and the NSRA Program had 18.2 ± 20.1, 26.5 ± 24.5, and 17.9 ± 26.3 publications, respectively. MSTP is a successful model for the training of physician scientists in the United States, but training at the postgraduate level also shows promising outcomes. An increase in the number of positions available for training at the postgraduate level should be considered. [ABSTRACT FROM AUTHOR]

A combined epidemiological-exposure panel study was conducted during the summer of 1998 in Baltimore, Maryland. The objectives of the exposure analysis component of the 28-day study were to investigate the statistical relationships between particulate matter (PM) and related co-pollutants from numerous spatial boundaries associated with an elderly population, provide daily mass concentrations needed for the epidemiological assessment, and perform an extensive personal exposure assessment. Repeated 24-h integrated PM[SUB2.5] (n=394) and PM[SUB10] (n=170) data collections corresponding to stationary residential central indoor, individual apartment, residential outdoor and ambient monitoring were obtained using the same sampling methodology. An additional 325 PM[SUB2.5] personal air samples were collected from a pool of 21 elderly ( 65 + years of age) subjects. These subjects were residents of the 18-story retirement facility where residential monitoring was conducted. Mean daily central indoor and residential apartment concentrations were approximately 10 μg/ m[SUP3]. Outdoor and ambient PM[SUB2.5] concentrations averaged 22 μg/m[SUP3] with a daily range of 6.7-59.3 μg/m[SUP3]. The slope of the central indoor/outdoor PM[SUB2.5] mass relationship was 0.38. The average daily ratio of PM[SUB2.5]/PM[SUB10] mass concentrations across the measurement sites ranged from 0.73 to 0.92. Both the central indoor and mean apartment PM[SUB2.5] mass concentrations were highly correlated with the outdoor variables (r>0.94). The lack of traditionally recognized indoor sources of PM present within the facility might have accounted for the high degree of correlation observed between the variables. Results associated with the personal monitoring effort are discussed in depth in Part 2 of this article. [ABSTRACT FROM AUTHOR]

An integrated epidemiological-exposure panel study was conducted during the summer of 1998 which focused upon establishing relationships between potential human exposures to particulate matter (PM) and related co-pollutants with detectable health effects. The study design incorporated repeated individual 24-h integrated PM[SUB2.5] personal exposure monitoring. A total of 325 PM[SUB2.5] personal exposure samples were obtained during a 28-day study period using a subject pool of 21 elderly (65 + years of age) residents of an 18- story retirement facility near Baltimore, Maryland. Each sample represented a unique 24-h breathing zone measurement of PM[SUB2.5] mass concentration. PM[SUB2.5] and PM[SUB10] mass concentrations collected from the apartments of the subjects as well as residential and ambient sites were compared to individual and mean PM[SUB2.5] personal exposures. Daily PM[SUB2.5] personal exposure concentrations ranged from 2.4 to 47.8 μg/m[SUP3] with an overall individual study mean of 12.9 μg/m[SUP3]. Mean PM[SUB2.5] personal exposures were determined to be highly correlated to those representing the central indoor (r=0.90) and ambient sites (r=0.89). Subjects reported spending an average of 92% of each day within the confines of the retirement center. Based upon measured and modeled exposures, a mean PM[SUB2.5] personal cloud of 3.1 μg/m[SUP3] was estimated. Data collected from these participants may be unique with respect to the general elderly population due to the communal lifestyle within the facility and reported low frequency of exposure to sources of PM. [ABSTRACT FROM AUTHOR]