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Although Indian Americans constitute the second-largest immigrant group in the United States, there is a paucity of information about Indian American youth, particularly with respect to substance use risk. We examined the relationship of social factors to permissive substance use beliefs (a proxy for substance use risk since they can lead to adulthood substance use and misuse) and family functioning. The study used structural equation modeling to examine the prevalence of permissive substance use beliefs in a sample of Indian American youth ages 12–17 (N = 223) and examined the degree to which discrimination, bicultural identity integration, and endorsement of the model minority stereotype were associated with permissive substance use beliefs. Findings suggest that bicultural identity integration (B = 0.267 [SE = 0.112], p = 0.01) and discrimination (B = 0.294 [SE = 0.087], p = 0.001) are positively associated with permissive substance use beliefs. Bicultural identity integration (B = 0.415 [SE = 0.090], p = 0.0001) was positively associated with family support (B= −0.329 [SE = 0.108], p = 0.002) which, in turn, was associated with less permissive substance use beliefs. In contrast, endorsement of the model minority stereotype (B = 0.351 [SE = 0.090], p = 0.001) was positively associated with family closeness (B = 0.232 [SE = 0.927], p = 0.01) which, in turn, was associated with family support and then with less permissive substance use beliefs. Discrimination and bicultural identity integration emerged as key constructs related to substance use risk among Indian American youth. These youth could benefit from culturally appropriate prevention programming that addresses the negative impact of discrimination and its effect on permissive substance use beliefs and highlights protective factors. [ABSTRACT FROM AUTHOR]

Indian Americans now constitute the nation's second largest foreign-born population group in the United States (U.S.). Concerning Indian American youth, there is a paucity of information about their experiences in the U.S., particularly with respect to cultural stress and model minority stress, and whether these stressors have an impact on their mental health. This article describes the dual experiences of Indian American youth in the Indian and American cultures and discusses two theoretical frameworks (cultural stress and model minority stress) that illuminate dynamics influencing the lives of these youth. We illustrate three core pathways (independent, synergistic and indirect) by which cultural stress and model minority stress can influence the mental health of Indian American youth. Social workers and other behavioral health providers can assist Indian American youth by examining their own biases related to the model minority stereotype, helping school personnel assess the impact of this stereotype, and remembering that Indian American youth are not a monolith. Researchers need to disaggregate data on Asian Americans to gather accurate statistics on the Indian American population and refine model-minority-stereotype assessment instruments. [ABSTRACT FROM AUTHOR]

Electronic Health Record (EHR) systems are often configured to address challenges and improve patient safety for persons with Parkinson's disease (PWP). For example, EHR systems can help identify Parkinson's disease (PD) patients across the hospital by flagging a patient's diagnosis in their chart, preventing errors in medication and dosing through the use of clinical decision support, and supplementing staff education through care plans that provide step-by-step road maps for disease-based care of a specific patient population. However, most EHR-based solutions are locally developed and, thus, difficult to scale widely or apply uniformly across hospital systems. In 2020, the Parkinson's Foundation, a national and international leader in PD research, education, and advocacy, and Epic, a leading EHR vendor with more than 35% market share in the United States, launched a partnership to reduce risks to hospitalized PWP using standardized EHR-based solutions. This article discusses that project which included leadership from physician informaticists, movement disorders specialists, hospital quality officers, the Parkinson's Foundation and members of the Parkinson's community. We describe the best practice solutions developed through this project. We highlight those that are currently available as standard defaults or options within the Epic EHR, discuss the successes and limitations of these solutions, and consider opportunities for scalability in environments beyond a single EHR vendor. The Parkinson's Foundation and Epic launched a partnership to develop best practice solutions in the Epic EHR system to improve safety for PWP in the hospital. The goal of the partnership was to create the EHR tools that will have the greatest impact on outcomes for hospitalized PWP. [ABSTRACT FROM AUTHOR]

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The methodology used by the First Street Foundation Wildfire Model (FSF-WFM) to compute estimates of the 30-year, climate-adjusted aggregate wildfire hazard for the contiguous United States at 30 m horizontal resolution is presented. The FSF-WFM integrates several existing methods from the wildfire science community and implements computationally efficient and scalable modeling techniques to allow for new high-resolution, CONUS-wide hazard generation. Burn probability, flame length, and ember spread for the years 2022 and 2052 are computed from two ten-year representative Monte Carlo simulations of wildfire behavior, utilizing augmented LANDFIRE fuel estimates updated with all the available disturbance information. FSF-WFM utilizes ELMFIRE, an open-source, Rothermel-based wildfire behavior model, and multiple US Federal Government open data sources to drive the simulations. LANDFIRE non-burnable fuel classes within the wildland–urban interface (WUI) are replaced with fuel estimates from machine-learning models, trained on data from historical fires, to allow the propagation of wildfire through the WUI in the model. Historical wildfire ignition locations and NOAA's hourly time series of surface weather at 2.5 km resolution are used to drive ELMFIRE to produce wildfire hazards representative of the 2022 and 2052 conditions at 30 m resolution, with the future weather conditions scaled to the IPCC CMIP5 RCP4.5 model ensemble predictions. Winds and vegetation were held constant between the 2022 and 2052 simulations, and climate change's impacts on the future fuel conditions are the main contributors to the changes observed in the 2052 results. Non-zero wildfire exposure is estimated for 71.8 million out of 140 million properties across CONUS. Climate change impacts add another 11% properties to this non-zero exposure class over the next 30 years, with much of this change observed in the forested areas east of the Mississippi River. "Major" aggregate wildfire exposure of greater than 6% over the 30-year analysis period from 2022 to 2052 is estimated for 10.2 million properties. The FSF-WFM represents a notable contribution to the ability to produce property-specific, climate-adjusted wildfire risk assessments in the US. [ABSTRACT FROM AUTHOR]

This study reports a new and significantly enhanced analysis of US flood hazard at 30 m spatial resolution. Specific improvements include updated hydrography data, new methods to determine channel depth, more rigorous flood frequency analysis, output downscaling to property tract level, and inclusion of the impact of local interventions in the flooding system. For the first time, we consider pluvial, fluvial, and coastal flood hazards within the same framework and provide projections for both current (rather than historic average) conditions and for future time periods centered on 2035 and 2050 under the RCP4.5 emissions pathway. Validation against high‐quality local models and the entire catalog of FEMA 1% annual probability flood maps yielded Critical Success Index values in the range 0.69–0.82. Significant improvements over a previous pluvial/fluvial model version are shown for high‐frequency events and coastal zones, along with minor improvements in areas where model performance was already good. The result is the first comprehensive and consistent national‐scale analysis of flood hazard for the conterminous US for both current and future conditions. Even though we consider a stabilization emissions scenario and a near‐future time horizon, we project clear patterns of changing flood hazard (3σ changes in 100 years inundated area of −3.8 to +16% at 1° scale), that are significant when considered as a proportion of the land area where human use is possible or in terms of the currently protected land area where the standard of flood defense protection may become compromised by this time. Plain Language Summary: We develop a method to estimate past, present, and future flood risk for all properties in the conterminous United States whether affected by river, coastal or rainfall flooding. The analysis accounts for variability within environmental factors including changes in sea level rise, hurricane intensity and landfall locations, precipitation patterns, and river discharge. We show that even for a conservative climate change trajectory we can expect locally significant changes in the land area at risk from floods by 2050, and by this time defenses protecting 2,200 km2 of land may be compromised. The complete dataset has been made available via a website (https://floodfactor.com/) created by the First Street Foundation in order to increase public awareness of the threat posed by flooding to safety and livelihoods. Key Points: First complete high‐resolution flood hazard analysis of conterminous US flood risk from all major sources (fluvial, pluvial, and coastal)In validation tests the model achieved Critical Success Index scores of 0.69–0.82, similar to many local custom‐built 2D modelsBy 2050, flood hazard increases for the Eastern seaboard and Western states, but decreases or changes little for the center and South‐West [ABSTRACT FROM AUTHOR]

Today, the vast majority of American workers are unaware of their substantive rights to organize and engage in concerted activities in the workplace. Over the last thirty years, union activism has experienced stark declines that have consequently lessened the level of public educational dialogue surrounding labor rights. As the agency tasked with promoting and enforcing labor organization rights, the National Labor Relations Board (NLRB) sought to combat this issue through its rarely utilized rulemaking authority--a measure fraught with perilous consequences. In 2011, the NLRB promulgated a regulation that required employers to display posters in the workplace that inform employees of their substantive rights. This effort faced major criticism, setting off litigation that invalidated the notice poster requirement and ultimately curtailed the NLRB's authority to codify substantive rules. Without reexamination, the results of the notice poster litigation will substantially impact the NLRB's future rulemaking efforts. Despite the Supreme Court's affirmation of the NLRB's power to issue substantive rules in American Hospital Ass'n v. NLRB, two courts invalidated the NLRB's notice-posting regulation as an overreach of the Board's rulemaking authority. Remarkably, both decisions arrived at the same conclusion through starkly different reasoning. Categorizing the NLRB as a purely reactive entity, the US. Court of Appeals for the Fourth Circuit invalidated the notice-posting rule as an impermissible proactive effort in Chamber of Commerce v. NLRB. Alternatively, in National Ass'n of Manufacturers v. NLRB, the US. Court of Appeals for the District of Columbia Circuit held that the notice-posting regulation violated statutory and constitutional protections of workplace speech regarding labor organization. This Comment argues that the Fourth and D.C. Circuit opinions create a difficult barrier for all future NLRB rulemakings, and their combined result contradicts the Supreme Court's decision in American Hospital Ass'n. Looking to constructions of the NLRB's rulemaking authority, as well as the legislative history of rulemaking and notice under the National Labor Relations Act, this Comment proposes that the NLRB possesses rulemaking authority to proactively restrict and influence matters through generally applicable regulations. In particular, the progeny of union-specific notice requirements pursuant to Communications Workers of America v. Beck provide a strong basis for NLRB authority to require more generalized notification of rights. Moreover, in examining the contents of the notice poster, this Comment argues that the regulation does not violate workplace speech protections because the poster bears a purely governmental message that is reasonable in the discourse and debate of labor rights. Furthermore, employers who disagree with the poster maintain the right to disavow any nexus or endorsement with the posters content. [ABSTRACT FROM AUTHOR]

In this Robert Wood Johnson Foundation-funded study (2009-2011), treatment staff ( n = 178) from 330 federally funded U.S. addiction treatment programs provided data through semistructured telephone interviews about factors that facilitated their implementation of four evidence-based practices (EBPs). Such studies can assist the addiction field in improving EBP implementation and ultimately, client care. Research questions: What factors were identified as facilitating implementation of the four EBPs? And, Do facilitating factors vary by EBP? Coders classified facilitating factors ( n = 518) using a six-category schema. Results showed that although facilitating factors varied by EBP, organization-related factors dominated. Study implications and limitations are described. [ABSTRACT FROM AUTHOR]

Social workers are needed to implement science-based treatments for alcohol and other drug (AOD) problems. Changes in insurance coverage through the Affordable Care Act will increase the demand for licensed Master of Social Work (MSW) clinicians. This national study of MSW programs (N = 210) examines prevalence of addiction courses and specializations. Web-based analyses showed that only 14.3% of accredited schools offered specialization; only 4.7% of accredited schools had one or more required courses. Social work education has not met addiction workforce development needs; there is no evidence this pattern will change. [ABSTRACT FROM AUTHOR]

The article provides advice and resources for religious librarians in the U.S. Tips include interviewing other religious librarians, researching core curriculum requirements for religion, and developing library collections on religious material. Resources for religion librarians include the American Theological Library Association (ATLA) organization, the "Journal of the American Academy of Religion" ("JAAR") periodical, and the Virtual Religion Index website located at http://virtualreligion.net/vri/. The author also discusses tips for collection development, such as determining the needs of the library patrons, researching denominational publishers from institutions and discovering supplementary titles.

This article examines whether female injection drug users (IDUs) who have a history of using mental health services (i.e., one or more psychiatric hospitalizations or counseling) enter types of drug treatment different from those of female IDUs who do not have a history of using mental health services. Data used for this exploration originate from a statewide drug-treatment database covering all women who entered drug treatment in the state of Massachusetts from 1996 to 2001. A total of 7776 women were included in the study. Through the use of logistic regression analysis, the study determined that those female IDUs who had a mental health service history, compared with female IDUs who had no such history, were about two-thirds more likely to enter substance abuse treatment other than detoxification only. Specifically, women with a mental health service history were about 66% more likely to enter substance abuse treatment modalities such as drug-free outpatient counseling, methadone maintenance, and/or long-term residential services rather than detoxification alone. This is a positive result, indicating that female IDUs who have mental health problems and therefore have high needs for effective substance abuse treatment are entering the more intensive and/or longer term modalities likely to lead to better outcomes. Possible factors accounting for this, including the referral process within detoxification centers, the role of community referral agents, and the experience women gain as a consequence of receiving services in more than one service system, are discussed. [ABSTRACT FROM AUTHOR]

Changing environmental conditions are driving worsening flood events, with consequences for counties, cities, towns, and local communities. To understand individual flood risk within this changing climate, local community resiliency and infrastructure impacts must also be considered. Past research has attempted to capture this but has faced several limitations. This study provides a nation-wide model of community flooding impacts within the United States currently and in 30 years through the use of high-resolution input data (parcel-level), multi-source flood hazard information (four major flood types), multi-return period hazard information (six return periods), operational threshold integration, and future-facing projections. Impacts are quantified here as the level of flooding relative to operational thresholds. This study finds that over the next 30 years, millions of additional properties will be impacted, as aspects of risk are expected to increase for residential properties by 10%, roads by 3%, commercial properties by 7%, critical infrastructure facilities by 6%, and social infrastructure facilities by 9%. Additionally, certain counties and cities persistently display impact patterns. A high-resolution model capturing aspects of flood risk as related to community infrastructure is important for an understanding of overall community risk. [ABSTRACT FROM AUTHOR]

Alcohol abuse and alcoholism are significant problems among Southeast Asians resettled in the United States. Contributing factors include experiences of trauma during the refugee and resettlement experience and traditional beliefs about alcohol as a health-promoting substance. The need for routine screening for alcohol and other drug problems is highlighted and culturally sensitive assessment and intervention methods are described. Clinical vignettes illustrate assessment issues. [ABSTRACT FROM AUTHOR]

The past two decades have witnessed an increase in ethnicity-related peer aggression, driven by the intensification of the migration phenomenon and rise of information and communication technologies. The goal of the current study is to extend the scope of previous reviews on peer aggression to examine the emerging evidence on the role of technological tools in the prevention, detection, and handling of ethnicity-related peer aggression among young people. We have identified 14 relevant papers published between 2005 and 2020 that help us answer the following research questions: What forms of aggression among young ethnic minorities do these technological interventions try to address? What types of technological interventions are being used? The results indicate that the technological tools are being used to tackle both intergroup as well as intragroup peer aggression, in which ethnic minorities youth is involved (as a victim, perpetrator or bystander). Most studies have focused on adolescents and young adults in the US or in Europe. The technological tools reported on, include: online games, videos, social media, and chat-based programmes, or machine learning algorithms aimed at tackling online and offline peer aggression. They can be used either as stand - alone tools, or as part of intervention programmes (at the school, family or community level). These findings can be useful to improve and elaborate future digital technologies developed to address ethnicity-related peer aggression. • The review maps the existing literature on the role of technological tools in tackling ethnicity-related peer aggression. • All forms of peer aggression are considered in which ethnic minorities youth was involved. • Three groups of technological interventions are identified and categorized into intra- or intergroup ethnicity-related peer aggression. • The digital tools presented include: online games, video, social media, chat-based programmes, and machine learning algorithms. • Our study reveals some follow-up research questions needed to expand current knowledge on digital technologies. [ABSTRACT FROM AUTHOR]

When patients develop acute kidney injury, a small fraction of them will develop end-stage renal disease later. The severity of renal impairment in the remaining patients is uncertain because studies have not carefully examined renal function over time or the precise timing of entry into a late stage of chronic kidney disease. To determine these factors, we used a United States Department of Veterans Affairs database to ascertain long-term renal function in 113,272 patients. Of these, 44,377 had established chronic kidney disease and were analyzed separately. A cohort of 63,491 patients was hospitalized for acute myocardial infarction or pneumonia and designated as controls. The remaining 5,404 patients had diagnostic codes indicating acute renal failure or acute tubular necrosis. Serum creatinine, estimated glomerular filtration rates, and dates of death over a 75-month period were followed. Renal function deteriorated over time in all groups, but with significantly greater severity in those who had acute renal failure and acute tubular necrosis compared to controls. Patients with acute kidney injury, especially those with acute tubular necrosis, were more likely than controls to enter stage 4 chronic kidney disease, but this entry time was similar to that of patients who initially had chronic kidney disease. The risk of death was elevated in those with acute kidney injury and chronic kidney disease compared to controls after accounting for covariates. We found that patients who had an episode of acute tubular necrosis were at high risk for the development of stage 4 disease and had a reduced survival time when compared to control patients. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the potential of dexmedetomidine added to ropivacaine to increase the thermal antinociception dose-dependent fashion in the nerve block of rats. It states that peripheral nerve blocks are often used in various surgical procedures since it provides analgesia which causes the patient to feel no pain. It notes that ropivocaine with dexmedetomidine has the ability to enhance the sensory motor blockade duration in rats. It also mentions that the U.S. Food and Drug Administration did not approve the use of dexmedetomidine in the perineural space because it has not yet been reported in humans. It concludes that the addition can prolong the peripheral nerve block in humans.

Introduction: Young adulthood, typically conceptualized as stretching from the late teens to the mid-twenties, is a period of elevated risk for residential mobility (i.e., moving or changing residences frequently) and drug involvement. However, our understanding of the trends and drug-related correlates of residential mobility among young adults remains limited.Methods: We analyzed national trend data from the National Survey on Drug Use and Health (2003-2016) on residential mobility and drug involvement among young adults (N = 230,790) in the United States. For tests of trend, we conducted logistic regression analyses with survey year specified as a continuous independent variable and residential mobility as the dependent variable (no/yes), controlling for sociodemographic factors.Results: The prevalence of residential mobility was stable among females, but decreased significantly-a 20% reduction in the relative proportion of respondents-among males during the study period (AOR = 0.98, 95% CI = 0.97-0.99). Male and female young adults reporting residential mobility were significantly more likely to report involvement in all drug-related outcomes examined, but effects were larger among females for drug selling and drug-related arrests.Discussion: Study findings show that a substantial minority of young adults experience residential mobility and that, while rates are declining among young men, the experience of mobility is connected with risk for drug involvement, particularly among females. Mobility may be an important target for drug prevention/intervention efforts, but further research is needed to provide insight into how mobility and drug involvement are connected in the lives of young adults. [ABSTRACT FROM AUTHOR]

Background: We are at a unique moment in United States (US) history as heroin overdose rates are higher than at any time in recent memory. Based on prior research and the developmental risks faced by young adults (ages 18-25), we examine the trends and correlates of perceived access to heroin among this group over a 15-year period.Methods: We analyzed national trend data from the National Survey on Drug Use and Health (2002-2016) on young adults' (N = 247,679; ages 18-25) perceived access to heroin. We conducted logistic regression analyses with survey year specified as an independent variable and heroin access specified as the dependent variable while controlling for sociodemographic factors.Results: A majority of respondents reported that it would be difficult or impossible to obtain heroin, if desired. Young adult reports that it would be "probably impossible" to access heroin increased significantly from 31% in 2002 to 41% in 2016. The upward trend in the perceived lack of access was most robust among African Americans and Hispanics as well as those reporting no past-year substance use or drug/criminal justice system involvement.Conclusions: In the midst of a very serious opioid epidemic, the present study found that most young adults in the US consider that it would be "probably impossible" to obtain heroin. This trend was observed across young adulthood and across gender, racial/ethnic, and family income differences. However, we found that these trends are largely driven by those at relatively low risk of drug misuse and deviant behaviors generally. [ABSTRACT FROM AUTHOR]