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Objectives. To examine the relationship between health care discrimination and COVID-19 vaccine hesitancy attributed to fears of immigration status complications among unvaccinated Latino adults and to determine whether the association differs among immigrants and US-born individuals. Methods. After universal adult eligibility for the COVID-19 vaccine, a nationally representative sample of 12 887 adults was surveyed using online and mobile random digit dialing from May 7 to June 7, 2021. The analytic sample (n = 881) comprised unvaccinated Latino adults. We examined the association between individual and cumulative health care discrimination measures and COVID-19 vaccine hesitancy assignable to immigration-related fears. Results. Using a cumulative measure of health care discrimination, each additional experience corresponded to a 28% higher odds of reporting vaccine hesitancy Because of immigration-related fears. Findings were consistent across US-born and immigrant Latino adults. Four of the 5 discriminatory experiences were positively associated with vaccine hesitancy, including the absence of optimal treatment options, denial or delayed access to necessary health care, physician communication barriers, and lack of specialist referrals. Conclusions. Findings confirm a positive association between health care discrimination and COVID-19 vaccine hesitancy attributable to immigration-related fears among Latino adults, regardless of immigration status. (Am J Public Health. 2024;114(S6):S505–S509. https://doi.org/10.2105/AJPH.2024.307668) [ABSTRACT FROM AUTHOR]

The article presents a robust quantitative approach for determining significant economic factors for sex trafficking in the United States. The aim is to study monthly counts of sex trafficking-related convictions, and use a wide range of economic variables as covariates to investigate their effect on conviction counts. A count time series model is considered along with a regression setup to include economic time series as covariates (economic factors) to explain the counts on sex trafficking-related convictions. The statistical significance of these economic factors is investigated and the significant factors are ranked based on appropriate model selection methods. The inclusion of time-lagged versions of the economic factor time series in the regression model is also explored. Our findings indicate that economic factors relating to immigration policy, consumer price index and labor market regulations are the most significant in explaining sex trafficking convictions. [ABSTRACT FROM AUTHOR]

The interplay of positive and negative species interactions controls species assembly in communities. Dryland plant communities, such as savannas, are important to global biodiversity and ecosystem functioning. Sandhill oaks in xeric savannas of the southeastern United States can facilitate longleaf pine by enhancing seedling survival, but the effects of oaks on recruitment and growth of longleaf pine have not been examined. We censused, mapped, and monitored nine contiguous hectares of longleaf pine in a xeric savanna to quantify oak-pine facilitation, and to examine other factors impacting recruitment, such as vegetation cover and longleaf pine tree density. We found that newly recruited seedlings and grass stage longleaf pines were more abundant in oak-dominated areas where densities were 230% (newly recruited seedlings) and 360% (grass stage) greater from lowest to highest oak neighborhood densities. Longleaf pine also grew faster under higher oak density. Longleaf pine recruitment was lowest under longleaf pine canopies. Mortality of grass stage and bolt stage longleaf pine was low (~1.0% yr−1) in the census interval without fire. Overall, our findings highlight the complex interactions between pines and oaks—two economically and ecologically important genera globally. Xeric oaks should be incorporated as a management option for conservation and restoration of longleaf pine ecosystems. [ABSTRACT FROM AUTHOR]

Prior research on racial/ethnic disparities in COVID-19 mortality has often not considered to what extent they reflect COVID-19–specific factors, versus preexisting health differences. This study examines how racial/ethnic disparities in COVID-19 mortality vary with age, sex, and time period over April-December 2020 in the United States, using mortality from other natural causes as a proxy for underlying health. We study a novel measure, the COVID excess mortality percentage (CEMP), defined as the COVID-19 mortality rate divided by the non-COVID natural mortality rate, converted to a percentage, where the CEMP denominator controls (albeit imperfectly) for differences in population health. Disparities measured using CEMP deviate substantially from those in prior research. In particular, we find very high disparities (up to 12:1) in CEMP rates for Hispanics versus Whites, particularly for nonelderly men. Asians also have elevated CEMP rates versus Whites, which were obscured in prior work by lower overall Asian mortality. Native Americans and Blacks have significant disparities compared with White populations, but CEMP ratios to Whites are lower than ratios reported in other work. This is because the higher COVID-19 mortality for Blacks and Native Americans comes partly from higher general mortality risk and partly from COVID-specific risk. [ABSTRACT FROM AUTHOR]

The nephrology and critical care communities have seen an increase in studies exploring acute kidney injury (AKI) epidemiology in children. As a result, we now know that AKI is highly prevalent in critically ill neonates, children, and young adults. Furthermore, children who develop AKI experience greater morbidity and higher mortality. Yet knowledge gaps still exist that suggest a more comprehensive understanding of AKI will form the foundation for future efforts designed to improve outcomes. In particular, the areas of community acquired AKI, AKI in non-critically ill children, and cohorts from low-middle income countries have not been well studied. Longer-term functional outcomes and patient-centric metrics including social determinants of health, quality of life, and healthcare utilization should be the foci of the next phase of scholarship. Current definitions identify AKI-based upon evidence of dysfunction which serves as a proxy for injury; biomarkers capable of identifying injury as it occurs are likely to more accurately define populations with AKI. Despite the strength of the association, the causal and mechanistic relationships between AKI and poorer outcomes remain inadequately examined. A more robust understanding of the relationship represents a potential to identify therapeutic targets. Once established, a more comprehensive understanding of AKI epidemiology in children will allow investigation of preventive, therapeutic, and quality improvement interventions more effectively. [ABSTRACT FROM AUTHOR]

Sexual minorities continue to face workplace discrimination, which leads to them experiencing concerns about disclosing their own sexual identities. Despite the benefits of disclosure, relatively little research has examined what organizational factors can work together to foster disclosure of a sexual minority identity. Across five experiments (N = 1662), we examined two main factors: diversity ideologies and information about diversity climate. Sexual minorities were more willing to disclose in organizations with diversity messages conveying that they value group differences (an identity‐conscious ideology) relative to those that downplay differences (an identity‐blind ideology). Identity‐conscious ideologies also increased belonging, perceptions of fair treatment and perceptions of LGBTQ+ representation. Despite expectations that contradictory evidence demonstrating a negative diversity climate might create mistrust and impede disclosure, the benefits of an identity‐conscious ideology persisted in the face of a negative diversity climate. These findings point to the complexities of facilitating visible sexual minority representation in many workplace environments. [ABSTRACT FROM AUTHOR]

Geospatial data and tools evolve as new technologies are developed and landscape change occurs over time. As a result, these data may become outdated and inadequate for supporting critical habitat-related work across the international boundary in the Sonoran and Mojave Deserts Bird Conservation Region (BCR 33) due to the area's complex vegetation communities and the discontinuity in data availability across the United States (US) and Mexico (MX) border. This research aimed to produce the first 30 m continuous land cover map of BCR 33 by prototyping new methods for desert vegetation classification using the Random Forest (RF) machine learning (ML) method. The developed RF classification model utilized multitemporal Landsat 8 Operational Land Imager spectral and vegetation index data from the period of 2013–2020, and phenology metrics tailored to capture the unique growing seasons of desert vegetation. Our RF model achieved an overall classification F-score of 0.80 and an overall accuracy of 91.68%. Our results portrayed the vegetation cover at a much finer resolution than existing land cover maps from the US and MX portions of the study area, allowing for the separation and identification of smaller habitat pockets, including riparian communities, which are critically important for desert wildlife and are often misclassified or nonexistent in current maps. This early prototyping effort serves as a proof of concept for the ML and data fusion methods that will be used to generate the final high-resolution land cover map of the entire BCR 33 region. [ABSTRACT FROM AUTHOR]

In 1998, the Higher Education Act of 1965 (HEA Reauthorization) was amended by the United States Congress, thereby encouraging the development of new strategies on college and university campuses for addressing alcohol and other drug (AOD) abuse. The HEA Reauthorization also served as a catalyst for colleges and universities to develop new policies related to AOD, including parental notification policies. This 3-year, longitudinal case study assesses the effectiveness of the collaborative, multifaceted environmental management and enforcement plan that was implemented at Syracuse University, a private 4-year university. Through measurement of behavioral indicators this study shows the effectiveness of a comprehensive environmental management strategy in reducing the frequency and severity of AOD abuse in college environments. The effectiveness of this comprehensive environmental management approach is evident in the university's 29.2% decrease in alcohol violations and corresponding 24.6% decline in overall discipline cases. Moreover this research provides theory and practical application for student affairs practitioners in the judicial, counseling, education, administrative, and health services. (Contains 1 table and 6 figures.)

Professor Julie Ann Sosa, an academic endocrine surgeon and researcher from the United States, has had an illustrious career in the medical field. Born in Montreal, Canada, she immigrated to the US at a young age and completed her education in upstate New York. After exploring other career paths, she ultimately decided to become a doctor and pursued her medical training at Johns Hopkins and Oxford University. Professor Sosa has made significant contributions to health services research and has authored numerous publications on topics such as outcomes research, health care delivery, hyperparathyroidism, and thyroid cancer. As a Latina woman in surgery, she faced challenges but has worked to create a more inclusive surgical community. She is also passionate about promoting careers in STEM and has mentored and inspired many young people to pursue medicine, surgery, and science. Professor Sosa's achievements have been recognized with various awards and honors. [Extracted from the article]

Objective Investigate scientific articles related to the cost of the Home Care Service for patients undergoing oncology palliative care. Methods Integrative literature review, which included primary articles indexed in the PubMed, Scopus, Virtual Health Library (VHL), Embase, Science Direct and Scielo databases, using the descriptors: neoplasms; oncology; home care; palliative care; cost analysis; costs. Results Ten studies were included, three from the United Kingdom, three from Spain, followed by two from Italy, one from the United States of America and one from Canada. Studies have shown lower costs for home hospitalization with monitoring by healthcare teams, including when analyzing terminally ill cancer patients and disease prognosis. Conclusion It was evidenced that the costs of care provided to patients undergoing oncological palliative care are lower in a home environment than at a hospital level. [ABSTRACT FROM AUTHOR]

Background: Patient‐centered care is the best practice in the care of pregnant and postpartum patients. The COVID‐19 pandemic prompted changes in perinatal care policies, which were often reactive, resulting in unintended consequences, many of which made the delivery of patient‐centered care more difficult. This study aimed to understand the impact of the COVID‐19 pandemic on perinatal health care delivery from the perspective of family physicians in the United States. Methods: From October 5 to November 4, 2020, we surveyed mid‐ to late‐career family physicians who provide perinatal care. We conducted descriptive analyses to measure the impact of COVID‐19 on prenatal care, labor and delivery, postpartum care, patient experience, and patient volume. An immersion‐crystallization approach was used to analyze qualitative data provided as open‐text comments. Results: Of the 1518 survey respondents, 1062 (69.8%) stated that they currently attend births; 595 of those elaborated about the impact of COVID‐19 on perinatal care in free‐text comments. Eight themes emerged related to the impact of COVID‐19 on perinatal care: visitation, patient decisions, testing, personal protective equipment, care continuity, changes in care delivery, reassignment, and volume. The greatest perceived impact of COVID‐19 was on patient experience. Conclusions: Family physicians who provided perinatal care during the COVID‐19 pandemic noted a considerable impact on patient experience, which particularly affected the ability to deliver patient‐centered and family‐centered care. Continued research is needed to understand the long‐term impact of policies affecting the delivery of patient‐centered perinatal care and to inform more evidence‐based, proactive policies to be implemented in future pandemic or disaster situations. [ABSTRACT FROM AUTHOR]

Background: Many physicians listed as primary care in databases such as the American Medical Association (AMA) Masterfile do not provide traditional ambulatory primary care.Objective: To compare physicians listed in the AMA Masterfile as primary care physician (PCPs) specialists for adult patients with their actual practice type.Methods: We conducted a cross-sectional study of the AMA Masterfile report for PCPs who care for adults (listed as family medicine, internal medicine, medicine-paediatrics, and geriatrics) in the summer and fall of 2018 (spring of 2019 for Hartford, CT) in the primary counties of 8 metropolitan areas across the United States. We searched multiple websites to determine the actual practice type of each physician in the study counties. We correlated the 2 datasets: the AMA Masterfile list vs the results of our searches.Results: Family physicians were more likely to function as traditional ambulatory PCPs than internists [1,738/2,101 (82.7%) vs 1,241/2,025 (60.9%), P < 0.001], and less likely to be hospitalists [83/2,101 (4.0%) vs 631/2,025 (31.0%), P < 0.001]. Other practice types included urgent care [105 (5.0%) family physicians, 16 (0.8%) internists] and emergency medicine [49 (2.3%) family physicians, 20 (1.0%) internists]. The AMA Masterfile identified 4,892 practicing PCPs for adult patients in the study counties, of which 3,084 (63.0%) matched by location and ambulatory PCP practice type [3,695 (75.5%) for ambulatory PCP practice type only].Conclusions: We provide an updated estimate using a unique methodology to estimate how to correct the AMA Masterfile for PCPs who actually provide traditional ambulatory primary care to adult patients. [ABSTRACT FROM AUTHOR]

Policies to reduce greenhouse gases associated with electricity generation have been a major focus of public policy in the United States, but their implications for achieving environmental justice among historically overburdened communities inappropriately remains a marginal issue. In this study we address research gaps in historical and current ambient air emissions burdens in environmental justice communities from power plants participating in the Regional Greenhouse Gases Initiative (RGGI), the country's first market-based power sector emissions reduction program. We find that in RGGI states the percentage of people of color that live within 0–6.2 miles from power plants is up to 23.5 percent higher than the percent of the white population that lives within those same distance bands, and the percentage of people living in poverty that live within 0–5 miles from power plants is up to 15.3 percent higher than the percent of the population not living in poverty within those same distance bands. More importantly, the transition from coal to natural gas underway before RGGI formally started resulted in large increases in both the number of electric-generating units burning natural gas and total net generation from natural gas in environmental justice communities hosting electric-generating units, compared to other communities. Our findings indicate that power sector carbon mitigation policies' focusing on aggregate emissions reductions have largely benefitted non-environmental justice communities and have not redressed the fundamental problem of disparities in pollutant burdens between EJ and non-EJ communities. These must be directly addressed in climate change and carbon emissions mitigation policy. [ABSTRACT FROM AUTHOR]

Background Contemporary information regarding fever and neutropenia (FN) management, including approaches to antibacterial prophylaxis, empiric therapy, and de-escalation across US cancer centers, is lacking. Methods This was a self-administered, electronic, cross-sectional survey of antimicrobial stewardship physicians and pharmacists at US cancer centers. The survey ascertained institutional practices and individual attitudes on FN management in high-risk cancer patients. A 5-point Likert scale assessed individual attitudes. Results Providers from 31 of 86 hospitals (36%) responded, and FN management guidelines existed in most (29/31, 94%) hospitals. Antibacterial prophylaxis was recommended in 27/31 (87%) hospitals, with levofloxacin as the preferred agent (23/27, 85%). Cefepime was the most recommended agent for empiric FN treatment (26/29, 90%). Most institutional guidelines (26/29, 90%) recommended against routine addition of empiric gram-positive agents except for specific scenarios. Eighteen of 29 (62%) hospitals explicitly provided guidance on de-escalation of empiric, systemic antibacterial therapy; however, timing of de-escalation was variable according to clinical scenario. Among 34 individual respondents, a majority agreed with use of antibiotic prophylaxis in high-risk patients (25, 74%). Interestingly, only 10 (29%) respondents indicated agreement with the statement that benefits of antibiotic prophylaxis outweigh potential harms. Conclusion Most US cancer centers surveyed had institutional FN management guidelines. Antibiotic de-escalation guidance was lacking in nearly 40% of centers, with heterogeneity in approaches when recommendations existed. Further research is needed to inform FN guidelines on antibacterial prophylaxis and therapy de-escalation. [ABSTRACT FROM AUTHOR]

Background and Objectives: According to a previous study, obstetric deliveries may be protective against burnout for family physicians. Analyses of interviews conducted during a larger qualitative study about the experiences of early-career family physicians who intended to include obstetric deliveries in their practice revealed that many interviewees discussed burnout. This study aimed to understand the relationship between practicing obstetrics and burnout based on an analysis of these emerging data on burnout.Methods: We conducted semistructured interviews with physicians who graduated from family medicine residency programs in the United States between 2013 and 2016. We applied an immersion-crystallization approach to analyze transcribed interviews.Results: Fifty-six early-career family physicians participated in interviews. Burnout was an emerging theme. Physicians described how practicing obstetrics can protect from burnout (eg, brings joy to practice, diversity in practice), how it can contribute to burnout (eg, time demands, increased stress), how it can do both simultaneously and the importance of professional agency (ie, the capacity to make own free choices), and other sources of burnout (eg, administrative tasks, complex patients).Conclusions: This study identifies a family medicine-obstetric paradox wherein obstetrics can simultaneously protect from and contribute to burnout for family physicians. Professional agency may partially explain this paradox. [ABSTRACT FROM AUTHOR]

Copyright of Revista Digital de Derecho Administrativo is the property of Universidad Externado de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

What motivated Trump Supporters to storm the US Capitol in protest of the US Election results? We examined how different dimensions of an identification (Trump, Republican) predicted intentions to engage in activism or radicalism in the wake of the 2020 US Presidential Election. We sampled self‐identified Republicans 3 weeks before (N = 273), and 10 days after (N = 277), the US Capitol Insurrection. We separately measured identification as a Republican and Trump Supporter before assessing people's perception that the 2020 Election was illegitimate. We then assessed two emotions (anger, contempt) and two forms of collective action intentions (activism, radicalism). Both studies showed that stronger Trump identification, but weaker Republican identification, predicted perceptions that the 2020 US Election was illegitimate. Perceptions of illegitimacy predicted feelings of anger and contempt, which differently predicted normative and nonnormative collective action. Results suggest that different dimensions of identification predispose people to different perceptions of events and, consequently, harbor different action intentions. [ABSTRACT FROM AUTHOR]

Three studies examine how women's benevolent sexism (BS) shapes support for other women's agentic responses to gender‐based threat. In Study 1, women read vignettes about a woman who agentically responded (vs. no response) to gender‐based threat (e.g., sexism). As hypothesized, BS predicted more positive attitudes towards the woman who chose not to challenge sexism and more negative attitudes towards the woman who did. Studies 2 and 3 focused on whether these effects are driven by the behaviour displayed by the target (response or not) or by the ideology it seeks to uphold (traditional or non‐traditional). There may be circumstances under which BS is associated with positive attitudes towards women's agentic (i.e., non‐gender role conforming) behaviour, for instance, when it is used to support traditional gender roles. Studies 2 and 3 showed that when women's agentic behaviour is used to uphold traditional gender roles (vs. challenge them), BS is positively associated with support for such behaviour. These findings underscore the importance of ideology underlying women's agentic behaviour: BS can support women's agentic responses that violate prescribed gender roles, so long as they reinforce the status quo. [ABSTRACT FROM AUTHOR]

Background: Vasodilatory shock refractory to catecholamine vasopressors and arginine vasopressin is highly morbid and responsible for significant mortality. Synthetic angiotensin II is a potent vasoconstrictor that may be suitable for use in these patients.Research Question: What is the safety and effectiveness of angiotensin II and what variables are associated with a favorable hemodynamic response?Study Design and Methods: We performed a multicenter, retrospective study at five tertiary medical centers in the United States. The primary end point of hemodynamic responsiveness to angiotensin II was defined as attainment of mean arterial pressure (MAP) of ≥ 65 mm Hg with a stable or reduced total vasopressor dosage 3 h after drug initiation.Results: Of 270 included patients, 181 (67%) demonstrated hemodynamic responsiveness to angiotensin II. Responders showed a greater increase in MAP (+10.3 mm Hg vs +1.6 mm Hg, P < .001) and reduction in vasopressor dosage (-0.20 μg/kg/min vs +0.04 μg/kg/min; P < .001) compared with nonresponders at 3 h. Variables associated with favorable hemodynamic response included lower lactate concentration (OR 1.11; 95% CI, 1.05-1.17, P < .001) and receipt of vasopressin (OR, 6.05; 95% CI, 1.98-18.6; P = .002). In severity-adjusted multivariate analysis, hemodynamic responsiveness to angiotensin II was associated with reduced likelihood of 30-day mortality (hazard ratio, 0.50; 95% CI, 0.35-0.71; P < .001). Arrhythmias occurred in 28 patients (10%) and VTE was identified in 4 patients.Interpretation: In postmarketing use for vasopressor-refractory shock, 67% of angiotensin II recipients demonstrated a favorable hemodynamic response. Patients with lower lactate concentrations and those receiving vasopressin were more likely to respond to angiotensin II. Patients who responded to angiotensin II experienced reduced mortality. [ABSTRACT FROM AUTHOR]

Hydrological and bioclimatic processes that lead to drought may stress plants and wildlife, restructure plant community type and architecture, increase monotypic stands and bare soils, facilitate the invasion of non‐native plant species and accelerate soil erosion. Our study focuses on the impact of a paucity of Colorado River surface flows from the United States (U.S.) to Mexico. We measured change in riparian plant greenness and water use over the past two decades using remotely sensed measurements of vegetation index (VI), evapotranspiration (ET) and a new annualized phenology assessment metric (PAM) for ET. We measure these long‐term (2000–2019) metrics and their short‐term (2014–2019) response to an environmental pulse flow in 2014, as prescribed under Minute 319 of the 1944 Water Treaty between the two nations. In subsequent years, small‐directed flows were provided to restoration areas under Minute 323. We use 250 m MODIS and 30 m Landsat imagery to evaluate three vegetation indices (NDVI, EVI, EVI2). We select EVI2 to parameterize an optical‐based ET algorithm and test the relationship between ET from Landsat and MODIS by regression approaches. Our analyses show significant decreases in VIs and ET for both the 20‐year and post‐pulse 5‐year periods. Over the last 20 years, EVI Landsat declined 34% (30% by EVIMODIS) and ETLandsat‐EVI declined 38% (27% by ETMODIS‐EVI), overall ca. 1.61 mm/day or 476 mm/year drop in ET; using PAM ETLandsat‐EVI the drop was from 1130 to 654 mm/year. Over the 5 years since the 2014 pulse flow, EVILandsat declined 20% (13% by EVIMODIS) and ETLandsat‐EVI declined 23% (4% by ETMODIS‐EVI) with a 0.77 mm/day or a 209 mm/year 5‐year drop in ET; using PAM ETLandsat‐EVI the drop was from 863 to 654 mm/year. Data and change maps show the pulse flow contributed enough water to slow the rate of loss, but only for the very short‐term (1–2 years). These findings are critically important as they suggest further deterioration of biodiversity, wildlife habitat and key ecosystem services due to anthropogenic diversions of water in the U.S. and Mexico and from land clearing, fires and plant‐related drought which affect hydrological processes. [ABSTRACT FROM AUTHOR]

This essay explores the notions of lyric, modernity, and America. I argue that the idea of America is inextricable tied to the emergence of modern lyric poetry. I question the understanding that the value of Latin American poetry is confined to the historiographic Hegelian spirit of "universal" history that marks the beginning of poetry in Latin America in the late 19th century, only after it first emerged in Europe and then in the United States. I analyze the image of America and the development of lyric poetry since the end of the so-called Middle Ages in relation to the heterogeneous constitution of modernity and modern subjectivity. I suggest that the Cartesian dualism would be completely meaningless without the parallel conceptualization and conquest of America. Finally, this essay proposes that the alleged poetic delay in Latin America must be abandoned in favor of a poetic approach that is written and verified without the teleological constraints of History. [ABSTRACT FROM AUTHOR]

Summary: Bioactive compounds from Brazilian hop (Humulus lupulus L.) cultivars were extracted by ultrasound and their phenolic profile compared with commercial hop from the USA. The most effective extraction conditions (solution of ethanol 49%, at 52 °C and a solid/liquid ratio of 1 g per 34 mL) for the total phenolic compounds (TPC) were determined using a Central Composite Rotatable Design. The Brazilian hop showed higher content of TPC (33.93 ± 0.67 mg GAE g−1), total flavonoids (54.47 ± 0.10 mg QE g−1) and higher antioxidant activity (ABTS: EC50 21.29 ± 1.36 μL mL−1; DPPH: EC50 3.91 ± 0.17 μL mL−1) when compared with the USA hop. The main phenolic compounds present in the extracts were the flavonoids isoquercitrin and quercetin. The antioxidant properties of the Brazilian hop extract had not been reported yet in the literature for this raw material, thus showing potential to be incorporated in polymeric films used as active packaging. [ABSTRACT FROM AUTHOR]

While evidence from California suggests that group threat mobilizes Latinos, nationally, there has never been a test case for this theory. In 2016, the Trump campaign provided a clear case of group threat through his divisive rhetoric and policy proposals targeting Mexican Americans and immigrants. Using the 2016 Collaborative Multi-Racial Post-Election Survey (CMPS) data, we find evidence that Latino voters were politically motivated by Trump's anti-Latino rhetoric. We hypothesize that Latino voters who perceive Latinos as a racialized group and feel a sense of immigrant-linked fate are more likely to hold negative views toward the Republican candidate, and feel angry during the 2016 election. We further find that Latino voters who were angry were more likely to engage in political activities such as donating to campaigns, contacting government officials, and protesting during and shortly after the 2016 election. The findings hold for U.S. born Latinos as well as among non-Mexican Latinos who felt similarly targeted by Trump's rhetoric and proposals. [ABSTRACT FROM AUTHOR]

Objective This study aimed to explore how new family medicine graduates who want to include obstetrics in their scope of practice identify and select jobs and to understand how employment influences scope of practice in family medicine, particularly the ability to provide maternity care and deliver babies. Design Mixed-methods study including a survey and qualitative interviews conducted in 2017. Setting We electronically surveyed US family physicians and followed up with a purposeful subsample of these physicians to conduct in-depth, semistructured telephone interviews. Participants 1016 US family medicine residency graduates 2014-2016 who indicated that they intended to deliver babies in practice completed a survey; 56 of these were interviewed. Main outcome measures The survey measured the reasons for not doing obstetrics as a family physician. To identify themes regarding finding family medicine jobs with obstetrics, we used a team-based, immersion- crystallisation approach to analyse the transcribed qualitative interviews. Results Survey results (49% response rate) showed that not finding a job that included obstetrics was the primary reason newly graduated family physicians who intended to do obstetrics were not doing so. Qualitative interviews revealed that family physicians often find jobs with obstetrics through connections or recruitment efforts and make job decisions based on personal considerations such as included geographical preferences, family obligations and lifestyle. However, job-seeking and job-taking decisions are constrained by employment-related issues such as job structure, practice characteristics and lack of availability of family medicine jobs with obstetrics. Conclusions While personal reasons drove job selection for most physicians, their choices were constrained by multiple factors beyond their control, particularly availability of family medicine jobs allowing obstetrics. The shift from physician as practice owner to physician as employee in the USA has implications for job-seeking behaviours of newly graduating medical residents as well as for access to healthcare services by patients; understanding how employment influences scope of practice in family medicine can provide insight into how to support family physicians to maintain the scope of practice they desire and are trained to provide, thus, ensuring that families have access to care. [ABSTRACT FROM AUTHOR]

The incidence and severity of Clostridium difficile infection (CDI) remain high across intensive care units in the United States despite national efforts to decrease this escalating health care burden. Most published literature and guidelines address treatment rather than prevention, yet this approach may be too downstream to limit morbidity and mortality from the disease and its complications. Mechanisms to prevent CDI successfully include reducing modifiable risk factors and minimizing horizontal transmission of C. difficile spores between patients and the health care environment. Because CDI prevention is characterized by a bundled approach, it is difficult to quantify the individual impact of any one element; however, a number of patient‐ and facility‐level strategies can be considered for CDI prevention. Robust hygiene strategies, diagnostic and antimicrobial stewardship, and particular prophylaxis maneuvers such as continuation of oral vancomycin or fidaxomicin in the setting of systemic antibiotics have all demonstrated benefit. The preventive roles of deprescribing acid suppressants, routine use of probiotics, or early fecal microbiota transplantation remain unclear. The focus of this review is to summarize the evidence related to primary and secondary CDI prevention in critically ill adults and provide a concise implementation pathway for clinicians and policymakers. [ABSTRACT FROM AUTHOR]

Copyright of Interface - Comunicação, Saúde, Educação is the property of Fundacao UNI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The American Board of Family Medicine routinely surveys its Diplomates in each national graduating cohort 3 years out of training. These data were used to characterize early career family physicians whose services include management of pregnancy and prescribing buprenorphine. A total of 261 (5.1%) respondents both provide maternity care and prescribe buprenorphine. Family physicians who care for pregnant women and also prescribe buprenorphine represented 50.4% of all buprenorphine prescribers. The family physicians in this group were trained in a small number of residency programs, with only 15 programs producing at least 25% of graduates who do this work. [ABSTRACT FROM AUTHOR]

The article discusses the effectiveness of interventions to prevent and treat Clostridium difficile infection, based on studies reviewed by the U.S. Agency for Healthcare Research and Quality (AHRQ). Topics covered include the link between antibiotic stewardship and decreased Clostridium difficile infection, the effectiveness of fecal microbiota transplantation, and the use of antimicrobials in treating and reducing the recurrence of this infection.

The article argues that survey methodology for polling Hispanic Americans is inconsistent or inaccurate based on a novel analysis of Latino votes from voting precincts across the U.S. in 1996-2016, and that a bilingual, bicultural, Latino-centred approach matters when collecting accurate data.

ABSTRACT This article introduces a web-based climate information resource: an El Niño Southern Oscillation ENSO-based monthly climatology for the United States, available on . Climate variability affects land managers and decision makers in a variety of ways. The ENSO is one of the leading drivers of seasonal and year-to-year climate variability. Understanding the historical rainfall and temperature anomalies associated with ENSO can be an important way for decision makers to learn how they might anticipate climate variability. We used the ENSO record from 1950 to 2013 to develop an ENSO-specific climatology. This allows decision makers to pinpoint the combinations of location and month in which there are substantial ENSO-associated rainfall or temperature anomalies. Learning about the timing of historical ENSO-driven climate impacts can be an important first step for decision makers to develop management adjustments that could make the most positive outcomes based on the available climate information. [ABSTRACT FROM AUTHOR]

Background: The objective of this work was to inform the design of a rapid response program to support evidence-informed decision-making in health policy and practice for the Americas region. Specifically, we focus on the following: (1) What are the best methodological approaches for rapid reviews of the research evidence? (2) What other strategies are needed to facilitate evidence-informed decision-making in health policy and practice? and (3) How best to operationalize a rapid response program?Methods: The evidence used to inform the design of a rapid response program included (i) two rapid reviews of methodological approaches for rapid reviews of the research evidence and strategies to facilitate evidence-informed decision-making, (ii) supplementary literature in relation to the "shortcuts" that could be considered to reduce the time needed to complete rapid reviews, (iii) four case studies, and (iv) supplementary literature to identify additional operational issues for the design of the program.Results: There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting them. Better reporting of rapid review methods is needed. The literature found in relation to shortcuts will be helpful in choosing shortcuts that maximize timeliness while minimizing the impact on quality. Evidence for other strategies that can be used concurrently to facilitate the uptake of research evidence, including evidence drawn from rapid reviews, is presented. Operational issues that need to be considered in designing a rapid response program include the implications of a "user-pays" model, the importance of recruiting staff with the right mix of skills and qualifications, and ensuring that the impact of the model on research use in decision-making is formally evaluated.Conclusions: When designing a new rapid response program, greater attention needs to be given to specifying the rapid review methods and reporting these in sufficient detail to allow a quality assessment. It will also be important to engage in other strategies to facilitate the uptake of the rapid reviews and to evaluate the chosen model in order to make refinements and add to the evidence base for evidence-informed decision-making. [ABSTRACT FROM AUTHOR]

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Is the essence of American identity civic, ethnic, or a combination of the two? The 2010 debate in the U.S. House of Representatives on a bill to hold a referendum on the Puerto Rico status question provided a unique opportunity to shed light on these approaches. House Resolution 2499 would have asked the island's electorate whether they preferred remaining a Commonwealth, become an independent country, or the fifty-first state. Despite three choices, House members overwhelming focused on one: statehood. Effectively this bill asked lawmakers, in keeping with the civic identity thesis, whether they were willing to accept a culturally and linguistically distinct territory as an equal partner in the federation. These deliberations divulge much about congressional views on the official, civic, American identity and its alternatives. At another level this debate questions the assumption that the stability and consolidation of national identities cannot proceed with clearly and consistently defined boundary markers. That clarity, some contend, is imperative on the part of government leaders. This article argues that significant differences in how the nation is objectified may be overlooked in the short run, but may incur significant long-term instability. [ABSTRACT FROM AUTHOR]

The article focuses on the residency program called Clinical Learning Environment Review (CLER) by the organization Accreditation Council of Graduate Medical Education (ACGME). Topics discussed include experiences of residents who completed the course, with subjects such as work life balance, information processing, and self confidence.

The article focuses on the increased suicide attempts among the black children especially in the mid-adolescence in females.

Objectives To determine whether high performing hospitals with low 30 day risk standardized readmission rates have a lower proportion of readmissions from specific diagnoses and time periods after admission or instead have a similar distribution of readmission diagnoses and timing to lower performing institutions. Design Retrospective cohort study. Setting Medicare beneficiaries in the United States. Participants Patients aged 65 and older who were readmitted within 30 days after hospital admission for heart failure, acute myocardial infarction, or pneumonia in 2007-09. Main outcome measures Readmission diagnoses were classified with a modified version of the Centers for Medicare and Medicaid Services' condition categories, and readmission timing was classified by day (0-30) after hospital discharge. Hospital 30 day risk standardized readmission rates over the three years of study were calculated with public reporting methods of the US federal government, and hospitals were categorized with bootstrap analysis as having high, average, or low readmission performance for each index condition. High and low performing hospitals had ≥95% probability of having an interval estimate respectively less than or greater than the national 30 day readmission rate over the three year period of study. All remaining hospitals were considered average performers. Results For readmissions in the 30 days after the index admission, there were 320 003 after 1 291 211 admissions for heart failure (4041 hospitals), 102 536 after 517 827 admissions for acute myocardial infarction (2378 hospitals), and 208 438 after 1 135 932 admissions for pneumonia (4283 hospitals). The distribution of readmissions by diagnosis was similar across categories of hospital performance for all three conditions. High performing hospitals had fewer readmissions for all common diagnoses. Median time to readmission was similar by hospital performance for heart failure and acute myocardial infarction, though was 1.4 days longer among high versus low performing hospitals for pneumonia (P<0.001). Findings were unchanged after adjustment for other hospital characteristics potentially associated with readmission patterns. Conclusions High performing hospitals have proportionately fewer 30 day readmissions without differences in readmission diagnoses and timing, suggesting the possible benefit of strategies that lower risk of readmission globally rather than for specific diagnoses or time periods after hospital stay. [ABSTRACT FROM AUTHOR]