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Black women social workers (BWSWs) represent essential workforce members who are burdened by ongoing COVID-19 circumstances. Strategies to deal with highly stressful situations on the job, such as those experienced in 2020, were absent from the research literature leaving intervention strategies to support highly stressed BWSWs unknown. This study aimed to uncover the various ways BWSWs experienced their organizations as they performed work duties. Atlas.ti. 9 was used to analyze verbatim transcripts from 17 semi-structured qualitative interviews given by BWSWs across the United States in February 2021. Hermeneutic phenomenology was implemented to interpret interview data. The convenience sample was drawn from professional organizations where BWSWs claimed membership and volunteered to be electronically interviewed for 2 hours generating themes such as stress perceptions, institutional barriers to efficient work productivity and recommendations for workplace support. BWSWs reported high stress work environments in the past year. Some believed that their health and mental health declined because of the inability to find work-home life balance. Findings suggest BWSWs persevere regardless of high levels of stress and being unsupported in the workplace in order to maintain a livelihood. BWSWs play a crucial role in the lives of vulnerable populations, but need to attend to ways to be healthier given the polarization associated with racism, classism, and sexism experienced. Thematically, the data revealed stressful situations in the workplace and how organizations have failed to implement strategies in order to improve social worker health. Suggestions for workplace supports were also identified. [ABSTRACT FROM AUTHOR]

Homelessness is growing internationally, and resources to guide occupational therapy practice in this area are needed. To identify competencies needed for occupational therapists to support individuals during and following homelessness. We conducted a three-round Delphi study with occupational therapy practitioners and researchers with expertise in homelessness. Of 35 potential participants, n = 16 participated in Round I, n = 20 participated in Round II, and n = 18 participated in Round III. Participants included occupational therapists and researchers in Canada, United States, Brazil, UK, Ireland and New Zealand. Consensus was achieved on a total of 93 competencies in 10 categories after 15 were eliminated in Rounds II and III. The categories with the greatest number of competencies included occupational knowledge (n = 18), followed by psychosocial competencies (n = 16). This study represents the first to identify the competencies needed for occupational therapists working in the area of homelessness. Practitioners and educators are encouraged to view the identified competencies as a guide for the professional development of occupational therapists in this context. Stakeholders consulted for this study were able to communicate in English and situated in middle to high-income countries. As such, the competencies identified in this study only apply to these sociocultural contexts. [ABSTRACT FROM AUTHOR]

Gender disparity persists in the United States; women are still paid less than men and are also subject to discrimination in the workplace based on the fact that they may become mothers. Further, there is evidence to indicate that single mothers are judged more harshly than their married mother counterparts and single fathers. As a form of amelioration, some women self medicate with alcohol and according to the CDC), alcohol use disorder (AUD) is on the rise for women. Although there is research on gender disparity, the motherhood penalty, and AUD, there are no experiments testing socio-cognitive judgments on those combined factors and specifically examining what we term "the single motherhood penalty". Therefore, in two experiments using between-participants designs, participants rated a picture of a person (female or male) paired with a brief description where marital status (single or married) and type of ailment (alcohol or physical) was manipulated. In Experiment 1, a passive AUD manipulation did not show a clear single motherhood penalty. In Experiment 2, the results of an active AUD manipulation supported the predicted single motherhood penalty (Experiment 2a), but did not show an analogous single fatherhood penalty (Experiment 2 b). These findings are the first to offer empirical evidence that socio-cognitive judgments might perpetuate the interplay of the single motherhood penalty and AUD. [ABSTRACT FROM AUTHOR]

In recent years, New York has re-focused on the widely debated topic of how to best manage and regulate prostitution in the United States. As a state-level issue, the debate presents an invaluable opportunity to re-examine how New York as a society views sex work. The answer in New York focuses on the idea that sex work is real work, where workers should be able to carry out their profession without stigma or fear of arrest. As it stands, the proposed reform largely focuses on decriminalizing both the purchase and sale of sex. This approach contrasts with the legal structure in Sweden, which criminalizes only the purchase or the patronizing of prostitution. The New York proposal still criminalizes patronizing prostitution from a minor but offers a mistake-of-age defense thereto. New York should close this loophole with an eye toward the Swedish model and refocus on strictly enforcing the statute against patrons. Such a solution represents a compromise between legitimizing sex work as a legal avenue toward a livelihood, while simultaneously targeting those who most threaten the safety of sex workers outside of law enforcement: male patrons soliciting sex from vulnerable minors. [ABSTRACT FROM AUTHOR]

With the adoption of statutes, policies and administrative guidance since the late 1980s, statutory child welfare agencies around the world have been implementing practice approaches to resolving and addressing child abuse and neglect concerns that involve extended family systems in decision making and planning. One such approach is the family group conference (FGC), enshrined in New Zealand law. This article provides a historical context and describes numerous provisions of the family group conference that protect participants and the proceedings. It then describes applications of FGC‐like approaches in the United States where practice models and policies—not laws—guide the implementation of such approaches. Key Points for the Family Court Community: To understand the privacy and confidentiality provisions of the family group conference as legislated in New Zealand.To support policy development for family meeting approaches that builds in sufficient participant protections. [ABSTRACT FROM AUTHOR]

The article discusses the plan of the U.S. to implement a nuclear reprocessing program called the Global Nuclear Energy Partnership (GNEP), revealed by Energy Secretary Samuel Bodman on February 6 2006. The project envisions a global nuclear order in which a nuclear-leasing program will be operated by the U.S. and fuel supplier countries like Russia, Great Britain and France. Bodma noted that the success of GNEP will increase energy security for the U.S. and overseas, and GNEP will support new technology of recycling spent nuclear fuel, while preventing the generation of separated plutonium. The program would include recycling facilities, fast reactors and waste facilities. However, individuals in the nuclear industry criticize GNEP implementation.

Clinicians' bias related to patients' race and substance use history play a role in pain management. However, patients' or clinicians' understandings about discriminatory practices and the structural factors that contribute to and exacerbate these practices are underexamined. We report on perceptions of discrimination from the perspectives of patients with chronic non-cancer pain (CNCP) and a history of substance use and their clinicians within the structural landscape of reductions in opioid prescribing in the United States. We interviewed 46 clinicians and 94 patients, using semi-structured interview guides, from eight safety-net primary care clinics across the San Francisco Bay Area from 2013 to 2020. We used a modified grounded theory approach to code and analyze transcripts. Clinicians discussed using opioid prescribing guidelines with the goals of increased opioid safety and reduced bias in patient monitoring. While patients acknowledged the validity of clinicians' concerns about opioid safety, they indicated that clinicians made assumptions about opioid misuse towards Black patients and patients suspected of substance use. Clinicians discussed evidence of discrimination in opioid prescribing at the clinic-wide level; racialized stereotypes about patients likely to misuse opioids; and their own struggles to overcome discriminatory practices regarding CNCP management. While clinicians and patients acknowledged opioid safety concerns, the practical application of opioid prescribing guidelines impacted how patients perceived and engaged with CNCP care particularly for patients who are Black and/or report a history of substance use. We recommend healthcare system and clinic-level interventions that may remediate discriminatory practices and associated disparities. • Application of 2016 opioid guidelines impacted how patients engaged with CNCP care. • Clinicians made assumptions about opioid misuse based on race and substance use. • Patients experienced the application of opioid tapering practices as discriminatory. • Patients and clinicians recognized harms of bias and discriminatory CNCP management. • Structural interventions are needed to address discrimination in CNCP management. [ABSTRACT FROM AUTHOR]

Most genotype–phenotype studies have historically lacked population diversity, impacting the generalizability of findings and thereby limiting the ability to equitably implement precision medicine. This well-documented problem has generated much interest in the ascertainment of new cohorts with an emphasis on multiple dimensions of diversity, including race/ethnicity, gender, age, socioeconomic status, disability, and geography. The most well known of these new cohort efforts is arguably All of Us, formerly known as the Precision Medicine Cohort Initiative Program. All of Us intends to ascertain at least one million participants in the United States representative of the multiple dimensions of diversity. As an incentive to participate, All of Us is offering the return of research results, including whole genome sequencing data, as well as the opportunity to contribute to the scientific process as non-scientists. The scale and scope of the proposed return of research results are unprecedented. Here, we briefly review possible return of genetic data models, including the likely data file formats and modes of data transfer or access. We also review the resources required to access and interpret the genetic or genomic data once received by the average participant, highlighting the nuanced anticipated barriers that will challenge both the digitally, computationally literate and illiterate participant alike. This inventory of resources required to receive, process, and interpret return of research results exposes the potential for access disparities and warns the scientific community to mind the gap so that all participants have equal access and understanding of the benefits of human genetic research. [ABSTRACT FROM AUTHOR]

The Comprehensive Assessment of Psychopathic Personality (CAPP; Cooke, Hart, Logan, & Michie, 2012) is a concept map that entails 33 personality traits; it integrates historical and contemporary conceptualizations and operationalizations of psychopathy. The current project sought to develop and validate a self-report inventory to operationalize this concept map. Study 1 reported on the development of a CAPP Self-Report (CAPP-SR) inventory using expert ratings to select items for an experimental version. Next, these experimental items were evaluated in an online sample of 550 community-dwelling U.S. participants who were carefully recruited to match current U.S. census data on gender, age, and race/ethnicity. The application of various latent modeling and classical test theory procedures resulted in the 99-item CAPP-SR measure. In Study 2, two samples from the United States and New Zealand were used for initial validation purposes. CAPP scales showed a promising pattern of convergent validity with other self-report psychopathy scales. The new CAPP-SR inventory is promising for furthering research on this emerging psychopathy model in correctional, forensic, business, and other settings in which this clinical construct is of high importance. (PsycINFO Database Record (c) 2019 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

In response to rising textbook costs, many have urged adoption of open educational resources (OER) for students. However, library-owned e-books also provide free access to students, without the potential disadvantages of OER. In this study the authors explore the suitability of e-books as textbooks by examining the social sciences textbook list in Fall 2017 at Florida Gulf Coast University (FGCU). Overall, 18% of the textbooks were available as a multi-user format and this rate increased with course level. Despite their limited availability, multi-user e-books provide a free, convenient option for students, and they may play a role in the textbook affordability solution. [ABSTRACT FROM AUTHOR]

Despite monumental advances in genomics, relatively few health care provider organizations in the United States offer personalized or precision medicine as part of the routine clinical workflow. The gaps between research and applied genomic medicine may be a result of a cultural gap across various stakeholders representing scientists, clinicians, patients, policy makers, and third party payers. Scientists are trained to assess the health care value of genomics by either quantifying population-scale effects, or through the narrow lens of clinical trials where the standard of care is compared with the predictive power of a single or handful of genetic variants. While these metrics are an essential first step in assessing and documenting the clinical utility of genomics, they are rarely followed up with other assessments of health care value that are critical to stakeholders who use different measures to define value. The limited value assessment in both the research and implementation science of precision medicine is likely due to necessary logistical constraints of these teams; engaging bioethicists, health care economists, and individual patient belief systems is incredibly daunting for geneticists and informaticians conducting research. In this narrative review, we concisely describe several definitions of value through various stakeholder viewpoints. We highlight the existing gaps that prevent clinical translation of scientific findings generally as well as more specifically using two present-day, extreme scenarios: (1) genetically guided warfarin dosing representing a handful of genetic markers and more than 10 years of basic and translational research, and (2) next-generation sequencing representing genome-dense data lacking substantial evidence for implementation. These contemporary scenarios highlight the need for various stakeholders to broadly adopt frameworks designed to define and collect multiple value measures across different disciplines to ultimately impact more universal acceptance of and reimbursement for genomic medicine. [ABSTRACT FROM AUTHOR]

Background The first year of university attendance represents a critical time frame for the development of alcohol use and misuse given changes in autonomy and increased access to alcohol. Prior studies have demonstrated that the establishment of drinking patterns during this period is impacted by an array of demographic, environmental, and familial factors. It is critical to consider such factors jointly, and to understand potentially differential effects on stages of alcohol use/misuse, in order to identify robust predictors that may be targeted in prevention and intervention programming. Methods As part of a longitudinal study, students at a large, public U.S. university were invited to complete online surveys that included questions related to alcohol use, emotional and behavioral health, environmental factors, sociodemographic factors, and familial environment. This study uses data from surveys administered in the fall and spring of the first year of university. We used univariate (maximum N = 7,291) and multivariate (maximum N = 4,788) logistic and linear regressions to evaluate the associations between potential risk and protective factors with 4 alcohol use outcomes: initiation, consumption, problems, and addiction resistance. Results In multivariate models, we observed associations between demographic, social/environmental, and personal-level predictors with all 4 alcohol outcomes, several of which were consistent across each stage of alcohol use. A deviant high school peer group was one of the strongest predictors of risk across outcomes. The influence of drinking motives and alcohol expectancies varied by alcohol use outcome. Externalizing characteristics were associated with increased risk across outcomes, while internalizing symptoms were associated with more problems and lower addiction resistance. Conclusions These findings underscore the complex network of factors influencing stages of alcohol use during the first year of university. Importantly, these findings demonstrate that the impact of predictors changes across stages of alcohol use/misuse, which presents opportunities for targeted prevention efforts. [ABSTRACT FROM AUTHOR]

This article discusses test and evaluation methods for benchmarking and comparison of non-lethal weapons (NLW, including munitions and devices) intended for use in crowd management situations. Several types of weapons of different modalities were tested, including a fielded acoustic non-lethal device, simulated dismounted infantry directed energy weapon, a simulated long distance directed energy weapon, and a projectile weapon. The work demonstrates that NLW effectiveness of any modality can be quantified into standard metrics and statistically analyzed. Relative effectiveness can then be compared among weapons of different technologies, platforms, and energies. The resulting information can be used for Analysis of Alternatives and data-driven trade-space studies. This testing can be applied to a variety of operational scenarios and should be conducted on current NLW inventory to establish benchmark performance and effectiveness. Once benchmark performance is established, new NLWs can be evaluated to determine if improvements are significant enough to warrant investment. [ABSTRACT FROM AUTHOR]

Background: Medical schools are challenged to incorporate more prevention-based education into curricula, offering an opportunity to revisit approaches to nutrition education. The objective of this study was to explore United States (US) medical students' understanding of childhood obesity, specifically barriers to childhood obesity prevention and treatment and students' perceived educational deficits. Methods: The research team conducted phone interviews with 78 3rd- and 4th-year medical students, representing 25 different medical schools across the US. Using a semi-structured interview guide, researchers asked students to describe the etiology of childhood obesity and reflect on where they acquired knowledge of the etiology and what additional resources they would need to treat obese children. Using a phenomenological approach to analysis, researchers identified five dominant emergent themes. Results: Student-perceived barriers to childhood obesity prevention and treatment in clinical care included student-centered (e.g., lack of knowledge), patient-centered (e.g., lack of access), and healthcare system-centered barriers (e.g., limited time). Students requested more applicable nutrition information and counseling skills relevant to preventing and treating childhood obesity; however, they tended to identify others (e.g., parents, schools), rather than themselves, when asked to describe how childhood obesity should be prevented or treated. Discussion: To provide students with an understanding of their role in preventing and treating childhood obesity, US medical schools need to provide students with childhood obesity-specific and general nutrition education. To build their self-efficacy in nutrition counseling, schools can use a combination of observation and practice led by skilled physicians and other healthcare providers. Increasing students' self-efficacy through training may help them overcome perceived barriers to childhood obesity prevention and treatment. [ABSTRACT FROM AUTHOR]

The article focuses on the separation of powers issues embedded in congressional suits in the U.S. and includes House v. Burwell which deals with power of Congress to sue the Executives at first place; and analysis of power of Congress under the U.S. Constitution,.

In the first three decades of the twentieth century, the Los Angeles metropolitan area emerged as the fastest growing urban–industrial economy on the Pacific Coast. This was a significant achievement for a city without a natural harbour. Despite formidable barriers presented by physical geography, the gradual development of a deep-water harbour in Los Angeles was fundamental to the emergence of oil-based capitalism in Southern California. In the first three decades of the twentieth century, under the municipal governance of a Board of Harbor Commissioners, private oil companies developed Los Angeles Harbor into a modern transhipment facility comprising infrastructures and technologies dedicated to the efficient transportation, storage, and refining of petroleum and petroleum-based products. From this perspective, Los Angeles Harbor needs to be understood as a long-term, fixed-capital investment into oil-based energy as fuel for industry and transportation. As a transhipment facility, Los Angeles Harbor also functioned as a critical outlet for surplus energy after the discovery of several large fields in the Los Angeles Basin in the early 1920s. By focusing on a particular built landscape, this paper aims to contribute insight into how geographies of fixed-capital investment play a role in the regional dynamics of energy transition and establishment. [ABSTRACT FROM PUBLISHER]

Rationale: The extent to which geographic variability in ICU admission across the United States is driven by patients with lower risk of death is unknown. Objectives: To determine whether patients at low to moderate risk of death contribute to geographic variation in ICU admission. Methods: Retrospective cohort of hospitalizations among Medicare beneficiaries (age > 64 years) admitted for ten common medical and surgical diagnoses (2004 to 2009). We examined population-adjusted rates of ICU admission per 100 hospitalizations in 304 health referral regions (HRR), and estimated the relative risk of ICU admission across strata of regional ICU and risk of death, adjusted for patient and regional characteristics. Measurement and Main Results: ICU admission rates varied nearly two-fold across HRR quartiles (quartile 1 to 4: 13.6, 17.3, 20.0, and 25.2 per 100 hospitalizations, respectively). Observed mortality for patients in regions (quartile 4) with the greatest ICU use was 17% compared to 21% in regions with lowest ICU use (quartile 1) (p<0.001). After adjusting for patient and regional characteristics, including regional differences in ICU, skilled nursing, and long-term acute care bed capacity, individuals’ risk of death modified the relationship between regional ICU use and an individual’s risk of ICU admission (p for interaction<0.001). Region was least important in predicting ICU admission among patients with high (quartile 4) risk of death (RR 1.27, 95% CI 1.22–1.31, for high versus low ICU use regions), and most important for patients with moderate (quartile 2; RR 1.63, 95% CI 1.53–1.72, quartile 3; RR 1.56 95% CI 1.47–1.65) and low (quartile 1) risk of death (RR 1.50, 95% CI 1.41–1.59). Conclusions: There is wide variation in in ICU use by geography, independent of ICU beds and physician supply, for patients with low and moderate risks of death. [ABSTRACT FROM AUTHOR]

Objective: Controversy exists regarding perceived benefits of early tracheostomy to facilitate weaning among mechanically ventilated patients, potentially leading to significant practice-pattern variation with implications for outcomes and resource utilization. We sought to determine practice-pattern variation and outcomes associated with tracheostomy timing in the United States.Design: In a retrospective cohort study, we identified mechanically ventilated patients with the most common causes of respiratory failure leading to tracheostomy: pneumonia/sepsis and trauma. "Early tracheostomy" was performed within the first week of mechanical ventilation. We determined between-hospital variation in early tracheostomy utilization and the association of early tracheostomy with patient outcomes using hierarchical regression.Setting: 2012 National Inpatient Sample.Patients: A total of 6,075 pneumonia/sepsis patients and 12,030 trauma patients with tracheostomy.Interventions: None.Measurements and Main Results: Trauma patients were twice as likely as pneumonia/sepsis patients to receive early tracheostomy (44.5% vs 21.7%; p < 0.001). Admission to hospitals with higher early tracheostomy-to-total-tracheostomy ratios was associated with increased risk for tracheostomy among mechanically ventilated trauma patients (adjusted odds ratio = 1.04; 95% CI, 1.01-1.07) but not pneumonia/sepsis (adjusted odds ratio =1.00; 95% CI, 0.98-1.02). We observed greater between-hospital variation in early tracheostomy rates among trauma patients (21.9-81.9%) compared with pneumonia/sepsis (14.9-38.3%; p < 0.0001). We found no evidence of improved hospital mortality. Pneumonia/sepsis patients with early tracheostomy had fewer feeding tube procedures and higher odds of discharge home.Conclusion: Early tracheostomy is potentially overused among mechanically ventilated trauma patients, with nearly half of tracheostomies performed within the first week of mechanical ventilation and large unexplained hospital variation, without clear benefits. Future studies are needed to characterize potentially differential benefits for early tracheostomy between disease subgroups and to investigate factors driving hospital variation in tracheostomy timing. [ABSTRACT FROM AUTHOR]

Background: Clergy are often important sources of guidance for patients and family members making medical decisions at the end-of-life (EOL). Previous research revealed spiritual support by religious communities led to more aggressive care at the EOL, particularly among minority patients. Understanding this phenomenon is important to help address disparities in EOL care. Objective: The study objective was to explore and describe clergy perspectives regarding 'good' versus 'poor' death within the participant's spiritual tradition. Methods: This was a qualitative, descriptive study. Community clergy from various spiritual backgrounds, geographical locations within the United States, and races/ethnicities were recruited. Participants included 35 clergy who participated in one-on-one interviews ( N = 14) and two focus groups ( N = 21). Semistructured interviews explored clergy viewpoints on factors related to a 'good death.' Principles of grounded theory were used to identify a final set of themes and subthemes. Results: A good death was characterized by wholeness and certainty and emphasized being in relationship with God. Conversely, a 'poor death' was characterized by separation, doubt, and isolation. Clergy identified four primary determinants of good versus poor death: dignity, preparedness, physical suffering, and community. Participants expressed appreciation for contextual factors that affect the death experience; some described a 'middle death,' or one that integrates both positive and negative elements. Location of death was not viewed as a significant contributing factor. Conclusions: Understanding clergy perspectives regarding quality of death can provide important insights to help improve EOL care, particularly for patients highly engaged with faith communities. These findings can inform initiatives to foster productive relationships between clergy, clinicians, and congregants and reduce health disparities. [ABSTRACT FROM AUTHOR]

In this paper we consider the effects of family migration on women's employment status, using census microdata from Great Britain and the United States. We test a simple hypothesis that families tend to move long distances in favor of the male's career and that this can have a detrimental effect on women's employment status. Unlike many previous studies of this question, our work emphasizes the importance of identifying couples that have migrated together, rather than simply comparing long-distance (fe)male migrants with nonmigrant (fe)males individually. We demonstrate that women's employment status is harmed by family migration; the results we present are surprisingly consistent for Great Britain and the United States, despite differing economic situations and cultural norms regarding gender and migration. We also demonstrate that studies that fail to identify linked migrant couples are likely to underestimate the negative effects of family migration on women's employment status. [ABSTRACT FROM AUTHOR]

The article focuses on the property insurance law of the U.S. with specific reference to court ruling in the case Nautilus Insurance Co. v. Board of Directors of Regal Lofts Condominium Association, a late 2014 Seventh Circuit Court of Appeals ruling. It states that this case shows that a completed-operations exclusion may apply to one portion of a property once it is put to its intended purpose, even though the insured is continuing operations on a different part of the property.

In this article, time-series models are developed to represent three alternative, potential monetary policy regimes as monetary policy returns to normal. The first regime is a return to the high and volatile inflation rate of the 1970s. The second regime, the one expected by most Federal Reserve officials and business economists, is a return to the credible low inflation policy that characterized the U.S. economy from 1983 to 2007, a period known as the Great Moderation. The third regime is one in which policymakers keep policy interest rates at or near zero for the foreseeable future; Japanese data are used to estimate this regime. These time-series models include four variables: per capita gross domestic product growth, consumer price index inflation, the policy rate, and the 10-year government bond rate. These models are used to forecast the U.S. economy from 2008 through 2013 and represent the possible outcomes for interest rates that may follow the return of monetary policy to normal. Here, "normal" depends on the policy regime that follows the liftoff of the federal funds rate target expected in mid-2015. (JEL E43, E47, E52, E58, E65) [ABSTRACT FROM AUTHOR]

Focusing on the energy history of Southern Pacific Company in Southern California between 1865 and 1926, this paper emphasizes the resilience of private property as a pillar of oil-based capitalism in the United States. As the western segment of the first transcontinental railroad, and as a consequence of land grants provided by the federal government, the Southern Pacific emerged at the turn of the twentieth century as the largest private owner of proven oil territory in California. Based on this ownership, the Southern Pacific became a major producer, consumer and transporter of oil-based energy in Southern California. Even when the federal government threatened this ownership as part of a strategy to conserve fossil fuels in the first two decades of the twentieth century, the rights of private property remained firm and continued to reinforce the dominance of the Southern Pacific as a major regional developer of oil-based energy. This article contributes to existing literature on the political economy of fossil fuels by emphasizing how the durability of private property has culminated in a strong inertia that sustains the dominance of oil-based capitalism. [ABSTRACT FROM AUTHOR]

The article discusses Puritan identity, religion, population growth, and reproduction in colonial New England. Topics examined more closely include Puritan theology, views on original sin, ties between sexuality and the institution of marriage, female sexuality, and the role of women in Puritan society.

Internal migration rates in the United States have been steadily declining for at least twenty-five years: In 1984, 6.4 percent of the population moved between counties but by 2006—well before the most significant economic crisis since the Great Depression—annual intercounty migration rates had already declined to 4.7 percent and by 2010 to 3.5 percent. Despite the implications of the migration decline, it is poorly recognized and understood. The analysis shows that over the last thirty years, three broad trends have combined to pull migration rates dramatically lower: an increase in dual-worker couples, increased household indebtedness, and the widespread rise of information and communication technologies (ICTs). The first two are probably linked, as households have responded to decreasing real income over the last quarter-century through greater female labor force participation and maintaining current levels of consumption by borrowing ever more heavily from the equity in their homes. Thus, although this analysis shows that the decline in migration rates is not directly linked to the Great Recession, the migration decline is surely linked to the broader macroeconomic shifts that gave rise to it. With respect to the role of ICTs, it is not surprising that as ICTs have transformed nearly everything else across society, their use has affected migration rates. It is presumed that ICTs are providing new forms of mobility that are substituting for migration. [ABSTRACT FROM PUBLISHER]

A major curriculum redesign effort at the University of Maryland is infusing all levels of our undergraduate biological sciences curriculum with increased emphasis on interdisciplinary connections and quantitative approaches. The curriculum development efforts have largely been guided by recommendations in the National Research Council'sBio 2010report and have resulted in revisions to courses in biology, mathematics, and physics over a period of 10 years. Important components of this effort included (1) developing online modules to infuse more mathematical content into six biology courses taken by biological sciences majors during their first 2 years of study; (2) strengthening the interdisciplinary connections of ancillary courses in mathematics and physics to support the development of quantitative skills in biological contexts; and (3) creating more quantitatively intensive courses for the final 2 years of the bachelors of science programme. These efforts, carried out by a large, multidisciplinary team of faculty, have resulted in increased coherence in the undergraduate biological sciences curriculum, increased quantitative skills in first- and second-year students, and a greater appreciation among graduates for the essential relationship between mathematics and modern biology. [ABSTRACT FROM PUBLISHER]

Background: Financial ties between health professionals and industry may unduly influence professional judgments and some researchers have suggested that widening disease definitions may be one driver of over-diagnosis, bringing potentially unnecessary labeling and harm. We aimed to identify guidelines in which disease definitions were changed, to assess whether any proposed changes would increase the numbers of individuals considered to have the disease, whether potential harms of expanding disease definitions were investigated, and the extent of members' industry ties. Methods and Findings: We undertook a cross-sectional study of the most recent publication between 2000 and 2013 from national and international guideline panels making decisions about definitions or diagnostic criteria for common conditions in the United States. We assessed whether proposed changes widened or narrowed disease definitions, rationales offered, mention of potential harms of those changes, and the nature and extent of disclosed ties between members and pharmaceutical or device companies. Of 16 publications on 14 common conditions, ten proposed changes widening and one narrowing definitions. For five, impact was unclear. Widening fell into three categories: creating “pre-disease”; lowering diagnostic thresholds; and proposing earlier or different diagnostic methods. Rationales included standardising diagnostic criteria and new evidence about risks for people previously considered to not have the disease. No publication included rigorous assessment of potential harms of proposed changes. Among 14 panels with disclosures, the average proportion of members with industry ties was 75%. Twelve were chaired by people with ties. For members with ties, the median number of companies to which they had ties was seven. Companies with ties to the highest proportions of members were active in the relevant therapeutic area. Limitations arise from reliance on only disclosed ties, and exclusion of conditions too broad to enable analysis of single panel publications. Conclusions: For the common conditions studied, a majority of panels proposed changes to disease definitions that increased the number of individuals considered to have the disease, none reported rigorous assessment of potential harms of that widening, and most had a majority of members disclosing financial ties to pharmaceutical companies. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]

This study explores beliefs held by young African American men newly diagnosed with a sexually transmitted infection (STI), regarding condom use. Recruited from a publicly funded STI clinic, participants were African American men (18–29 years of age) who reported using a condom in the past 3 months for penile–vaginal intercourse. Through face-to-face qualitative interviews, 20 men shared their perceptions of condom use with female partners. Findings suggest that condom use among high-risk African American men may best be understood as part of the complex relational dynamics associated with having multiple partnerships. Given the high seroprevalence of STIs in their communities and sexual networks, men also describe the tensions related to sexual pleasure and the fear associated with non-condom use. [ABSTRACT FROM AUTHOR]

Drainage water management (DWM) is the practice of varying the drainage intensity of a subsurface drainage system to ensure that no more water is transported from a field than is necessary for optimizing crop growth and for facilitating seedbed preparation and other agrotechnical practices. This variation is achieved by using stop logs in a control structure to adjust the outlet elevation of the drainage system. An experiment was set up to test the hypothesis that the implementation of this practice will reduce nitrate (N03) loads from subsurface drainage systems in Illinois, United States, without adversely affecting yields. This experiment consisted of instrumenting and collecting precipitation, flow, and water quality data from four pairs of fields on different soils in Illinois. Each pair consisted of one field with a conventional (free) drainage system and one field with a drainage system whose outlet was managed in accordance with the Illinois Practice Standard for DWM. Annual NO3 load reductions from the managed fields ranged from 37% to 79%, with an average load reduction of 61%. However, because of difficulties in measuring flow under submerged outlet conditions and because water left the managed fields by pathways other than through the outlets of the drainage systems, the efficacy of the practice is likely less than these numbers would indicate. There were no consistent patterns to the relationship between DWM and yields. In some instances, yields increased on the managed fields, and in others, yields decreased. Because of confounding factors, such as weather and topography, studies of longer duration are required to determine the effect of DWM on yield. [ABSTRACT FROM AUTHOR]

Objectives To ascertain the absolute number of Medicare beneficiaries surviving at least 3 years after severe sepsis and to estimate their burden of cognitive dysfunction and disability. Design Retrospective cohort analysis of Medicare data. Setting All short-stay inpatient hospitals in the United States, 1996 to 2008. Participants Individuals aged 65 and older. Measurements Severe sepsis was detected using a standard administrative definition. Case-fatality, prevalence, and incidence rates were calculated. Results Six hundred thirty-seven thousand eight hundred sixty-seven Medicare beneficiaries were alive at the end of 2008 who had survived severe sepsis 3 or more years earlier. An estimated 476,862 (95% confidence interval ( CI) = 455,026-498,698) had functional disability, with 106,311 (95% CI = 79,692-133,930) survivors having moderate to severe cognitive impairment. The annual number of new 3-year survivors after severe sepsis rose 119% during 1998 to 2008. The increase in survivorship resulted from more new diagnoses of severe sepsis rather than a change in case-fatality rates; severe sepsis rates rose from 13.0 per 1,000 Medicare beneficiary-years to 25.8 ( P < .001), whereas 3-year case fatality rates changed much less, from 73.5% to 71.3% ( P < .001) for the same cohort. Increasing rates of organ dysfunction in hospitalized individuals drove the increase in severe sepsis incidence, with an additional small contribution from population aging. Conclusions Sepsis survivorship, which has substantial long-term morbidity, is a common and rapidly growing public health problem for older Americans. There has been little change in long-term case-fatality, despite changes in practice. Clinicians should anticipate more-frequent sequelae of severe sepsis in their patient populations. [ABSTRACT FROM AUTHOR]

The article presents a retrospective cohort study which examines the race-specific incidence of acute respiratory failure in the U.S. Hospitalization estimates from the National Hospital Discharge Survey database from 1992 to 2007 are investigated. According to the study, the incidence of noncardiogenic acute respiratory failure increased between 1992 and 2007.

Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death in the United States. Despite clinical practice guidelines endorsed by national organizations, the management of COPD deviates from guideline recommendations. Patients with COPD are frequently underdiagnosed and misdiagnosed, due in large part to the lack of spirometry testing. When diagnosed, about one third of patients are not receiving any COPD-related drug therapy. Factors that contribute to suboptimal management include provider, patient, and system factors. Physician factors such as understanding and attitude toward the disease, and awareness of guidelines, may affect appropriate management of COPD. Patient factors include medication non-adherence, understanding of the disease, severity of their symptoms, and access to medications. System factors such as insurance coverage may limit aspects of COPD care. To overcome clinical inertia, a multifaceted approach is required. Provider and patient education, the use of health informatics, changes in provider work-flow and the recent development of performance measures, such as the use of spirometry in patients with COPD, can improve the delivery of recommended care for COPD patients. [ABSTRACT FROM AUTHOR]

This article used an interdisciplinary approach to a theory of paranoia as a political and cultural survival tool among Blacks in America. Focusing on a particularly contested moment in Black history—the Apollo 11 moon launch and its implications regarding funding for civil rights issues—the article approached its topic from literary, psychological, cultural, and scientific-technological perspectives, both historical and contemporary. The aim was to explore the issue of the post—civil rights “death” of the utility of appeals for full enfranchisement from the federal government and its subsequent impact on Black community life and cultural production. One of the major results of this event—seen here through the late sixties space race—was the rise of sociocultural paranoia as a productive resource in the Black community, as represented through the press, popular discourse, and literary endeavors, most notably the work of writer John A. Williams. [ABSTRACT FROM PUBLISHER]

Costa and Kahn hypothesize that the growing concentration of skilled couples in large cities is due to their migration to large cities to solve their dual-employment problem. However, there is only limited empirical evidence in support of this hypothesis. This research tests an alternative hypothesis: The intermetropolitan distribution of skilled couples is largely the result of marriages among skilled singles in large cities. The relative merits of both the 'co-location' and 'marriage market' hypotheses are evaluated by comparing the effects of migration and marriage on the intermetropolitan distribution of dual-degree couples using data from the 2008 American Community Survey. Migration is found to have little effect on the distribution of dual-degree couples. Rather, the concentration of dual-degree couples is strongly related to the high rate of marriages among single college graduates in the same cities. [ABSTRACT FROM AUTHOR]

Many hail wives’ part-time employment as a work—family balance strategy, but theories offer competing predictions as to the effects of wives’ employment on relationship stability. We use panel data to test these competing hypotheses among recent cohorts of first-married couples in Great Britain, West Germany 1 and the United States. We find effects of wives’ employment on marital stability var y across the countries. In West Germany with its high-quality part-time employment, couples where the wife works part time are significantly more stable. In the more liberal British and US labour markets, neither wives’ part- nor full-time employment significantly alters divorce risk. In the United States, however, mothers working part time have significantly lower divorce risk. West German and British husbands’ unemployment proves more detrimental to marital stability than wives’ employment. These results highlight the impor tance of the socioeconomic context in structuring the optimal employment participation of both partners. [ABSTRACT FROM PUBLISHER]

Background Military personnel exposed to potentially traumatic events whilst deployed on operational duties may develop psychological problems. The Royal Marines have made extensive use of Trauma Risk Management (TRiM), a peer-support system that operates through practitioners embedded within operational units. TRiM aims to promote recognition of psychological illness and to facilitate social support.Aims To evaluate the effects of TRiM in two units at different stages of implementation.Methods Royal Marines and Army personnel were surveyed prior to, during and upon return from an operational deployment to Afghanistan. Participants completed measures of general mental health (GHQ12) and traumatic stress [PCL(C)].Results We received responses from 180 pre-deployment, 105 during deployment and 137 post-deployment. Personnel within units with experience of TRiM reported lower levels of psychological distress than personnel in the unit who were using TRiM for the first time. Both groups reported higher psychological distress scores before and during deployment, compared with post-deployment. However, we found personnel who reported having more access to social support during deployment reported less psychological distress.Conclusions The use of TRiM may assist in increasing the psychological resilience of military personnel through the facilitation of social support; this may have particular utility during operational deployments. [ABSTRACT FROM AUTHOR]

Objectives: To identify what factors affect women's' decisions to delay childbearing, and to explore women's' experiences and their perceptions of associated risks. Design: Systematic procedures were used for search strategy, study selection, data extraction and analysis. Findings were synthesised using an approach developed from meta-ethnography. Data sources: We included qualitative papers, not confined to geographical area (1980–2009). Databases included CINAHL, MEDLINE, EMBASE, PsycInfo, ASSIA, MIDIRS, British Nursing Index and the National Research Register. We selected qualitative empirical studies exploring the views and experiences of women of advanced maternal age who were childless or primigravidae with a singleton pregnancy or primiparous. Review methods: Twelve papers fulfilled the selection criteria and were included for synthesis. Results: Women appear to face an issue of ‘informed and uninformed decision making’; those who believe they are informed but may not be, those who are not informed and find out they are at risk once pregnant, and those who are well informed but choose to delay pregnancy anyway. Maternity services could provide information to enable informed choice regarding timing of childbearing. Conclusions: Health professionals need to be mindful of the fact that women delay childbearing for various reasons. A strategy of pre-conception education may be beneficial in informing childbearing decisions. Obstetricians and midwives should be sensitive to the fact that women may not be aware of all the risks associated with delayed childbearing. [Copyright &y& Elsevier]

The article discusses American social and political reformer Charles Francis Adams Jr., focusing particularly on the evolution of his ideas regarding the U.S. possession of the Philippines, the Anti-Imperialist movement, and the New England Mugwumps, former Republicans who became political independents during the 1884 U.S. presidential election between Republican candidate James G. Blaine and Democratic candidate Grover Cleveland. Other subjects considered include Adams' views on racism, Spain's political influence in the Caribbean area and South America, the Spanish American War, and the Boston Committee of the Anti-Imperialist League.

Abstract: Cellulosic fibers produced by the kraft pulping process from slash pine trees (Pinus elliottii), a softwood from the south-eastern US, have been evaluated in fiber cement products. These fibers are longer and coarser than most wood fibers and have been found to provide many benefits in fiber cement applications due to their high modulus and high fiber strength. Lignin levels can be finely controlled ranging from 0% to 4%. Laboratory preparations of multiple formulations of fiber cement products have been carried out incorporating these fibers. High modulus of rupture, high fracture energy (toughness), excellent dimensional stability, and low water absorption were observed. Accelerated aging tests were also run and high performance mix designs showed the most strength retention after aging. Recently conducted plant trials with these fibers have confirmed laboratory findings. [Copyright &y& Elsevier]

The article offers information on SequenceL programming language. The entry notes that SequenceL language is composed of 12 grammar rules, with semantics based on the laws of consume-simplify-produce, and normalize-transpose (CSP-NT). The section cites that the code runtime performance of SequenceL language can be compared to the performance of C code versions handwritten by engineers of the U.S. National Aeronautics and Space Administration (NASA) for the space shuttle simulator and Orion exploration vehicle.

This article uses longitudinal data for the United States and Great Britain to examine the impact of residential mobility and childbirth on the earnings of women, their family earnings, and the related division of earnings by gender. This project is the first to compare explicitly the impact of childbirth and family migration on women's earnings, and it extends prior cross-sectional and longitudinal studies on isolated countries by providing a direct contrast between two major industrialized nations, using comparable measures. The results indicate that families respond in similar ways in both countries to migration and childbirth. In response to both migration and childbirth, women's earnings fall at the time of the event and recover slowly afterward, but the magnitude of the impact is roughly twice as large for childbirth as for migration. However; migration--but not the birth of a child--is also associated with a significant increase in total family earnings because of increased husbands' earnings. As a result, the effect of migration on the relative earnings of wives to husbands is similar to the effect of childbirth. These results suggest that family migration should be given consideration in the literature on the gender earnings gap. [ABSTRACT FROM AUTHOR]